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Clinics in Plastic Surgery

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https://www.readbyqxmd.com/read/27894588/pre-expanded-perforator-flaps
#1
EDITORIAL
Lee L Q Pu, Chunmei Wang
No abstract text is available yet for this article.
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894587/pre-expanded-paraumbilical-perforator-flap
#2
REVIEW
Yuanbo Liu, Mengqing Zang, Shan Zhu, Bo Chen, Qiang Ding
The paraumbilical perforator flap is the first and the most famous perforator flap. Pre-expansion increases the flap dimension and reduces the flap thickness and donor site morbidities, making the paraumbilical perforator flap a more effective option for upper extremity reconstruction. Pre-expanded pedicled paraumbilical perforator flaps can achieve excellent function and aesthetic outcomes in patients with extensive scar contracture and giant melanocytic nevi in the upper extremity. Although this technique requires multiple procures, each operation is relatively simple and has a low complication rate, when properly planned and performed...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894586/pre-expanded-thoracodorsal-artery-perforator-flap
#3
REVIEW
Yalcin Kulahci, Cihan Sahin, Huseyin Karagoz, Fatih Zor
The size of the thoracodorsal artery perforator (TDAP) flap or pedicle, in general, may be found to be inadequate. Pre-expansion of the flap before harvest can be a solution to increase the size of the TDAP flap in such instances. The pre-expanded TDAP flap can be used to reconstruct large-sized defects with the advantage of primary closure of the donor site. This article presents details on the surgical technique and provides discussion of the authors' experiences.
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894585/pre-expanded-intercostal-perforator-super-thin-skin-flap
#4
REVIEW
Yunjun Liao, Yong Luo, Feng Lu, Hiko Hyakusoku, Jianhua Gao, Ping Jiang
This article introduces pre-expanded super-thin intercostal perforator flaps, particularly the flap that has a perforator from the first to second intercostal spaces. The key techniques, advantages and disadvantages, and complications and management of this flap are described. At present, the thinnest possible flap is achieved by thinning the pre-expanded flap that has a perforator from the first to second intercostal spaces. It is used to reconstruct large defects on the face and neck, thus restoring function and cosmetic appearance...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894584/pre-expanded-internal-mammary-artery-perforator-flap
#5
REVIEW
Stacy Wong, James D Goggin, Nicholas D Webster, Michel H Saint-Cyr
Internal mammary artery (IMA)-based pedicled perforator flaps can be used to reconstruct defects of the neck and anterior chest wall. Pre-expansion causes a possible delay phenomenon, improves flap survival, and decreases donor site morbidity. It also increases the area that can be covered. Pre-expanding can allow for perforator flaps that require a shorter arc of rotation. The pre-expanded internal mammary artery perforator (IMAP) flap is an excellent option for patients who have undergone multiple failed reconstructions and require large amounts of soft tissue while lacking other donor sites...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894583/pre-expanded-supraclavicular-artery-perforator-flap
#6
REVIEW
Norbert Pallua, Bong-Sung Kim
The supraclavicular artery perforator (SAP) flap is a versatile flap for the reconstruction of head and neck defects. Recently, the authors have modified the SAP flap by using an anterior branch of the transverse cervical artery. The anterior SAP flap allows the harvest of a tissue island in the deltopectoral fossa, which is even thinner, is more pliable, and shows a superior color match to the face and neck compared with the original SAP flap. Pre-expansion increases flap size considerably, enabling the coverage of extended defects without the need of microsurgery...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894582/pre-expanded-transverse-cervical-artery-perforator-flap
#7
REVIEW
Huifeng Song, Jiake Chai
The face and neck are important areas for function and appearance. High-quality skin flaps should be used to reconstruct defects in the cervicofacial region. This article introduces the pre-expanded transverse cervical artery perforator flap, which can be used for cervicofacial reconstruction after burns, trauma, and tumor resection with excellent results. This perforator flap is one of the best options for cervicofacial reconstruction in terms of color and texture match, and has fewer flap complications. With regard to the expanded flap, the donor site can be sutured directly leaving only an inconspicuous linear scar...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894581/pre-expanded-super-thin-skin-perforator-flaps
#8
REVIEW
Chunmei Wang, Sifen Yang, Lee L Q Pu
