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Arash Momeni, Suhail K Kanchwala
BACKGROUND: Autologous breast reconstruction is associated with long-term patient satisfaction that is superior to implant-based approaches. Occasionally, however, patients who desire autologous reconstruction present with inadequate donor-site volume. A hybrid approach, combining free flap reconstruction with simultaneous implant placement, is a solution. We present our experience with the use of mesh for improved pocket control using this reconstructive modality. METHODS: A retrospective analysis of a prospectively maintained database of patients undergoing autologous breast reconstruction was performed...
October 22, 2016: Microsurgery
Jin Yong Shin, Si-Gyun Roh, Nae-Ho Lee, Kyung-Moo Yang
No abstract text is available yet for this article.
October 22, 2016: Microsurgery
Mario F Scaglioni, Nicole Lindenblatt, André A Barth, Bruno Fuchs, Walter Weder, Pietro Giovanoli
Reusing tissue of amputated or unsalvageable limbs to reconstruct soft tissue defects is one aspect of the "spare parts concept." Using a free fillet flap in such situations enables the successful formation of a proximal stump with the length needed to cover a large defect from forequarter amputation without risking additional donor-site morbidity. The use of free fillet flaps for reconstruction after forequarter and traumatic upper extremity amputations is illustrated here in a case report. A 41-year old patient required a forequarter amputation to resect a desmoid tumor, resulting in an extensive soft-tissue defect of the upper extremity...
October 20, 2016: Microsurgery
Maurizio Calcagni, Simon Zimmermann, Mario F Scaglioni, Thomas Giesen, Pietro Giovanoli, Richard M Fakin
INTRODUCTION: None of the existing treatments in the management of painful end-neuromas of the superficial branch of the radial nerve (SBRN) has been proven superior due to high levels of pain relapse. Fat grafts enriched with the stromal vascular fraction (SVF) could act as a mechanic barrier with biological effects decreasing the resorption rate and boosting the graft's regenerative potential. This study describes the novel surgical treatment technique of SVF-enriched fat grafting. PATIENTS AND METHODS: In this clinical study, five consecutive patients treated for painful end-neuromas of the SBRN between 2012 and 2013 were analyzed retrospectively...
October 12, 2016: Microsurgery
Alvin C Kwok, Jayant P Agarwal
PURPOSE: We sought to use the NSQIP database to determine the national rate and predictors of free flap failure based upon flap sites and flap types. METHODS: Free flaps were identified using the 2005-2010 NSQIP database. We examined overall flap failure rates as well as failure rates based upon flap sites (head and neck, extremities, trunk, and breast) and flap types (muscle, fascial, skin, bone, and bowel flaps). Univariate and multivariate analyses were used to determine predictors of flap failure...
October 7, 2016: Microsurgery
Semih Baghaki, Murat Diyarbakirlioglu, Ugur Sahin, Muge Anil Kucuksucu, Akif Turna, Bilgi Baca, Yağmur Aydın
Besides conventional flaps, intercostal artery perforator flaps have been reported to cover trunk defects. In this report the use of anterior intercostal artery perforator (AICAP) flap, lateral intercostal artery perforator (LICAP) flap and dorsal intercostal artery perforator (DICAP) flap for thoracic, abdominal, cervical, lumbar and sacral defects with larger dimensions and extended indications beyond the reported literature were reevaluated. Thirty-nine patients underwent surgery between August 2012 and August 2014...
October 5, 2016: Microsurgery
Romina Deldar, Stephen Duquette, Eugene P Ceppa, Mary Lester, Rajiv Sood, Juan Socas
No abstract text is available yet for this article.
October 5, 2016: Microsurgery
Zaher Jandali, Martin C Lam, Kiomars Aganloo, Benedikt Merwart, Jouke Buissink, Klaus Müller, Lucian P Jiga
BACKGROUND: The medial sural artery perforator (MSAP) flap shows advantages for reconstruction in the foot and ankle, where bulk is a liability. We evaluated the versatility of this flap and provide further evidence on its use for covering small-to-moderate size defects by comparing the outcome depending on the region of reconstruction. METHODS: Twenty-two patients with variable defects of 4 × 4 to 18 × 7 cm underwent MSAP flap reconstruction. Final outcomes of all patients were evaluated 12-months postoperatively using the AOFAS ankle-hindfoot, midfoot and hallux scale for clinical-functional evaluation, and the SF-36 health survey for quality-of-life measurement...
October 5, 2016: Microsurgery
Ki Yong Hong, Lan Sook Chang, Hak Chang, Kyung Won Minn, Ung Sik Jin
BACKGROUND: Breast reconstruction with microvascular free tissue transfer has become a widely used method. Despite a high rate of success, a compromised flap necessitating re-exploration can occur. Here, we introduce direct thrombectomy as a flap salvage technique, and compared the results with conventional thrombectomy. METHODS: A total of 488 patients who underwent breast reconstruction using a free transverse rectus abdominis myocutaneous flap between March 2009 and February 2014 were retrospectively analyzed...
October 5, 2016: Microsurgery
Michael C Nicoson, Michael J Franco, Thomas H Tung
BACKGROUND: With complete plexus injuries or late presentation, free functional muscle transfer (FFMT) becomes the primary option of functional restoration. Our purpose is to review cases over a 10-year period of free functioning gracilis muscle transfer after brachial plexus injury to evaluate the effect of different donor nerves used to reinnervate the FFMT on functional outcome. METHODS: A retrospective study from April 2001 to January 2011 of a single surgeon's practice was undertaken...
