Modified Vertical Rectus Abdominis Musculocutaneous Flap for Limb Salvage Procedures in Proximal Lower Limb Musculoskeletal Sarcomas
Identifieur interne : 003933 ( Pmc/Checkpoint ); précédent : 003932; suivant : 003934Modified Vertical Rectus Abdominis Musculocutaneous Flap for Limb Salvage Procedures in Proximal Lower Limb Musculoskeletal Sarcomas
Auteurs : Haitham H. Khalil ; Ahmed El-Ghoneimy [Égypte] ; Yasser Farid [Égypte] ; Walid Ebeid [Égypte] ; Ahmed Afifi ; Ahmed Elaffandi [Royaume-Uni] ; Tarek Mahboub [Égypte]Source :
- Sarcoma [ 1357-714X ] ; 2008.
Abstract
Url:
DOI: 10.1155/2008/781408
PubMed: 18389069
PubMed Central: 2278233
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Modified Vertical Rectus Abdominis Musculocutaneous Flap for Limb Salvage Procedures in Proximal Lower Limb Musculoskeletal Sarcomas</title><author><name sortKey="Khalil, Haitham H" sort="Khalil, Haitham H" uniqKey="Khalil H" first="Haitham H." last="Khalil">Haitham H. Khalil</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="El Ghoneimy, Ahmed" sort="El Ghoneimy, Ahmed" uniqKey="El Ghoneimy A" first="Ahmed" last="El-Ghoneimy">Ahmed El-Ghoneimy</name><affiliation wicri:level="1"><nlm:aff id="I3">Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559</wicri:regionArea><wicri:noRegion>Cairo 11559</wicri:noRegion></affiliation></author><author><name sortKey="Farid, Yasser" sort="Farid, Yasser" uniqKey="Farid Y" first="Yasser" last="Farid">Yasser Farid</name><affiliation wicri:level="1"><nlm:aff id="I3">Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559</wicri:regionArea><wicri:noRegion>Cairo 11559</wicri:noRegion></affiliation></author><author><name sortKey="Ebeid, Walid" sort="Ebeid, Walid" uniqKey="Ebeid W" first="Walid" last="Ebeid">Walid Ebeid</name><affiliation wicri:level="1"><nlm:aff id="I3">Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559</wicri:regionArea><wicri:noRegion>Cairo 11559</wicri:noRegion></affiliation></author><author><name sortKey="Afifi, Ahmed" sort="Afifi, Ahmed" uniqKey="Afifi A" first="Ahmed" last="Afifi">Ahmed Afifi</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Elaffandi, Ahmed" sort="Elaffandi, Ahmed" uniqKey="Elaffandi A" first="Ahmed" last="Elaffandi">Ahmed Elaffandi</name><affiliation wicri:level="1"><nlm:aff id="I5">Department of Surgery, Royal Free Hospital, London NW3 2PN, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Surgery, Royal Free Hospital, London NW3 2PN</wicri:regionArea><wicri:noRegion>London NW3 2PN</wicri:noRegion></affiliation></author><author><name sortKey="Mahboub, Tarek" sort="Mahboub, Tarek" uniqKey="Mahboub T" first="Tarek" last="Mahboub">Tarek Mahboub</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Plastic and Reconstructive Surgery, Cairo University Teaching Hospital, Cairo University, Kasr Al Ainy, Cairo 11559, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Cairo University Teaching Hospital, Cairo University, Kasr Al Ainy, Cairo 11559</wicri:regionArea><wicri:noRegion>Cairo 11559</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18389069</idno><idno type="pmc">2278233</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2278233</idno><idno type="RBID">PMC:2278233</idno><idno type="doi">10.1155/2008/781408</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">002697</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002697</idno><idno type="wicri:Area/Pmc/Curation">002696</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002696</idno><idno type="wicri:Area/Pmc/Checkpoint">003933</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">003933</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Modified Vertical Rectus Abdominis Musculocutaneous Flap for Limb Salvage Procedures in Proximal Lower Limb Musculoskeletal Sarcomas</title><author><name sortKey="Khalil, Haitham H" sort="Khalil, Haitham H" uniqKey="Khalil H" first="Haitham H." last="Khalil">Haitham H. Khalil</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="El Ghoneimy, Ahmed" sort="El Ghoneimy, Ahmed" uniqKey="El Ghoneimy