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Microsurgery

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https://www.readbyqxmd.com/read/28066911/outcomes-of-microvascular-free-tissue-transfer-in-twice-irradiated-patients
#1
Kate Clancy, Sami Melki, Musaddiq Awan, Shawn Li, Pierre Lavertu, Nicole Fowler, Min Yao, Rod Rezaee, Chad A Zender
BACKGROUND: Patients may require microvascular free tissue transfer (MFTT) following re-irradiation for recurrent cancer or radiation complications. The objective of this study was to describe the indications for and outcomes of free flaps performed in twice-radiated patients. METHODS: A retrospective chart review identified the indications for and outcomes of 36 free flaps performed on 29 twice-irradiated patients. RESULTS: The free flap success rate was 92%...
January 9, 2017: Microsurgery
https://www.readbyqxmd.com/read/28052404/perineal-reconstruction-with-multiple-perforator-flaps-based-on-anatomical-divisions
#2
Joon P Hong, Chang G Kim, Hyun S Suh, Hoon Kim, Chi S Yoon, Kyu N Kim
PURPOSE: Reconstruction of perineal defects remains a challenge because such defects can be extensive, complex, and three-dimensional. This report presents a retrospective review of our past 5 years of experience in perineal reconstruction, and suggests a simple algorithmic approach according to anatomical divisions with multiple pedicled perforator flaps for extensive perineal defects. METHODS: From January 2011 to December 2015, 16 patients, including 5 men and 11 women, underwent reconstruction of extensive perineal defects...
January 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/28052401/microsurgical-precision-grip-and-spring-instrument-with-a-ring-supporter
#3
LETTER
Ricardo Ordorica-Flores, Arturo Minor-Martínez, Fernando Pérez-Escamirosa, Daniel Lorias-Espinoza
No abstract text is available yet for this article.
January 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/28052381/the-lateral-calcaneal-artery-as-an-alternative-recipient-vessel-option-for-heel-and-lateral-foot-reconstruction
#4
Kyong-Je Woo, Jin-Woo Park, Goo-Hyun Mun
BACKGROUND: Clinical outcomes of consecutive use of the lateral calcaneal artery (LCA) as a recipient vessel for microsurgical reconstruction have not been reported. This study aimed to evaluate the feasibility and safety of the LCA as a recipient vessel for microsurgical foot reconstruction based on anatomical study of CT angiography and clinical results of using this vessel as the recipient. METHODS: Anatomic study was performed using CT angiography of 61 lower extremities (31 patients)...
January 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/28052379/supermicrosurgical-lymphaticovenous-anastomosis-for-a-patient-with-breast-lymphedema-secondary-to-breast-cancer-treatment
#5
Guido Giacalone, Takumi Yamamoto
Breast lymphedema (BLE) has been reported as a complication following breast cancer treatment. As for extremity lymphedema treatment, supermicrosurgical lymphaticovenous anastomosis (LVA) is considered an option for the treatment of progressive BLE refractory to conservative treatments, but no case has been reported so far. We report the first case of BLE successfully treated with supermicrosurgical LVA. A 55-year-old female presented with left BLE after breast conserving surgery and axillary lymph node dissection and adjuvant radiotherapy...
January 3, 2017: Microsurgery
https://www.readbyqxmd.com/read/28035702/refinements-of-nerve-repair-with-connector-assisted-coaptation
#6
REVIEW
Ivica Ducic, Bauback Safa, Erick DeVinney
Peripheral nerve repair can be very rewarding for both surgeon and patient when expected outcomes are achieved. In many cases, however, the results are suboptimal due to number of possible objective and technical reasons. Although we cannot influence patent's comorbidities, the extent or mechanism of the nerve injury, we may help optimize technical details when aiming towards improved outcomes. While the suture coaptation for primary nerve repair or nerve reconstruction with grafting served as the reconstructive standard for many decades, technical imperfections remain threats to reconstructive goals...
December 30, 2016: Microsurgery
https://www.readbyqxmd.com/read/28032653/a-simple-technique-for-introducing-small-diameter-vessels-into-a-coupler-device
#7
LETTER
Matthew Philip Murphy, Niall Michael Mc Inerney, Katherine Mary Browne, Robert Henry Caulfield, Richard Patrick Hanson
No abstract text is available yet for this article.
December 29, 2016: Microsurgery
https://www.readbyqxmd.com/read/28026918/upper-and-lower-extremity-reconstructive-applications-utilizing-free-flaps-from-the-medial-genicular-arterial-system-a-systematic-review
#8
Nikolas H Kazmers, Stephanie Thibaudeau, Zvi Steinberger, L Scott Levin
BACKGROUND: Free flaps derived from the medial genicular artery (MGA) system, including the medial femoral condyle (MFC) and medial femoral trochlear (MFT) flaps, are potential reconstructive options to address upper and lower extremity bony pathology. Our primary aim was to comprehensively search the literature to describe the spectrum of pathology treated with these flaps, and to assess patient outcomes to improve our understanding of expected union and complication rates. METHODS: Following PRISMA guidelines, a systematic review using Pubmed and Embase databases with citation cross-referencing was performed to identify all original clinical articles characterizing MGA flap treatment of upper and lower extremity pathology...
