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Tissue Defects (tissue + defect)

Distribution by Scientific Domains

Medical Sciences	94%

Kinds of Tissue Defects

soft tissue defect

Selected Abstracts

Rupture of chordae tendineae in patients with ,-thalassemia

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 4 2004
Dimitrios Farmakis
Abstract: Cardiac disease is the primary cause of mortality in , -thalassemia patients. Except for ventricular dysfunction and pulmonary hypertension that represent the main forms of heart disease in these patients, valvular abnormalities including valvular regurgitation, endocardial thickening and calcification and mitral valve prolapse have also been described. Here we present two patients with thalassemia major and mitral chordal rupture, a previously undescribed abnormality in this population. Pathogenesis of this finding may involve thalassemia-related pseudoxanthoma elasticum-like syndrome, a diffuse elastic tissue defect, which is observed with a notable frequency in these patients and has been associated with numerous cardiovascular complications, including valvular ones. [source]

Wound conditioning of a deep tissue defect including exposed bone after tumour excision using PROMOGRAN* Matrix, a protease-modulating matrix

INTERNATIONAL WOUND JOURNAL, Issue 3 2005
Article first published online: 7 SEP 200
Conditionnement d'une plaie créant un défect tissulaire exposant l'os après excision tumorale par Matrice de PROMOGRAN, une matrice modulant les protéases. L'étude d'un cas clinique rapportant le succès thérapeutique sur un patient atteint d'un carcinome baso-cellulaire est relatée. Du fait d'une infiltration cancéreuse profonde, une excision large incluant la résection du tissu osseux, était nécessaire. .Le défect tissulaire profond a été traité par Matrice PROMOGRAN, une matrice modulant les protéases, pour promouvoir le tissu de bourgeonnement et s'assurer que la peau greffée prenne de façon normale. Dans le cas clinique décrit ici, un rapide développement du tissu de bourgeonnement sur la surface osseuse exposée a été observée. Les bénéfices de ce type de pansement ont permis à la greffe de peau d'épaisseur partielle de prendre rapidement et d'aboutir à un résultat satisfaisant sur le plan esthétique et fonctionnel. Wundkonditionierung eines tiefen Gewebedefekts mit freiliegenden Knochen nach Tumorentfernung durch Anwendung einer Promogron Matrix- einer proteasenmodulierenden Matrix Berichtet wird eine Fallstudie nach erfolgreicher Behandlung eines Patienten mit Basalzellcarcinom. Aufgrund der ausgedehnten Tumorinfiltration war eine ausgedehnte Excision des Gewebes unter Einschluss von Knochengewebe erforderlich. Der Tiefe Gewebedefekt wurde mit Promogran, einer proteasemodulierenden Matrix behandelt, um die Granulation zu fördern und eine erfolgreiche Hautransplantation anzuschließen. In dem berichteten Fall konnte eine rasche Ausbildung von Granulationsgewebe auf der Knochenoberfläche beobachtet werden. Dadurch war eine erfolgreiche Spalthauttransplantation mit einem sehr guten ästhetischen und funktionalen Ergebnis möglich. Decorso di una ferita con difetto tessutale profondo, incluso l'esposizione di tessuto osseo dopo escissione di un tumore, dopo utilizzo della matrice Promogran®, una matrice che modula le proteasi. Viene messo in risalto un caso clinico di un paziente trattato con successo per un carcinoma basocellulare. Dal momento che il carcinoma era infiltrato in profondità, è stata necessaria una escissione molto ampia che includesse la rimozione di tessuto osseo. La profonda soluzione di continuo che si è creata è stata trattata con la matrice Promogran®, una matrice che modula le metalloproteasi, per promuovere il tessuto di granulazione ed assicurare che la cute trapiantata avesse buon attecchimento. In questo caso è stato osservato un rapido sviluppo di tessuto di granulazione sulla parte esposta dell'osso. I vantaggi della medicazione hanno consentito l'applicazione di un innesto a spessore parziale che ha portato ad un risultato funzionale ed estetico molto buoni. Acondicionamiento de la herida de un defecto tisular profundo, incluyendo hueso expuesto, tras la escisión de un tumor mediante la matriz PROMOGRAN*, una matriz moduladora de proteasas Se presenta el estudio de un caso informando sobre el tratamiento satisfactorio de un paciente afecto de un carcinoma basocelular. Dado que el carcinoma había causado una infiltración profunda, fue necesario practicar una escisión amplia incluyendo la extirpación de tejido óseo. El defecto tisular profundo fue tratado con la matriz PROMOGRAN*, una matriz moduladora de proteasas, para fomentar la granulación y asegurar que la piel transplantada actuara con éxito. En el estudio de este caso se observó un rápido desarrollo de tejido de granulación sobre la superficie ósea expuesta. Los beneficios del apósito permitieron la realización de un injerto de piel laminar satisfactorio que proporcionó muy buenos resultados estéticos y funcionales. Sårbetingning vid djup vävnadsskada med blottställt ben efter tumör excision, med hjälp av PROMOGRAN* Matrix, ett proteas-modulerande matrix En fallstudie som rapporterar lyckad behandling av en patient med basalcellcancer framställs. En omfattande excision, som inkluderar avlägsnandet av benvävnad, var nödvändig emedan cancern hade infiltrerat djupt. Den djupa vävnadsskadan behandlades med PROMOGRAN* Matrix, ett protease-modulerande matrix, för att befrämja granulation och för att säkerställa lyckad inläkning av hudtransplantatet. I denna fallstudie iakttogs en snabb uppkomst av granulationsvävnad på den blottställda benytan. Den fördelaktiga effekten av sårförbandet möjliggjorde en lyckad ,split-thickness' hudtransplantation med mycket gott estetiskt och funktionellt resultat. [source]