Patients with severe postburn scar contractures underwent reconstruction of skin defects after scar excision with pre-expanded super-thin skin perforator flaps supplied primarily by perforators via the "bridging effect" from the branches of the adjacent arteries as 2-stage procedures. Pre-expansion is an innovative technique and may improve the anastomoses between subdermal vascular plexuses and extend the supplying area of these vessels to the flap. Such a flap becomes super thin, but with a prefabricated blood supply it can be used for reconstruction of skin defects of the face, neck, or other body part with improved functional and cosmetic outcomes...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894580/imaging-studies-for-preoperative-planning-of-perforator-flaps-an-overview
#9
REVIEW
Shimpei Ono, Hiromitsu Hayashi, Hiroyuki Ohi, Rei Ogawa
The vascular anatomy of perforators varies between individuals; thus, accurate preoperative assessment of perforators is essential for safely planning perforator flaps. Perforator computed tomographic angiography (P-CTA) with multidetector-row computed tomography (MDCT) is one of the best available methods to precisely reveal the 3-dimensional anatomic details of perforators. The aim of this report is to describe the authors' experience using P-CTA with MDCT for detecting the perforating vessel preoperatively and a step-by-step approach to harvest perforator flaps based on this technique...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894579/future-perspectives-of-pre-expanded-perforator-flaps
#10
REVIEW
Lee L Q Pu, Chunmei Wang
Although clinical application of a pre-expanded perforator flap is primarily focused on face and neck reconstructions, such a flap has also been used to reconstruct defects in the trunk, extremities, or hands. With better understanding of the improved blood supply to the flap and the mechanism on the prefabrication of blood supply within the flap, the pre-expanded perforator flap will definitely play a more important role in reconstructive surgery and can be used in selected patients by many plastic surgeons worldwide with good reconstructive and cosmetic outcomes...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894578/pre-expanded-and-prefabricated-abdominal-superthin-skin-perforator-flap-for-total-hand-resurfacing
#11
REVIEW
Chunmei Wang, Junyi Zhang, Sifen Yang, Ping Song, Lun Yang, Lee L Q Pu
Reconstruction of the postburn hand remains a challenge for surgeons. For cosmetic and functional requirements, the desired flap should be thin enough to ensure the flexibility of the hand. Conventional perforator flaps serve as a viable option when reconstructing the postburn hand to regain functionality. However, limitations include the discrepancy in tissue thickness and the difficulty with donor site closure. Thus, a preexpanded superthin skin perforator flap is an ideal choice for postburn hand reconstruction, with the trade-off being a longer treatment course (3-4 months), but with results that satisfy both patients and their surgeons...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894577/pre-expanded-prefabricated-monoblock-perforator-flap-for-total-facial-resurfacing
#12
REVIEW
Tao Zan, Yashan Gao, Haizhou Li, Bin Gu, Feng Xie, Qingfeng Li
In this article, we present the pre-expanded, prefabricated supercharged cervicothoracic monoblock perforator flap for total or subtotal facial resurfacing. This technique can be a reliable reconstruction option for extensive facial skin defect with undamaged muscles and deep structures, which could provide excellent aesthetic and functional outcomes with acceptable complications. Our approach may replace a conventional "skin-only" face allotransplantation in selected patients.
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894576/pre-expanded-bipedicled-supratrochlear-perforator-flap-for-simultaneous-reconstruction-of-the-nasal-and-upper-lip-defects
#13
REVIEW
Shaoqing Feng, Zheng Zhang, Wenjing Xi, Davide Lazzeri, Yong Fang, Yi Xin Zhang
The double "S" principle should be followed for facial reconstruction: the "similarity" of the donor site to the defect area and the reconstruction should be based on the different "subunits" of the face. In this article the pre-expanded, bipedicled supratrochlear perforator flap method is described, which is used for the resurfacing of both nasal and upper lip defects. This method can provide 2 independent flaps with sufficient tissue from 1 single donor site, resurfacing the nasal and upper lip units separately and providing an unparalleled color and texture match and ideal reconstructive result...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894575/pre-expanded-free-perforator-flaps
#14
REVIEW
Emre Hocao─člu
Pre-expanded perforator flaps are the most recent technical way to shape tissue for exact needs. Reconstruction with pre-expanded free perforator flaps has proven successful in terms of obtaining more extensive, more pliable, and thinner flaps that have increased vascularity, and also causing less donor site morbidity. In this article the author's experience with the clinical application of such flaps and the relevant published literature are reviewed.
