Delayed grafting for banked skin graft in lymph node flap transfer.
Identifieur interne : 000A22 ( PubMed/Corpus ); précédent : 000A21; suivant : 000A23Delayed grafting for banked skin graft in lymph node flap transfer.
Auteurs : Pedro Ciudad ; Shivprasad Date ; Georgios Orfaniotis ; Rory Dower ; Fabio Nicoli ; Michele Maruccia ; Shu-Ping Lin ; Chu-Yi Chuang ; Tsan-Yu Chuang ; Gou-Jen Wang ; Hung-Chi ChenSource :
- International wound journal [ 1742-481X ] ; 2017.
Abstract
Over the last decade, lymph node flap (LNF) transfer has turned out to be an effective method in the management of lymphoedema of extremities. Most of the time, the pockets created for LNF cannot be closed primarily and need to be resurfaced with split thickness skin grafts. Partial graft loss was frequently noted in these cases. The need to prevent graft loss on these iatrogenic wounds made us explore the possibility of attempting delayed skin grafting. We have herein reported our experience with delayed grafting with autologous banked split skin grafts in cases of LNF transfer for lymphoedema of the extremities. Ten patients with International Society of Lymphology stage II-III lymphoedema of upper or lower extremity were included in this study over an 8-month period. All patients were thoroughly evaluated and subjected to lymph node flap transfer. The split skin graft was harvested and banked at the donor site, avoiding immediate resurfacing over the flap. The same was carried out in an aseptic manner as a bedside procedure after confirming flap viability and allowing flap swelling to subside. Patients were followed up to evaluate long-term outcomes. Flap survival was 100%. Successful delayed skin grafting was done between the 4th and 6th post-operative day as a bedside procedure under local anaesthesia. The split thickness skin grafts (STSG) takes more than 97%. One patient needed additional medications during the bedside procedure. All patients had minimal post-operative pain and skin graft requirement. The patients were also reported to be satisfied with the final aesthetic results. There were no complications related to either the skin grafts or donor sites during the entire period of follow-up. Delayed split skin grafting is a reliable method of resurfacing lymph node flaps and has been shown to reduce the possibility of flap complications as well as the operative time and costs.
DOI: 10.1111/iwj.12570
PubMed: 26833759
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Delayed grafting for banked skin graft in lymph node flap transfer.</title><author><name sortKey="Ciudad, Pedro" sort="Ciudad, Pedro" uniqKey="Ciudad P" first="Pedro" last="Ciudad">Pedro Ciudad</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Date, Shivprasad" sort="Date, Shivprasad" uniqKey="Date S" first="Shivprasad" last="Date">Shivprasad Date</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Orfaniotis, Georgios" sort="Orfaniotis, Georgios" uniqKey="Orfaniotis G" first="Georgios" last="Orfaniotis">Georgios Orfaniotis</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Dower, Rory" sort="Dower, Rory" uniqKey="Dower R" first="Rory" last="Dower">Rory Dower</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Nicoli, Fabio" sort="Nicoli, Fabio" uniqKey="Nicoli F" first="Fabio" last="Nicoli">Fabio Nicoli</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Maruccia, Michele" sort="Maruccia, Michele" uniqKey="Maruccia M" first="Michele" last="Maruccia">Michele Maruccia</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Shu Ping" sort="Lin, Shu Ping" uniqKey="Lin S" first="Shu-Ping" last="Lin">Shu-Ping Lin</name><affiliation><nlm:affiliation>Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Chuang, Chu Yi" sort="Chuang, Chu Yi" uniqKey="Chuang C" first="Chu-Yi" last="Chuang">Chu-Yi Chuang</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Chuang, Tsan Yu" sort="Chuang, Tsan Yu" uniqKey="Chuang T" first="Tsan-Yu" last="Chuang">Tsan-Yu Chuang</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Gou Jen" sort="Wang, Gou Jen" uniqKey="Wang G" first="Gou-Jen" last="Wang">Gou-Jen Wang</name><affiliation><nlm:affiliation>PhD Program in Tissue Engineering and Regenerative Medicine, National Chung Hsing University, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Hung Chi" sort="Chen, Hung Chi" uniqKey="Chen H" first="Hung-Chi" last="Chen">Hung-Chi Chen</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:26833759</idno><idno type="pmid">26833759</idno><idno type="doi">10.1111/iwj.12570</idno><idno type="wicri:Area/PubMed/Corpus">000A22</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000A22</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Delayed grafting for banked skin graft in lymph node flap transfer.