Wound conditioning of a deep tissue defect including exposed bone after tumour excision using PROMOGRAN* Matrix, a protease-modulating matrix

INTERNATIONAL WOUND JOURNAL, Issue 3 2005
Anne-Kathrin Tausche MD
Abstract A case study reporting on the successful treatment of a patient affected by a basal cell carcinoma is submitted. Because the carcinoma had infiltrated deeply, a wide excision was necessary, including the removal of bone tissue. The deep tissue defect was treated with PROMOGRAN* Matrix, a protease-modulating matrix, to promote granulation and ensure that the skin graft do survive and heal successfully. In this case study, a rapid development of granulation tissue on the exposed surface of the bone was observed. The benefits of the dressing enabled a successful split-thickness skin grafting to be carried out which gave very good aesthetic and functional results. [source]

Face resurfacing using a cervicothoracic skin flap prefabricated by lateral thigh fascial flap and tissue expander

MICROSURGERY, Issue 7 2009
Ph.D., Qingfeng Li M.D.
Background: Resurfacing of facial massive soft tissue defect is a formidable challenge because of the unique character of the region and the limitation of well-matched donor site. In this report, we introduce a technique for using the prefabricated cervicothoracic skin flap for facial resurfacing, in an attempt to meet the principle of flap selection in face reconstructive surgery for matching the color and texture, large dimension, and thinner thickness (MLT) of the recipient. Materials: Eleven patients with massive facial scars underwent resurfacing procedures with prefabricated cervicothoracic flaps. The vasculature of the lateral thigh fascial flap, including the descending branch of the lateral femoral circumflex vessels and the surrounding muscle fascia, was used as the vascular carrier, and the pedicles of the fascial flap were anastomosed to either the superior thyroid or facial vessels in flap prefabrication. A tissue expander was placed beneath the fascial flap to enlarge the size and reduce the thickness of the flap. Results: The average size of the harvested fascia flap was 6.5 × 11.7 cm. After a mean interval of 21.5 weeks, the expanders were filled to a mean volume of 1,685 ml. The sizes of the prefabricated skin flaps ranged from 12 × 15 cm to 15 × 32 cm. The prefabricated skin flaps were then transferred to the recipient site as pedicled flaps for facial resurfacing. All facial soft tissue defects were successfully covered by the flaps. The donor sites were primarily closed and healed without complications. Although varied degrees of venous congestion were developed after flap transfers, the marginal necrosis only occurred in two cases. The results in follow-up showed most resurfaced faces restored natural contour and regained emotional expression. Conclusion: MLT is the principle for flap selection in resurfacing of the massive facial soft tissue defect. Our experience in this series of patients demonstrated that the prefabricated cervicothoracic skin flap could be a reliable alternative tool for resurfacing of massive facial soft tissue defects. © 2009 Wiley-Liss, Inc. Microsurgery, 2009. [source]

Spontaneous cecum perforation following rectus abdominis free flap transfer for isolated lower limb trauma

