Chimeric SCIP flap with iliac bone for reconstruction of foot first ray in a radiated surgical bed: A case report
Surgical management of sarcoma has evolved from amputation to limb salvage. Nevertheless, subsequent resections in previously irradiated feet are still challenging to reconstruct. First foot ray functional reconstruction is relevant due to its function in weight‐bearing and gait. The reconstruction...
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| Veröffentlicht in: | Microsurgery 2023-05, Vol.43 (4), p.403-407 |
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| creator | Torrano, Laura Zamora Alarcón, Paúl Ibarra, Andreé Masiá, Jaume Sisternas Hernández, Lucía Fernández‐Garrido, Manuel |
| description | Surgical management of sarcoma has evolved from amputation to limb salvage. Nevertheless, subsequent resections in previously irradiated feet are still challenging to reconstruct. First foot ray functional reconstruction is relevant due to its function in weight‐bearing and gait. The reconstruction should include a thin, pliable and non‐shearing skin paddle with vascularized long cortical bone to mimic the first metatarsal. A clinical case of a 37‐year‐old patient with a second sarcoma recurrence of the first metatarsal is presented. The patient was irradiated before this new recurrence and had a previous reconstruction with fibula allograft, but subsequently developed a first metatarsal pseudoarthrosis. A wide resection was performed (3.5 cm bone defect) and immediate soft tissue and bone reconstruction with a chimeric SCIP flap with a 17 × 8 cm skin paddle and 3.5 × 1.5 cm iliac bone (cSCIP‐IB). At 7 months post‐operatively, the patient was able to resumed full weight‐bearing. Three years later, remains without disease progression. CSCIP‐IB is a good option for foot first ray reconstruction in irradiated beds. This flap has low donor site morbidity and a higher ossification success rate compared to bone allografts. |
| doi_str_mv | 10.1002/micr.31019 |
| format | Article |
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Nevertheless, subsequent resections in previously irradiated feet are still challenging to reconstruct. First foot ray functional reconstruction is relevant due to its function in weight‐bearing and gait. The reconstruction should include a thin, pliable and non‐shearing skin paddle with vascularized long cortical bone to mimic the first metatarsal. A clinical case of a 37‐year‐old patient with a second sarcoma recurrence of the first metatarsal is presented. The patient was irradiated before this new recurrence and had a previous reconstruction with fibula allograft, but subsequently developed a first metatarsal pseudoarthrosis. A wide resection was performed (3.5 cm bone defect) and immediate soft tissue and bone reconstruction with a chimeric SCIP flap with a 17 × 8 cm skin paddle and 3.5 × 1.5 cm iliac bone (cSCIP‐IB). At 7 months post‐operatively, the patient was able to resumed full weight‐bearing. Three years later, remains without disease progression. CSCIP‐IB is a good option for foot first ray reconstruction in irradiated beds. This flap has low donor site morbidity and a higher ossification success rate compared to bone allografts.</description><identifier>ISSN: 0738-1085</identifier><identifier>EISSN: 1098-2752</identifier><identifier>DOI: 10.1002/micr.31019</identifier><identifier>PMID: 36748171</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Adult ; Allografts ; Amputation ; Bone grafts ; Case reports ; Cortical bone ; Feet ; Fibula ; Fibula - transplantation ; Gait ; Humans ; Long bone ; Lower Extremity - surgery ; Metatarsus ; Morbidity ; Ossification ; Perforator Flap - surgery ; Plastic Surgery Procedures ; Reconstructive surgery ; Sarcoma ; Sarcoma - surgery ; Shearing ; Skin ; Soft tissues ; Surgical Flaps - surgery</subject><ispartof>Microsurgery, 2023-05, Vol.43 (4), p.403-407</ispartof><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3249-e638b9520c88291f3611667f58f0ba59c48ee81c3836dfe554c394729a6c08243</citedby><cites>FETCH-LOGICAL-c3249-e638b9520c88291f3611667f58f0ba59c48ee81c3836dfe554c394729a6c08243</cites><orcidid>0000-0002-8055-1683 ; 0000-0001-8024-8986 ; 0000-0003-3399-0672 ; 0000-0003-1539-7066</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmicr.31019$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmicr.31019$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36748171$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Torrano, Laura</creatorcontrib><creatorcontrib>Zamora Alarcón, Paúl</creatorcontrib><creatorcontrib>Ibarra, Andreé</creatorcontrib><creatorcontrib>Masiá, Jaume</creatorcontrib><creatorcontrib>Sisternas Hernández, Lucía</creatorcontrib><creatorcontrib>Fernández‐Garrido, Manuel</creatorcontrib><title>Chimeric SCIP flap with iliac bone for reconstruction of foot first ray in a radiated surgical bed: A case report</title><title>Microsurgery</title><addtitle>Microsurgery</addtitle><description>Surgical management of sarcoma has evolved from amputation to limb salvage. Nevertheless, subsequent resections in previously irradiated feet are still challenging to reconstruct. First foot ray functional reconstruction is relevant due to its function in weight‐bearing and gait. The reconstruction should include a thin, pliable and non‐shearing skin paddle with vascularized long cortical bone to mimic the first metatarsal. A clinical case of a 37‐year‐old patient with a second sarcoma recurrence of the first metatarsal is presented. The patient was irradiated before this new recurrence and had a previous reconstruction with fibula allograft, but subsequently developed a first metatarsal pseudoarthrosis. A wide resection was performed (3.5 cm bone defect) and immediate soft tissue and bone reconstruction with a chimeric SCIP flap with a 17 × 8 cm skin paddle and 3.5 × 1.5 cm iliac bone (cSCIP‐IB). At 7 months post‐operatively, the patient was able to resumed full weight‐bearing. Three years later, remains without disease progression. CSCIP‐IB is a good option for foot first ray reconstruction in irradiated beds. This flap has low donor site morbidity and a higher ossification success rate compared to bone allografts.</description><subject>Adult</subject><subject>Allografts</subject><subject>Amputation</subject><subject>Bone grafts</subject><subject>Case reports</subject><subject>Cortical bone</subject><subject>Feet</subject><subject>Fibula</subject><subject>Fibula - transplantation</subject><subject>Gait</subject><subject>Humans</subject><subject>Long bone</subject><subject>Lower Extremity - surgery</subject><subject>Metatarsus</subject><subject>Morbidity</subject><subject>Ossification</subject><subject>Perforator Flap - surgery</subject><subject>Plastic Surgery Procedures</subject><subject>Reconstructive surgery</subject><subject>Sarcoma</subject><subject>Sarcoma - surgery</subject><subject>Shearing</subject><subject>Skin</subject><subject>Soft tissues</subject><subject>Surgical Flaps - surgery</subject><issn>0738-1085</issn><issn>1098-2752</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kFtLwzAUgIMobk5f_AES8E3ozKVpE99G8TKYKF6eS5omLqNruqRl7N_b2emjT-dw-PgOfABcYjTFCJHbtVV-SjHC4giMMRI8Iikjx2CMUsojjDgbgbMQVgghIVJxCkY0SWOOUzwGm2xp19pbBd-z-Ss0lWzg1rZLaCsrFSxcraFxHnqtXB1a36nWuho6019dC431oYVe7qCtoeyX0spWlzB0_ssqWcFCl3dwBpUMunc0zrfn4MTIKuiLw5yAz4f7j-wpWrw8zrPZIlKUxCLSCeWFYAQpzonAhiYYJ0lqGDeokEyomGvNsaKcJqXRjMWKijglQiYKcRLTCbgevI13m06HNl-5ztf9y5zwPgpihCU9dTNQyrsQvDZ54-1a-l2OUb6vm-_r5j91e_jqoOyKtS7_0N-cPYAHYGsrvftHlT_Ps7dB-g21S4M_</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Torrano, Laura</creator><creator>Zamora Alarcón, Paúl</creator><creator>Ibarra, Andreé</creator><creator>Masiá, Jaume</creator><creator>Sisternas Hernández, Lucía</creator><creator>Fernández‐Garrido, Manuel</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>7T7</scope><scope>7TK</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><orcidid>https://orcid.org/0000-0002-8055-1683</orcidid><orcidid>https://orcid.org/0000-0001-8024-8986</orcidid><orcidid>https://orcid.org/0000-0003-3399-0672</orcidid><orcidid>https://orcid.org/0000-0003-1539-7066</orcidid></search><sort><creationdate>202305</creationdate><title>Chimeric SCIP flap with iliac bone for reconstruction of foot first ray