</title><author><name sortKey="Ciudad, Pedro" sort="Ciudad, Pedro" uniqKey="Ciudad P" first="Pedro" last="Ciudad">Pedro Ciudad</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Date, Shivprasad" sort="Date, Shivprasad" uniqKey="Date S" first="Shivprasad" last="Date">Shivprasad Date</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Orfaniotis, Georgios" sort="Orfaniotis, Georgios" uniqKey="Orfaniotis G" first="Georgios" last="Orfaniotis">Georgios Orfaniotis</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Dower, Rory" sort="Dower, Rory" uniqKey="Dower R" first="Rory" last="Dower">Rory Dower</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Nicoli, Fabio" sort="Nicoli, Fabio" uniqKey="Nicoli F" first="Fabio" last="Nicoli">Fabio Nicoli</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Maruccia, Michele" sort="Maruccia, Michele" uniqKey="Maruccia M" first="Michele" last="Maruccia">Michele Maruccia</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Shu Ping" sort="Lin, Shu Ping" uniqKey="Lin S" first="Shu-Ping" last="Lin">Shu-Ping Lin</name><affiliation><nlm:affiliation>Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Chuang, Chu Yi" sort="Chuang, Chu Yi" uniqKey="Chuang C" first="Chu-Yi" last="Chuang">Chu-Yi Chuang</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Chuang, Tsan Yu" sort="Chuang, Tsan Yu" uniqKey="Chuang T" first="Tsan-Yu" last="Chuang">Tsan-Yu Chuang</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Gou Jen" sort="Wang, Gou Jen" uniqKey="Wang G" first="Gou-Jen" last="Wang">Gou-Jen Wang</name><affiliation><nlm:affiliation>PhD Program in Tissue Engineering and Regenerative Medicine, National Chung Hsing University, Taichung, Taiwan.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Hung Chi" sort="Chen, Hung Chi" uniqKey="Chen H" first="Hung-Chi" last="Chen">Hung-Chi Chen</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation></affiliation></author></analytic><series><title level="j">International wound journal</title><idno type="eISSN">1742-481X</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Over the last decade, lymph node flap (LNF) transfer has turned out to be an effective method in the management of lymphoedema of extremities. Most of the time, the pockets created for LNF cannot be closed primarily and need to be resurfaced with split thickness skin grafts. Partial graft loss was frequently noted in these cases. The need to prevent graft loss on these iatrogenic wounds made us explore the possibility of attempting delayed skin grafting. We have herein reported our experience with delayed grafting with autologous banked split skin grafts in cases of LNF transfer for lymphoedema of the extremities. Ten patients with International Society of Lymphology stage II-III lymphoedema of upper or lower extremity were included in this study over an 8-month period. All patients were thoroughly evaluated and subjected to lymph node flap transfer. The split skin graft was harvested and banked at the donor site, avoiding immediate resurfacing over the flap. The same was carried out in an aseptic manner as a bedside procedure after confirming flap viability and allowing flap swelling to subside. Patients were followed up to evaluate long-term outcomes. Flap survival was 100%. Successful delayed skin grafting was done between the 4th and 6th post-operative day as a bedside procedure under local anaesthesia. The split thickness skin grafts (STSG) takes more than 97%. One patient needed additional medications during the bedside procedure. All patients had minimal post-operative pain and skin graft requirement. The patients were also reported to be satisfied with the final aesthetic results. There were no complications related to either the skin grafts or donor sites during the entire period of follow-up. Delayed split skin grafting is a reliable method of resurfacing lymph node flaps and has been shown to reduce the possibility of flap complications as well as the operative time and costs.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">26833759</PMID><DateCreated><Year>2016</Year><Month>02</Month><Day>02</Day></DateCreated><DateRevised><Year>2017</Year><Month>01</Month><Day>05</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1742-481X</ISSN><JournalIssue CitedMedium="Internet"><Volume>14</Volume><Issue>1</Issue><PubDate><Year>2017</Year><Month>Feb</Month></PubDate></JournalIssue><Title>International wound journal</Title><ISOAbbreviation>Int Wound J</ISOAbbreviation></Journal><ArticleTitle>Delayed grafting for banked skin graft in lymph node flap transfer.