Solutiones of cutaneous defects over achilles tendon by microsurgical techniques
Authors:
Tomáš Kempný 1,2; Bronislav Vřeský 2; Marcela Hándlová 2; Martin Rozprým 2
Authors‘ workplace:
Regional Hospital T. Bati, Zlín
1; Oddělení plastické chirurgie KNTB a. s. Zlín
1; Plastic and Hand Surgery Centre University Hospital Ostrava
2; Centrum plastické chirurgie a chirurgie ruky FNsP Ostrava
2
Published in:
Úraz chir. 15., 2007, č.2
Overview
Introduction:
Soft tissue defects were, are and will be an area for cooperation between traumatology and plastic surgery. This is very important in cases where tendons are denuded, because they can not create quality granulation tissue. In the few cases where granulation tissues arise from surrounding tissue, we can cover them with dermoepidermal grafts. However, from long term results this tends to irritate the scar tissue above the Achilles tendon by the shoes, and this leads to the opening of the scarred area.
Methodics:
It is then necessary to use quality soft tissue above the Achilles tendon. It is possible to use pedicled or free flaps.
Results:
The authors used only free flaps in a group of thirteen patients in the course of four years. All patients healed promptly and from long term results it was not return of a defects over the Achilles tendon
Conclusion:
Early indicated soft tissue transfer is the best prevention of long term illness, opening of wounds and disability.
Key words:
Achilles tendon, defect, free flap, microsurgery.
Sources
1. German, G., Erdmann, D. Foot reconstruction with microvascular flaps. Oper Tech Plast Reconstr Surg. 1997, 4, 172–182.
2. Hoon-Bum Lee, Dae-Hyun Lew, Seung-Hoon Oh et al. Simultaneous reconstruction of the Achilles tendon and soft-tissue defects using only a latissimus dorsi muscle free flap. Plast Reconstr Surg. 1999, 104, 111–119.
3. Kimura, N., Satoh, K., Hasumi, T., Ostuka, T. Clinical application of the free thin anterolateral thigh flap in 31 consecutive patients. Plast Reconstr Surg. 2001, 108, 1197–1210.
4. Kletenský, J., Tvrdek, M., Pros, Z., Nejedlý, A., Svoboda, S. Treatment of defects and instabile skin scars on heavily exposed parts of the leg. Acta Chir Plast. 1996, 38, 87–89.
5. Koshima, I., Nanba,Y., Tsutsui, T. et al. Perforator flaps in lower extremity reconstruction. Hand-chirurgie, Mikrochirurgie und Plastiche Chirurgie. 2002, 34, 251–256.
6. LEE, J. W., YU, J.C., Shieh, S., J. et al. Reconstruction of the Achilles tendon and overlying soft tissue using anterolateral thigh free flap. Br J Plast Surg. 2000, 53, 574–577.
7. Le Fourn, B., Caye, N., Pannier M. Distally based sural fasciomuscular flap: Anatomic study and application for filling of leg or foot defects. Plast Reconstr Surg. 2001, 107, 67–72.
8. Masquelet, A.C., Romana, M.C., Wolf, G. Skin island flaps supplied by the vascular axis of the sensitive superficial nerves: Anatomic study and clinical experience in the leg. Plast Reconstr Surg. 1992, 89, 1115–1121.
9. Nejedlý, A., Tvrdek, M., Kletenský, J., Pros, Z. Importance of an early tissue transfer in the treatment of complicated injuries of lower extremities. Acta Chir Plast. 1994, 36, 11–14.
10. Pros, Z., Tvrdek, M., Kletenský, J. et al. Chronic traumatic wounds of the leg, Acta Chir Plast. 1996, 38, 83–86.
11. Schmidt, J., Winkler, K.H. Der chronisch - infizierte Haut- und Weichteildefekt – allgemeine Behandlungsrechtlinien. OP-Journal. 1996, 12, 50–54.
12. Touam, C., Rostoucher, P., Bhatia, A., Oberlin, C. Comparative study of two series of distaly based fasciocutaneous flap for coverage of the lower leg, the ankle and the foot. Plast Reconstr Surg. 2001, 107, 383–392.
Labels
Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2007 Issue 2
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