Long-term follow-up of coverage of weight bearing surface of the foot with free muscular flap in a pediatric population
Between 1985 and 1991, 13 muscular free flaps with split thickness skin grafts (10 latissimus dorsi, 2 rectus abdominis, and 1 gracilis) were done in 12 patients to cover the weight bearing surface of the foot. Four open wounds were closed primarily and nine unstable scars were replaced with a free...
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| Veröffentlicht in: | Microsurgery 1994, Vol.15 (6), p.424-429 |
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| creator | Harris, Patrick G. Letrosne, Eric Caouette-Laberge, Louise Egerszegi, E. Patricia |
| description | Between 1985 and 1991, 13 muscular free flaps with split thickness skin grafts (10 latissimus dorsi, 2 rectus abdominis, and 1 gracilis) were done in 12 patients to cover the weight bearing surface of the foot. Four open wounds were closed primarily and nine unstable scars were replaced with a free flap.
A retrospective analysis shows that over the short term the flaps provided a complete coverage of wounds, with a 100% survival of flaps, and permitted normal weight bearing ambulation starting at 1 month postoperatively. Long‐term results show deep pressure sensation but no light touch sensation. All patients are able to wear normal shoes. Six patients (seven flaps) required further surgery to close subsequent wounds on the flaps: Three hypertrophic scars with recurrent ulcerations needed scar revisions, one child presented a fistula through the flap due to underlying osteomyelitis, and one patient presented a friction wound on the lateral malleolus requiring thinning of the flap. Two flaps presented an area of pressure necrosis through the full thickness of the flap and had to be replaced with another free flap (fasciocutaneous sensate flap) over the heel area.
In conclusion, it seems that in the pediatric population, skin‐grafted muscular coverage of the weight bearing surface of the foot is a good alternative, even if more problems with hypertrophic scarring around the grafts have been found than in the adult population. In two cases, the flaps had to be replaced because of pressure necrosis over the calcaneus. Long‐term follow‐up of the sensate fasciocutaneous flaps will be needed to find out if they provide a better alternative for foot coverage. © 1994 Wiley‐Liss, Inc.
SUIVI À LONG TERME DU RECOUVREMENT DE LA SURFACE PORTEUSE DU PIED AVEC LAMBEAU MUSCULAIRE LIBRE CHFZ LA POPULATIOMN PÉDIATRIQUE
Entre 1985 et 1991, 13 lambeaux musculaires libres avec greffe cutanée d'épaisseur (10 grands dorsaux, 2 grands droits de l'abdomen et 1 gracilis) ont été réalisés chez 12 patients pour recouvirir la surface porteuse du pied. Quatre plaies ont ainsi été remplacées primairement tandis que 9 cicatrices instables ont été remplacés.
Une analyse rétrospective démontre à court terme une couverture compléte des plaies, une survie de 100% des lambeaux et une mise en charge normale débutée Progressivement 1 mois aprés la chirurgie A long terme, on retrouve une sensibilité profonde à la pression mais pas de sensibilité superficielle au toucher, Tous les patients portent |
| doi_str_mv | 10.1002/micr.1920150611 |
| format | Article |
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A retrospective analysis shows that over the short term the flaps provided a complete coverage of wounds, with a 100% survival of flaps, and permitted normal weight bearing ambulation starting at 1 month postoperatively. Long‐term results show deep pressure sensation but no light touch sensation. All patients are able to wear normal shoes. Six patients (seven flaps) required further surgery to close subsequent wounds on the flaps: Three hypertrophic scars with recurrent ulcerations needed scar revisions, one child presented a fistula through the flap due to underlying osteomyelitis, and one patient presented a friction wound on the lateral malleolus requiring thinning of the flap. Two flaps presented an area of pressure necrosis through the full thickness of the flap and had to be replaced with another free flap (fasciocutaneous sensate flap) over the heel area.
