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At least 811 records · Page 45Linked to original sources
PubMed1997

The tensor fascia lata free flap in abdominal-wall reconstruction.

The pedicled tensor fascia lata flap (TFL flap) is a method of choice for abdominal-wall reconstruction. Frequently, the size and location of the defect produce this option. Microsurgical transfer may overcome these disadvantages. Therefore, the ability of the TFL free flap to reconstruct complex abdominal wounds was evaluated. Seven patients with full-thickness abdominal-wall defects reconstructed by TFL free flaps were reviewed. Their average age was 44.6 years (range: 27 years to 59 years); follow-up averaged 10.5 months (range: 2 months to 18 months). Fifty-seven percent of the wounds were either infected or contaminated; the defect averaged 15 cm x 26 cm Six 85.7 percent) of the wounds involved the epigastrum. No total flap loss was seen, but three flaps developed distal tip necrosis (42.9%). Microsurgical transfer of the TFL free flap overcomes the limitations of the arc of rotation seen with the pedicled flap. It increases the vascularity of the distal portion of the flap. The TFL free flap is therefore an option in abdominal wounds, particularly those with defects of large size or supraumbilical location.

Abdominal Injuries↗
PubMed1997

Pharyngoesophageal reconstruction: a clinical comparison between free tensor fasciae latae and radial forearm flaps.

Recent progress in microsurgery and free-tissue transfer has facilitated the one-stage reconstruction of pharyngoesophageal defects. As to flap selection, the forearm flap (RF) is commonly used because of its convenience, but the authors believe that the tensor fasciae latae flap (TFL) has equal capability. In the past 5 years, 18 cases of pharyngoesophageal reconstruction have been carried out: 8 cases using the TFL flap, and 10 cases using the RF flap. The flaps are compared and the advantages and disadvantages of both are presented.

Adult↗
PubMed1997

Microsurgical reconstruction of the Achilles tendon with a fascia lata flap.

A case of total reconstruction of the Achilles tendon is reported. A compound free musculocutaneous unit of fascia lata was used to supply the absent tendon and soft tissues, achieving excellent cosmetic and functional results. This technique is suggested as an alternative for combating infection, providing soft-tissue cover, and bridging the gap in the tendon.

Achilles Tendon↗
PubMed2002

The investing layer of the deep cervical fascia does not exist between the sternocleidomastoid and trapezius muscles.

OBJECTIVE: We sought to describe the 3-dimensional organization of connective tissues in the suboccipital region. STUDY DESIGN AND SETTING: We conducted a sectional anatomic investigation with the use of E12 sheet plastination. SUBJECTS: Six human adult cadavers (2 male and 4 female; age range, 54 to 86 years) were used in this study. Five of them were sectioned as 2.5-mm-thick coronal (1 cadaver), transverse (2 cadavers), or sagittal (2 cadavers) sections. RESULTS: No aggregation of fibrous connective tissue was seen between the sternocleidomastoid and trapezius muscles. The intervening space was fully occupied by fatty tissue that was indistinguishable from the subcutaneous tissue. CONCLUSIONS: The investing layer of the deep cervical fascia is incomplete so that the carotid sheath is directly exposed to the subcutaneous tissue via a gap between the sternocleidomastoid and trapezius muscle. SIGNIFICANCE: This anatomic feature should be considered when designing a minimally invasive endoscopic approach to the carotid sheath and the surrounding deep cervical structures.

Aged↗
PubMed2003

Anatomic variations in the levator ani muscle, endopelvic fascia, and urethra in nulliparas evaluated by magnetic resonance imaging.

OBJECTIVE: The purpose of this study was to develop a system to quantify interindividual variation in the appearance of continence system structures in normal continent nulliparous women. STUDY DESIGN: Magnetic resonance imaging (1.5 T) was performed in 20 healthy continent nulliparous women (mean age, 30.1 +/- 5.1 years) with normal pelvic organ support and urodynamics. Morphometric measurements of the levator ani muscle, endopelvic fascia, and urethra were performed. RESULTS: The ratio of the maximum-to-minimum measured values shows that 2- to 3-fold differences occur in distance, area, or volume measures of continence system morphologic features. The mean urogenital hiatus area was 15.2 +/- 2.9 cm(2) in women without a visible connection of the levator ani muscle to the pubic bone (4/20 women) and 12.3 +/- 2.4 cm(2) in women with an levator ani muscle-pubic bone connection (16/20 women, P =.05). CONCLUSION: Considerable variation that was not attributable to limitations of the measuring technique that was used occurs in the size and configuration of the urethral support structures in nulliparous asymptomatic women.

Adult↗
PubMedDate not supplied

Results of pectoralis major transfer with fascia lata autograft augmentation for scapula winging.