MICROSURGERY, Issue 3 2009
Ch.B., Roger J. G. Stevens M.Sc.
A case of a 32-year-old motorcyclist, who sustained an open comminuted fracture of the left tibia and subsequently developed spontaneous cecal perforation following successful fixation of the fracture and reconstruction of the soft tissue defect with a rectus abdominis free flap, is reported. Although benign cecal perforation has been described in patients with thermal burns and blunt trauma of the abdomen or pelvis, our association has not been reported previously in the medical literature. It is important to recognize cecal perforation early as it is associated with a high mortality from peritonitis and septicaemia. © 2009 Wiley-Liss, Inc. Microsurgery, 2009. [source]

Anatomic basis of perforator flaps of medial vastus muscle

MICROSURGERY, Issue 1 2008
Heping Zheng Ph.D.
The purpose of this study was to elucidate anatomical features of perforating branch flaps based on the muscular branches of the medial vastus muscle and to seek a new, applicable technique that could be used in repairing soft tissue defects around human knees. In this study, the origin, the course, the branches, the distribution, and the distal anastomosis of the muscular branch of the medial vastus muscle were observed in 30 sides of adult cadaveric lower limb specimens with the adductor tubercle, the patella midpoint, and the inguinal ligament midpoint as the observation markers. The specimens had been perfused arterially with red gelatin before they were supplied. It was observed that the femoral artery gave constant muscular branches into the medial vastus muscle at the tip of the femoral triangle. The artery entered the muscle via the hilum and ran laterally downwards along the muscular bundle until it reached the lateral patella to anastomose with the arterial circle around the bone. Along its course, it also gave 1,3 (1/77%) musculocutaneous perforating branches (0.5,0.9 mm in diameter). It then extended vertically through the medial vastus muscle into the deep fascia and ran superficially to the overlying skin of the muscle. A flap based on the perforating branch of the medial vastus muscle could be harvested at a size of about 8.5 cm × 15.0 cm and might be transferred retrograde to repair the soft tissue defect around the knee. © 2007 Wiley-Liss, Inc. Microsurgery, 2008. [source]

Anatomic study and clinical application of distally-based neuro-myocutaneous compound flaps in the leg

MICROSURGERY, Issue 6 2007
Ai-Xi Yu M.D., Ph.D.
Objective: Anatomical study on the anastomosis between the neurovascular axis and the musculocutaneous perforators in leg. The distally-based neuron-myocutaneous flap was used for repairing special patients with soft tissue defect in foot and ankle. Methods: Systematical observation was carried out on 30 injected lower legs about the anastomosis between the neurovascular axis and the musculocutaneous perforators, and we summarized the clinical experiences from February 2004 on 12 cases using distally-based neuron-myocutaneous flap for repairing special patients with soft tissue defect in foot and ankle. Results: The neuron-vessels of sural nerve anastomosed permanently with the musculocutaneous perforators of medial and lateral head of gastrocnemius. There were two to three anastomoses found, respectively. The medial anastomotic branches were found larger in caliber than the lateral ones. The spatium intermuscular branches of the posterior tibial artery gave off their junior branches and anastomosed with the vessels in or out of the soleus muscle. There were two to three muscular branches perforated out of the soleus muscle, with mean caliber 0.5 ± 0.2 mm and accompanying with one to two veins. The neuron-vessels of the superficial fibular nerve gave off alone its course two to three muscular branches to the long extensor muscle digits and the long fibular muscle, and one to two fasciocutaneous to the skin. The diameter of the muscular branches was 0.4 ± 0.2 mm in average. Accounting for the operating models in the 12 cases, we had distally-based sural neuron-myocutaneous flap in 7 cases, saphenous neuron-myocutaneous flap in 4 cases, and superficial fibular neuron-myocutaneous flap in 1 case. All these cases were followed up at least for 2,6 months and had the significant results of nice limb's shape and cured osteomyelitis. Conclusion: Distally-based neuro-myocutaneous flap in leg can live with reliable blood circulation. These flaps offer excellent donor sites for repairing special the soft tissue defect in foot and ankle. © 2007 Wiley-Liss, Inc. Microsurgery, 2007. [source]

Aesthetic reconstruction of thumb or finger partial defect with trimmed toe-flap transfer

