scholarly journals Chronic Scalp Ulcer 35 Years after Skull Trepanation Surgery and Radiotherapy for Oligodendroglioma: A Further Example of Immunocompromised Cutaneous Districts

2017 ◽  
Vol 6 (1) ◽  
pp. 55-57
Author(s):  
Uwe Wollina ◽  
Andreas Nowak ◽  
Georgi Tchernev ◽  
Torello Lotti
Keyword(s):  
Soft Tissue ◽  
Cancer Patients ◽  
Soft Tissue Defect ◽  
Second Malignancy ◽  
Complex Defect ◽  
Complex Reconstruction ◽  
Exposed Bone ◽  
Defect Repair ◽  
Chronic Ulcers ◽  
Dermal Template

BACKGROUND: Chronic ulcers of the scalp have a variety of underlying pathologies. In case of cancer patients, a second malignancy must be excluded.CASE REPORT: A 78-year-old female patient presented to our department with a large soft tissue defect on the frontotemporal left side. The lesion was about 3 cm in diameter with exposed bone and inflammatory soft tissue on the edges of the defect. About 35 years ago, she had undergone a combined neurosurgery with skull trepanation and radiotherapy for an oligodendroglioma. Three years ago, sandwich transplantation with the dermal template and meshed skin graft failed. Now she re-presented with inflammatory ulcer borders. A complex defect repair was performed after exclusion of a second malignancy.CONCLUSION: Chronic scalp ulcers may be the result immunocompromised cutaneous districts and need a complex reconstruction.

scholarly journals The «Propeller»–technique in plastic surgery of the extensive wounds of distal leg and the foot

2019 ◽  
Vol 86 (3) ◽  
pp. 27-31
Author(s):  
G. E. Samoylenko ◽  
S. O. Zharikov ◽  
R. P. Klimanskyi
Keyword(s):  
Soft Tissue ◽  
Plastic Surgery ◽  
Large Scale ◽  
Occupational Injuries ◽  
Vascular Supply ◽  
Soft Tissue Defect ◽  
Defect Repair ◽  
Effective Instrument ◽  
Group 2 ◽  
Blast Trauma

Objective. To increase the efficacy of plastic surgery in treatment of the extensive soft tissue defects, applying “sparing” resection of the lower third of the shin and foot for consequences of mechanical and/or thermal trauma or infectious–necrotic processes.   Materials and methods. We conducted a retrospective evaluation of the “Propeller”–technique application for the elevation of the skin islet flaps on sural neurovascular pedicle in 11 patients, who underwent surgery between 2014 and 2017. The task for investigation was to eliminate the shin and foot defects, developed due to large–scale tissue damage. The Group 1 was organized for patients with the mine–blast trauma and the coal mine occupational injuries (2 patients followed in each category). Management of purulent–necrotic wounds (Group 2) was required in cases of amputation and resection of the foot due to either osteomyelitis (3 patients followed) or frostbites (4 patients followed).   Results. All the patients had an adequate vascular supply of the affected limbs, even in 3 patients from the Group II, who had only one artery preserved. In all cases a secondary surgical debridement, necrectomy and the soft tissue defect repair were performed during the same operation.   Conclusions. Using of the tegument tissues mobilization complex “Propeller”– technique is an effective instrument for sealing of deep complex defects of different etiology, localized in distal part of the lower extremity.

Heterodigital Free Flap of Index Finger Amputee for Coverage of the Long Finger Soft Tissue Defect

2013 ◽  
Vol 22 (2) ◽  
pp. 82-85 ◽  
Author(s):  
So-Min Hwang ◽  
Jang Hyuk Kim ◽  
Hong-Il Kim ◽  
Yong-Hui Jung ◽  
Hyung-Do Kim
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Index Finger ◽  
Soft Tissue Defect ◽  
Tissue Defect

scholarly journals No implant, no solution, lost cases to surgery: orthopedic trauma triage for surgery in an NGO hospital in Sierra Leone

2021 ◽  
Author(s):  
F. Wichlas ◽  
V. Hofmann ◽  
M. Moursy ◽  
G. Strada ◽  
C. Deininger
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Sierra Leone ◽  
Low Income ◽  
Soft Tissue Defect ◽  
Low Income Countries ◽  
Pelvic Surgery ◽  
Closed Fractures ◽  
Trauma Triage ◽  
Tissue Defects