A" first="Ahmed" last="El-Ghoneimy">Ahmed El-Ghoneimy</name><affiliation wicri:level="1"><nlm:aff id="I3">Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559</wicri:regionArea><wicri:noRegion>Cairo 11559</wicri:noRegion></affiliation></author><author><name sortKey="Farid, Yasser" sort="Farid, Yasser" uniqKey="Farid Y" first="Yasser" last="Farid">Yasser Farid</name><affiliation wicri:level="1"><nlm:aff id="I3">Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559</wicri:regionArea><wicri:noRegion>Cairo 11559</wicri:noRegion></affiliation></author><author><name sortKey="Ebeid, Walid" sort="Ebeid, Walid" uniqKey="Ebeid W" first="Walid" last="Ebeid">Walid Ebeid</name><affiliation wicri:level="1"><nlm:aff id="I3">Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559</wicri:regionArea><wicri:noRegion>Cairo 11559</wicri:noRegion></affiliation></author><author><name sortKey="Afifi, Ahmed" sort="Afifi, Ahmed" uniqKey="Afifi A" first="Ahmed" last="Afifi">Ahmed Afifi</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Elaffandi, Ahmed" sort="Elaffandi, Ahmed" uniqKey="Elaffandi A" first="Ahmed" last="Elaffandi">Ahmed Elaffandi</name><affiliation wicri:level="1"><nlm:aff id="I5">Department of Surgery, Royal Free Hospital, London NW3 2PN, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Surgery, Royal Free Hospital, London NW3 2PN</wicri:regionArea><wicri:noRegion>London NW3 2PN</wicri:noRegion></affiliation></author><author><name sortKey="Mahboub, Tarek" sort="Mahboub, Tarek" uniqKey="Mahboub T" first="Tarek" last="Mahboub">Tarek Mahboub</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Plastic and Reconstructive Surgery, Cairo University Teaching Hospital, Cairo University, Kasr Al Ainy, Cairo 11559, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Cairo University Teaching Hospital, Cairo University, Kasr Al Ainy, Cairo 11559</wicri:regionArea><wicri:noRegion>Cairo 11559</wicri:noRegion></affiliation></author></analytic><series><title level="j">Sarcoma</title><idno type="ISSN">1357-714X</idno><idno type="eISSN">1369-1643</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><italic>Introduction and aim</italic>. Management of complicated wounds after tumor extipiration of pelvic and proximal lower limb musculoskeletal sarcoma represents an essential component in the outcome of these patients. The authors present modified vertical rectus abdominis musculocutaneous (VRAM) flap techniques to reconstruct extensive defects after debridment of these complicated wounds. <italic>Material and Methods</italic>. Over a period of 4 years (2002–2005), 5 men and 2 women were managed. Median age was 21 years (range 15–49). The patients were managed for complicated lower trunk, groin, and upper thigh wounds after resection of three pelvic chondrosarcomas as well as two pelvic and two proximal femur osteosarcomas. The modifications included a VRAM flap with lateral and tongue-like extension design of the skin paddle (5 cases) or a delayed extended VRAM flap (2 cases). <italic>Results</italic>. All flaps showed complete survival and healing with no ischemic events providing stable coverage. All patients were ambulant with good limb functions in terms of walking and gait after adequate rehabilitation, 2 needed support with crutches. <italic>Conclusion</italic>. The modified VRAM flaps offer reliable reconstructive tools for coverage of complex groin and thigh defects by providing larger well-vascularized soft tissue with acceptable donor site.