MICROSURGERY, Issue 2 2007
Guoliang Cheng M.D.
A new concept of esthetic reconstruction for partial loss of distal finger segment was introduced. In a series of 77 patients, 80 thumb or finger partial defects of lateral, dorsal, or volar half, or composite tissue defect of the finger body were reconstructed with lateral skin-nail flap, dorsal skin-nail flap, pulp flap, or composite tissue transplant taken from corresponding part of the toes. The blood circulations were reestablished by anastomosing digit arteries of the toe transplants and fingers. Seventy-eight fingers in 75 patients of this series were successfully reconstructed. The overall survival rate was 97.5%. Follow-up examinations made half to 12 years postoperatively showed normal length, outward appearance, and function of the reconstructed digits. Their nails are preserved or reconstructed. The pulps are full. Sweating is present. 2-PD was 4,6 mm. Esthetic reconstruction can achieve the goal of mending any part of tissue loss precisely with good result. © 2007 Wiley-Liss, Inc. Microsurgery, 2007. [source]

Primary oromandibular reconstruction using free flaps and thorp plates in cancer patients: A 5-year experience,

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 1 2003
Tito Poli MD
Abstract Background. Low-profile second-generation THORP titanium plates combined with soft tissues free flaps (forearm or TRAM) can be used for oromandibular reconstruction in patients with SCC in advanced stage (stage III,IV). Methods. To evaluate long-term stability and possible complications of this reconstructive technique, we recorded, retrospectively, data of 25 patients with posterolateral oromandibular defects after tumor resection collected during a 5-year period. Results. All free flaps were successfully transferred, although eight patients were initially seen with delayed hardware-related reconstructive complications: plate exposure in four patients and plate fracture in four patients. Conclusions. Nowadays, the state-of-the-art treatment for mandibular defects is primary bone reconstruction with bone free flaps, but in selected cases (elderly patients, poor performance status, posterolateral oromandibular defects, soft tissue defects much more important than bone defects) the association with THORP plate-soft tissue free flaps represents a good reconstructive choice. © 2002 Wiley Periodicals, Inc. Head Neck 24: 000,000, 2002 [source]

Functional reconstruction of the lateral face after ablative tumor resection: Use of free muscle and musculocutaneous flaps

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2001
Tugrul Maral MD
Abstract Background Wide resection of tumors of the middle third of the face often results in complex three-dimensional defects and facial paralysis either due to removal of the facial nerve within the tumoral tissue or to extensive resection of the facial muscles. Methods We report the cases of three patients who underwent wide excision of tumors of the cheek region, operations that resulted in tissue defects and facial palsy. Defect reconstruction and facial reanimation was accomplished in one stage through functional muscle transplantation. Results Follow-up of more than 1 year showed good symmetry at rest and reanimation of the corner of the mouth in all cases, but one patient, in which the ipsilateral facial main trunk was used as motor nerve supply to the transplanted muscle, developed significant muscle contracture and binding of the cheek skin. Conclusions Every effort should be made to optimize the functional and cosmetic outcomes of neurovascular muscle transfers through precise planning and careful execution of the intricate details of the surgical technique for muscle transplantation. © 2001 John Wiley & Sons, Inc. Head Neck 23: 836,843, 2001. [source]

Mesenchymal stem cell interaction with a non-woven hyaluronan-based scaffold suitable for tissue repair

JOURNAL OF ANATOMY, Issue 5 2008
G. Pasquinelli
Summary The fabrication of biodegradable 3-D scaffolds enriched with multipotent stem cells seems to be a promising strategy for the repair of irreversibly injured tissues. The fine mechanisms of the interaction of rat mesenchymal stem cells (rMSCs) with a hyaluronan-based scaffold, i.e. HYAFF®11, were investigated to evaluate the potential clinical application of this kind of engineered construct. rMSCs were seeded (2 × 106 cells cm,2) on the scaffold, cultured up to 21 days and analysed using appropriate techniques. Light (LM), scanning (SEM) and transmission (TEM) electron microscopy of untreated scaffold samples showed that scaffolds have a highly porous structure and are composed of 15-µm-thick microfibres having a rough surface. As detected by trypan blue stain, cell adhesion was high at day 1. rMSCs were viable up to 14 days as shown by CFDA assay and proliferated steadily on the scaffold as revealed by MTT assay. LM showed rMSCs in the innermost portions of the scaffold at day 3. SEM revealed a subconfluent cell monolayer covering 40 ± 10% of the scaffold surface at day 21. TEM of early culture showed rMSCs wrapping individual fibres with regularly spaced focal contacts, whereas confocal microscopy showed polarized expression of CD44 hyaluronan receptor; TEM of 14-day cultures evidenced fibronexus formation. Immunohistochemistry of 21-day cultures showed that fibronectin was the main matrix protein secreted in the extracellular space; decorin and versican were seen in the cell cytoplasm only and type IV collagen was minimally expressed. The expression of CD90, a marker of mesenchymal stemness, was found unaffected at the end of cell culture. Our results show that HYAFF®11 scaffolds support the adhesion, migration and proliferation of rMSCs, as well as the synthesis and delivery of extracellular matrix components under static culture conditions without any chemical induction. The high retention rate and viability of the seeded cells as well as their fine modality of interaction with the substrate suggest that such scaffolds could be potentially useful when wide tissue defects are to be repaired as in the case of cartilage repair, wound healing and large vessel replacement. [source]