December 27, 2016: Microsurgery
https://www.readbyqxmd.com/read/28019023/academic-productivity-of-faculty-associated-with-microsurgery-fellowships
#9
Qing Zhao Ruan, Joseph A Ricci, Jason Silvestre, Olivia A Ho, Bernard T Lee
BACKGROUND: The Hirsch index (h-index) is widely recognized as a reliable measure of academic productivity. While previous studies have applied the h-index to surgical disciplines, none have analyzed microsurgery faculty. This manuscript aims to examine the h-index of microsurgery fellowship faculty to categorize its applicability to microsurgeons as a determinant of academic output. METHODS: Faculty demographics and institution characteristics were obtained from the American Society of Reconstructive Microsurgery (ASRM) and official program websites...
December 26, 2016: Microsurgery
https://www.readbyqxmd.com/read/28008654/application-of-a-multi-directional-transformable-retractor-for-lymphatic-supermicrosurgery-using-seki-method
#10
LETTER
Takumi Yamamoto, Nana Yamamoto, Ryohei Ishiura
No abstract text is available yet for this article.
December 23, 2016: Microsurgery
https://www.readbyqxmd.com/read/27991695/application-of-extended-bi-pedicle-anterolateral-thigh-free-flaps-for-reconstruction-of-large-defects-a-case-series
#11
Michele Maruccia, Georgios Orfaniotis, Pedro Ciudad, Fabio Nicoli, Emanuele Cigna, Giuseppe Giudice, Kidakorn Kiranantawat, Diego Ribuffo, Hung-Chi Chen
BACKGROUND: The anterolateral thigh flap is a workforce flap in reconstructive surgery, however, variations in it is vascular anatomy are not uncommon. These variations may affect flap design and survival, especially when large flaps are required. In some anatomical variants the anterolateral thigh flap is supplied by two separate dominant pedicles, and in these cases a bi-pedicle modification may be necessary to ensure complete flap viability. The aim of this report is to evaluate the outcomes, and present our approach in using bi-pedicle anterolateral thigh flaps as a method to reduce the risk of partial flap necrosis when reconstructing sizeable soft tissue defects...
December 19, 2016: Microsurgery
https://www.readbyqxmd.com/read/27987254/application-of-free-serratus-anterior-fascial-flap-for-reconstruction-of-ear-deformity-due-to-hemifacial-microsomia-a-report-of-two-cases
#12
Takashi Nuri, Koichi Ueda, Akira Yamada
Reconstructing congenital auricular defects due to hemifacial microsomia (HFM) is often required to deal with low hairline and defects of the temporal fascia/muscular systems. In this report, we present two cases of HFM patients (16-year-old and 20-year-old) with positional anomaly of the remnant lobule and 95% low hairline, who were treated with serratus anterior fascial flap (SFF) at the second stage of auricular construction. At the first stage, 3D costal cartilage framework was placed following the removal of hair-bearing skin, and was resurfaced with the pericranial flap...
December 17, 2016: Microsurgery
https://www.readbyqxmd.com/read/27987230/the-lymphatic-superficial-circumflex-iliac-vessels-deep-branch-perforator-flap-a-new-preventive-approach-to-lower-limb-lymphedema-after-groin-dissection-preliminary-evidence
#13
Stefano Gentileschi, Maria Servillo, Giorgia Garganese, Simona Fragomeni, Francesca De Bonis, Alessandro Cina, Giovanni Scambia, Marzia Salgarello
OBJECTIVE: Groin dissection is the procedure with the highest risk of lower limb lymphedema.As lymph stasis causes irreversible alterations to the limb over time,therapies should be administered in early stages,or better yet, lymphatic drainage impairment should be prevented.We developed a new preventive approach to lymphedema after groin dissection, and we report our preliminary experience. PATIENTS AND METHODS: We enrolled 5 patients undergoing bilateral groin dissection for vulvar cancer...
December 17, 2016: Microsurgery
https://www.readbyqxmd.com/read/27935644/to-reverse-or-not-to-reverse-a-systematic-review-of-autograft-polarity-on-functional-outcomes-following-peripheral-nerve-repair-surgery
#14
REVIEW
S E Roberts, S Thibaudeau, J C Burrell, E L Zager, D K Cullen, L S Levin
BACKGROUND: The literature describing the best clinical practice for proximal-distal autograft orientation, otherwise known as nerve graft polarity, is inconsistent. With existing disparities in the peripheral nerve literature, the clinical question remains whether reversing nerve autograft polarity bears an advantage for nerve regeneration. METHODS: A comprehensive review of the literature using Embase and PubMed databases (1940-June 2015) was performed to retrieve all original articles on the effects of nerve autograft polarity on nerve regeneration and functional recovery following primary repair of peripheral nerve defects...
