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Microsurgery

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https://www.readbyqxmd.com/read/29737002/lower-limb-reconstruction-with-chimeric-flaps-the-quad-flap
#1
Solomon M Azouz, Nikki A Castel, Aparna Vijayasekaran, Alanna M Rebecca, Salvatore C Lettieri
Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. We describe 2 cases of lower-extremity crush injuries salvaged with the quad flap. This novel flap consists of parascapular, scapular, serratus, and latissimus dorsi free flaps in combination on one pedicle...
May 7, 2018: Microsurgery
https://www.readbyqxmd.com/read/29736923/reconstruction-of-complex-tissue-defect-of-forearm-with-a-chimeric-flap-composed-of-a-sural-neurocutaneous-flap-and-a-vascularized-fibular-graft-a-case-report
#2
Chunyang Wang, Jia Xu, Gen Wen, Yimin Chai
One-stage reconstruction of composite bone and soft-tissue defects in the forearm remains a tough challenge. Here, we present a case of reconstruction of complex tissue defect at forearm with a chimeric flap consisting of a sural neurocutaneous flap and a fibular graft. A 61-year-old man suffered from a machine crush injury in his left forearm, resulting in a complex tissue defect including extensive dorsomedial soft-tissue, digit extensor muscles of 2-4 fingers, the muscle flexor carpi ulnaris, the ulna bone with 5...
May 7, 2018: Microsurgery
https://www.readbyqxmd.com/read/29719080/lymphovenous-anastomosis-and-debulking-procedure-for-treatment-of-combined-severe-lower-extremity-and-genital-lymphedema-a-case-report
#3
Mario F Scaglioni, Semra Uyulmaz
Lymphedema most commonly occurs after cancer treatment and can affect limbs and genitalia. Genital lymphedema (GL) is a rare condition and can be disabling psychologically and physically. It often occurs along with lower extremity lymphedema (LEL). Conservative and physiologic reconstructive surgery such as lymphaticovenous anastomosis (LVA) offer good treatment options for LEL. GL however remains a reconstructive dilemma. The most effective surgical therapies in advanced GL are still debulking procedures in properly selected patients...
May 2, 2018: Microsurgery
https://www.readbyqxmd.com/read/29719063/diabetes-is-not-associated-with-increased-rates-of-free-flap-failure-analysis-of-outcomes-in-6030-patients-from-the-acs-nsqip-database
#4
Rami S Kantar, William J Rifkin, Joshua A David, Michael J Cammarata, J Rodrigo Diaz-Siso, Jamie P Levine, Alyssa R Golas, Daniel J Ceradini
BACKGROUND: Diabetes affects a significant proportion of the population in the United States. Microsurgical procedures are common in this patient population, and despite many conflicting reports in the literature, there are no large studies evaluating the direct association between diabetes and outcomes, specifically failure, following free flap reconstruction. In this study, we sought to determine the impact of diabetes on postoperative outcomes following free flap reconstruction using a national multi-institutional database...
May 2, 2018: Microsurgery
https://www.readbyqxmd.com/read/29719062/the-facial-artery-perforator-flap-for-intraoral-reconstruction-of-a-mouth-floor-defect
#5
Ricardo Horta, Sergio Teixeira, Ricardo Nascimento, Alvaro Silva, Jose Amarante
Facial artery perforator flaps have been recently reported by different authors for perioral, nasal alar and cheek defects, but not for intraoral reconstruction. We have extended the use of the facial artery perforator flap in a 56-year-old man with a squamous cell carcinoma of left mouth floor, who was submitted to tumor resection with marginal mandibulectomy and left supraomohyoid neck dissection. The flap was designed according to the size of the defect (5 × 3 cm), centered on the perforator to create a symmetric flap and was tunnelled intraorally by means of a 90° rotation...
May 2, 2018: Microsurgery
https://www.readbyqxmd.com/read/29664209/vein-wrapping-technique-for-side-to-end-anastomosis-in-lymphatic-venous-anastomosis
#6
LETTER
Motoi Kato
No abstract text is available yet for this article.
April 17, 2018: Microsurgery
https://www.readbyqxmd.com/read/29664183/posterior-tibial-perforators-relationship-with-superficial-nerves-and-veins-a-cadaver-study
#7
Antonio Bulla, Alberto Bolletta, Luca Fiorot, Matteo Maffei, Pasquale Bandiera, Vincent Casoli, Andrea Montella, Gian Vittorio Campus
BACKGROUND: Most authors have evaluated the location of lower leg arterial perforators, but little is still known about the relationship between the arterial network and great saphenous vein (GSV) and saphenous nerve (SN). The aim of this study is to evaluate the relationship between the arterial network of the posterior tibial artery perforators, the cutaneous nerves, and the superficial venous system in the lower one third of the leg. METHODS: Eighteen lower limbs from cadavers were used for this study...