Starch,poly(,-caprolactone) and starch,poly(lactic acid) fibre-mesh scaffolds for bone tissue engineering applications: structure, mechanical properties and degradation behaviour

JOURNAL OF TISSUE ENGINEERING AND REGENERATIVE MEDICINE, Issue 5 2008
M. E. Gomes
Abstract In scaffold-based tissue engineering strategies, the successful regeneration of tissues from matrix-producing connective tissue cells or anchorage-dependent cells (e.g. osteoblasts) relies on the use of a suitable scaffold. This study describes the development and characterization of SPCL (starch with ,-polycaprolactone, 30:70%) and SPLA [starch with poly(lactic acid), 30:70%] fibre-meshes, aimed at application in bone tissue-engineering strategies. Scaffolds based on SPCL and SPLA were prepared from fibres obtained by melt-spinning by a fibre-bonding process. The porosity of the scaffolds was characterized by microcomputerized tomography (µCT) and scanning electron microscopy (SEM). Scaffold degradation behaviour was assessed in solutions containing hydrolytic enzymes (,-amylase and lipase) in physiological concentrations, in order to simulate in vivo conditions. Mechanical properties were also evaluated in compression tests. The results show that these scaffolds exhibit adequate porosity and mechanical properties to support cell adhesion and proliferation and also tissue ingrowth upon implantation of the construct. The results of the degradation studies showed that these starch-based scaffolds are susceptible to enzymatic degradation, as detected by increased weight loss (within 2 weeks, weight loss in the SPCL samples reached 20%). With increasing degradation time, the diameter of the SPCL and SPLA fibres decreases significantly, increasing the porosity and consequently the available space for cells and tissue ingrowth during implantation time. These results, in combination with previous cell culture studies showing the ability of these scaffolds to induce cell adhesion and proliferation, clearly demonstrate the potential of these scaffolds to be used in tissue engineering strategies to regenerate bone tissue defects. Copyright © 2008 John Wiley & Sons, Ltd. [source]

The bipedicled latissimus dorsi myocutaneous free flap: Clinical experience with 53 patients

MICROSURGERY, Issue 3 2010
Mehmet Veli Karaaltin M.D.
The Latissimus dorsi musculocutaneous flap is a valuable workhorse of the microsurgeon, especially in closing large body defects. One of the pitfalls in harvesting the flap, is particularly in its inferior aspect which may be unreliable. Here we report a series of 53 patients who were undergone bipedicled free latissimus dorsi musculocutaneous free flaps for extensive tissue defects. The age of patients were between 5 and 64 and all of them were males. The wound sizes in these patients ranged between 31,35 × 10,12 cm and flap dimensions were between 38,48 × 6,8 cm. Perforator branches of the 10th intercostal vessels were dissected and supercharged to the flaps to reduce the risk of ischemia of the inferior cutaneous extensions. The secondary pedicles were anastomosed to recipient vessels other than the primary pedicles. Recipient areas were consisted of lower extremities. Four patients suffered of early arterial failure in the major pedicle and all revisions were successfully attempted. Neither sign of venous congestion nor arterial insufficiency were observed at the inferior cutaneous extensions of the flaps, and all defects were reconstructed successfully. All donor sites were primarily closed, only two patients suffered from a minor area of superficial epidermal loss at the donor site, without suffering any adjunct complications. In conclusion coverage of large defects can be safely performed with extending the skin paddle of latissimus dorsi flap as a bipedicled free flap. © 2009 Wiley-Liss, Inc. Microsurgery, 2010. [source]

Face resurfacing using a cervicothoracic skin flap prefabricated by lateral thigh fascial flap and tissue expander

The distal superficial femoral arterial branch to the sartorius muscle as a recipient vessel for soft tissue defects around the knee: Anatomic study and clinical applications

