Abstract:
INTRODUCTION:Full-thickness soft tissue defects of the back remain challenging clinical problems for reconstructive surgeons. Among a vast variety of local flap options, perforator-based local flaps gain increasing popularity lately. Because mostly heterogeneous patient cohort comparison of different perforator flaps is difficult and decision-making algorithms are lacking. METHODS:Patients, who received a local perforator-based soft tissue reconstruction between 2012 and 2019, were evaluated retrospectively. Patients' data were evaluated in terms of flap type and dimension, wound size and cause, surgery time, postoperative complications, and hospitalization. A focus was set on decision making concerning reconstructive techniques and flap choice for defect closure. RESULTS:Thirty-six patients (17 women, 19 men) were included, who received 40 perforator-based local flaps to reconstruct extended defects of the posterior trunk. Mean patient age was 56.3 years and mean hospitalization was 29 days. Average time of flap surgery was 179.7 minutes. Mean flap size was 160.8 cm and average defect size was 110 cm. Defects occurred because of tumor resection (50%), orthopedic/trauma surgery (16.7%), or pressure sores (33.3%). Twenty-eight propeller flaps (PPFs, 70%) and 12 perforator-based VY-advancement flaps (P-VYF, 30%) were transferred. In 4 patients, a bilateral approach using more than one flap was necessary. Revision surgery was required in 9 patients (25%) because of postoperative hematoma (n = 3), postoperative wound infection (n = 3), partial flap necrosis (1× P-VYF) and 2 flap losses (2× PPFs). CONCLUSIONS:Pedicled perforator flaps are a reliable option for soft tissue reconstruction of complex wounds of the posterior trunk. A flexible surgical strategy is mandatory, and the individual perforator anatomy has to be considered. In most cases, P-VYFs or PPFs are reliably possible and allow sufficient defect reconstruction. However, skin incisions should always be performed in a way that classic random pattern flaps are still possible. Even in large defects combined, local perforator flaps may lead to sustainable soft tissue reconstructions without functional donor site deficits.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Hernekamp JF,Cordts T,Kremer T,Kneser Udoi
10.1097/SAP.0000000000002439subject
Has Abstractpub_date
2021-01-01 00:00:00pages
72-77issue
1eissn
0148-7043issn
1536-3708journal_volume
86pub_type
杂志文章abstract:PURPOSE:The purpose of this study was to examine our hypotheses that botulinum toxin A (BoTA) protect necrosis of perforator flap from perforator twisting. METHODS:Twenty-four rats were randomly divided into 2 groups. Twelve International Units of BoTA versus 1.2 mL normal saline was injected subdermally 3 days before...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000563
更新日期:2016-08-01 00:00:00
abstract::The anatomical variations encountered in the dissection of 50 facial arteries in 25 adult preserved cadavers are presented. The facial artery was symmetrical in 17 of 25 (68%) of the dissections. The facial artery terminated as an angular facial artery in 34 (68%), a lateral nasal vessel in 13 (26%), and a superior la...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198807000-00003
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Lower eyelid reconstruction is challenging because of the risk of severe postreconstruction deformities of the lower eyelid, such as drooping, entropion, and ectropion. However, the risk factors for these postreconstruction deformities are unclear. The present study aimed to quantify the drooping deformity o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002080
更新日期:2020-06-01 00:00:00
abstract::Oronasal fistula formation is a recalcitrant complication following palatoplasty, resulting in nasal emission during speech and deglutition. We review our series to identify factors associated with fistula incidence. A retrospective review of all children with nonsyndromic cleft palate who underwent 2-flap palatoplast...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318199669b
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:The facial dismasking flap (FDF) approach to operations on the deep skull base region consists of a coronal incision and a circumpalpebral incision. This approach provides a wide surgical field for extirpation of deep extended craniofacial tumors without leaving any undesirable scars on the face. Therefore, ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000662
更新日期:2017-01-01 00:00:00
abstract::The authors describe a case of microvascular ear replantation with repair of the artery only and medicinal leech therapy that survived for 14 days but ultimately failed as a result of the absence of development of venous channels between the replant and the recipient bed. A 35-year-old man presented with complete avul...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200104000-00016
更新日期:2001-04-01 00:00:00
