Complications of Muscle-Flap Transposition for Traumatic Defects of the Leg

Neale, Henry W.; Stern, Peter J.; Kreilein, Joel G.; Gregory, Richard O.; Webster, Karen

doi:10.1097/00006534-198310000-00017

Cited by 52 publications

(6 citation statements)

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“…3 In the study of Kaukmann et al (2004) partial necrosis in one and flap failure in on patient (out of 12 patients), and that of Neale et al (1982) were 8 and 5 respectively (out of 71 patients). 18,19 In the study of Pu (2006), one patient developed flap necrosis (out of 14 patients) and was treated by debridement and flap advancement. Chittoria & Mishra (2000) reported 5% partial flap necrosis.…”

Section: Resultsmentioning

confidence: 96%

Soleus muscle flap for the coverage of pre-tibial defect of middle third of leg

Satter¹,

Khan

Awwal

2014

Bangladesh J Plastic Surg

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Soft tissue defects of the lower limb are a challenge to the plastic surgeon but a soleus muscle flap often provides the solution. Early reconstruction by soft tissue to cover exposed bone significantly reduces the risk of infection, nonunion and subsequent amputation. A Prospective, observational study was carried out in the Department of Plastic Surgery & Burn Unit, Dhaka Medical College Hospital and Department of Plastic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, from September 2011 to March 2013. 30 cases were selected by purposive continuous sampling who had soft tissue defect in front of the middle third of the legs only. Proximally based soleus muscle transposition flap was done by standard operative procedure under spinal anaesthesia or general anaesthesia and under tourniquet control. After 2 months of operation, final follow-up was done. Regarding the outcome of flap surgery, 18 (60%) cases were found excellent. 7 (23.33%) cases were good, 3 (10%) were fair and 2 (6.66%) were poor. In the final follow up, according to the preset criteria for evaluation of wound coverage by soleus muscle flap, the satisfactory result (excellent and good) was 83.33%. Unsatisfactory (fair and poor) result was in 16.67% cases. Effective coverage of pretibial defect of middle third of leg by soleus muscle flap with satisfactory outcome was seen in this study. DOI: http://dx.doi.org/10.3329/bdjps.v4i1.18685 Bangladesh Journal of Plastic Surgery January 2013, 4(1): 10-15

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Section: Resultsmentioning

confidence: 96%

Soleus muscle flap for the coverage of pre-tibial defect of middle third of leg

Satter¹,

Khan

Awwal

2014

Bangladesh J Plastic Surg

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“…The overall complication rate was 25.8% which is similar to reported rates for free flaps ranging from 16% to 38%. 26,27,[33][34][35] The primary complications were partial flap necrosis and venous congestion, however only 6.45% required surgical reintervention. The flap failure rate was 1.1% which is lower than the reported failure rate of free flaps (4% to 19%).…”

Section: Discussionmentioning

confidence: 99%

Pedicled-Perforator (Propeller) Flaps in Lower Extremity Defects: A Systematic Review

Gir

Cheng

Oni

et al. 2012

J reconstr Microsurg

134

128

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Pedicled-perforator (propeller) flaps for lower extremity reconstruction have gained popularity due to minimal donor site morbidity, relatively simple surgical technique, and replacement of tissue using "like-by-like" principles. We reviewed and analyzed the clinical use of these flaps in regards to patient age and gender, etiology and location of the defect, size and type of flap, arc of rotation, and complications to determine the reliability of this technique. A systematic review of the PubMed database using search terms to include perforator, pedicled, and propeller flaps in the lower extremity. Data from 15 case series provided 186 cases of pedicled-perforator (propeller) flaps for analysis using Chi-square tests. The Peroneal Artery Perforator (PAP) flaps and Posterior Tibial Artery Perforator (PTAP) flaps were the most frequently used flaps. The overall complication rate was 25.8% and the failure rate was 1.1%. No significant differences were found in complication rate related to age, gender, etiology or location of the defect, type or size of the flap. The most common complications were partial flap loss and venous congestion (11.3 and 8.1%). Pedicled-perforator flaps appear to be a reliable and safe procedure for the coverage soft tissue defects of the lower extremity based on favorable results reported in the literature.

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“…Neale et al . [ 44 ] reported on major or minor complication at the lower extremity in 32% of cases of a total of 95 muscle flaps, and they agreed that the causes were mainly technical errors, inadequate debridement, use of diseased or traumatized muscle, and unrealistic objectives. For treatment of recalcitrant hip joint infection the interposition of the vastus lateralis and/ or rectus femoris muscle has proven to be useful and reliable [ 45 - 47 ].…”

Section: Discussionmentioning

confidence: 99%

A Devasting Course of an Iliopsoas Muscle Abscess Subsequently Leading to Septic Shock, Septic Hip Arthritis, and Extended Gluteal Soft Tissue Necroses in an Elderly Immunocompromised Patient with Multiple Carcinomas: A Case Report and Brief Review of Literature

Schmidt¹

2018

TOORTHJ

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Background:A devasting course of Iliopsoas Muscle (IPM) abscess remains a challenging therapeutic problem.Methods:A 69-year-old polymorbid male had a history of multiple carcinomas and presented with advanced stage of septic shock due to a right IPM abscess which communicated with the right hip joint and subsequently led to septic hip arthritis accompanied with post-infectious right gluteal deep soft tissue necroses. Management of surgical treatment included abscess revision, coverage with the use of Long Head Biceps Femoris Muscle (LHBFM) 180° turnover flap, and creating a Girdlestone resection-arthroplasty.Results:After a duration of patient's hospitalization of six months that included the necessity of artificial respiration over two months accompanied with in summary 18 required surgical procedures, the patient could be recovered successfully regarding his polymorbidity and his low-demand claims in activities of daily living with his Girdlestone resection-arthroplasty.Conclusion:Recovery of immunocompromised patients with those life-threatening situations can only be achieved by an interdisciplinary management. The LHBFM 180° turnover flap can be useful for filling off post-infectious deep soft tissue cavities communicating with the hip joint. The definitive Girdlestone resection-arthroplasty for treatment of septic hip arthritis is the method of choice for mobilization of elderly polymorbid patients with low demand claims in their activities of daily living.

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Complications of Muscle-Flap Transposition for Traumatic Defects of the Leg

Cited by 52 publications

References 0 publications

Soleus muscle flap for the coverage of pre-tibial defect of middle third of leg

Soleus muscle flap for the coverage of pre-tibial defect of middle third of leg

Pedicled-Perforator (Propeller) Flaps in Lower Extremity Defects: A Systematic Review

A Devasting Course of an Iliopsoas Muscle Abscess Subsequently Leading to Septic Shock, Septic Hip Arthritis, and Extended Gluteal Soft Tissue Necroses in an Elderly Immunocompromised Patient with Multiple Carcinomas: A Case Report and Brief Review of Literature

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