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Microsurgery

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https://www.readbyqxmd.com/read/28334447/starting-a-microsurgery-fellowship-a-program-s-perspective
#1
EDITORIAL
Albert H Chao
No abstract text is available yet for this article.
March 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28334445/double-gastroepiploic-vascularized-lymph-node-tranfers-to-middle-and-distal-limb-for-the-treatment-of-lymphedema
#2
Pedro Ciudad, Oscar J Manrique, Shivprasad Date, Mouchammed Agko, John Jaime Perez Coca, Wei-Ling Chang, Federico Lo Torto, Fabio Nicoli, Michelle Maruccia, Javier López Mendoza, Hung-Chi Chen
BACKGROUND: Vascularized lymph node (VLN) transfer for lymphedema treatment has shown promising results. Optimal donor and recipient sites remain a matter of debate. We describe the technique and outcomes of a laparoscopically harvested extended gastroepiploic VLN flap with two levels of inset. PATIENTS AND METHODS: Between 2014 and 2015, four-patients with upper limb breast cancer-related lymphedema and three-patients with lower limb pelvic cancer-related lymphedema who underwent VLN transfers were included...
March 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28319327/bilateral-breast-reconstruction-with-deep-inferior-epigastric-perforator-flaps-in-slim-patients
#3
Maria Mani, Samer Saour, Kelvin Ramsey, Kieran Power, Paul Harris, Stuart James
BACKGROUND: Slim women are not always considered candidates for bilateral autologous breast reconstruction. The study aims to assess the volume considerations and complications of deep inferior epigastric perforator (DIEP) flap in bilateral breast reconstruction among slim patients. METHODS: All patients undergoing bilateral DIEP breast reconstruction at the Royal Marsden Hospital, London, September 2007-March 2015, were reviewed. Flap weight was compared to mastectomy weight (weight ratio) and complications were recorded...
March 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28319277/the-systematic-review-and-meta-analysis-of-free-flap-safety-in-the-elderly-patients
#4
Galip Gencay Üstün, Ali Emre Aksu, Hakan Uzun, Ozan Bitik
BACKGROUND: Prolonged mean life expectancy gives rise to a more populated and older patient group. With increasing number of cases during the past decades, older patients are regarded as candidates for microsurgical interventions. Whether advanced patient age is an independent risk factor for microsurgical reconstruction is still an ongoing matter of debate. METHODS: The Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, CINAHL and EMBASE databases were screened for combination of the key words "elderly", "geriatric", "advanced age", "free flap", "microsurgery", free tissue transfer" by using time limits between 1989 and 2015...
March 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28314066/comparison-of-propeller-perforator-flap-and-venous-supercharged-propeller-perforator-flap-in-reconstruction-of-lower-limb-soft-tissue-defect-a-prospective-study
#5
Benoit Chaput, Nicolas Bertheuil, Jean-Louis Grolleau, Farid Bekara, Raphael Carloni, Jerome Laloze, Christian Herlin
INTRODUCTION: In lower limbs, reliability of propeller perforator flaps (PPF) remains uncertain. The main complication is venous congestion, which can lead to distal necrosis. We aim to highlight if venous supercharging of PPF could substantially limit complications in lower limb coverage. METHODS: Between 2011 and 2016, we developed a standardized procedure of venous supercharging in the lower limb reconstruction with PPF using saphenous veins anastomosis. Then, we prospectively compared a consecutive series of 30 PPF to cover lower limbs defect, with a consecutive series of 30 venous-supercharged PPF (vsPPF)...
March 17, 2017: Microsurgery
https://www.readbyqxmd.com/read/28233928/extending-the-limits-of-the-anterior-tibial-artery-as-the-recipient-vessel-for-around-the-knee-and-proximal-lower-extremity-defect-reconstruction-using-the-free-anterolateral-thigh-and-gracilis-flap
#6
Mathias Tremp, Elisabeth A Kappos, Carlo M Oranges, Pietro G di Summa, Dirk J Schaefer, Yi Xin Zhang, Reto Wettstein, Daniel F Kalbermatten
PURPOSE: The aim is to describe a technique with orthograde dissection of the anterior tibial artery (ATA) used as the recipient vessel for the end-to-end (ETE) anastomosis in defect reconstruction around the knee and for proximal/middle third leg defects with free anterolateral thigh (ALT) and gracilis flaps. PATIENTS AND METHODS: Between March 2009 and May 2014, 22 patients undergoing lower extremity reconstruction were evaluated. Of those, 4 patients were included...