In conclusion, it seems that in the pediatric population, skin‐grafted muscular coverage of the weight bearing surface of the foot is a good alternative, even if more problems with hypertrophic scarring around the grafts have been found than in the adult population. In two cases, the flaps had to be replaced because of pressure necrosis over the calcaneus. Long‐term follow‐up of the sensate fasciocutaneous flaps will be needed to find out if they provide a better alternative for foot coverage. © 1994 Wiley‐Liss, Inc.
SUIVI À LONG TERME DU RECOUVREMENT DE LA SURFACE PORTEUSE DU PIED AVEC LAMBEAU MUSCULAIRE LIBRE CHFZ LA POPULATIOMN PÉDIATRIQUE
Entre 1985 et 1991, 13 lambeaux musculaires libres avec greffe cutanée d'épaisseur (10 grands dorsaux, 2 grands droits de l'abdomen et 1 gracilis) ont été réalisés chez 12 patients pour recouvirir la surface porteuse du pied. Quatre plaies ont ainsi été remplacées primairement tandis que 9 cicatrices instables ont été remplacés.
Une analyse rétrospective démontre à court terme une couverture compléte des plaies, une survie de 100% des lambeaux et une mise en charge normale débutée Progressivement 1 mois aprés la chirurgie A long terme, on retrouve une sensibilité profonde à la pression mais pas de sensibilité superficielle au toucher, Tous les patients portent des chaussures réguliéres. Six Patients (7 lambeau) ont eu une chirurgie additionnelle à cause de plaies sur le lambeau: 3 cicatrices hypertrophiques avec ulcérations récidivantes ont nécesité des révisions de cicatrices, 1 enfant a présenté une fistule à travers le lambeau en raison d'une oséomyélite sous‐jacente, 1 patient a présenté une plaie par friction sur la malléole externe et le lambeau a dû être aminci. Deux lambeaux chez le même patient ont présenté une zone do nécrose par pression à travers toute l'épaisseur do lambeau au‐dessus do calcanéum. Cette zone a été recouverte avec un lambeau libre sensitif fasciocutané sur chaque paid.
En conclusion, il semble que les lambeau musculaires greffés soit une bonne alternative pour recouvrir la zone porteuse du pied chez l'enfant vien que plus de problémes de cictrices hypertrophiques aient été retrouvés comparativement aux adultes. Dans deux cas, une partie du lambeau a présenté une plaie par pression au‐dessus du calcanéum. Un suivi à long terme des lambeaux sensitifs fasciocutanés sera nécessaire pour savoir s'ils procurent un meilleur recouvrement du pied. © 1994 Wiley‐Liss, Inc.</description><identifier>ISSN: 0738-1085</identifier><identifier>EISSN: 1098-2752</identifier><identifier>DOI: 10.1002/micr.1920150611</identifier><identifier>PMID: 7968467</identifier><identifier>CODEN: MSRGDQ</identifier><language>eng</language><publisher>New York: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adolescent ; Biological and medical sciences ; Child ; Child, Preschool ; Female ; Foot - physiology ; Foot Injuries - complications ; Foot Injuries - surgery ; Humans ; Infant ; Male ; Medical sciences ; Postoperative Complications ; Pressure Ulcer - etiology ; Retrospective Studies ; Skin plastic surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgical Flaps ; Weight-Bearing</subject><ispartof>Microsurgery, 1994, Vol.15 (6), p.424-429</ispartof><rights>Copyright © 1994 Wiley‐Liss, Inc., A Wiley Company</rights><rights>1994 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4111-d9376a497c27391af50ab5d43222e9961b0dd61249b0e3930cae25754668ea4d3</citedby><cites>FETCH-LOGICAL-c4111-d9376a497c27391af50ab5d43222e9961b0dd61249b0e3930cae25754668ea4d3</cites></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.1920150611$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmicr.1920150611$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>309,310,314,777,781,786,787,1412,4010,4036,4037,23911,23912,25121,27904,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4221985$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7968467$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harris, Patrick G.</creatorcontrib><creatorcontrib>Letrosne, Eric</creatorcontrib><creatorcontrib>Caouette-Laberge, Louise</creatorcontrib><creatorcontrib>Egerszegi, E. Patricia</creatorcontrib><title>Long-term follow-up of coverage of weight bearing surface of the foot with free muscular flap in a pediatric population</title><title>Microsurgery</title><addtitle>Microsurgery</addtitle><description>Between 1985 and 1991, 13 muscular free flaps with split thickness skin grafts (10 latissimus dorsi, 2 rectus abdominis, and 1 gracilis) were done in 12 patients to cover the weight bearing surface of the foot. Four open wounds were closed primarily and nine unstable scars were replaced with a free flap.
