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J Coll Physicians Surg Pak ; 32(1): 92-95, 2022 Jan.
Article En | MEDLINE | ID: mdl-34983155

OBJECTIVE: To determine if local flap coverage is functionally compatible of digital defects. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Plastic and Reconstructive Surgery, Fauji Foundation Hospital, Rawalpindi, from January 2017 to June 2019. METHODOLOGY: Patients with small and medium skin defects on digits were included. Data was collected for both independent and dependent variables, emphasising on functional outcome based on five parameters (adequate coverage of the defect, functional length of the digit, painless scar, finger-tip sensation, and inter-phalangeal joint motion). Follow-up was done for six months. RESULTS: Total number of patients included in the study was 96, with 45 male and 51 female patients. Mean age of study participants was 26.6 ± 16.9 years. Small to medium size defects were included in the study for coverage by local flaps like cross figure, lateral proximal phalanx, flag, thenar, homo-digital flaps etc. Results were studied in terms of functional outcomes. All the five parameters were achieved in 84 (87.5%) patients. Complications were observed in 10 (10.4%) patients. The most frequent complication was wound infection, which was observed in 2 (2.1%) patients. CONCLUSION: Local flaps for finger defects are a very effective way of providing durable soft tissue coverage. Key Words: Digital defects, Digital reconstruction, Local flaps for digits, Hand injuries.

Finger Injuries , Reconstructive Surgical Procedures , Soft Tissue Injuries , Adolescent , Adult , Child , Female , Finger Injuries/surgery , Fingers/surgery , Humans , Male , Skin Transplantation , Soft Tissue Injuries/surgery , Surgical Flaps , Treatment Outcome , Young Adult
In Vivo ; 36(1): 501-509, 2022.
Article En | MEDLINE | ID: mdl-34972755

BACKGROUND/AIM: The use of sternocleidomastoid muscle (SCM) flap for facial reanimation was established in the 1980s by the senior author of this paper. We aimed to analyze long-term outcome and complications of this procedure. PATIENTS AND METHODS: We conducted a retrospective chart review of all patients undergoing SCM reanimation for longstanding facial palsy between January 2009 and December 2015. Patients with follow-up longer than 12 months (range=12-96) were included in the study. Facial muscle function was evaluated before and at each follow-up after the surgery with the House-Brackmann (HB) scale-facial nerve grading system and Facegram analysis. Donor site morbidity and overall complication rates were documented and analyzed. RESULTS: Forty-two patients aged 18-66 years (mean age=37) with a mean duration of facial palsy of 5 years (range=2-48) met the inclusion criteria. The HB score 2 years after surgery improved significantly (p<0.05) in comparison to the pre-operative condition (3.6 vs. 4.7). Twelve months after surgery, oral commissure excursion improved by mean 8.95 mm. No flap necrosis occurred, nor compromise of neck and shoulder function despite an obvious contour defect in the SCM donor site. None of the patients presented head posture or movement issues. CONCLUSION: The SCM flap transfer is a reliable and effective procedure to achieve moderate improvement of the oral commissure excursion using a local method with moderate donor site morbidity. It can be regarded as a valuable option for dynamic facial reanimation in case of longstanding facial palsy.

Facial Paralysis , Reconstructive Surgical Procedures , Adolescent , Adult , Child , Child, Preschool , Facial Paralysis/surgery , Humans , Middle Aged , Muscles , Retrospective Studies , Surgical Flaps , Treatment Outcome , Young Adult
Plast Reconstr Surg ; 149(1): 57e-59e, 2022 Jan 01.
Article En | MEDLINE | ID: mdl-34936618

SUMMARY: Syndactyly is one of the most common congenital differences treated by hand surgeons. Although dozens of techniques for syndactyly release have been described, a reliable method is based on a dorsal rectangular flap for commissure construction and a combination of interdigitating zigzag flaps and skin grafts for digital coverage. In this article, the authors present a detailed description of syndactyly release emphasizing principles integral to successful outcomes.

