The Experts below are selected from a list of 1266 Experts worldwide ranked by ideXlab platform

David G. Genecov - One of the best experts on this subject based on the ideXlab platform.

  • Vacuum-assisted closure for the treatment of Degloving injuries.
    Plastic and reconstructive surgery, 1999
    Co-Authors: Anthony J. Defranzo, Malcolm W. Marks, Louis C. Argenta, David G. Genecov
    Abstract:

    Degloving injuries of the hand and foot pose difficult reconstructive and rehabilitation challenges. After an excellent experience with split-thickness skin grafting with the vacuum-assisted closure device, we began studies with full-thickness skin grafts and traumatized skin. The device has been used with successful reapplication of full-thickness degloved skin in two patients. The first patient suffered Degloving of the foot; the second patient, Degloving of the hand.

Hari Venkatramani - One of the best experts on this subject based on the ideXlab platform.

  • revascularization of a circumferential hand and forearm Degloving injury using an arteriovenous shunt
    Journal of Hand Surgery (European Volume), 2020
    Co-Authors: Hari Venkatramani, Raja S Sabapathy, Dafang Zhang
    Abstract:

    Major upper-extremity Degloving injuries with distal dysvascularity are rare and challenging surgical problems. When these Degloving injuries occur over nonexpendable regions, such as the glabrous skin of the palm and digits, revascularization or replantation may be the treatment of choice. Because the degloved skin flap is often separated in the suprafascial plane, direct arterial repair may be impossible. We present a rare case of circumferential Degloving of the hand and forearm with distal dysvascularity, treated successfully with revascularization with arterial anastomosis, venous anastomosis, and arteriovenous shunt creation. The patient required reoperation for partial flap loss and ligation of the arteriovenous fistula. At final follow-up 16 months after the injuries, she showed independence in activities, reported good functional use of the hand, and worked full-time at her original occupation.

  • The use of pedicled abdominal flaps for coverage of acute bilateral circumferential Degloving injuries of the hand.
    Trauma Case Reports, 2015
    Co-Authors: Shanmunagathan Raja Sabapathy, Hari Venkatramani, Patricia Martin Playa
    Abstract:

    Reconstruction of bilateral soft tissue defects in hand and distal third of the forearm, is a challenge for any reconstructive surgeon. When there is circumferential skin loss affecting the whole hand and fingers as in major Degloving injuries, the extent of tissue required for reconstruction narrows down the choice of flaps. When the injury affects both hands the magnitude of the problem becomes compounded. There is no report in the literature of free skin flaps to cover circumferential Degloving injuries in both hands. We are presenting the technical considerations and outcome of pedicled abdominal flaps used for immediate coverage of circumferential Degloving injuries of both hands.

  • The use of pedicled abdominal flaps for coverage of acute bilateral circumferential Degloving injuries of the hand
    Elsevier, 2015
    Co-Authors: Shanmunagathan Raja Sabapathy, Hari Venkatramani, Patricia Martin Playa
    Abstract:

    Reconstruction of bilateral soft tissue defects in hand and distal third of the forearm, is a challenge for any reconstructive surgeon. When there is circumferential skin loss affecting the whole hand and fingers as in major Degloving injuries, the extent of tissue required for reconstruction narrows down the choice of flaps. When the injury affects both hands the magnitude of the problem becomes compounded. There is no report in the literature of free skin flaps to cover circumferential Degloving injuries in both hands. We are presenting the technical considerations and outcome of pedicled abdominal flaps used for immediate coverage of circumferential Degloving injuries of both hands. Keywords: Pedicled abdominal flap, Bilateral hand injury, Degloving injury han

Tommaso Agostini - One of the best experts on this subject based on the ideXlab platform.

Yong Shen - One of the best experts on this subject based on the ideXlab platform.

  • revision surgery with dermal regeneration template and vacuum sealing drainage for reconstruction of complex wounds following necrosis of reattached avulsed skins in a Degloving injury a case report
    Medicine, 2019
    Co-Authors: Qiusheng Wang, Rui Jia, Wenyuan Ding, Yong Shen
    Abstract:

    RATIONALE Degloving injury of the upper limb often extends to underlying tendons and bone, which is at high risk of treatment failure if only simple reattachment of defatted avulsed skins was performed. Pelnac dermal regeneration template could be used as a treatment choice for necrosis of the reattached avulsed skins in a Degloving injury. PATIENT CONCERNS A 48-year-old woman with a Degloving injury of the right forearm, wrist, and hand received initial treatment by reattachment of the defatted avulsed skins over the wound bed. However, 17 days postoperatively, the reattached skins developed complete necrosis, leaving large size of tissue defects and tendon/bone exposure. DIAGNOSIS Failure to reconstruct the skin and soft-tissue envelop by reattachment of the defatted avulsed skins in a severe Degloving injury of the upper limb. INTERVENTIONS We decided to use a 2-stage procedure of Pelnac dermal regeneration template and secondary skin graft to solve this issue, in consideration of these conditions and the patient' demanding of limb function and aesthetic appearance. OUTCOMES At the final follow-up, this patient obtained an excellent result, in term of scar quality, aesthetic appearance, and the ability to perform the daily activities. LESSONS We believe this could become an interesting option in patients who needed revision procedure for management of complex wounds with tendon/bone exposure following the necrosis of reattached skins in Degloving injuries.

Bin Wang - One of the best experts on this subject based on the ideXlab platform.