Abstract Introduction In low-income countries (LIC), international surgeons face the fact that there are patients they cannot treat. The goal of this study was to identify and analyze patients lost to treatment. Material and methods We analyzed retrospectively the data of 282 trauma victims from a non-governmental organizational (NGO) hospital in Sierra Leone, Africa. During a 3-month period (10.10.2015–08.01.2016), these patients had 367 injuries and underwent 263 orthopedic surgeries. Despite a clear indication, some patients did not receive surgical treatment. We identified these injuries and the reason why they could not be operated. The anatomic region of the injury was evaluated and if they had a bone or soft tissue defect or were infected. Results We identified 95 (25.89%) injuries in 70 patients (47 males; 23 females) that were not be operated. The reasons were lack of specific implants (no implant group; N = 33), no treatment strategy for the injury (no solution group; N = 29), and patients that were lost (lost patient group; N = 33), almost equally distributed by 1/3. In the no implant group were mainly closed fractures and fractures of the pelvis and the proximal femur. The implants needed were locking plates (N = 19), proximal femoral nails (N = 8), and implants for pelvic surgery (N = 6). In the no solution group were nearly all bone (P < 0.0000), soft tissue defects (P < 0.00001) and infections (P = 0.00003) compared to the rest and more open fractures (P < 0.00001). In the lost patients group, most fractures were closed (24 out of 33, P = 0.033). These fractures were mostly not urgent and were postponed repeatedly. Conclusion One quarter of the patients did not receive the surgical treatment needed. Besides acquisition of implants, surgical skills and expertise could be a solution for this issue. Nevertheless, these skills must be passed to local surgeons.

Nanofiber-hydrogel composite–mediated angiogenesis for soft tissue reconstruction

2019 ◽  
Vol 11 (490) ◽  
pp. eaau6210 ◽  
Author(s):  
Xiaowei Li ◽  
Brian Cho ◽  
Russell Martin ◽  
Michelle Seu ◽  
Chi Zhang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Rabbit Model ◽  
Soft Tissue Defect ◽  
Fat Grafting ◽  
Foreign Body Response ◽  
Soft Tissue Reconstruction ◽  
Hydrogel Composite ◽  
Tissue Flaps ◽  
Tissue Restoration

Soft tissue losses from tumor removal, trauma, aging, and congenital malformation affect millions of people each year. Existing options for soft tissue restoration have several drawbacks: Surgical options such as the use of autologous tissue flaps lead to donor site defects, prosthetic implants are prone to foreign body response leading to fibrosis, and fat grafting and dermal fillers are limited to small-volume defects and only provide transient volume restoration. In addition, large-volume fat grafting and other tissue-engineering attempts are hampered by poor vascular ingrowth. Currently, there are no off-the-shelf materials that can fill the volume lost in soft tissue defects while promoting early angiogenesis. Here, we report a nanofiber-hydrogel composite that addresses these issues. By incorporating interfacial bonding between electrospun poly(ε-caprolactone) fibers and a hyaluronic acid hydrogel network, we generated a composite that mimics the microarchitecture and mechanical properties of soft tissue extracellular matrix. Upon subcutaneous injection in a rat model, this composite permitted infiltration of host macrophages and conditioned them into the pro-regenerative phenotype. By secreting pro-angiogenic cytokines and growth factors, these polarized macrophages enabled gradual remodeling and replacement of the composite with vascularized soft tissue. Such host cell infiltration and angiogenesis were also observed in a rabbit model for repairing a soft tissue defect filled with the composite. This injectable nanofiber-hydrogel composite augments native tissue regenerative responses, thus enabling durable soft tissue restoration outcomes.

Free hemiback flap with surgical delay for reconstruction of extensive soft tissue defect: A case report

Microsurgery ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 152-155 ◽  
Author(s):  
Masao Fujiwara ◽  
Takeshi Nagata ◽  
Yuki Matsushita ◽  
Hidekazu Fukamizu
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Soft Tissue Defect ◽  
Surgical Delay ◽  
Tissue Defect
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