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Intraoperative blood perfusion factors in free anterolateral thigh flap repair for diabetic foot ulcers:A retrospective analysis 认领 引用 被引量：1
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作者 Hong-Liang Wu Huan Huang +2 位作者 Bin-Qi Chen Jian Xia Li-Bing Jiang 《World Journal of Diabetes》 SCIE 2025年第8期38-51,共14页
BACKGROUND Diabetic foot ulcers(DFUs)in patients with type 2 diabetes(T2D)are associated with heightened risks of infection and amputation and thus require effective surgical interventions to enhance outcomes.Free ant... BACKGROUND Diabetic foot ulcers(DFUs)in patients with type 2 diabetes(T2D)are associated with heightened risks of infection and amputation and thus require effective surgical interventions to enhance outcomes.Free anterolateral thigh(ALT)perforator flap is a promising reconstructive method;however,diabetic vasculopathy challenges optimal perfusion.This study analyzes factors influencing intraoperative blood perfusion in ALT flap repair for DFUs.AIM To identify key factors affecting intraoperative blood perfusion during free ALT perforator flap repair in patients with T2D and DFUs,thereby providing insights to improve surgical outcomes.METHODS This retrospective case-control study included 100 patients with T2D who underwent ALT flap repair at our institution between June 2016 and June 2024.Patients were categorized into normal(n=50)and abnormal(n=50)blood perfusion groups based on intraoperative perfusion assessments.Data on demographics,clinical characteristics,vascular status,metabolic control,and preoperative laboratory parameters were collected.Statistical analyses,including univariate and multivariate logistic regression,were conducted to identify significant predictive factors for perfusion outcomes.RESULTS Old age,high body mass index,long diabetes duration,and presence of diabetic peripheral neuropathy were associated with impaired perfusion.Abnormal perfusion was correlated with poor ankle-brachial index and elevated glycated hemoglobin(HbA1c),creatinine,triglycerides,and partial pressure of carbon dioxide.Conversely,high hemoglobin,albumin,and prealbumin levels and partial pressure of oxygen(PaO2)were protective.Multivariate analysis identified diabetes duration,HbA1c,PaCO2,PaO2,and albumin as independent predictors of perfusion,underscoring the roles of metabolic control and vascular health.CONCLUSION Optimizing metabolic control,vascular health,and nutritional status was crucial to enhance intraoperative blood perfusion in diabetic patients undergoing ALT perforator flap repair for DFUs. 展开更多
关键词 Diabetic foot ulcers Intraoperative blood perfusion Anterolateral thigh perforator flap Type 2 diabetes Surgical outcomes Vascular health
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The application of anterolateral thigh flap in post-operative repairing of vulva tumor 认领 引用 被引量：1
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作者 Qi Zhou Xiangjun Chen Yingjie Yang 《The Chinese-German Journal of Clinical Oncology》 2010年第9期539-542,共4页
Objective： The aim of this study was to evaluate the value of the application of anterolateral thigh flap in postoperative repairing of vulva tumor. Methods： Anterolateral thigh flap with the descending branch of th... Objective： The aim of this study was to evaluate the value of the application of anterolateral thigh flap in postoperative repairing of vulva tumor. Methods： Anterolateral thigh flap with the descending branch of the lateral circumflex femoral artery and the pedicle of anterolaterat thigh cutaneous nerve was used in primary repairing of the defect from postoperative vulva tumor, the sizes of the flaps ranged from 10 cm ×14 cm-14 cm× 20 cm. Results： All flaps survived, during a follow-up of 2 to 12 months, the appearance of the flaps was satisfactory with sensitive function without local recurrences. Conclusion： Anterelateral thigh flap has fairly long vessel pedicle, wider vessel diameter, and is in the covert area. Anterolateral thigh flap with sensory nerve is the ideal choice for postoperative repairing of vulva tumor. 展开更多
关键词 anterolateral thigh flap vulvar tumor repair
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Prefabricated Anterolateral Thigh Flaps for Phalloplasty in Female-to-Male Transsexuals 认领 引用
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作者 Chen CHENG Caiyue LIU +4 位作者 Sunxiang MA Xiaohai ZHU Kaixiang CHENG Yang LIU Yingfan ZHANG 《Chinese Journal of Plastic and Reconstructive Surgery》 2021年第1期11-16,共6页
