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A retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma

BACKGROUND: Many flaps have been described for reconstruction of lower extremity defects, including, Latissimus Dorsi, Rectus abdominis, Anterolateral thigh perforator flaps, each having advantages and disadvantages. The defect location, size and specific geometric pattern of defect influences the t...

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Autores principales: Mahajan, Ravi Kumar, Srinivasan, Krishnan, Bhamre, Abhiskek, Singh, Mahipal, Kumar, Prakash, Tambotra, Ankush
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992936/
https://www.ncbi.nlm.nih.gov/pubmed/29928076
http://dx.doi.org/10.4103/ijps.IJPS_121_17
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author Mahajan, Ravi Kumar
Srinivasan, Krishnan
Bhamre, Abhiskek
Singh, Mahipal
Kumar, Prakash
Tambotra, Ankush
author_facet Mahajan, Ravi Kumar
Srinivasan, Krishnan
Bhamre, Abhiskek
Singh, Mahipal
Kumar, Prakash
Tambotra, Ankush
author_sort Mahajan, Ravi Kumar
collection PubMed
description BACKGROUND: Many flaps have been described for reconstruction of lower extremity defects, including, Latissimus Dorsi, Rectus abdominis, Anterolateral thigh perforator flaps, each having advantages and disadvantages. The defect location, size and specific geometric pattern of defect influences the type of flap that can be used. In this case series, we describe the specific situations where the use of chimeric latissimus dorsi–serratus anterior (LD + SA) free flaps are of advantage in providing complete wound cover. MATERIALS AND METHODS: Case records of all patients who underwent LD + SA free flap transfer for lower extremity trauma at Amandeep Hospital, from Feb 2006 to Feb 2017 were reviewed. Patients were categorised based on the anatomical location and size of defect. The method of usage of the chimeric segments, recipient vessels and type of anastomosis were noted. Flap complications, if any were reviewed. RESULT: 47 patients with lower limb defects were included in the study. All cases were post traumatic in nature. Defect size ranged from 180 sq cm to 1050 sq cm. Average defect size was 487.70 sq cm. All patients underwent soft tissue reconstruction with LD + SA flap. Complete wound cover was obtained. CONCLUSION: Latissimus dorsi + Serratus anterior free tissue transfer is an effective, reliable method of providing cover to extensive lower limb traumatic defects with minimal donor site morbidity, with added freedom of inset and flap positioning. Specific use is seen in patients with broad proximal defect, long defect in the leg, defects involving adjacent anatomical areas and in large defect with dead space.
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spelling pubmed-59929362018-06-20 A retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma Mahajan, Ravi Kumar Srinivasan, Krishnan Bhamre, Abhiskek Singh, Mahipal Kumar, Prakash Tambotra, Ankush Indian J Plast Surg Original Article BACKGROUND: Many flaps have been described for reconstruction of lower extremity defects, including, Latissimus Dorsi, Rectus abdominis, Anterolateral thigh perforator flaps, each having advantages and disadvantages. The defect location, size and specific geometric pattern of defect influences the type of flap that can be used. In this case series, we describe the specific situations where the use of chimeric latissimus dorsi–serratus anterior (LD + SA) free flaps are of advantage in providing complete wound cover. MATERIALS AND METHODS: Case records of all patients who underwent LD + SA free flap transfer for lower extremity trauma at Amandeep Hospital, from Feb 2006 to Feb 2017 were reviewed. Patients were categorised based on the anatomical location and size of defect. The method of usage of the chimeric segments, recipient vessels and type of anastomosis were noted. Flap complications, if any were reviewed. RESULT: 47 patients with lower limb defects were included in the study. All cases were post traumatic in nature. Defect size ranged from 180 sq cm to 1050 sq cm. Average defect size was 487.70 sq cm. All patients underwent soft tissue reconstruction with LD + SA flap. Complete wound cover was obtained. CONCLUSION: Latissimus dorsi + Serratus anterior free tissue transfer is an effective, reliable method of providing cover to extensive lower limb traumatic defects with minimal donor site morbidity, with added freedom of inset and flap positioning. Specific use is seen in patients with broad proximal defect, long defect in the leg, defects involving adjacent anatomical areas and in large defect with dead space. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5992936/ /pubmed/29928076 http://dx.doi.org/10.4103/ijps.IJPS_121_17 Text en Copyright: © 2018 Indian Journal of Plastic Surgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Mahajan, Ravi Kumar
Srinivasan, Krishnan
Bhamre, Abhiskek
Singh, Mahipal
Kumar, Prakash
Tambotra, Ankush
A retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma
title A retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma
title_full A retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma
title_fullStr A retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma
title_full_unstemmed A retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma
title_short A retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma
title_sort retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992936/
https://www.ncbi.nlm.nih.gov/pubmed/29928076
http://dx.doi.org/10.4103/ijps.IJPS_121_17
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