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At least 19 recordsLinked to original sources
PubMed1987

Reconstruction of soft tissue defects including the Achilles tendon with free neurovascular tensor fascia lata flap and fascia lata. Case report.

The combined loss of the Achilles tendon and the overlying soft tissue in the young ambulant patient with expectations of a normal life is a challenge. These patients need not only skin coverage but also dynamic, functioning repair. Two cases of major defects after tumour resection are presented. In each case the tendon was reconstructed using the remaining gastrocnemius aponeurosis reinforced with fascia lata. This was covered by a free tensor fascia lata (TFL) flap. In one of the cases the flap was transferred as a neurovascular free flap.

Achilles Tendon↗
PubMed2005

Comparison of long-term outcomes of autologous fascia lata slings with Suspend Tutoplast fascia lata allograft slings for stress incontinence.

OBJECTIVE: This study was undertaken to compare the objective and subjective long-term surgical outcomes in patients receiving Tutoplast fascia lata allograft slings with those receiving autograft slings for the treatment of stress urinary incontinence (SUI). STUDY DESIGN: We reviewed all patients (n = 71) undergoing suburethral sling with either autologous fascia lata (n = 39) or Tutoplast fascia lata (n = 32) for urodynamic stress incontinence (USI) from October 1, 1998, to August 1, 2001. RESULTS: Of the original 71 patients, 47 were evaluated by objective and/or subjective means at a minimum of 2 years after surgery. Subjective quality of life measures, subjective continence, maximum urethral closure pressure, and bladder neck mobility were not different between the 2 groups. USI was demonstrated in 41.7% of allograft patients compared with no autograft patients (P = .007). CONCLUSION: Although patient reported cure of SUI is high for both sling types, USI recurs at a significantly higher rate in Tutoplast slings compared with autologous slings.

Aged↗
PubMed1992

Histological comparison of autogenous canine fascia lata, Gore-Tex, lyophilized human fascia lata, and autogenous canine vein for vascular patch graft material in a canine arteriotomy model.

Autogenous fascia lata has found little clinical use as a vascular patch graft material. Previous experience, however, suggests that it possesses attributes that might make it useful in this regard. To assess its efficacy as a vascular patch graft, nine adult mongrel dogs each underwent four arteriotomies with placements of patch grafts. The four sites included both carotid arteries and both femoral arteries. In each animal, one of four patch graft materials (autogenous canine fascia lata, Gore-Tex, lyophilized human fascia lata, and autogenous canine vein) were placed as patch material at the arteriotomy site utilizing 7-0 running sutures and loop magnification. The site for placement of each graft material was rotated serially in the animals so that each site would have equal numbers of all four graft materials applied. The animals were killed at either 6 to 8 weeks or 11 to 12 weeks after angiography of all four vessels. The specimens were then evaluated histologically. No difference was observed among any of the patch graft materials with regard to myofibroblast plaque formation. Inflammatory responses were noted to be substantially less in the canine fascia lata group than in the other three groups. Granuloma formation, however, appeared to be most significant in the autogenous canine vein group. Only one vessel was occluded. Aneurysm or pseudoaneurysm formation was not noted in any specimen. It appears from the above results that autogenous fascia lata may be an appropriate alternative to currently utilized arterial patch graft materials and that it should be evaluated further for this purpose.

Animals↗
PubMed2002

Pubovaginal sling using allograft fascia lata versus autograft fascia for all types of stress urinary incontinence: 2-year minimum followup.

PURPOSE: Allografts have been substituted for autografts as a pubovaginal sling to decrease postoperative morbidity, although to our knowledge their long-term durability is unknown. Since 1997, we have offered allograft fascia lata as an alternative to autograft fascia in women undergoing the pubovaginal sling procedure. We describe our continued experience with those with a minimum 2-year followup. MATERIALS AND METHODS: We retrospectively reviewed the records of 134 consecutive women with all types of stress urinary incontinence but without neurovesical voiding dysfunction or a significant degree of pelvic prolapse who underwent pubovaginal sling (allografts in 63 and autografts in 71) performed by a single surgeon. Rectus abdominis or fascia lata autograft and freeze-dried, gamma irradiated allograft slings were placed using identical techniques and a 2 x 12 cm. piece of fascia. Outcome analysis included a chart review, third party telephone interview and selective videourodynamics. Surgical outcome was categorized by daily pad use as cured-0, improved-1 or failed-greater than 1 pad. RESULTS: Of 140 women who received a pubovaginal sling 134 were still evaluable. Preoperative parameters were similar in each group. Mean followup plus or minus standard deviation was less in the allograft group (29 +/- 3 versus 44 +/- 7 months, p < 0.05). There was no statistical difference in the overall stress and urge incontinence cure rate in the allograft and autograft groups (45 of 63 cases and 55 of 71, p = 0.42), nor was there a difference in the total number with recurrent stress urinary incontinence (8 and 7, respectively, p = 0.58). In 24% and 16% of cases postoperative incontinence was due to urge incontinence in the allograft and autograft groups, respectively. Using allografts instead of autografts resulted in a significantly decreased postoperative pain and disability (p < 0.05). CONCLUSIONS: Using allograft fascia lata as an alternative to autologous fascia for a pubovaginal sling significantly decreases postoperative pain and disability without compromising efficacy at 2 years. Therefore, we believe that allograft fascia should remain a suitable alternative to autografts for pubovaginal slings.

