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Microsurgery

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https://www.readbyqxmd.com/read/29232006/reconstruction-of-a-large-full-thickness-abdominal-wall-defect-with-flow-through-based-alt-flaps-a-case-report
#1
Dong Yeon Kim, Junho Lee, Jeong Tae Kim, Hye Kyung Chang, Suk-Ho Moon
An extensive 35 × 20 cm sized full-thickness abdominal wall defect was created after resection of aggressive abdominal fibromatosis in a 19-year-old male patient. Immediate reconstruction was not possible due to prolonged operation time and resulting severe bowel edema. A silicone sheet with NPWT was applied over the exposed viscera. After 1 week, silicone sheet was substituted with a composite mesh. Then, abdominal wall reconstruction with bilateral free anterolateral thigh (ALT) flaps (30 × 12 cm and 25 × 12 cm sized) was performed...
December 12, 2017: Microsurgery
https://www.readbyqxmd.com/read/29230869/microvascular-replantation-of-a-composite-facial-avulsion-in-a-24-month-old-child-after-dog-bite
#2
David Macias, Daniel I Kwon, Paul C Walker, Nathaniel R Peterson
Dog bite injuries are common sources of morbidity with an estimated incidence of 4.5 million bites per year with over 350,000 requiring treatment in the emergency room. Children under the age of 14 are most likely to be affected with a peak age of 5-9 years old. We report a case of a 24-month-old female who sustained a large composite facial avulsion injury from a pit bull dog bite. The avulsed tissue involved a substantial portion of the patient's mid-face, including the entire soft tissue of the nose, upper lip, part of the left cheek, and left oral commissure...
December 12, 2017: Microsurgery
https://www.readbyqxmd.com/read/29218849/reconstruction-of-full-thickness-cheek-defect-with-chimeric-facial-artery-free-flap-a-case-report
#3
Olindo Massarelli, Luigi Angelo Vaira, Roberta Gobbi, Giovanni Dell'aversana Orabona, Giacomo De Riu
Full-thickness cheek defects represent a difficult challenge for reconstructive surgeons. Multiple techniques have been described, including local, regional, and free flaps. In this report, the reconstruction of a through and through left cheek defect, resulting from a self-inflicted gunshot injury, with a chimeric facial artery free flap is presented. The patient underwent reconstruction with a chimeric full-thickness facial artery free flap, with 9 × 3 cm diameter skin paddle and a 6 × 5 cm myomucosal paddle, was harvested on the contralateral cheek with a 7-cm length of facial pedicle...
December 8, 2017: Microsurgery
https://www.readbyqxmd.com/read/29218804/impact-of-diabetes-on-free-flap-surgery-of-the-head-and-neck-a-nsqip-analysis
#4
Jacob S Brady, Aparna Govindan, Meghan M Crippen, Andrey Filimonov, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVE: Diabetes is associated with microvascular pathology and may predispose patients undergoing microvascular surgery to complications. This study assesses diabetes as a risk factor for complications following free flap surgery of the head and neck. PATIENTS AND METHODS: In this retrospective cohort study, data on free flap surgeries of the head and neck between 2005 and 2014 was collected from the National Surgical Quality Improvement Program (NSQIP) database...
December 8, 2017: Microsurgery
https://www.readbyqxmd.com/read/29214678/pedicled-iliac-crest-bone-flap-transfer-for-the-treatment-of-upper-femoral-shaft-fracture-nonunion-an-anatomic-study-and-clinical-applications
#5
Dewei Zhao, Meng Cao, Tienan Wang, Benjie Wang, Baoyi Liu, William C Lineaweaver
PURPOSE: We present the results of a study on the anatomy of the ascending branch of the lateral circumflex femoral artery (AB-LCFA) and the use of the pedicled iliac bone flap transfer perfused by AB-LCFA combined with external fixation for the treatment of the nonunion of upper femoral shaft fractures. METHODS: The orientation, diameter, length, and distribution of the AB-LCFA from 40 lower limbs of adult cadavers were dissected and measured. From 2000 to 2012, 13 patients with nonunion of upper femoral shaft fractures underwent pedicled iliac bone flap transfer perfused by the AB-LCFA combined with external fixation...
December 7, 2017: Microsurgery
https://www.readbyqxmd.com/read/29205488/single-stage-functional-reconstruction-of-both-peroneal-tendons-and-overlying-skin-with-an-anterolateral-thigh-flap-and-vascularized-fascia-lata-a-case-report
#6
Efstathios G Lykoudis, Ioannis Dalianoudis, Konstantinos Seretis, George E Lykoudis, Marios G Lykissas
Reconstruction of complex soft tissue defects in the distal lower leg remains challenging, since anatomical constraints limit the local options available in this area. In this report, we present a case of single stage functional reconstruction of both peroneal tendons and overlying skin with an anterolateral thigh flap and vascularized fascia lata. A 55-year-old patient underwent wide excision of a synovial sarcoma in the distal lower leg, which resulted in a complex defect including the peroneus longus and brevis tendons (10 cm), and the overlying skin (14 × 8 cm)...
