Aim: Management of lower extremity soft tissue defects, which are encountered due to many reasons is quite difficult. The use of the reconstructive ladder and elevator directs to the appropriate reconstruction method for these defects. Materials and methods: We retrospectively evaluated 162 patients with lower extremity defects treated in our clinic between 2014 and 2019. The patients were evaluated according to age, gender, accompanying morbidity factors, defect location, etiology, reconstruction method, complication and secondary reconstruction methods. Results: Of the 48 were female and 114 were male. The age range was between 5 and 91. The most common etiology of the defects was trauma. The most common defect site was in foot and leg. The most commonly preferred reconstruction method was skin grafts, followed by free flaps. The failure rate of all reconstructions was 11%. Conclusion: Reconstruction of lower extremity defects with free or perforator flaps is a reliable and effective method.
1.Eisenschenk A, Noack N, Lautenbach M, Hartmann B, Küntscher M. Algorithmus zur Rekonstruktion von Weichteildefekten am distalen Unterschenkel, Sprunggelenk und Rückfuß. Z Orthop Grenzgeb. 2006;144:524–31.
2.Shakir S, Messa CA, Broach RB, Rheumtulla IA, Chatman B, D’Angelantonio A et al. Indications and limitations of bilayer wound matrix-based lower extremity reconstruction. Plast Reconstr Surg. 2020;145:813–22.
3.Macedo JLS, Rosa SC, Botelho DL, Santos CPD, Queiroz MND, Gomes TGACB. Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital. Rev Col Bras Cir. 2017;44:9–16.
4.Paro J, Chiou G, Sen SK. Comparing muscle and fasciocutaneous free flaps in lower extremity reconstruction - does it matter? Ann Plast Surg. 2016;76:213–5.
5.Novakovic D, Patel RS, Goldstein DP, Gullane PJ. Salvage of failed free flaps used in head and neck reconstruction. Head&Neck Oncology. 2009;1:33.
6.Xiong L, Gazyakan E., Kremer T, Hernekamp FJ, Harhaus L, Saint-Cyr M et al. Free flaps for reconstruction of soft tissue defects in lower extremity: A meta-analysis on microsurgical outcome and safety. Microsurgery. 2016;36:511–24.
7.Abdelfattah U, Power HA, Song S, Min K, Suh HP, Hong JP. Algorithm for free perforator flap selection in lower extremity reconstruction based on 563 cases. Plast Reconstr Surg. 2019;144:1202–13.
8.Ducic I, Brown BJ, Rao SS. Lower extremity free flap reconstruction outcomes using venous coupler. Microsurgery. 2011;31:360–4.
9.Culliford AT, Spector J, Blank A, Karp NS, Kasabian A, Levine JP. The fate of lower extremities with failed free flaps. Ann Plast Surg. 2007;59:18–22.
10.Hong JP. Reconstruction of the diabetic foot using the anterolateral thigh perforator flap. Plast Reconstr Surg. 2006;117:1599–608.
11.Karaaltin MV, Erdem A, Kuvat S, Cavdar G, Kerem H, Baghaki S et al. A. Comparison of clinical outcomes between single and multiple perforator-based free thoracodorsal artery perforator flaps: Clinical experience in 87 patients. Plast Reconstr Surg. 2011;128:158–65.
12.Kim SW, Youn S, Kim J, Do Kim JT, Hwang KT, Kim YH. Reconstruction of extensive lower limb defects with thoracodorsal axis chimeric flaps. Plast Reconstr Surg. 2013;132:470–9.
Alt Ekstremite Rekonstrüksiyonu: 5 Yıllık Klinik Deneyim
Amaç: Birçok nedene bağlı olarak karşılaşılan alt ekstremite yumuşak doku defektlerinin tedavisi oldukça zordur. Rekonstrüksiyon merdiveni ve asansörün kullanımı defektin yerine uygun rekonstrüksiyon yöntemine yönlendirir. Gereç ve Yöntemler: Kliniğimizde 2014-2019 yılları arasında tedavi edilen 162 alt ekstremite defektli hasta retrospektif olarak değerlendirdi. Hastalar yaş, cinsiyet, eşlik eden morbidite faktörleri, defekt yerleşim yeri, etiyoloji, rekonstrüksiyon yöntemi, komplikasyon ve ikincil rekonstrüksiyon yöntemlerine göre karşılaştırıldı. Bulgular: Hastaların 48'i kadın, 114'ü erkekti. Yaş aralığı 5 ile 91 arasındaydı. Defektlerin en sık etiyolojisi travmaydı. En sık görülen defekt bölgesi ayak ve bacakta idi. En sık tercih edilen rekonstrüksiyon yöntemi cilt greftleri idi, bunu serbest flepler izliyordu. Tüm onarımların başarısızlık oranı %11 olarak izlendi. Sonuç: Alt ekstremite defektlerinin serbest veya perforator flep ile rekonstrüksiyonu güvenilir ve etkili bir yöntemdir.