Background Phalloplasty is still a challenging operation because of the high urethral complication rate.Several options regarding different flaps can be chosen,but there is still no perfect solution for phalloplasty i... Background Phalloplasty is still a challenging operation because of the high urethral complication rate.Several options regarding different flaps can be chosen,but there is still no perfect solution for phalloplasty in female-to-male(FTM)transgender patients.Our group tried to use prefabricated anterolateral thigh(ALT)flaps for phalloplasty to overcome the urethral complications.Methods A total of 21 transgender patients were included from 2010 to 2019.A twostage operation was performed to reconstruct the phallus.The vaginal mucosa was prefabricated as neourethra at the first stage,and the shaft of the phallus was reconstructed at the second stage.Results All reconstructed phallus survived completely in our study,and the satisfaction rate was 76.2%.The total complication rate was 57.1%.The occurrence of fistula and strictures after the operation was 52.4%and 5.8%,respectively Conclusion Prefabricated ALT flaps with vaginal mucosa have a lower stricture rate.This technique provides a simple,effective surgical option in FTM transsexuals. 展开更多
关键词 Vaginal mucosal graft Urethra prefabrication Anterolateral thigh flap Phalloplasty Female-to-male transsexuals
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Free Flow-through Anterolateral Thigh Flaps for Wrist High-tension Electrical Burns:A Retrospective Case Series 认领 引用 被引量：14
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作者 WANG Cheng SHEN Yu Ming +1 位作者 QIN Feng Jun HU Xiao 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2020年第7期510-517,共8页
Objective The objective of this report was to demonstrate the clinical application of free flow-through anterolateral thigh flaps for the treatment of high-tension electrical wrist burns.Methods We collected the data ... Objective The objective of this report was to demonstrate the clinical application of free flow-through anterolateral thigh flaps for the treatment of high-tension electrical wrist burns.Methods We collected the data of 8 patients with high-tension electrical wrist burns admitted to Beijing Jishuitan Hospital from January 2014 to December 2018.The clinical and pathological data were extracted from electronic hospital medical records.We obtained follow-up information through clinic visits.Results The injury sites for all 8 patients were the wrists,specifically 5 right and 3 left wrists,all of which were on the flexor side.Five patients had ulnar artery embolism necrosis and patency,with injury to the radial artery.Two patients had ulnar and radial arterial embolization and necrosis.The last patient had ulnar arterial embolization and necrosis with a normal radial artery.After debridement,the wound area ranged from 12 cm×9 cm to 25 cm×16 cm.The diagnoses for the eight patients were type II to type III high-tension electrical wrist burns.Free flow-through anterolateral thigh flaps(combined with great saphenous vein transplantation if necessary)were used to repair the wounds.The prognosis for all patients was good after six months to one year of follow-up.Conclusion Treating wrist types II and III high-tension electrical burns is still challenging in clinical practice.The use of free flow-through anterolateral thigh flaps(combined with great saphenous vein transplantation if necessary)to repair the wound and to restore the blood supply for the hand at the same time is a good choice for treating severe wrist electrical burns. 展开更多
关键词 High-tension electrical burns Wrist flap surgery Free flow-through anterolateral thigh flaps
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A Case of Harvesting Anterolateral Thigh Flaps Twice from the Ipsilateral Thigh of a Single Patient in Separate Operations 认领 引用 被引量：1
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作者 Saito Masami Kimura Naohiro +3 位作者 Okochi Masayuki Tomizuka Yosuke Onda Masamitsu Ueda Kazuki 《Surgical Science》 2016年第4期185-190,共6页
Until now, harvesting of flap elevations from the ipsilateral thigh twice in the same patient in two operations has not been reported. We harvested thigh flaps twice from the ipsilateral thigh of a single patient in s... Until now, harvesting of flap elevations from the ipsilateral thigh twice in the same patient in two operations has not been reported. We harvested thigh flaps twice from the ipsilateral thigh of a single patient in separate operations. A 44-year-old man had skin defects of the right thumb and the left middle finger. In the first operation, his right thumb was reconstructed by the hemi-pulp flap. The anterolateral thigh flap harvested from the left thigh transferred to the donor site defect of the hemi-pulp flap. Sixteen days after the first operation, another anterolateral thigh flap harvested from the left thigh transferred to the defect of the left middle finger. This operative procedure is very useful for cases requiring multi-flap transfer. 展开更多
