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Ryusho Hamada, Akira Shinaoka, Narushi Sugiyama, Toshiyuki Watanabe, Yuki Miura, Yoshihiro Kimata
Despite various options for the reconstruction of soft tissue defects in the distal forearm, perforator-based propeller flap is rarely used. Here, we presented 2 cases of distal forearm injuries that were repaired using the recurrent branch of anterior interosseous artery perforator-based propeller flap. Patients in these cases were 57 and 67 years of age. Wounds resulting from farming machine injury and pyogenic extensor tenosynovitis following cat bite wounds were localized to the distal forearm and dorsum of the hand...
October 31, 2018: Microsurgery
Tomokazu Fukuda, Hirohisa Kusuhara, Takuya Nakagoshi, Noritaka Isogai, Yu Sueyoshi
BACKGROUND: A basic fibroblast growth factor (bFGF) slow-release system was combined to a biodegradable nerve conduit with the hypothesis this slow-release system would increase the capacity to promote nerve vascularization and Schwann cell proliferation in a rat model. MATERIALS AND METHODS: Slow-release of bFGF was determined using Enzyme-Linked ImmunoSorbent Assay (ELISA). A total of 60 rats were used to create a 10 mm gap in the sciatic nerve. A polyglycolic acid-based nerve conduit was used to bridge the gap, either without or with a bFGF slow-release incorporated around the conduit (n = 30 in each group)...
October 31, 2018: Microsurgery
Erhan Sönmez, Ersin Aksam, Mustafa Durgun, Onder Karaaslan
BACKGROUND: Posterior interosseous artery flap PIAF is one of the most preferred reconstructive options for upper extremity defects. As a reverse flap, venous congestion is always a threatening factor. In this report authors aimed to present their experience with venous super-drained posterior interosseous artery flap VS-PIAF. METHODS: Between January 2013 to September 17, 2017 patients were treated with VS-PIAF. Tumor excision, trauma, traffic accident, burn contracture release, and industrial injuries were the causes of defects...
October 31, 2018: Microsurgery
Wataru Kamei, Hajime Matsumine, Hironobu Osaki, Yoshifumi Ueta, Satoshi Tsunoda, Mari Shimizu, Kazuki Hashimoto, Yosuke Niimi, Mariko Miyata, Hiroyuki Sakurai
PURPOSE: Interpositional jump-graft (IPJG) technique with the hypoglossal nerve for supercharging can be applied in a facial nerve paresis case. In IPJG, an autologous nerve is required, and the donor site morbidity is unavoidable. Biodegradable nerve conduits are made from polyglycolic acid (PGA) and used recently without donor site complications after providing autologous grafts. Hybrid artificial nerve conduits with adipose-derived stem cells (ASCs) also attract attention as a nerve-regeneration enhancing agent...
October 31, 2018: Microsurgery
Ryo Karakawa, Hidehiko Yoshimatsu, Tomoyuki Yano, Masayuki Sawaizumi
No abstract text is available yet for this article.
October 31, 2018: Microsurgery
Amir K Bigdeli, Benjamin Thomas, Volker J Schmidt, Dimitra Kotsougiani, Frederick J Hernekamp, Christoph Hirche, Ulrich Kneser, Emre Gazyakan
BACKGROUND: Extensive soft-tissue defects affecting the knee region pose a significant reconstructive challenge and may require separate or multiple flaps for coverage. We evaluated the conjoined parascapular and latissimus dorsi free flap as an alternative reconstructive option. METHODS: From January 2013 to December 15, 2016 patients (7 female and 8 male) with a mean age of 47.5 years underwent reconstruction of such defects. Causes were trauma (12 cases) and infection (3 cases)...
October 25, 2018: Microsurgery
Beniamino Brunetti, Stefania Tenna, Mauro Barone, Gabriella Cassotta, Manuele Casale, Paolo Persichetti
INTRODUCTION: Many techniques have been described to treat full thickness nasal defects. The authors introduce the bipaddle chimaeric forehead flap (BCFF), a new alternative technique to achieve simultaneous lining and cutaneous reconstruction in case of full thickness hemi-nasal defects, presenting surgical details and applications for its clinical use. PATIENTS AND METHODS: From June 2015 to April 2017, 10 patients presenting with oncological full thickness defects involving nasal sidewall and/or nasal ala were reconstructed with the BCFF technique...
