Advanced Plastic Surgery Techniques for Soft Tissue Coverage of the Diabetic Foot

Zgonis, Thomas; Stapleton, John J.; Roukis, Thomas S.

doi:10.1016/j.cpm.2007.03.002

Cited by 39 publications

(45 citation statements)

References 70 publications

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“…[10][11][12] The authors have found the lateral aspect of the leg as the donor site to be beneficial for the following reasons: (1) relatively large grafts can be harvested from here, (2) the site is readily accessible during surgery, (3) less pain is associated compared with the thigh, (4) it can be performed under local anesthesia, and (5) the site can be easily enclosed within the same dressing as the recipient site. 4,5,9,24 In addition, the mean time to healing for our STSG patients was shorter than healing times associated with the use of human skin equivalents, which also often require multiple applications. 25,26 It is important to point out that in our study, the STSG sites were evaluated for the first time 3 or 4 weeks postoperatively; therefore, true healing times may have been shorter if evaluated at shorter intervals.…”

Section: Discussionmentioning

confidence: 93%

Split-Thickness Skin Grafts for Closure of Diabetic Foot and Ankle Wounds

Ramanujam

Stapleton

Kilpadi

et al. 2010

Foot & Ankle Specialist

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The aim of this study was to determine if split-thickness skin grafts could be successfully used for closure of foot and ankle wounds in diabetic patients. The authors retrospectively reviewed the charts of 100 consecutive patients who underwent a soft tissue surgical reconstruction with split-thickness skin grafts to their foot and/or ankle in our institution from 2005 to 2008. After application of inclusion criteria, 83 eligible charts remained. Of the 83 patients, 54 (65%) healed uneventfully, 23 (28%) required regrafting, and 6 (7%) had a complication resolved with conservative management. All patients had a successful surgical outcome, defined as having achieved complete wound closure at the final follow-up. Surgical outcome was not significantly associated with age, gender, race, hemoglobin A1C, wound size, wound location, illicit drug use, amputation history, Charcot history, or preoperative infection. However, postoperative graft complications were significantly associated with current or previous smoking history (P = .016) and the level of previous pedal amputation to which the split-thickness skin graft was applied (P = .009). This study demonstrates that application of split-thickness skin grafts with an appropriate postoperative regimen is a beneficial procedure to achieve foot and ankle wound closure in diabetic patients.

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Section: Discussionmentioning

confidence: 93%

Split-Thickness Skin Grafts for Closure of Diabetic Foot and Ankle Wounds

Ramanujam

Stapleton

Kilpadi

et al. 2010

Foot & Ankle Specialist

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“…However, a number of studies have recently reported successful management of large-tissue defects in patients with diabetic foot ulcers with microsurgical grafts. 4,5 This case highlights the fact that the treatment of diabetic foot ulcers presents a constant challenge in diabetes care and requires an approach involving specialists from multiple disciplines, physicians, surgeons, physiotherapists, specialised podologists and orthopaedic technicians. …”

Section: Resultsmentioning

confidence: 95%

A case of successful skin transplantation in persistent diabetic foot ulcer

Tsourdi

Rietzsch

Barthel

et al. 2011

Diabetes & Vascular Disease

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“…Negative pressure wound therapy, skin grafts, or skin substitutes can enhance healing but might not produce tissue that is resilient to weightbearing forces (11,12). Our preference has been to cover exposed bone with durable, vascular flaps, which will contribute to prompt healing, the delivery of antibiotics, and avoidance of repeat ulceration and infection.…”

Section: Discussionmentioning

confidence: 98%