Fingers/surgery , Skin Transplantation/methods , Surgical Flaps/transplantation , Syndactyly/surgery , Child, Preschool , Esthetics , Fingers/abnormalities , Humans , Infant , Male , Suture Techniques , Treatment Outcome
Plast Reconstr Surg ; 149(1): 197-201, 2022 Jan 01.
Article En | MEDLINE | ID: mdl-34936623

SUMMARY: Encouraging results have been described for the use of pedicled buccal fat pad flap in primary cleft palate repair. This retrospective study describes the surgical technique and early results of a technical innovation utilizing the split buccal fat flaps in modified Furlow palatoplasty with small double-opposing Z-plasty. This technique introduces buccal fat tissue for coverage of lateral denuded palate surfaces to reduce the bone exposure and scar formation to potentially attenuate maxillary growth interference and for reinforcement of the palatal areas of high tension or with incomplete closure to decrease the risk of postoperative dehiscence and oronasal fistula formation. Consecutive nonsyndromic patients (n = 56) with cleft palate were treated with this method, all of whom demonstrated fast mucosalization of lateral palatal recipient regions within 3 weeks postoperatively and showed no fistula with 12 months' follow-up. Of 19 patients (33.9 percent) who underwent auditory-perceptual assessment, 15 (78.9 percent) had normal resonance. Surgeons could add this alternative surgical maneuver to their armamentarium during the primary palatoplasty, in which coverage of lateral surfaces and reinforcement with fat tissue in the anterior soft palate space are of paramount relevance. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Cheek/surgery , Cleft Palate/surgery , Postoperative Complications/epidemiology , Reconstructive Surgical Procedures/methods , Surgical Flaps/transplantation , Child, Preschool , Female , Humans , Infant , Male , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Reconstructive Surgical Procedures/adverse effects , Retrospective Studies , Surgical Flaps/adverse effects , Treatment Outcome
Plast Reconstr Surg ; 149(1): 70e-73e, 2022 Jan 01.
Article En | MEDLINE | ID: mdl-34936624

SUMMARY: Surgical management of unilateral cleft lip is challenging. Correction requires a comprehensive approach to ensure optimal aesthetic outcomes. Various techniques have been proposed for the repair of cleft lip. This article and video vignette highlight the senior author's (D.S.) preferred method for repair of a unilateral cleft lip using a modified inferior triangle technique, a Noordhoff triangular flap for vermillion augmentation, orbicularis oris chemodenervation to reduce tension at the repair site, and autologous fat grafting for lip sculpting.

Adipose Tissue/transplantation , Cleft Lip/surgery , Reconstructive Surgical Procedures/methods , Surgical Flaps/transplantation , Esthetics , Facial Muscles/innervation , Humans , Lip/surgery , Male , Nerve Block/methods , Transplantation, Autologous/methods , Treatment Outcome
Indian J Ophthalmol ; 70(1): 281-286, 2022 Jan.
Article En | MEDLINE | ID: mdl-34937255

Facial skin defect reconstruction in medial-canthal area of the lids can be a challenge even when performed by a skilled surgeon. The excision of large tumors in this area leads to significant surgical defects that cannot be repaired by merely closing the wound. The glabellar area provides a source of redundant skin with similar characteristics to that of the medial-canthal lid area. The purpose show the possibility of the glabellar flap technique surgery in patients after tumor excision in the medial canthal area with the formation of a large surgical defect and especially those with defect under the medial canthal tendon. We selected 15 well-documented retrospective cases of patients operated over 2 years and followed up for a minimum of 36 months, who underwent surgery with a glabellar flap technique. Patients were operated with V-Y glabellar rotation, advancement, or combined transposition flap techniques. According to the defect's location, we divided the patients into three groups: upper, medial, and lower surgical defects. A satisfactory functional result was obtained in all the patients. In most of them, the cosmetic results were also good. No additional surgical procedures were required in any of the patients. Our experience showed excellent results with the glabellar flap technique in all three types of lesions in the medial canthal zone-upper, medial, and especially lower which until recently was thought to be inappropriate.

Carcinoma, Basal Cell , Eyelid Neoplasms , Reconstructive Surgical Procedures , Skin Neoplasms , Carcinoma, Basal Cell/surgery , Eyelid Neoplasms/surgery , Humans , Retrospective Studies , Skin Neoplasms/surgery , Surgical Flaps
Indian J Ophthalmol ; 70(1): 288-291, 2022 Jan.
Article En | MEDLINE | ID: mdl-34937257

We describe a modified technique of intraoperative optical coherence tomography (iOCT)-guided removal of post-laser-assisted in situ keratomileusis (LASIK) epithelial ingrowth with interface ethyl alcohol and mitomycin C application to prevent a recurrence. Epithelial ingrowth was visualized as hyperreflective deposits in the interface on iOCT, and the location and extent were noted at the beginning of the procedure. A simple dimple-down maneuver was performed to help identify the circumference of the LASIK flap. iOCT helped to delineate the flap edge and ensure dissection in the correct plane with complete removal of epithelial cell nests. Real-time visualization of the interface helped in on-table decision making regarding the extent of lifting the flap to encompass the entire region of hyperreflective epithelial ingrowth, as well as the need for additional interventions to ensure complete flap apposition at the end of surgery. All patients gained an uncorrected visual acuity of 20/20-20/25 with no recurrence.

