A Novel Technique for Closing Difficult Diabetic Cleft Foot Wounds With Skin Grafting and a Ring-Type External Fixation System

Operative Techniques in Orthopaedics

Volumn 16, Issue 1, 2006, Pages 38-43

  Zgonis, Thomas ^a   Öznur, Ali ^b   Roukis, Thomas S ^c  

^a UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO   (United States)

^b GÜVEN HOSPITAL   (Turkey)

^c MADIGAN ARMY MEDICAL CENTER   (United States)

Author keywords

cleft foot deformity; diabetic ulceration; external fixation; Ilizarov; skin graft

Indexed keywords

ARTICLE; BONE RESECTION; CLEFT FOOT MALFORMATION; CONTRACTURE; DIABETIC FOOT; EXTERNAL FIXATOR; FOOT MALFORMATION; FOOT ULCER; FOREFOOT; GANGRENE; HUMAN; ILIZAROV TECHNIQUE; METATARSAL BONE; OSTEOMYELITIS; POSTOPERATIVE PERIOD; PRIORITY JOURNAL; SCAR FORMATION; SKIN TRANSPLANTATION; SOFT TISSUE DEFECT; SPLIT THICKNESS SKIN GRAFT; SURGICAL TECHNIQUE; TIME MANAGEMENT; WEIGHT BEARING; WOUND CLOSURE; WOUND HEALING;

EID: 33646201158     PISSN: 10486666     EISSN: None     Source Type: Journal    
DOI: 10.1053/j.oto.2006.01.005     Document Type: Article

References (50)

