Primary reattachment of avulsed skin flaps with negative pressure wound therapy in degloving injuries of the lower extremity
| Autor: | Y. Shirai, Takashi Suzuki, G. Sakai, M. Shindo, T. Hishikawa, T. Kurozumi |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Wound therapy Adolescent medicine.medical_treatment Skin flap Surgical Flaps Young Adult 03 medical and health sciences 0302 clinical medicine Japan Graft take Negative-pressure wound therapy medicine Humans Degloving Injuries Aged Retrospective Studies General Environmental Science Aged 80 and over Wound Healing 030222 orthopedics Degloving Periosteum integumentary system business.industry 030208 emergency & critical care medicine Skin Transplantation Fascia Middle Aged Plastic Surgery Procedures Surgical procedures medicine.disease Surgery Treatment Outcome medicine.anatomical_structure Debridement Lower Extremity General Earth and Planetary Sciences Female business Negative-Pressure Wound Therapy |
| Zdroj: | Injury. 48:137-141 |
| ISSN: | 0020-1383 |
| DOI: | 10.1016/j.injury.2016.10.026 |
| Popis: | Large avulsed skin flaps of the lower extremity caused by degloving injuries eventually develop skin necrosis in most cases. The current treatment option involves excision of the degloved skin and reapplication as a full- or split-thickness skin graft. We considered that reattachment of avulsed skin flaps without excision would be theoretically beneficial, since some circulation may remain around the connected pedicle and thus facilitate graft take. Furthermore, securing the skin to the original anatomic position is much easier using retained landmarks. We treated a total of 12 patients (13 cases) with degloving injuries of the lower extremity. In all cases, the avulsed skin flap was defatted and sewn back to the original position, then negative-pressure wound therapy was applied over those grafts as a bolster for approximately 7 days. Most of the avulsed skin flap took excellently, particularly close to the connected pedicle. Nine cases did not need any additional surgical procedures. Four cases required secondary skin graft for a small area of open wound due to partial necrosis of the defatted skin, as well as the raw surface left by the primary skin defect in the initial operation. Primary reattachment of the avulsed skin flaps without excision is convenient and efficient to cover the open wound over the exposed fascia and periosteum in degloving injuries. This would potentially offer a better alternative to definitive wound closure. |
| Databáze: | OpenAIRE |
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