The circumflex scapular artery perforator flap for palm reconstruction in a recurrent severe case of Dupuytren's disease

Branford, Olivier A.; Davis, Marcus; Schreuder, F.

doi:10.1016/j.bjps.2008.11.106

Cited by 9 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In other words, only closing the skin is not sufficient. Various techniques have been attempted previously, such as Burner volar zig-zag, [ 17 , 18 ] open palm technique, [ 19 , 20 ] the “Jacobsen flap” technique, [ 21 ] multiple ZP, [ 22 ] multiple V-Y plasty, [ 18 ] YV and ZP, [ 23 ] skin grafting, [ 24 , 25 ] artery perforator flap, [ 1 , 2 ] hypothenar flap, [ 3 ] ulnar parametacarpal flap, [ 4 ] and DLF, [ 5 ] among others. In our department, we initially performed YV and ZP, but we later used a DLF, which is the simplest and least invasive of these techniques for closing the wound, in combination with YV and ZP.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, we had often experienced cases in which extension restriction of the joint persists. In addition, various flaps, such as the artery perforator flap, [ 1 , 2 ] hypothenar flap, [ 3 ] and ulnar parametacarpal flap, [ 4 ] have also been attempted for skin extension. Although these techniques generally yield good results, they are complicated and result in large wounds.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Skin extension with a digito-lateral flap and early active finger extension training for Dupuytren contracture: A retrospective study

et al. 2022

View full text Add to dashboard Cite

In the surgical management of Dupuytren contracture (DC), Y-V plasty (YV) and Z-plasty (ZP) are techniques often used for skin extension. However, achieving sufficient skin extension with these procedures alone is often difficult. Therefore, we addressed this issue with an adjunctive digito-lateral flap (DLF) and report the clinical results of the surgery using a DLF in addition to YV and ZP. Fifteen patients with DC (15 affected fingers) underwent partial fasciectomy using a DLF in addition to YV or ZP, and early active finger extension training was performed immediately after the operation. The flap survival rate, preoperative and postoperative extension angle, Tonkin contracture improvement (TCI) rate, and Tubiana staging grades were evaluated. The contracture sites were at 4 proximal interphalangeal (PIP) and 3 metacarpophalangeal (MP) joints of the little finger and 4 PIP and MP joints each of the ring and little fingers. All the flaps survived, and the extension angle improved at the final observation from a preoperative mean of −45° to −3° and −55° to 5° for the PIP and MP joints, respectively. One patient with PIP joint contracture treated in the early stage of the study experienced a persistent 5° limitation of extension, even though the TCI rate was satisfactory (91.9%) and the outcome was "good." Full extension of the joints was achieved in 15 patients, in whom the TCI rate was 100% and the outcome was "very good." This technique was able to solve 3 important steps to achieve full extension: intraoperatively, wound closure, and rehabilitation. We attained and maintained long-term full extension intraoperatively and immediately after surgery and obtained very good treatment results, as shown in this study. In conclusion, highly favorable clinical outcomes were achieved through the combination of a DLF with YV and ZP. Skin extension with a DLF is a useful surgical technique for DC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Skin extension with a digito-lateral flap and early active finger extension training for Dupuytren contracture: A retrospective study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In addition, the dense and thick skin and subcutaneous tissues of ALT restrict the ability to cover the heel, where elasticity, flexibility, and thinness are required. Circumflex scapular artery perforator (CSAP) flap reconstruction is another popular treatment, which was first reported in 2007 22–24 . However, without tendinous tissue present in this flap, the second donor site is required to reconstruct Achilles tendon defects, thus reducing its scope for application.…”

Section: Discussionmentioning

confidence: 99%

Novel Design of the Chimeric Deep Inferior Epigastric Artery Perforator Flap that Provides for Three‐Dimensional Reconstruction of Composite Tissue Defects of the Heel in Children