关键词 Anterolateral Thigh Flap Twice from the Ipsilateral Thigh Perforator Flap
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Scalp and Dura Matter Complex Reconstruction Using Free Anterolateral Thigh Flap with Vascularized Fascia 认领 引用
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作者 Masayuki Okochi Masanori Momiyama +1 位作者 Masaru Horikiri Kazuku Ueda 《Surgical Science》 2016年第3期137-143,共7页
The reconstruction of large scalp and dural defects is difficult. Anterolateral thigh (ALT) flap is now widely used because of its reliable blood supply to the skin paddle. Additionally, ALT can be harvested with a la... The reconstruction of large scalp and dural defects is difficult. Anterolateral thigh (ALT) flap is now widely used because of its reliable blood supply to the skin paddle. Additionally, ALT can be harvested with a large skin paddle and large, well-vascularized fascia. We have successfully treated eight scalp and dural composite defect cases (five male and three female) using ALT with vascularized fascia. The patients’ mean age was 59.1 ± 20.4 years ranging from 31 to 83 years. The mean dural defect size was 73 ± 21 cm2, ranging from 50 to 120 cm2. There were no postoperative infections, bleeding, cerebrospinal fluid leakage, or meningitis. Further discussion about the usefulness of vascularized fascia may be required and we believe that plastic surgeons, head and neck surgeons, and neurosurgeons should report on the results of dural reconstruction. 展开更多
关键词 Dural Reconstruction Vascularized Fascia Anterolateral Thigh Flap
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Scrotal reconstruction using anterolateral thigh flap in a pediatric patient:A case report 认领 引用
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作者 Shi Gao Haiqiong Chen Guoqiang Zhao 《Chinese Journal of Traumatology》 CAS CSCD 2026年第2期153-156,共4页
Avulsion injury of genitalia is rare,particularly in pediatric patients.The reconstruction of necrotic scrotal tissue presents a significant challenge.This case report describes a pediatric patient who experienced com... Avulsion injury of genitalia is rare,particularly in pediatric patients.The reconstruction of necrotic scrotal tissue presents a significant challenge.This case report describes a pediatric patient who experienced complete avulsion of the left inguinal,scrotal,and penile regions,accompanied by multiple pelvic fractures,and the scrotal tissue subsequently became necrotic.We performed scrotal reconstruction using a pedicled anterolateral thigh flap and fixed both testes.Postoperatively,the scrotum had a satisfactory appearance,with no significant reduction in testicular size compared to age-matched peers,indicating a successful repair. 展开更多
关键词 External genitalia degloving injuries Scrotal reconstruction Anterolateral thigh flap
Improving intraoperative perfusion reliability in anterolateral thigh free flap reconstruction for diabetic foot ulcers 认领 引用
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作者 Peng-Yu Lu Zhuang-Yu Hao +4 位作者 Guang-Wei Xing Peng-Fei Zhang Yan-Song Liu Wen-Yang Li Ming-Jie Xu 《World Journal of Diabetes》 SCIE 2026年第6期40-51,共12页
Anterolateral thigh free-flap reconstruction remains an important limb-salvage option for patients with diabetic foot ulcers,particularly when complex soft-tissue defects,infection,or exposed deep structures preclude ... Anterolateral thigh free-flap reconstruction remains an important limb-salvage option for patients with diabetic foot ulcers,particularly when complex soft-tissue defects,infection,or exposed deep structures preclude simpler reconstructive approaches.However,intraoperative perfusion insufficiency continues to limit flap reliability and may compromise wound healing,flap survival,and long-term limb salvage.In this setting,flap perfusion should not be regarded as a purely technical consequence of microsurgical anastomosis but rather as the product of a systemic-regional-microcirculatory continuum shaped by distal vascular capacity,diabetes-related microvascular dysfunction,and modifiable host factors.This review summarizes current advances in intraoperative perfusion assessment for anterolateral thigh flap reconstruction in diabetic foot ulcer,with particular emphasis on indocyanine green fluorescence angiography(ICG-FA).We highlight the limitations of relying on static fluorescence intensity alone and argue that quantitative fluorescence-time curve metrics,including wash-in slope,time to maximum intensity,and area under the curve,may