Comparison of Anterolateral Thigh, Lateral Arm, and Parascapular Free Flaps with Regard to Donor-Site Morbidity and Aesthetic and Functional Outcomes

Klinkenberg, Marek; Fischer, Sebastian; Kremer, Thomas; Hernekamp, Frederick; Lehnhardt, Marcus; Daigeler, Adrien

doi:10.1097/prs.0b013e31827786bc

Cited by 98 publications

(88 citation statements)

References 39 publications

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“…This scale has been validated in several studies. 5,8,11 There are few prospective studies regarding the effect of RFF flap reconstruction on function. When preoperative and postoperative forearms were compared with nonoperated forearms, there were statistically significant differences in wrist flexion, pinch strength and sensation, but no subjective complaints of loss of function by any patient.…”

Section: Discussionmentioning

confidence: 99%

“…RFF flaps have been found to have widely varying effects on hand function, [4][5][6][7][8][9][10][11] but studies of their effect on upper extremity function are few and have failed to take into consideration the possible effect of neck dissection. 4,5,8,9 The aim of the present prospective matched-pair study was to determine the effect of the RFF flap on upper extremity function.…”

Section: Introductionmentioning

confidence: 99%

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Upper extremity morbidity after radial forearm flap harvest: a prospective study

et al. 2013

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Objective: To determine the effect of radial forearm free (RFF) flap harvest on patient-reported postoperative upper extremity disability. Methods: Patients undergoing RFF flap reconstruction following resection of head and neck cancer were recruited and matched with similar patients undergoing non-RFF reconstruction. All subjects completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire preoperatively and at least 1 year postoperatively. Results: Postoperative DASH scores were significantly higher (more severe disability) in patients undergoing RFF flap reconstruction (6.93 AE 5.54; n ¼ 52) compared with those undergoing non-RFF flap surgeries (2.95 AE 4.42; n ¼ 52). Preoperative DASH score, flap size, patient age and tumour stage were significantly correlated with postoperative DASH score. Conclusion: Excluding the effect of neck dissection, RFF flap reconstruction has a significant deleterious effect on upper extremity function.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Upper extremity morbidity after radial forearm flap harvest: a prospective study

et al. 2013

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“…20 demostraron que el colgajo paraescapular era fiable por la facilidad para su elevación y su anatomía vascular confiable; [21][22][23][24][25][26][27] se ha demostrado que el pedículo vascular del colgajo paraescapular es más constante que el del colgajo anterolateral del muslo. 20,[27][28][29][30] En los 20 colgajos paraescapulares evaluados en esta serie, no se observaron anomalías vasculares durante la disección del pedículo y, sobre la base de reportes previos, no se realizó una evaluación preoperatoria para confirmar su presencia. La longitud total efectiva del pedículo del colgajo paraescapular promedio es de 11 a 14 cm, 20 pero puede prolongarse si la disección se extiende a la arteria angular de la escápula.…”

Section: Discussionunclassified

“…El colgajo paraescapular se caracteriza por presentar una baja tasa de complicaciones en el sitio donante. 7,30,39 Roll y cols., 39 en su serie de colgajos paraescapulares, no observaron complicaciones mayores, como seroma, infección o dehiscencia de la herida, solo registraron retraso en la curación de la herida en dos casos. Klinkenberg y cols.…”

Section: Discussionunclassified

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Colgajo paraescapular en pérdidas postraumáticas de tejidos blandos de las extremidades. [Parascapular flap in post-traumatic soft-tissue loss at the limbs.]

