Reconstruction of Chopart’s Amputation Stump Using Artificial Dermis Combined with Free Anterolateral Thigh Flap

Shimizu, Mika; Matsumine, Hajime; Takeuchi, Masaki

doi:10.1097/gox.0000000000000547

Cited by 7 publications

(8 citation statements)

References 10 publications

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“…Autologous flap transplantation has a good effect on repairing exposed bone and tendon wounds and can effectively cover the wounds, but the operation is difficult, and the doctor's workload and psychological pressure are heavy. Similarly, the donor flap area of flap surgery needs skin grafting to repair, and the scar is obvious in the later stage, and the risk of vascular crisis and necrosis of the transplanted flap is high [7,8]. In recent years, with the improvement of tissue engineering technology, the use of artificial skin to repair various skin wounds is slowly moving towards the clinic, and the key to skin tissue engineering technology lies in the development of dermal substitutes.…”

Section: Introductionmentioning

confidence: 99%

Clinical Application of Artificial Dermis and Autologous Skin in Repairing Skin and Soft Tissue Defects of Hands and Feet with Bone Exposure Injuries

Song

Lei

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Patients with skin and soft tissue defects are very common. Mild trauma often causes mild skin damage, while severe injuries are often accompanied by bone and tendon exposure, which brings great pain to patients. For the defect of skin and soft tissue, the traditional treatment methods are mostly medium or full-thickness skin or skin flap transplantation. These methods are effective in wound repair, but there are still many problems. In recent years, with the improvement of tissue engineering technology, the use of artificial skin to repair various skin wounds is gradually becoming clinical, and the key technology of skin tissue engineering lies in the development of dermal substitutes. The appearance of artificial dermis not only solves the shortage of autologous skin source but also makes the operation simple and easy. The purpose of this study was to investigate the clinical effect of artificial dermis combined with autologous skin grafts in repairing hand and foot skin and soft tissue defects with bone exposure. The results show that the use of artificial dermis combined with autogenous blade thick skin to treat patients with hand and foot soft tissue injury with bone exposure has a good clinical effect, and the skin is alive and has fewer complications, which is worthy of promotion.

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Section: Introductionmentioning

confidence: 99%

Clinical Application of Artificial Dermis and Autologous Skin in Repairing Skin and Soft Tissue Defects of Hands and Feet with Bone Exposure Injuries

Song

Lei

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…However, in this study, the formation of firm dermis-like tissue took approximately 2 weeks, as described in Case 3 where the patient had the amputation of the digital apex and a small wound surface area, or Case 1 where the patient had the exposure of the Achilles tendon and poor angiogenesis in the transplant bed. This form of treatment may present a new effective option for treating patients with wounds with exposure of tendon or bone in weight-bearing regions, and these patients previously have required highly invasive surgery such as a free flap transplantation [14].…”

Section: Discussionmentioning

confidence: 99%

Full-thickness skin reconstruction with basic fibroblast growth factor-impregnated collagen-gelatin sponge

Matsumine

Fujimaki

Takagi

et al. 2019

Regenerative Therapy

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Introduction This study examined the usefulness of basic fibroblast growth factor impregnated collagen-gelatin sponge (bFGF-CGS) in reconstructive surgery for various acute skin defects including deep dermal burns, facial full-thickness skin defects, and finger amputations as the first clinical application. Methods Reconstructive surgery was performed in two stages with bFGF-CGS in 8 male subjects, ranging in age from 6 to 84 years, with acute full-thickness skin defects. Following the adequate debridement of the defect, surgeons prepared a bFGF-CGS with bFGF solution at a dose of 7–14 mg/cm 2 approximately 10 min just before application and then secured the bFGF-CGS in place with non-absorbable sutures. Second-stage wound closure was performed with autologous skin grafting following adequate dermis-like tissue regeneration at the site postoperatively. Follow-up was continued for 6 months. Results Of the 8 subjects, the mean duration from the adequate vascularization of the dermis-like tissue until the second-stage autologous skin graft was 22 ± 4 days. Wound closure was achieved in all cases; the mean duration until wound closure was 32 ± 8 days. During the 6-month follow-up period, no wound infection, recurrent skin ulceration, and no exposure of tendon, bone, and cartilage were observed, and there were no cases of indirectly restricted range of motion from postoperative scar contracture and none with disfiguring scars. Conclusion The authors achieved favorable outcomes following reconstructive surgery with a hybrid artificial dermis impregnated with bFGF for treating acute full-thickness skin defects. bFGF-CGS serves as a convenient regenerative device requiring no specialized medical facilities.