provide more robust and reproducible information for intraoperative decision-making.Because diabetes-associated medial arterial calcification and microvascular impairment can confound perfusion interpretation,ICG-FA should be integrated with complementary measures such as toe pressureoe-brachial index,skin perfusion pressure,and transcutaneous oxygen tension rather than used as a stand-alone tool.We further discuss the importance of preoperative and perioperative optimization of modifiable systemic factors,including glycemic control,anemia,oxygenation and ventilation,and nutritional reserve,all of which influence tissue oxygen delivery and flap viability.Finally,we propose a quantitative,multimodal clinical framework that links preoperative vascular assessment,standardized intraoperative perfusion imaging,and structured postoperative monitoring to clinically meaningful outcomes.Future priorities include harmonization of ICG-FA acquisition and reporting protocols,prospective multicenter validation,and development of registry-based prediction models to improve reproducibility,risk stratification,and implementation of evidence-based limb-salvage strategies in diabetic foot reconstruction. 展开更多
关键词 Anterolateral thigh flap Diabetic foot ulcer Indocyanine green angiography Limb salvage Nutritional status Perfusion assessment Systemic optimization Tissue oxygenation
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Unusual case of a free anterolateral thigh flap partial necrosis in a COVID-19 positive young male following extremity reconstruction 认领 引用 被引量：1
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作者 Sourabh Shankar Chakraborty Anjana Malhotra +4 位作者 Urvi Ashok Shah Shylesh Ramesh Babu Puja Bhaurao Dandekar Doddi Avinash Kumar Chindarkar Himanshu Prakash 《Chinese Journal of Traumatology》 CAS CSCD 2023年第5期308-310,共3页
Free flap procedure provides an overall success rate of 97%, which decreases to 85% in hypercoagulable states. COVID-19, as a pro-thrombotic disorder, therefore seems detrimental to free flap survival. We encountered ... Free flap procedure provides an overall success rate of 97%, which decreases to 85% in hypercoagulable states. COVID-19, as a pro-thrombotic disorder, therefore seems detrimental to free flap survival. We encountered a case of unique pattern of free flap partial failure in a young male who underwent extremity reconstruction. The patient was diagnosed as COVID-19 positive on the 3rd day post-reconstruction. The flap survived well for the first 7 days post-operatively, but gradually the skin got necrosed and the subcutaneous fat layer was preserved when debriding. To our knowledge, this is the only case in which the skin of the free flap of a COVID-19 positive patient was necrosed almost entirely subsequently, while the subcutaneous fat was relatively preserved. 展开更多
关键词 COVID-19 Free anterolateral thigh flap Partial flap failure Freeflapcomplication
Repair of a severe palm injury with anterolateral thigh and ilioinguinal flaps: A case report 认领 引用 被引量：1
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作者 Hong-Yang Gong Xi-Guang Sun +2 位作者 Lai-Jin Lu Peng-Cheng Liu Xin Yu 《World Journal of Clinical Cases》 SCIE 2021年第2期502-508,共7页
BACKGROUND In daily life and work,there are more and more patients with trauma to the hand,which often results in skin and soft tissue defects.Although there are many repair methods,the function and appearance of the ... BACKGROUND In daily life and work,there are more and more patients with trauma to the hand,which often results in skin and soft tissue defects.Although there are many repair methods,the function and appearance of the fingers will be adversely affected if the repair is inadequate.CASE SUMMARY In the present report we describe an 18-year-old male patient whose right hand was mangled by a machine.X-ray imaging showed that a right hand bone(middle finger)was absent and the alignment was poor.After hospitalization,he was diagnosed with a severe right hand injury,skin and soft tissue defects,partial finger defects,and a skin degloving injury.He underwent reconstructive surgery with anterolateral thigh and ilioinguinal flaps.After two repair operations,satisfactory results were obtained,including good fracture healing,good skin flap shape,and good wrist joint function.CONCLUSION This case highlights the good effect of anterolateral thigh and ilioinguinal flaps repair technique on severe palm injury. 展开更多
关键词 Palm injury Mechanical damage Anterolateral thigh flap Ilioinguinal flap Case report
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Utility of Preoperative Positron Emission Tomography (PET) in Localizing Perforator Vessels of Anterolateral Thigh Free Flap 认领 引用
