44. A PRELIMINARY ASSESSMENT OF OUTCOMES IN TREATING WOUNDS WITH EXPOSED TENDONS AND BONES BY PERIFASCIAL AREOLAR TISSUE GRAFTING
Main Article Content
Abstract
Objectives: Open wounds with exposed tendons and bones are always challenging to treat due to the lack of blood supply, leading to slow and incomplete healing. Currently, perifascial areolar tissue (PAT) is considered a promising solution for these difficult lesions thanks to its many advantageous properties. This study was conducted to preliminarily evaluate the effectiveness of autologous PAT grafting in treating wounds with exposed tendons and bones.
Methods: A descriptive case series study on 8 patients with wounds exposing tendons and bones treated with autologous PAT grafting combined with thin skin grafting, performed at the Hospital for Traumatology and Orthopedics in Ho Chi Minh City.
Results: The mean age was 40.43 ± 6.9 years old, all patients were male. The size of exposed tendons and bones ranged from 1 x 0.5 cm to 8 x 2 cm. The completed survival rate of PAT grafts was 75% (6/8 cases). There was 2 cases of partial graft necrosis occupied 25% (2/8 cases). The survival rate of skin grafts was 37,5% (3/8 cases). All PAT grafts covered the exposed tendon and bone, along with the good gliding ability of the underlying tendon.
Conclusion: Autologous PAT grafting is a simple, minimally invasive and effective method to cover lesions exposing tendons and bones. This method can be widely indicated for most small to medium-sized defects. Further studies with larger sample sizes are needed to confirm the applicability of this technique in clinical practice.
Article Details
Keywords
Wounds with exposed tendons and bones, perifascial areolar tissue, skin grafting
References
[2] Tsai SL, Nödl MT, Galloway JL. Bringing tendon biology to heel: Leveraging mechanisms of tendon development, healing, and regeneration to advance therapeutic strategies. Dev Dyn. Mar 2021;250(3):393-413. doi:10.1002/dvdy.269
[3] Janis JE, Kwon RK, Attinger CE. The new reconstructive ladder: modifications to the traditional model. Plast Reconstr Surg. Jan 2011;127 Suppl 1:205s-212s. doi:10.1097/PRS.0b013e318201271c
[4] Hayashi A, Komoto M, Tanaka R, et al. The availability of perifascial areolar tissue graft for deep cutaneous ulcer coverage. J Plast Reconstr Aesthet Surg. Dec 2015;68(12):1743-9. doi:10.1016/j.bjps.2015.08.008
[5] T, Akazawa S, Ichikawa Y, et al. Exposed Artificial Plate Covered With Perifascial Areolar Tissue as a Nonvascularized Graft. Plast Reconstr Surg Glob Open. Feb 2019;7(2):e2109. doi:10.1097/gox.0000000000002109
[6] Koizumi T, Nakagawa M, Nagamatsu S, et al. The versatile perifascial areolar tissue graft: adaptability to a variety of defects. J Plast Surg Hand Surg. Sep 2013;47(4):276-80. doi:10.3109/2000656x.2012.759955
[7] Miyanaga T, Haseda Y, Daizo H, et al. A Perifascial Areolar Tissue Graft With Topical Administration of Basic Fibroblast Growth Factor for Treatment of Complex Wounds With Exposed Tendons and/or Bones. J Foot Ankle Surg. Jan-Feb 2018;57(1):104-110. doi:10.1053/j.jfas.2017.08.026
[8] Simman R, Hermans MHE. Managing Wounds with Exposed Bone and Tendon with an Esterified Hyaluronic Acid Matrix (eHAM): A Literature Review and Personal Experience. J Am Coll Clin Wound Spec. 2017;9(1-3):1-9. doi:10.1016/j.jccw.2018.04.002
[9] Abe Y, Hashimoto I, Ishida S, Mineda K, Yoshimoto S. The perifascial areolar tissue and negative pressure wound therapy for one-stage skin grafting on exposed bone and tendon. J Med Invest. 2018;65(1.2):96-102. doi:10.2152/jmi.65.96
[10] Oshima J, Sasaki K, Shibuya Y, Sekido M. A Novel Model of Perifascial Areolar Tissue Transplant in Rats. Indian J Plast Surg. Jun 2022;55(3):268- 271. doi:10.1055/s-0042-1756130