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Sengfeng Jeng - One of the best experts on this subject based on the ideXlab platform.
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versatility of the anterolateral thigh flap with vascularized Fascia Lata for reconstruction of complex soft tissue defects clinical experience and functional assessment of the donor site
2009Co-Authors: Yurren Kuo, Mingchung Yeh, Hsiangshun Shih, Chienchang Chen, Paoyuan Lin, Yuanchang Chiang, Sengfeng JengAbstract:Background: The anterolateral thigh flap is commonly used for reconstruction of various soft-tissue defects. This article presents the authors' approach to one-stage reconstruction of composite soft-tissue defects using an anterolateral thigh flap with a vascularized Fascia Lata. Methods: This retrospective review analyzed 973 patients who had undergone anterolateral thigh flap reconstruction for various soft-tissue defects over the past 10 years. Various types of complicated defects in 36 patients were reconstructed with a composite anterolateral thigh flap combined with vascularized Fascia Lata. The Fascia Lata component of the flap was used for abdominal wall and Fascial defect reconstruction in 12 patients, for lip-cheek defect reconstruction in 15 patients, for reconstruction of composite defects in extremities in nine patients, and for reconstruction of the perineum in one patient. Functional outcomes of donor sites were investigated by using a dynamometer. Results: All flaps except one survived. The overall flap survival rate was 97 percent. Patients achieved satisfactory results without major postoperative complications. The study revealed that vascularized Fascia may mimic a Fascial sheath but lacks the muscle-synchronized excursion properties. Apart from a mild deficiency in quadriceps femoris muscles contraction in the donor thighs, no difficulties in daily ambulation were reported by the patients. Conclusions: The anterolateral thigh flap with vascularized Fascia Lata provides a reliable Fascial component for single-stage reconstruction of complex softtissue defects.
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one stage reconstruction of large midline abdominal wall defects using a composite free anterolateral thigh flap with vascularized Fascia Lata
2004Co-Authors: Yurren Kuo, Meihui Kuo, Barbara S Lutz, Yuchi Huang, Yitien Liu, Kunchou Hsieh, Chinghua Hsien, Sengfeng JengAbstract:Objective: Large midline abdominal wall defects are continuously a challenge for reconstructive surgeons. Adequate skin coverage and Fascia repair of the abdominal wall is necessary for achieving acceptable results. The purpose of this paper is to present a new approach to abdominal wall reconstruction using a free vascularized composite anterolateral thigh (ALT) flap with Fascia Lata. Methods: Seven patients with large full-thickness abdominal wall defects were successfully reconstructed by means of a composite ALT flap combined with vascularized Fascia Lata. The size of the skin islands ranged from 20 to 32 cm in length and 10 to 22 cm in width, and the vascularized Fascia Lata sheath measured 14 to 28 cm and 8 to 18 cm, respectively. Functional outcome of the abdominal wall strength and donor thigh morbidity were investigated by using a Cybex kinetic dynamometer. Results: All flaps survived. No postoperative ventral hernia occurred except for one mild inguinal incision hernia. Subjectively there were no significant donor site problems. Objective assessment was performed in 4 patients 2 years postoperatively. In the reconstructed abdomen, isokinetic concentric and eccentric measurements of extension/flexion ratios of the abdominal wall strength showed no apparent decrease compared with other references. Functional evaluation of quadriceps femoris muscle contraction forces after free ALT composite flap harvest showed an averaged deficit of 30% as compared with the contralateral legs. However, no difficulties in daily ambulating were reported by the patients. Conclusion: The free composite ALT myocutaneous flap with vascularized Fascia Lata provides an alternative option for a stable repair in complex abdominal wall defects.
Yurren Kuo - One of the best experts on this subject based on the ideXlab platform.
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versatility of the anterolateral thigh flap with vascularized Fascia Lata for reconstruction of complex soft tissue defects clinical experience and functional assessment of the donor site
2009Co-Authors: Yurren Kuo, Mingchung Yeh, Hsiangshun Shih, Chienchang Chen, Paoyuan Lin, Yuanchang Chiang, Sengfeng JengAbstract:Background: The anterolateral thigh flap is commonly used for reconstruction of various soft-tissue defects. This article presents the authors' approach to one-stage reconstruction of composite soft-tissue defects using an anterolateral thigh flap with a vascularized Fascia Lata. Methods: This retrospective review analyzed 973 patients who had undergone anterolateral thigh flap reconstruction for various soft-tissue defects over the past 10 years. Various types of complicated defects in 36 patients were reconstructed with a composite anterolateral thigh flap combined with vascularized Fascia Lata. The Fascia Lata component of the flap was used for abdominal wall and Fascial defect reconstruction in 12 patients, for lip-cheek defect reconstruction in 15 patients, for reconstruction of composite defects in extremities in nine patients, and for reconstruction of the perineum in one patient. Functional outcomes of donor sites were investigated by using a dynamometer. Results: All flaps except one survived. The overall flap survival rate was 97 percent. Patients achieved satisfactory results without major postoperative complications. The study revealed that vascularized Fascia may mimic a Fascial sheath but lacks the muscle-synchronized excursion properties. Apart from a mild deficiency in quadriceps femoris muscles contraction in the donor thighs, no difficulties in daily ambulation were reported by the patients. Conclusions: The anterolateral thigh flap with vascularized Fascia Lata provides a reliable Fascial component for single-stage reconstruction of complex softtissue defects.