Luo

2021

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective The aim of the present study was to report a novel design of the chimeric deep inferior epigastric artery perforator flap (DIEP) to achieve dead space filling, Achilles tendon bridging, and skin resurfacing simultaneously with minimal donor‐site morbidity. Methods From September 2012 to May 2016, a retrospective study was carried out on six pediatric patients with composite soft tissue defects of the heel that were repaired with the chimeric DIEP flap. The chimeric flap design included a flap of the anterior sheath of the rectus, a block of rectus muscle, and a large skin paddle. All the parts were supplied by a common artery. After harvesting the flap, all element parts were inserted at the corresponding sites in a tension‐free manner. With one set of vessel anastomoses at the recipient site, accurate repair with tendon reconstruction, dead space elimination, and wound covering were accomplished. The donor site incisions were closed initially. Data on patient age, medical history, injury severity, defect size, flap dimensions, recipient vessels, donor site closure, complications, and follow‐up were collected and reviewed. Results Five of the six chimeric DIEP flaps survived without complications. The remaining one case experienced partial necrosis of the skin paddle caused by venous congestion, which healed after routine dressing changes. Primary donor site closure was accomplished in all cases. The mean follow‐up was 18.6 months (range, 10–36 months). Five patients had satisfactory aesthetic and functional outcomes; one patient needed a secondary debulking procedure. Compared to the unaffected side, the affected side showed no obvious difference for ankle movement, tiptoe function, and patient gait during the follow‐up period. Good ankle function was observed in all patients. There was no donor site breakdown, with only a slightly noticeable linear scar. Conclusion The chimeric DIEP flap reduced the operative time, solved the problem of deficiency of recipient vessels, and attained satisfactory functional and aesthetic outcomes with low donor site morbidity. Therefore, it is a promising option for three‐dimensional reconstruction of composite defects with dead space and Achilles tendon defects as well as skin loss in children.

show abstract

“…Myofibroblasts are known to be the key cells responsible for both contraction and extracellular matrix deposition, but the initiating event causing myofibroblast proliferation is unresolved. Numerous published studies support various treatment modalities for potentially effective treatment of Dupuytren's disease by regulating contractile myofibroblasts . However, its pathogenesis remains largely obscure .…”

Section: Introductionmentioning

confidence: 99%

“…Numerous published studies support various treatment modalities for potentially effective treatment of Dupuytren's disease by regulating contractile myofibroblasts. [2][3][4][5][6][7][8][9][10] However, its pathogenesis remains largely obscure. 11 Only over the past 30 years, many researchers suggest a strong genetic heritance in Dupuytren's disease.…”

Section: Introductionmentioning

confidence: 99%

A meta‐analysis to identify novel diagnostic and therapeutic targets for Dupuytren's disease

Park

Kim

Lee

et al. 2019

Wound Repair Regeneration

View full text Add to dashboard Cite

The aim of this study was to determine novel candidate genes for Dupuytren's disease by performing a meta‐analysis. We identified 261 genes (111 up‐regulated and 150 down‐regulated) that were consistently expressed differentially in Dupuytren's disease across the studies. We performed functional enrichment on total sets of the identified 261 genes and confirmed that most of the genes were closely related to common processes of diseases in general. From the integrated studies of the gene‐correlation network and the protein–protein interaction network, we identified three functional modules in the gene co‐expression network and four hub gene clusters in the protein–protein interaction network that shared the same genes and represented similar biological functions, implying that the seven groups identified in the systematic analysis of these two networks might be involved in the pathogenesis of Dupuytren's disease. This work demonstrates potential in developing experimental and clinical strategies for understanding and treating Dupuytren's disease.

show abstract

The circumflex scapular artery perforator flap for palm reconstruction in a recurrent severe case of Dupuytren's disease

Cited by 9 publications

References 5 publications

Skin extension with a digito-lateral flap and early active finger extension training for Dupuytren contracture: A retrospective study

Skin extension with a digito-lateral flap and early active finger extension training for Dupuytren contracture: A retrospective study

Novel Design of the Chimeric Deep Inferior Epigastric Artery Perforator Flap that Provides for Three‐Dimensional Reconstruction of Composite Tissue Defects of the Heel in Children

A meta‐analysis to identify novel diagnostic and therapeutic targets for Dupuytren's disease

Contact Info

Product

Resources

About