1.Eisenschenk A, Noack N, Lautenbach M, Hartmann B, Küntscher M. Algorithmus zur Rekonstruktion von Weichteildefekten am distalen Unterschenkel, Sprunggelenk und Rückfuß. Z Orthop Grenzgeb. 2006;144:524–31.
2.Shakir S, Messa CA, Broach RB, Rheumtulla IA, Chatman B, D’Angelantonio A et al. Indications and limitations of bilayer wound matrix-based lower extremity reconstruction. Plast Reconstr Surg. 2020;145:813–22.
3.Macedo JLS, Rosa SC, Botelho DL, Santos CPD, Queiroz MND, Gomes TGACB. Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital. Rev Col Bras Cir. 2017;44:9–16.
4.Paro J, Chiou G, Sen SK. Comparing muscle and fasciocutaneous free flaps in lower extremity reconstruction - does it matter? Ann Plast Surg. 2016;76:213–5.
5.Novakovic D, Patel RS, Goldstein DP, Gullane PJ. Salvage of failed free flaps used in head and neck reconstruction. Head&Neck Oncology. 2009;1:33.
6.Xiong L, Gazyakan E., Kremer T, Hernekamp FJ, Harhaus L, Saint-Cyr M et al. Free flaps for reconstruction of soft tissue defects in lower extremity: A meta-analysis on microsurgical outcome and safety. Microsurgery. 2016;36:511–24.
7.Abdelfattah U, Power HA, Song S, Min K, Suh HP, Hong JP. Algorithm for free perforator flap selection in lower extremity reconstruction based on 563 cases. Plast Reconstr Surg. 2019;144:1202–13.
8.Ducic I, Brown BJ, Rao SS. Lower extremity free flap reconstruction outcomes using venous coupler. Microsurgery. 2011;31:360–4.
9.Culliford AT, Spector J, Blank A, Karp NS, Kasabian A, Levine JP. The fate of lower extremities with failed free flaps. Ann Plast Surg. 2007;59:18–22.
10.Hong JP. Reconstruction of the diabetic foot using the anterolateral thigh perforator flap. Plast Reconstr Surg. 2006;117:1599–608.
11.Karaaltin MV, Erdem A, Kuvat S, Cavdar G, Kerem H, Baghaki S et al. A. Comparison of clinical outcomes between single and multiple perforator-based free thoracodorsal artery perforator flaps: Clinical experience in 87 patients. Plast Reconstr Surg. 2011;128:158–65.
12.Kim SW, Youn S, Kim J, Do Kim JT, Hwang KT, Kim YH. Reconstruction of extensive lower limb defects with thoracodorsal axis chimeric flaps. Plast Reconstr Surg. 2013;132:470–9.
Sabri Öztürk
University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery0000-0001-6511-9609Türkiye
Hatice Aylin Akbulut
University of Health Sciences, Ankara Training and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery0000-0002-7048-021XTürkiye
Baş, S., Öztürk, S., Akbulut, H. A., Öner, Ç. (2022). Lower Extremity Reconstruction: 5 Years of Clinical Experience. İzmir Tıp Fakültesi Dergisi, 1(2), 84-90.
AMA
Baş S, Öztürk S, Akbulut HA, Öner Ç. Lower Extremity Reconstruction: 5 Years of Clinical Experience. İzmir Tıp Fak. Derg. Eylül 2022;1(2):84-90.
Chicago
Baş, Soysal, Sabri Öztürk, Hatice Aylin Akbulut, ve Çağatay Öner. “Lower Extremity Reconstruction: 5 Years of Clinical Experience”. İzmir Tıp Fakültesi Dergisi 1, sy. 2 (Eylül 2022): 84-90.
EndNote
Baş S, Öztürk S, Akbulut HA, Öner Ç (01 Eylül 2022) Lower Extremity Reconstruction: 5 Years of Clinical Experience. İzmir Tıp Fakültesi Dergisi 1 2 84–90.
IEEE
S. Baş, S. Öztürk, H. A. Akbulut, ve Ç. Öner, “Lower Extremity Reconstruction: 5 Years of Clinical Experience”, İzmir Tıp Fak. Derg., c. 1, sy. 2, ss. 84–90, 2022.
ISNAD
Baş, Soysal vd. “Lower Extremity Reconstruction: 5 Years of Clinical Experience”. İzmir Tıp Fakültesi Dergisi 1/2 (Eylül 2022), 84-90.
JAMA
Baş S, Öztürk S, Akbulut HA, Öner Ç. Lower Extremity Reconstruction: 5 Years of Clinical Experience. İzmir Tıp Fak. Derg. 2022;1:84–90.
MLA
Baş, Soysal vd. “Lower Extremity Reconstruction: 5 Years of Clinical Experience”. İzmir Tıp Fakültesi Dergisi, c. 1, sy. 2, 2022, ss. 84-90.
Vancouver
Baş S, Öztürk S, Akbulut HA, Öner Ç. Lower Extremity Reconstruction: 5 Years of Clinical Experience. İzmir Tıp Fak. Derg. 2022;1(2):84-90.