title: The versatile perifascial areolar tissue graft: adaptability to a variety of defects.
abstract: Reconstruction using flaps with good blood circulation is appropriate for covering an intractable ulcer or a fistula in which tendon or bones are exposed. A non-vascularised perifascial areolar tissue (PAT) graft can also survive in such an area. This study reports the versatile application of a PAT graft for use as a non-vascularised graft material. A total of 32 patients were treated between April 2004 and December 2010 (16 men and 16 women). The donor sites were the inguinal region in 20, the thigh in 11, and the subclavian region in one. There were 13 inlay grafts to the dead space after tumour resection, eight closures for cerebrospinal fluid leakage, seven skin ulcers with exposed bones and tendons, three fistulas, and one vascular leak of the common carotid artery. The total survival rate of the grafts was 91%. The complications associated with this procedure included infection in 9% and seroma in the donor site in 19%. However, all cases improved after conservative treatment. The PAT is a pliable loose areolar tissue with a rich vascular plexus, and the harvesting technique is quite simple and minimally invasive. The PAT graft could therefore represent an alternative for flaps that are used as a free graft material for the reconstruction of such defects as intractable skin ulcers, fistulas or dead spaces that usually require reconstruction with vascularised flaps.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan. takuya-k@juntendo.ac.jp
authors.forename: Takuya
authors.initials: T
authors.lastname: Koizumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Shogo
authors.initials: S
authors.lastname: Nagamatsu
authors.forename: Shuji
authors.initials: S
authors.lastname: Kayano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Akazawa
authors.forename: Yoko
authors.initials: Y
authors.lastname: Katsuragi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Matsui
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yamamoto
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005402:Fistula / Q000601:surgery; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012883:Skin Ulcer / Q000601:surgery; D013524:Surgical Flaps / Q000601:surgery*; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000601:surgery