Catalogo Articoli (Spogli Riviste)

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Titolo:
Coverage of distal lower extremity soft tissue defects and unstable scars over the Achilles tendon
Autore:
Sauerbier, M; Erdmann, D; Bruner, S; Pelzer, M; Menke, H; Germann, G;
Indirizzi:
Univ Heidelberg, Abt Verbrennungen Plast & Handchirurg, Berufsgenossenschaftliche Unfallklin Ludwigshafen, D-67071 Ludwigshafen, Germany Univ Heidelberg Ludwigshafen Germany D-67071 67071 Ludwigshafen, Germany
Titolo Testata:
CHIRURG
fascicolo: 9, volume: 71, anno: 2000,
pagine: 1161 - 1166
SICI:
0009-4722(200009)71:9<1161:CODLES>2.0.ZU;2-L
Fonte:
ISI
Lingua:
GER
Soggetto:
SURAL ISLAND FLAP; FASCIOCUTANEOUS FLAP; PARASCAPULAR FLAP; FASCIAL FLAP; LOWER-LIMB; LOWER LEG; RECONSTRUCTION; REPAIR; EXPERIENCE; REGION;
Keywords:
microsurgery; free flap; Achilles tendon defect; soft tissue coverage; lower extremity;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Sauerbier, M Univ Heidelberg, Abt Verbrennungen Plast & Handchirurg, Berufsgenossenschaftliche Unfallklin Ludwigshafen, Ludwig Guttmann Str 13, D-67071 Ludwigshafen, Germany Univ Heidelberg Ludwig Guttmann Str 13 Ludwigshafen Germany D-67071
Citazione:
M. Sauerbier et al., "Coverage of distal lower extremity soft tissue defects and unstable scars over the Achilles tendon", CHIRURG, 71(9), 2000, pp. 1161-1166

Abstract

Introduction: Coverage of the exposed Achilles tendon requires thin, supple tissue to provide adequate range of motion and a satisfying aesthetic result for the distal lower extremity. Various local flaps and free flaps havebeen described for reconstruction of small and large defects. Small defects can be closed with local tissue, whereas free flap coverage may be necessary for coverage of large defects. Methods: From July 1993 to September 1998 14 patients between the age of 15 and 74 years (mean 47 years; 3 female, 11 male) underwent free flap coverage for the exposed Achilles tendon due to primary trauma, chronic wounds or tumors. The mean duration of follow-up was 33.3 months. The defect size ranged from 8 x 8 to 25 x 28 cm. Results: Six parascapular flaps (three with a vascularized scapular fascial extension), four radial forearm flaps and four latissimus dorsi flaps (one combinedwith free serratus fascia) were used for soft tissue coverage over the Achilles tendon. Thirteen flaps survived. In one case a parascapular flap had to be removed due to venous thrombosis and a free latissimus dorsi flap wasused as secondary salvage procedure. The donor site morbidity was acceptable for most patients after flag harvesting in the subscapular region and also satisfactory in the forearm region. Average active range of motion in the upper ankle joint was 15-0-40 degrees for extension/flexion. All patientswere satisfied with the functional and aesthetic result. Conclusion: Soft tissue coverage over the exposed Achilles tendon requires an optimal solution for each patient to achieve an aesthetically pleasing result and acceptable function. Microvascular free flaps can be used to reconstruct medium and large defects and to provide gliding tissue for the Achilles tendon. The complication rate of microvascular flaps is comparable with that of local flaps.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/09/20 alle ore 05:14:53