Article Sidebar

pdf
Date Published: 05/05/2025
Abstract Views: 85
Views pdf: 36
DOI: https://doi.org/10.51298/vmj.v549i3.14003
Issue
Vol. 549 No. 3 (2025)
Section
Các bài báo
How to Cite
Phạm Hiếu, L., Thân Văn, H., Hoàng Trần, B., Trần Quốc, G., Đỗ Mạnh, H., Mai Xuân, T., Võ Cao Hoàng, P., & Mai Trọng, T. (2025). EVALUATION OF SURGICAL OUTCOMES OF PERIFASCIAL AREOLAR TISSUE (PAT) GRAFTING COMBINED WITH SKIN GRAFTING IN THE TREATMENT OF COMPLEX WOUNDS WITH EXPOSED TENDONS. Vietnam Medical Journal, 549(3). https://doi.org/10.51298/vmj.v549i3.14003

EVALUATION OF SURGICAL OUTCOMES OF PERIFASCIAL AREOLAR TISSUE (PAT) GRAFTING COMBINED WITH SKIN GRAFTING IN THE TREATMENT OF COMPLEX WOUNDS WITH EXPOSED TENDONS

Liêm Phạm Hiếu, Hùng Thân Văn, Bá Hoàng Trần, Gia Trần Quốc, Hiếu Đỗ Mạnh, Trường Mai Xuân, Phú Võ Cao Hoàng, Tường Mai Trọng

Main Article Content

Abstract

Background: Soft tissue defects with exposed tendons present a significant challenge in treatment due to the tendon’s inherently poor vascularity, making it prone to infection and necrosis when exposed to the external environment. Direct skin grafting over tendons is often unfeasible due to inadequate blood supply, leading to graft necrosis. Consequently, identifying an appropriate material for early coverage of exposed tendons is critical. Autologous perifascial areolar tissue (PAT) grafting has emerged as a promising option, providing a vascularized base to replace granulation tissue and facilitate successful skin grafting. Objectives: - To describe the characteristics of wounds with exposed tendons in cases treated with PAT grafting. - To evaluate the viability and efficacy of PAT grafting combined with skin grafting in covering exposed tendon regions. Materials and Methods: Study Population: The study included 26 patients with 36 wounds involving exposed tendons, treated with PAT grafting combined with skin grafting. Procedures were performed at the Department of Burns,Microsurgery and Plastic Surgery,  Institute of Orthopedic Trauma, Military Hospital 175, from March 2021 to October 2024. Study Design: A descriptive case series with retrospective analysis. Data Collection: Patient demographics, wound characteristics, and outcomes were recorded. The survival of PAT grafts and skin grafts was assessed at 7 days, 14 days, 1 month, and 3 months post-surgery, with tendon gliding function evaluated at 3 months. Results: The survival rate of PAT grafts was 97.4%, while the skin graft survival rate reached 93.3%. The majority of patients (86.4%) exhibited no tendon adhesion, allowing normal functional movement. Conclusion: PAT grafting combined with skin grafting is a reliable technique for covering exposed tendons, serving as an effective alternative to flap surgery. It minimizes tendon adhesion and is particularly suitable for wounds with small to medium-sized tendon exposure.

Article Details

Keywords

Perifascial areolar tissue, PAT, exposed tendon, tendon-bone exposed wound, reconstructive surgery

References

1. Abe Y, Hashimoto I, Ishida S, Mineda K, Yoshimoto S (2018), "The perifascial areolar tissue and negative pressure wound therapy for one-stage skin grafting on exposed bone and tendon". J Med Invest, 65, (1.2), pp. 96-102.
2. Abe Y, Ishida S, Mineda K, et al. (2022), "One-Stage Perifascial Areolar Tissue and Skin Grafting Combined with Negative Pressure Wound Therapy for a Refractory Wound with an Exposed Elbow Joint and Extensive Skin Defect". Indian Journal of Surgery, 84, (5), pp. 1067-1073.
3. Akazawa T, Sekido M (2023), "Convenient Treatment of Lateral Malleolar Refractory Ulcers Using Perifascial Areolar Tissue Graft and Integra Dermal Regeneration Template". Indian Journal of Surgery, 85, (1), pp. 282-287.
4. Hayashi A, Komoto M, Tanaka R, et al. (2015), "The availability of perifascial areolar tissue graft for deep cutaneous ulcer coverage". J Plast Reconstr Aesthet Surg, 68, (12), pp. 1743-1749.
5. Ito T, Akazawa S, Ichikawa Y, et al. (2019), "Exposed Artificial Plate Covered With Perifascial Areolar Tissue as a Nonvascularized Graft". Plast Reconstr Surg Glob Open, 7, (2), e2109.
6. Koizumi T, Nakagawa M, Nagamatsu S, Kayano S, Akazawa S (2010), "Perifascial areolar tissue graft as a nonvascularized alternative to flaps". Plast Reconstr Surg, 126, (4), 182e-183e.
7. Koizumi T, Nakagawa M, Nagamatsu S, et al. (2013), "The versatile perifascial areolar tissue graft: adaptability to a variety of defects". J Plast Surg Hand Surg, 47, (4), pp. 276-280.
8. Kouraba S, Takeuchi A, Honda K (2003), "Perifascial areolar tissue graft: novel autologous graft material and its clinical application for coverage of exposed bone and tendon". AHZ J Surg, 73, (260).
9. Kouraba S, Takeuchi A, Honda K, et al. (2001), Perifascial Areolar Tissue (PAT) Graft: Novel Autologous Graft Material and Its Clinical Application for Coverage of Exposed Bone and Tendon.
10. Miyanaga T, Haseda Y, Daizo H, et al. (2018), "A Perifascial Areolar Tissue Graft With Topical Administration of Basic Fibroblast Growth Factor for Treatment of Complex Wounds With Exposed Tendons and/or Bones". J Foot Ankle Surg, 57, (1), pp. 104-110.