in a radiated surgical bed: A case report</title><author>Torrano, Laura ; Zamora Alarcón, Paúl ; Ibarra, Andreé ; Masiá, Jaume ; Sisternas Hernández, Lucía ; Fernández‐Garrido, Manuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3249-e638b9520c88291f3611667f58f0ba59c48ee81c3836dfe554c394729a6c08243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Allografts</topic><topic>Amputation</topic><topic>Bone grafts</topic><topic>Case reports</topic><topic>Cortical bone</topic><topic>Feet</topic><topic>Fibula</topic><topic>Fibula - transplantation</topic><topic>Gait</topic><topic>Humans</topic><topic>Long bone</topic><topic>Lower Extremity - surgery</topic><topic>Metatarsus</topic><topic>Morbidity</topic><topic>Ossification</topic><topic>Perforator Flap - surgery</topic><topic>Plastic Surgery Procedures</topic><topic>Reconstructive surgery</topic><topic>Sarcoma</topic><topic>Sarcoma - surgery</topic><topic>Shearing</topic><topic>Skin</topic><topic>Soft tissues</topic><topic>Surgical Flaps - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Torrano, Laura</creatorcontrib><creatorcontrib>Zamora Alarcón, Paúl</creatorcontrib><creatorcontrib>Ibarra, Andreé</creatorcontrib><creatorcontrib>Masiá, Jaume</creatorcontrib><creatorcontrib>Sisternas Hernández, Lucía</creatorcontrib><creatorcontrib>Fernández‐Garrido, Manuel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Microsurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Torrano, Laura</au><au>Zamora Alarcón, Paúl</au><au>Ibarra, Andreé</au><au>Masiá, Jaume</au><au>Sisternas Hernández, Lucía</au><au>Fernández‐Garrido, Manuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chimeric SCIP flap with iliac bone for reconstruction of foot first ray in a radiated surgical bed: A case report</atitle><jtitle>Microsurgery</jtitle><addtitle>Microsurgery</addtitle><date>2023-05</date><risdate>2023</risdate><volume>43</volume><issue>4</issue><spage>403</spage><epage>407</epage><pages>403-407</pages><issn>0738-1085</issn><eissn>1098-2752</eissn><abstract>Surgical management of sarcoma has evolved from amputation to limb salvage. Nevertheless, subsequent resections in previously irradiated feet are still challenging to reconstruct. First foot ray functional reconstruction is relevant due to its function in weight‐bearing and gait. The reconstruction should include a thin, pliable and non‐shearing skin paddle with vascularized long cortical bone to mimic the first metatarsal. A clinical case of a 37‐year‐old patient with a second sarcoma recurrence of the first metatarsal is presented. The patient was irradiated before this new recurrence and had a previous reconstruction with fibula allograft, but subsequently developed a first metatarsal pseudoarthrosis. A wide resection was performed (3.5 cm bone defect) and immediate soft tissue and bone reconstruction with a chimeric SCIP flap with a 17 × 8 cm skin paddle and 3.5 × 1.5 cm iliac bone (cSCIP‐IB). At 7 months post‐operatively, the patient was able to resumed full weight‐bearing. Three years later, remains without disease progression. CSCIP‐IB is a good option for foot first ray reconstruction in irradiated beds. This flap has low donor site morbidity and a higher ossification success rate compared to bone allografts.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>36748171</pmid><doi>10.1002/micr.31019</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-8055-1683</orcidid><orcidid>https://orcid.org/0000-0001-8024-8986</orcidid><orcidid>https://orcid.org/0000-0003-3399-0672</orcidid><orcidid>https://orcid.org/0000-0003-1539-7066</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Allografts Amputation Bone grafts Case reports Cortical bone Feet Fibula Fibula - transplantation Gait Humans Long bone Lower Extremity - surgery Metatarsus Morbidity Ossification Perforator Flap - surgery Plastic Surgery Procedures Reconstructive surgery Sarcoma Sarcoma - surgery Shearing Skin Soft tissues Surgical Flaps - surgery |
| title | Chimeric SCIP flap with iliac bone for reconstruction of foot first ray in a radiated surgical bed: A case report |
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