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894574/an-overview-of-pre-expanded-perforator-flaps-part-2-clinical-applications
#15
REVIEW
Chunmei Wang, Jing Zhang, Hiko Hyakusoku, Ping Song, Lee L Q Pu
Pre-expanded perforator flaps have several advantages over their traditional counterparts owing to the thin, more pliable nature, larger size, and minimum morbidity of the donor site. Recently, plastic surgeons have begun to use pre-expanded perforator flaps to reconstruct defects of almost the entire body, including the cervicofacial region, axilla, trunk, and extremities resulting from scar, congenital melanocytic nevi, hemangiomas, and neurofibromas. Such a versatile flap is especially appropriate for face and neck resurfacing, which requires more optimal functional and cosmetic outcomes...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894573/pre-expanded-anterolateral-thigh-perforator-flap-for-phalloplasty
#16
REVIEW
Salvatore D'Arpa, Britt Colebunders, Filip Stillaert, Stan Monstrey
The anterolateral thigh (ALT) perforator flap for phalloplasty is gaining popularity because it avoids the well-known scars of the radial forearm flap. However, scars are not eliminated, just moved to a different location, the thigh, that can for some patients be of great sexual value. Preexpansion of the ALT flap allows primary donor site closure, thus avoiding not only the unsightly appearance of a skin grafted ALT donor site, but also the skin graft donor site scar. Preoperative perforator location by means of computed tomography angiography allows safe expander placement through 2 small remote incisions...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894572/pre-expanded-brachial-artery-perforator-flap
#17
REVIEW
Yuanbo Liu, Mengqing Zang, Maolin Tang, Shan Zhu, Jianhua Zhang, Yu Zhou
The medial upper arm flap is a time-honored yet ignored technique. It may be revitalized by combining the techniques of tissue expansion and perforator flap surgery. Pre-expansion increases flap dimension, remodels flap vasculature, and reduces donor site morbidities, making the medial arm flap a more effective option for various defect reconstructions. A pre-expanded brachial artery perforator flap achieves excellent functional and aesthetic outcomes in patients with soft tissue defects on the head and neck, axilla, chest wall, and upper extremity...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894571/pre-expanded-deep-inferior-epigastric-perforator-flap
#18
REVIEW
Sharon E Monsivais, Nicholas D Webster, Stacy Wong, Michel H Saint-Cyr
The deep inferior epigastric perforator (DIEP) flap can be used to cover large defects of the proximal lower extremity, abdominal wall, perineum, vulva, and buttock. Pre-expanding DIEP flaps cause a possible delay phenomenon improving vascularity, decrease donor site morbidity, and increase the area that can be covered. Pre-expansion requires staged procedures, has risk of extrusion and infection, causes temporary contour deformity during the expansion process, and requires a longer course. Pre-expanded DIEP flaps can be a useful flap with proper patient selection and planning...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894570/an-overview-of-pre-expanded-perforator-flaps-part-1-current-concepts
#19
REVIEW
Chunmei Wang, Sifen Yang, Jing Zhang, Lun Yan, Ping Song, Hiko Hyakusoku, Lee L Q Pu
Pre-expanded perforator flaps, a combination of tissue expansion with perforator flaps, are emerging as another landmark of plastic surgery. This flap inherits the characteristics of both perforator flaps and expanded flaps, making it a highly versatile option in reconstructive surgery. However, the definition of the pre-expanded perforator flap and the impact of pre-expansion on the superficial angio-architecture remain controversial. In this article, the authors review current concepts including the mechanism of expansion and the resultant changes in the angio-architecture...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27601400/the-unfavorable-outcome-here-we-conquer
#20
EDITORIAL
Fu-Chan Wei, Nidal Farhan Al Deek
No abstract text is available yet for this article.
October 2016: Clinics in Plastic Surgery
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