Plastic Surgery
doi: 10.25005/2074-0581-2023-25-2-260-270
REPAIR OF SEVERE POST-BURN CICATRICIAL CONTRACTURES AND DEFORMATIONS OF THE LOWER LIMB

M.Kh. Malikov1, A.A. Davlatov2, D.D. Dzhononov2, M.M. Khaydarov1, N.A. Makhmadkulova3, G.D. Karim-Zade1

1Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Department of Reconstructive and Plastic Microsurgery, Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of Tajikistan
3Department of Topographic Anatomy and Operative Surgery, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To improve the outcomes of surgical treatment of severe contractures, deformities, and lower limb (LL) soft tissue defects using optical magnification and precision techniques.

Methods: 54 patients with sequelae of traumatic injury underwent surgical repair of severe contractures, deformities, and soft tissue defects of the LL. Contractures were accompanied by extended cicatricial deformities and soft tissue defects of the LL. Traumatic injuries often lead to sequelae in children, as observed in 39 patients. The leading causes of burn injuries were boiling water and hot oil.

Results: Various types of Z-plasty were used in 29 (53.7%) cases to correct contracture and toe and foot deformities. Tailored surgeries were performed for severe injuries and extended cicatricial deformities with residual defects covered with skin grafts. Optical magnification with precision technique contributed to adequately mobilizing the fasciocutaneous flaps and the neurovascular bundle (NVB) release. By using ultrasonic dopplerography (USDG), it was possible to determine how the degree circulatory disorders in the affected LL is dependent on the duration between injury and presentation at our center, the severity of the contracture, and the size and depth of the soft tissue damage. Purulent wound infection and superficial partial necrosis of the fasciocutaneous flaps occurred in 3 and 5 patients, respectively

Conclusion: In managing concomitant injuries, including assessing their extent, appropriately evaluating the initial severity of the trauma is essential. The evaluation requires using additional diagnostic methods and selecting the optimal reconstruction method. Optical magnification and precision techniques enable the effective mobilizing of fasciocutaneous flaps while preserving their blood supply. This leads to adequate mobilization and decompression of the NVB, effectively preventing NVB iatrogenic damage.

Keywords: Lower limb, burn, contracture, deformity, soft tissue defect, local plastic surgery.

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Authors' information:

Malikov Mirzobadal Khalifaevich,
Doctor of Medical Sciences, Associate Professor, Head of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
Researcher ID: ABG-2983-2021
Scopus ID: 21934165100
ORCID ID: 0000-0002-7816-5521
Author ID: 375497
E-mail: mmirzobadal@mail.ru

Davlatov Abdumalik Abdulkhakovich,
Candidate of Medical Sciences, Hospital Resident of the Department of Reconstructive and Plastic Microsurgery, Republican Scientific Center for Cardiovascular Surgery; Assistant of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
Researcher ID: AAF-6440-2022
Scopus ID: 21933830600
ORCID ID: 0000-0003-2776-074X
SPIN: 3766-9641
Author ID: 998715
E-mail: davlatov.abdumalik@mail.ru

Dzhononov Dzhonibek Davlatalievich,
Candidate of Medical Sciences, Head of the Department of Reconstructive and Plastic Microsurgery, Republican Scientific Center for Cardiovascular Surgery
ORCID ID: 0000-0003-2383-7770
E-mail: dr.jonibek@mail.ru

Khaydarov Mekhroj Rakhmatulloevich,
PhD Student of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
ORCID ID: 0000-0003-1993-8285
E-mail: mehroj.doctor92@mail.ru

Makhmadkulova Nigora Akhtamovna,
Candidate of Medical Sciences, Assistant of the Department of Topographic Anatomy and Operative Surgery, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-4269-6611
E-mail: malikovanigora@mail.ru

Karim-Zade Gulandom Dzhangovarovna,
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
Researcher ID: ABD-4810-2021
Scopus ID: 55908934800
SPIN: 4462-0734
Author ID: 1182202
ORCID ID: 0000-0003-0845-3197
E-mail: gulandom71@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Karim-Zade Gulandom Dzhangovarovna
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (918) 808766

E-mail: gulandom71@mail.ru

Materials on the topic:
  1. OXIDATIVE STRESS AND ANTIOXIDANT SYSTEM IN SEVERE UPPER LIMB INJURIES
  2. ANALYSIS OF COMPLICATIONS AFTER AUTOGRAFT TRANSPLANTATION IN SEVERE UPPER LIMB INJURY
  3. A MODEL FOR ASSESSING THE RISK OF A DELAYED WOUND HEALING IN OBESE PATIENTS
  4. MAMMOPLASTY: FROM RECONSTRUCTIVE TO AESTHETIC SURGERY
  5. THE EFFECT OF THE MENSTRUAL CYCLE PHASE ON THE OUTCOME OF AUGMENTATION MAMMOPLASTY
  6. CORRECTION OF SOFT-TISSUE DEFECTS AND CONSEQUENCES OF NEUROVASCULAR BUNDLES DAMAGE OF THE UPPER EXTREMITIES
  7. SURGICAL TREATMENT OF POST-BURN CICATRICIAL DEFORMITIES OF WOMAN’S BREAST

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