Free Vascularized Tissue Transfer to Preserve Upper Extremity Amputation Levels

Abstract

Use of free vascularized tissue transfer for preservation of upper extremity amputation level in well-selected cases facilitates prosthetic rehabilitation and improves residual limb function.

Merkel cell carcinoma of the upper eyelid: presentation and management

“…13 As this was a full-thickness total upper lid defect, the sacrifice of the lower lid as a transposition flap warranted consideration and execution, in spite of the principle of restoring like-with-like tissues. 9,14,15 Owing to the defect size, the initial plan of a standard 'switch flap' from the lower lid was changed to a more sophisticated perforator-based flap, which required the dissection of the lower lateral palpebral artery. This dissection allowed for significant thinning of the pedicle, for a comfortable reach to the recipient site and for a natural fit of all specialized tissue components to restore all layers, while maintaining an adequate blood supply.…”

Functional Salvage of a Hand After Unsuccessfull Attempt of Replantation

“…Complex traumatic mechanisms create very difficult injuries, which are demanding in terms of reconstruction, due to the advanced destruction of tissues [1–3,8,9,16]. Even though there are very specific indications regarding the tissue replantation [4], there are a lot of relative indications and contraindications in performing this type of surgeries [4,16], taking into consideration the traumatic mechanism, the age and health status of the patient, his/her profession and desire, the expected potential for rehabilitation and social reinsertion and the estimated patient’s motivation for complying with the rehabilitation regimen.…”

“…There are a lot of possibilities to cover a soft tissue defect, starting with axial flaps [1], loco-regional perforator flaps [1], pedicled distance flaps [1,3] and free flaps [1–3]. But, taking into consideration also the necessity for a functional hand, the prehension had to be reconstructed too.…”

“…They can be produced by various mechanisms, but the crush injuries are the most common and can result in significant tissue damage and injury [3]. The association of crushing with other mechanisms, i.e.…”

Management of Upper Limb Amputations

“…Skin grafts, dermal substitutes, 13 filleted flaps, 14 and free tissue transfer 15 (Fig. 3) have been used to help preserve limb length when the residual soft tissue is inadequate to allow stump closure without further bone shortening.…”