The Experts below are selected from a list of 1092 Experts worldwide ranked by ideXlab platform
Viktor M Grishkevich - One of the best experts on this subject based on the ideXlab platform.
-
first web space post Burn Contracture types Contracture elimination methods
Burns, 2011Co-Authors: Viktor M GrishkevichAbstract:Abstract First web space adduction Contractures are a common consequence of hand Burns. Many reconstructive techniques are used and investigation for more effective methods continues. Effective hand reconstruction usually considers anatomy as its foundation. Based on the experience of over 500 web space Contracture elimination cases, three anatomical types of thumb adduction Contractures were identified: edge, medial and total. Edge Contractures (80% of all thumb adduction Contractures) are caused by a fold in which only one sheet is scarred, either the palmar or dorsal surface. The contraction is caused by a trapeze-shaped length deficiency of the scar sheet, which has a surface surplus in width. Reconstruction consists of surface deficiency compensation with trapezoid flap prepared from the non-scarred side and skin–fat tissues of the web space. In most cases, the small scar–fat trapezoid flaps should be prepared from the non-scarred side to cover the donor wounds on both sides of the main flap. Medial Contractures (10% of thumb adduction Contractures) are caused by the fold, both sheets of which are scarred and have trapeze-shaped surface deficiency in length and surplus in width. Both fold sheets are converted into one or several pairs of trapezoid scar–fat flaps by radial incisions. The oppositely located flaps are transposed towards each other. As a result of the counter flaps transposition, the Contracture is eliminated; the web space's shape and depth are restored by the use of flaps alone or in combination with skin grafting. The trapeze-flap plasty is very simple and effective with the length gain of up to 100–200%. Neither flap loss nor re-Contracture occurs. Total Contractures (about 10% of all) have no fold. Reconstruction consists of the creation of the central zone of the first web space depth with the rectangular subdermal pedicle flap; the wounds on both sides of the flap are skin grafted. The flap sustains normal web depth and prevents the Contracture recurrence and skin graft shrinkage.
David A Kulber - One of the best experts on this subject based on the ideXlab platform.
-
the use of acellular dermal matrix in release of Burn Contracture scars in the hand
Plastic and Reconstructive Surgery, 2011Co-Authors: Morad Askari, Myles J Cohen, Peter H Grossman, David A KulberAbstract:Background:Contracture deformities of the upper extremity are encountered frequently in Burn victims. Surgical repair of this problem is challenged by a paucity of soft tissue, poor functional outcome, and a high rate of recurrence. Acellular dermal matrix has become increasingly popular in reconstr
Chunhui Xie - One of the best experts on this subject based on the ideXlab platform.
-
release of severe post Burn Contracture of the first web space using the reverse posterior interosseous flap our experience with 12 cases
Burns, 2013Co-Authors: Shi Kai, Jingchun Zhao, Zhenghua Jin, Ming Yang, Yan Wang, Chunhui XieAbstract:Abstract We retrospectively assessed outcomes after treating severe Contractures of the first web space from Burns with the reverse posterior interosseous flaps (RPIF). Twelve consecutive patients (ages 18–58 years) with Burns from 10% to 70% (mean, 30.1%) total body surface area and severe Contractures of the first web space of the hand (initial thumb to index angles from 10° to 35° [mean, 23°]) underwent Contracture release using the RPIF. Seventeen RPIFs were used, with sizes from 9 cm × 6 cm to 14 cm × 10 cm (mean area, 83.6 cm 2 ). The patients were followed for 5–26 months. All flaps survived completely, rapidly adapted to the recipient beds, and achieved good color and texture harmony. No early complications occurred. Fifteen donor sites were closed with skin grafts. Two donor sites were closed by direct suture. No paralysis of the posterior interosseous nerve was observed in these cases. At last follow-up the mean thumb to index angle was 78°, increasing the web length 260%. All patients regained fundamental hand functions. The RPIF is reliable and safe for releasing severe Contractures of the first web space of the hand after Burn, with distinct advantages over currently used alternative methods.
Willy Boeckx - One of the best experts on this subject based on the ideXlab platform.
