Simple to Extreme: Following the Reconstructive Ladder for Complex Posterior Trunk Reconstruction
Summary:. Reconstruction of the posterior trunk and torso defects presents unique challenges to the reconstructive surgeon, particularly in the setting of oncologic resection and adjuvant multimodality therapy such as chemotherapy and radiation. The operation can be more complicated in the setting o...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2021-10-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003856 |
| _version_ | 1818575025020600320 |
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| author | Samer Jabbour, MD Edward I. Chang, MD Sahil K. Kapur, MD |
| author_facet | Samer Jabbour, MD Edward I. Chang, MD Sahil K. Kapur, MD |
| author_sort | Samer Jabbour, MD |
| collection | DOAJ |
| description | Summary:. Reconstruction of the posterior trunk and torso defects presents unique challenges to the reconstructive surgeon, particularly in the setting of oncologic resection and adjuvant multimodality therapy such as chemotherapy and radiation. The operation can be more complicated in the setting of hardware exposure. Although local flaps represent the primary workhorse option, reconstruction using a microvascular free tissue transfer should be considered when local flap options have been exhausted. Here, we present a unique case reconstructing a complex, radiated back wound with exposed hardware that failed prior bilateral paraspinous, latissimus dorsi, and trapezius muscle flaps. A unilateral free TRAM flap was used and revascularized through an arteriovenous loop to provide stable coverage of the 15 × 25 cm defect. The patient also had preexisting upper extremity ischemia, which limited flap perfusion and positioning options. The usage of arteriovenous loops and free musculocutaneous flaps can provide another potential adequate option for the treatment of these complex defects. |
| first_indexed | 2024-12-15T00:34:26Z |
| format | Article |
| id | doaj.art-eb323972c72e4781a54961160578c363 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-15T00:34:26Z |
| publishDate | 2021-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-eb323972c72e4781a54961160578c3632022-12-21T22:41:51ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742021-10-01910e385610.1097/GOX.0000000000003856202110000-00015Simple to Extreme: Following the Reconstructive Ladder for Complex Posterior Trunk ReconstructionSamer Jabbour, MD0Edward I. Chang, MD1Sahil K. Kapur, MD2From the * Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, D.C.† Department of Plastic Surgery, University of Texas M.D. Anderson Cancer Center, Houston, Tex.† Department of Plastic Surgery, University of Texas M.D. Anderson Cancer Center, Houston, Tex.Summary:. Reconstruction of the posterior trunk and torso defects presents unique challenges to the reconstructive surgeon, particularly in the setting of oncologic resection and adjuvant multimodality therapy such as chemotherapy and radiation. The operation can be more complicated in the setting of hardware exposure. Although local flaps represent the primary workhorse option, reconstruction using a microvascular free tissue transfer should be considered when local flap options have been exhausted. Here, we present a unique case reconstructing a complex, radiated back wound with exposed hardware that failed prior bilateral paraspinous, latissimus dorsi, and trapezius muscle flaps. A unilateral free TRAM flap was used and revascularized through an arteriovenous loop to provide stable coverage of the 15 × 25 cm defect. The patient also had preexisting upper extremity ischemia, which limited flap perfusion and positioning options. The usage of arteriovenous loops and free musculocutaneous flaps can provide another potential adequate option for the treatment of these complex defects.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003856 |
| spellingShingle | Samer Jabbour, MD Edward I. Chang, MD Sahil K. Kapur, MD Simple to Extreme: Following the Reconstructive Ladder for Complex Posterior Trunk Reconstruction Plastic and Reconstructive Surgery, Global Open |
| title | Simple to Extreme: Following the Reconstructive Ladder for Complex Posterior Trunk Reconstruction |
| title_full | Simple to Extreme: Following the Reconstructive Ladder for Complex Posterior Trunk Reconstruction |
| title_fullStr | Simple to Extreme: Following the Reconstructive Ladder for Complex Posterior Trunk Reconstruction |
| title_full_unstemmed | Simple to Extreme: Following the Reconstructive Ladder for Complex Posterior Trunk Reconstruction |
| title_short | Simple to Extreme: Following the Reconstructive Ladder for Complex Posterior Trunk Reconstruction |
| title_sort | simple to extreme following the reconstructive ladder for complex posterior trunk reconstruction |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003856 |
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