Clinical applications of the pedicled anterolateral thigh flap in reconstruction

Lin, Chin-Ta; Wang, Chih-Hsing; Chang, Stephen S.; Dai, Niann‐Tzyy; Chen, Shyi-Gen; Chen, Tim‐Mo; Tzeng, Yuan‐Sheng

doi:10.1111/ans.12973

Cited by 19 publications

(14 citation statements)

References 27 publications

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Section: Discussionmentioning

confidence: 97%

“…According to Wang et al and our previous studies, the modified design of the pALT myocutaneous flap without skeletonisation of perforators is reliable and easily harvested for the reconstruction of trochanteric and ischium pressure sores with limited morbidity. 13,15,16 Li et al 17 reported that pALT flaps have a lower recurrence rate but require a longer FIGURE 2 An 83-year-old woman with multiple pressure sores. A, B, C, 12 cm × 16 cm sacral pressure sore, 8 cm × 5 cm right trochanteric pressure sore, and 3 cm × 3 cm left trochanteric pressure sore, respectively; D, left trochanteric pressure sores treated with delayed primary closure; E, right trochanteric defect covered with hatchet-shaped tensor fascia lata flap; F, planning of SGAP flap for sacrum defect; G, appearance of elevated f lap; and H, I, postoperative result 8 weeks after the surgery operative time and prolonged anaesthesia than hatchetshaped TFL flaps for the surgical management of trochanteric sores.…”

Section: Discussionmentioning

confidence: 99%

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Surgical treatment and strategy in patients with multiple pressure sores

Chiang

Wang

Tzeng

2018

International Wound Journal

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Pressure sores remain a common health problem, particularly among the physically limited or bedridden elderly, and can cause significant morbidity and mortality. This study aimed to present our surgical treatment and strategy for patients with multiple pressure sores. Between January 2010 and December 2016, 18 patients were enrolled. After adequate debridement, pressure sores were managed based on our treatment protocol. Patients' age, aetiology, defect size and location, flap reconstruction, outcome, and follow-up period were reviewed. A total of 10 men and 8 women (average age, 82.3 years) with a mean follow-up period of 28.3 months (6-72 months) were included. The mean defect area was 63.7 cm . The most common aetiology of the bedridden state was cerebrovascular accident (38.89%), and the most frequent sores were trochanteric pressure sores (53.57%). The average operative time and blood loss were 105.5 minutes and 100.8 mL, respectively. No haemodynamic variation or blood transfusion was noted during the surgery. The complication rate for each sore was 10.7%, including late recurrence. In conclusion, treating pressure ulcers requires careful patient education, intensive multidisciplinary optimisation, and meticulous wound care, and our treatment protocol ensures a shorter surgery time, less bleeding, and low complication rate.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Surgical treatment and strategy in patients with multiple pressure sores

Chiang

Wang

Tzeng

2018

International Wound Journal

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“…miR-181b-5p is carried in AT-MSC-derived EVs and enhances the mobility and angiogenesis of brain microvascular endothelial cells (BMECs) after oxygen-glucose deprivation by targeting transient receptor potential melastatin 7 (TRPM7) expression [63]. Several other miRNAs with angiogenic potential such as miRNA-494, miR-125a, or miR-210 were recently reported in MSC-derived EVs [64][65][66].…”

Section: Ev-associatedmentioning

confidence: 99%

Paracrine Mechanisms of Mesenchymal Stromal Cells in Angiogenesis

Maacha

Sidahmed²,

Jacob

et al. 2020

Stem Cells International

176

131

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The role of the mesenchymal stromal cell- (MSC-) derived secretome is becoming increasingly intriguing from a clinical perspective due to its ability to stimulate endogenous tissue repair processes as well as its effective regulation of the immune system, mimicking the therapeutic effects produced by the MSCs. The secretome is a composite product secreted by MSC in vitro (in conditioned medium) and in vivo (in the extracellular milieu), consisting of a protein soluble fraction (mostly growth factors and cytokines) and a vesicular component, extracellular vesicles (EVs), which transfer proteins, lipids, and genetic material. MSC-derived secretome differs based on the tissue from which the MSCs are isolated and under specific conditions (e.g., preconditioning or priming) suggesting that clinical applications should be tailored by choosing the tissue of origin and a priming regimen to specifically correct a given pathology. MSC-derived secretome mediates beneficial angiogenic effects in a variety of tissue injury-related diseases. This supports the current effort to develop cell-free therapeutic products that bring both clinical benefits (reduced immunogenicity, persistence in vivo, and no genotoxicity associated with long-term cell cultures) and manufacturing advantages (reduced costs, availability of large quantities of off-the-shelf products, and lower regulatory burden). In the present review, we aim to give a comprehensive picture of the numerous components of the secretome produced by MSCs derived from the most common tissue sources for clinical use (e.g., AT, BM, and CB). We focus on the factors involved in the complex regulation of angiogenic processes.

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“…Many authors focussed the utility of pedicled ALT for various soft tissue defects pertaining to specific anatomical regions [4][5][6][7]. To the best of our knowledge, very few articles described the diverse anatomical locations where pedicled ALT flap was used, including the abdomen, groin, trochanteric region, and the knee [8].…”

Section: Discussionmentioning

confidence: 99%