</ArticleTitle><Pagination><MedlinePgn>125-129</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/iwj.12570</ELocationID><Abstract><AbstractText>Over the last decade, lymph node flap (LNF) transfer has turned out to be an effective method in the management of lymphoedema of extremities. Most of the time, the pockets created for LNF cannot be closed primarily and need to be resurfaced with split thickness skin grafts. Partial graft loss was frequently noted in these cases. The need to prevent graft loss on these iatrogenic wounds made us explore the possibility of attempting delayed skin grafting. We have herein reported our experience with delayed grafting with autologous banked split skin grafts in cases of LNF transfer for lymphoedema of the extremities. Ten patients with International Society of Lymphology stage II-III lymphoedema of upper or lower extremity were included in this study over an 8-month period. All patients were thoroughly evaluated and subjected to lymph node flap transfer. The split skin graft was harvested and banked at the donor site, avoiding immediate resurfacing over the flap. The same was carried out in an aseptic manner as a bedside procedure after confirming flap viability and allowing flap swelling to subside. Patients were followed up to evaluate long-term outcomes. Flap survival was 100%. Successful delayed skin grafting was done between the 4th and 6th post-operative day as a bedside procedure under local anaesthesia. The split thickness skin grafts (STSG) takes more than 97%. One patient needed additional medications during the bedside procedure. All patients had minimal post-operative pain and skin graft requirement. The patients were also reported to be satisfied with the final aesthetic results. There were no complications related to either the skin grafts or donor sites during the entire period of follow-up. Delayed split skin grafting is a reliable method of resurfacing lymph node flaps and has been shown to reduce the possibility of flap complications as well as the operative time and costs.</AbstractText><CopyrightInformation>© 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ciudad</LastName><ForeName>Pedro</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>PhD Program in Tissue Engineering and Regenerative Medicine, National Chung Hsing University, Taichung, Taiwan.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Date</LastName><ForeName>Shivprasad</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Orfaniotis</LastName><ForeName>Georgios</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dower</LastName><ForeName>Rory</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nicoli</LastName><ForeName>Fabio</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Maruccia</LastName><ForeName>Michele</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lin</LastName><ForeName>Shu-Ping</ForeName><Initials>SP</Initials><AffiliationInfo><Affiliation>Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chuang</LastName><ForeName>Chu-Yi</ForeName><Initials>CY</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chuang</LastName><ForeName>Tsan-Yu</ForeName><Initials>TY</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Gou-Jen</ForeName><Initials>GJ</Initials><AffiliationInfo><Affiliation>PhD Program in Tissue Engineering and Regenerative Medicine, National Chung Hsing University, Taichung, Taiwan.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Hung-Chi</ForeName><Initials>HC</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>02</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Int Wound J</MedlineTA><NlmUniqueID>101230907</NlmUniqueID><ISSNLinking>1742-4801</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Banking split thickness skin graft</Keyword><Keyword MajorTopicYN="N">Delayed skin grafting</Keyword><Keyword MajorTopicYN="N">Lymph node flap transfer</Keyword><Keyword MajorTopicYN="N">Lymph node transfer</Keyword><Keyword MajorTopicYN="N">Lymphoedema</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>11</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>12</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>2</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>2</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>2</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26833759</ArticleId><ArticleId IdType="doi">10.1111/iwj.12570</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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