Tensor Fascia Lata Flap Versus Tensor Fascia Lata Perforator-Based Island Flap for the Coverage of Extensive Trochanteric Pressure Sores

Kim, Youn Hwan; Kim, Sang Wha; Kim, Jeong Tae; Kim, Chang Yeon

doi:10.1097/sap.0b013e31823dcec2

Cited by 17 publications

(8 citation statements)

References 24 publications

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“…However, all these modifications were random-pattern flaps and there were concerns regarding the vascularity of the distal flap. 9 In our case, re-advancement of a skin flap was attempted in the same manner. However, while elevating the flap, it was divided into 2 planes by dissecting the subfascial and submuscular planes.…”

Section: Discussionmentioning

confidence: 90%

“…Moreover, unlike a random flap, these flaps were reliable. Moreover, the concept of a “perforator-based flap” is distinct from that of a “perforator flap.” 9 Following to the concept of a “perforator-based flap,” no further dissection is needed to find the proximal source of vessels or to dissect the area around the perforator. 9 Since the undissected proximal portion of the flap always includes numerous invisible “microperforators” that penetrate the TFL, these modifications provide greater versatility and reliability than the perforator flap.…”

Section: Discussionmentioning

confidence: 99%

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Free-Style Dual Plane Recycling Tensor Fascia Lata Musculocutaneous Perforator Flap for Reconstruction of Recurrent Trochanteric Defects

Han

Choi

2014

The International Journal of Lower Extremity Wounds

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Sequential flap coverage might be required for recurrent defects, but reusing a flap as a donor site has seldom been reported. The concept of a "free-style flap" has been developed, and it allows reconstructive surgeons to raise flaps with various designs reliably, even at sites of previous flap surgery. This article presents the concept of free-style recycling of a tensor fascia lata flap into a perforator-based flap separated in 2 planes in a patient with a recurrent bilateral trochanteric defect. If a reliable perforator is preserved and identified within the tissues by computed tomography angiography or a Doppler device, a new perforator flap can be designed and raised at the previous flap site.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Free-Style Dual Plane Recycling Tensor Fascia Lata Musculocutaneous Perforator Flap for Reconstruction of Recurrent Trochanteric Defects

Han

Choi

2014

The International Journal of Lower Extremity Wounds

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“…Generally, if the flap is less than 9 cm wide, the donor site can be closed directly without the use of a skin graft. Kim et al 39 reported on their use of the TFL in coverage of large trochanteric pressure sores. A limitation identified in their study was the instability of the T junction where the middle of the TFL flap met the donor site.…”

Section: Discussionmentioning

confidence: 99%

The Marriage of Sartorius and Tensor Fasciae Latae in Treating Vascular Prosthetic Graft Infections

Zoepke

Weerd

2017

Plastic and Reconstructive Surgery - Global Open

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Background:Vascular prosthetic graft infection in the groin is associated with high morbidity and mortality. This article presents a case series on the use of 2 flaps in the treatment of this condition.Methods:Five patients, mean age 65 years (range, 49–74 years), with significant comorbidity were treated for an exposed and infected vascular prosthetic graft in the groin with a combination of sartorius muscle (SM) flap and tensor fascia lata (TFL) myocutaneous flap after debridement and start of microbiologic culture–guided antibiotic treatment. The SM flap was used to cover the exposed graft. To obtain stable wound coverage, the SM and remaining groin defect were closed with a pedicle TFL flap.Results:All flaps survived, with only 1 TFL flap suffering a small tip necrosis. All patients obtained stable wound coverage. Donor-site morbidity was minimal. During the follow-up, mean 46 months (range, 15–79 months), 1 patient had a recurrence after 15 months due to a kink in the elongated prosthetic graft that protruded through the skin alongside the SM and TFL flaps.Conclusions:The combination of SM and TFL flaps could be a new treatment option for patients who have an exposed and infected vascular prosthetic graft in the groin. This flap combination could also be used as a prophylactic procedure for those patients with a high risk to develop such a serious complication.

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“…Flap surgery is a fundamental reconstruction method for covering defects. Many surgical methods have been proposed, and perforator flaps are commonly used worldwide [1][2][3][4][5]. Perforator flaps are popular because they allow reconstruction of wide defects requiring long pedicles and large rotating arcs while preserving underlying muscles.…”

Section: Introductionmentioning

confidence: 99%

Successful Perforator-Based Island Flap Placement Using the Push Technique

Lee

Kim

et al. 2022

J Wound Manag Res

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Background: Several surgical options are available for covering soft tissue defects. Perforator-based flaps can be utilized without skeletonization of the perforator, and surgery is usually straightforward, albeit with limited arcs of rotation. To overcome this limitation, we present our experience of the push technique, whereby the flap is manually pushed to release soft tissue attachments, allowing circumvention of the meticulous dissection required to enhance arc rotation. This technique allows faster flap elevation with minimal complications.Methods: The records of 37 patients that underwent perforator-based flap surgery using the push technique from September 2020 to June 2021 at our institution were retrospectively reviewed.Results: All 38 flaps survived completely though one flap developed congestion resulting in partial necrosis and revision. Mean operation time was less than 80 minutes. No dehiscence or recurrence was encountered at any donor or recipient site during follow-up.Conclusion: We present the “push technique” used during perforator-based flap surgery. This method allows for efficient, minimal, and rapid flap elevation without meticulous dissection and helps the operator determine which parts of soft tissue attachments require further release. The push technique can be performed safely and easily without jeopardizing flap survival due to venous ischemic or congestive change. It serves as a good practice model for inexperienced surgeons wishing to cover moderate-to large-sized defects.

show abstract

Tensor Fascia Lata Flap Versus Tensor Fascia Lata Perforator-Based Island Flap for the Coverage of Extensive Trochanteric Pressure Sores

Cited by 17 publications

References 24 publications

Free-Style Dual Plane Recycling Tensor Fascia Lata Musculocutaneous Perforator Flap for Reconstruction of Recurrent Trochanteric Defects

Free-Style Dual Plane Recycling Tensor Fascia Lata Musculocutaneous Perforator Flap for Reconstruction of Recurrent Trochanteric Defects

The Marriage of Sartorius and Tensor Fasciae Latae in Treating Vascular Prosthetic Graft Infections

Successful Perforator-Based Island Flap Placement Using the Push Technique

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