December 3, 2017: Microsurgery
https://www.readbyqxmd.com/read/29194743/optimizing-venous-outflow-in-reconstruction-of-gustilo-iiib-lower-extremity-traumas-with-soft-tissue-free-flap-coverage-are-two-veins-better-than-one
#7
John T Stranix, Z-Hye Lee, Lavinia Anzai, Adam Jacoby, Tomer Avraham, Pierre B Saadeh, Jamie P Levine, Vishal D Thanik
PURPOSE: The dependent nature of the lower extremity predisposes to venous congestion, especially following significant trauma. The benefit of a second venous anastomosis, however, remains unclear in lower extremity trauma free flap reconstruction. This study investigated the effect of an additional venous anastomosis on flap outcomes in lower extremity trauma reconstruction. METHODS: Retrospective review between 1979 and 2016 identified 361 soft tissue flaps performed for Gustilo IIIB/C coverage meeting inclusion criteria...
November 30, 2017: Microsurgery
https://www.readbyqxmd.com/read/29193270/comments-on-ileocecal-vascularized-lymph-node-transfer-for-the-treatment-of-extremity-lymphedema-a-case-report
#8
LETTER
Andrej Ring, Josef Stern, George Udrescu
No abstract text is available yet for this article.
November 29, 2017: Microsurgery
https://www.readbyqxmd.com/read/29193255/evaluation-of-the-single-medial-circummuscular-perforator-diep-flap-outcomes-and-comparison-to-traditional-transmuscular-single-perforator-flap
#9
Jessica F Rose, Dmitry Zavlin, Amanda E Garrett, Vishwanath Chegireddy, Warren A Ellsworth
INTRODUCTION: Successful breast reconstruction using deep inferior epigastric perforator (DIEP) flaps depends on optimal perforator choice. Circummuscular wraparound medial perforators allow for no rectus dissection and minimal fascial incisions, often presenting as an ideal option. The aim of our study is to evaluate outcomes of the single medial wraparound perforator flap in comparison to more traditional transmuscular single-perforator DIEP flaps. PATIENTS AND METHODS: A retrospective chart review was conducted of all DIEP flaps performed by the senior author from 2011 to 2016, yielding 269 flaps on 157 patients...
November 29, 2017: Microsurgery
https://www.readbyqxmd.com/read/29193249/turbocharged-bilateral-pedicled-diep-flap-for-reconstruction-of-thigh-defect-without-recipient-vessels-a-case-report
#10
Manuel Fernández Garrido, Nicolás Pereira, Susana López Fernández, Carmen Vega, Jaume Masià
Reconstruction of thigh defects is usually straightforward, but in cases of poor soft tissue quality, free flap reconstruction is not possible due to the absence of recipient vessels. The turbocharge technique may increase the viable, vascularized area of a flap. In this report we present a case of the use of a turbocharged bilateral pedicled DIEP flap for reconstruction of thigh defect without recipient vessels. A 29-year-old woman who underwent neoadjuvant chemotherapy plus radiation therapy for a leiomyosarcoma on the left thigh...
November 29, 2017: Microsurgery
https://www.readbyqxmd.com/read/29178527/reconstruction-of-elbow-skin-and-soft-tissue-defects-using-perforator-pedicled-propeller-flaps
#11
Junichi Nakao, Hiroki Umezawa, Rei Ogawa, Musa A Mateev
BACKGROUND: The elbow is a challenging region to reconstruct functionally. Several closure methods for elbow wounds have been reported, including flap surgery. Here, we present the results obtained using a propeller flap pedicled by a posterior ulnar recurrence artery perforator (PURAP) or a radial collateral artery perforator (RCAP) for functional reconstruction of soft tissue defects in elbows. METHODS: Twenty-four patients with an average age of 27.0 years (range, 9-52 years) underwent elbow soft tissue reconstructions between 2005 and 2015...
November 27, 2017: Microsurgery
https://www.readbyqxmd.com/read/29178479/face-allotransplantation-for-various-types-of-facial-disfigurements-a-series-of-five-cases
#12
Ömer Özkan, Özlenen Özkan, Mehmetcan Ubur, Necmiye Hadimioğlu, Melike Cengiz, İsmail Afşar
BACKGROUND: The aim of this report is to present our long-term experiences with a series of 5 face-transplanted patients in terms of surgical aspects and postoperative outcomes, and to describe possible salvage strategies in case of difficulties. METHODS: Five patients, 4 receiving full-face transplantation and 1 undergoing partial transplantation at our institution were included. The patients were aged between 19 and 54 years. Two had extensive burn scars to the face, and 3 had suffered gunshot injuries...