Fifteen patients (9 male and 6 female) with a mean age of 32.8 years (range, 17-44 years) were examined at a mean follow-up of 64 months (range, 33-118 months) after undergoing pectoralis major transfer with a fascia lata autograft for scapular winging. Ten patients were treated as part of a worker's compensation claim. Twelve reported that they would undergo the procedure again. The mean Rowe score was 66 (range, 41-92), the mean Constant-Murley score was 74 (range, 32-95), the mean Simple Shoulder Test score was 8 of 12 positive responses, and the mean American Shoulder and Elbow Surgeons score was 63 (range, 10-87). Pain decreased in 11 patients, whereas function improved in 10 patients. According to the Rowe scoring system, the results were excellent in 2 patients, good in 5, fair in 4, and poor in 4. Better results occur in patients attaining at least 60 degrees of external rotation postoperatively. Although complete relief of pain and full function were not always achieved, most patients returned to their preoperative level of activity with minor adaptations.

Adolescent↗
PubMed2002

Adenovirus vector-mediated transfer of the vascular endothelial growth factor cDNA to healing abdominal fascia enhances vascularity and bursting strength in mice with normal and impaired wound healing.

BACKGROUND: We hypothesized that adenovirus-mediated transfer of the vascular endothelial growth factor (VEGF121) complementary DNA (cDNA) to murine laparotomy fascial wounds would enhance vascularity and bursting strength. METHODS: Microfibrillar collagen sponges saturated with adenovirus (Ad) vectors encoding for the human VEGF121 cDNA (Ad(CU)VEGF121.1), a control marker gene (Ad beta gal, AdLuc) or no transgene (AdNull) were sutured to fascial edges during laparotomy closure in normal mice and mice treated with dexamethasone. Endpoints addressed included transgene expression in the fascia and surrounding tissue, the number of blood vessels in the healing wound determined using immunostaining, and wound bursting strength using a calibrated tensinometer. RESULTS: Transgene expression was detected readily in the fascial edges, but only marginally detectable in neighboring tissues. In normal mice and mice treated with dexamethasone, no differences were observed at 7 days. Strikingly, however, 21 days after wound closure/therapy, significantly more blood vessels were present in the wounds that received the VEGF121 vector compared with controls (normal: AdNull: 4.2 +/- 1.8; Ad(CU)VEGF121.1: 11.2 +/- 1.2; P <.05; dexamethasone: AdNull: 1.4 +/- 0.8; Ad(CU)VEGF121.1: 5.4 +/- 1.2; P <.05), and bursting strength was significantly higher in VEGF121-treated wounds (normal: AdNull: 665 +/- 68 mN/mm; Ad(CU)VEGF121.1: 956 +/- 82 mN/mm; P <.0005; dexamethasone: AdNull: 234 +/- 111 mN/mm; Ad(CU)VEGF121.1: 592 +/- 121 mN/mm; P <.03). CONCLUSIONS: Adenovirus-mediated gene transfer to healing fascial wounds is achieved readily using a microfibrillar collagen sponge, with transfer of the human VEGF121 cDNA significantly enhancing wound vascularity and bursting strength in normal mice, as well as in mice treated with dexamethasone.

Adenoviridae↗
PubMedDate not supplied

Role of TIMP-2 in fascia transversalis on development of inguinal hernias.

The exact reason for the development of inguinal hernia has not been completely determined. However, it is known that the fascia transversalis (FT) is one of the structures preventing development of hernias. In the etiology of the inguinal hernia, disorders in collagen metabolism have been proposed, and the role of metalloproteinases in remodeling the collagen has recently been of great importance. We could not encounter any study where the role of metalloproteinase inhibitors was evaluated in inguinal hernia. We obtained samples of FT from patients with direct and indirect hernia and used an immunohistochemical method to determine tissue inhibitor of metalloproteinase-2 (TIMP-2) expression. In the study group, samples of FT were taken during the operation from 45 patients, of which 35 were indirect and 10 were direct inguinal hernias. In the control group, samples of FT from various abdominal incisions were also taken from 45 patients with no hernia and operated upon for another pathology. TIMP-2 scores of a direct inguinal hernia were significantly less than those of the control group. However, no difference has been found between the TIMP-2 scores of an indirect inguinal hernia and those of the control group. Decreased TIMP-2 scores in patients with a direct inguinal hernia, compared with both the indirect inguinal hernia group and the control group, explain the reason for the increase in matrix metalloproteinase-2 (MMP-2) that has been proposed in some studies. Therefore, it can be expressed that a decreased activity of TIMP-2 plays a role in inguinal hernia development.

Abdominal Muscles↗
PubMed1981

The tensor fascia lata V-Y retroposition flap.

