Reconstruction of Soft Tissue Defect of Feet and Legs Using Alloderm

Variable methods have been using for reconstruction of soft tissue defect of feet and legs. Skin graft, local flap, and free flap have been using for this purpose. But, skin graft produced secondary contracture of recipient site and increased in donor site scarring. Local flap was limited its donor site and remained severe deformities of recipient site. Free flap was required prolonged operation time and secondary operation. Acelluar human dermal allograft, AlloDerm, was removed cellular elements of the epidermis and dermis. It was relatively immunologically inert. From August 1997 to April 1998, we have grafted acellular human dermal allograft with thin split-thickness skin graft on soft tissue defect of feet and legs in 7 cases. We concluded that cryopreserved acelluar human dermal allograft has been proposed as the solution to problems of skin graft, local flap, and free flap.

Clinical study for skin graft donor site after regional thigh blockade

In general, split thickness skin graft was done under general anesthesia. However, there was a difficulty to do general anesthesia in some cases due to poor general condition. The lateral cutaneous nerve block of the thigh(LCNBT) anesthesia the usual donor site of split-thickness skin graft in the thigh. Using 10 ml of 0.5% bupivacaine, LCNBT was used thigh for harvesting split-thickness skin in 42 patients. Patients age ranged from 18 to 62 years with mean 49 years. The onset of full anesthesia took between 12 and 21 minutes. The area anesthetised ranged from 200 cm2to 940 cm2with mean 551 cm2. The duration of full anesthesia was from 6 to 16 hours. In 6 patients, LCNBT was compared with previous lidocaine local anesthesia and all patients preferred to do LCNBT. In our experience, LCNBT is a safe, and simple method for harvesting split-thickness from the thigh and LCNBT provided good postoperative analgesia.