3.Repair of a soft tissue defect of medial malleolus with cross-leg bridge free transfer of anterolateral thigh muscle flap: a case report.
Gong-Lin ZHANG ; Ke-Ming CHEN ; Jun-Hua ZHANG ; Shi-Yong WANG
Chinese Journal of Traumatology 2012;15(5):306-308
A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cm multiply 4 cm. Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis. The anterior tibial artery was patent. Three weeks after injury, the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect, and an end-to-side anastomosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap's vascular pedicle. A split thickness free skin graft was used to cover the muscle flap and around the flap's vascular pedicle. The vascular pedicle was cut off after 28 days and the muscle flap survived completely. After 3-year follow-up postoperatively, the right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations. This technique can be used to preserve the flow and patency of recipient arteries.
Humans
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Leg
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Leg Injuries
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surgery
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Soft Tissue Injuries
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surgery
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Surgical Flaps
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Thigh
4.Microsurgical repair at early stage for soft tissue defect of limbs wounded by modern firearm.
Jincai LIU ; Xueliang PENG ; Yinqiu LIU ; Xinan LAI ; Shuguang LI ; Mingang WANG ; Haiyang HUANG ; Quanyin DU ; Hongzhen SUN
Chinese Journal of Traumatology 2002;5(3):142-145
OBJECTIVETo explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result.
METHODSDefects of the hind limbs of dogs were repaired with skin, muscle and myocutaneous flaps.
RESULTSWounds healed within 2 weeks in the experimental group except one that healed in 3 weeks because of infection. Limb function was close to normal. The treatment result was better in the experimental group than the control.
CONCLUSIONSSkin, muscle and myocutaneous flaps can cover soft tissue defect at an early stage, prevent and reduce infection, promote the healing and recovery of combined injury, reduce the time of treatment and disability rate.
Animals ; Debridement ; Dogs ; Hindlimb ; injuries ; Microsurgery ; Soft Tissue Injuries ; surgery ; Wound Healing ; Wounds, Gunshot ; surgery
5.Reconstruction of forefoot skin defect with island flap pedicled with lateral tarsal artery.
Ji-Chun ZHANG ; Wei ZHANG ; Xiao-Ming XIA ; Liang ZHANG ; Jin-Bao HAN
Chinese Journal of Plastic Surgery 2012;28(5):347-349
OBJECTIVETo investigate the therapeutic effect of island flap pedicled with lateral tarsal artery for forefoot skin defect.
METHODSFrom March 2007 to January 2009, 12 cases with forefoot skin defects were treated by reversed island flap pedicled with lateral tarsal artery.
RESULTSAll the flaps survived completely with a followed-up period of 8-22 months, 13 months in average. The flaps and skin grafts had soft texture and a similar color as the surrounding skin. The flaps had a suitable thickness with deep pain sensation. Shallow touch and pain sensation recovered in the skin graft and within 1-2 cm of the flap edge, which was graded as S1-S2. There was no problem in shoes-wearing and walking. No flap ulcer happened.
CONCLUSIONIsland flap pedicled with lateral tarsal artery is suitable for forefoot skin defect, leaving less morbidity to donor site.
Adult ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply
7.Clinic application of skin flap based lateral supramalleolar branches of the peroneal artery.
Shun-bing WANG ; Fa-lin WU ; Sheng-hua NI ; Jian-hua HUANG ; Jian-feng CHEN ; Ding-jin SHAN
China Journal of Orthopaedics and Traumatology 2008;21(7):521-522
Adolescent
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Adult
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Aged
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Ankle Injuries
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surgery
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Female
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Foot Injuries
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surgery
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Humans
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Male
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Middle Aged
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Soft Tissue Injuries
;
surgery
;
Surgical Flaps
8.Delayed of reverse sural nerve flap to repair large soft tissue defect on foot: a case report.
Jun-Lin YANG ; Gong-Lin ZHANG ; Lai-Xu ZHAO
China Journal of Orthopaedics and Traumatology 2013;26(11):906-907
Adult
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Foot
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innervation
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surgery
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Humans
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Male
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Soft Tissue Injuries
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surgery
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Sural Nerve
;
surgery
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Surgical Flaps
;
innervation
9.Repair of lower extremity soft tissue defect with free musculo-cutaneous flaps bridging with healthy contralateral posterior tibial vessel.
Xia CHENGDE ; Di HAIPING ; Xue JIDONG ; Zhao YAOHUA ; Li XIAOLIANG ; Li QIANG ; Niu XIHUA ; Li YONGLIN ; Lian HONGKAI
Chinese Journal of Plastic Surgery 2015;31(3):183-187
OBJECTIVETo observe the clinical effects of free musculo-cutaneous flap bridging with contralateral posterior tibial vessel on repair of lower extremity soft tissue defect.
METHODSFrom February 2006 to June 2013, 10 patients with soft tissue defect on lower shank and foot were included. The posterior tibial vessel on healthy lower extremity was chosen as recipient vessel and anastomosed with free latissimus dorsi musculo-cutaneous flap, or free latissimus dorsi musculo-cutaneous flap combined with thoracic-umbilical skin flap or anterolateral femoral musculo-cutaneous flap. The retrograde bridged flap was transposed to repair defect on contralateral lower shank and foot. The wound area ranged from 40 cm x 21 cm to 22 cm x 15 cm, with flap size from 48 cm x 26 cm to 25 cm x 18 cm. Meanwhile the defects on donor sites were covered with skin graft and both lower extremities were fixed with kirschner wires at middle tibia and calcaneus. The kirschner wires were removed at 4 weeks and pedicles were cut off 5-8 weeks postoperatively. Six patients received posterior tibial vessel reanastomosis at the same time of pedicle cutting.
RESULTSAll the 10 flaps survived and 3 patients received thinning of flaps due to excessive thickness. During the follow-up period of 3 months to 2 years follow up, the ambulatory function of injured legs recovered gradually with satisfactory appearance. The reanastomosed posterior tibial vessel on the healthy side was recovered.
CONCLUSIONSAppropriate bridged musculo-cutaneous flaps is suitable for extensive soft tissue defect of lower shank and foot. It is a safe and effective method for limb salvage.
Foot ; Free Tissue Flaps ; transplantation ; Humans ; Lower Extremity ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Wound Healing
10.Application of skin and soft tissue expansion in repairing pediatric patients with superficial defects.
Chinese Journal of Burns 2022;38(4):301-305
Skin and soft tissue expansion can provide skin tissue similar to the recipient area in color and texture, which is one of the ideal methods in the repair of superficial defects. However, due to the long treatment cycle and relatively high complications rate in pediatric patients, expansion still faces many challenges. Based on the clinical practice and the current progress in skin and soft tissue expansion, this paper briefly discusses the change of skin after expansion, and the application, prevention and treatment of complications in the application of expansion in pediatric patients, aiming to provide reference for expansion in pediatric patients.
Child
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Humans
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Reconstructive Surgical Procedures
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Skin Transplantation
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Soft Tissue Injuries/surgery*
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Tissue Expansion
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Treatment Outcome