Corneal Diseases , Epithelium, Corneal , Keratomileusis, Laser In Situ , Corneal Diseases/diagnosis , Corneal Diseases/etiology , Corneal Diseases/surgery , Epithelium, Corneal/surgery , Humans , Keratomileusis, Laser In Situ/adverse effects , Lasers , Postoperative Complications , Surgical Flaps , Tomography, Optical Coherence
J Craniofac Surg ; 33(1): e78-e80, 2022.
Article En | MEDLINE | ID: mdl-34967530

ABSTRACT: The forehead flap is the gold standard procedure for nasal reconstruction to address a partial or complete rhinectomy. Traditionally, the three-dimensional (3D) nasal defect is manually templated intraoperatively to design the two-dimensional (2D) flap shape on intact morphology. In this clinical study, digital preoperative planning is used to template with computer-assisted design and manufacturing. Preoperative digital templates were implemented for 3 representative patients (1 in Supplementary Digital Content, This includes designs for a hemi-rhinectomy case from 3D mirroring, a partial total rhinectomy case generated from a 3D scan, and a total rhinectomy case generated from a 3D morphable model based on a prepathology 2D photo. Digital unwrapping flattened the patient's 3D nasal geometry designs to 2D skin flap shapes. Finally, the 2D designs were printed as traceable intraoperative templates at a 1:1 scale. This clinical study demonstrates the application of digital 3D preoperative templating to improve workflow for nasal reconstruction.

Forehead , Nose , Computer-Aided Design , Forehead/diagnostic imaging , Forehead/surgery , Humans , Imaging, Three-Dimensional , Nose/diagnostic imaging , Nose/surgery , Surgical Flaps
Plast Reconstr Surg ; 149(1): 13e-17e, 2022 Jan 01.
Article En | MEDLINE | ID: mdl-34936603

SUMMARY: Oncoplastic breast surgery is an evolving field combining both breast aesthetic surgery and oncologic breast surgery. It aims to optimize cosmetic outcomes without interfering with oncologic safety. The superior hemimastectomy is a technique that can be considered for large upper-quadrant breast tumors or multifocal and multicentric breast tumors localized in the upper quadrants. As with mastectomy, axillary procedures can be performed through the same incision. The nipple-areola complex can be preserved and reimplanted. Superior hemimastectomy allows wide excision of the breast tissue, but its main disadvantage is the increased risk of necrosis of the free grafted nipple-areola complex. In this article, the authors present the surgical technique of superior hemimastectomy with an inferior pedicle nipple-bearing flap. This technique is presented as a simple five-step algorithm. A modified superior hemimastectomy with nipple-areola complex preservation using an inferior pedicle nipple-bearing flap is an alternative to the classic superior hemimastectomy technique. This modified technique decreases the risk of nipple-areola complex necrosis and preserves better nipple-areola complex sensitivity.

Breast Neoplasms/surgery , Mammaplasty/methods , Mastectomy/methods , Nipples/surgery , Surgical Flaps , Female , Humans , Middle Aged
Plast Reconstr Surg ; 149(1): 96-104, 2022 Jan 01.
Article En | MEDLINE | ID: mdl-34936608

