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Eui Cheol Jeong - One of the best experts on this subject based on the ideXlab platform.
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A dual padding method for ischial pressure sore reconstruction with an inferior gluteal artery perforator Fasciocutaneous Flap and a split inferior gluteus maximus muscle Flap.
Archives of plastic surgery, 2019Co-Authors: Gordon K. Lee, Saehoon Yoon, Eui Cheol JeongAbstract:BACKGROUND Various surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based Fasciocutaneous Flap and a muscle Flap is expected to resolve the disadvantages of previously introduced surgical methods. METHODS Fifteen patients with ischial pressure ulcers with chronic osteomyelitis or bursitis, who underwent reconstructive procedures with an inferior gluteal artery perforator (IGAP) Fasciocutaneous Flap and a split inferior gluteus maximus muscle Flap from January 2011 to June 2016, were analyzed retrospectively. The split muscle Flap was rotated to obliterate the deep ischial defect, managing the osteomyelitis or bursitis, and the IGAP Fasciocutaneous Flap was rotated or advanced to cover the superficial layer. The patients' age, sex, presence of bursitis or osteomyelitis, surgical details, complications, follow-up period, and ischial sore recurrence were reviewed. RESULTS All ischial pressure ulcers were successfully reconstructed without any Flap loss. The mean duration of follow-up was 12.9 months (range, 3-35 months). Of 15 patients, one had a recurrent ulcer 10 months postoperatively, which was repaired by re-advancing the previously elevated Fasciocutaneous Flap. CONCLUSIONS The dual-Flap procedure with an IGAP Fasciocutaneous Flap and split inferior gluteus maximus muscle Flap for ischial pressure ulcer reconstruction is a useful method that combines the useful characteristics of perforator and muscle Flaps, providing thick dual padding with sufficient vascularization while minimizing donor morbidity and vascular pedicle injury.
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a dual padding method for ischial pressure sore reconstruction with an inferior gluteal artery perforator Fasciocutaneous Flap and a split inferior gluteus maximus muscle Flap
Archives of Plastic Surgery, 2019Co-Authors: Inhoe Ku, Saehoon Yoon, Eui Cheol JeongAbstract:Background Various surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based Fasciocutaneous Flap and a muscle Flap is expected to resolve the disadvantages of previously introduced surgical methods.
Hemant S. Patankar - One of the best experts on this subject based on the ideXlab platform.
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Reverse sural Fasciocutaneous Flap with a cutaneous pedicle to cover distal lower limb soft tissue defects: experience of 109 clinical cases
Journal of Orthopaedics and Traumatology, 2014Co-Authors: Anoop C. Dhamangaonkar, Hemant S. PatankarAbstract:Background Soft tissue defects over the mid- and distal third tibia, heel, dorsum and plantar aspect of the foot and over the medial, lateral and posterior aspect of the ankle are a common scenario in clinical orthopaedic practice. In this article, we describe the utility of the reverse sural Fasciocutaneous Flap with a cutaneous pedicle in 109 clinical cases with distal lower limb soft tissue defects. Materials and methods A total of 109 patients were operated on for moderate (5–15 cm) and large (more than 15 cm) soft tissue defects at various sites along the lower limb including foot, heel and sole with the reverse sural Fasciocutaneous Flap. The defects were secondary to trauma (61 cases), diabetic ulcers (12 cases), post-traumatic scar contracture (8 cases), venous ulcer (4 cases), wound dehiscence (10 cases), leprotic non-healing ulcer (1 case), post-infective wound (1 case), radiation-induced ulcer following radiotherapy for synovial cell sarcoma (1 case), post-fibromatosis excision (1 case), post-dermatofibrosarcoma excision (1 case), post-heel melanoma excision (1 case) and actinomycosis foot (1 case). Patients were assessed for Flap uptake and healing of defects. Results Among the 102 cases analysed, 81 were male and 21 female with an average age of 32.7 years. The average size of the Flaps was 148.10 ± 59.54 cm^2. The Flap healed uneventfully in 89.21 % of patients. Edge necrosis occurred in 9 cases. Donor site regrafting was required in 7 patients. Conclusion The reverse sural Fasciocutaneous Flap with a cutaneous pedicle is a quick, versatile, easy and safe soft tissue defect coverage technique to cover most of the soft tissue defects of the lower limb in common orthopaedic practice and does not require any microvascular repair, though it may be cosmetically unappealing in a few cases. Level of evidence IV (Case series)
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reverse sural Fasciocutaneous Flap with a cutaneous pedicle to cover distal lower limb soft tissue defects experience of 109 clinical cases
Journal of Orthopaedics and Traumatology, 2014Co-Authors: Anoop C. Dhamangaonkar, Hemant S. PatankarAbstract:Background Soft tissue defects over the mid- and distal third tibia, heel, dorsum and plantar aspect of the foot and over the medial, lateral and posterior aspect of the ankle are a common scenario in clinical orthopaedic practice. In this article, we describe the utility of the reverse sural Fasciocutaneous Flap with a cutaneous pedicle in 109 clinical cases with distal lower limb soft tissue defects.