December 9, 2016: Microsurgery
https://www.readbyqxmd.com/read/27911477/vascularized-appendicular-lymph-node-transfer-for-treatment-of-extremity-lymphedema-a-case-report
#15
Pedro Ciudad, Oscar J Manrique, Shivprasad Date, Wei-Ling Chang, Fabio Nicoli, Stamatis Sapountzis, Hsu-Tang Cheng, Mouchammed Agko, Hung-Chi Chen
Vascularized lymph node transfer has demonstrated promising results for the treatment of extremity lymphedema. In an attempt to find the ideal donor site, several vascularized lymph nodes have been described. Each has a common goal of decreasing morbidity and avoiding iatrogenic lymphedema while obtaining good clinical results. Herein, we present the preliminary clinical outcomes of an intra-abdominal lymph node flap option based on the appendicular artery and vein used for the treatment of extremity lymphedema...
December 2, 2016: Microsurgery
https://www.readbyqxmd.com/read/27898199/microsurgical-reconstruction-in-patients-greater-than-80-years-old
#16
Paul I Heidekrueger, Albrecht Heine-Geldern, Milomir Ninkovic, Frank Herter, Daniel Schmauss, Thiha Aung, P Niclas Broer
BACKGROUND: Demographic change implies that the human population is getting older and the elderly are living longer. Consequently, achieving good functional and aesthetic outcomes in microvascular procedures, especially in very old patients with higher incidence of atherosclerosis and vessel calcifications, constitutes a microsurgical challenge. This study evaluates the feasibility of microsurgical procedures in a very old patient cohort. PATIENTS AND METHODS: Between 2009 and 2015, 754 patients underwent 838 free flap reconstructions...
November 29, 2016: Microsurgery
https://www.readbyqxmd.com/read/27880017/comparison-of-the-outcomes-of-free-jejunal-flap-reconstructions-of-pharyngoesophageal-defects-in-hypopharyngeal-cancer-and-corrosive-injury-patients
#17
Mu-Han Hsieh, Yun-Tai Yang, Yueh-Ju Tsai, Yur-Ren Kuo, Pao-Yuan Lin
INTRODUCTION: Free jejunal flap is one of the optimal choices for restoring upper digestive tract. The purpose of this study was to introduce the treatment strategies and to compare the outcomes of free jejunal flap for pharyngoesophageal reconstruction between hypopharyngeal cancer and chemical corrosive injured esophagus. METHODS: From 2001 to 2012, patients who had been received esophageal reconstruction by free jejunal flap for pharyngoesophageal defect were divided into squamous cell carcinoma (SCC) group and corrosive chemical injury (CCI) group...
November 23, 2016: Microsurgery
https://www.readbyqxmd.com/read/27859622/effects-of-hptp%C3%AE-inhibitor-on-microcirculation-of-rat-cremaster-muscle-flap-following-ischemia-reperfusion-injury
#18
Fatih Zor, Cem Meric, Maria Siemionow
INTRODUCTION: Inhibition of protein tyrosine phosphatases (PTP) enhances endothelial receptor tyrosine kinases activation and may have beneficial effects on vessel growth and improve blood flow to ischemic tissue. The purpose of this study is to determine influence of hPTPß inhibitors on ischemia-reperfusion injury in muscle flap. MATERIALS AND METHODS: Following cremaster muscle dissection, 60 rats divided into 10 experimental groups (placebo and treatment groups following 0, 1, 2, 3, and 4 h of ischemia)...
November 17, 2016: Microsurgery
https://www.readbyqxmd.com/read/27859595/recipient-bone-marrow-derived-stromal-cells-prolong-graft-survival-in-a-rat-hind-limb-allotransplantation-model
#19
Ryosuke Ikeguchi, Ryosuke Kakinoki, Souichi Ohta, Hiroki Oda, Hirofumi Yurie, Yukitoshi Kaizawa, Hiroto Mitsui, Tomoki Aoyama, Junya Toguchida, Shuichi Matsuda
BACKGROUND: Recent studies have indicated that bone marrow-derived stromal cells (BMSCs) have immunomodulatory properties that suppress the T cell responses that cause graft rejection. The purpose of this study is to evaluate the effect of recipient BMSCs intravenous infusion for immunomodulation in a rat vascularized composite allotransplantation model. METHODS: A total of nine Wistar (WIS) rats and thirty Lewis (LEW) rats were used. BMSCs were harvested from three LEW rats...
November 17, 2016: Microsurgery
https://www.readbyqxmd.com/read/27862251/anatomic-variability-of-the-lateral-femoral-cutaneous-nerve-value-of-3t-mri-in-identifying-anomaly-for-surgical-intervention
#20
Jan Fritz, Denniz Zolnoun, A Lee Dellon
The anatomic variability of the lateral femoral cutaneous nerve (LFC) creates diagnostic as well as therapeutic problems. A case is reported in which a woman with complaints of pain in the anterior and lateral thigh was referred for evaluation. Symptoms arose after an abdominal hysterectomy. Her symptoms were the territory of the LFC and not of the L2/L3 dermatome. She had a Tinel sign that was positive for the LFC skin territory, but this was located over the anterior superior iliac spine (ASIS), instead of medial to it...
November 11, 2016: Microsurgery
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