BACKGROUND: Abdominoplasty is a surgical technique for body contouring that has been shown to improve the patient's quality of life. It has become more common among male patients, so clear differences between procedures for men and women have to be stated. The authors present their experience with high-definition lipoabdominoplasty with transverse plication in men. METHODS: Records of male patients undergoing transverse plication full abdominoplasty in addition to high-definition liposculpture were analyzed. A total of 24 consecutive cases were found between January of 2017 and June of 2019. Patient ages ranged from 24 to 60 years. Patients aged 18 years or younger were excluded. Body mass index ranged from 25 to 33 kg/m2. Photographic records were taken before and during follow-up at 2 days and 1, 3, 6, and 12 months after surgery. RESULTS: Male TULUA (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar) with high-definition lipoabdominoplasty was successfully achieved in 24 cases. No major complications were reported. Six minor complications were reported (25 percent). Rectus abdominis diastases are less common in men compared to women, as pregnancy is the most determining factor in its development. Fat distribution is also a key difference when performing lipoabdominoplasty for the male or the female patient. The authors recommend a transverse plication of the abdominal wall, instead of a vertical one, as flap viability is preserved and enhanced muscular definition can be accomplished. CONCLUSIONS: Combining transverse plication with high-definition lipoabdominoplasty (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar plus high-definition lipoabdominoplasty) is a safe and reproducible technique for the male patient. It offers higher aesthetic results in line with modern beauty ideals. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Abdominal Wall/surgery , Lipoabdominoplasty/methods , Quality of Life , Surgical Flaps , Adult , Body Mass Index , Follow-Up Studies , Humans , Male , Middle Aged , Time Factors , Treatment Outcome , Young Adult
Plast Reconstr Surg ; 149(1): 163-167, 2022 Jan 01.
Article En | MEDLINE | ID: mdl-34936617

BACKGROUND: Digital neurovascular bundle defects are often encountered during crush or avulsion injuries and require complex reconstruction. Use of an arterialized nerve graft (neurovascular graft) serving both as an interpositional arterial conduit and as a nerve graft could be a reconstructive option in these cases. In this anatomical study, the authors aimed to describe a neurovascular graft of the posterior interosseous nerve and a branch of the anterior interosseous artery for neurovascular bundle reconstruction of the fingers. METHODS: Eighteen forearms were injected with red latex in order to collect the anatomical characteristics of the posterior interosseous nerve and the artery running near it. RESULTS: In all cases, the posterior interosseous nerve was followed by a branch of the anterior interosseous artery: the distal dorsal branch of the anterior interosseous nerve. The origin of this artery was proximal to the radiocarpal joint, at an average of 56.5 ± 11.1 mm. The proximal and distal diameters of the branch of the anterior interosseous artery were 1.6 ± 0.2 and 1.1 ± 0.2 mm, respectively. The proximal and distal diameters of the posterior interosseous nerve were 1.2 ± 0.3 mm and 1.1 ± 0.3 mm, respectively. CONCLUSIONS: These results show that a potential free neurovascular graft using the posterior interosseous nerve as nerve graft and the anterior interosseous artery as an arterial bypass to reconstruct both the nerve and arterial tree of the finger could be a useful approach. The authors speculate that this graft could be used to reconstruct the neurovascular bundle of amputated or devascularized digits.

Fingers/surgery , Hand Injuries/surgery , Peripheral Nerves/transplantation , Surgical Flaps/blood supply , Ulnar Artery/anatomy & histology , Cadaver , Fingers/blood supply , Humans , Peripheral Nerves/blood supply
Afr J Paediatr Surg ; 19(1): 5-8, 2022.
Article En | MEDLINE | ID: mdl-34916343

Objectives: We aim to describe the management of fingertip injuries treated by flaps in the paediatric surgery emergency ward and evaluate the long-term results. Patients and Methods: Through a 2-year prospective study, we analysed all fingertip injuries treated by flaps in the paediatric emergency ward. We collected patients' data and the clinical and imaging characteristics of the lesions. The type of flap was chosen on a case-by-case basis. We evaluated aesthetic and functional results. Results: Forty-two fingertip injuries required the use of flaps. The average age was 7 years, and boys were more affected. The smashed fingertip was the most common mechanism; pulp lesions and amputation were located mainly in zone I or II. We performed Atasoy flaps, palm flap, free skin grafts, McGregor flap and the cross finger flap. Our results were good to excellent in 66.67%. Conclusions: The best management of fingertip injuries in children remains prevention.

Surgical Flaps , Child , Humans , Male , Prospective Studies
Magn Reson Imaging Clin N Am ; 30(1): 121-133, 2022 Feb.
Article En | MEDLINE | ID: mdl-34802575

Head and neck reconstructive surgical techniques are complex; now the microvascular free tissue transfer is the most frequently used. The postreconstruction imaging interpretation is challenging due to the altered anatomy and flap variability. We aim to improve radiologists' knowledge with diverse methods of flap reconstruction for an accurate appreciation of their expected cross-sectional imaging appearance and early detection of tumor recurrence and other complication.

