The value of perforator flap reconstruction in painful soft tissue calcifications.

IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Clinical and Experimental Medicine Pub Date : 2024-08-13 DOI:10.1007/s10238-024-01421-0
Loraine Kouba, Adriano Fabi, Kathrin Glatz, Anna Thoma, Ana Lariu, Maximilian Burger, Thierry Schweizer, Dirk J Schaefer, Elisabeth A Kappos
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Abstract

Soft tissue calcifications frequently cause debilitating pain and functional impairments, considerably affecting patients' quality of life. As they are rare entities, evidence remains sparse, especially regarding treatment effectiveness and recurrence rates. While both pharmacological and surgical treatments may alleviate symptoms, complete resection is currently believed to prevent long-term recurrence of deposits. To improve understanding and raise awareness for soft tissue calcifications, the goal of this study was to review the current state of treatment and to compare benefits and possibilities of flap reconstruction versus simple excision in improving quality of life. Furthermore, we include a successful case report of complete resolution of symptoms following quadruple perforator flap reconstruction. By systematic literature review, studies published in MEDLINE between 1980 and 2024 reporting on surgical treatment and outcome of soft tissue calcifications were included, in addition to a detailed description of our case report. A total of 53 studies reporting on 197 patients with soft tissue calcifications were included. Simple surgical excision was the most commonly (85.9%) employed procedure, demonstrating a substantial recurrence rate of 13.3%. In contrast, no patients who underwent radical excision experienced recurrence. Dermal matrix grafts and flap reconstruction were successfully used in patients requiring substantial tissue coverage, highlighting their value in complex defect reconstruction following radical excision. The combination of complete surgical resection and flap reconstruction reduces recurrence rates and improves postoperative outcomes and quality of life of these patients, supporting early radical surgical intervention as the gold standard treatment for soft tissue calcifications.

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穿孔器皮瓣重建术对疼痛性软组织钙化的价值。
软组织钙化经常会引起令人衰弱的疼痛和功能障碍,严重影响患者的生活质量。由于软组织钙化十分罕见,因此相关证据仍然很少,尤其是在治疗效果和复发率方面。虽然药物和手术治疗可减轻症状,但目前认为完全切除可防止沉积物长期复发。为了加深对软组织钙化的理解并提高人们的认识,本研究旨在回顾目前的治疗现状,并比较皮瓣重建与单纯切除在改善生活质量方面的优势和可能性。此外,我们还收录了一份成功的病例报告,该病例在四重穿孔器皮瓣重建术后症状完全缓解。通过系统性文献回顾,我们纳入了 1980 年至 2024 年间发表在 MEDLINE 上的有关软组织钙化手术治疗和结果的研究,并对我们的病例报告进行了详细描述。共纳入了 53 项研究,报告了 197 例软组织钙化患者。简单的手术切除是最常用的方法(85.9%),复发率高达 13.3%。相比之下,接受根治性切除术的患者无一复发。真皮基质移植和皮瓣重建成功用于需要大量组织覆盖的患者,凸显了它们在根治性切除术后复杂缺损重建中的价值。彻底手术切除和皮瓣重建相结合的方法降低了复发率,改善了术后效果和这些患者的生活质量,支持将早期根治性手术干预作为治疗软组织钙化的金标准。
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来源期刊
Clinical and Experimental Medicine
Clinical and Experimental Medicine 医学-医学:研究与实验
CiteScore
4.80
自引率
2.20%
发文量
159
审稿时长
2.5 months
期刊介绍: Clinical and Experimental Medicine (CEM) is a multidisciplinary journal that aims to be a forum of scientific excellence and information exchange in relation to the basic and clinical features of the following fields: hematology, onco-hematology, oncology, virology, immunology, and rheumatology. The journal publishes reviews and editorials, experimental and preclinical studies, translational research, prospectively designed clinical trials, and epidemiological studies. Papers containing new clinical or experimental data that are likely to contribute to changes in clinical practice or the way in which a disease is thought about will be given priority due to their immediate importance. Case reports will be accepted on an exceptional basis only, and their submission is discouraged. The major criteria for publication are clarity, scientific soundness, and advances in knowledge. In compliance with the overwhelmingly prevailing request by the international scientific community, and with respect for eco-compatibility issues, CEM is now published exclusively online.
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