MOC-PS(SM) CME Article: Lower Extremity Reconstruction

Reddy, Vikram; Stevenson, Thomas R.

doi:10.1097/01.prs.0000305928.98611.87

Cited by 67 publications

(42 citation statements)

References 29 publications

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“…Several publications report on the benefits of NPWT as an advanced means of wound bed preparation in wounds with exposed bone [3,21,[26][27][28][29][30][31][32][33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Exposed tibial bone after burns: Flap reconstruction versus dermal substitute

Verbelen

Hoeksema

Pirayesh

et al. 2016

Burns

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“…Several publications report on the benefits of NPWT as an advanced means of wound bed preparation in wounds with exposed bone [3,21,[26][27][28][29][30][31][32][33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Exposed tibial bone after burns: Flap reconstruction versus dermal substitute

Verbelen

Hoeksema

Pirayesh

et al. 2016

Burns

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“…Early fracture stabilization is essential and can be achieved by means of external fixation, plate and screws, and reamed or unreamed tibial nails. Combined with stabilization, a thorough debridement is essential for further treatment [4, 5]. …”

mentioning

confidence: 99%

The treatment of soft-tissue defects of the lower leg after a traumatic open tibial fracture

2010

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The treatment of large soft-tissue defects of the lower leg remains a challenge. The timing of the operation, the most suitable type of tissue, and the decision between local or free flap coverage still remains under discussion. Fifty-two patients were treated with local or free flap coverage after a traumatic soft-tissue defect of the lower leg. We compared the results after treatment with local versus free flaps and fasciocutaneous flaps versus musculocutaneous flaps. In the case of primary reconstruction, we also compared the results regarding the timing of the operation: patients treated within 72 h after the trauma versus patients treated after 72 h. Thirty-five patients (67%) have been treated because of posttraumatic soft-tissue defects and, therefore, insufficient fracture coverage. Seventeen patients (33%) were treated because of a chronic osteomyelitis that arose after the trauma. In our study, we did not find a statistically significant difference between the postoperative complications of local and free flaps. A significant increase could be demonstrated in the number of revisions after treatment with a free flap. Treatment with a fasciocutaneous flap in the entire study group was associated with significantly more postoperative complications than treatment with a musculocutaneous flap. There was no significant difference in results after early or late flap coverage. Patients treated with local or free flaps achieved equal outcomes, except for the number of postoperative revisions in which local flaps required lesser revisions. Treatment with a musculocutaneous flap is preferable to treatment with a fasciocutaneous flap regarding postoperative complications. The timing of operation proved not to be a discriminating factor.

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“…Functional recovery should always be sought, regardless of the proposed treatment, reconstruction or amputation 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital

Macedo¹,

Rosa

Botelho³

et al. 2017

Rev. Col. Bras. Cir.

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Objective: to evaluate the management of lower limbs complex traumatic injuries by analyzing their characteristics, types, conduct and evolution, with emphasis on surgical treatment. Methods: we conducted a prospective study of patients treated by Plastic Surgery at a regional hospital of the Federal District during a one-year period. We collected data through serial evaluations and telephone contact records. Results: we studied 40 patients, with a mean age of 25.6 years, predominantly male (62.5%). The most frequent wounds were of the distal third of the lower limb (37.5%). Bone or tendon exposures occurred in 55% had and there was a 35% rate of exposed lower limb fractures. The treatments employed were skin grafting (57.5%), local fasciocutaneous flap (15%), muscle flap (12.5%), cross-leg fasciocutaneous flap, reverse sural flap (12.5%) and microsurgical flap (2.5%). Short-term evaluation showed that 35 patients had excellent or good results (87.5%), four had a regular result (10%), and one had an unsatisfactory result (2.5%). In the long term, of the 18 patients who answered the questionnaire, ten resumed walking, even with support, in the first three months after surgery (55.6%). Conclusion: young men involved in motorcycle accidents during leisure time represented the profile of patients with lower limb trauma requiring surgical reconstruction; the distal third of the leg was the most affected region. Grafting was the most used technique for reconstruction and postoperative functional evaluation showed that, despite complex lesions, most patients evolved with a favorable healing process and successful functional evolution.

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MOC-PS(SM) CME Article: Lower Extremity Reconstruction

Cited by 67 publications

References 29 publications

Exposed tibial bone after burns: Flap reconstruction versus dermal substitute

Exposed tibial bone after burns: Flap reconstruction versus dermal substitute

The treatment of soft-tissue defects of the lower leg after a traumatic open tibial fracture

Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital

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