A neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities: the obliteration of deep dead space
Abstract Background Deep dead space may be thought as an independent risk factor of the poor infection control after flap reconstruction in complex limb wounds. But it can be easily neglected. The conventional skin flap and musculocutaneous flap are difficult to obliterate the deep dead space in irr...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01914-0 |
| _version_ | 1817988781856260096 |
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| author | Gao-hong Ren Da-yong Xiang Xiao-hu Wu Yun-biao Chen Runguang Li |
| author_facet | Gao-hong Ren Da-yong Xiang Xiao-hu Wu Yun-biao Chen Runguang Li |
| author_sort | Gao-hong Ren |
| collection | DOAJ |
| description | Abstract Background Deep dead space may be thought as an independent risk factor of the poor infection control after flap reconstruction in complex limb wounds. But it can be easily neglected. The conventional skin flap and musculocutaneous flap are difficult to obliterate the deep dead space in irregular shape effectively. It was investigated that the clinical application of chimeric anterolateral thigh perforator flap in the treatment of complex wounds complicated with deep dead space of the extremities in the paper. Methods Fifty-six cases complicated with deep dead space wounds were registered in group. Following thorough debridement and treatment with VSD, the granulation tissues grew with well-controlled infection. And then the chimeric anterolateral thigh perforator flap was used to obliterate the deep dead space and repair the wounds. The postoperative flap survival and infection conditions were evaluated. Results Overall, the infection was effectively controlled, without persistent exudation or sinus tract formation after wound healing. While 5 cases lost to follow-up, the remaining 51 cases were followed up until 15 months on average. Generally, the affected extremities recovered satisfactorily with normal appearances and texture of the flaps, along with normal functions. Importantly, no recurrence of infection was observed. Conclusion During the grafting of chimeric perforator flap pedicled with lateral thigh muscle flap, the muscle flap is recommended to obliterate the deep dead space while the skin flap is being used to cover the wound. The combination of these two technologies performed well in the repair and reconstruction of the complex wounds of the extremities, possessing potential for broader clinical application. |
| first_indexed | 2024-04-14T00:38:44Z |
| format | Article |
| id | doaj.art-6bd62a25491b433182945b3068c7a22b |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T00:38:44Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-6bd62a25491b433182945b3068c7a22b2022-12-22T02:22:15ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-10-011511810.1186/s13018-020-01914-0A neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities: the obliteration of deep dead spaceGao-hong Ren0Da-yong Xiang1Xiao-hu Wu2Yun-biao Chen3Runguang Li4Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDepartment of Orthopedics, The Third Affiliated Hospital of Southern Medical UniversityAbstract Background Deep dead space may be thought as an independent risk factor of the poor infection control after flap reconstruction in complex limb wounds. But it can be easily neglected. The conventional skin flap and musculocutaneous flap are difficult to obliterate the deep dead space in irregular shape effectively. It was investigated that the clinical application of chimeric anterolateral thigh perforator flap in the treatment of complex wounds complicated with deep dead space of the extremities in the paper. Methods Fifty-six cases complicated with deep dead space wounds were registered in group. Following thorough debridement and treatment with VSD, the granulation tissues grew with well-controlled infection. And then the chimeric anterolateral thigh perforator flap was used to obliterate the deep dead space and repair the wounds. The postoperative flap survival and infection conditions were evaluated. Results Overall, the infection was effectively controlled, without persistent exudation or sinus tract formation after wound healing. While 5 cases lost to follow-up, the remaining 51 cases were followed up until 15 months on average. Generally, the affected extremities recovered satisfactorily with normal appearances and texture of the flaps, along with normal functions. Importantly, no recurrence of infection was observed. Conclusion During the grafting of chimeric perforator flap pedicled with lateral thigh muscle flap, the muscle flap is recommended to obliterate the deep dead space while the skin flap is being used to cover the wound. The combination of these two technologies performed well in the repair and reconstruction of the complex wounds of the extremities, possessing potential for broader clinical application.http://link.springer.com/article/10.1186/s13018-020-01914-0Chimeric flapAnterolateral thigh perforator flapComplex woundsWound reconstructionDeep dead space |
| spellingShingle | Gao-hong Ren Da-yong Xiang Xiao-hu Wu Yun-biao Chen Runguang Li A neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities: the obliteration of deep dead space Journal of Orthopaedic Surgery and Research Chimeric flap Anterolateral thigh perforator flap Complex wounds Wound reconstruction Deep dead space |
| title | A neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities: the obliteration of deep dead space |
| title_full | A neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities: the obliteration of deep dead space |
| title_fullStr | A neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities: the obliteration of deep dead space |
| title_full_unstemmed | A neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities: the obliteration of deep dead space |
| title_short | A neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities: the obliteration of deep dead space |
| title_sort | neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities the obliteration of deep dead space |
| topic | Chimeric flap Anterolateral thigh perforator flap Complex wounds Wound reconstruction Deep dead space |
| url | http://link.springer.com/article/10.1186/s13018-020-01914-0 |
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