1. Frykberg R.G. Diabetic foot ulcers. Current concepts. J. Foot Ankle Surg 37 (1998) 440-446
2. Isakov E., Budoragin N., Shenhav S., et al. Anatomic sites of foot lesions resulting in amputation among diabetics and non-diabetics. Am J Phys Rehabil 74 (1995) 130-133
3. Margolis D.J., Kantor J., Santanna J., et al. Risk factors for delayed healing of neuropathic diabetic foot ulcers. Arch Dermatol 136 (2000) 1531-1535
4. Delbridge L., Perry P., Marr S., et al. Limited joint mobility in the diabetic foot. Relationship to neuropathic ulceration. Diabet. Med 5 (1988) 333-337
5. Mueller M.J., Diamond J.E., Delitto A., et al. Insensitivity, limited joint mobility, and plantar ulcers in patients with diabetes mellitus. Phys Ther 69 (1989) 453-462
6. Fernando D.J.S., Masson E.A., Veves A., et al. Relationship of limited joint mobility to abnormal foot pressures and diabetic foot ulceration. Diabetes Care 14 (1991) 8-11
7. Crisp A.J., and Heathcote J.G. Connective tissue abnormalities in diabetes mellitus. J Roy Coll Phys London 18 (1984) 132-141
8. Armstrong D.G., Stacpoole-Shea S., Nguyen H., et al. Lengthening of the Achilles tendon in diabetic patients who are at high risk for ulceration of the foot. J Bone Joint Surg Am 81 (1999) 535-538
9. Mueller M.J., Sinacore D.R., Hastings M.K., et al. Effect of Achilles tendon lengthening on neuropathic plantar ulcers. A randomized clinical trial. J Bone Joint Surg Am 85 (2003) 1436-1445
10. Ger R., Angus G., and Scott P. Transmetatarsal amputation of the toe. An analytic study of ischemic complications. Clin Anat 12 (1999) 407-411
11. Nehler M.R., Whitehall T.A., Bowers S.P., et al. Intermediate-term outcome of primary digit amputations in patients with diabetes mellitus who have forefoot sepsis requiring hospitalization and presumed adequate circulatory status. J Vasc Surg 30 (1999) 509-517
12. Sommerlad B.C., and McGrouther D.A. Resurfacing the sole. Long-term follow-up and comparison of techniques. Br J Plast Surg 31 (1978) 107
13. Levin L.S., and Serafin D. Plantar skin coverage. Prob Plast Reconstr Surg 1 (1991) 156-184
14. Attinger C. Soft-tissue coverage for lower-extremity trauma. Orthop Clin N Am 26 (1995) 295-334
15. Rosen R.C. Digital amputations. Clin Podiatr Med Surg 22 (2005) 343-363
16. Bowker J.H. Partial foot amputations and disarticulations. Foot Ankle Clin 2 (1997) 153-170
17. Pinzur M.S., Sage R., and Schaegler P. Ray resection in the dysvascular foot. Clin Orthop 191 (1984) 232-234
18. Pinzur M.S., Sage R., Stuck R., et al. Amputations in the diabetic foot and ankle. Clin Orthop 296 (1993) 64-67
19. Smith D.G. Principles of partial foot amputations in the diabetic. Foot Ankle Clin 2 (1997) 171-186
20. Weinfeld S.B., and Schon L.C. Amputations of the perimeters of the foot. Resection of toes, metatarsals, rays, and calcaneus. Foot Ankle Clin N Am 4 (1999) 17-37
21. Hansen Jr. S.T. Amputation techniques. In: Hurley R., Seigafuse S.L., and Marino-Vasquez D. (Eds). Functional Reconstruction of the Foot and Ankle (2000), Lippincott Williams & Wilkins, Philadelphia, PA 274-278
22. Anderson J.J., Woelffer K.E., Holtzman J.J., et al. Bisphosphonates for the treatment of Charcot neuroarthropathy. J Foot Ankle Surg 43 (2004) 285
23. Strauss M.B., Bryant B.J., and Hart J.D. Forefoot narrowing with external fixation for problem cleft wounds. Foot Ankle Int 23 (2002) 433-439
24. Armstrong D.G., Wunderlich R.P., and Lavery L.A. Reaching closure with skin stretching. Applications in the diabetic foot. Clin Podiatr Med Surg 15 (1998) 109-116
25. Öznur A., and Tokgözoǧlu M. Closure of central defects of the forefoot with external fixation. A case report. J Foot Ankle Surg 43 (2004) 56-59
26. Öznur A. Management of large soft-tissue defects in a diabetic patient. Foot Ankle Int 24 (2003) 79-82
27. Margolis D.J., Allen-Taylor L., Hoffstad O., et al. Diabetic neuropathic ulcers. predicting which ones will not heal. Am J Med 115 (2003) 627-631
28. Margolis D.J., Hoffstad O., Gelfand J.M., et al. Surrogate end points for the treatment of diabetic neuropathic foot ulcers. Diabetes Care 26 (2003) 1696-1700
29. Roukis T.S. Radical solutions. Bold debridement techniques can work for both chronic and acute wounds. OrthoKinetic Rev 4 (2004) 20-23
30. Levin L.S. Débridement. Tech Orthop 10 (1995) 104-108
31. Attinger C.E., Bulan E., and Blume P.A. Surgical debridement. The key to successful wound healing and reconstruction. Clin Podiatr Med Surg 17 (2000) 599-630
32. Attinger C.E., and Bulan E.J. Debridement. The key initial first step in wound healing. Foot Ankle Clin N Am 6 (2001) 627-660
33. Donato M.C., Novicki D.C., and Blume P.A. Skin grafting. Historic and practical approaches. Clin Podiatr Med Surg 17 (2000) 561-598
34. Roukis T.S. Use of the medial arch as a donor site for split-thickness skin grafts. J Foot Ankle Surg 42 (2003) 312-314
35. Attinger C. Use of skin grafting in the foot. J Am Podiatr Med Assoc 85 (1995) 49-56
36. Roukis T.S., and Zgonis T. Advanced skin grafting techniques for soft-tissue coverage of diabetic foot and ankle wounds. J Wound Care 14 (2005) 173-176
37. Puttirutvong P. Meshed skin graft versus split-thickness graft in diabetic ulcer coverage. J Med Assoc Thai 87 (2004) 66-72
38. Ratner D. Skin grafting. From here to there. Dermatol Clin 16 (1998) 75-90
39. Ablove R., and Howell R.M. The physiology and technique of skin grafting. Hand Clin 13 (1997) 163-173
40. Schneider A.M., Morykwas M.J., and Argenta L.C.A. new and reliable method of securing skin grafts to the difficult recipient bed. Plast Reconstr Surg 102 (1998) 1195-1198
41. Chouhary S., and Lam D.G.K. Simple tie-over. The herniotomy approach. Plast Reconstr Surg 104 (1999) 1573-1574
42. Fullerton J.K., Smith C.E., and Milner S.M. The "stegosaurus" dressing. A simple and effective method of securing skin grafts in the burn patient. Ann Plast Surg 45 (2000) 462-464
43. Eroǧlu L., Akbas H., Güneren E., et al. Securing skin grafts using a surgical glove. Plast Reconstr Surg 108 (2001) 1459-1460
44. Kaplan H.Y. A quick stapler tie-over fixation for skin grafts. Ann Plast Surg 22 (1999) 173-174
45. Stone P., Prigozen J., Hofeldt M., et al. Bolster versus negative pressure wound therapy for securing split-thickness skin grafts in trauma patients. Wounds 16 (2004) 219-223
46. Moisidis E., Heath T., Boorer C., et al. prospective, blinded, randomized, controlled clinical trial of topical negative pressure use in skin grafting. Plast Reconstr Surg 114 (2004) 917-922
47. Majumder S., and Knight S.L.A. simple method of decreasing the morbidity of split-thickness skin graft donor sites. Br J Plast Surg 52 (1999) 159
48. Dahl A.W., Toksvig-Larsen S., and Lindstrand A. No difference between daily and weekly pin site care. A randomized study of 50 patients with external fixation. Acta Orthop Scand 74 (2003) 704-708
49. Davies R., Holt N., and Nayagan S. The care of pin sites with external fixation. J Bone Joint Surg Br 87 (2005) 716-719
50. Roukis T.S., and Zgonis T. Post-operative shoe modifications for weightbearing with the Ilizarov external fixation system. J. Foot Ankle Surg 43 (2004) 433-435