Reduction of 'Dead Space' and 'Shear' Through Flap Adhesion may Reduce Short Term Complication Rates in Flap-Based Reconstruction for Stage IV Pressure Sores: A Retrospective Comparison Cohort Series

Kuhfuß, I.; Cordi, Alessandro

doi:10.4172/2165-7939.1000318

Cited by 1 publication

(3 citation statements)

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“…Dead space, which can be defined as the residual void after tissue loss, commonly occurs after removal of an implant or extensive debridement 13,14 . Also, dead space may occur if a surgical flap is not properly sized or shaped, or if the flap is not properly adhered 15–17 . Dead space, if left unaddressed, inevitably leads to seroma, hematoma, and recurrent infection 13,15 .…”

Section: Introductionmentioning

confidence: 99%

“…13,14 Also, dead space may occur if a surgical flap is not properly sized or shaped, or if the flap is not properly adhered. [15][16][17] Dead space, if left unaddressed, inevitably leads to seroma, hematoma, and recurrent infection. 13,15 Treatments involve padding the exposed bone surface using fasciocutaneous flaps, using flaps containing muscles, or a combination of these.…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17] Dead space, if left unaddressed, inevitably leads to seroma, hematoma, and recurrent infection. 13,15 Treatments involve padding the exposed bone surface using fasciocutaneous flaps, using flaps containing muscles, or a combination of these. [18][19][20] However, there are currently no studies that accurately evaluate this type of dead space prior to surgery.…”

Section: Introductionmentioning

confidence: 99%

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Volumetric Evaluation of Dead Space in Ischial Pressure Injuries Using Magnetic Resonance Imaging: A Case Series

Kim¹,

Park²,

Nam³

et al. 2021

Adv Skin Wound Care

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OBJECTIVE To establish a preoperative evaluation procedure by measuring the volume of dead space using MRI in patients with ischial pressure injuries. METHODS Patients with spinal cord injury and ischial pressure injuries who underwent treatment between August 2016 and November 2019 were included in the study. Preoperative MRI scan was conducted on all patients. The volume estimation and three-dimensional (3D) reconstruction were performed based on MRI data using a 3D Slicer. Based on the resulting volume, a muscle flap that could fit the dead space was selected. Surgery was performed with the selected muscle flap, and a fasciocutaneous flap was added, if necessary. RESULTS A total of eight patients with ischial pressure injuries were included in the study. The mean patient age was 59.0 ± 11.0 years. The mean body mass index was 26.62 ± 3.89 kg/m2. The mean volume of dead space was 104.75 ± 81.05 cm3. The gracilis muscle was the most selected muscle flap and was used in four patients. In five of eight cases, a fasciocutaneous flap was used as well. The mean follow-up period was 16 months, and by that point, none of the patients evinced complications that required surgery. CONCLUSIONS To the authors’ knowledge, this is the first report on volumetric evaluation of dead space in ischial pressure injuries. The authors believe that the 3D reconstruction process would enable adequate dead space obliteration in ischial pressure injuries. The authors propose that preoperative MRI scans in patients with ischial pressure injury should become an essential part of the process.

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Section: Introductionmentioning

confidence: 99%