Adult↗
PubMed1997

Fascia lata in penile reconstructive surgery: a reappraisal of the fascia lata graft.

Various surgical techniques and innovations have been applied to manage complex penile deformities. As an adjunct to penile reconstructive surgery, use of fascia lata, the superficial connective tissue structure of the thigh, may also be considered. Herein, four case reports are described in which fascia lata was applied: penile deformity associated with multiple unsuccessful penile prosthesis surgeries; penile prosthesis migration after phalloplasty; partial penile loss after ablative penile cancer surgery; and penile fibromatosis (Peyronie's disease). Fascia lata was autogenously obtained from the lateral thigh in all cases and used for, respectively, corporoplasty, penile prosthesis fixation, penile elongation, and tunica albuginea grafting. Surgeries were successful in every instance, and each patient reported satisfactory neophallic appearance and function postoperatively. The functional anatomy of the fascia lata was investigated further with lower extremity cadaveric dissections. For penile reconstructive surgery, fascia lata offers an autogenous source, it can be expeditiously obtained causing minimal morbidity, and it serves as a viable graft material with good tensile strength. Its application derives from, and may extend to, other reconstructive surgeries.

Adult↗
PubMed2005

A single tensor fasciae latae musculocutaneous and fascia flap for composite reconstruction of urogenital and groin defect.

The tensor fasciae latae flap is a well known musculocutaneous flap used for many indications in the field of plastic surgery. The flap has some modifications to fit different reconstructive requirements of the defects. Osseous-muscle flap, osseous musculocutaneous flap, muscle flap, muscle-fascial flap and musculocutaneous-fasciocutaneous flap are some known alternatives. We used a modification of this well-known flap as musculocutaneous and fascia flap for a composite reconstruction of groin and urogenital defect. We reconstructed the groin defect with musculocutaneous part of the flap, and the defect over neourethra with the fascial extension and grafting. The aim of this modification was to reconstruct a genital defect with a thin and more pliable tissue to overcome the problem of distortion, kinking and thickness of the flap.

Adult↗
PubMed1999

Functional failure of fascia lata allografts.

OBJECTIVES: Fascia lata allografts are commonly used in urogynecologic procedures. Functional failure of several grafts has occurred, and such failure has been recognized as a materials problem in 12 patients. STUDY DESIGN: Twelve patients with failure of an initial urogynecologic procedure performed with irradiated and freeze-dried donor fascia lata grafts underwent reoperation. Portions of the implanted fascia lata grafts could be retrieved in 7 cases. Graft specimens underwent histologic processing followed by hematoxylin and eosin staining. RESULTS: Histopathologic analyses of the retrieved material demonstrated several ongoing processes in the failed grafts. A few grafts showed areas of ideal remodeling. Most grafts, however, showed areas of disorganized remodeling and areas of graft degeneration. Evidence of immune reaction to the graft was observed in some cases. CONCLUSION: The high materials failure rate associated with the use of irradiated and freeze-dried donor fascia lata grafts suggests that such tissue should not be used for urogynecologic procedures.

Fascia Lata↗
PubMed1989

HIV and banked fascia lata.

Banked irradiated fascia lata is used in many ophthalmic procedures. Along with its increased popularity has come concern over protection from the AIDS virus. Banked fascia lata is protected against the AIDS virus by donor selection, antibody testing and irradiation sterilization. With the knowledge that fascia may also be heated as additional protection, this study was performed to determine if heat treatment weakens the fascia. Results suggest that heat treatment does not clinically or statistically weaken banked homogenous fascia lata.

Acquired Immunodeficiency Syndrome↗
PubMed1981

[Contribution to the study of the vascularization of the fascia lata tensor muscle].

