- Use of the cutaneous-subcutaneous-fascial rotational flap on nutrition branch for covering surface defects in children
Use of the cutaneous-subcutaneous-fascial rotational flap on nutrition branch for covering surface defects in children
Paediatric surgery.Ukraine.2020.4(69):51-56; doi 10.15574/PS.2020.69.51
Bodnar O.1, Sokolnyk S.1, Vatamanesku L.1, Randiuk R.1, Bodnar A.2
1Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Chernivtsy
2Chernivtsy Lyceum No.3 medical field lyceum, Ukraine
For citation: Bodnar O, Sokolnyk S, Vatamanesku L, Randiuk R, Bodnar A. (2020). Use of the cutaneous-subcutaneous-fascial rotational flap on nutrition branch for covering surface defects in children. Paediatric Surgery.Ukraine. 4(69):51-56; doi 10.15574/PS.2020.69.51
Article received: Jun 03, 2020. Accepted for publication: Nov 12, 2020.
Introduction. Diseases that are accompanied by significant cutaneous-subcutaneous-fascial defects during surgery in children include: pilonidal cyst (PC), spinal hernia (SH), Fournier’s gangrene and wounds. Various methods of surgical treatment of PC consist of the stages: removal of the cyst and covering the wound surface with suturing or leaving the wound surface open. The existing methods of covering a defect in SH in children cannot satisfy surgeons, because they are accompanied by significant tissue tension, which causes complications. Fournier’s gangrene in children is a rare disease with a large area of soft tissue damage. Initial surgical debridement of wounds in childhood requires an individual approach with the choice of the correct method to close the defect.
Purpose. To study the possibilities of using the rotation of vascularized cutaneous-subcutaneous-fascial flap (CSFF) for the surgical treatment of superficial defects in children.
Materials and methods. The surgical treatment of superficial defects in 73 children in a City Children’s Hospital (Chernivtsi) with PC (29 children), SH (20 children), wounds of the face, limbs and trunk (23 children), Fournier gangrene (1 child) was analyzed. We compared the performing of traditional methods of treatment and rotational methods of using CSFF. Recovery time and postoperative complications were analyzed.
Results. By using traditional methods of treating PC, complications were observed in 50%, when using the proposed plastic surgery with rotational CSFF in 6.67%; in case of SH – in 44.44% and 18.18%, with wounds – in 27.27% and 8.33%, respectively. Plastic reconstruction in Fournier’s gangrene recovered on the 40th day of the postoperative period.
Conclusion. The use of cutaneous-subcutaneous-fascial rotational flap with perforating vessels surgery allows to reduce the amount of complications after operations for PC, SH, initial surgical debridement of wounds, Fournier’s gangrene.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution.
The informed consent of the patient was obtained for conducting the studies.
Key words: cutaneous-subcutaneous-fascial flaps, superficial defects, children.
REFERENCES
1. Bodnar O, Roshka A, Vatamanesku L et al. (2020). Spinal Dysraphism of Lumbosacral Area in Infants: Aspects of Surgical Treatment. J Pediatr Neonatal. 2(1): 1–6.
2. Bordakov PV, Bordakov VN, Gain YuM, Shakhrai SV, Gain MYu. (2017). Fournier's gangrene: clinic, diagnostics, treat-ment. Wounds and Wound Infections. The Prof. B.M. Kostyuchenok Journal. 4(1): 14-23. https://doi.org/10.17650/2408-9613-2017-4-1-14-23
3. Cymbalyuk VI, Luzan BN, Tatarchuk MM. (2013). Prichiny povtornyh operacij pri travme nervov verhnih i nizhnih konechnostej. Mezhdunarodnyj nevrologicheskij zhurnal. 4 (58): 11-14.
4. Duman K, Gırgın M, Harlak A. (2017). Prevalence of sacrococcygeal pilonidal disease in Turkey. Asian Journal of Surgery. 40: 434-437. https://doi.org/10.1016/j.asjsur.2016.04.001; PMid:27188235
5. Farrell D, Murphy S. (2011). Negative pressure wound therapy for recurrent pilonidal disease: a review of the literature. J Wound Ostomy Continence Nurs. 38: 373-378. https://doi.org/10.1097/WON.0b013e31821e5117; PMid:21606863
6. Kim JT. (2005). New nomenclature concept of perforator flap. Br J Plast Surg. 58(4): 431-440. https://doi.org/10.1016/j.bjps.2004.12.009; PMid:15897023
7. Mustafa Kurşat Evrenos, Haldun Onuralp Kamburoğlu, Mehmet Secer, Kadir Cınar, Mehmet Dadacı5, Bilsev İnce. (2017). Clinical Outcomes of Large Meningomyelocele Defect Repair by Bilateral Fasciocutaneous Rotation and Advancement Flaps with Perforators. Turkish Journal of Plastic Surgery. Turk Plastik Rekonstruktif ve Estetik Cerrahi Dergisi. 25(3): 113-119. https://doi.org/10.5152/TurkJPlastSurg.2017.2144
8. Pini Prato A, Mazzola C, Mattioli G et al. (2018). Preliminary report on endoscopic pilonidal sinus treatment in children: results of a multicentric series. Pediatric Surgery International. 34(6): 687-692. https://doi.org/10.1007/s00383-018-4262-0; PMid:29675752