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one stage reconstruction of large midline abdominal wall defects using a composite free anterolateral thigh flap with vascularized Fascia Lata
2004Co-Authors: Yurren Kuo, Meihui Kuo, Barbara S Lutz, Yuchi Huang, Yitien Liu, Kunchou Hsieh, Chinghua Hsien, Sengfeng JengAbstract:Objective: Large midline abdominal wall defects are continuously a challenge for reconstructive surgeons. Adequate skin coverage and Fascia repair of the abdominal wall is necessary for achieving acceptable results. The purpose of this paper is to present a new approach to abdominal wall reconstruction using a free vascularized composite anterolateral thigh (ALT) flap with Fascia Lata. Methods: Seven patients with large full-thickness abdominal wall defects were successfully reconstructed by means of a composite ALT flap combined with vascularized Fascia Lata. The size of the skin islands ranged from 20 to 32 cm in length and 10 to 22 cm in width, and the vascularized Fascia Lata sheath measured 14 to 28 cm and 8 to 18 cm, respectively. Functional outcome of the abdominal wall strength and donor thigh morbidity were investigated by using a Cybex kinetic dynamometer. Results: All flaps survived. No postoperative ventral hernia occurred except for one mild inguinal incision hernia. Subjectively there were no significant donor site problems. Objective assessment was performed in 4 patients 2 years postoperatively. In the reconstructed abdomen, isokinetic concentric and eccentric measurements of extension/flexion ratios of the abdominal wall strength showed no apparent decrease compared with other references. Functional evaluation of quadriceps femoris muscle contraction forces after free ALT composite flap harvest showed an averaged deficit of 30% as compared with the contralateral legs. However, no difficulties in daily ambulating were reported by the patients. Conclusion: The free composite ALT myocutaneous flap with vascularized Fascia Lata provides an alternative option for a stable repair in complex abdominal wall defects.
Michael Heit - One of the best experts on this subject based on the ideXlab platform.
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a randomized controlled trial comparing Fascia Lata and synthetic mesh for sacral colpopexy
2005Co-Authors: Patrick J Culligan, Linda Blackwell, Linda J Goldsmith, Carol A Graham, Aimee Rogers, Michael HeitAbstract:Objective:To compare the objective anatomic outcomes after sacral colpopexy performed with cadaveric Fascia Lata and polypropylene mesh.Methods:Patients undergoing a sacral colpopexy were randomized to receive either Fascia Lata or polypropylene mesh in a double-blinded fashion. Data were collected
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poor surgical outcomes after Fascia Lata allograft slings
2001Co-Authors: T M Soergel, Susan Shott, Michael HeitAbstract:The objective of this retrospective case control study was to determine whether our poor surgical outcomes were associated with the material used to construct our pubovaginal slings. Autologous rectus Fascia was used in 33 patients and cadaveric Fascia Lata was used in 12 patients who underwent pubovaginal sling placement for intrinsic urethral sphincter deficiency (ISD). Treatment was successful in 78.8% and 33.3% of patients who underwent rectus Fascia and Fascia Lata allograft slings, respectively (P=0.006). Based on regression analysis, the sling material was found to be strongly associated with surgical outcome after controlling for all confounding variables (β coefficient = 1204.6, P<0.00005). We conclude that Fascia Lata allografts are a poor choice for pubovaginal slings.
Sang Yeul Lee - One of the best experts on this subject based on the ideXlab platform.