February 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28218414/dual-vascular-pedicles-to-ensure-free-jejunum-flap-survival-in-post-radiotherapeutic-esophageal-reconstruction
#7
LETTER
Tony C T Huang, Pedro Ciudad, Mouchammed Agko, Oscar Manrique, Hung-Chi Chen
No abstract text is available yet for this article.
February 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28207955/can-an-injured-nerve-be-used-as-a-donor-nerve-for-distal-nerve-transfer-an-experimental-study-in-rats
#8
Chieh-Han John Tzou, Chuieng-Yi Johnny Lu, Tommy Naj-Jen Chang, David Chwei-Chin Chuang
BACKGROUND: Distal nerve transfer has proven efficacy. The purpose of this study was to investigate if an injured nerve can be used as a donor nerve for transfer, and to determine the threshold of injury. MATERIALS AND METHODS: Rat's left ulnar-nerves in the axilla with different degrees of injury were selected as the donor nerves for transfer, and the musculocutaneous-nerves the target nerves for being re-innervated. Six rats each served as positive and negative controls: Group A, intact ulnar-nerve transfer; and Group E, the ulnar-nerve was cut but no transfer...
February 16, 2017: Microsurgery
https://www.readbyqxmd.com/read/28206687/thirty-micron-needle-for-precise-supermicrosurgery
#9
LETTER
Takumi Yamamoto, Nana Yamamoto, Ryohei Ishiura
No abstract text is available yet for this article.
February 16, 2017: Microsurgery
https://www.readbyqxmd.com/read/28205260/comparison-between-anterolateral-thigh-radial-forearm-and-peroneal-artery-flap-donor-site-thickness-in-asian-patients-a-sonographic-study
#10
Kuei-Chang Hsu, Wei-Hsuan Tsai, Pei-San Ting, Jung-Hua Hsueh, Lee-Wei Chen, Ying-Sheng Lin
PURPOSE: This study aimed to determine the thicknesses of the three locations used as donor sites for radial forearm (RF), anterolateral thigh (ALT), and peroneal flaps and to determine probable contributing factors of the thickness. METHODS: This study included 201 healthy participants (mean age: 45.8 ± 17.2 years; male: 114; female: 87; BMI: 24.3 ± 4.3). Sonography was used to measure the thickness of flap donor sites. Forward stepwise regressions were conducted to determine the contributing factors of flap thickness...
February 16, 2017: Microsurgery
https://www.readbyqxmd.com/read/28205252/sensory-deficits-after-a-radial-nerve-injury
#11
Jayme Augusto Bertelli, Erica Cavalli, Vera Lúcia Mendes Lehn, Marcos Flávio Ghizoni
BACKGROUND: The aim of our study was to objectively test sensibility on the dorsal side of the hand in patients with radial nerve injury, to document deficits and to detect if surgery for sensory reconstruction is needed. METHODS: Nineteen patients of mean age 31 ± 10 years were examined at a mean of 26.4 ± 27.8 months post radial nerve injury. Sensory mechanical thresholds on the dorsal surface of the hand were evaluated using Semmes-Weinstein monofilaments...
February 16, 2017: Microsurgery
https://www.readbyqxmd.com/read/28198595/free-microvascular-rotationplasty-with-nerve-repair-for-rhabdomyosarcoma-in-a-18-month-old-patient
#12
Alberto Pérez-García, Marta Salom, María Eloísa Villaverde-Doménech, Francisco Baixauli, Eduardo Simón-Sanz
Rotationplasty is a limb-sparing surgical option in lower limb malignancies. Sciatic or tibial nerve encasement has been considered an absolute contraindication to this procedure. We report a case of an 18-month-old girl with a rhabdomyosarcoma that affected the leg and popliteal fossa, with neurovascular involvement. Knee and proximal leg intercalary resection was performed followed by reconstruction with free microvascular rotationplasty and neurorraphy from tibial division of sciatic nerve to sural and tibial nerves, and from saphenous nerve to superficial peroneal nerve...
February 15, 2017: Microsurgery
https://www.readbyqxmd.com/read/28198585/vessel-loop-assisted-vein-anastomosis-a-possible-aid-in-some-difficult-situations
#13
LETTER
Alberto Franchi, Mario F Scaglioni
No abstract text is available yet for this article.