November 27, 2017: Microsurgery
https://www.readbyqxmd.com/read/29152783/comparison-of-sub-versus-suprafascially-raised-anterolateral-thigh-free-flaps-with-regard-to-donor-site-morbidity-function-and-aesthetics
#13
Sebastian Fischer, Yannick Diehm, Christoph Hirche, Thomas Kremer, Adrien Daigeler, Ulrich Kneser, J Frederick Hernekamp
BACKGROUND: Although the anterolateral thigh flap (ALT) is one of the most frequently applied free flaps in plastic surgery, it remains controversial if the flap should be raised in a sub- or suprafascial plane. The purpose of this study was to compare both harvest techniques regarding donor-site morbidity and outcomes. METHODS: We included 40 pair-matched patients, of whom 20 received a fasciocutaneous and 20 an adipocutaneous ALT free flap for extremity reconstruction...
November 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/29134687/bone-reconstruction-a-history-of-vascularized-bone-transfer
#14
EDITORIAL
David S Sparks, Michael Wagels, G Ian Taylor
No abstract text is available yet for this article.
November 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/29131393/flap-monitoring-with-continuous-oxygen-partial-tension-measurement-in-breast-reconstructive-surgery-a-preliminary-report
#15
Emilio Trignano, Nefer Fallico, Luca Fiorot, Alberto Bolletta, Matteo Maffei, Pedro Ciudad, Michele Maruccia, Hung-Chi Chen, Gian Vittorio Campus
BACKGROUND: The best method for the postoperative monitoring of flaps in reconstructive surgery is still a matter of debate. The aim of this study is to evaluate the usefulness of an oxygen partial tension monitoring system for the postoperative follow-up of a series of breast flaps, in addition to the traditional periodical clinical evaluations. PATIENTS AND METHODS: Twenty-one consecutive female patients (mean age: 61 years) who underwent free- or pedicled-flap reconstruction of the breast were included in the study...
November 13, 2017: Microsurgery
https://www.readbyqxmd.com/read/29131389/a-new-porcine-vascularized-tibial-bone-allotransplantation-model-anatomy-and-surgical-technique
#16
Dimitra Kotsougiani, Joost I Willems, Alexander Y Shin, Patricia F Friedrich, Caroline A Hundepool, Allen T Bishop
INTRODUCTION: Vascularized bone allotransplantation may provide new options for reconstruction of segmental defects if problems of long-term immune modulation can be solved. The current literature lacks an orthotopic large animal model, limited to bone and without the confounding effects of other tissue types, permitting a multifaceted evaluation before new methods are used clinically. The purpose of this study was to develop a large animal model for vascularized bone allotransplantation...
November 13, 2017: Microsurgery
https://www.readbyqxmd.com/read/29131382/a-simple-and-effective-crepe-bandage-splinting-method-to-decrease-tension-after-large-superficial-circumflex-iliac-artery-perforator-scip-flap-donor-site-closure
#17
LETTER
Pedro Ciudad, Roshan Vijayan, Georgios Pafitanis, Luis Parra Pont, Burak Kaya, Mouchammed Agko, Oscar J Manrique, Wei-Ling Chang, Hung-Chi Chen
No abstract text is available yet for this article.
November 13, 2017: Microsurgery
https://www.readbyqxmd.com/read/29125707/vascularized-humeral-periosteal-flap-to-treat-lateral-humeral-condyle-nonunion-an-anatomical-study-and-report-of-two-successfully-treated-pediatric-cases
#18
S Sergi Barrera-Ochoa, Francisco Soldado, Alfonso Rodriguez-Baeza, Paula Diaz-Gallardo, Felipe Hodgson, Pablo S Corona, Jorge Knörr
PURPOSE: Nonunion is a common complication of lateral condyle humeral (LCH) fractures in children. In situ fixation with a screw and bone grafting is the classically-recommended method of treatment. The purpose of this study is to analyze the feasibility of obtaining a vascularized periosteal flap obtained from the lateral humerus and based on the posterior collateral radial vessels (PCRV). Second, to report the results after the application in two pediatric cases. METHODS: Periosteal branches of PCRV were studied in ten upper limbs from fresh human cadavers...
November 10, 2017: Microsurgery
https://www.readbyqxmd.com/read/29125661/eyelid-reanimation-using-crossface-nerve-graft-relationship-between-surgical-outcome-and-preoperative-paralysis-duration
#19
Masayuki Okochi, Hiromi Okochi, Emiko Asai, Takao Sakaba, Kazuki Ueda
BACKGROUND: To reanimate the mimetic muscles, crossface nerve graft (CFNG) is an effective surgical option. However, muscle atrophy after facial paralysis may influence the surgical result. We analyzed the relationship between surgical result and preoperative paralysis duration. METHODS: We performed CFNG on 15 patients. The sural nerve was transferred between the affected and nonaffected sides of the zygomatic branch. Eyelid function and eyelid lid were evaluated using the modified House-Brackmann scale...
November 10, 2017: Microsurgery
https://www.readbyqxmd.com/read/29111603/optimizing-outcomes-of-lymphatic-venous-anastomosis-lva-supermicrosurgery-by-preoperative-identification-of-reflux-free-vein-choose-the-vein-wisely
#20
LETTER
Mario F Scaglioni, Semra Uyulmaz
No abstract text is available yet for this article.
November 7, 2017: Microsurgery
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