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作者 Alexandra McMillan Sameer A. Alvi +3 位作者 Zaid Al-Qurayshi Zachary Fleishacker Nitin A. Pagedar Marisa R. Buchakjian 《International Journal of Otolaryngology and Head & Neck Surgery》 2024年第4期275-284,共10页
Objectives: The anterolateral thigh (ALT) flap is often considered the workhorse in soft tissue reconstruction of head and neck defects secondary to trauma, infection, or tumor resection. Despite its many advantages, ... Objectives: The anterolateral thigh (ALT) flap is often considered the workhorse in soft tissue reconstruction of head and neck defects secondary to trauma, infection, or tumor resection. Despite its many advantages, ALT flaps have been criticized due to variability in vasculature, which may result in inadequate or non-existent perforators. This retrospective study aims to investigate the utility and validity of positron emission tomography (PET) scan to identify the location and characteristics of perforators to the ALT flap. Methods: We performed a 10-year retrospective review of ALT flaps at our institution to identify patients with preoperative PET scans available for analysis. Three reviewers (attending physician, fellow, and resident) were asked to identify the number, location, and characteristics (myocutaneous versus septocutaneous) of ALT perforators on imaging, and reviewer agreement was assessed. Results were then compared to available operative data. Results: One hundred twenty-one patients were identified who underwent ALT free flap surgery. Thirty-eight preoperative PET scans were identified for review. At least one perforator was identified in 92.1% of scans. Agreement percentages regarding the number of perforators ranged from 53% - 61% whereas agreement regarding the location of a single perforator ranged from 79% - 90%. However, reviewers did not agree regarding the type of perforator, with agreement ranging from 34% - 53%. Poor agreement was observed when compared to intraoperative data, with the number of perforators ranging from 26% - 34% and the type of perforator 11% - 24%. These findings are likely due to insufficient data available in operative reports. Conclusion: Although initial studies suggest that PET scan shows promising evidence to support the capacity to preoperatively identify ALT perforators, future prospective studies are warranted to fully validate these findings. 展开更多
关键词 Anterolateral Thigh Flaps Positron Emission Tomography Head and Neck Defects Perforator Mapping
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Clinical observation of endoscopic skull base reconstruction with an anterolateral thigh free fascia flap 认领 引用 被引量：1
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作者 Hong Pan Mang Xiao +2 位作者 Jing Ye Chen Qin Xiaohua Jiang 《Laparoscopic, Endoscopic and Robotic Surgery》 2023年第2期73-77,共5页
Objective:Radiation osteonecrosis of the skull base after radiotherapy for nasopharyngeal carcinoma is one of the most serious complications,affecting patient survival and quality of life.To date,surgical resection is... Objective:Radiation osteonecrosis of the skull base after radiotherapy for nasopharyngeal carcinoma is one of the most serious complications,affecting patient survival and quality of life.To date,surgical resection is the main treatment for radiation osteonecrosis.The repair after the operation is very important.Inappropriate repair or lack of repair can easily cause local infection that can even spread to the brain,aggravating osteonecrosis.This study aimed to verify the feasibility and safety of the ante-rolateral thigh free fascia flap in repairing large skull base defects.Methods:From June 2021 to July 2022,a total of 12 patients with a history of radiotherapy for naso-pharyngeal carcinoma received surgical treatment at the Department of Otolaryngology Head&Neck Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.All patients were diagnosed with radiation osteonecrosis of the skull base with large skull base defects.During the endoscopic operation,a free anterolateral thigh fascia flap was used to repair the skull base and complete vascular anastomosis reconstruction.The preoperative and postoperative pain scores were retrospectively analyzed,and the dynamic changes in endoscopic surgery sites were observed.Results:The 12 patients had a median age of 58 y,with 8(66.7%)males and 4(33.3%)females.The median headache score for the patients was 5(4-7)before surgery.The patient's headache was significantly relieved postoperatively,with 11 patients having a score of 0 and one patient having a score of 1.The stench was completely resolved after the operation.There were no serious complications during the perioperative period or 12 months after the operation.Conclusion:The application of anterolateral thigh free fascia flap in skull base reconstruction is a safe and reliable reconstruction technique suitable for endoscopic surgical repair of large-scale skull base necrosis. 展开更多
