Soft Tissue Reconstruction Pyramid in the Diabetic Foot

Capobianco, Claire M.; Stapleton, John J.; Zgonis, Thomas

doi:10.1177/1938640010375113

Cited by 22 publications

(13 citation statements)

References 79 publications

(97 reference statements)

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“…Of the remaining eighteen articles, eight detailed techniques on application of STSG, or as one possible treatment option used on diabetic wounds [10–17]. Three articles used bioengineered or advanced techniques (platelet-rich plasma) in conjunction with STSG [18–20].…”

Section: Resultsmentioning

confidence: 99%

The Use of Split-Thickness Skin Grafts on Diabetic Foot Ulcerations: A Literature Review

McCartan

Dinh

2012

Plastic Surgery International

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Diabetic foot ulcerations are historically difficult to treat despite advanced therapeutic modalities. There are numerous modalities described in the literature ranging from noninvasive topical wound care to more invasive surgical procedures such as primary closure, skin flaps, and skin grafting. While skin grafting provides faster time to closure with a single treatment compared to traditional topical wound treatments, the potential risks of donor site morbidity and poor wound healing unique to the diabetic state have been cited as a contraindication to its widespread use. In order to garner clarity on this issue, a literature review was undertaken on the use of split-thickness skin grafts on diabetic foot ulcers. Search of electronic databases yielded four studies that reported split-thickness skin grafts as definitive means of closure. In addition, several other studies employed split-thickness skin grafts as an adjunct to a treatment that was only partially successful or used to fill in the donor site of another plastic surgery technique. When used as the primary closure on optimized diabetic foot ulcerations, split-thickness skin grafts are 78% successful at closing 90% of the wound by eight weeks.

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Section: Resultsmentioning

confidence: 99%

The Use of Split-Thickness Skin Grafts on Diabetic Foot Ulcerations: A Literature Review

McCartan

Dinh

2012

Plastic Surgery International

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“…There are numerous therapy methods be used to treat different types of wounds, such as negative pressure wound therapy, bioengineered tissue alternatives, pedicle aps, free tissue transfer. Based on the "Reconstruction Pyramid" ,which is a guide for wound healing, these treatments are arranged hierarchically, from minimally invasive procedures for small and super cial wounds, to highly complex procedures for large, deep, and complicated soft tissue defects (9).…”

Section: Introductionmentioning

confidence: 99%

Acellular dermal matrix treats lower extremity full-thickness skin defect on one-stage without skin graft or flaps

Zhou

Liu

et al. 2020

Preprint

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Background Self-repair of lower limb wounds has always been one of the research hotspots. Flaps and skin graft are the preferred treatment for lower extremity wound reconstruction. However, these treatments have many disadvantages, such as secondary damage, poor healing quality. In recent years, the use of acellular dermal matrix has emerged as an alternative treatment option for extremity ulcers. Methods This study aimed to explore whether acellular dermal matrix can be used as a single treatment to promote wound healing. 7 patients with lower extremities cutaneous deficiency exposing bone or tendon, was covered by Pelnac, which was an acellular dermal matrix product approved by China Food and Drug Administration. All the wound was treated by Pelnac without flaps and skin graft. The external dressing was changed every 10 days. Results After a maximum of 20 weeks, all the wounds were completely healed. During the 12 months follow-up period none of the patients developed skin wear on the treatment area. All patients maintained their postoperative ambulatory ability. All patients were satisfied with the appearance and feeling after wound healing. Conclusions These findings may mean acellular dermal matrix is a novel method oﬀering opportunity for treatment of lower extremities cutaneous deficiency exposing bone or tendon. It also has the potential to close wounds of all uninfected, non-ischemic, full-thickness cutaneous deficiency.

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“…Various wound closure procedures in the soft tissue reconstructive pyramid for the treatment of the diabetic foot include NPWT, allogeneic skin graft substitutes, autogenous skin grafting, local random, muscle, pedicle/perforator and free flaps . In cases of diabetic foot osteomyelitis with or without Charcot neuroarthropathy, osseous resection of the infected bone and/or joints can lead to large osseous defects that might require staged treatment with or without local antibiotic beads/spacers, bone grafting and circular external fixation.…”

Section: Introductionmentioning

confidence: 99%

“…Surgical treatment of diabetic foot infections and osteomyelitis may lead into major resected soft tissue and/or osseous defects that need further staged reconstruction for definitive wound closure. Staged surgical interventions in the setting of acute or chronic diabetic foot complications are not uncommon and are performed within the setting of an MDT approach.Various wound closure procedures in the soft tissue reconstructive pyramid for the treatment of the diabetic foot include NPWT, allogeneic skin graft substitutes, autogenous skin grafting, local random, muscle, pedicle/perforator and free flaps 30. In cases of diabetic foot osteomyelitis with or without Charcot neuroarthropathy, osseous resection of the infected bone and/or joints can lead to large osseous defects that might require staged treatment with or without local antibiotic beads/spacers, bone grafting and circular external fixation.The podoplastic approach describes the combined method of utilizing the circular external fixation system with plastic surgical closure techniques in the diabetic Charcot neuroarthropathy 31.…”

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confidence: 99%

Surgery for the diabetic foot: A key component of care

Frykberg

Wukich

Kavarthapu

et al. 2019

Diabetes Metabolism Res

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Surgery for acute and chronic diabetic foot problems has long been an integral component of care. While partial foot amputations remain as important diabetic limb‐salvaging operations, foot‐sparing reconstructive procedures have become equally important strategies to preserve the functional anatomy of the foot while addressing infection, chronic deformities, and ulcerations. A classification of types of diabetic foot surgery is discussed in accordance with the soft tissue status and acuity of the presenting foot problem. This brief overview from the Association for Diabetic Foot Surgeons describes common conditions best treated by surgical interventions, as well as specific indications. While techniques and indications continue to evolve, effective surgical management of the diabetic foot remains an integral component of care as well as for the prevention of recurrent ulceration.

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Soft Tissue Reconstruction Pyramid in the Diabetic Foot

Cited by 22 publications

References 79 publications

The Use of Split-Thickness Skin Grafts on Diabetic Foot Ulcerations: A Literature Review

The Use of Split-Thickness Skin Grafts on Diabetic Foot Ulcerations: A Literature Review

Acellular dermal matrix treats lower extremity full-thickness skin defect on one-stage without skin graft or flaps

Surgery for the diabetic foot: A key component of care

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