October 5, 2016: Microsurgery
Shimpei Miyamoto
No abstract text is available yet for this article.
September 27, 2016: Microsurgery
Amy R Sharkey, Samuel W King, Alexander J Ramsden, Dominic Furniss
INTRODUCTION: Recurrent cellulitis is a frequent and challenging complication of lymphoedema. British Lymphology Society cellulitis guidelines state that decongestive lymphatic therapy reduces the frequency of cellulitis attacks, but do not mention the effect of surgical interventions. This systematic review aims to assess whether surgical interventions for lymphoedema reduce the frequency of attacks of cellulitis. MATERIALS AND METHODS: Embase, Medline, and the Cochrane database were searched for relevant articles from database inception to January 2016...
September 23, 2016: Microsurgery
Jeong Tae Kim, Sang Wha Kim
BACKGROUND: Intractable chronic wounds share the basic problem of the environment being unfavorable for wound healing and prone to infection, inflammation, and recurrences. Microsurgical flap provides a healthy, well-vascularized normal tissue to compromised intractable environment, and promotes wound healing. In this report, we present the results of microsurgical flaps used for the reconstruction of chronic intractable conditions including chronic ulcer with an ischemic environment and pathologic lesions with a congestive environment...
September 23, 2016: Microsurgery
Ravi K Garg, Aaron M Wieland, Gregory K Hartig, Samuel O Poore
INTRODUCTION: Unplanned readmissions are associated with decreased healthcare quality and increased costs. This nationwide study examines causes for unplanned readmission among head and neck cancer patients undergoing immediate microsurgical reconstruction. METHODS: Patients undergoing head and neck tumor resection with microsurgical reconstruction were identified in the 2011-2014 National Surgical Quality Improvement Program database. Clinical characteristics and complications were compared among patients who did and did not undergo unplanned readmission...
September 23, 2016: Microsurgery
Karl F B Payne, Samuel Mattine
No abstract text is available yet for this article.
September 20, 2016: Microsurgery
Ines E Tinhofer, Chieh-Han J Tzou, Dominik Duscher, Michael S Pollhammer, Wolfgang J Weninger, Georg M Huemer, Manfred Schmidt
BACKGROUND: Fasciocutaneous flaps supplied by discrete perforator arteries can be raised in numerous parts of the human body and are routinely used in plastic surgery. The aim of this anatomical investigation was to provide a description of the vascular supply of the medial upper arm, to localize and measure the perforator arteries and to define potential perforator flap dimensions in pendency of individual anatomical conditions. MATERIAL AND METHODS: A total of 20 upper limbs from 11 fresh cadavers were examined...
September 16, 2016: Microsurgery
Hua Xu, Yi Zhang, Jinguang He, Yuan Lin, Tao Wang, Jiasheng Dong
Total scalp avulsion with severe cervical spine injury is a contraindication for emergency replantation of the scalp to its anatomical site. We describe a case involving the ectopic implantation of an avulsed scalp on the forearm. A 41-year-old woman presented with severe total scalp avulsion and tears in the intervertebral discs at the C4/5 and C5/6 levels. The avulsed scalp was ectopically implanted on the left forearm with a tissue expander to provide support. Two-stage replantation of the scalp at its anatomical site was performed 19 and 40 days later...
September 16, 2016: Microsurgery
Jeong Tae Kim, Youn Hwan Kim, Sang Wha Kim
INTRODUCTION: Fibrin sealants have had applications in hemostasis, cohesion, and promotion of healing in plastic surgery. In this article, we review cases where fibrin sealant was used to stabilize microvascular pedicles and compared with previous free flaps performed without fibrin sealant. METHODS: Between 2008 and 2010, 62 consecutive patients underwent free tissue transfer for reconstruction; this involved 33 latissimus dorsi perforator flaps, 14 thoracodorsal artery perforator flaps, 9 latissimus dorsi myocutaneous flaps, 3 lateral thoracic artery perforator flaps, and 3 transverse rectus abdominis myocutaneous flaps, used in head and neck reconstruction, lower limb reconstructions, breast reconstructions, and facial palsy reconstruction...
September 16, 2016: Microsurgery
Kenji Hayashida, Hiroto Saijo, Masaki Fujioka
We describe the use of a composite flap composed of a sural neurofasciocutaneous flap and a vascularized peroneus longus tendon for the reconstruction of severe composite forearm tissue defects in a patient. A 43-year-old man had his left arm caught in a conveyor belt resulting in a large soft-tissue defect of 18 × 11 cm over the dorsum forearm. The extensor carpi radialis, superficial radial nerve, and radial artery were severely damaged. A free neurofasciocutaneous composite flap measuring 16 × 11 cm was outlined on the patient's left lower leg to allow simultaneous skin, tendon, nerve, and artery reconstruction...
September 4, 2016: Microsurgery
Bommie Florence Seo, Byung Yeun Kwon, Hyun Ho Han
In this report we present a case of large sized volar surface defect of a digit reconstructed by hypothenar perforator free flap coverage. A 57-year-old male patient presented with a 5 × 2 cm sized avulsive injury on his left little finger involving near total loss of the volar surface. The perforator arteries of the hypothenar area were identified around 5-15% on the x-axis and 25-50% on the y-axis (y-axis: a line from the pisiform base to the metacarpophalangeal joint, x-axis: a line perpendicular to the y-axis...
September 4, 2016: Microsurgery
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