Treatment of unfavourable results of flexor tendon surgery: Skin deficiencies

We recently reported a small study at the Federation of European Societies for Surgery of the hand, which was entitled ′What is secondary flexor tendon surgery′? This study concluded that ′secondary flexor tendon surgery′ was a generic name encompassing a multitude of pathologies. Between 10% and 15...

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Main Authors: David Elliot, Thomas Giesen
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2013-01-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=2;spage=325;epage=332;aulast=Elliot
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author David Elliot
Thomas Giesen
author_facet David Elliot
Thomas Giesen
author_sort David Elliot
collection DOAJ
description We recently reported a small study at the Federation of European Societies for Surgery of the hand, which was entitled ′What is secondary flexor tendon surgery′? This study concluded that ′secondary flexor tendon surgery′ was a generic name encompassing a multitude of pathologies. Between 10% and 15% of cases exhibited pathology of the skin and subcutaneous fat and required flap reconstruction of these tissues. Skin replacement may be used prophylactically at primary surgery or become necessary at secondary surgery after release of scar contractures, to achieve cover of vital structures. The long-term problem of skin deficiency relating to flexor tendon function is one of loss of extension from longitudinal scar shortening of the integument, even if the flexor tendons are primarily concerned with bending the digits, not straightening them. This loss of extension can only be tolerated in a hand to a certain degree without significant loss of function. This paper is largely an analysis of the flaps available and suitable for different degrees of skin deficiency and at different places along the course of the flexor system. It attempts to dispel the idea that ′any flap will do′ provided the flexors are adequately covered.
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spelling doaj.art-a39f798e3aca4575b8f0e63e27dfa08e2022-12-21T19:19:03ZengThieme Medical Publishers, Inc.Indian Journal of Plastic Surgery0970-03581998-376X2013-01-0146232533210.4103/0970-0358.118611Treatment of unfavourable results of flexor tendon surgery: Skin deficienciesDavid ElliotThomas GiesenWe recently reported a small study at the Federation of European Societies for Surgery of the hand, which was entitled ′What is secondary flexor tendon surgery′? This study concluded that ′secondary flexor tendon surgery′ was a generic name encompassing a multitude of pathologies. Between 10% and 15% of cases exhibited pathology of the skin and subcutaneous fat and required flap reconstruction of these tissues. Skin replacement may be used prophylactically at primary surgery or become necessary at secondary surgery after release of scar contractures, to achieve cover of vital structures. The long-term problem of skin deficiency relating to flexor tendon function is one of loss of extension from longitudinal scar shortening of the integument, even if the flexor tendons are primarily concerned with bending the digits, not straightening them. This loss of extension can only be tolerated in a hand to a certain degree without significant loss of function. This paper is largely an analysis of the flaps available and suitable for different degrees of skin deficiency and at different places along the course of the flexor system. It attempts to dispel the idea that ′any flap will do′ provided the flexors are adequately covered.http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=2;spage=325;epage=332;aulast=ElliotFinger flapsskin defect in secondary flexor tendon surgerytendon cover
spellingShingle David Elliot
Thomas Giesen
Treatment of unfavourable results of flexor tendon surgery: Skin deficiencies
Indian Journal of Plastic Surgery
Finger flaps
skin defect in secondary flexor tendon surgery
tendon cover
title Treatment of unfavourable results of flexor tendon surgery: Skin deficiencies
title_full Treatment of unfavourable results of flexor tendon surgery: Skin deficiencies
title_fullStr Treatment of unfavourable results of flexor tendon surgery: Skin deficiencies
title_full_unstemmed Treatment of unfavourable results of flexor tendon surgery: Skin deficiencies
title_short Treatment of unfavourable results of flexor tendon surgery: Skin deficiencies
title_sort treatment of unfavourable results of flexor tendon surgery skin deficiencies
topic Finger flaps
skin defect in secondary flexor tendon surgery
tendon cover
url http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=2;spage=325;epage=332;aulast=Elliot
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