September 16, 2018: Microsurgery
Kensuke Tashiro, Masaki Arikawa, Yutaka Fukunaga, Fumihiko Nakatani, Eisuke Kobayashi, Akira Kawai, Shimpei Miyamoto
INTRODUCTION: External hemipelvectomy is one of the most extensive surgical procedures for locally advanced pelvic tumors. Stump coverage with the local tissues can be difficult in recurrent cases. Herein, we report our experience with immediate stump coverage using a free latissimus dorsi musculocutaneous (LDMC) flap after external hemipelvectomy for recurrent pelvic malignancies. METHODS: Six patients underwent external hemipelvectomy and immediate reconstruction using a free LDMC flap between November 2012 and June 2017...
September 6, 2018: Microsurgery
Oscar Ochoa, Michael Metzner, Constantine Theoharis, Minas Chrysopoulo, Steven Pisano, Chet Nastala, Peter Ledoux, Gary Arishita, Ramon Garza, Ted Snider
INTRODUCTION: Breast cancer-related extremity lymphedema is a potentially devastating condition. Vascularized lymph node transfer (VLNT) has shown benefit in lymphedema treatment. Due to concerns over potential iatrogenic complications, various donor sites have been described. The current study aims at defining the deep inferior epigastric lymph node basin as a novel donor site for VLNT. METHODS: A retrospective study was performed on patients undergoing routine abdominal-based breast reconstruction...
September 5, 2018: Microsurgery
Christopher R Davis, Lyn Jones, Rachel L Tillett, Helen Richards, Sherif M Wilson
BACKGROUND: Venous congestion is the principle cause of flap failure after microsurgical breast reconstruction. We aim to correlate preoperative computed tomography angiography (CTA) findings with postoperative venous congestion to predict patients at risk of congestion. METHODS: All patients undergoing deep inferior epigastric perforator (DIEP) breast reconstruction between August 2009 and August 2013 underwent preoperative CTA and prospectively entered the study...
September 5, 2018: Microsurgery
Yoon Jae Lee, Seung Eun Baek, Junho Lee, Deuk Young Oh, Jong Won Rhie, Suk-Ho Moon
BACKGROUND: The reconstruction of complex defects in the posterior trunk is a challenging problem. Various surgical methods using local flap, propeller flap, and muscle flap have been reported. However, in case where a free flap is inevitable, due to the absence of usable recipient vessels, eventually it may fail to perform or the use of long vessel graft is mandatory. To overcome this problem, we investigated use of perforator as recipient vessel in posterior trunk region and here we report satisfactory outcomes of the cases...
September 5, 2018: Microsurgery
Kian Adabi, Oscar J Manrique, Aparna Vijayasekaran, Steven L Moran, Pedro Ciudad, Tony C T Huang, Fabio Nicoli, Sarah Bishop, Hung-Chi Chen
INTRODUCTION: Reconstruction of abdominal wall defects with enterocutaneous fistulas (ECF) remains challenging. The purpose of this report is to describe a single-stage approach using combined microscopic enterolysis, pedicle seromuscular bowel flaps, mesh, fasciocutaneous, and myocutaneous flaps. METHODS: Between 1990 and 2016 a retrospective review identified a total of 18 patients with an average age of 39 years (ranging 26-59 years). Thirteen cases were associated with trauma, four were complication of previous mesh repair, and one was after an aortic dissection...
September 3, 2018: Microsurgery
Natalie A Krane, Scott H Troob, Mark K Wax
We report a case during which a new method of reconstruction for a nasopharyngeal and skull base defect was successfully performed. A 45-year-old female with granulomatosis with polyangiitis presented with computed tomography (CT) findings demonstrative of chronic clival and cervical spine osteomyelitis secondary to nasopharyngeal destruction. The posterior nasopharyngeal defect, evident as a wide area of mucosal erosion exposing the clivus centrally, was successfully reconstructed with an anterior serratus muscle-free tissue transfer via both transcervical and endoscopic transnasal approaches utilizing a laparoscopic fixation device, a previously unreported method for free flap inset, to secure the free flap...
September 3, 2018: Microsurgery
David Mattos, Jason H Ko, Matthew L Iorio
BACKGROUND: Osteomyelitis of the wrist is rare but destructive. Subsequent bone defects often require vascularized bone for successful healing. Recent literature has pointed to the successful use of the medial femoral condylar (MFC) flap for difficult non-unions, yet it has not been specifically described for wrist fusion. We present our experience with this technique for limited and complete wrist arthrodesis. PATIENTS AND METHODS: We reviewed 4 cases of radiocarpal bone loss from osteomyelitis...