关键词 Radiation osteonecrosis Skull base reconstruction Anterolateral thigh free fascia flap Endoscopic
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The Antero-Lateral Thigh Flap in Coverage of Extensive Post Traumatic Upper Limb Defects 认领 引用
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作者 Rasha Abdelkader Hossam El Mahdy +2 位作者 Tamer Nagy Khairalla Ayman Mansour Nisar Haider Zaidi 《Surgical Science》 2016年第7期309-315,共7页
Objective: To assess the role of antero-lateral thigh flaps in coverage in cases with traumatic injury to the upper limb. Methods: A total of fifteen cases of upper limb trauma were studied between May 2014 and Februa... Objective: To assess the role of antero-lateral thigh flaps in coverage in cases with traumatic injury to the upper limb. Methods: A total of fifteen cases of upper limb trauma were studied between May 2014 and February 2016. Antero-lateral thigh flaps were performed to cover post traumatic upper limb soft tissue defects. Brachial interposition grafts were used in all cases. Harvesting was performed using saphenous vein graft. A 10% larger than defect, flap was used to cover defect. Results: The age range was 15 to 46 years. All 15 cases were male. The indication for soft tissue reconstruction was trauma all patients. Each procedure was performed by a “two team” approach with an experienced surgeon raising the flap and a team preparing the recipient vessels. Flap size ranged from 15 to 25 cm in length and from 8 to 10 cm in width. Ischaemic time ranged from 91 to 157 min. We experienced a 100% flap success rate, with good cosmesis and return to function in all cases. Only two anastomoses required explorations or revision. Minor complications were seen in two patients including a superficial wound infection and a small wound dehiscence. The donor site was closed directly all cases, light dressing with slab support was utilized in all patients Early postoperative management warming the patient, half-hourly flap observations, and ensuring adequate hydration and urinary output. All patients received antithrombotic therapy. Conclusion: The anterolateral thigh flap is one of the most versatile and useful perforator flaps for multidimensional reconstructions for head and neck, limb, trunk, and perineal region. It can be ultrathin flap for resurfacing and filling dead spaces with superior functional and aesthetic outcomes. 展开更多
关键词 Anterolateral Thigh Flap Perforator Trauma Defects
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Reconstructing abdominal wall defects with a free composite tissue flap:A case report 认领 引用 被引量：2
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作者 Jun Wang 《World Journal of Clinical Cases》 SCIE 2021年第7期1734-1740,共7页
BACKGROUND Reconstructive repair of huge full-thickness abdominal wall defects following debridement for abdominal electric burns remains a clinically challenging task.An ideal abdominal wall repair means a re-closure... BACKGROUND Reconstructive repair of huge full-thickness abdominal wall defects following debridement for abdominal electric burns remains a clinically challenging task.An ideal abdominal wall repair means a re-closure of the defected abdominal wall with pedicled neurovascular myofascial flaps,restoration of the abdominal wall integrity,and maintenance of the abdominal wall muscle tension to prevent the occurrence of abdominal wall hernia.When treating huge full-thickness defects,composite autologous tissue flaps are a good option for the repair.CASE SUMMARY This study reported the case of a 43-year-old male patient suffering from fullthickness abdominal wall defects complicated with necrosis of multiple bowel segments and duodenal leak following high-voltage burns involving the left upper limb and abdomen.After debridement for abdominal electric burns and end-to-end anastomosis for the necrotic bowels,reconstruction with acellular dermal matrix grafting and vacuum sealing drainage were performed for temporary abdominal closure.The remaining 18 cm×15 cm full-thickness abdominal wall defect was repaired using a combined anterolateral thigh and tensor fascia lata free flap.The proposed method achieved the functional reconstruction of the abdominal wall.CONCLUSION This approach restored the abdominal wall integrity,maintained certain muscle tension,avoided abdominal hernia,reached satisfactory aesthetic effect,and resulted in no complications in the grafting regions. 展开更多