Feng Zhang - One of the best experts on this subject based on the ideXlab platform.
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modified distally based sural neuro veno Fasciocutaneous Flap anatomical study and clinical applications
Microsurgery, 2005Co-Authors: Fahui Zhang, Shimin Chang, M Songqing D Lin, M Yiping D Song, Heping Zheng, C William M D Lineaweaver, Feng ZhangAbstract:The distally based sural neuro-veno-Fasciocutaneous Flap has been used widely for reconstruction of foot and ankle soft-tissue defects. The distal pivot point of the Flap is designed at the lowest septocutaneous perforator from the peroneal artery of the posterolateral septum, which is, on average, 5 cm (4-7 cm) above the lateral malleolus. A longer neuro-veno-adipofascial pedicle would be needed to reversely reach the distal foot defect when the Flap is dissected based on this perforating branch, which may result in more trauma in Flap elevation and morbidity of the donor site. In this article, we explored new pivot points for this distally based Flap in an anatomic study of 30 fresh cadavers. The results showed that the peroneal artery terminates into two branches: the posterior lateral malleolus artery and lateral calcaneal artery. These two branches also send off cutaneous perforators at about 3 and 1 cm above the tip of lateral malleolus, respectively, which can be used as arterial pivot points for the Flap. A communicating branch between the lesser saphenous vein and the peroneal venae comitantes was found, accompanied by the perforator of the posterior lateral malleolus artery. This modified, distally based sural Flap with lower pivot points was successfully transferred for repair of soft-tissue defects in 21 patients. The size of Flaps ranged from 4 x 3 cm to 18 x 12 cm. All Flaps survived without complications. Neither arterial ischemia nor venous congestion was noted. In conclusion, the vascular pivot point of a distally based sural Flap can be safely designed at 1.5 cm proximal to the tip of the lateral malleolus. This modified Flap provides a valuable tool for repair of foot and ankle soft-tissue defects.
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Microsurgical anterolateral thigh Fasciocutaneous Flap for facial contour correction in patients with hemifacial microsomia.
Microsurgery, 2002Co-Authors: Susan Shamburger, William C. Lineaweaver, Ji Jin, Feng ZhangAbstract:The correction of facial asymmetry in complex hemifacial microsomia presents a challenging problem for reconstructive surgeons. Numerous microsurgical Flaps have been introduced for reconstruction of facial asymmetry. This article reports our experience in facial soft tissue reconstruction with microsurgical anterolateral thigh Fasciocutaneous Flap transfer in six patients with hemifacial microsomia. This Flap, which has a reliable vascular pedicle and relatively thin pliable soft tissue, can provide an ideal treatment for facial asymmetry in hemifacial microsomia.
Anoop C. Dhamangaonkar - One of the best experts on this subject based on the ideXlab platform.
