Saving of Foot Support Ability in Post-traumatic Defects Using Microsurgical Tissue Autotransplantation-Reference-Cited by-同舟云学术

Saving of Foot Support Ability in Post-traumatic Defects Using Microsurgical Tissue Autotransplantation

Published:2020-10-22 Issue:3 Volume:9 Page:434-441
ISSN:2541-8017
Container-title:Russian Sklifosovsky Journal "Emergency Medical Care"
language:
Short-container-title:Neotložnaâ med. pomoŝʹ

Author:

Vlasov A. P.¹^ORCID,Shibayev E. Y.¹^ORCID,Fayn A. M.¹^ORCID,Ivanov P. A.¹^ORCID,Kisel D. A.¹^ORCID,Lazarev M. P.¹^ORCID,Svetlov K. V.¹,Nevedrov A. V.¹^ORCID

Affiliation:

1. N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department

Abstract

Background. Severe open injuries of the lower extremities in most cases are the result of high-energy trauma, because the foot and ankle are damaged as a result of automobile accidents almost in every fourth victim. According to the literature, the percentage of infectious complications after surgical debridement of open injuries of the foot is 43–67.9% and shows no tendency to decrease.Material and methods. We performed 32 operations with the use of free revascularized grafts in patients aged from 16 to 70 years with extensive posttraumatic defects of the foot between 2010 and 2018.Results. As a result, 30 (93.7%) out of 32 grafts provided foot support ability provided during the post-operative period. When replacing large defects (more than 80 cm2) of soft tissues supporting surface of the foot we used free musculocutaneous flap of the latissimus dorsi, fasciocutaneous flaps were used for defects of the dorsum of the foot (less than 80 cm2). Long-term results were assessed using the Foot and ankle ability Measure (FAAM) questionnaire.Conclusion. Primary early replacement of tissue defects on the foot with free revascularized autografts is the method of choice for solving this problem, as it allows you to maintain the supporting function of the foot and is often alternative method to amputation.

Publisher

The Scientific and Practical Society of Emergency Medicine Physicians

Subject

Emergency Medicine

Reference18 articles.

1. Koryshkov NA. Travma stopy. Yaroslavl’; Rybinsk: Rybinskiy dom pechati Publ.; 2006. (In Russ.)

2. Rodomanova, LA. Vozmozhnosti rekonstruktivnoy mikrokhirurgii v rannem lechenii bol’nykh s obshirnymi posttravmaticheskimi defektami konechnostey: cand. med. sci. diss. synopsis. Saint Peterburg; 2010. (In Russ.)

3. Shibaev EY, Ivanov PA, Vlasov AP, Kisel DA, Lasarev MP, Nevedrov AV, Tsoglin LL. Soft Tissue Reconstruction in Patients With Severe Open Tibia Fractures. Russian Sklifosovsky Journal Emergency Medical Care. 2014;(1):30–36. (In Russ.)

4. Bosse MJ, MacKenzie EJ, Kellam JF, Burgess AR, Webb LX, Swiontkowski MF, et al. A prospective evaluation of the clinical utility of the lowerextremity injury-severity scores. J Bone Joint Surg Am. 2001;83(1):3–14. PMID: 11205855 https://doi.org/10.2106/00004623-200101000-00002

5. Moroz VYu, Yudenich AA, Mikhaylov IA, Kafarof TG, Guntsevich GI. Mikrokhirurgicheskoe ustranenie defektov myagkikh tkaney stopy svobodnymi vaskulyarizirovannymi loskutami. Pirogov Russian Journal of Surgery. 1997;(7):40–43. (In Russ.)