MICROSURGERY, Issue 6 2009
Fernando A. Herrera M.D.
Complex wounds surrounding the knee and proximal tibia pose a significant challenge for the reconstructive surgeon. Most of these defects can be managed using local or regional flaps alone. However, large defects with a wide zone of injury frequently require microvascular tissue transfers to aid in soft tissue coverage and closure of large cavities. We describe a unique recipient vessel for microvascular anastomosis for free flap reconstruction involving the knee and proximal tibia through anatomic and clinical studies. © 2009 Wiley-Liss, Inc. Microsurgery 2009. [source]

The thoracodorsal vascular tree-based combined fascial flaps

MICROSURGERY, Issue 2 2009
Meisei Takeishi M.D.
In this study, combined fascial flaps pedicled on the thoracodorsal artery and vein were raised and used for thin coverage of dorsal surfaces of the fingers and the dorsum of hand and foot with favorable results. The combined fascial flaps consist of the serratus anterior fascia and the axillary fascia at the entrance of the latissimus dorsi. These flaps were used for reconstruction of the hand, fingers, or foot in nine patients. Reconstruction was performed for burn or burn scar contracture, after resection of malignant tumors, posttraumatic skin defects, and chronic regional pain syndrome. The sites of reconstruction were dorsal surfaces of fingers, dorsum of hand, wrist and palm, forearm, lower leg, and foot. The flaps were used in various configurations including two independent fascial flaps, two-lobed fascial flap with separate feeding vessels, and composite fascial and thoracodorsal artery perforator flap. The fascial and skin flaps survived in all nine patients, with favorable results both functionally and esthetically. Good coverage of soft tissue defects and good recovery of range of motion in resurfaced joints were achieved. There were no complications. The scars at the sites of harvest were not noticeable. The advantage of this method is that not only a single flap but flaps of a variety of configurations can be harvested for different purposes. The thoracodorsal vascular tree-based combined fascial flaps are useful for the reconstruction of soft tissue defects in the extremities. © 2008 Wiley-Liss, Inc. Microsurgery, 2009. [source]

Peroneal artery perforator-based propeller flap reconstruction of the lateral distal lower extremity after tumor extirpation: Case report and literature review

MICROSURGERY, Issue 8 2008
Ariel N. Rad M.D.
Background: Soft tissue defects in the distal lower extremity present a formidable challenge due to the lack of reliable local flap options. Pedicled adipofasciocutaneous flaps provide the closest match to local tissues, but random pattern flaps are limited in reliability, size, reach, and arc-of-rotation. One hundred and eighty degree perforator-based propeller flaps are an innovative option because they provide robust axial perfusion to flaps with significantly greater surface area and ease of transposition versus that provided by their random pattern counterparts in these anatomic regions traditionally addressed with free tissue transfer. Case: We present a rare case of aggressive digital papillary carcinoma of the posteriolateral ankle and Achilles region. Wide local excision resulted in a defect with Achilles tendon exposure and denudation. A fasciocutaneous propeller flap based on a dominant peroneal artery perforator was raised and rotated 180° to resurface the wound, providing a gliding surface for Achilles tendon function. The reconstruction was successful with no complications, excellent contour, and esthetic appearance. Conclusions: Peroneal perforator-based propeller flaps in the ankle region are useful local options providing unparalleled form and function, with excellent surface area and mobility, for dynamic areas of the lower extremity, without sacrificing any major vessels or nerves. This technique adds to the reconstructive microsurgeon's armamentarium for complex coverage of the ankle region. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source]

Replantation of amputated finger composite tissues with microvascular anastomosis

MICROSURGERY, Issue 5 2008
Yimin Chai M.D.
Replantation of the partial amputated finger or the composite tissue in finger would achieve better functional and esthetical results than any reconstructive procedure. In this article, we report the results of microsurgical partial finger or composite tissue replantation at different anatomic sites of 24 fingers in 21 patients. Microvascular anastomosis was performed in all cases of replantation. For the digital palmar and lateral composite tissue defects, the proper palmar digital artery and volar or dorsal subcutaneous veins were repaired by end-to-end anastomoses. For the digital dorsal defects, the blood supply was reestablished by arterialization of a dorsal central vein in the replanted part with one of the proper palmar digital arteries. The average follow-up period was 12.3 months. Twenty-two of 24 fingers survived completely with good functional and esthetic results. Two replantations failed because of vascular complications. In conclusion, if the vascular vessels in amputations of partial finger and composite tissue of finger are suitable for anastomosis, a successful replantation of these parts with excellent functional and esthetical recovery can be achieved. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source]