A retrospective analysis shows that over the short term the flaps provided a complete coverage of wounds, with a 100% survival of flaps, and permitted normal weight bearing ambulation starting at 1 month postoperatively. Long‐term results show deep pressure sensation but no light touch sensation. All patients are able to wear normal shoes. Six patients (seven flaps) required further surgery to close subsequent wounds on the flaps: Three hypertrophic scars with recurrent ulcerations needed scar revisions, one child presented a fistula through the flap due to underlying osteomyelitis, and one patient presented a friction wound on the lateral malleolus requiring thinning of the flap. Two flaps presented an area of pressure necrosis through the full thickness of the flap and had to be replaced with another free flap (fasciocutaneous sensate flap) over the heel area.
In conclusion, it seems that in the pediatric population, skin‐grafted muscular coverage of the weight bearing surface of the foot is a good alternative, even if more problems with hypertrophic scarring around the grafts have been found than in the adult population. In two cases, the flaps had to be replaced because of pressure necrosis over the calcaneus. Long‐term follow‐up of the sensate fasciocutaneous flaps will be needed to find out if they provide a better alternative for foot coverage. © 1994 Wiley‐Liss, Inc.
SUIVI À LONG TERME DU RECOUVREMENT DE LA SURFACE PORTEUSE DU PIED AVEC LAMBEAU MUSCULAIRE LIBRE CHFZ LA POPULATIOMN PÉDIATRIQUE
Entre 1985 et 1991, 13 lambeaux musculaires libres avec greffe cutanée d'épaisseur (10 grands dorsaux, 2 grands droits de l'abdomen et 1 gracilis) ont été réalisés chez 12 patients pour recouvirir la surface porteuse du pied. Quatre plaies ont ainsi été remplacées primairement tandis que 9 cicatrices instables ont été remplacés.
Une analyse rétrospective démontre à court terme une couverture compléte des plaies, une survie de 100% des lambeaux et une mise en charge normale débutée Progressivement 1 mois aprés la chirurgie A long terme, on retrouve une sensibilité profonde à la pression mais pas de sensibilité superficielle au toucher, Tous les patients portent des chaussures réguliéres. Six Patients (7 lambeau) ont eu une chirurgie additionnelle à cause de plaies sur le lambeau: 3 cicatrices hypertrophiques avec ulcérations récidivantes ont nécesité des révisions de cicatrices, 1 enfant a présenté une fistule à travers le lambeau en raison d'une oséomyélite sous‐jacente, 1 patient a présenté une plaie par friction sur la malléole externe et le lambeau a dû être aminci. Deux lambeaux chez le même patient ont présenté une zone do nécrose par pression à travers toute l'épaisseur do lambeau au‐dessus do calcanéum. Cette zone a été recouverte avec un lambeau libre sensitif fasciocutané sur chaque paid.
