Lymphedema of the Upper Extremity Following Circumferential Burns

Balakrishnan, Chenicheri; Bradt, Lisa M; Khalil, Abdullah J; Trupiano, John M

doi:10.1177/229255030401200205

Cited by 5 publications

(8 citation statements)

References 8 publications

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“…After removing duplicate entries and applying our inclusion and exclusion criteria, 14 unique articles were included in the final analysis (Table 1) [678910111213141516171819]. …”

Section: Resultsmentioning

confidence: 99%

“…In terms of circumferential involvement in thermal burns resulting in Tajima 1 to 3 defects, the sequelae of chronic lymphedema [11] and scar contractures [12] oftentimes result in very poor functional outcomes due, in part, to involvement of the deep fascia, muscles and tendons, as well as the application of STSGs which have a high propensity for developing scar contractures. Similarly, electrical burns result in Tajima 1 to 3 defects with deep tissue involvement, especially that of the vasculature, which portends especially poor outcomes, both in the early and late postoperative period [1314].…”

Section: Resultsmentioning

confidence: 99%

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Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity

Tan

Lellouch

et al. 2017

Arch Plast Surg

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BackgroundUpper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment to be tailored to both the patient and the wound. The aim of this study is to review the various options for soft tissue reconstruction of complete circumferential defects in the upper extremity.MethodsA literature review of PubMed and MEDLINE up to December 2016 was performed. The current study focuses on forearm and arm defects from the level at or proximal to the wrist and were assessed based on Tajima's classification (J Trauma 1974). Data reviewed for analysis included patient demographics, causality, defect size, reconstructive technique(s) employed, and postoperative follow-up and functional outcomes (when available).ResultsIn accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 14 unique articles were identified for a total of 50 patients (mean=28.1 years). Underlying etiologies varied from extensive thermal or electrical burns to high impact trauma leading to degloving or avulsion, crush injuries, or even occur iatrogenically after tumor extirpation or extensive debridement. Treatment options ranged from the application of negative pressure wound dressings to the opposite end of the spectrum in hand transplantation.ConclusionsWith the evolution of reconstructive techniques over time, the extent of functional and aesthetic rehabilitation of these complex upper extremity injuries has also improved. The proposed management algorithm comprehensively addresses the inherent challenges associated with these complex cases.

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“…After removing duplicate entries and applying our inclusion and exclusion criteria, 14 unique articles were included in the final analysis (Table 1) [678910111213141516171819]. …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity

Tan

Lellouch

et al. 2017

Arch Plast Surg

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“…Skin grafts covering large circumferential defects of the extremities can also cause prolonged swelling or lymphedema of the distal regions, including the hand [7,8]. Flap coverage-as in the use of a latissimus dorsi flap with vascularized lymph node transfer or a myocutaneous flap-limits lymphedema of the upper extremities after oncologic surgery [9,10]. Therefore, skin grafting is considered to be a secondary measure for coverage of large defects or the joint areas.…”

Section: Discussionmentioning

confidence: 99%

Giant congenital melanocytic nevus of the upper extremity: Coverage with a pre-expanded pedicled thoracodorsal artery perforator flap and re-expanded transferred flap

Yang

Kang

2020

Arch Aesthetic Plast Surg

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Giant congenital melanocytic nevi are rare, and it is recommended to excise due to the possibility of malignancy. Although tissue expansion for nevus removal involves multiple stages, the advantages of tissue expansion are known well. We report a case of a giant congenital melanocytic nevus of the upper extremity that extended from the elbow to the shoulder. This case was challenging due to the circumferential nature of the lesion, the lack of healthy skin, the need to ensure minimal scarring, and the desire to impact the patient's daily life as little as possible. The use of a pre-expanded thoracodorsal artery perforator (TDAP) flap and re-expansion of the transferred flap were considered most appropriate. A pre-expanded pedicled TDAP flap can be transferred to any anatomical region with its versatility. The re-expansion of the transferred flap ensures the health of the skin and minimizes donor site scarring. Here, we achieved the optimal outcome through the combined use of a pre-expanded pedicled TDAP flap and sequential re-expansion of the transferred flap in the treatment of a giant nevus of the upper extremity.

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“…The most common causes of lymphedema are surgical trauma such as lymph node dissection and radiation therapy (2). Additionally, although it rarely occurs, critical traumatic injury such as extensive burns and massive fractures can cause lymphedema, as described in previous case reports (3)(4)(5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 95%