Vanoli

Murillo

Centeno

et al. 2018

Rev. Asoc. Arg. Ort. y Traumatol

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ResumenIntroducción: El objetivo de este artículo es comunicar los resultados obtenidos con el uso del colgajo paraescapular para cubrir defectos severos postraumáticos de tejidos blandos en las extremidades. Materiales y Métodos: Estudio retrospectivo, descriptivo, de una serie de 20 pacientes a los que se les realizó un colgajo libre paraescapular para cubrir lesiones masivas combinadas postraumáticas de tejidos blandos en las extremidades, entre 2006 y 2017. La edad de los pacientes promedió 30 años (18 hombres, 2 mujeres). La localización de las lesiones fue: 10 en antebrazo y muñeca, una en la región inguinal, siete en la pierna y dos en tobillo/pie. Resultados: El seguimiento promedio fue de 3.6 años. Se logró la cobertura exitosa en 17 casos. El tamaño de los colgajos promedió 24,8 x 10,7 cm. Seis casos presentaron lesiones vasculonerviosas que necesitaron injerto, seis se asociaron a pérdidas óseas, 11 requirieron injerto de piel y cuatro, reconstrucciones tendinosas. En todos los pacientes, el área donante cerró en forma primaria y sin secuelas funcionales. Dicho colgajo se combinó con el escapular en tres casos y con colgajo de dorsal ancho en tres casos. Dos colgajos fallaron y debió amputarse la extremidad lesionada; un paciente falleció por embolia masiva al séptimo día de la cirugía. Conclusiones: El colgajo paraescapular permitió salvar y reconstruir satisfactoriamente defectos masivos extensos en 17 de 20 extremidades, sin morbilidad para la zona donante del colgajo, pero su uso no está exento de complicaciones, y un abordaje multidisciplinario es necesario para disminuir esta morbilidad. The aim of this paper is to present the results after the use of parascapular free flaps to cover severe softtissue defects at the extremities. Methods: A retrospective, descriptive study of 20 patients who received parascapular free flaps to cover massive combined soft-tissue lesions at the extremities as a salvage procedure from 2006 to 2017 was performed. Patients' age averaged 30 years (18 men, 2 women). Sites of lesions were: ten at the forearm and wrist, one at the inguinal region, seven at the leg and two at the ankle/foot. Results: Follow-up averaged 3.6 years. Successful coverage was achieved in 17 cases. Flap size averaged 24.8 x 10.7 cm. There were six cases with neurovascular lesions that needed grafting, six cases had associated bone loss, eleven patients needed skin graft and four required tendon reconstructions. Donor area closed primarily without functional limitations in all patients. In three cases the flap was combined with a scapular flap and in three cases with a latissimus dorsi flap. Two flaps failed and the injured limb was amputated; one patient died due to massive embolism seven days after surgery. Conclusions: Parascapular free flaps allowed salvage and reconstruction of 17 out of 20 severely injured limbs, without morbidity for the donor area. But its use is not free of complications, and a multidisciplinary approach is necessary to reduce this morbidity.

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Highly Stretchable Piezoelectric Elastomer for Accelerated Repairing of Skeletal Muscles Loss

Fang,

Wang,

Lin

et al. 2024

Adv Funct Materials

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Skeletal muscle loss is a common clinical disease, whose long treatment period and expensive treatment costs bring a heavy burden to patients. Currently, the use of piezoelectric materials to generate in situ and efficient electrical stimulation has been proven to significantly promote wound healing and other defects. However, skeletal muscle requires repaired materials with high elastic deformation to accompany its reciprocating movement during the healing process. Therefore, developing biocompatible materials that combine high piezoelectricity and stretchability is a great challenge. In the present work, a piezoelectric elastomer PPBE is prepared by copolymerization of bio‐based diacid and diol. PPBE has matching elastic modulus with the skeletal muscle to accompanied proceed stretching and recovery movements. Piezoelectrical charge from PPBE scaffold under ultrasound and mechanical stimuli could promote myogenic differentiation via Ca2+ signaling pathway and modulate cell functions, resulting in improved muscle morphology and functional performance of skeletal muscle. Thus, development of the degradable PPBE scaffold would provide new therapy strategy for volumetric muscle loss (VML) and present great potential in repairing of other tissues.

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Comparison of Anterolateral Thigh, Lateral Arm, and Parascapular Free Flaps with Regard to Donor-Site Morbidity and Aesthetic and Functional Outcomes

Abstract: In terms of reducing donor-site morbidity, the parascapular flap represents a valuable alternative to the anterolateral thigh and lateral arm flaps, but side positioning and increased seroma are drawbacks.

Cited by 98 publications

References 39 publications

Upper extremity morbidity after radial forearm flap harvest: a prospective study

Upper extremity morbidity after radial forearm flap harvest: a prospective study

Colgajo paraescapular en pérdidas postraumáticas de tejidos blandos de las extremidades. [Parascapular flap in post-traumatic soft-tissue loss at the limbs.]

Highly Stretchable Piezoelectric Elastomer for Accelerated Repairing of Skeletal Muscles Loss

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