Two-team-approached free flap reconstruction for plantar malignant melanoma: An observational (STROBE-compliant) trial

Kim, Jun Hyeok; Kwon, Hyo Jeong; Oh, Deuk Young; Jun, Young Joon; Rhie, Jong Won; Moon, Suk‐Ho

doi:10.1097/md.0000000000029442

Cited by 2 publications

(3 citation statements)

References 57 publications

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“…Based on our experience and literature, we recommend, whenever possible, to perform a two‐team approach. In such time‐consuming microsurgical cases, working in two teams allows us to decrease safely operative times and potentially alleviate surgeon fatigue and thus increase overall surgeon productivity (Bauermeister et al, 2017; Kim et al, 2022). However, to avoid the complications related to microvascular anastomosis, the approach should be always performed by a very experienced reconstructive surgeon and a well‐trained surgical team (Fong & Levin, 2019).…”

Section: Discussionmentioning

confidence: 99%

The use of double free flaps with intra‐flap anastomosis for complex defects reconstruction

2023

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BackgroundOver the years, the improvements in microsurgical field allowed the reconstruction of increasingly larger and more complex defects. In this context, we conceived linking more flaps with a single vascular supply. The double free flaps with intra‐flap anastomosis offer a better match with recipient site requirements, still having a minimal donor and recipient site morbidity. In the present paper, we describe our experience with this procedure, focusing on its features and providing a collection of cases in different areas and clinical settings.Patients and MethodsConsecutive single‐center case series with 16 patients who received defect reconstruction using double free flaps with intra‐flap anastomosis between February 2019 and August 2021. The median age was 58 years old (range 39–77). Nine patients were men and seven were women. The defects were located throughout the body, including breast, head and neck, lower and upper limbs. In 12 cases, the cause of the defect was surgical removal of a tumor, while in four cases the cause was trauma. The main indication for this procedure was related to the need of covering a large defect, either in terms of volume or surface, resorting to only one vascular axis.ResultsA total of 32 flaps were harvested, including 10 different techniques. The flaps size ranged from 6 × 3 cm to 24 × 8 cm. Eleven patients completely healed without any complications. No flaps were lost. Three patients developed a minor wound dehiscence and one a wound infection treated conservatively with antibiotic therapy. One patient experienced both of these complications. The median follow up was 12 months and ranged between 6 and 24 months. At the final clinical evaluation, the reconstructive result was stable in all cases and all the patients had a complete resumption of their daily activities.ConclusionsDouble free flaps reconstruction with intra‐flap anastomosis represents a valid and reliable option for the coverage of complex defects in case of depleted recipient sites. This procedure allows us to transfer high amounts of tissue resorting to a single vascular axis. However, it represents a technical challenge and a highly experienced microsurgical team is required.

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Section: Discussionmentioning

confidence: 99%

The use of double free flaps with intra‐flap anastomosis for complex defects reconstruction

2023

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“…The main challenge when reconstructing surgical defects following the excision of acral melanoma on the foot is to preserve function. A range of flaps offering greater thickness and cushioning are frequently used in weight‐bearing areas 1,2 . Alternatives include secondary intention healing 3 and skin grafts 4 .…”

Section: Introductionmentioning

confidence: 99%

“…A range of flaps offering greater thickness and cushioning are frequently used in weightbearing areas. 1,2 Alternatives include secondary intention healing 3 and skin grafts. 4 Previous studies have suggested that dermal substitutes and STSGs may ease reconstruction by adding extra tissue to soften the impact on weightbearing areas.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of plantar surgical defects with synthetic dermal matrix and split‐thickness skin grafts: A case series and functional podiatry outcomes

Gil‐Pallares,

González‐Moure,

Mosquera‐Fernández

et al. 2023

Aust J Dermatology

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Reconstruction of surgical defects after wide local excision of acral melanoma on the sole should allow patients to walk and bear weight. Moreover, certain options such as local transposition flaps can compromise follow‐up. We present a case series of surgical defects on weight‐bearing areas of the sole reconstructed using a synthetic dermal matrix and a split‐thickness skin graft. This approach prevents surrounding tissue displacement and results in good functional outcomes assessed by baropodometry and computer‐based podoscopy.

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Two-team-approached free flap reconstruction for plantar malignant melanoma: An observational (STROBE-compliant) trial

Cited by 2 publications

References 57 publications

The use of double free flaps with intra‐flap anastomosis for complex defects reconstruction

The use of double free flaps with intra‐flap anastomosis for complex defects reconstruction

Reconstruction of plantar surgical defects with synthetic dermal matrix and split‐thickness skin grafts: A case series and functional podiatry outcomes

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