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prediction of postoperative eyelid height after frontalis suspension using autogenous Fascia Lata for pediatric congenital ptosis
2012Co-Authors: Chang Yeom Kim, Jin Sook Yoon, Jongmyon Bae, Sang Yeul LeeAbstract:Purpose To predict eyelid height after frontalis suspension using autogenous Fascia Lata for congenital ptosis. Design Retrospective, observational case series. Methods Eighty eyes of 54 children who underwent frontalis suspension using autogenous Fascia Lata were included. The amount of intraoperative eyelid lift and the postoperative change in eyelid height were assessed 6 months after surgery by reviews of photographs and medical records. The amount of operative eyelid lift was measured from 2 different baselines, and each amount was compared with the amount of real change in eyelid height after surgery. The difference between those was measured. Results The postoperative eyelid height stabilized 3 months after surgery. The average amount of operative eyelid lift was 5.91 mm with anesthesia-induced lagophthalmos and 3.51 mm without. The amount of real change in eyelid height after surgery was 3.24 ± 1.14 mm. In less severe ptosis ( P = .002) and anesthesia-induced lagophthalmos ( P Conclusions Postoperative eyelid height may predicted be more accurately by compensating for anesthesia-induced lagophthalmos and adjusting the palpebral fissure to be larger than the desired eyelid height for patients with more severe ptosis.
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long term functional and cosmetic outcomes after frontalis suspension using autogenous Fascia Lata for pediatric congenital ptosis
2009Co-Authors: Jin Sook Yoon, Sang Yeul LeeAbstract:Objective To assess long-term functional and cosmetic outcomes after frontalis suspension using Fascia Lata autografts for congenital ptosis in Asian children. Design Retrospective, observational case series. Participants Two hundred thirty-nine patients who underwent frontalis suspension using Fascia Lata autografts from 1998 through 2006 with a minimum of 6 months of follow-up. Methods Functional success was assessed by review of photographs and medical charts. Cosmetic success was scored by objective analysis of photographs. Main Outcome Measures Functional success was defined as improvement of eyelid position above the pupillary margin without serious complications. Cosmetic outcomes were assessed in terms of lid contour, symmetry of height bilaterally, and lid crease and were categorized as excellent, good, or poor at 1 month and at 6 months after surgery. Results The follow-up time ranged from 6 to 144 months (median, 18 months). The functional success rates were 100% at 1 month after surgery and 94% at the last follow-up. In the early postoperative period, 96.7%, 91.6%, and 97.5% of patients showed excellent cosmetic success rates regarding lid contour, symmetry, and lid crease, respectively. However, these rates decreased to 85.4%, 65.7%, and 66.9% at 6 months after surgery, respectively ( P P Conclusions The use of Fascia Lata autografts for pediatric congenital ptosis resulted in high functional success rates in both the short-term and long-term. In contrast, whereas cosmetic success rates were high in the short-term, they decreased by 6 months after surgery. This deterioration in cosmetic outcome was the result of gradual elevation of lid height, medial inversion of eyelashes, and poor lid creases, possibly resulting from contracture of the grafted Fascia Lata and the anatomic characteristics of Asian eyelids. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Fred E Govier - One of the best experts on this subject based on the ideXlab platform.
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intermediate term failure of pubovaginal slings using cadaveric Fascia Lata a case series
2002Co-Authors: Keith J Oreilly, Fred E GovierAbstract:Purpose: The pubovaginal sling procedure using autologous Fascia has become the gold standard for treating intrinsic sphincter deficiency and stress urinary incontinence in women. A recent modification has been the use of cadaveric Fascia as the sling material. We recently reported similar results for cadaveric Fascia Lata in 121 women and autologous Fascia Lata in 46 at a mean followup of 12 months. We have now identified 8 patients who experienced intermediate term failure at 4 to 13 months using cadaveric Fascia Lata.Materials and Methods: We retrospectively reviewed the records of 8 of 121 patients who received a pubovaginal sling using cadaveric Fascia Lata between February 1997 and June 1999 and had recurrent stress incontinence after 4 to 13 months. We reviewed the type of Fascia, surgical technique, preoperative and postoperative urodynamics, surgical history and medical co-morbidities.Results: We identified 8 patients who underwent a pubovaginal sling using cadaveric Fascia Lata and had recurrent...
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cadaveric versus autologous Fascia Lata for the pubovaginal sling surgical outcome and patient satisfaction
2000Co-Authors: Scott L Brown, Fred E GovierAbstract:Purpose: We report our initial experience with cadaveric Fascia Lata in pubovaginal sling procedures.Materials and Methods: We compared 121 consecutive women who underwent a sling procedure using cadaveric Fascia Lata from February 1997 through June 1999 (group 1) with 46 consecutive women who underwent a sling procedure using autologous Fascia Lata from May 1994 through July 1997 (group 2).Results: Mean followup was longer in group 2 (44 versus 12 months). A total of 104 of the 121 group 1 patients (86%) responded to the questionnaire, of whom 85% were cured of stress incontinence, 83% reported overall improvement in urinary control and 74% had no or minimal leakage not requiring pads. Median catheterization time was 9 days (range 4 to 120). Overall 89% of the women were satisfied with the results and 83% would recommend this surgery. A total of 30 of the 46 group 2 patients (65%) responded to the questionnaire, of whom 90% were cured of stress incontinence, 90% reported overall improvement in urinary co...