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Wallace, Rd" uniqKey="Wallace R">RD Wallace</name></author><author><name sortKey="Davoudi, Mm" uniqKey="Davoudi M">MM Davoudi</name></author><author><name sortKey="Neal, Md" uniqKey="Neal M">MD Neal</name></author><author><name sortKey="Lachica, Rd" uniqKey="Lachica R">RD Lachica</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Senchenkov, A" uniqKey="Senchenkov A">A Senchenkov</name></author><author><name sortKey="Thomford, Nr" uniqKey="Thomford N">NR Thomford</name></author><author><name sortKey="Barone, Fe" uniqKey="Barone F">FE Barone</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosen, G" uniqKey="Rosen G">G Rosen</name></author><author><name sortKey="Murphy, Ml" uniqKey="Murphy M">ML Murphy</name></author><author><name sortKey="Huvos, Ag" uniqKey="Huvos A">AG Huvos</name></author><author><name sortKey="Gutierrez, M" uniqKey="Gutierrez M">M Gutierrez</name></author><author><name sortKey="Marcove, Rc" uniqKey="Marcove R">RC Marcove</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cedidi, Cc" uniqKey="Cedidi C">CC Cedidi</name></author><author><name sortKey="Felmerer, G" uniqKey="Felmerer G">G Felmerer</name></author><author><name sortKey="Berger, A" uniqKey="Berger A">A Berger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lee, S" uniqKey="Lee S">S Lee</name></author><author><name sortKey="Oh, J" uniqKey="Oh J">J Oh</name></author><author><name sortKey="Lee, K" uniqKey="Lee K">K Lee</name></author><author><name sortKey="Yoo, K" uniqKey="Yoo K">K Yoo</name></author><author><name sortKey="Kim, H" uniqKey="Kim H">H Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jeys, Lm" uniqKey="Jeys L">LM Jeys</name></author><author><name sortKey="Grimer, Rj" uniqKey="Grimer R">RJ Grimer</name></author><author><name sortKey="Carter, Sr" uniqKey="Carter S">SR Carter</name></author><author><name sortKey="Tillman, Rm" uniqKey="Tillman R">RM Tillman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Windle, Bh" uniqKey="Windle B">BH Windle</name></author><author><name sortKey="Stroup, Rt" uniqKey="Stroup R">RT Stroup</name></author><author><name sortKey="Beckenstein, Ms" uniqKey="Beckenstein M">MS Beckenstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Taylor, Gi" uniqKey="Taylor G">GI Taylor</name></author><author><name sortKey="Corlett, R" uniqKey="Corlett R">R Corlett</name></author><author><name sortKey="Boyd, Jb" uniqKey="Boyd J">JB Boyd</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Drake, Db" uniqKey="Drake D">DB Drake</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosenberg, Sa" uniqKey="Rosenberg S">SA Rosenberg</name></author><author><name sortKey="Tepper, J" uniqKey="Tepper J">J Tepper</name></author><author><name sortKey="Glatstein, E" uniqKey="Glatstein E">E Glatstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eilber, Fr" uniqKey="Eilber F">FR Eilber</name></author><author><name sortKey="Morton, Dl" uniqKey="Morton D">DL Morton</name></author><author><name sortKey="Eckardt, J" uniqKey="Eckardt J">J Eckardt</name></author><author><name sortKey="Grant, T" uniqKey="Grant T">T Grant</name></author><author><name sortKey="Weisenburger, T" uniqKey="Weisenburger T">T Weisenburger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hardes, J" uniqKey="Hardes J">J Hardes</name></author><author><name sortKey="Gebert, C" uniqKey="Gebert C">C Gebert</name></author><author><name sortKey="Schwappach, A" uniqKey="Schwappach A">A Schwappach</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hui, K" uniqKey="Hui K">K Hui</name></author><author><name sortKey="Zhang, F" uniqKey="Zhang F">F Zhang</name></author><author><name sortKey="Pickus, E" uniqKey="Pickus E">E Pickus</name></author><author><name sortKey="Rodriguez, Lf" uniqKey="Rodriguez L">LF Rodriguez</name></author><author><name sortKey="Teng, N" uniqKey="Teng N">N Teng</name></author><author><name sortKey="Lineaweaver, W" uniqKey="Lineaweaver W">W Lineaweaver</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tran, Nv" uniqKey="Tran N">NV Tran</name></author><author><name sortKey="Sim, Fh" uniqKey="Sim F">FH Sim</name></author><author><name sortKey="Lewallen, Dg" uniqKey="Lewallen D">DG Lewallen</name></author><author><name sortKey="Carmichael, Sw" uniqKey="Carmichael S">SW Carmichael</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kuntscher, Mv" uniqKey="Kuntscher M">MV Küntscher</name></author><author><name sortKey="Mansouri, S" uniqKey="Mansouri S">S Mansouri</name></author><author><name sortKey="Noack, N" uniqKey="Noack N">N Noack</name></author><author><name sortKey="Hartmann, B" uniqKey="Hartmann B">B Hartmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Buchel, Ew" uniqKey="Buchel E">EW Buchel</name></author><author><name sortKey="Finical, S" uniqKey="Finical S">S Finical</name></author><author><name sortKey="Johnson, C" uniqKey="Johnson C">C Johnson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Halim, As" uniqKey="Halim A">AS Halim</name></author><author><name sortKey="Zulmi, W" uniqKey="Zulmi W">W Zulmi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Glatt, Bs" uniqKey="Glatt B">BS Glatt</name></author><author><name sortKey="Disa, Jj" uniqKey="Disa J">JJ Disa</name></author><author><name sortKey="Mehrara, Bj" uniqKey="Mehrara B">BJ Mehrara</name></author><author><name sortKey="Pusic, Al" uniqKey="Pusic A">AL Pusic</name></author><author><name sortKey="Boland, P" uniqKey="Boland P">P Boland</name></author><author><name sortKey="Cordeiro, Pg" uniqKey="Cordeiro P">PG Cordeiro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lee, Mj" uniqKey="Lee M">MJ Lee</name></author><author><name sortKey="Dumanian, Ga" uniqKey="Dumanian G">GA Dumanian</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fujiwara, M" uniqKey="Fujiwara M">M Fujiwara</name></author><author><name sortKey="Nakamura, Y" uniqKey="Nakamura Y">Y Nakamura</name></author><author><name sortKey="Sano, A" uniqKey="Sano A">A Sano</name></author><author><name sortKey="Nakayama, E" uniqKey="Nakayama E">E Nakayama</name></author><author><name sortKey="Nagasawa, M" uniqKey="Nagasawa M">M Nagasawa</name></author><author><name sortKey="Shindo, T" uniqKey="Shindo T">T Shindo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moon, Hk" uniqKey="Moon H">HK Moon</name></author><author><name sortKey="Taylor, Gi" uniqKey="Taylor G">GI Taylor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Boyd, Jb" uniqKey="Boyd J">JB Boyd</name></author><author><name sortKey="Taylor, Gi" uniqKey="Taylor G">GI Taylor</name></author><author><name sortKey="Corlett, R" uniqKey="Corlett R">R Corlett</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lesavoy, Ma" uniqKey="Lesavoy M">MA Lesavoy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tosun, Z" uniqKey="Tosun Z">Z Tosun</name></author><author><name sortKey="Ozkan, A" uniqKey="Ozkan A">A Özkan</name></author><author><name sortKey="Karacor, Z" uniqKey="Karacor Z">Z Karaçor</name></author><author><name sortKey="Savaci, N" uniqKey="Savaci N">N Savaci</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Erdmann, D" uniqKey="Erdmann D">D Erdmann</name></author><author><name sortKey="Sundin, Bm" uniqKey="Sundin B">BM Sundin</name></author><author><name sortKey="Moquin, Kj" uniqKey="Moquin K">KJ Moquin</name></author><author><name sortKey="Young, H" uniqKey="Young H">H Young</name></author><author><name sortKey="Georgiade, Gs" uniqKey="Georgiade G">GS Georgiade</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suzman, Ms" uniqKey="Suzman M">MS Suzman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Knox, K" uniqKey="Knox K">K Knox</name></author><author><name sortKey="Bitzos, I" uniqKey="Bitzos I">I Bitzos</name></author><author><name sortKey="Granick, M" uniqKey="Granick M">M Granick</name></author><author><name sortKey="Datiashvili, R" uniqKey="Datiashvili R">R Datiashvili</name></author><author><name sortKey="Benevenia, J" uniqKey="Benevenia J">J Benevenia</name></author><author><name sortKey="Patterson, F" uniqKey="Patterson F">F Patterson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Santanelli, F" uniqKey="Santanelli F">F Santanelli</name></author><author><name sortKey="Berlin, O" uniqKey="Berlin O">O Berlin</name></author><author><name sortKey="Fogdestam, I" uniqKey="Fogdestam I">I Fogdestam</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kimata, Y" uniqKey="Kimata Y">Y Kimata</name></author><author><name sortKey="Uchiyama, K" uniqKey="Uchiyama K">K Uchiyama</name></author><author><name sortKey="Ebihara, S" uniqKey="Ebihara S">S Ebihara</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bach, Ad" uniqKey="Bach A">AD Bach</name></author><author><name