Colgajo pediculado de músculo gastrocnemio para la reconstrucción de tejidos blandos de tibia superior
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La cirugía de colgajos ha cambiado el pronóstico de los traumas en la Ortopedia. En este estudio se muestra el uso del músculo gastrocnemio como colgajo pediculado para la reconstrucción de defectos de tejidos blandos en el tercio superior de tibia. Siete pacientes se sometieron a la reconstrucción y se les realizó un injerto de piel de espesor parcial para cubrir el músculo.
Los colgajos transferidos sobrevivieron sin compromiso vascular, la cobertura del defecto fue satisfactoria y la herida tuvo buena cicatrización primaria. No se constató recurrencia de osteomielitis. Los sitios donantes sanaron sin discapacidad funcional. El seguimiento reveló óptimos resultados estéticos.
La transferencia del músculo gastrocnemio es una técnica útil para cubrir defectos de tejidos blandos en la tibia superior; confiable para cobertura de hueso expuesto, relleno de cavidades y tratamiento de infecciones óseas.
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Gkiatas I, Korompilia M, Kostas-Agnantis I, Tsirigkakis S, Stavraki M, Anastasios Korompilias A. Gastrocnemius pedicled muscle flap for knee and upper tibia soft tissue reconstruction. A useful tool for the orthopaedic surgeon. Injury. 2021;5:58.
Boretto JG, De Cicco FL. Fasciocutaneous Flaps. StatPearls Publishing, Treasure Island (FL); 2021 [acceso 05/01/2021]. Disponible en: https://europepmc.org/article/MED/32965951
Korompilias A, Gkiatas I, Korompilia M, Kosmas D, Kostas-Agnantis I. Reverse sural artery flap: a reliable alternative for foot and ankle soft tissue reconstruction. Eur J Orthop Surg Traumatol. 2019;29:367-72.
Kilic A, Denney B, de la Torre J. Reconstruction of knee defects using pedicled gastrocnemius muscle flap with split-thickness skin grafting: a single surgeon’s experience with 21 patients. J Knee Surg. 2019;32:463-7.
Walton Z, Armstrong M, Traven S, Leddy L. Pedicled rotational medial and lateral gastrocnemius flaps: surgical technique. J Am Acad Orthop Surg. 2017;25:744-51.
Mayoly A, Mattei JC, Moullot P, Jaloux C, Rochwerger A, Casanova D. Gastrocnemius myocutaneous flaps for knee joint coverage. Ann Plast Surg. 2018;81:208-14.
Kendall JV, McNally M, Taylor C, Ferguson J, Galitzine S, Critchley P, et al. The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction. J. Bone Joint Infect. 2019;4(4):181-8.
Russell E, Stinner DJ, Fergason JR, Wilken JM. Gait biomechanics following lower extremity trauma: amputation vs. reconstruction. Gait Posture 2017; 54:167-73.
Cho EH, Shammas RL, Carney MJ, Weissler JM, Bauder AR, Glener AD, et al. Muscle versus Fasciocutaneous Free Flaps in Lower Extremity Traumatic Reconstruction: A Multicenter Outcomes Analysis. Plast Reconstr Surg. 2019;141(1):191-9.
Colen DL, Colen LB, Levin LS, Kovach SJ. Godina's principles in the twenty-first century and the evolution of lower extremity trauma reconstruction. J Reconstr Microsurg 2018;34(8):563-71.
Chou YC, Wu CC, Chan YS, Chang CH, Hsu YH, Huang YC. Medial gastrocnemius muscle flap for treating wound complications after double-plate fixation via two-incision approach for complex tibial plateau fractures. J Trauma Inj Infect Crit Care. 2010;68:138-45.
Xiong L, Gazyakan E, Kremer T. Free flaps for reconstruction of soft tissue defects in lower extremity: A meta-analysis on microsurgical outcome and safety. Microsurgery. 2016;36(06):511-24.
Patterson CW, Stalder MW, Richardson W, Steele T, Wise MW, St Hilaire H. Timing of Free Flaps for Traumatic Wounds of the Lower Extremity: Have Advances in Perioperative Care Changed the Treatment Algorithm?. J Reconstr Microsurg. 2019;35(8):616-21.
Akin S, Durak K. One-stage treatment of chronic osteomyelitis of the proximal tibia using a pedicled vascularised double-barrel fibular flap together with a muscle flap. Br J Plast Surg. 2002;55:520-3.
Panteli M, Giannoudis PV. Chronic osteomyelitis: what the surgeon needs to know. EFORT Open Rev. 2017;1(5):128-35.
Buono P, Castus P, Dubois-Ferrière V. Muscular versus non-muscular free flaps for soft tissue coverage of chronic tibial osteomyelitis. World J Plast Surg 2018;7(3):294-300.
Hong JPJ, Goh TLH, Choi DH, Kim JJ, Suh HS. The efficacy of perforator flaps in the treatment of chronic osteomyelitis. Plast Reconstr Surg 2017;140(1):179-88.
Hong JPJ, Song S, Suh HSP. Supermicrosurgery: principles and applications. J Surg Oncol.2018;118:832-9.
Chao WN, Wang PH, Chen BR, Chen SC. Chimeric groin free flaps: design and clinical application. Microsurgery 2016;36:206-15.
Klein HJ, Fuchs N, Mehra T. Extending the limits of reconstructive microsurgery in elderly patients. J Plast Reconstr Aesthet Surg 2016;69(8):1017-23.
Abad CL, Haleem A. Prosthetic Joint Infections: an update. Curr Infect Dis Rep. 2018;20(7):15.
Cherubino M, Corno M, D’Arpa S, Di Summa P, Pellegatta I, Valdatta L, et al. Muscle versus fasciocutaneous flap in lower limb reconstruction: is there a best option? J Reconstr Microsurg. 2017;33:S27-S33.
Warren SI, Murtaugh TS, Lakra A, Reda LA, Shah RP, Geller JA. Treatment of periprosthetic knee infection with concurrent rotational muscle flap coverage is associated with high failure rates. J Arthroplasty. 2018;33:3263-7.
Houdek MT, Wagner ER, Wyles CC, Harmsen WS, Hanssen AD, Taunton MJ. Long-term outcomes of pedicled gastrocnemius flaps in total knee arthroplasty. J Bone J Surg. 2018;100:850-6.
Brown E, Suh HP, Han H, Pak Ch, Hong JP. Best New Flaps and Tips for Success in Microsurgery. Plast. Reconstr. Surg. 2020;146:796e.
Aguilera-Saez J, Lopez-Masramon B, Collado JM, Monte-Soldado A, Rivas-Nicolls D, Serracanta J, et al. Severely damaged lower limb salvage in a critically ill burned patient. Lessons learned. Int J Burn Trauma 2020;10(5):191-00.
Kovar A, Colakoglu S, Iorio ML. Choosing between Muscle and Fasciocutaneous Free Flap Reconstruction in the Treatment of Lower Extremity Osteomyelitis: Available Evidence for a Function-Specific Approach. J Reconstr Microsurg. 2020;36(3):197-203.
Jiang N, Wang BW, Chai YM, Wu XB, Tang PF, Zhang YZ. Chinese expert consensus on diagnosis and treatment of infection after fracture fixation. Injury. 2019;50(11):1952-8.
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