Head and Neck Neoplasms , Reconstructive Surgical Procedures , Head and Neck Neoplasms/diagnostic imaging , Head and Neck Neoplasms/surgery , Humans , Magnetic Resonance Imaging , Neck/diagnostic imaging , Neck/surgery , Neoplasm Recurrence, Local , Surgical Flaps
Khirurgiia (Mosk) ; (12): 104-110, 2021.
Article Ru | MEDLINE | ID: mdl-34941217

Incidence of postoperative sternomediastinitis depends on various risk factors and makes up 8%. Surgical debridement with local management of the wound are used to achieve wound sterility. In some cases, sternectomy or subtotal sternal resection are performed for total sternal osteomyelitis with osteoporotic bone and multiple fractures. This procedure results an extensive bone defect. The final stage is anterior chest wall reconstruction. The most popular method is wound closure with autologous muscle or omental flaps. The authors describe a patient with sternomediastinitis who underwent staged treatment. At the final stage, subtotal sternectomy with simultaneous omentoplasty were performed. Additionally, mammary-gastroepiploic bypass grafting with right internal mammary artery and right gastroepiploic artery was carried out for additional vascularization of the omental flap. We found no similar surgery for sternomediastinitis in the literature. Long-term treatment outcome was followed-up (>50 months of relapse-free period and good quality of life).

Quality of Life , Reconstructive Surgical Procedures , Humans , Sternum/surgery , Surgical Flaps , Surgical Wound Infection/diagnosis , Surgical Wound Infection/etiology , Surgical Wound Infection/surgery
Zhonghua Nan Ke Xue ; 27(2): 134-139, 2021 Feb.
Article Zh | MEDLINE | ID: mdl-34914329

Objective: To explore the application value of staged urethroplasty by tubularization of the reconstructed urethral plate using the preputial island flap in the treatment of severe hypospadias. METHODS: From May 2014 to February 2019, 91 children with severe hypospadias received one- or two-stage urethroplasty by tubularization of the reconstructed urethral plate with the preputial island flap. We compared the patients' age, glans diameter, length of the straightened urethral defect, and incidence rates of postoperative urethral fistula, urethral diverticulum, glans dehiscence and urethral stricture between the two groups of patients. RESULTS: The 56 patients in the one-stage group were aged 7-144 (21.92 ± 13.37) months old, the urethral defect 3-5 (3.565 ± 0.528) cm in length and the glans 1.0-1.4 (1.195 ± 0.083) cm in diameter, and the 35 in the two-stage group aged 7 -153 (24.78 ± 13.59) months, the urethral defect 3-5 (3.857 ± 0.696) cm in length and the glans 0.8-2.5 (1.206 ± 0.389) cm in diameter. There were no statistically significant differences in age, glans diameter and the length of urethral defect between the two groups. In the one-stage group were found 18 cases of postoperative urinary fistula, 1 case of glans dehiscence, 1 case of urethral diverticulum, and 1 case of both urethral diverticulum and glans dehiscence, all cured by repeated urinary fistula repair/urethroplasty. No urinary fistula occurred in the two-stage group postoperatively except 4 cases of glans dehiscence, of which 2 were cured by repeated repair and the other 2 refused reoperation. The success rate was significantly higher in the two-stage than in the one-stage urethroplasty group (88.57% vs 62.50%, P < 0.05). CONCLUSIONS: Two-stage urethroplasty by tubularization of the reconstructed urethral plate with the preputial island flap can significantly reduce the incidence of urethral fistula in patients with severe hypospadias, but may increase the number of operations in those who do not need staged surgery. The necessity of two-stage urethroplasty can be determined according to the development of the glans, the degree of penile curvature, and the length of urethra defect.

Hypospadias , Urinary Fistula , Child, Preschool , Humans , Hypospadias/surgery , Infant , Male , Penis , Surgical Flaps , Urethra/surgery , Urinary Fistula/etiology , Urinary Fistula/surgery
World J Surg Oncol ; 19(1): 349, 2021 Dec 20.
Article En | MEDLINE | ID: mdl-34930342