sortKey="Kopp, J" uniqKey="Kopp J">J Kopp</name></author><author><name sortKey="Stark, Gb" uniqKey="Stark G">GB Stark</name></author><author><name sortKey="Horch, Re" uniqKey="Horch R">RE Horch</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="other"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Sarcoma</journal-id><journal-id journal-id-type="iso-abbrev">Sarcoma</journal-id><journal-id journal-id-type="publisher-id">SRCM</journal-id><journal-title-group><journal-title>Sarcoma</journal-title></journal-title-group><issn pub-type="ppub">1357-714X</issn><issn pub-type="epub">1369-1643</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">18389069</article-id><article-id pub-id-type="pmc">2278233</article-id><article-id pub-id-type="doi">10.1155/2008/781408</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Study</subject></subj-group></article-categories><title-group><article-title>Modified Vertical Rectus Abdominis Musculocutaneous Flap for Limb Salvage Procedures in Proximal Lower Limb Musculoskeletal Sarcomas</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Khalil</surname><given-names>Haitham H.</given-names></name><xref ref-type="aff" rid="I1"><sup>1, 2</sup></xref><xref ref-type="aff" rid="I2"></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>El-Ghoneimy</surname><given-names>Ahmed</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Farid</surname><given-names>Yasser</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ebeid</surname><given-names>Walid</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Afifi</surname><given-names>Ahmed</given-names></name><xref ref-type="aff" rid="I2"><sup>2, 4</sup></xref><xref ref-type="aff" rid="I4"></xref></contrib><contrib contrib-type="author"><name><surname>Elaffandi</surname><given-names>Ahmed</given-names></name><xref ref-type="aff" rid="I5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Mahboub</surname><given-names>Tarek</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup> Department of General Surgery, King's College Hospital, Denmark Hill, London SE59RS, UK</aff><aff id="I2"><sup>2</sup>Department of Plastic and Reconstructive Surgery, Cairo University Teaching Hospital, Cairo University, Kasr Al Ainy, Cairo 11559, Egypt</aff><aff id="I3"><sup>3</sup>Center of Preservation and Musculoskeletal Tissue Transfer, Cairo University Teaching Hospital, Kasr Al Ainy, Cairo University, Cairo 11559, Egypt</aff><aff id="I4"><sup>4</sup>Division of Plastic & Reconstructive Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA</aff><aff id="I5"><sup>5</sup>Department of Surgery, Royal Free Hospital, London NW3 2PN, UK</aff><author-notes><corresp id="cor1">*Haitham H. Khalil: <email>heheaa73@yahoo.com</email></corresp><fn fn-type="other"><p>Recommended by Ajay Puri</p></fn></author-notes><pub-date pub-type="ppub"><year>2008</year></pub-date><pub-date pub-type="epub"><day>12</day><month>3</month><year>2008</year></pub-date><volume>2008</volume><elocation-id>781408</elocation-id><history><date date-type="received"><day>7</day><month>6</month><year>2007</year></date><date date-type="rev-recd"><day>6</day><month>9</month><year>2007</year></date><date date-type="accepted"><day>26</day><month>12</month><year>2007</year></date></history><permissions><copyright-statement>Copyright © 2008 Haitham H. Khalil et al.</copyright-statement><copyright-year>2008</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p><italic>Introduction and aim</italic>. Management of complicated wounds after tumor extipiration of pelvic and proximal lower limb musculoskeletal sarcoma represents an essential component in the outcome of these patients. The authors present modified vertical rectus abdominis musculocutaneous (VRAM) flap techniques to reconstruct extensive defects after debridment of these complicated wounds. <italic>Material and Methods</italic>. Over a period of 4 years (2002–2005), 5 men and 2 women were managed. Median age was 21 years (range 15–49). The patients were managed for complicated lower trunk, groin, and upper thigh wounds after resection