Aim:The aim was to evaluate the integrity and functional outcomes of skin grafts following external beam radiotherapy (EBRT).Materials and Methods:A prospective study of 15 patients, in whom EBRT was planned after their wound coverage with split-thickness skin graft (STSG). Parameters evaluated include defect size, time to postoperative radiotherapy, total radiotherapy dose, delays and interruptions in radiotherapy, wound complications, and the need for further surgical interventions.Results:In all the 15 (6 men, 9 women) patients of STSG, radical doses of EBRT, that is, 50–70 Gy in 25–35 fractions are delivered over around 6 weeks. All STSGs were placed on healthy vascular tissue beds. Median time to initial radiotherapy after grafting was 3 weeks (range 3–6 weeks). There were no interruptions in radiotherapy treatment. In one patient, there was partial skin graft loss after radiotherapy that was adequately managed with conservative treatment. No patient requires further surgical intervention.Conclusion:Adjuvant postoperative radiotherapy can be delivered to STSGs without significant complications. Postoperative radiotherapy can be started as early as 3–4 weeks after skin grafting. Skin grafts should be placed on well-vascularized healthy tissues. Minor skin graft loss resulting from postoperative radiotherapy can usually be treated conservatively.
Introduction: It has always been a challenging task for the reconstructive surgeons to resurface the lost skin and soft tissue over the heel. This is done by use of skin grafts, local flap or microvascular free flap (MFF). The postoperative care and splintage of these limbs is a difficult task, and often the success or failure of the flap will depend on proper postoperative splintage and positioning of the operated limb. A simple and reusable frame is being described for pedicle protection in flap surgery for posterior heel and ankle wounds.
Aims and objective:To devise a reusable frame for pedicle protection in heel and ankle defects.
Materials and methods:A reusable frame splint designed by holding up the foot against gravity at a narrower circumference of forefoot just proximal to the wider circumference of the foot at the metatar sophalangeal joint (MTP) level. This frame was used in the early postoperative period for positioning the lower limb in patients undergoing surgery for coverage of posterior heel defects.Result: A total of 14 patients underwent wound coverage of post heel defect over a period of 3 years. Out of these 14 patients, nine had reverse sural artery pedicle flap, three had splitthickness skin grafting and remaining two had MFF done. In all the cases, a specially designed frame was used for pedicle protection. One patient had developed erosion and blistering, which healed subsequently.
Conclusion:This innovation in the splint helps in providing adequate elevation of limb and protection of pedicle of local or MFF used for coverage of heel and ankle defects.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.