The tensor fascia lata is a short flat muscle arising from the anterior superior iliac spine and inserting into the fascia lata at mid thigh. It is supplied by three arterial pedicles of unequal importance, branching from the external iliac, gluteal and deep femoral arteries. The 'dominant' blood supply is carried by the lateral circumflex femoral artery which comes from the deep femoral and enters the muscle, approximately 8.8 cm beneath the anterior superior iliac spine. This vessel varies in size from 2 to 3.5 mm; it is 8 cm long but can be lengthened by ligating the branch for the vastus lateralis. On the deep sheath of the iliotibial tract it gives off three branches which supply each third of the fleshy body. The upper branch runs vertically to the iliac insertion of the muscle but not so far as the iliac crest and provides no cutaneous twig. On the contrary, the mid branch runs transversally through the muscle and sends perforating vessels to the skin overlying the fascia lata 6--7 cm below the anterior superior iliac spine. The descending branch runs parallel to the muscular fibers of the muscle and supplies the skin of the lateral lower thigh down to 8 cm above the knee. So the pedicle supports an area of the skin which is double the length (22 cm) and triple the width (9.5 cm) of the fleshy body. The tensor fascia lata including the two layers of the iliotibial tract but excluding its upper insertion, together with the skin of the lateral aspect of the thigh can be safely used as a myocutaneous flap for covering defects of the trochanteric, ischial and sacral areas.

Fascia↗
PubMed1987

Obtaining fascia lata.

The surgical procedure for obtaining fascia lata can be easily carried out by the ophthalmic surgeon. However, anatomy related to obtaining the tissue, as outlined in standard surgical textbooks, is not entirely accurate and should be clarified. The tissue necessary for strong frontalis slings should come from a thick band of fascia lata referred to as the "iliotibial tract." If one attempts to obtain fascia lata by directing a fascia stripper along an imaginary line directed from the head of the fibula to the anterior iliac spine, as suggested in most textbooks, an inadequate specimen may be obtained. The iliotibial tract of fascia lata actually runs from the lateral tibial condyle to the iliac crest. The fascia stripper, therefore, needs to be directed along an imaginary line from the lateral tibial condyle to the iliac crest to obtain the strongest fascia lata and avoid transecting the longitudinal fibers.

Fascia Lata↗
PubMed2004

Effects of fascia lata on HIFU lesioning in vitro.

The effects of fascia lata on high intensity focused ultrasound (US), or HIFU,-induced lesions were demonstrated through comparison with and without fascia lata in bovine thigh muscle tissue. Experiments were conducted in an arrangement with a three-way multiscan ultrasonic inspection system and imaging done by B-mode US. Bovine thigh muscle (8-cm thick) was treated with 1.5 MHz for 8 s. Spatial peak intensity (ISP) was 3000 W/cm2. B-mode US imaging detected appearance at the HIFU treatment site. At a free-field intensity of 4000 W/cm2, the observed lesion length (along the axis) with fascia lata was 12 +/- 1.82 mm, compared with 4 +/- 1.54 mm for samples without fascia lata. At 3000 W/cm2, the values for samples with fascia lata and samples without fascia lata, respectively, were 13 +/- 1.50 mm and 2 +/- 1.42 mm. During a 30-s exposure, at ISP of 2000 W/cm2, the peak temperature reached 41 degrees C in samples without fascia lata and 70 degrees C in samples with fascia lata. At ISP of 3000 and 4000 W/cm2, the peak temperature reached, respectively, 73 degrees C and 84 degrees C in samples without fascia lata, compared with 102 degrees C and 104 degrees C, respectively, for samples with fascia lata. The results confirm that fascia lata contributes to increasing tissue necrosis, temperature elevation and echogenicity in US images.

Animals↗
PubMed2000

The antigenicity of fascia lata allografts.

OBJECTIVE: To determine whether commercially available fascia lata allograft material contains donor antigens. MATERIALS AND METHODS: Human leukocyte antigens (HLA) class I and II were assessed in: (i) freeze-dried fascia lata allografts; (ii) a Tutoplast fascia lata graft (Mentor Urology, Santa Barbara, CA, USA); (iii) an acellular dermal graft; and (iv) a successful donor fascia sacrocolpopexy graft one year after implantation, using a polymerase chain reaction sequence-specific primer-based assay. RESULTS: The donor for both the freeze-dried fascia lata and Tutoplast fascia lata was fully HLA-typed. At one year after implantation, antigens from the implanted sacrocolpopexy graft matched the host blood antigens. The antigenicity of the acellular dermal graft could not be ascertained because this material interfered with the assay. CONCLUSION: Donor fascia lata grafts prepared by freeze-drying or by the Tutoplast technique retain donor antigens. The significance of this antigenicity is unknown. All donor antigens are replaced by host antigens after implantation.