abstract::A 66-year-old woman with an abdominal wound caused by infected synthetic mesh had failed to heal in spite of many surgical attempts to close the wound. A sealed transparent vinyl chamber was glued to the periphery of the wound and antibiotics in high concentrations (up to 2,500 times the minimum inhibitory concentrati...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199601000-00016
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Dynamic Infrared Imaging (DIRI) is a noninvasive technique that precisely analyzes the infrared radiation of any object. We used this technique to locate the dominant perforator vessels in flap surgery in conjunction with conventional Doppler. METHODS:Ten patients scheduled for deep inferior epigastric arte...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181ef6da3
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The challenging breast reshaping after massive weight loss (MWL) has been increasingly performed as the number of bariatric surgery procedures increase worldwide. The breasts often appear wide, lateralized, and deflated, with significant ptosis. OBJECTIVES:The aim of this article is to share our initial exp...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SAP.0000000000000816
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Changes in breast sensation after reconstruction are expected. Return of breast sensation after reconstruction and whether nipple-sparing mastectomy offers a substantial benefit in terms of sensation has been inconsistently documented in the literature. We conducted the current study using the pressure-speci...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000900
更新日期:2017-06-01 00:00:00
abstract::The use of external devices for cranial suspension or immobilization may facilitate the transfer of skin grafts or flaps needed for scalp coverage. Skull tongs are readily available in any trauma center. Following composite tissue transfer to the skull, skull tongs can prevent compromise of the microanastomoses or the...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198901000-00015
更新日期:1989-01-01 00:00:00
abstract::An extension of the "crane" principle is presented for use in compound frontal defects, and several case histories are described. The procedure would obviously not be possible if a foreign material had been used for the osseous defects, since take of the skin graft depends on circulation through the autogenous bone gr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198410000-00008
更新日期:1984-10-01 00:00:00
abstract::Technically we can divide full-thickness thoracic reconstruction into 2 parts: providing a rigid support and ensuring well-vascularized coverage. Since 1986, the authors' center has had ample experience with bone banks and the use of cryopreserved bone grafts, which led them to consider the possibility of using these ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000099961.00590.9b
更新日期:2004-01-01 00:00:00
abstract::A new surgical repair of enterocutaneous fistula associated with abdominal wound defects is presented. The authors turned over the fasciocutaneous flap from the surrounding skin and sutured the intestinal lumen directly to the cutaneous side of the flap. The method is a risk-free extraperitoneal approach that can be p...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200205000-00019
更新日期:2002-05-01 00:00:00
abstract::Multiple symmetric lipomatosis (MSL) is a rare disease of unknown etiology, characterized by the presence of multiple, symmetrical, noncapsulated lipomas, mostly in the neck and upper trunk. To date, there is no effective medical treatment of MSL. Surgical treatment is based on 2 options, namely, lipectomy and/or lipo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31827f5295
更新日期:2014-11-01 00:00:00
abstract::Norian CRS, Bone Cement (Synthes CMF), and Mimix (Lorenz) have been used to reconstruct large cranio-orbital defects in 85 patients. Resorbable mesh (Macropore), used in combination in selected patients, obviates dura pulsations that have been postulated to cause fragmentation of alloplastic material. Norian is compos...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000168157.10664.9c
更新日期:2005-07-01 00:00:00
abstract::Surgical errors in the length and orientation of a flap pedicle can result in kinks, twists, or tension on the pedicle vessels. When these errors occur together with the microvascular repairs associated with free flap transfer, thrombosis and flap failure may be the outcome. A model was designed to simulate these even...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199405000-00006
更新日期:1994-05-01 00:00:00
abstract::The structural and circulatory dynamics of expanded skin in connection with expander fillings were assessed in pigs following 7, 14, and 21 days of expansion by measuring the pressure of te fluid in the expander (Pexp) and the dermal blood flow. The results differed consistently on thoracic and abdominal sites. It was...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198808000-00007
更新日期:1988-08-01 00:00:00
