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Clinics in Plastic Surgery

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https://www.readbyqxmd.com/read/28340677/microsurgical-technical-training-differences-between-china-and-the-united-states
#1
EDITORIAL
Jin Bo Tang
No abstract text is available yet for this article.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340676/erratum
#2
(no author information available yet)
No abstract text is available yet for this article.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340675/development-and-historical-evolution-half-a-century-ago-at-the-dawn-of-microsurgery
#3
EDITORIAL
Cheng Hua Tang
No abstract text is available yet for this article.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340674/microsurgery-half-a-century-after-establishment-global-perspectives
#4
EDITORIAL
Jin Bo Tang, Michel Saint-Cyr
No abstract text is available yet for this article.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340673/the-advent-of-vascularized-composite-allotransplantation
#5
REVIEW
Curtis L Cetrulo, Zhi Yang Ng, Jonathan M Winograd, Kyle R Eberlin
Modern microsurgical techniques have made possible a broad spectrum of novel means for the reconstruction of complex bone and soft tissue defects. These techniques, in combination with developments in transplant immunology, have led to successful hand and facial allotransplantation and achievement of the highest rung in the reconstructive ladder - truly replacing like with like. The utilization of contemporary microsurgical technique in the context of vascularized composite allotransplantation (VCA) (1) permits successful technical execution and feasibility of VCA, (2) facilitates the study of immunologic tolerance in VCA preclinical models, and (3) optimizes functional VCA outcomes...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340672/new-frontiers-in-robotic-assisted-microsurgical-reconstruction
#6
REVIEW
Amir E Ibrahim, Karim A Sarhane, Jesse C Selber
Robotic surgery has revolutionized minimally invasive surgery. Owing to its unique features and key advantages, robotic surgery is being used for complex cases across surgical specialties. It has been introduced into reconstructive surgery, and is being applied in microsurgery. Robotic surgery combines properties of conventional microsurgery, endoscopic surgery, and telesurgery. It holds great promise in expanding the boundaries of reconstructive microsurgery. However, there are constraints that limit its widespread use...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340671/unique-techniques-or%C3%A2-approaches-in-microvascular-and-microlymphatic-surgery
#7
REVIEW
Jin Bo Tang, Luis Landín, Pedro C Cavadas, Alessandro Thione, Jing Chen, Gemma Pons, Jaume Masià
Several methods can be used for identifying tissues for transfer in donor-site-depleted patients. A fillet flap can be temporarily stored in other parts of the body and transferred back to the site of tissue defect, including covering the amputated stump of the lower extremity. Human arm transplant is rare and has some unique concerns for the surgery and postsurgical treatment. Cosmetics of the narrow neck of transferred second toes can be improved with insertion of a flap. Lymphedema of the breast after cancer treatment can be diagnosed with several currently available imaging techniques and treated surgically with lymphaticovenous anastomosis...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340670/keystone-and-pedicle-perforator-flaps-in-reconstructive-surgery-new-modifications-and-applications
#8
REVIEW
Jasson T Abraham, Michel Saint-Cyr
Pedicle perforator flaps and keystone perforator island flaps are additional tools for reconstructive surgeons. Advances in understanding of vascular anatomy, the dynamic nature of perforator perfusion, inter-perforator flow and the hot-spot principle have led to reconstructive techniques that allow innovative autologous tissue transfer while limiting donor site morbidity. Further modifications of the pedicle perforator flap have led to a multitude of freestyle pedicle perforator flap options, as well as freestyle free flaps for soft tissue reconstruction...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340669/maximizing-the-utility-of-the-pedicled-anterolateral-thigh-flap-for-locoregional-reconstruction-technical-pearls-and-pitfalls
#9
REVIEW
Aparna Vijayasekaran, Waleed Gibreel, Brian T Carlsen, Steven L Moran, Michel Saint-Cyr, Karim Bakri, Basel Sharaf