April 17, 2018: Microsurgery
https://www.readbyqxmd.com/read/29656450/comments-on-perioperative-pain-management-after-fibular-free-flap-harvesting-for-head-and-neck-reconstruction-using-mini-catheters-to-inject-local-anesthetic-a-pilot-study
#8
LETTER
https://www.readbyqxmd.com/read/29656387/a-nationwide-analysis-of-30-day-adverse-events-unplanned-readmission-and-length-of-hospital-stay-after-peripheral-nerve-surgery-in-extremities-and-the-brachial-plexus
#9
Enrico Martin, Ivo S Muskens, Joeky T Senders, David J Cote, Timothy R Smith, Marike L D Broekman
BACKGROUND: Little is known on adverse events and their timing after peripheral nerve surgery in extremities. The aim of this study is to identify predictors and typical timing of complications, unplanned readmission, and length of hospital stay for patients undergoing peripheral nerve surgery in the extremities. METHODS: Data were extracted from the National Surgical Quality Improvement Program (NSQIP) registry from 2005 to 2015. Adult patients undergoing peripheral nerve surgery in the extremities were included...
April 15, 2018: Microsurgery
https://www.readbyqxmd.com/read/29624731/a-novel-microsurgical-rodent-model-for-the-transplantation-of-engineered-cardiac-muscle-flap
#10
Richard Tee, Wayne Allan Morrison, Rodney J Dilley
BACKGROUND: The survival of engineered cardiac muscle 'grafts' to the epicardium is limited by vascularization post-transplantation in rat models. In this article, we describe the methodology of a novel rat model that allows for the transplantation of an engineered cardiac muscle flap (ECMF) onto the epicardium. MATERIALS AND METHODS: A total of 40 rats were used. Twenty-four neonatal rats were used to harvest cardiomyocytes. At week 1, ECMF were generated by seeding cardiomyocytes into the arteriovenous loop (AVL) tissue engineering chamber implanted into the right groin of adult rats (n = 8)...
April 6, 2018: Microsurgery
https://www.readbyqxmd.com/read/29603787/intraoperative-use-of-indocyanine-green-angiography-for-selecting-the-more-reliable-perforator-of-the-anterolateral-thigh-flap-a-comparison-study
#11
Simone La Padula, Barbara Hersant, Jean Paul Meningaud
INTRODUCTION: Anatomical variability of anterolateral thigh flap (ALT) perforators has been reported. The aim of this study is to assess if the use of intraoperative indocyanine green angiography (iICGA) can help surgeons to choose the ALT flap best perforator to be preserved. PATIENTS AND METHODS: A retrospective study was conducted in 28 patients with open tibial fracture, following a road traffic crash, who had undergone ALT flap. Patients were classified into two groups: ICGA group (iICGA was used to select the more reliable perforator) and control group...
March 30, 2018: Microsurgery
https://www.readbyqxmd.com/read/29603352/comparison-of-symmetry-after-smile-reconstruction-for-flaccid-facial-paralysis-with-combined-fascia-lata-grafts-and-functional-gracilis-transfer-for-static-suspension-or-gracilis-transfer-alone
#12
Jurij Kiefer, David Braig, Jan R Thiele, Holger Bannasch, G Björn Stark, Steffen U Eisenhardt
PURPOSE: Facial paralysis has a profound impact on functionality and esthetics of the oral region. In patients with strong skin laxity and soft tissue ptosis, functional smile reconstruction is challenging due to the accentuated asymmetry at rest. Thus, the purpose of the study was to analyze facial symmetry in this patient clientele following a combination of dynamic reanimation with fascial strips for static suspension compared to functional gracilis transfer alone. METHODS: In 2014, we altered the single-stage approach for microsurgical smile reconstruction in patients with significant soft tissue ptosis by adding fascia lata grafts for static support...
March 30, 2018: Microsurgery
https://www.readbyqxmd.com/read/29600516/obliquely-arranged-double-skin-paddles-a-novel-design-to-reconstruct-extensive-head-and-neck-defects-with-a-single-fibula-or-peroneal-flap
#13
Ying-Sheng Lin, Wen-Chung Liu, Kuan-Ying Wang, Yaoh-Shiang Lin, Kuo-Chung Yang
OBJECTIVE: To reconstruct extensive head and neck defects usually necessitates double free flaps, which require a time-and-manpower-consuming surgical procedure. We present using a single fibula or peroneal flap with the novel design of obliquely-arranged double skin paddles to reconstruct an extensive head and neck defect. METHODS: From 1998 to 2016, eight patients with the age of 52.25 (35-71) years old had extensive head and neck defects after oral cancer ablation...
