Autologous Breast Reconstruction Using a Tensor Fascia Lata/Anterior Lateral Thigh-Freestyle Flap After Extensive Electric Burn: A Case Report (original) (raw)
Related papers
2020
Defects located on the lower leg and the foot represents a challenging task for the reconstructive surgeon, especially in high voltage electric burned patients. We admitted a 29-year-old male patient for forefeet defects following high voltage electric burns in our national burn and plastic surgery center. There was an exposition of metatarsal bones on both forefeet. We performed the distally-based superficial artery fasciocutaneous sural flap in a one-stage surgery separately for each side; the fascio subcutaneous pedicles were 5 cm wide buried under skin tunnels. We noticed suture dehiscence on the right foot and tip necrosis on the left foot. The bones were still covered. We used a V-Y advancement flap and split-thickness skin graft to complete the reconstruction. The wounds healed without any infectious complication. The ambulation was normal. The patient was satisfied with the flaps and did not complain about the donor sites.
Plastic Surgery
Introduction: Post electric burn defects are difficult to manage due to deep injury involving all the structures up to bony level. A good vascularized flap is required to resurface the defect for preventing the complication and for reconstruction. Aim of study: Resurface the post electric burn defect with different flaps according to need of defect. Material and method: All patients of electric burn hand and fore arm defect admitted to burn, plastic and reconstructive department of SCB Medical College, Cuttack and Dept. of Burn and Plastic Surgery, AIIMS Bhubaneswar between January 2015 to December 2017 with different flap covers used for reconstruction. Observation: Out of 30 cases of post electric burn forearm and hand reconstruction, 10 cases undergone groin flap cover, 6 cases undergone abdominal flap cover,5 cases undergone cross finger flap cover 4 cases undergone free anterolateral thigh flap cover, four cases undergone free Latissimus dorsi flap cover. Flaps have resurfaced the defect with minor complication like infection and minor necrosis of flaps which were managed. Conclusion: Reconstruction of post electric burn defect of distal fore arm and hand represents great challenge due to depth of injury involving full thickness of skin and other structures Choice depends on size of defect, availability of local or regional tissue, patient's acceptance and cooperation, keeping in mind the cost effectiveness of the procedures.
Post-burn breast reconstruction using an artificial dermis—a long-term follow-up
Burns & Trauma, 2016
Background Full thickness burns of the chest in childhood are a devastating problem that requires challenging reconstructive options. Integra is a bilaminate artificial dermis composed of shark chondroitin 6-sulfate and bovine collagen. The dermal matrix serves as a scaffold for fibroblasts and endothelial cells. Vascularization of the matrix begins after 2–3 weeks, and eventually, the matrix incorporates with the tissue to create a new dermis. The main advantage of the Integra is that the neodermis is of the same quality as a native dermis. Case presentation In this case report, we present post-burn breast reconstruction of a 12-year-old girl using Integra, with a long follow-up of 7 years. To the best of our knowledge, there is no published follow-up of breast development after reconstruction with Integra from its beginning point at the age of puberty until after the growing process has terminated. Conclusions Integra is a reliable reconstructive tool for burned breast. If done be...
Journal of Internal Medicine and Emergency Research, 2022
Electric burn is a devastating injury causing tissue and organ loss. We present here a case of an electric burn injury over bilateral lower limb and bilateral upper limb. The patient had undergone left above knee amputation, thus cross leg flap from the left side was not possible and due to electric burns, the vascularity of the right leg was also doubtful therefore a delayed flap was planned to cover the exposed defect over right knee and defect over the right tibia. The Flaps underwent delay procedure before the final inset so that the flap undergo ischemic preconditioning and the neovascularization that increases the size of the flap and chances of survival of the flap by manifold.
Thermal injury in TAPIA breast reconstruction—thermal injury to thoracodorsal artery perforator flap
Gland Surgery, 2017
This paper presents two case reports on thermal injury to a breast reconstructed by the TAPIA method. In both cases the injuries were caused by excessive sun exposure. Thermal injury to flaps used in breast reconstruction has previously been described but most commonly in abdominal flaps, which may be due to the relative high frequency of this type of reconstructions. Reports of thermal injury to reconstructions using the Latissimus Dorsi flap are rare. The injuries previously described are most often caused by severe heat exposure. The thoracodorsal artery perforator (TAP)-flap can be used as an alternative to the Latissimus Dorsi flap but it may be more susceptible to thermal insult due to the total denervation, the restricted blood supply and the limited thickness of the flap. Precautions are recommended to avoid this type of injury.
Burns, 1991
A young patient sustained a high-voltage burn with extensive destruction of the soft tissue in his left lower exfremity. Occlusion of the anferior and posferior tibia1 arteries, loss of foe extensors and the supe+ial and deep pwoneal nerves were noted, besides the exposure of the lower end of the tibia and metafarsal bones. In the absence of proper recipient vessels, a floss-leg free lafissimw dorsi muscle flap with overlying skin and depending on the vessels of the contralateral foot was used successfully for reconsfrucfion of the defect. 7'he pedicle was divided 3 weeks after microvascular anasfomosis and the fip survived completely. 7'his technique permits transfer of free flaps to compromised wounds without available recipient vessels, and the latissimw dorsi muscle flap, with its characterisfics of large size and copiow vascularify, could be split to cover exposed bones in difirenk areas simultaneously.
Free flap cover of acute burns and post-burn deformity
European Journal of Plastic Surgery, 1996
Free flaps are currently used in reconstructive surgery as a one-stage procedure to achieve optimal functional and aesthetic results. The results of free flap reconstruction performed on 23 patients, ten of whom had acute burns and 13 with secondary burn deformity, are presented. The latissimus dorsi, parascapular, dorsalis pedis, temporalis and posterior calf fascia where the free flap donor sites. Flap necrosis due to venous thrombosis occurred in only one instance.
Inferior pole breast reconstruction by TDAP flap in post-burn breast contracture
European Journal of Plastic Surgery, 2019
Background Post-burn breast deformities are not an uncommon condition after severe second-degree or third-degree burn and present as severe asymmetry of the breast as compared to the opposite side, displacement of nipple-areola complex, obliteration of inframammary fold, and reduced breast projection. Based on deformities especially for lower pole breast contracture, we propose a new classification to describe breast contracture. There is no tailor-made approach described to deal such deformities. Various options are available ranging from skin graft to different flaps. We present reconstruction by TDAP flap after the release of breast contracture grades I and II. This study aimed to classify the lower pole breast contracture according to its severity and to evaluate the outcome of TDAP flap reconstruction and augmentation of the lower pole of the breast in terms of symmetry and aesthesis. Methods This is a descriptive retrospective study of 10 patients with 15 post-burn contracted breast affecting the inferior pole of the breast and inframammary fold within a period of January 2012 to March 2016 in Kasralainy hospital, Cairo. All cases were evaluated according to flap vascularity, donor site morbidity, symmetry, and esthetic outcome. Results All flaps survived completely. Flap dimension ranged from 18 × 10 to 22 × 12 cm. The muscle sparing design had been used in three patients due to lack of reliable perforators. Patients were evaluated for their satisfaction, and all of them were satisfied. Conclusions It is essential to classify the grade of post-burn lower pole breast contracture according to the proposed classification. TDAP is a valuable option in case of grade I and II deformities only. For severe grade III breast contracture, more volume restoring procedure is advisable. Level of Evidence: Level IV, therapeutic study.