Fascia Lata↗
PubMed2006

[Designing a surgical device for harvesting autologous fascia lata grafts as a minimal invasive procedure].

AIMS: Fascia lata is used in different shapes and sizes as a graft material in surgical procedures. The conventional method of harvesting a fascia lata graft is through a long skin incision on the lateral aspect of the thigh. Minimal invasive procedures have been established to reduce the disadvantages of an extensive surgical approach for obtaining the autotransplant. However, they do not facilitate to suture the remaining fascia after harvesting the transplant and therefore bear the risk of a symptomatic herniation of the muscle belly. The aim of this study was to design a surgical device to harvest a fascia lata graft and close the resulting fascia defect as a minimal invasive procedure. MATERIALS AND METHODS: The prototype was tested in 11 human cadaver specimens. It was introduced subcutanously via two small skin incisions. The device contained a special fixation- and working mechanism which enabled the fascial closure using a continuous suture. After the harvest procedure, both the transplant and the sutured fascia lata were examined. RESULTS: The experiments demonstrated the suitability of this method for minimal invasive harvesting of fascia lata. The removed transplants complied in all experiments with the expected dimensions. The continuous suture of the femoral fascia ran with accurate gaps between the sutures and constant tension without dehiscence. Neither the transplant nor the tissue in the region of harvest have shown unduly macroscopic damage due to the use of the device. CONCLUSION: The designed prototype can be used for harvesting a fascia lata graft and repairing the resulting defect minimal invasively. Clinical implementation seems possible. However, improvements could be made mainly concerning the handling of the device.

Cadaver↗
PubMed1997

High leg incision fascia lata harvesting.

OBJECTIVE: The traditional method of harvesting fascia lata has been through an incision above the lateral knee. Problems with this method include a conspicuous scar, herniation of the muscle belly, and hematoma formation. The authors describe a new method of harvesting fascia lata in the region of the hip to minimize these complications. DESIGN: Cohort study. PARTICIPANTS: Twenty-three patients underwent harvesting of fascia lata by the technique described by the authors. Twenty-one patients had ptosis with poor levator function. In two patients, the fascia lata was used to wrap a hydroxyapatite implant. INTERVENTION: The technique for harvesting fascia lata through an incision between the greater trochanter and anterior iliac crest is described. Long-term results were collected from chart reviews and patient interviews after surgery. MAIN OUTCOME MEASURES: The patients were evaluated to determine whether any complications resulted from the new incision site. RESULTS: No permanent complications were noted at the incision site. CONCLUSIONS: Fascia lata can be harvested safely in the region of the iliac crest with an inconspicuous scar and with fewer complications than with the more traditional site slightly above the lateral knee.

Adolescent↗
PubMed1998

Role of tensor fasciae latae in abdominal wall reconstruction.

The role of the tensor fasciae latae as autogenous tissue in reconstruction of abdominal wall defects is well established. The use of various forms of the tensor fasciae latae (free graft versus pedicled flap versus free flap) is determined by the characteristics of the defect. A review of abdominal wall reconstructions using tensor fasciae latae was completed to determine efficacy and establish guidelines for its use. Abdominal wall reconstructions from 1991 to 1994 using tensor fasciae latae were reviewed. Demographics, wound characteristics, and complications were evaluated. Twenty-seven patients with a mean follow-up of 23.6 months underwent abdominal wall reconstruction with the tensor fasciae latae: free grafts, 12; pedicled flaps, 9; and free flaps, 6. An average defect size of 14.4 x 13.1 cm was seen. Fourteen (52 percent) of the reconstructions were completed in contaminated or infected wounds. One recurrent enteric fistula was seen. Twelve (44 percent) of the patients had flap complications of which 50 percent involved partial flap necrosis. Donor site complications were seen in five patients (18 percent) and included a hematoma, seroma, and two cases of skin graft dehiscence along the edge of the wound. Tensor fasciae latae free grafts are an option for repair of abdominal hernias if abdominal soft tissue is adequate. Pedicled flaps may be used for defects of soft tissue and fascia but are limited by the arc of rotation and size of the defect. Tensor fasciae latae free flaps are versatile in orientation and may be used for supraumbilical defects. Tip necrosis is significant in both types of vascularized flaps.

Abdominal Muscles↗