March 30, 2018: Microsurgery
https://www.readbyqxmd.com/read/29577423/intraoperative-evaluation-of-perfusion-in-free-flap-surgery-a-systematic-review-and-meta-analysis
#14
REVIEW
Jan Maerten Smit, Vera L Negenborn, Sanne M Jansen, Mariëlle E H Jaspers, Ralph de Vries, Martijn W Heymans, Hay A H Winters, Ton G van Leeuwen, Margriet G Mullender, Nicole M A Krekel
BACKGROUND: Free flap survival relies on adequate tissue perfusion. We aim to give an overview of the available literature of all objective methods to intraoperatively assess free flap tissue perfusion, and the effects on (partial) flap loss. METHODS: A systematic review and meta-analysis according to the PRISMA guidelines was performed (PubMed, Cochrane Library, Embase) regarding English language articles. Meta-analyses were performed by pooling means and slopes using random-effect models...
March 25, 2018: Microsurgery
https://www.readbyqxmd.com/read/29577379/a-free-anterolateral-thigh-flap-for-pharyngeal-reconstruction-following-dynamic-hip-screw-femur-fixation
#15
LETTER
Benjamin L Smith, Timothy P Crowley, Maniram Ragbir
No abstract text is available yet for this article.
March 25, 2018: Microsurgery
https://www.readbyqxmd.com/read/29575166/anatomy-of-medial-plantar-superficial-branch-artery-perforators-facilitation-of-medial-plantar-superficial-branch-artery-perforator-mpap-flap-harvesting-and-design-for-finger-pulp-reconstruction
#16
Suphalerk Lohasammakul, Chairat Turbpaiboon, Kongkrit Chaiyasate, Parin Tatsanavivat, Supin Chompoopong, Ali Roham, Rosarin Ratanalekha, Chongdee Aojanepong
BACKGROUND: Medial plantar artery perforator (MPAP) flap was proposed as proper option for finger pulp reconstruction. To provide the previously unavailable vessel information required for this small flap design, this study aimed to gather all necessary anatomy of MPA, MPAP, and their territories of blood supply to apply in clinical MPAP flap reconstruction minimizing perforator injury. METHODS: Dissection of 30 Thai cadaveric feet for visualizing superficial branch of MPA and its perforators (MPAP) using acrylic dye cannulation were performed...
March 25, 2018: Microsurgery
https://www.readbyqxmd.com/read/29575014/vision-testing-in-microsurgery-subspecialties-does-it-matter
#17
LETTER
Sofia Androudi, Anna Dastiridou, Marilita M Moschos, Periklis Brazitikos
No abstract text is available yet for this article.
March 25, 2018: Microsurgery
https://www.readbyqxmd.com/read/29537712/laser-doppler-imaging-as-additional-monitoring-after-digital-replanting-a-prospective-study
#18
Marc Schmid, S Morteza Seyed Jafari, Luzian Haug, Carsten Surke, Robert E Hunger, Dimitri Van De Ville, Bettina Juon Personeni, Maziar Shafighi, Esther Voegelin
BACKGROUND: Despite various exisiting monitoring methods, there is still a need for new technologies to improve the quality of post-operative evaluation of digital replantation. The purpose of the study is using a laser Doppler imaging device (Easy-LDI) as an additional tool to assess perfusion. In this method, the changes in the frequency of the laser ligth provide information regarding perfusion of the monitored tissue. PATIENTS AND METHODS: This study included seven patients (10 fingers; age of patients: 21-57 years) who suffered from a total (n = 6) or subtotal amputation (n = 4) due to accidents...
March 14, 2018: Microsurgery
https://www.readbyqxmd.com/read/29537102/using-a-kidney-pump-to-perfuse-a-free-filet-flap-for-reconstruction-after-hemipelvectomy-a-case-report
#19
Katharine M Hinchcliff, Jessica Crockett, Steven W Thorpe, Christopher O Bayne
Long ischemia times adversely affect free flap survival, and large muscle flaps are particularly vulnerable. Hypothermic machine perfusion (HMP) is a well-established method of organ preservation, and recent literature has detailed the use of HMP to extend free flap ischemia times, predominantly in the laboratory setting. One limitation in the study and adoption of free flap HMP has been the availability of standardized perfusion machinery, as thus far institutions have built their own devices. We present a case of a 75-year-old woman with dedifferentiated chondrosarcoma of her right proximal femur...
March 14, 2018: Microsurgery
https://www.readbyqxmd.com/read/29520951/decreasing-alt-donor-site-morbidity-with-the-keystone-flap
#20
Sergey Y Turin, Jamie A Spitz, Karina Alexander, Marco F Ellis
BACKGROUND: The anterolateral thigh (ALT) flap is a workhorse flap for a variety of wounds. The primary disadvantage of ALT flaps is donor site morbidity associated with large skin paddle defects. We present a strategy of managing the donor site with the Keystone flap to avoid skin grafts in cases where primary closure is not possible. METHODS: A retrospective, multi-institutional review from December 2015 to March 2017 based on a single surgeon's experience was performed...
March 9, 2018: Microsurgery
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