of three pelvic chondrosarcomas as well as two pelvic and two proximal femur osteosarcomas. The modifications included a VRAM flap with lateral and tongue-like extension design of the skin paddle (5 cases) or a delayed extended VRAM flap (2 cases). <italic>Results</italic>. All flaps showed complete survival and healing with no ischemic events providing stable coverage. All patients were ambulant with good limb functions in terms of walking and gait after adequate rehabilitation, 2 needed support with crutches. <italic>Conclusion</italic>. The modified VRAM flaps offer reliable reconstructive tools for coverage of complex groin and thigh defects by providing larger well-vascularized soft tissue with acceptable donor site.</p></abstract></article-meta></front><floats-group><fig id="fig1" position="float"><label>Figure 1</label><caption><p>(a) A two-week picture after delay procedure (surgical and vascular delay) for extended
inferiorly based VRAM flap. The arrow points to line of demarcation between nonperfused
and augmented perfused skin in the parasternal fasciocutaneous extension of the
VRAM flap. This extension provided additional predictable length of 7 cm for
coverage of exposed plate femur after osteosarcoma resection of the proximal femur. (b) Intraoperative
picture after harvesting of VRAM flap and debridement of necrotic thigh flap.
The VRAM extension marked by the suture markings of the delay procedure
provides the extra length avoiding tension and providing durable coverage. (c) Postoperative
picture 3 months during chemotherapy course showing complete survival of the
flap providing stable coverage and complete healing of the donor site.</p></caption><graphic xlink:href="SRCM2008-781408.001"></graphic></fig><fig id="fig2" position="float"><label>Figure 2</label><caption><p>(a) Preoperative picture showing the dimensions and design of contralateral, laterally oriented
VRAM with a tongue-like extension. The arrow points to the necrotic thigh flap
advocated achieving adequate oncological resection for pelvic osteosarcoma. (b) Intraoperative
picture showing insetting of flap after debridment of the necrotic area. The
distal muscular component of the flap fills the composite defect which helps
resist infection in this potentially infected area. (c) Intraoperative
picture showing coverage of the defect with application of a split thickness
graft on the remaining muscular bed. The arrow points to the tongue-like skin
extension which avoids tension on the vascular pedicle especially after
dividing the origin and insertion and ensures adequate perfusion to the distal
portion of the flap. (d) Late postoperative picture 6 months after completion of chemotherapy course showing
complete survival of the flap with long-term durability and complete take of
the graft.</p></caption><graphic xlink:href="SRCM2008-781408.002"></graphic></fig></floats-group></pmc><affiliations><list><country><li>Royaume-Uni</li><li>Égypte</li></country></list><tree><noCountry><name sortKey="Afifi, Ahmed" sort="Afifi, Ahmed" uniqKey="Afifi A" first="Ahmed" last="Afifi">Ahmed Afifi</name><name sortKey="Khalil, Haitham H" sort="Khalil, Haitham H" uniqKey="Khalil H" first="Haitham H." last="Khalil">Haitham H. Khalil</name></noCountry><country name="Égypte"><noRegion><name sortKey="El Ghoneimy, Ahmed" sort="El Ghoneimy, Ahmed" uniqKey="El Ghoneimy A" first="Ahmed" last="El-Ghoneimy">Ahmed El-Ghoneimy</name></noRegion><name sortKey="Ebeid, Walid" sort="Ebeid, Walid" uniqKey="Ebeid W" first="Walid" last="Ebeid">Walid Ebeid</name><name sortKey="Farid, Yasser" sort="Farid, Yasser" uniqKey="Farid Y" first="Yasser" last="Farid">Yasser Farid</name><name sortKey="Mahboub, Tarek" sort="Mahboub, Tarek" uniqKey="Mahboub T" first="Tarek" last="Mahboub">Tarek Mahboub</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Elaffandi, Ahmed" sort="Elaffandi, Ahmed" uniqKey="Elaffandi A" first="Ahmed" last="Elaffandi">Ahmed Elaffandi</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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