September 3, 2018: Microsurgery
Sebastian Fischer, Yannick Diehm, Miguel I Dorante, Dimitra Kotsougiani, Maximilian Kueckelhaus, Muayyad Alhefzi, Ericka M Bueno, Bohdan Pomahac
INTRODUCTION: Assessment of outcomes after face transplantation (FT) is necessary to provide sound evidence on the benefits of this life-giving surgery. Current methods for outcomes assessment, however, are imprecise or prone to subjectivity. Software-based video analysis may allow fast, objective and retrospective assessment of restoration of facial movements and functions after FT. PATIENTS AND METHODS: We recorded videos of 7 subjects before as well as every 3-6 months after facial transplantation...
August 29, 2018: Microsurgery
Carsten Rendenbach, Friedemann Goehler, Lara Hansen, Carsten Kohlmeier, Michael Amling, Henning Hanken, Benedicta Beck-Broichsitter, Max Heiland, Bjoern Riecke
PURPOSE: Free flap surgery can be associated with donor-site morbidity. The purpose of this study was to analyze long-term functional outcomes at the donor site after deep circumflex iliac artery (DCIA) bone flap harvesting. METHODS: Fourteen patients (8 men and 6 women, mean age 53.9 years; range 22-87 years) with mandible resection (8 carcinomas, 4 ameloblastomas, 1 osteonecrosis, and 1 myxofibroma) and DCIA flap reconstruction were included in an observational study...
August 29, 2018: Microsurgery
Tateki Kubo, Tomoyuki Kurita, Hiroki Tashima, Motoyuki Suzuki, Hirokazu Uemura, Takashi Fujii, Shien Seike, Hidenori Inohara, Ko Hosokawa
BACKGROUND: "Window" resection of the trachea is sometimes performed to remove tumors invading the trachea. Here, we present a novel reconstructive procedure to this end. METHODS: Eleven patients (mean age, 64 years; range, 46-80 years) were included. Primary diagnoses included thyroid cancer and adenoid cystic carcinoma of the trachea. All defects were partial and located in the neck (mean width and length, 3/5 circle and 7.5 rings; range, 1/2-2/3 circle and 5-9 rings)...
August 29, 2018: Microsurgery
Tateki Kubo, Tomoyuki Kurita, Hiroki Tashima, Shien Seike, Takashi Fujii, Masahiko Yano, Makoto Yamasaki, Yuichiro Doki, Ko Hosokawa
BACKGROUND: When pharyngoesophagectomy is performed in conjunction with anterior mediastinal tracheostomy, reconstructing both the trachea and alimentary tract is extremely difficult. We developed a novel 1-stage reconstructive procedure using a single free jejunal flap containing multiple vascular pedicles to decrease postoperative morbidity and mortality. Free jejunal flap transfer with multiple vascular pedicles could offer a viable option for reducing associated life-threatening complications...
August 27, 2018: Microsurgery
Felix F Strübing, Amir K Bigdeli, Volker J Schmidt, Spyridoula Maraka, Ulrich Kneser, Dimitra Kotsougiani
Late free flap failures due to pedicle obstruction are rare adverse events. The purpose of this report is to present a case in which the near-infrared indocyanine green video angiography (ICG-NIR-VA) was used to evaluate the perfusion in a compromised fasciocutaneous flap in the late postoperative period. A 55-year-old male patient, who initially suffered from an open tibial fracture, developed concurrent osteomyelitis with fistulae of the proximal tibia requiring excision. Reconstruction was achieved using a parascapular flap of 25 × 8 cm, anastomosed to an arterio-venous (AV) Loop in the adductor canal...
August 24, 2018: Microsurgery
Andrew A Gassman, Judy Pan, Edwin Acevedo, Nicholas Haddock, Sumeet Teotia
The superficial inferior epigastric artery (SIEA) flap and the deep inferior epigastric perforator (DIEP) flap have been increasingly adopted for breast reconstruction; however, each have its own set of advantages and disadvantages. In the select subset of patients that cannot tolerate minimal abdominal fasciotomy that occurs with DIEP harvest and do not have adequate pedicle length that often occurs after SIEA harvest, we suggest another option for abdominally-based free flap breast reconstruction. Here, we describe the formation of a composite perforator based on the pedicle of the retro-rectus deep inferior epigastric vessels and the superficial inferior epigastric vessels, known as a superficial and deep inferior epigastric artery (SADIE) flap, which allows for a more compatible anastomotic size match than the SIEA and elongation of the vascular pedicle with minimal dissection of the anterior rectus fascia...
October 2018: Microsurgery
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