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“…The most challenging conditions are those characterized by a fracture of talar neck (the most common fracture site) and/or talar body, with "peritalar" displacement (tibio-talar, subtalar and/or naviculo-talar displacement) [27,28]. The peculiar anatomical features of talar vascularization, characterized by vessels entering from the talar neck and supplying the talar body in a retrograde manner, explain the high risk of post-traumatic osteonecrosis, that has been deemed as the most common and dramatic consequence following a displaced fracture [29]. Since the first reports on the management of talar fractures, authored by Hawkings [4], the threat of ON has always been impending, and looking at the data emerging from "early" literature, the percentage of ON was in most cases more than 50%.…”

Section: Discussionmentioning

confidence: 99%

Complications after Displaced Talar Neck Fracture: Results from a Case Series and a Critical Review of Literature

Leonetti¹,

Matteo²,

Barca³

et al. 2018

TOORTHJ

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Introduction: Talar fractures are uncommon injuries, whose outcome is often characterized by the onset of serious complications. The aims of the present study are: 1) to review the available evidence concerning the outcome and complications of talar neck fractures; 2) to describe the clinical results and the rate of post-op complications in a series of patients treated surgically after talar fracture-dislocations. Materials and methods: The review of the literature was performed on the Pubmed, Embase and Web of Science databases and aimed at identifying clinical trials with at least 10 patients and dealing with surgical management of talar fracture-dislocation (Hawkins grade II to IV). All the papers were analyzed to extract data concerning common complications such as non-union, mal-union, infection, osteonecrosis and osteoarthtritis. The clinical arm of this paper included 26 patients (19 men and 7 women), who underwent fixation of displaced talar fracture by cannulated screws and were retrospectively evaluated, both clinically and radiographically, at a mean 51.2 ± 23.4 months of follow-up. Results: The evaluation through the AOFAS score revelead a loss of functional performance with respect to the pre-injury status. Four patients were re-operated within final follow up, whereas the remaining 22 presented excellent results in 2 cases, good results in 4 cases, fair results in 11 cases and poor results in 5 cases. Osteoarthritis and osteonecrosis incidence were 51.9% and 25.9% respectively. Sixteen studies were included in the review and it was confirmed that the most frequent complication was post-traumatic OA, followed by osteonecrosis and mal-union. A variable range in percentage of complications described should be ascribed to the low quality of trials currently available. Conclusion: Displaced talar fracture are challenging to treat and the outcomes at middle-term are often modest. Looking at complications, the present case series and the review of literature revealed that the most common one is peritalar OA. Osteonecrosis, traditionally regarded as the most fearsome adverse event, is relevant but less frequent than OA.

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Reconstruction of Chopart’s Amputation Stump Using Artificial Dermis Combined with Free Anterolateral Thigh Flap

Cited by 7 publications

References 10 publications

Clinical Application of Artificial Dermis and Autologous Skin in Repairing Skin and Soft Tissue Defects of Hands and Feet with Bone Exposure Injuries

Clinical Application of Artificial Dermis and Autologous Skin in Repairing Skin and Soft Tissue Defects of Hands and Feet with Bone Exposure Injuries

Full-thickness skin reconstruction with basic fibroblast growth factor-impregnated collagen-gelatin sponge

Complications after Displaced Talar Neck Fracture: Results from a Case Series and a Critical Review of Literature

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