Surgical management of hidradenitis suppurativa with keystone perforator island flap

Virág, Timea Helga; Kadar, Iuliu Alpar; Matei, Ileana Rodica; Georgescu, Alexandru Valentin

doi:10.1016/j.injury.2020.03.025

Cited by 10 publications

(19 citation statements)

References 23 publications

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“…The KPIF advantage is to negate the need for skin grafting and to replace like with like by using tissues of similar texture, thickness, pliability, colour and contour. Compared to skin grafting and free flaps, long‐term immobilisation can be avoided, and early physiotherapy can be started 17,28 . In our institute, we recommend immobilisation of all skin grafted limbs and all free flap cases (the period depends on the patient cooperation), because this immobilisation could reduce pain and postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to skin grafting and free flaps, long-term immobilisation can be avoided, and early physiotherapy can be started. 17,28 In our institute, we recommend immobilisation of all skin grafted limbs and all free flap cases (the period depends on the patient cooperation), because this immobilisation could reduce pain and postoperative complications. In the case of KPIF, we recommended immobilisation just in 21% of the cases, as our results show.…”

Section: Discussionmentioning

confidence: 99%

“…To reduce any dead space, a narrow medial portion of the flap can be deepithelialized for dead space reduction (Figure 2). 24,28 …”

Section: Surgical Techniquementioning

confidence: 99%

“…To reduce any dead space, a narrow medial portion of the flap can be deepithelialized for dead space reduction (Figure 2). 24,28 If the defect is larger and/or a greater mobility is neededespecially in the anteromedial aspect of the lower leg with poor skin laxity of the flap is finally approximated which may reduce tension (Figures 1, 3 and 5). 17,23,26 Progressive tension suture technique can be used for redistribution of tension and for dead space obliteration.…”

Section: Surgical Techniquementioning

confidence: 99%

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Minimising donor‐site morbidity following limbs' injuries with keystone perforator island flap reconstruction

Virág

Muntean

Georgescu

2022

Wound Repair Regeneration

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Plastic surgeons strive to choose better techniques to reconstruct the defects of the limbs, minimising the wound healing problems, improving the aesthetic and functional outcome with less complications. This study refers to the use of keystone perforator island flap (KPIF) in limbs' reconstruction, their harvesting technique to minimise donorsite morbidity, maximise the functional and cosmetic outcome, and will point on the most important indications and advantages. Between January 2014 and June 2020, a number of 28 cases were treated in our department, with simple or complex defects of the limbs. The database included patients' demographics, comorbidities, aetiology, characteristics of the flap, surgical factors, follow-up period and flap outcomes. We performed 28 KPIFs, 14 of type I, 12 of type IIA, 1 of type III, and 1 of type IV, with an average size of 69 cm 2 (ranged from 1.25 cm 2 to 318 cm 2 ). Trauma was the major cause of the defects. One flap exhibited approximately 4% partial superficial necrosis.All donor sites healed without any adverse events. All patients were satisfied with the functional and aesthetic results. The KPIFs provide a simple and effective method of wound closure by using tissues of similar texture, thickness and colour. Preserving the main artery and the underlying muscle, this flap reduces the donor site morbidity. The use of KPIFs seems to be one of the most suitable choices whenever possible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…To reduce any dead space, a narrow medial portion of the flap can be deepithelialized for dead space reduction (Figure 2). 24,28 …”

Section: Surgical Techniquementioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

See 2 more Smart Citations

Minimising donor‐site morbidity following limbs' injuries with keystone perforator island flap reconstruction

Virág

Muntean

Georgescu

2022

Wound Repair Regeneration

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“…For wide excisions, complication rates range from 0.0% to 87.0% 23,24 . In a recent 2020 systematic review, the complication rate for wide excision was 25.1%, based on 2844 patients 19 .…”

Section: Surgical Outcomes For Hidradenitis Suppurativa and The Gaps ...mentioning

confidence: 99%

Surgical management of hidradenitis suppurativa: A review of techniques, data, and future directions

Klufas

Saylor

2022

Dermatological Reviews

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Hidradenitis suppurativa (HS) is a debilitating, chronic dermatologic condition that when left untreated can lead to irreversible structural changes in the skin, often manifesting as subcutaneous tunnels, defined as linear tracts that may open onto the skin surface. While medical management may delay architectural damage to the skin, for those patients whose disease has progressed past the point of medical intervention and irreversible tissue damage is present, surgical treatment is a critical component in disease management. Various surgical treatment modalities such as unroofing and excision exist to treat HS surgically, however, the data regarding efficacy and surgical outcomes for these techniques is heterogeneously reported and often of low quality. As such, it is difficult to assess this data and determine what the best surgical option is for an individual patient. This manuscript will focus on categorizing the various types of surgical procedures used in the surgical and procedural management of HS, summarize data on outcomes measures of various treatment modalities, identify current gaps in the literature regarding HS surgery, and outline the necessary steps to address these gaps to standardize and improve the surgical care of all HS patients.

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Dynamic anatomical study of the posterior brachial artery perforator flap: Aesthetic refinement and clinical results

Guena,

Chaput,

Lopez

et al. 2024

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Surgical management of hidradenitis suppurativa with keystone perforator island flap

Cited by 10 publications

References 23 publications

Minimising donor‐site morbidity following limbs' injuries with keystone perforator island flap reconstruction

Minimising donor‐site morbidity following limbs' injuries with keystone perforator island flap reconstruction

Surgical management of hidradenitis suppurativa: A review of techniques, data, and future directions

Dynamic anatomical study of the posterior brachial artery perforator flap: Aesthetic refinement and clinical results

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