The pedicled anterolateral thigh (PALT) flap is an underutilized flap for locoregional reconstruction largely because methods to maximize its reach are neither universally implemented nor fully understood. In addition, most of the available literature has focused on the utility of the free anterolateral thigh flap with less emphasis on the PALT flap. Moreover, flap design concepts to maximize its utility and reach and optimize outcomes have not been comprehensively described. In an effort to address this knowledge gap, the authors sought to review their institution's experience with the PALT flap for locoregional reconstruction...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340668/anastomosis-of-the-superficial-inferior-epigastric-vein-to-the-internal-mammary-vein-to-augment-deep-inferior-artery-perforator-flaps
#10
REVIEW
Aparna Vijayasekaran, Anita T Mohan, Lin Zhu, Basel Sharaf, Michel Saint-Cyr
Use of the retrograde limb of the internal mammary vein has been described previously as a lifeboat for venous congestion but not prophylactically. Maximizing the length of the deep inferior artery perforator (DIEP) flap pedicle, identifying and dissecting the superficial inferior epigastric vein proximally in every patient, and taking advantage of the retrograde internal mammary vein are all technical details that facilitate the additional venous anastomosis and flap inset. Performing a second venous anastomosis routinely using the superficial inferior epigastric vein to the retrograde internal mammary vein helps with flap inset...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340667/microsurgical-tissue-transfer-in-breast-reconstruction
#11
REVIEW
Nakul Gamanlal Patel, Venkat Ramakrishnan
Autologous breast reconstructions have grown in popularity because of their durability, aesthetic outcomes, symmetry, increase in external beam radiotherapy use, and potential aesthetic enhancement at the donor site. Increasing patient expectations for predictable high aesthetic outcomes with minimal complications or need for further procedures has been met by refinement in the use of flaps. The authors' microsurgical breast reconstruction center aims to provide this while delivering efficient service. The deep inferior epigastric flaps form 85% and transverse upper gracilis and profunda artery perforator flaps account for 10%; lumbar artery perforator flaps are a new addition to the authors' armamentarium...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340666/innovations-and-future-directions-in-head-and-neck-microsurgical-reconstruction
#12
REVIEW
Marissa Suchyta, Samir Mardini
Head and neck reconstructive microsurgery is constantly innovating because of a combination of multidisciplinary advances. This article examines recent innovations that have affected the field as well as presenting research leading to future advancement. Innovations include the use of virtual surgical planning and three-dimensional printing in craniofacial reconstruction, advances in intraoperative navigation and imaging, as well as postoperative monitoring, development of minimally invasive reconstructive microsurgery techniques, integration of regenerative medicine and stem cell biology with reconstruction, and the dramatic advancement of face transplant...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340665/pediatric-microsurgery-a-global-overview
#13
REVIEW
Ali Izadpanah, Steven L Moran
As microsurgical expertise has improved, allowing for the safe transfer of smaller and more refined flaps, free tissue transfer has continued to gain popularity for the management of pediatric soft tissue and bony defects. For the past 2 decades pediatric microsurgery has been shown to be technically feasible and reliable. The major advantage of free tissue transfer in children is the ability to reconstruct defects in a single stage, avoiding the historic treatments of skin grafting, tissue expansion, and pedicled flaps...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340664/complex-microsurgical-reconstruction-after-tumor-resection-in-the-trunk-and-extremities
#14
REVIEW
Omar N Hussain, M Diya Sabbagh, Brian T Carlsen
Reconstruction of soft tissue defects following tumor ablation procedures in the trunk and extremities can challenge the microsurgeon. The goal is not just to provide adequate soft tissue coverage but also to restore form and function and minimize donor site morbidity. Although the principles of the reconstructive ladder still apply in the trunk and extremities, free tissue transfer is used in many cases to optimally restore form and function. Microsurgery has changed the practice in soft tissue tumors, and amputation is less frequently necessary...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340663/compound-or-specially-designed-flaps-in-the-lower-extremities
