Soft tissue coverage of war extremity injuries: the use of pedicle flap transfers in a combat support hospital

Abstract

Reconstruction of traumatic soft tissue defect can be achieved in CSHs for local nationals. Pedicle flap transfers provide simple and safe coverage for war extremity injuries in this challenging environment whatever the injury mechanism.

Correction to: Extremity soft tissue coverage in the combat zone: use of pedicled flap transfers by the deployed orthopedic surgeon

“…Factors that affect treatment decisions include the surgeon's expertise and available resources (e.g., surgical equipment, antibiotics, laboratory analysis facilities and the number of available beds) [4]. For these reasons, the simplest solution for coverage is always preferred [4,6]. In our experience, pedicled flaps combined with skin grafts allowed reconstruction of almost all types soft tissue extremity injuries, even large ones.…”

“…In battlefield MTF environment, however, the choices for soft tissue coverage methods are restricted. Factors that affect treatment decisions include the surgeon's expertise and available resources (e.g., surgical equipment, antibiotics, laboratory analysis facilities and the number of available beds) [4]. For these reasons, the simplest solution for coverage is always preferred [4,6].…”

“…Due to the lack of plastic surgeons in the battlefield, orthopedic surgeons often find themselves alone when managing local patients who present with complex extremity injuries requiring multi-tissue reconstruction. In this austere environment, they routinely perform soft tissue coverage procedures using "simple, reliable and replicable" techniques [4][5][6].…”

Lambeau de Mac Gregor, solution de sauvetage: à propos d'un cas, clinique et résultat

“…Dans les grandes pertes de substances, nous recommandons comme Tintle et al [6] l'utilisation de lambeaux locorégionaux combines, voire de lambeaux pédicules à distance. Il s'agit en particulier du lambeau inguinal de Mac Gregor permettant de couvrir la main ou l'avant-bras et des lambeaux hétéro-jambier bien que très contraignants gardent des indications en situation précaire [7].…”

Guidelines for Models of Skeletal Muscle Injury and Therapeutic Assessment

“…The closest intervention to a gold standard treatment for large, traumatic extremity injuries is early soft tissue coverage of the exposed defect region with muscle or fasciocutaneous flaps; though it is important to note that this approach is largely to provide bone coverage and skin closure, and that most VML injuries go without any definitive therapy [Mathieu et al, 2014]. Regardless, the testing of autografts is still a critical benchmark for the evaluation of novel interventional strategies in VML models.…”