关键词 Abdominal wall defect Anterolateral thigh flap Repair Tensor fascia lata Case report
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Clinical application of digital technology in the use of anterolateral thigh lobulated perforator flaps to repair complex soft tissue defects of the limbs 认领 引用 被引量：13
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作者 Kai-xuan Dong Ya Zhou +6 位作者 Yao-yu Cheng Hao-tian Luo Jia-zhang Duan Xi Yang Yong-qing Xu Sheng Lu Xiao-qing He 《Burns & Trauma》 SCIE 2024年第1期427-435,共9页
Background:It is challenging to repair wide or irregular defects with traditional skin flaps,and anterolateral thigh(ALT)lobulated perforator flaps are an ideal choice for such defects.However,there are many variation... Background:It is challenging to repair wide or irregular defects with traditional skin flaps,and anterolateral thigh(ALT)lobulated perforator flaps are an ideal choice for such defects.However,there are many variations in perforators,so good preoperative planning is very important.This study attempted to explore the feasibility and clinical effect of digital technology in the use of ALT lobulated perforator flaps for repairing complex soft tissue defects in limbs.Methods:Computed tomography angiography(CTA)was performed on 28 patients with complex soft tissue defects of the limbs,and the CTA data were imported into Mimics 20.0 software in DICOM format.According to the perforation condition of the lateral circumflex femoral artery and the size of the limb defect,one thigh that had two or more perforators from the same source vessel was selected for 3D reconstruction of the ALT lobulated perforator flap model.Mimics 20.0 software was used to visualize the vascular anatomy,virtual design and harvest of the flap before surgery.The intraoperative design and excision of the ALT lobulated perforator flap were guided by the preoperative digital design,and the actual anatomical observations and measurements were recorded.Results:Digital reconstruction was successfully performed in all patients before surgery;this reconstruction dynamically displayed the anatomical structure of the flap vasculature and accurately guided the design and harvest of the flap during surgery.The parameters of the harvested flaps were consistent with the preoperative parameters.Postoperative complications occurred in 7 patients,but all flaps survived uneventfully.All of the donor sites were closed directly.All patients were followed up for 13-27 months(mean,19.75 months).The color and texture of each flap were satisfactory and each donor site exhibited a linear scar.Conclusions:Digital technology can effectively and precisely assist in the design and harvest of ALT lobulated perforator flaps,provide an effective approach for individualized evaluation and flap design and reduce the risk and difficulty of surgery. 展开更多
关键词 Digital technology Anterolateral thigh lobulated perforator flap Complex limb defect Reconstruction Microsurgery
Successful reconstruction of an ankle defect with free tissue transfer in a hemophilia A patient with repetitive hemoarthrosis:A case report 认领 引用
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作者 Dong Yun Lee SooA Lim +1 位作者 SuRak Eo Jung Soo Yoon 《World Journal of Clinical Cases》 SCIE 2023年第17期4079-4083,共5页
BACKGROUND Hemophilia, an uncommon yet consequential hereditary bleeding disorder, manifests as two clinically indistinguishable forms that hinder the normal functioning of the coagulation cascade. This impairment ren... BACKGROUND Hemophilia, an uncommon yet consequential hereditary bleeding disorder, manifests as two clinically indistinguishable forms that hinder the normal functioning of the coagulation cascade. This impairment renders individuals more susceptible to excessive bleeding during significant surgical interventions. Moreover, individuals with severe hemophilia frequently encounter recurring hemarthrosis, resulting in progressive joint destruction and, subsequently, the need for hip and knee replacement surgeries.CASE SUMMARY The patient was a 53-year-old man with hemophilia A as the underlying disease and had self-injected factor Ⅷ twice weekly for several decades. He had undergone ankle fusion surgery for recurrent hemarthrosis at the Department of Orthopedic Surgery 1 mo prior and was referred to our department because of skin necrosis after a hematoma at the surgical site. An anterolateral thigh perforator free flap was created after three cycles of factor Ⅷ administration in addition to the concomitant administration of tranexamic acid(TXA)(Transamin 250 mg cap, 1 cap tid, q8h). After the operation, from postoperative days(PODs) 1-5, the factor Ⅷ dose and interval were