Immediate application of vacuum assisted closure dressing over free muscle flaps in the lower extremity does not compromise flap survival and results in decreased flap thickness

Chim, Harvey; Zoghbi, Yasmina; Nugent, Ajani George; Kassira, Wrood; Askari, Morad; Salgado, Christopher John

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자료유형: 학술저널

저자정보: Chim, Harvey (Division of Plastic Surgery, University of Florida College of Medicine) Zoghbi, Yasmina (Division of Plastic Surgery, University of Florida College of Medicine) Nugent, Ajani George (Division of Plastic Surgery, University of Florida College of Medicine) Kassira, Wrood (Division of Plastic Surgery, University of Florida College of Medicine) Askari, Morad (Division of Plastic Surgery, University of Florida College of Medicine) Salgado, Christopher John (Division of Plastic Surgery, University of Florida College of Medicine)

저널정보: 대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제45권 제1호

발행연도: 2018.1

수록면: 45 - 50 (6page)

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Background Free muscle flaps are a mainstay for reconstruction of distal third leg wounds and for large lower extremity wounds with exposed bone. However a major problem is the significant postoperative flap swelling, which may take months to resolve. We studied the efficacy and safety of immediate application of a vacuum assisted closure (VAC) dressing after a free muscle flap to the lower extremity. Methods Over a 19 months period, all consecutive free muscle flaps for lower extremity reconstruction at a Level I trauma center were evaluated prospectively for postoperative flap thickness, complications and flap survival. Immediate application of a VAC dressing was performed in 9 patients, while the flap was left exposed for monitoring in 8 patients. Results There was no statistically significant difference in flap survival between both cohorts. Mean flap thickness at postoperative day 5 for the VAC group was $6.4{\pm}6.4mm$, while flap thickness for the exposed flap group was $29.6{\pm}13.5mm$. Flap thickness was significantly decreased at postoperative day 5 for the VAC dressing group. Conclusions Immediate application of VAC dressing following free muscle flaps to the lower extremity does not compromise flap survival or outcomes and results in decreased flap thickness and a better aesthetic outcome.

#Free tissue flaps #Negative pressure wound therapy #Reconstructive surgery #Tibial fractures #Gustilo classification #Surgical flaps

참고문헌 (8)

참고문헌 신청

Irons GB Jr / 1986 / Soft-tissue coverage for the treatment of osteomyelitis of the lower part of the leg / Mayo Clin Proc 61:382~387

Chang N / 1982 / Comparison of the effect of bacterial inoculation in musculocutaneous and random-pattern flaps / Plast Reconstr Surg 70:1~10

Calderon W / 1986 / Comparison of the effect of bacterial inoculation in musculocutaneous and fasciocutaneous flaps / Plast Reconstr Surg 77:785~794

Gosain A / 1990 / A study of the relationship between blood flow and bacterial inoculation in musculocutaneous and fasciocutaneous flaps / Plast Reconstr Surg 86:1152~1162

Yazar S / 2006 / Outcome comparison between free muscle and free fasciocutaneous flaps for reconstruction of distal third and ankle traumatic open tibial fractures / Plast Reconstr Surg 117:2468~2475

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