En conclusion, il semble que les lambeau musculaires greffés soit une bonne alternative pour recouvrir la zone porteuse du pied chez l'enfant vien que plus de problémes de cictrices hypertrophiques aient été retrouvés comparativement aux adultes. Dans deux cas, une partie du lambeau a présenté une plaie par pression au‐dessus du calcanéum. Un suivi à long terme des lambeaux sensitifs fasciocutanés sera nécessaire pour savoir s'ils procurent un meilleur recouvrement du pied. © 1994 Wiley‐Liss, Inc.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Foot - physiology</subject><subject>Foot Injuries - complications</subject><subject>Foot Injuries - surgery</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Postoperative Complications</subject><subject>Pressure Ulcer - etiology</subject><subject>Retrospective Studies</subject><subject>Skin plastic surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgical Flaps</subject><subject>Weight-Bearing</subject><issn>0738-1085</issn><issn>1098-2752</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1v1DAQhi1EVbYtZ05IPiBuaW3nw7E4wQq2VReoEKhHa-JMdg1JHGyHtP-eLLtaxImTLb3POzN6CHnB2SVnTFx11vhLrgTjOSs4f0IWnKkyETIXT8mCybRMOCvzZ-QshO-MMaWkOiWnUhVlVsgFmdau3yQRfUcb17ZuSsaBuoYa9ws9bHD3n9ButpFWCN72GxpG34D5k8QtzjUX6WTjljYekXZjMGMLnjYtDNT2FOiAtYXoraGDG-YsWtdfkJMG2oDPD-85-fbh_dfldbL-vLpZvl0nJuOcJ7VKZQGZkkbIVHFocgZVXmepEAKVKnjF6rrgIlMVw1SlzACKXOZZUZQIWZ2ek9f7uYN3P0cMUXc2GGxb6NGNQcvZg2Asn8GrPWi8C8FjowdvO_CPmjO9U613qvVf1XPj5WH0WHVYH_mD2zl_dcghGGgbD72x4YhlQnBV7ha_2WOTbfHxf1v1x5vll3-OSPZtGyI-HNvgf-j5BJnr-08rfbe-vV-V6Tt9nf4GxwWnzw</recordid><startdate>1994</startdate><enddate>1994</enddate><creator>Harris, Patrick G.</creator><creator>Letrosne, Eric</creator><creator>Caouette-Laberge, Louise</creator><creator>Egerszegi, E. Patricia</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>BSCLL</scope><scope>IQODW</scope><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>7X8</scope></search><sort><creationdate>1994</creationdate><title>Long-term follow-up of coverage of weight bearing surface of the foot with free muscular flap in a pediatric population</title><author>Harris, Patrick G. ; Letrosne, Eric ; Caouette-Laberge, Louise ; Egerszegi, E. Patricia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4111-d9376a497c27391af50ab5d43222e9961b0dd61249b0e3930cae25754668ea4d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Foot - physiology</topic><topic>Foot Injuries - complications</topic><topic>Foot Injuries - surgery</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Postoperative Complications</topic><topic>Pressure Ulcer - etiology</topic><topic>Retrospective Studies</topic><topic>Skin plastic surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgical Flaps</topic><topic>Weight-Bearing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harris, Patrick G.</creatorcontrib><creatorcontrib>Letrosne, Eric</creatorcontrib><creatorcontrib>Caouette-Laberge, Louise</creatorcontrib><creatorcontrib>Egerszegi, E. Patricia</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Microsurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harris, Patrick G.</au><au>Letrosne, Eric</au><au>Caouette-Laberge, Louise</au><au>Egerszegi, E. Patricia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term follow-up of coverage of weight bearing surface of the foot with free muscular flap in a pediatric population</atitle><jtitle>Microsurgery</jtitle><addtitle>Microsurgery</addtitle><date>1994</date><risdate>1994</risdate><volume>15</volume><issue>6</issue><spage>424</spage><epage>429</epage><pages>424-429</pages><issn>0738-1085</issn><eissn>1098-2752</eissn><coden>MSRGDQ</coden><abstract>Between 1985 and 1991, 13 muscular free flaps with split thickness skin grafts (10 latissimus dorsi, 2 rectus abdominis, and 1 gracilis) were done in 12 patients to cover the weight bearing surface of the foot. Four open wounds were closed primarily and nine unstable scars were replaced with a free flap.