maintained, and q12h administration was tapered to q24h administration after POD 6. Because the patient’s flap was stable 12 d after the operation, factor Ⅷ administration was tapered to twice a week. At 6 mo follow-up, the patient recovered well without any complications.CONCLUSION To the best of our knowledge, there are very few reports of successful free flaps in patients with hemophilia, and none have been reported in patients with hemophilia A. Moreover, there are several reports on the efficacy of TXA in free flaps in general patients;however, there are no case reports of combining factor Ⅷ and TXA in patients with hemophilia. Therefore, we report this case to contribute to future academic research. 展开更多
关键词 Free tissue transfer Anterolateral thigh free flap Hemophilia A Hemoarthrosis Factor VIII Tranexamic acid Case report
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Established and experimental techniques to improve phalloplasty outcomes/optimization of a hypercomplex surgery 认领 引用
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作者 Erin E.Carter Curtis N.Crane Richard A.Santucci 《Plastic and Aesthetic Research》 2020年第6期50-64,共15页
An increasing number of transgender and gender non-conforming patients are seeking genital gender affirming surgeries in order to better align their physical characteristics with their innate gender identity and treat... An increasing number of transgender and gender non-conforming patients are seeking genital gender affirming surgeries in order to better align their physical characteristics with their innate gender identity and treat gender dysphoria.Phalloplasty is the most complex of these surgeries,and this complexity creates a wide range of potential complications.Some of the most common complications and therefore,targets for improvement in outcomes,concern neourethral fistula/stricture,efficacy of reinnervation of the phalloplasty flap,postoperative flap monitoring,and donor site morbidity.In the setting of no established"gold standard",this review seeks to describe the components and staging of phalloplasty,with an emphasis on established and experimental solutions to the most common and vexing problems. 展开更多
关键词 Phalloplasty transgender female to male transmasculine surgical complications radial forearm flap anterolateral thigh flap genital gender confirmation
Penoscrotal defect:a functional,esthetic,and psychological challenge 认领 引用
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作者 Durga Karki Pankaj Kumar Patel Ravi Prakash Narayan 《Plastic and Aesthetic Research》 2016年第1期64-67,共4页
Aim:Penoscrotal defects may be caused by a variety of events.Reconstruction of the penoscrotal region is required not only for aesthetic appearance but also for functional and psychological reasons.Numerous techniques... Aim:Penoscrotal defects may be caused by a variety of events.Reconstruction of the penoscrotal region is required not only for aesthetic appearance but also for functional and psychological reasons.Numerous techniques have been described for penoscrotal reconstruction reflecting the challenge and complexity of the region involved.This suggests that no single method is satisfactory for all types and degrees of tissue defects.This prospective study was conducted in a tertiary care hospital in India,over a period of 5 years.Methods:Eighteen patients with penoscrotal defects of varying etiology were included in the study and underwent different surgical techniques.Age of the patients ranged from 20 to 60 years.The etiology of penoscrotal defect was Fournier’s gangrene in 12 cases,trauma in 4 cases,and burn in 2 cases.The patients with Fournier’s gangrene were initially treated by debridement,drainage,and antibiotics.The penoscrotal defects were treated with local flap advancement with skin grafting(n=7),pedicled anterolateral thigh flap(n=4),gracilis muscle flap with split skin grafting(n=4),and medial thigh flap(n=3).Results:There was complete healing in 16 patients with minor complications in the form of partial skin graft loss(n=1)and wound dehiscence(n=1).Results were highly satisfactory in 6 patients,satisfactory in 8 patients,and not satisfactory in 4 patients.Scarring at the donor site was limited and acceptable.Conclusion:The vast arsenal of options for penoscrotal defect coverage ranges from skin grafting to flaps,and every case needs a customized approach with regard to its feasibility,outcome,and complication rate.Flaps should be the preferred choice over the skin grafts because of the superior functional and aesthetic results and better compliance. 展开更多
关键词 Anterolateral thigh flap gracilis muscle flap penoscrotal defect
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