Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 610-615 |
| Number of pages | 6 |
| Journal | Microsurgery |
| Volume | 31 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 2011 |
| Externally published | Yes |
Fingerprint
Keywords
- adult
- age
- aged
- anterolateral thigh flap
- article
- clinical article
- comorbidity
- debridement
- feet tophaceous gout
- female
- free tissue graft
- gout
- human
- leg ulcer
- male
- medial sural flap
- patient safety
- priority journal
- sex difference
- skin necrosis
- skin ulcer
- surgical wound
- tarsometatarsal joint
- tendon
- treatment outcome
- Adult
- Aged
- Arthritis, Gouty
- Follow-Up Studies
- Foot Ulcer
- Gout
- Graft Survival
- Humans
- Male
- Microsurgery
- Middle Aged
- Retrospective Studies
- Sampling Studies
- Severity of Illness Index
- Skin Transplantation
- Surgical Flaps
- Taiwan
- Toes
- Treatment Outcome
- Wound Healing
Cite this
Free-flap resurfacing of tissue defects in the foot due to large gouty tophi. / Lin, Chin-Ta; Chang, Shun-Cheng; Chen, Tim-Mo; Dai, Niann-Tzyy; Fu, Ju-Peng; Deng, Shou-Cheng; Tzeng, Yuan-Sheng; Chen, Shyi-Gen.
In: Microsurgery, Vol. 31, No. 8, 2011, p. 610-615.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Free-flap resurfacing of tissue defects in the foot due to large gouty tophi
AU - Lin, Chin-Ta
AU - Chang, Shun-Cheng
AU - Chen, Tim-Mo
AU - Dai, Niann-Tzyy
AU - Fu, Ju-Peng
AU - Deng, Shou-Cheng
AU - Tzeng, Yuan-Sheng
AU - Chen, Shyi-Gen
N1 - 被引用次數：2 Export Date: 21 March 2016 CODEN: MSRGD 通訊地址: Chen, S.-G.; Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Gung Road, Taipei 11490, Taiwan; 電子郵件： shyigen@ms26.hinet.net 參考文獻: Landry, J.R., Schilero, J., The medical/surgical management of gout (1986) Journal of Foot Surgery, 25 (2), pp. 160-175; Lin, K.-C., Lin, H.-Y., Chou, P., The interaction between uric acid level and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study (2000) Journal of Rheumatology, 27 (6), pp. 1501-1505; Lee, S.S., Lin, S.D., Lai, C.S., Lin, T.M., Chang, K.P., Yang, Y.L., The soft-tissue shaving procedure for deformity management of chronic tophaceous gout (2003) Ann Plast Surg, 51, pp. 372-375; Larmon, W.A., Surgical management of tophaceous gout (1970) Clin Orthop Relat Res, 71, pp. 56-69; Ford, T.C., Surgical management of chronic tophaceous gout (1992) J Am Podiatr Med Assoc, 82, pp. 514-519; Ishikawa, K., Isshiki, N., Suzuki, S., Shimamura, S., Distally based dorsalis pedis island flap for coverage of the distal portion of the foot (1987) Br J Plast Surg, 40, pp. 521-525; Mathes, S.J., Nahai, F., (1979) Abductor Hallucis Muscle Flap. Clinical Atlas of Muscle and Musculocutaneous Flaps, pp. 269-277. , St Louis: CV Mosby;; Yoshimura, Y., Nakajima, T., Kami, T., Distally based abductor digiti minimi muscle flap (1985) Annals of Plastic Surgery, 14 (4), pp. 375-377. , DOI 10.1097/00000637-198504000-00012; Wee, J.T.K., Reconstruction of the lower leg and foot with the reverse-pedicled anterior tibial flap: Preliminary report of a new fasciocutaneous flap (1986) British Journal of Plastic Surgery, 39 (3), pp. 327-337; Liu, K., Li, Z., Lin, Y., Cao, Y., The reverse-flow posterior tibial island flap: Anatomic study and 72 clinical cases (1990) Plast Reconstr Surg, 86, pp. 312-316; Yoshimura, M., Imura, S., Shimamura, K., Peroneal flap for reconstruction in the extremity: Preliminary report (1984) Plastic and Reconstructive Surgery, 74 (3), pp. 402-409; Ou, K.L., Tzeng, Y.S., Yu, C.C., Chen, T.M., Resurfacing tophaceous gout in the foot with anterolateral thigh flap (2010) Microsurgery, 30, pp. 79-82; Lee, K.S., Lee, H.S., Kim, N.G., Kim, J.S., Lee, S.I., Choi, T.H., Treatment of chronic tophaceous gout with a free flap (2010) Clin Rheumatol, 29, pp. 333-334; Chen, S.L., Chen, T.M., Lee, C.H., Free medial sural artery perforator flap for resurfacing distal limb defects (2005) J Trauma, 58, pp. 323-327; Shimizu, F., Kato, A., Sato, H., Taneda, H., Sural perforator flap: Assessment of the posterior calf region as donor site for a free fasciocutaneous flap (2009) Microsurgery, 29, pp. 253-258; Aydin, O.E., Tan, O., Kuduban, S.D., Barin, E.Z., Nerve sparing-distally based sural flap (2011) Microsurgery, 31, pp. 276-280; Wei, F.C., Jain, V., Celik, N., Chen, H.C., Chuang, D.C., Lin, C.H., Have we found an ideal soft tissue flap? An experience with 672 anterolateral thigh flaps (2002) Plast Reconstr Surg, 109, pp. 2219-2230
PY - 2011
Y1 - 2011
