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Microsurgery

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https://www.readbyqxmd.com/read/28646588/duration-and-cessation-characteristics-of-heparinization-after-finger-replantation-a-retrospective-analysis-of-outcomes
#1
Johnny I Efanov, Julia Khriguian, Sophie Cassier, Elie Boghossian, Patrick G Harris, Joseph Bou-Merhi, M A Danino
BACKGROUND: To prevent postoperative thrombosis, indications for anticoagulation in finger replantation have been described, but no consensus has yet been found for cessation protocols. The aim of this study is to investigate cessation methods of intravenous anticoagulation after finger replantation. METHODS: A retrospective review of all patients treated for a finger replantation between December 2014 and July 2016 was performed. Only those who required postoperative treatment with intravenous heparin were extracted...
June 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28646587/perioperative-pain-management-after-fibular-free-flap-harvesting-for-head-and-neck-reconstruction-using-mini-catheters-to-inject-local-anesthetic-a-pilot-study
#2
Andrea Ferri, Andrea Varazzani, Adriana Valente, Giuseppe Pedrazzi, Bernardo Bianchi, Silvano Ferrari, Enrico Sesenna
BACKGROUND: Fibular donor site pain management in the early postoperative period can help minimize complications, patient discomfort, and agitation. Traditional management of postoperative pain consists of systemic administration of opioids and NSAIDS. The use of local anesthetics in addition to systemic analgesics has the potential to improve pain control. Purpose of the study is to evaluate the efficacy of mini-catheters used to inject local anesthetic into the fibular donor site after flap harvesting for reconstruction of the head-and-neck area...
June 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28621805/noninvasive-screening-test-for-detecting-early-stage-lymphedema-using-follow-up-computed-tomography-imaging-after-cancer-treatment-and-results-of-treatment-with-lymphaticovenular-anastomosis
#3
Shinsuke Akita, Fusa Ogata, Ichiro Manabe, Akira Mitsuhashi, Rikiya Nakamura, Yoshihisa Yamaji, Yoshitaka Kubota, Nobuyuki Mitsukawa
BACKGROUND: Although early detection is valuable for secondary lymphedema treatment, existing screening tests are not popular. This study aimed to propose a novel method of screening lymphedema patients based on the thickness of the subcutaneous fat measured with perioperative computed tomography (CT) and present the results from evaluation of patients who underwent those examinations was performed. METHOD: The medical records of 96 gynecological cancer patients and 189 breast cancer patients, whose lymphatic function was assessed with indocyanine green lymphography, were reviewed...
June 16, 2017: Microsurgery
https://www.readbyqxmd.com/read/28573680/the-effect-of-age-on-microsurgical-free-flap-outcomes-an-analysis-of-5-951-cases
#4
Kevin T Jubbal, Dmitry Zavlin, Ahmed Suliman
BACKGROUND: The growing elderly population necessitates a greater number of aging patients requiring complex reconstructive surgery involving free tissue transfer. The purpose of this study was to assess the safety, efficacy, and outcomes of microsurgical free tissue transfer in elderly patients using a national multi-institutional database. METHODS: We performed a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to identify patients undergoing free tissue transfer...
June 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28556461/double-flap-phalloplasty-in-transgender-men-surgical-technique-and-outcome-of-pedicled-anterolateral-thigh-flap-phalloplasty-combined-with-radial-forearm-free-flap-urethral-reconstruction
#5
Wouter B van der Sluis, Jan Maerten Smit, Garry L S Pigot, Marlon E Buncamper, Henri A H Winters, Margriet G Mullender, Mark-Bram Bouman
INTRODUCTION: Radial forearm free flap (RFFF) tube-in-tube phalloplasty is the most performed phalloplasty technique worldwide. The conspicuous donor-site scar is a drawback for some transgender men. In search for techniques with less conspicuous donor-sites, we performed a series of one-stage pedicled anterolateral thigh flap (ALT) phalloplasties combined with RFFF urethral reconstruction. In this study, we aim to describe this technique and assess its surgical outcome in a series of transgender men...
