Author:
MALIKOV M.KH., ,DAVLATOV A.A.,DZHONONOV D.D.,KHAYDAROV M.M.,MAKHMADKULOVA N.A.,KARIM-ZADE G.D., , , , ,
Abstract
Objective: To improve the outcomes of surgical treatment of severe contractures, deformities, and lower limb (LL) soft tissue defects using optical magnification and precision techniques. Methods: 54 patients with sequelae of traumatic injury underwent surgical repair of severe contractures, deformities, and soft tissue defects of the LL. Contractures were accompanied by extended cicatricial deformities and soft tissue defects of the LL. Traumatic injuries often lead to sequelae in children, as observed in 39 patients. The leading causes of burn injuries were boiling water and hot oil. Results: Various types of Z-plasty were used in 29 (53.7%) cases to correct contracture and toe and foot deformities. Tailored surgeries were performed for severe injuries and extended cicatricial deformities with residual defects covered with skin grafts. Optical magnification with precision technique contributed to adequately mobilizing the fasciocutaneous flaps and the neurovascular bundle (NVB) release. By using ultrasonic dopplerography (USDG), it was possible to determine how the degree circulatory disorders in the affected LL is dependent on the duration between injury and presentation at our center, the severity of the contracture, and the size and depth of the soft tissue damage. Purulent wound infection and superficial partial necrosis of the fasciocutaneous flaps occurred in 3 and 5 patients, respectively Conclusion: In managing concomitant injuries, including assessing their extent, appropriately evaluating the initial severity of the trauma is essential. The evaluation requires using additional diagnostic methods and selecting the optimal reconstruction method. Optical magnification and precision techniques enable the effective mobilizing of fasciocutaneous flaps while preserving their blood supply. This leads to adequate mobilization and decompression of the NVB, effectively preventing NVB iatrogenic damage. Keywords: Lower limb, burn, contracture, deformity, soft tissue defect, local plastic surgery.
Publisher
Avicenna Tajik State Medical University
Subject
Psychiatry and Mental health
Reference20 articles.
1. 1. Yasir M, Wani AH, Zargar HR. Ergonomics and biogeometry of perforator/propeller flaps in the lower limb reconstruction. World J Plast Surg. 2017;6(2):238- 42
2. Perforator pedicled propeller flaps for soft tissue coverage of lower leg and foot defects;Dong;Orthop Surg,2014
3. 3. Nazarov KhN, Linnik SA, Mirzoev RR. Profilaktika i lechenie posttravmaticheskoy kontraktury, ankilozov i artrozov sustavov pri sochetannykh i mnozhestvennykh travmakh nizhney konechnosti [Prevention and treatment of post-traumatic contracture, ankylosis and arthrosis of the joints with combined and multiple injuries of the lower extremity]. Vestnik Akademii meditsinskikh nauk Tadzhikistana. 2018;8(3):341-8.
4. 4. Shibaev EYu, Ivanov PA, Nevedrov AV, Lazarev MP, Vlasov AP. Taktika lecheniya posttravmaticheskikh defektov myagkikh tkaney konechnostey [Treatment of post-traumatic soft tissue defects of the extremities]. Zhurnal im. N.V. Sklifosovskogo «Neotlozhnaya meditsinskaya pomoshch'». 2018;7(1):37-43.
5. 5. Gupta M, Pai AA, Setty RR, Sawarappa R, Majumdar BK, Banerjee B, et al. Perforator plus asciocutaneous flaps in the reconstruction of post-burn flexion contractures of the knee joint. J Clinical and Diagnostic Research. 2013;7(5):896- 901.