BACKGROUND: Previous studies on sternocleidomastoid flaps, have defined the importance of preserving sternocleidomastoid (SCM) branch of superior thyroid artery (STA). This theory drew criticism, as this muscle is known to be a type II muscle, i.e., the muscle has one dominant pedicle (branches from the occipital artery at the superior pole) and smaller vascular pedicles entering the belly of muscle (branches from STA and thyrocervical trunk) at the middle and lower pole respectively. It was unlikely for the SCM branch of STA to supply the upper and lower thirds of the muscle. We undertook a cadaveric angiographic study to investigate distribution of STA supply to SCM muscle. METHODS: It is a cross-sectional descriptive study on 10 cadaveric SCM muscles along with ipsilateral STA which were evaluated with angiography using diatrizoate (urograffin) dye. Radiographic films were interpreted looking at the opacification of the muscle. Results were analyzed using frequency distribution and percentage. RESULTS: Out of ten specimens, near complete opacification was observed in eight SCM muscle specimens. While one showed poor uptake in the lower third of the muscle, the other showed poor uptake in the upper third segment of muscle. CONCLUSION: Based on the above findings we suggest to further investigate sternocleidomastoid muscle as a type III flap, as the STA branch also supplies the whole muscle along with previously described pedicle from occipital artery. However, this needs to be further corroborated intra-operatively using scanning laser doppler. This also explains better survival rates of superior thyroid artery based sternomastoid flaps.

Neck , Surgical Flaps , Cross-Sectional Studies , Humans , Subclavian Artery , Thyroid Gland/diagnostic imaging , Thyroid Gland/surgery
Acta Orthop Traumatol Turc ; 55(6): 541-546, 2021 Dec.
Article En | MEDLINE | ID: mdl-34967744

OBJECTIVE: The aim of this study was to analyze and classify hypertrophy seen in vascularized fibula flaps used for reconstruction of tubular bone defects. METHODS: Thirty-three patients who underwent a vascularized fibula flap for the reconstruction of massive bone defects of the upper or lower extremity long bones were retrospectively reviewed and included in this study. There were 24 lower extremities (21 tibial and 3 femoral) and 9 upper extremities (4 humeral, 2 radial and 3 ulnar) reconstructions in this series. The mean age was 32.7 (range= 10- 59) years. The mean length of bony defect following initial debridement was 10.3 (range= 4-25) cm. The fibula was inserted as a single strut in 29 patients, and as a double barrel construct in 4 patients. The degree of fibular hypertrophy was calculated based on anteroposterior (AP) and lateral X-ray measurements of fibular flaps at an average postoperative period of 52 months. The difference in thickness between the initial and final x- ray measurements were expressed as percentage of hypertrophy. The variances seen in this period were defined and classified. RESULTS: When bony consolidation of the 33 cases were examined in detail, 4 different modes of flap hypertrophy were defined: type 0- absence of hypertrophy, type 1- limited hypertrophy, type 2- marked hypertrophy triggered by stress fracture, and type 3- massive hypertrophy enhanced by peripheral bone production. CONCLUSION: Fibular hypertrophy follows different modes based on vascularity of the flap, amount of stress imparted on the flap, site of reconstruction, and whether the periosteal sleeve is retained at the reconstruction site. Determination of these factors at the initial period may help the surgeons to predict the final hypertrophy that will be seen at the end of flap maturation Level of Evidence: Level IV, Therapeutic Study.

Bone Transplantation , Reconstructive Surgical Procedures , Adult , Fibula/diagnostic imaging , Fibula/surgery , Humans , Hypertrophy , Retrospective Studies , Surgical Flaps , Treatment Outcome , X-Rays
BMC Musculoskelet Disord ; 22(Suppl 2): 1059, 2021 Dec 23.
Article En | MEDLINE | ID: mdl-34949162

BACKGROUND: Deep periprosthetic infection after total hip arthroplasty (THA) is a serious and challenging complication for the orthopedic surgeon. Muscular flaps may represent a valid management option for the treatment of this condition. We present a systematic literature review about the use of muscular flaps for the treatment of hip prosthetic joint infection. METHODS: The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seventy-seven articles, out of 279 titles, were considered eligible for the full-text analysis. Finally 15 studies that met inclusion criteria were included in this review. RESULTS: Overall, 210 patients (49% males, 48.6% females and 2.4% not reported) suffering from THA infection treated with muscular flaps were collected. The mean age was 69.6 years. Mean follow-up, reported in all studies, was 3.3 years. The results presented by the different authors, highlight the effectiveness of muscular flaps for the treatment of periprosthetic infection, in terms of function, limb salvage, prevention of the recurrences, cost-effectiveness, and quality of life postoperatively. CONCLUSIONS: Muscle flaps provide an excellent management option for patients with persistent infection after total hip arthroplasty.

Arthritis, Infectious , Arthroplasty, Replacement, Hip , Hip Prosthesis , Muscle, Skeletal/transplantation , Surgical Flaps , Aged , Arthritis, Infectious/surgery , Arthroplasty, Replacement, Hip/adverse effects , Female , Hip Joint , Hip Prosthesis/adverse effects , Humans , Male , Quality of Life