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Reverse sural Fasciocutaneous Flap with a cutaneous pedicle to cover distal lower limb soft tissue defects: experience of 109 clinical cases
Journal of Orthopaedics and Traumatology, 2014Co-Authors: Anoop C. Dhamangaonkar, Hemant S. PatankarAbstract:Background Soft tissue defects over the mid- and distal third tibia, heel, dorsum and plantar aspect of the foot and over the medial, lateral and posterior aspect of the ankle are a common scenario in clinical orthopaedic practice. In this article, we describe the utility of the reverse sural Fasciocutaneous Flap with a cutaneous pedicle in 109 clinical cases with distal lower limb soft tissue defects. Materials and methods A total of 109 patients were operated on for moderate (5–15 cm) and large (more than 15 cm) soft tissue defects at various sites along the lower limb including foot, heel and sole with the reverse sural Fasciocutaneous Flap. The defects were secondary to trauma (61 cases), diabetic ulcers (12 cases), post-traumatic scar contracture (8 cases), venous ulcer (4 cases), wound dehiscence (10 cases), leprotic non-healing ulcer (1 case), post-infective wound (1 case), radiation-induced ulcer following radiotherapy for synovial cell sarcoma (1 case), post-fibromatosis excision (1 case), post-dermatofibrosarcoma excision (1 case), post-heel melanoma excision (1 case) and actinomycosis foot (1 case). Patients were assessed for Flap uptake and healing of defects. Results Among the 102 cases analysed, 81 were male and 21 female with an average age of 32.7 years. The average size of the Flaps was 148.10 ± 59.54 cm^2. The Flap healed uneventfully in 89.21 % of patients. Edge necrosis occurred in 9 cases. Donor site regrafting was required in 7 patients. Conclusion The reverse sural Fasciocutaneous Flap with a cutaneous pedicle is a quick, versatile, easy and safe soft tissue defect coverage technique to cover most of the soft tissue defects of the lower limb in common orthopaedic practice and does not require any microvascular repair, though it may be cosmetically unappealing in a few cases. Level of evidence IV (Case series)
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reverse sural Fasciocutaneous Flap with a cutaneous pedicle to cover distal lower limb soft tissue defects experience of 109 clinical cases
Journal of Orthopaedics and Traumatology, 2014Co-Authors: Anoop C. Dhamangaonkar, Hemant S. PatankarAbstract:Background Soft tissue defects over the mid- and distal third tibia, heel, dorsum and plantar aspect of the foot and over the medial, lateral and posterior aspect of the ankle are a common scenario in clinical orthopaedic practice. In this article, we describe the utility of the reverse sural Fasciocutaneous Flap with a cutaneous pedicle in 109 clinical cases with distal lower limb soft tissue defects.
Saehoon Yoon - One of the best experts on this subject based on the ideXlab platform.
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A dual padding method for ischial pressure sore reconstruction with an inferior gluteal artery perforator Fasciocutaneous Flap and a split inferior gluteus maximus muscle Flap.
Archives of plastic surgery, 2019Co-Authors: Gordon K. Lee, Saehoon Yoon, Eui Cheol JeongAbstract:BACKGROUND Various surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based Fasciocutaneous Flap and a muscle Flap is expected to resolve the disadvantages of previously introduced surgical methods. METHODS Fifteen patients with ischial pressure ulcers with chronic osteomyelitis or bursitis, who underwent reconstructive procedures with an inferior gluteal artery perforator (IGAP) Fasciocutaneous Flap and a split inferior gluteus maximus muscle Flap from January 2011 to June 2016, were analyzed retrospectively. The split muscle Flap was rotated to obliterate the deep ischial defect, managing the osteomyelitis or bursitis, and the IGAP Fasciocutaneous Flap was rotated or advanced to cover the superficial layer. The patients' age, sex, presence of bursitis or osteomyelitis, surgical details, complications, follow-up period, and ischial sore recurrence were reviewed. RESULTS All ischial pressure ulcers were successfully reconstructed without any Flap loss. The mean duration of follow-up was 12.9 months (range, 3-35 months). Of 15 patients, one had a recurrent ulcer 10 months postoperatively, which was repaired by re-advancing the previously elevated Fasciocutaneous Flap. CONCLUSIONS The dual-Flap procedure with an IGAP Fasciocutaneous Flap and split inferior gluteus maximus muscle Flap for ischial pressure ulcer reconstruction is a useful method that combines the useful characteristics of perforator and muscle Flaps, providing thick dual padding with sufficient vascularization while minimizing donor morbidity and vascular pedicle injury.
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a dual padding method for ischial pressure sore reconstruction with an inferior gluteal artery perforator Fasciocutaneous Flap and a split inferior gluteus maximus muscle Flap
Archives of Plastic Surgery, 2019Co-Authors: Inhoe Ku, Saehoon Yoon, Eui Cheol JeongAbstract:Background Various surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based Fasciocutaneous Flap and a muscle Flap is expected to resolve the disadvantages of previously introduced surgical methods.
