The Use of Negative-Pressure Therapy and Skin Grafting in the Treatment of Soft-Tissue Defects Over the Achilles Tendon

2005 ◽  
Vol 55 (4) ◽  
pp. 367-370 ◽  
Author(s):  
Remus Repta ◽  
R Ford ◽  
L Hoberman ◽  
B Rechner
2008 ◽  
Vol 12 (5) ◽  
pp. 223-229 ◽  
Author(s):  
Raymund E. Horch ◽  
Adrian Dragu ◽  
Werner Lang ◽  
Paul Banwell ◽  
Mareike Leffler ◽  
...  

Background: Soft tissue defects of the limb with exposure of tendons and bones in critically ill patients usually lead to extremity amputation. A potential treatment with topical negative pressure may allow split-thickness skin grafting to the bone, which leads to limb salvage. Materials and Methods: We report on 21 multimorbid patients, 46 to 80 years of age, with severe lower limb soft tissue loss and infection with exposed bone following débridement with critical limb ischemia. Attempts to salvage the extremities were undertaken with repeated surgical débridement followed by vacuum-assisted closure therapy and subsequent split-thickness skin grafting procedures. Results: Infection control and limb salvage were achieved in all cases with multiple débridements, topical negative pressure therapy, and skin grafts. In all patients, the exposure of tendons and bones was reversible by this strategy without a free flap transfer. Discussion: The patients described in this study were severely compromised by systemic and vascular disorders, so extremity amputation had been considered owing to the overall condition and the exposure of tendons and bones. Since it was possible to salvage the affected limbs with this straightforward and simple procedure, this type of treatment should be considered as a last attempt to prevent amputation.


2015 ◽  
Vol 37 (3) ◽  
pp. 185-190 ◽  
Author(s):  
Teruaki FUJITANI ◽  
Yukichi ZENKE ◽  
Michitaka SHINONE ◽  
Kunitaka MENUKI ◽  
Keizo FUKUMOTO ◽  
...  

2018 ◽  
Vol 108 (5) ◽  
pp. 409-418
Author(s):  
Jiasharete Jielile ◽  
Pengfei Li ◽  
Wulan Bahetiya ◽  
Aynaz Badelhan ◽  
Bayixiati Qianman ◽  
...  

Motorcycle spoke injuries involving the soft tissue, Achilles tendon, and calcaneal defects are rare in children. Currently, calcaneal defects are very challenging to treat. Multiple methods have been used in clinical practice; however, an effective treatment has yet to be established, especially when Achilles tendon and soft-tissue defects are also present. It is important to address this condition, because the calcaneus plays a key role in standing and gait. Unsatisfactory treatment of calcaneal defects may significantly decrease patients' quality of life (eg, by limiting mobility). In this article, we report the effective treatment of calcaneal defects in four children using distraction osteogenesis with an external fixator framework designed by the authors. From May 2014 to May 2015, four children (age range, 6–11 years) with defects of the Achilles tendon, soft tissue, and calcaneus resulting from a motorcycle accident were treated at our hospital. The Achilles tendon and soft-tissue defects were treated with second-stage reconstruction. In the third-stage surgery, osteotomy of the residual calcaneus was performed. A customized external fixator was used to lengthen the calcaneus at a rate of 1.5 mm/day in the posterior direction and reposition it by 40° in the inferior direction. In all four children, the calcaneus was lengthened by 5 cm. Distraction osteogenesis through external fixation is effective for restoring the length, width, and height of the calcaneus in children.


2015 ◽  
Vol 74 (1) ◽  
pp. 121-125 ◽  
Author(s):  
Matthew L. Iorio ◽  
Kevin D. Han ◽  
Karen K. Evans ◽  
Christopher E. Attinger

2020 ◽  
pp. 1-4
Author(s):  
Ratnakar Sharma ◽  
Mir Adnan Samad ◽  
Kumar Sourav Dogra ◽  
Shaarang Gupta

Background: The defects of the groin and the genitalia are complex and pose a challenge to the reconstructive surgeon. These defects may arise out of a variety of insults which include – extirpative oncologic surgeries, necrotizing fasciitis, post burn defects, post traumatic defects including road traffic accidents and animal bites etc. Objectives: To study the epidemiology of the acquired soft tissue defects of the groin and genitalia. To evaluate the role of various reconstructive modalities for the acquired soft tissue defects of groin and genitalia. Materials & Methods: This study was conducted in the Department of Surgery, Govt. Medical College Jammu, J&K, India and included 25 patients admitted with acquired soft-tissue defects of groin and genitalia over a period extending from November 2018 to October 2019 (Prospective study). Personal and demographic data of the patient was noted. A detailed history regarding the cause of the defect along with history of trauma, discharge and bleed from the site was taken. Any past history of surgery and irradiation of the region was noted. The patients having soft tissue defects of the groin and genitalia secondary to the release of post burn contracture were subjected to the detailed history as regards cause of burn, treatment taken and time taken for burn wounds to heal. Examination included general physical examination along with the local wound condition which included site, size, discharge, slough, granulation tissue and any exposed vital structures such as vessels/ nerves. A hemogram, assessment of blood sugar, renal function (blood urea nitrogen and serum creatinine), coagulation profile, blood grouping, viral markers, chest x-ray and ECG were done as a part of routine pre-operative investigations. Wound swab was sent for culture. Biopsy was taken wherever required. Analysis of report of any previously taken biopsy was done. Split thickness skin grafting was the modality of coverage utilized in 56% cases followed by flap coverage in 32% cases. 12% of the defects were closed primarily. Results: Majority of the patients had durable coverage of the defects of groin/genitalia and the coverage modality was acceptable to the patient as regards aesthesis and functional outcome. No major complication was encountered in any of the patients. Conclusion: The reconstruction of the soft tissue defects of groin and genitalia need a meticulous examination and planning of reconstructive modality which may include skin grafting or a flap coverage.


2006 ◽  
Vol 19 (1) ◽  
pp. 67 ◽  
Author(s):  
Keun Bae Lee ◽  
Jin Choi ◽  
Eun Sun Moon ◽  
Taek Rim Yoon ◽  
Keun Young Lim

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