  • repair of distal thumb Degloving injury using combination of reverse dorsoradial flap of the thumb and middle finger proper digital arterial island flap
    Journal of Orthopaedic Surgery and Research, 2020
    Co-Authors: Ruizheng Hao, Hui Wang, Bin Wang, Huanyou Yang, Yongxin Huo
    Abstract:

    To examine the efficacy of combination of the reverse dorsoradial flap of the thumb and middle finger proper digital arterial island flap for repair of distal thumb Degloving injury. Twelve patients with mechanical distal thumb Degloving injuries were treated between February 2017 and August 2019. A combination of the reverse dorsoradial flap of the thumb and the middle finger proper digital arterial island flap were used. Semmes–Weinstein (SW) monofilament and static two-point discrimination (S-2PD) tests, active range-of-motion (ROM) of the joints, cold intolerance, visual analog scale (VAS) score patient complications, and patient satisfaction were sequentially evaluated. Two cases with postoperative flap blisters were treated at time of dressing changes up to successful scab formation. One case with postoperative arterial crisis of finger arterial dorsal branch vessel was successfully released in the pedicle. Ten cases healed by first intention and 2 cases by secondary intention. Twelve patients received follow-up examinations between 3 and 20 months (average 13 months) post-treatment, and all exhibited full, soft flaps with no fingertip pain. The combined use of the reverse dorsoradial flap of the thumb and the middle finger proper digital arterial island flap is a practical and effective approach to surgical repair of distal thumb Degloving injuries.

  • transfer of double hump flap from the same finger for repair of distal finger Degloving injury
    Chinese Journal of Hand Surgery, 2017
    Co-Authors: Jianfeng Zhang, Wei Wang, Bin Wang, Huanyou Yang, Xiaoxuan Fei
    Abstract:

    Objective To investigate the surgical procedures and the clinical results of repairing Degloving injury of the distal finger. Methods Between January 2010 and May 2014, 34 patients (34 fingers) with Degloving injury of the distal finger were treated. There were 24 males and 10 females with ages ranging from 21 to 60 years (mean, 35 years). The time from injury to operation was 1 to 8 hours (mean, 4.5 hours). Affected fingers included index finger in 7 cases, middle finger in 15 cases, ring finger in 9 cases, and little finger in 3 cases. Twelve cases were complicated with fracture of the distal phalanx. The defect area ranged from 2.0 cm×1.8 cm to 3.0 cm×2.5 cm. Modified reverse island flap based on the dorsal branch of the digital artery was used to cover the defects of the distal finger caused by the Degloving injury. The flap shaped like the humps of a camel (double hump flap). Full thickness skin graft from the forearm was used to cover the donor site. Results Blister and scabs occurred in 8 cases, and two of them were revised by second intention. The other flaps and skin grafts survived uneventfully. The patients were follow-up for 6 to 20 months (mean, 9.3 months). All the flaps presented satisfactory appearance and texture, and the flexion and extension function of affected fingers nearly returned to normal. Two-point discrimination ranged from 6.2 to 9.1 mm at the last follow-up. According to the functional assessment criteria of the upper limb formulated by the Hand Surgery Society of the Chinese Medical Association, the results were excellent in 24 cases, good in 8 cases, and fair in 2 cases, the excellent and good rate being 94.1%. Conclusion Modified reverse island flap based on the dorsal branch of the digital artery, namely the double-hump flap, is a simple and safe, easy-to-operate and effective method for treating Degloving injury of the distal finger. Key words: Finger injuries; Surgical flaps; Degloving injury; Proper digital artery

  • treatment of fingertip Degloving injury using the bilaterally innervated sensory cross finger flap
    Annals of Plastic Surgery, 2014
    Co-Authors: Chao Chen, Peifu Tang, Lihai Zhang, Bin Wang
    Abstract:

    Treatment of a fingertip Degloving injury continues to be a challenge problem. This article reports repair of this type of injury using a modified cross-finger flap, including both dorsal branches of the digital nerves. From December 2007 to March 2010, the flap was used in 17 digits of 17 patients who had a fingertip Degloving injury. There were 13 men and 4 women with mean age of 33 years. The injured fingers requiring reconstruction included 5 index, 6 middle, and 6 ring fingers. The mean size of the soft tissue losses was 4.2 × 1.9 cm. The mean flap size was 4.4 × 2.2 cm. Neurorrhaphy was performed between the dorsal branches harvested with the flap and the digital nerves of the injured finger. For comparison, we also collected a series of 28 patients who had a fingertip Degloving injury treated with a cross-finger flap without nerve repair. In the study group, all flaps survived completely. At a mean follow-up of 23 months, the average score of static 2-point discrimination on the finger pulp was 7.2 mm. According to the visual analog scale, 12 patients had no pain, 4 reported mild pain, and 1 experienced moderate pain. Positive Tinel sign was found in only 1 reconstructed finger. Of the comparison group (mean follow-up, 22 months), the average static 2-point discrimination was 9.8 mm. On the basis of the visual analog scale, no pain, mild pain, and moderate pain were noted in 18, 7, and 3, fingers, respectively. Positive Tinel sign was found in 9 reconstructed fingers. The outcomes of the 2 groups were significantly different. The bilaterally innervated sensory cross-finger flap is an effective method for repairing the fingertip Degloving injury. The authors suggest that double nerve repairs should be performed to improve the pulp sensation and reduce the incidence of the painful neuroma.