Perifascial Areolar Tissue Graft as a Nonvascularized Alternative to Flaps

• DOI: 10.1097/prs.0b013e3181ea91e3
• Publication Date: 2010-10-01T10:09:21Z
• Authors: Takuya Koizumi; Masahiro Nakagawa; Shogo Nagamatsu; Shuji Kayano; Satoshi Akazawa
• Keywords: Deep fascia; Dense connective tissue; Fascia lata; Granulation tissue

Sir: The treatment of skin ulcers and fistulas with poor blood circulation associated tendon bone exposure1,2 is frequently difficult. Various distant flaps free are used for treatment; however, Kouraba et al. have recently advocated the use perifascial areolar tissue as a graft material, which survives on such areas.3–5 Perifascial loose connective deep fascias has an abundant vascular plexus. This study reports utility minimally invasive surgical material accompanied by or exposure. clinical indications were (1) small range defects, (2) restricted local because post-irradiation postoperative scar around bed, (3) absence grafted onto infected wound. donor site was usually in inguinal region outside thigh elevation grafts. can be raised easily scalpel attachment to fascia (Fig. 1). laid over defect, spread thinly close attachment.Fig. 1.: (muscle) exposed.A 28-year-old man sustained orocervical fistula after ablation submandibular gland cancer. filled outer surface mouth covered lip mucosal flap, whereas neck remained raw 2, left). Six months surgery, wound well healed without complications right).Fig. 2.: (Left) Orocervical abrasion fistula. (Right) 6 surgery.Perifascial new that rich plexus survive area scarce while providing defect. sufficiently flexible fix many types plane spaces complex shapes, does not require microsurgical anastomosis. advantageous patients those general condition. A should performed delayed but simultaneous successful some cases. Therefore, possible at initial operation, depending condition bed thickness graft. Schwabegger al.2 stated fascial molded fit three-dimensional defect; thus, obviously amorphous fill With its special advantages minimal donor-site morbidity short easy procedure, may become valuable tool available reconstructive surgeon. Takuya Koizumi, M.D. Masahiro Nakagawa, Shogo Nagamatsu, Shuji Kayano, Satoshi Akazawa, Division Plastic Reconstructive Surgery Shizuoka Cancer Center Hospital Shizuoka, Japan