Adipose Tissue-preserved Skin Grafts for Lower Extremity Defects: Recommendations to Optimize Outcomes

Plastic and Reconstructive Surgery. Global Open
Emily A Van Kouwenberg, David T W Chiu

Abstract

Adipose tissue-preserved skin grafts (ATPSGs) are full-thickness skin grafts with inclusion of a thin layer of adipose tissue. ATPSGs are recommended for reconstruction of anatomic areas that are cosmetically sensitive and for areas that functionally benefit from additional soft tissue thickness compared to traditional skin grafts. Careful intraoperative technique and postoperative care are mandatory for ATPSG success, given the expected higher metabolic demands compared to traditional grafts. A strict postoperative protocol is especially important after reconstruction of lower extremity defects. Detailed descriptions of intraoperative and postoperative care for ATPSG reconstructions are provided. A case is presented displaying lower extremity reconstruction with an ATPSG. The intraoperative technique includes meticulous hemostasis of the recipient site, atraumatic handling of recipient skin edges, anatomical epidermal-to-epidermal reapproximation, avoidance of tissue strangulation during inset, and careful bolster placement. The postoperative protocol after lower extremity reconstruction includes strict elevation, non-weight-bearing status, and eventual dangle protocol. An 85-year-old woman was treated with an ATSG for a middl...Continue Reading

References

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May 31, 2018·Plastic and Reconstructive Surgery·David T W Chiu, Bryan Chung
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Jul 26, 2018·Plastic and Reconstructive Surgery·David T W Chiu, Bryan Chung
Nov 30, 2018·Plastic and Reconstructive Surgery·David T W Chiu, Bryan Chung

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