-
release of hand Burn Contracture comparing the alt perforator flap with the gracilis free flap with split skin graft
Burns, 2013Co-Authors: M Misani, C Zirak, Le Thua Trung Hau, A De Mey, Willy BoeckxAbstract:Abstract Background The use of microsurgery in the management of Burn sequelae is not a new idea. According to the properties of various types of free flaps different goals can be achieved or various additional procedures have to be combined. We report the comparison of two different free flaps on a single patient for reconstruction of both upper extremities for Burn sequelae. Case report A 1-year-old child sustained severe Burns on both hands, arms and thorax and was initially only treated conservatively. This resulted in severe Contractures. At the age of 4-years a free gracilis flap was selected for reconstruction of his left hand and a free anterolateral thigh flap for the right hand. Results We noticed a better functional and esthetic result for the gracilis flap associated with a shorter operative time and a minor donor site morbidity. The intraoperative technique and time, postoperative complications, functional and esthetic results and donor site morbidities were studied in the two types of flaps chosen. A review of literature was also performed. Conclusion Our experience reported a better success of the gracilis muscle flap covered with a split skin graft compared to the anterolateral thigh flap in the reconstruction of hand function after severe Burn sequelae.
Raashid Hamid - One of the best experts on this subject based on the ideXlab platform.
-
Clinical Study Outcome of Split Thickness Skin Grafting and Multiple Z-Plasties in PostBurn Contractures of Groin and Perineum: A 15-Year Experience
2016Co-Authors: Wani Sajad, Raashid HamidAbstract:License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Groin and perineal Burn Contracture is a rare postBurn sequel. Such postBurn Contractures causes distressing symptoms to the patients and in the management of these Contractures, both functional and cosmetic appearance should be the primary concern. Aims. To study the outcome of surgical treatment (STSG and multiple Z-plasties) in postBurn Contractures of groin and perineum.Material and Methods. We conducted a study of 49 patients, with postBurn groin and perineal Contractures. Release of Contracture with split thickness skin grafting (STSG) was done in 44 (89.79%) patients and release of Contracture and closure by multiple Z-plasties was done in 5 (10.21%) patients. Results. Satisfactory functional and cosmetic outcome was seen in 44 (89.79%) patients. Minor secondary Contractures of the graft were seen in 3 (6.81%) patients who were managed by physiotherapy and partial recurrence of the Contracture in 4 (8.16%) patients required secondary surgery. Conclusion. We conclude that postBurn Contractures of the groin and perineum can be successfully treated with release of Contracture followed by STSG with satisfactory functional and cosmetic results. Long term measures like regular physiotherapy, use of pressure garments, and messaging with emollient creams should not be neglected and should be instituted postoperatively to prevent secondary Contractures of the graft and recurrence of the Contracture. 1
-
Outcome of Split Thickness Skin Grafting and Multiple Z-Plasties in PostBurn Contractures of Groin and Perineum: A 15-Year Experience
Plastic Surgery International, 2014Co-Authors: Wani Sajad, Raashid HamidAbstract:Background . Groin and perineal Burn Contracture is a rare postBurn sequel. Such postBurn Contractures causes distressing symptoms to the patients and in the management of these Contractures, both functional and cosmetic appearance should be the primary concern. Aims . To study the outcome of surgical treatment (STSG and multiple Z-plasties) in postBurn Contractures of groin and perineum. Material and Methods . We conducted a study of 49 patients, with postBurn groin and perineal Contractures. Release of Contracture with split thickness skin grafting (STSG) was done in 44 (89.79%) patients and release of Contracture and closure by multiple Z-plasties was done in 5 (10.21%) patients. Results . Satisfactory functional and cosmetic outcome was seen in 44 (89.79%) patients. Minor secondary Contractures of the graft were seen in 3 (6.81%) patients who were managed by physiotherapy and partial recurrence of the Contracture in 4 (8.16%) patients required secondary surgery. Conclusion . We conclude that postBurn Contractures of the groin and perineum can be successfully treated with release of Contracture followed by STSG with satisfactory functional and cosmetic results. Long term measures like regular physiotherapy, use of pressure garments, and messaging with emollient creams should not be neglected and should be instituted postoperatively to prevent secondary Contractures of the graft and recurrence of the Contracture.