The design of the tensor fascia lata myocutaneous flap can be modified, allowing its use as a V-Y retroposition flap for treatment of trochanteric pressure ulcers. This technique eliminates the rotation point, puts the thickest portion of the flap over the defect, and obviates the need for skin grafts. It has been successfully employed to treat 11 trochanteric pressure ulcers in 10 patients in the past two years.

Adult↗
PubMed1988

The innervated tensor fasciae latae flap in patients with meningomyelocele.

An anatomical study concerning the sensory innervation of the tensor fascia lata (TFL) area was performed in 51 cadavers. Consequently, an innervated TFL flap was developed with an extended anteromedial border, by comparison with the classic TFL flap. This flap was used in surgery on 6 patients with meningomyelocele at L3 or lower level for unilateral ischial pressure sores. During follow-up, no recurrences were seen either on the operated side or on the contralateral side.

Fascia Lata↗
PubMed1989

Use of temporoparietal fascia free flap in digital reconstruction.

Temporoparietal fascia free flap is an excellent source for resurfacing soft tissue defects of the hand and fingers. Because of the reliable anatomical bifurcation of the superficial temporal vessels, this flap can be very useful in simultaneous reconstruction of more than one digit without having to create a temporary syndactyly.

Adult↗
PubMed1991

The sensory tensor fasciae latae flap: a 9-year follow-up.

From January 1979 to April 1989, 19 neurosensory tensor fasciae latae flaps were used to cover ischial pressure sores in paraplegic patients. This flap provides protective sensation and improves the sensory control of the filling status of the rectum and the sitting control in a wheelchair. Patients were reexamined between 12 and 110 months; no recurrence or new pressure sores were seen. Indications, early and late complications, and evolution of the sensation are discussed.

Adolescent↗
PubMed2001

Fibroblasts from the transversalis fascia of young patients with direct inguinal hernias show constitutive MMP-2 overexpression.

OBJECTIVE: To determine the expression pattern of certain metalloproteinases (MMPs) known to be involved in the degradation of the extracellular matrix in cultured fibroblasts from the transversalis fascia (TF) of patients with inguinal hernia. SUMMARY BACKGROUND DATA: Inguinal hernia is a common pathology, the cause of which remains unknown. It is, however, clear that the TF is one of the anatomical structures that may impede the formation of hernias, and particularly the direct type of hernia. In previous studies the authors found enhanced MMP-2 expression in TF specimens in vivo. The persistence of increased expression in cultured fibroblasts might support the idea of a genetic defect as the cause for this pathology. METHODS: Fibroblasts from the TF of patients with direct and indirect inguinal hernia were cultured and compared with those obtained from control TF in terms of MMP (MMP-2 and MMP-9) expression. RESULTS: Significant active MMP-2 expression was shown by TF fibroblasts from young patients with direct hernias. These findings were confirmed by immunosorbent assay, immunoblotting, and zymography of the fibroblast culture media. No MMP-9 expression was detected. CONCLUSION: These results indicate that MMP-2 may be involved in the TF matrix degradative process in patients with direct hernia. The persistence of changes in MMP-2 levels in the cell cultures appears to suggest a genetic defect or irreversible change as the origin of this pathology rather than environmental factors, which may later participate in the development of the hernial process.

Adult↗
PubMed2004

Enhanced frontalis sling with double-fixed, solvent-dehydrated cadaveric fascia lata allograft in the management of eye ptosis.

The article describes an enhanced frontalis sling procedure in the management of blepharoptosis with poor or no levator function. This modified method were used in the care of three patients and based on the principal of two-point fixation of the graft material that was prepared from solvent-dehydrated cadaveric fascia lata onto the frontalis muscle. After more than 1 year of follow-up, no recurrence was noted. With no extra incision over the skin, this surgical approach could be useful in the correction of difficult ptosis cases.

Adolescent↗
PubMed1989

Eyelid reconstruction using temporalis fascia.

A case is reported of traumatic full-thickness loss of half the upper eyelid. The defect was reconstructed using a pedicled temporalis fascial flap in conjunction with a skin graft. The method is useful when more standard forms of reconstruction are impossible. The advantages of using temporalis fascia and some pitfalls are described.

Adolescent↗
PubMed1989

Utilization of the superficial temporoparietal fascia in reconstructive plastic surgery. A clinical case.

Reconstruction of the orbit can at times be difficult when tumors of this region are resected. We describe a new surgical procedure to reconstruct the outer canthus of the orbital region, including lateral portions of the upper and lower lids. The techniques that were used until now are often limited in repairing this anatomical area, and the results we obtained with this case encourage us to utilize the superficial temporal fascia.

Carcinoma, Squamous Cell↗