N2 - Background: Large or extensive gouty tophi on the feet can cause functional impairment, drainage sinus, and infected necrosis, finally resulting in complex soft-tissue defects with tendon, joint, bone, nerve, and vessel exposure. Reconstruction of complex soft-tissue defects of the foot is still challenging. The purpose of this report was to review the outcomes of free-flap reconstructive surgery for treating the metatarsal joint defects of the feet caused by chronic tophaceous gout. Methods: Ten patients who had large tophus masses (>5 cm) and ulceration on the feet were admitted to our hospital between September 2006 and September 2010. Six patients underwent free-flap reconstruction after debridement to resurface the circumferential wound, protect the underlying structures, and provide a gliding surface for exposed tendons. The patients' age, sex, comorbidities, location and size of the defects, reconstructive procedures, surgical outcomes, complications, follow-ups, and recurrence of tophaceous gout were reviewed and recorded. Results: The mean patient age was 49.8 years (range, 36-72 years). The average skin defect size was 92.2 cm 2. Five patients were treated using free anterolateral thigh flaps, and 1, using a free medial sural flap. These free flaps were safely raised and showed excellent functional and cosmetic results, with a mean follow-up of 31.7 months (range, 7-50 months). Conclusion: Chronic tophaceous gout can cause severe skin infection and necrosis, even resulting in deformity or sepsis if left untreated. Surgical debridement is inevitable in patients with extensive wounds. We reconstructed the large, ulcerative skin and soft-tissue defects on the dorsum of the foot by performing free-flap reconstruction after adequate debridement and achieved good functional and cosmetic results. © C 2011 Wiley Periodicals, Inc.
AB - Background: Large or extensive gouty tophi on the feet can cause functional impairment, drainage sinus, and infected necrosis, finally resulting in complex soft-tissue defects with tendon, joint, bone, nerve, and vessel exposure. Reconstruction of complex soft-tissue defects of the foot is still challenging. The purpose of this report was to review the outcomes of free-flap reconstructive surgery for treating the metatarsal joint defects of the feet caused by chronic tophaceous gout. Methods: Ten patients who had large tophus masses (>5 cm) and ulceration on the feet were admitted to our hospital between September 2006 and September 2010. Six patients underwent free-flap reconstruction after debridement to resurface the circumferential wound, protect the underlying structures, and provide a gliding surface for exposed tendons. The patients' age, sex, comorbidities, location and size of the defects, reconstructive procedures, surgical outcomes, complications, follow-ups, and recurrence of tophaceous gout were reviewed and recorded. Results: The mean patient age was 49.8 years (range, 36-72 years). The average skin defect size was 92.2 cm 2. Five patients were treated using free anterolateral thigh flaps, and 1, using a free medial sural flap. These free flaps were safely raised and showed excellent functional and cosmetic results, with a mean follow-up of 31.7 months (range, 7-50 months). Conclusion: Chronic tophaceous gout can cause severe skin infection and necrosis, even resulting in deformity or sepsis if left untreated. Surgical debridement is inevitable in patients with extensive wounds. We reconstructed the large, ulcerative skin and soft-tissue defects on the dorsum of the foot by performing free-flap reconstruction after adequate debridement and achieved good functional and cosmetic results. © C 2011 Wiley Periodicals, Inc.
KW - adult
KW - age
KW - aged
KW - anterolateral thigh flap
KW - article
KW - clinical article
KW - comorbidity
KW - debridement
KW - feet tophaceous gout
KW - female
KW - free tissue graft
KW - gout
KW - human
KW - leg ulcer
KW - male
KW - medial sural flap
KW - patient safety
KW - priority journal
KW - sex difference
KW - skin necrosis
KW - skin ulcer
KW - surgical wound
KW - tarsometatarsal joint
KW - tendon
KW - treatment outcome
KW - Adult
KW - Aged
KW - Arthritis, Gouty
KW - Follow-Up Studies
KW - Foot Ulcer
KW - Gout
KW - Graft Survival
KW - Humans
KW - Male
KW - Microsurgery
KW - Middle Aged
KW - Retrospective Studies
KW - Sampling Studies
KW - Severity of Illness Index
KW - Skin Transplantation
KW - Surgical Flaps
KW - Taiwan
KW - Toes
KW - Treatment Outcome
KW - Wound Healing
U2 - 10.1002/micr.20949
DO - 10.1002/micr.20949
M3 - Article
VL - 31
SP - 610
EP - 615
JO - Microsurgery
JF - Microsurgery
SN - 0738-1085
IS - 8
ER -