May 29, 2017: Microsurgery
https://www.readbyqxmd.com/read/28543692/the-impact-of-resident-involvement-in-breast-reconstruction-surgery-outcomes-by-modality-an-analysis-of-4-500-cases
#6
Kevin T Jubbal, Anthony Echo, Aldona J Spiegel, Shayan A Izaddoost
BACKGROUND: The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. METHODS: We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28543381/ileocecal-vascularized-lymph-node-transfer-for-the-treatment-of-extremity-lymphedema-a-case-report
#7
Pedro Ciudad, Oscar J Manrique, Mouchammed Agko, En-Wei Liu, Wei-Ling Chang, Matthew Sze-Wei Yeo, Tony Chieh-Ting Huang, Ram M Chilgar, Hung-Chi Chen
Vascularized lymph node (VLN) transfer has been of high interest in the past decade for the treatment of lymphedema, since it has been shown to be effective in reducing limb volumes, decreasing infectious episodes and improving quality of life. Multiple donor sites have been described in the quest for the optimal one. Herein, we describe a novel lymph node flap option based on the ileocolic artery and vein. The ileocecal vascularized lymph node (IC-VLN) flap was used in the management of a 33-year-old male patient with lower extremity lymphedema secondary to left inguinal trauma...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28544074/single-stage-aesthetic-and-functional-reconstruction-of-composite-facial-gunshot-wound-with-a-chimeric-functioning-muscle-and-fibular-osseous-flap-case-report-and-review-of-the-literature
#8
Andreas Gravvanis, Konstantinos Apostolou, Dimitrios Anterriotis, Dimosthenis Tsoutsos
The current concepts in the aesthetic and functional reconstruction of complex oromandibular defects are presented with a case of a patient with self-inflicted gunshot wound to the face. The patient presented with a 6 cm composite mandibular defect; the buccomandibular and suborbital aesthetic zones of the cheek along with the mucosa lining, and the ipsilateral facial musculature were missing. A rapid prototyping model of the facial skeleton was used to assist in preoperative planning. A single stage reconstruction with two free flaps was planned; a free fibula osseous flap to reconstruct the mandibular defect, and a free chimeric ALT/functioning vastus lateralis muscle...
May 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28509409/soft-tissue-reconstruction-and-salvage-of-infected-fixation-hardware-in-lower-extremity-trauma
#9
Hyuma A Leland, Alexis D Rounds, Karen E Burtt, Daniel J Gould, Geoffrey S Marecek, Ram K Alluri, Ketan M Patel, Joseph N Carey
BACKGROUND: Tibial fracture management may be complicated by infection of internal fixation hardware (iIFH) resulting in increased morbidity and amputation rate. When iIFH removal is not possible, salvage of the lower extremity is attempted through debridement, antibiotics, and vascularized soft tissue coverage. This study investigates lower extremity salvage with retention of iIFH. METHODS: Demographics, outcomes, and bacterial speciation in patients with tibial fractures at a level 1 trauma center from 2007 to 2014 were reviewed...
May 16, 2017: Microsurgery
https://www.readbyqxmd.com/read/28498546/the-use-of-inverted-l-posteromedial-thigh-l-pmt-flap-for-autologous-breast-reconstruction-a-case-report
#10
Mario F Scaglioni, Maximilian Eder, Pietro Giovanoli
The posteromedial thigh (PMT) flap has been described for breast reconstruction in vertical fashion (vPMT). However, it might not incorporate enough soft tissue for reconstruction of a medium size breast. Here, we present a case utilizing the free inverted-L posteromedial thigh (L-PMT) flap for autologous reconstruction of the breast. A 65-year-old woman with a body max index (BMI) of 24.5 kg/m(2) underwent nipple sparring mastectomy and received immediate unilateral breast reconstruction. The flap was raised based on the first medial perforator of the profunda femoris artery (PFA)...
May 12, 2017: Microsurgery
https://www.readbyqxmd.com/read/28493355/consideration-of-difficulties-and-exit-strategies-in-a-case-of-face-allotransplantation-resulting-in-failure
#11
Özlenen Özkan, Ömer Özkan, Umuttan Doğan, Vural Taner Yılmaz, Hilmi Uysal, Levent Ündar, Ebru Apaydın Doğan, Ozan Salim, Anı Çinpolat, Atilla Ramazanoglu
We describe the first rescue procedure in a case of total face allotransplantation. The recipient was a 54-year-old man with severe disfigurement of the entire face following an accidental gunshot injury 5 years previously. The large defect included the maxilla, mandible, and mid-face. Full face procurement was performed from a multiorgan cadaveric donor and was allotransplanted to the recipient. The post-transplant induction immunosuppressive regimen included ATG combined with tacrolimus, mycophenolate mofetil, and prednisone, while maintenance was provided by the last three of these...
May 11, 2017: Microsurgery
https://www.readbyqxmd.com/read/28480988/the-split-vein-graft-splint-to-avoid-kinking-and-compression-of-the-vascular-pedicle
#12
LETTER
Mouchammed Agko, En-Wei Liu, Tony C T Huang, Federico LoTorto, Pedro Ciudad, Oscar Javier Manrique, Hung-Chi Chen
No abstract text is available yet for this article.
