Lower Extremity Reconstruction with Free Gracilis Flaps.
Research article published in Journal of reconstructive microsurgery (2016)
Abstract
Background There have been significant advancements in lower extremity reconstruction over the last several decades, and the plastic surgeon's armamentarium has grown to include free muscle and fasciocutaneous flaps along with local perforator and propeller flaps. While we have found a use for a variety of techniques for lower extremity reconstruction, the free gracilis has been our workhorse flap due to the ease of harvest, reliability, and low donor site morbidity. Methods This is a retrospective review of a single surgeon's series of free gracilis flaps utilized for lower extremity reconstruction. Demographic information, comorbidities, outcomes, and secondary procedures were analyzed. Results We identified 24 free gracilis flaps. The duration from injury to free flap coverage was ≤ 7 days in 6 patients, 8-30 days in 11 patients, 31-90 days in 4 patients, and > 90 days in 3 patients. There were 22 (92%) successful flaps and an overall limb salvage rate of 92%. There was one partial flap loss. Two flaps underwent incision and drainage in the operating room for infection. Two patients developed donor site hematomas. Four patients underwent secondary procedures for contouring. Our subset of pediatric patients had 100% flap survival and no secondary procedures at a mean 30-month follow-up. Conclusion This study demonstrates the utility of the free gracilis flap in reconstruction of small- to medium-sized defects of the lower extremity. This flap has a high success rate and a low donor site morbidity. Atrophy of the denervated muscle over time allows for good shoe fit, often obviating the need for secondary contouring procedures.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
There have been significant advancements in lower extremity reconstruction over the last several decades, and the plastic surgeon's armamentarium has grown to include free muscle and fasciocutaneous flaps along with local perforator and propeller flaps. While we have found a use for a variety of...
Почему это важно для гирудотерапии
В ретроспективном обзоре одного хирурга, охватывающем 24 свободных лоскута из мышцы gracilis для реконструкции нижних конечностей, сообщается о 92% приживаемости лоскутов и 92% частоте спасения конечности при низкой донорской заболеваемости. Отношение к ASH в лучшем случае косвенное: реконструкция нижней конечности свободным лоскутом — это хирургический контекст, где медицинские пиявки иногда применяют как вспомогательное средство при венозном застое в compromised flaps. Однако в статье не упоминаются пиявки, гирудотерапия, венозный застой или вспомогательные методы спасения лоскута. Исследование не предоставляет данных о лечении пиявками как таковом, и связь ограничена общим клиническим контекстом, в котором гирудотерапия может эпизодически применяться.
Цитирование
Lower Extremity Reconstruction with Free Gracilis Flaps.
Franco et al. · Journal of reconstructive microsurgery, 2016
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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