A retrospective analysis shows that over the short term the flaps provided a complete coverage of wounds, with a 100% survival of flaps, and permitted normal weight bearing ambulation starting at 1 month postoperatively. Long‐term results show deep pressure sensation but no light touch sensation. All patients are able to wear normal shoes. Six patients (seven flaps) required further surgery to close subsequent wounds on the flaps: Three hypertrophic scars with recurrent ulcerations needed scar revisions, one child presented a fistula through the flap due to underlying osteomyelitis, and one patient presented a friction wound on the lateral malleolus requiring thinning of the flap. Two flaps presented an area of pressure necrosis through the full thickness of the flap and had to be replaced with another free flap (fasciocutaneous sensate flap) over the heel area.
In conclusion, it seems that in the pediatric population, skin‐grafted muscular coverage of the weight bearing surface of the foot is a good alternative, even if more problems with hypertrophic scarring around the grafts have been found than in the adult population. In two cases, the flaps had to be replaced because of pressure necrosis over the calcaneus. Long‐term follow‐up of the sensate fasciocutaneous flaps will be needed to find out if they provide a better alternative for foot coverage. © 1994 Wiley‐Liss, Inc.
SUIVI À LONG TERME DU RECOUVREMENT DE LA SURFACE PORTEUSE DU PIED AVEC LAMBEAU MUSCULAIRE LIBRE CHFZ LA POPULATIOMN PÉDIATRIQUE
Entre 1985 et 1991, 13 lambeaux musculaires libres avec greffe cutanée d'épaisseur (10 grands dorsaux, 2 grands droits de l'abdomen et 1 gracilis) ont été réalisés chez 12 patients pour recouvirir la surface porteuse du pied. Quatre plaies ont ainsi été remplacées primairement tandis que 9 cicatrices instables ont été remplacés.
Une analyse rétrospective démontre à court terme une couverture compléte des plaies, une survie de 100% des lambeaux et une mise en charge normale débutée Progressivement 1 mois aprés la chirurgie A long terme, on retrouve une sensibilité profonde à la pression mais pas de sensibilité superficielle au toucher, Tous les patients portent des chaussures réguliéres. Six Patients (7 lambeau) ont eu une chirurgie additionnelle à cause de plaies sur le lambeau: 3 cicatrices hypertrophiques avec ulcérations récidivantes ont nécesité des révisions de cicatrices, 1 enfant a présenté une fistule à travers le lambeau en raison d'une oséomyélite sous‐jacente, 1 patient a présenté une plaie par friction sur la malléole externe et le lambeau a dû être aminci. Deux lambeaux chez le même patient ont présenté une zone do nécrose par pression à travers toute l'épaisseur do lambeau au‐dessus do calcanéum. Cette zone a été recouverte avec un lambeau libre sensitif fasciocutané sur chaque paid.
En conclusion, il semble que les lambeau musculaires greffés soit une bonne alternative pour recouvrir la zone porteuse du pied chez l'enfant vien que plus de problémes de cictrices hypertrophiques aient été retrouvés comparativement aux adultes. Dans deux cas, une partie du lambeau a présenté une plaie par pression au‐dessus du calcanéum. Un suivi à long terme des lambeaux sensitifs fasciocutanés sera nécessaire pour savoir s'ils procurent un meilleur recouvrement du pied. © 1994 Wiley‐Liss, Inc.</abstract><cop>New York</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>7968467</pmid><doi>10.1002/micr.1920150611</doi><tpages>6</tpages></addata></record> |
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| ispartof | Microsurgery, 1994, Vol.15 (6), p.424-429 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Biological and medical sciences Child Child, Preschool Female Foot - physiology Foot Injuries - complications Foot Injuries - surgery Humans Infant Male Medical sciences Postoperative Complications Pressure Ulcer - etiology Retrospective Studies Skin plastic surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical Flaps Weight-Bearing |
| title | Long-term follow-up of coverage of weight bearing surface of the foot with free muscular flap in a pediatric population |
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