May 8, 2017: Microsurgery
https://www.readbyqxmd.com/read/28467614/autologous-breast-reconstruction-in-the-postbariatric-patient-population
#13
Andrew R Bauder, Fares Samra, Suhail K Kanchwala, Joseph M Serletti, Stephen J Kovach, Liza C Wu
BACKGROUND: Over 175,000 Americans underwent bariatric surgery in 2013 alone, resulting in rapid growth of the massive weight loss population. As obesity is a known risk factor for breast cancer, plastic surgeons are increasingly challenged to reconstruct the breasts of massive weight loss patients after oncologic resection. The goal of this study is to assess the outcomes of autologous breast reconstruction in postbariatric surgery patients at a single institution. METHODS: Patients who underwent autologous breast reconstruction between 2008 and 2014 were identified...
May 3, 2017: Microsurgery
https://www.readbyqxmd.com/read/28449390/partial-tibial-nerve-transfer-to-tibialis-anterior-for-traumatic-peroneal-nerve-palsy
#14
Scott Ferris, Simon J Maciburko
BACKGROUND: Partial tibial nerve transfer to the motor branches of tibialis anterior is an emerging reconstructive technique for the treatment of traumatic common peroneal nerve (CPN) injury; however, few papers in the literature describe clinical outcomes. METHODS: A prospective single-surgeon series of nine consecutive patients who underwent partial tibial nerve transfers to the motor branches of tibialis anterior for traumatic CPN injuries between 2008 and 2014...
April 27, 2017: Microsurgery
https://www.readbyqxmd.com/read/28432769/pocketable-ultrasonography-for-bedside-flap-monitoring
#15
LETTER
Takumi Yamamoto, Nana Yamamoto, Ryohei Ishiura
No abstract text is available yet for this article.
April 22, 2017: Microsurgery
https://www.readbyqxmd.com/read/28432762/microvascular-replantation-of-head-and-neck-amputated-parts-a-systematic-review
#16
REVIEW
Johnny I Efanov, Ixchel J Montoya, Ke N Huang, Charles Guertin, Patrick G Harris, Joseph Bou-Merhi, Alain M Danino
BACKGROUND: As opposed to upper and lower extremity amputations representing a considerable volume of admissions, the prowess of microsurgeons is seldom solicited in complex cases of head and neck replantation. Our aim was to determine the rate of successful replantation of craniofacial parts in a systematic review of the literature. METHODS: We performed a systematic review of English literature using PubMed/MEDLINE for every replantation of a head and neck parts...
April 22, 2017: Microsurgery
https://www.readbyqxmd.com/read/28425594/trilobed-pedicled-superior-gluteal-artery-perforator-flap-for-lumbosacral-defect-coverage
#17
Ji Min Kim, Jun Ho Lee, Deuk Young Oh, Suk-Ho Moon
BACKGROUND: There are many available options for the coverage of lumbosacral area defects. Surgeons usually use the superior gluteal artery perforator flap (SGAP) by rotational fashion, which risks complications, such as wound dehiscence or skin necrosis at the Y-point on the donor site due to the tension. In this report, the authors present the experience of using trilobed pedicled SGAP flaps in coverage of the lumbosacral area defects. METHODS: From 2011 to 2015, 16 trilobed pedicled SGAP flaps were performed for the coverage of sacral defects in our facility...
April 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28419553/eight-year-follow-up-after-vascularized-fibular-epiphyseal-transfer-for-hip-reconstruction
#18
LETTER
Sergi Barrera-Ochoa, Francisco Soldado, Jorge Knörr
No abstract text is available yet for this article.
April 17, 2017: Microsurgery
https://www.readbyqxmd.com/read/28397296/reconstruction-of-late-esophagus-perforation-after-anterior-cervical-spine-fusion-with-an-adipofascial-anterolateral-thigh-free-flap-a-case-report
#19
Ruben Coelho, Tomas Ekberg, Malin Svensson, Maria Mani, Andres Rodriguez-Lorenzo
Reconstruction of late esophageal perforation usually requires flap surgery to achieve wound healing. However, restoring the continuity between the digestive tract and retropharyngeal space to allow for normal swallowing remains a technical challenge. In this report, we describe the use of a thin and pliable free adipofascial anterolateral thigh (ALT) flap in a 47-year-old tetraplegic man with a history of C5-C6 fracture presented with a large posterior esophagus wall perforation allowing an easier flap insetting for a successful wound closure...
April 11, 2017: Microsurgery
https://www.readbyqxmd.com/read/28374516/laparoscopic-harvest-of-ileocolon-flap-in-pharyngoesophageal-reconstruction
#20
LETTER
Federico Lo Torto, William Tzu-Liang Chen, Mouchammed Agko, Pedro Ciudad, Oscar J Manrique, Diego Ribuffo, Hung-Chi Chen
No abstract text is available yet for this article.
April 4, 2017: Microsurgery
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