abstract::There have been numerous techniques and refinements for nipple-areola reconstruction described that have required the use of distant donor sites. A further modification of the skate flap is described, whereby the entire reconstruction can be performed on site, thus avoiding a second scar and any subsequent morbidity. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199203000-00014
更新日期:1992-03-01 00:00:00
abstract:PURPOSE:Since its description in the 1970s, the radial forearm free flap has earned a clearly defined role in the armamentarium of reconstructive head and neck surgery. Three decades later, the donor site remains an intrinsic drawback primarily due to its esthetic impact, although functional morbidity is significant in...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000221622.41450.60
更新日期:2006-09-01 00:00:00
abstract:INTRODUCTION:The aim of any reconstruction is to provide a robust and cosmetically pleasing result that does not significantly alter function. We describe our experience of using the V-Y principle in advancement flaps designed around a distinct perforator to reconstruct soft tissue defects of the upper limb. The shortc...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002138
更新日期:2020-05-01 00:00:00
abstract::We have previously demonstrated in a rat surgical incision model that charged dextran beads enhance wound repair in a charge-specific manner: positively charged beads increased wound breaking strength (WBS), whereas neutral or negatively charged beads were ineffective. The present work extends these observations into ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199606000-00008
更新日期:1996-06-01 00:00:00
abstract::The arcuate line is a relevant structure when reconstructing the abdominal wall after rectus abdominis musculocutaneous flap harvest. Its location is classically taught to be half the distance from the pubic symphysis to the umbilicus, but recent anatomic literature provides evidence to the contrary. Better understand...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000112285.44287.21
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:We describe the risk factors for complications and outcome of perineal wounds after abdominoperineal resections (APRs). METHODS:A retrospective chart review was performed, and patient demographics, risk factors, extent of APR, closure of perineal wounds, exposure to radiation, and outcome were collected. R...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31823fac2b
更新日期:2013-08-01 00:00:00
abstract::This represents the initial report of intestinal revascularization with pedicled omental flaps producing bowel segments that are capable of surviving without their native mesenteric perfusion. In 10 mongrel dogs, a pedicled omental flap supplied by the left gastroepiploic arcade was sutured along a seromuscular incisi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199412000-00007
更新日期:1994-12-01 00:00:00
abstract::Reconstruction involving seven venous flaps on six patients was performed. One saphenous venous flap demonstrated partial dermal necrosis; the remaining six survived completely. The largest flap to survive was 5 x 15 cm. Three technical requirements are emphasized; (1) a healthy recipient bed, (2) a donor site with a ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199505000-00011
更新日期:1995-05-01 00:00:00
abstract::The majority of patients with breast carcinoma are being treated with breast conservation therapy (BCT): lumpectomy and postoperative radiation. Local recurrence reported at 8% to 11% is often treated with salvage mastectomy. This has led to a growing group of patients requiring breast reconstruction after failed BCT....
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000215252.05233.b0
更新日期:2006-08-01 00:00:00
abstract::An evaluation of 220 cases of frontocranial remodeling for craniosynostosis is reported. The follow-up period was 10 years for children, 7 years for infants. The principles of the craniofacial techniques described in 1974 [4] and 1978 [3] were not modified; only variations were added. The floating forehead [5] concept...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198501000-00009
更新日期:1985-01-01 00:00:00
abstract::The authors present the successful transfer of a compound flap based on the sternocleidomastoid muscle in a patient who had undergone radiation therapy and a near-total laryngectomy. The surgical procedure, a one-stage reconstruction with a regional rotational flap, utilized a segment of the sternal periosteum and und...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200045020-00018
更新日期:2000-08-01 00:00:00
abstract:INTRODUCTION:Human placental membranes (hPMs) have a long history in treating burns and wounds. The composition of hPMs includes structural matrix, growth factors, and neonatal cells, all of which contribute to their regenerative potential. However, most hPM products are devitalized after dehydration and irradiation. W...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001101
更新日期:2017-08-01 00:00:00