February 15, 2017: Microsurgery
https://www.readbyqxmd.com/read/28168747/double-paddle-peroneal-flap-for-extensive-lip-defect-reconstruction
#14
Ying-Sheng Lin, Wen-Chung Liu, Yaoh-Shiang Lin, Lee-Wei Chen, Jung-Hua Hsueh, Kuo-Chung Yang
INTRODUCTION: Today, reconstructive surgeons offer an array of options to reconstruct the lip defects. Herein we present our experience of using free double-paddle peroneal flaps for extensive lip defect reconstruction. PATIENTS AND METHODS: From 1996 to 2014, 16 patients with extensive lip defects after tumor ablation were included. Free double-paddle peroneal flaps were used for reconstructions. In terms of flap design, one skin paddle superiorly placed on the lateral lower leg was used to reconstruct intraoral defects, whereas the other was inferiorly located and was used to reconstruct extraoral defects...
February 7, 2017: Microsurgery
https://www.readbyqxmd.com/read/28160323/recipient-vessels-for-microsurgical-flaps-to-the-abdomen-a-systematic-review
#15
REVIEW
Raffi Gurunluoglu, Michael J Rosen
BACKGROUND: Large soft tissue defects of the abdominal wall resulting from various reasons may require free tissue transfer. METHODS: A literature search of PubMed and Cochrane electronic databases was conducted to identify articles involving abdominal wall reconstruction (AWR) with microsurgical flap. Number of cases, etiology, and reconstruction site, type of microsurgical flap and recipient vessels were analyzed. RESULTS: Thirty-eight articles published between 1983 and 2016 reported on 149 patients undergoing free flap AWR...
February 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/28121366/the-use-of-vascularised-bone-capping-to-prevent-and-treat-amputation-stump-spiking-in-the-paediatric-population
#16
Adrian D Murphy, Sara E Atkins, Damon J Thomas, David McCombe, Chris J Coombs
BACKGROUND: Overgrowth of the stump skeleton is a major complication seen in children after an amputation. In advanced cases, perforation of the bone spike through the skin can occur. Many surgical treatments have been employed to treat and prevent this, with best results seen when non-vascularised osteo-chondral bone grafts are placed to try to mimic a trans-articular amputation. We reviewed our outcomes using vascularized bone flaps to prevent and treat spiking. PATIENTS AND METHODS: Between 2000 and 2016 we carried out six vascularised osteo-cartilaginous bone capping procedures...
January 25, 2017: Microsurgery
https://www.readbyqxmd.com/read/28112431/the-proximal-superficial-femoral-artery-perforator-flap-anatomic-study-and-clinical-cases
#17
Imran Ratanshi, Colin W McInnes, Avinash Islur
BACKGROUND: The upper thigh has provided multiple new soft tissue free flaps in recent decades, including the anterolateral thigh, anteromedial thigh, transverse upper gracilis, the profunda artery perforator, and superficial circumflex iliac perforator flaps. The purpose of this study is to describe a new, reliable free flap option in the upper thigh: the proximal superficial femoral artery perforator (p-SFAP) flap. METHODS: A cadaveric dissection study was performed to confirm clinical landmarks and evaluate pedicle characteristics...
January 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28112411/medial-sural-artery-as-a-salvage-recipient-vessel-for-complex-post-traumatic-microvascular-lower-limb-reconstruction
#18
Amresh Baliarsing, Shivprasad Date, Pedro Ciudad
BACKGROUND: Complex lower extremity trauma still poses a formidable challenge for micro vascular reconstruction. The extensive surrounding zone of trauma can make it difficult to find a suitable recipient pedicle for anastomosis. A need was felt for exploration of newer recipient vessels in lower extremity which could be harnessed for reliable and tension free micro anastomosis. The purpose of the present report is to highlight the possibility of using medial sural artery for safe micro vascular anastomosis in selected scenarios like vessel depleted extremity...
January 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28111790/pedicled-chimeric-sensitive-fasciocutaneous-anterolateral-thigh-alt-and-vastus-lateralis-muscle-vlm-flap-for-groin-defect-reconstruction-a-case-report
#19
Mario F Scaglioni, Alberto Franchi, Pietro Giovanoli
The anterolateral thigh (ALT) flap is one of the most commonly used flap worldwide, as both free flap and pedicled local flap. Here, we report the use of a pedicled chimeric sensitive ALT and vastus lateralis muscle (VLM) flap in a patient with a 12 cm × 8 cm contaminated soft tissue defect of the right inguinal region with exposed femoral vessels. The flap was harvested based on two perforators, one musculocutaneous and one pure muscular, each nourished separately a sensitive fasciocutaneous component and a vastus lateralis muscle component, respectively...
January 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28066911/outcomes-of-microvascular-free-tissue-transfer-in-twice-irradiated-patients
#20
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
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