#15
REVIEW
Bruno Battiston, Davide Ciclamini, Jin Bo Tang
Novel and combined tissue transfers from the lower extremity provide new tools to combat soft tissue defects of the hand, foot, and ankle, or fracture nonunion. Flaps can be designed for special purposes, such as providing a gliding bed for a grafted or repaired tendon or for thumb or finger reconstruction. Propeller flaps can cover soft tissue defects of the leg and foot. In repairing severe bone and soft tissue defects of the lower extremity, combined approaches, including external fixators, one-stage vascularized bone grafting, and skin or muscle flap coverage of the traumatized leg and foot, have become popular...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340662/vascularized-small-bone-transfers-for-fracture-nonunion-and-bony-defects
#16
REVIEW
Ai Dong Deng, Marco Innocenti, Rohit Arora, Markus Gabl, Jin Bo Tang
Vascularized small-bone grafting is an efficient and often necessary surgical approach for nonunion or necrosis of several bones in particular sites of the body, including scaphoid, lunate, distal ulna, and clavicle. The medial femoral condyle is an excellent graft source that can be used in treating scaphoid, ulna, clavicle, or lower-extremity bone defects, including nonunion. Vascularized bone grafting to the small bones, particularly involving reconstruction of damaged cartilage surfaces, should enhance subchondral vascular supply and help prevent cartilage regeneration...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340661/medial-femoral-trochlea-osteochondral-flap-applications-for-scaphoid-and-lunate-reconstruction
#17
REVIEW
James P Higgins, Heinz K Bürger
Vascularized osteochondral flaps are a new technique described for the reconstruction of challenging articular defects of the carpus. The medial femoral trochlea osteochondral flap is supplied by the descending geniculate artery. This osteochondral flap has shown promise in the treatment of recalcitrant scaphoid proximal pole nonunions and advanced avascular necrosis of the lunate. The anatomy, surgical technique, and results are discussed, with clinical cases provided.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340660/severe-crush-injury-to-the-forearm-and-hand-the-role-of-microsurgery
#18
REVIEW
Francisco Del Piñal, Esteban Urrutia, Maciej Klich
The main goals of treating severe crush injuries are debriding away devitalized tissue and filling any resultant dead space with vascularized tissue. In the authors' experience, the most ideal methods for soft tissue coverage in treating crush injuries are the iliac flap, the adipofascial lateral arm flap, and the gracilis flap. Accompanying bone defects respond very well to free corticoperiosteal flaps. Digital defects often require the use of complete or subtotal toe transfer to avoid amputation and restore function to the hand...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340659/exploring-new-frontiers-of-microsurgery-from-anatomy-to-clinical-methods
#19
REVIEW
Zeng Tao Wang, You Mao Zheng, Lei Zhu, Li Wen Hao, Ya Bin Zhang, Chao Chen, Li Feng Xia, Lin Feng Liu
This article presents the authors' understanding and experience concerning anatomic studies and clinical methods in microsurgical hand reconstruction. The 4 parts of this article include anatomic study of the hand for developing new flaps; application of miniflaps from the hand, including clinical experience with 8 unique flaps in the hand; anatomic and clinical considerations concerning several flaps from other parts of the human body; And our experience with vascularized free toe joint transfer.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340658/a-global-view-of-digital-replantation-and-revascularization
#20
REVIEW
Jin Bo Tang, Zeng Tao Wang, Jing Chen, Jason Wong
Survival rates of digital replantation vary in different regions and countries, and Asian surgeons see more challenging cases and have developed some unique methods. Replantation of multiple digits in one or both hands can follow a structure-by-structure method or a digit-by-digit method. For replanting all 10 digits, 3 or 4 teams should be organized. Flow-through flaps, often venous flaps, can be taken from the distal forearm or lower extremity to repair defects of soft tissues and arteries. A pedicled digital artery flap from the adjacent digit can also repair tissue defects and supply blood to the replanted digit...
April 2017: Clinics in Plastic Surgery
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