Full-Thickness Skin Graft as a One-Stage Debulking Procedure after Free Flap Reconstruction for the Lower Leg

Lin, Tsan-Shiun; Jeng, Seng‐Feng

doi:10.1097/01.prs.0000227624.99710.ee

Cited by 29 publications

(14 citation statements)

References 17 publications

(19 reference statements)

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“…1 Although fasciocutaneous flaps are relatively thin and pliable, which renders them suitable for non-weight-bearing parts of the foot, they can still be quite thick and thus preclude the wearing of regular shoes. 3 These flaps, like scapular flaps or flaps from the radial forearm, are also improper for sole defects because of the excessive shear between the flap tissue and the underlying bed. 4 Muscle flaps, however, provide well-vascularized, durable tissue.…”

Section: Discussionmentioning

confidence: 99%

The Reconstruction of Foot Soft Tissue Defects by Tangential Debulking of the Latissimus Dorsi Flap

Parmaksizoglu

Ünal²,

Cansü³

2011

J reconstr Microsurg

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Reconstruction of foot soft tissue is challenging particularly in the presence of a large defect involving both dorsal and plantar surfaces. In large defects, use of a latissimus dorsi muscle (LDM) flap is the preferred coverage method, yet LDM flaps are bulky. Despite undergoing multiple debulking procedures, patients whose feet are repaired with LDM flaps must wear oversized custom-made shoes. We developed an approach to allow patients to wear regular shoes. In six patients, we used a debulking procedure that was based on tangential trimming of the flap to the level of thickness required for normal foot contour. All patients underwent debulking 3 months after initial LDM flap coverage. The mean duration of follow-up care was 21 months (range, 8 to 32 months). All flaps survived a secondary debulking procedure. One patient developed an ulcer at the weight-bearing area of a sole. All six patients were able to wear regular shoes without difficulty.

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Section: Discussionmentioning

confidence: 99%

The Reconstruction of Foot Soft Tissue Defects by Tangential Debulking of the Latissimus Dorsi Flap

Parmaksizoglu

Ünal²,

Cansü³

2011

J reconstr Microsurg

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“…The raw surface of flaps was then covered with split thickness skin graft 10 or regrafting old skin islands of flaps. 11 But this debulking procedure needed secondary surgical operation and resulted in donor site morbidity from harvesting skin graft. Although suction lipectomy is simple surgery and provides adequate thinning of the flap, it is not ideal for myocutaneous flap.…”

Section: Nasır and Aydınmentioning

confidence: 99%

Reconstruction of Soft Tissue Defect of Lower Extremity With Free SCIA/SIEA Flap

Nasır

Aydın²

2008

Annals of Plastic Surgery

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Free tissue transfer is the most important means of soft tissue reconstruction for the lower extremity. However, cosmetic results and donor site morbidity are only of secondary concern of lower extremity reconstruction. In our efforts to obtain the best possible outcome for patients, as our first priority we chose free superficial circumflex inferior artery (SCIA)/superficial inferior epigastric artery (SIEA) flap over other free flap options in the soft tissue reconstruction of lower extremity because of some advantages. Over the past 3 year, 25 patients underwent lower extremity reconstruction with free SCIA/SIEA flap (n = 27). Twenty-six of 27 flaps were successful (96%), 6 required emergent postoperative re-exploration of the anastomosis, and 1 failed. Although secondary debulking procedure was performed for some flaps (n = 3), most flaps had acceptable thickness for functional and esthetic outcomes especially in the pretibial, ankle, and foot defect reconstruction with an average of 1-year follow-up. Based on our results, free SCIA/SIEA flap has the following advantages in soft tissue reconstruction of lower extremity: (1) large flaps may be harvested for extensive defect and/or to reach recipient artery for passing zone of injury; (2) if necessary, final flap debulking may be performed by surgical procedure using local anesthesia; (3) the donor site is closed in a similar manner to abdominoplasty incision so that excellent cosmetic result may be achieved.

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“…However, the anterolateral thigh flap can be thinned using simple and effective procedures. [38][39][40] According to Kimura and Satoh, the anterolateral thigh flap represents the best thin flap because more uniform thinning is allowed by the anatomy of its perforators. 39 Instead of thinning the anterolateral thigh flap, we can also harvest it as an adipofascial flap.…”

Section: Applications Of the Anterolateral Thigh Flap In Upper-and Lomentioning

confidence: 99%

Microsurgical Coverage Reconstruction in Upper and Lower Extremities

Spyropoulou

Jeng

2010

Seminars in Plastic Surgery

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Trauma is one of the main causes of upper-and lower-limb defects. Limb injuries frequently result in complex defects, hence reconstruction can be demanding. The basic principles of trauma management and methods of reconstruction are analyzed. Then, the evolution of free tissue transfer is reviewed with particular attention to the use of anterolateral thigh flap in reconstruction of upper-and lower-limb trauma cases. The anterolateral thigh flap is the workhorse flap in our department due to its versatility in the reconstruction of complex defects. Finally, the concept of free-style perforator flaps is presented. Microsurgery has supplied the armamentarium of the plastic surgeon with a very powerful tool. Essentially, microsurgery may almost always provide a solution in cases of complex defects that cannot be covered with the simpler options of the reconstructive ladder. The recently acquired perforator flap concept will gradually become the most popular method of microsurgical reconstruction, as it minimizes donor-site morbidity and replaces ''like tissue with like tissue.''

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Full-Thickness Skin Graft as a One-Stage Debulking Procedure after Free Flap Reconstruction for the Lower Leg

Abstract: This method can provide a one-stage debulking procedure for the pretibial area, ankle, and foot after free flap reconstruction, and achieves good aesthetic and functional outcomes.

Cited by 29 publications

References 17 publications

The Reconstruction of Foot Soft Tissue Defects by Tangential Debulking of the Latissimus Dorsi Flap

The Reconstruction of Foot Soft Tissue Defects by Tangential Debulking of the Latissimus Dorsi Flap

Reconstruction of Soft Tissue Defect of Lower Extremity With Free SCIA/SIEA Flap

Microsurgical Coverage Reconstruction in Upper and Lower Extremities

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