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Journal of Reconstructive Microsurgery

John Henry Pang, Sebastian Brooke, Mark W Kubik, Robert L Ferris, Matilda Dhima, Matthew M Hanasono, Eric W Wang, Mario G Solari
No abstract text is available yet for this article.
March 12, 2018: Journal of Reconstructive Microsurgery
Mario Cherubino, Luigi Valdatta, Pierluigi Tos, Salvatore D'arpa, Luigi Troisi, Igor Pellegatta, Federica Corradi, Umraz Khan
No abstract text is available yet for this article.
March 12, 2018: Journal of Reconstructive Microsurgery
Adriana C Panayi, Riaz A Agha, Brady A Sieber, Dennis P Orgill
BACKGROUND:  Increased rates of both breast cancer and obesity have resulted in more obese women seeking breast reconstruction. Studies demonstrate that these women are at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who underwent breast reconstruction following mastectomy. METHODS:  Cochrane, PUBMED, and EMBASE electronic databases were screened and data were extracted from included studies...
March 6, 2018: Journal of Reconstructive Microsurgery
Ledibabari Mildred Ngaage, Georgette Oni, Rudolph Buntic, Charles M Malata, Gregory Buncke
BACKGROUND:  Traumatic amputation of one or more digits can have a serious detrimental effect on social and economic standings which can be mitigated by successful replantation. Little has been recorded on preoperative management before replantation and how this affects the outcomes of the replanted digit. METHODS:  A retrospective cohort study was conducted and data collected over an 18-month period. Three protocols for preoperative management were examined: minimal (basic wound management), complete Buncke (anticoagulation, dry dressing on amputate placed on indirect ice and absence of a digital block), and incomplete (any two or three criteria from complete Buncke in addition to the minimal) protocols...
March 6, 2018: Journal of Reconstructive Microsurgery
Liancai Mu, Jingming Chen, Jing Li, Themba Nyirenda, Mary Fowkes, Stanislaw Sobotka
BACKGROUND:  We have demonstrated that the native motor zone (NMZ) within a muscle is an ideal target for performing nerve-muscle-endplate band grafting (NMEG) to restore motor function of a denervated muscle. This study was designed to determine spatiotemporal alterations of the myofibers, motor endplates (MEPs), and axons in the NMZ of long-term denervated muscles for exploring if NMEG-NMZ technique would have the potential for delayed reinnervation. METHODS:  Sternomastoid (SM) muscles of adult female Sprague-Dawley rats ( n  = 21) were experimentally denervated and denervation-induced changes in muscle weight, myofiber size, MEPs, and intramuscular nerve axons were evaluated histomorphometrically and immunohistochemically at the end of 3, 6, and 9 months after denervation...
March 6, 2018: Journal of Reconstructive Microsurgery
Antonio Merolli, Maria Lucia Manunta, Yong Mao, Gerolamo Masala, Giovanni Mario Careddu, Francesca Cubeddu, Maria Antonietta Evangelisti, Maria Letizia Guida, Caroline Antonia Verardi, Claudio Proietti, Andrea Manunta, Giuseppe Falvo D'Urso Labate, Gerardo Catapano, Marianne Polunas, Pedro Louro, Eraldo Sanna Passino
BACKGROUND:  We describe the development of a new surgical procedure to be used in the treatment of disruptive brachial plexus (BP) lesions. It is centered on an artificial device designed to assist nerve regeneration by providing a confined and protected environment. Nerve fibers can repair inside the device, while the adverse massive scar-tissue formation is limited to the outside of the device. METHODS:  Steps in the development of the procedure were (1) definition of the rationale, (2) design of the device, (3) choice of an in vivo translational model, (4)refinement of the surgical procedure, and (5) performance of an in vivo pilot study as a proof of concept...
March 6, 2018: Journal of Reconstructive Microsurgery
Musa Kemal Keleş, Hatice Gözde Muratoğlu, Feridun Elmas, Sebat Karamürsel
No abstract text is available yet for this article.
March 6, 2018: Journal of Reconstructive Microsurgery
Emil Dediol, Vedran Uglešić, Predrag Knežević, Domagoj Lemac
No abstract text is available yet for this article.
March 6, 2018: Journal of Reconstructive Microsurgery
Rohini Kadle, Joshua Cohen, William Hambley, Alejandro Gomez-Viso, William J Rifkin, Robert Allen, Nolan Karp, Pierre Saadeh, Daniel Ceradini, Jamie Levine, Tomer Avraham
No abstract text is available yet for this article.
March 6, 2018: Journal of Reconstructive Microsurgery
Sean S Li, Libby R Copeland-Halperin, Alexander J Kaminsky, Jihui Li, Fahad K Lodhi, Reza Miraliakbari
BACKGROUND:  Computer-aided surgical simulation (CASS) has redefined surgery, improved precision and reduced the reliance on intraoperative trial-and-error manipulations. CASS is provided by third-party services; however, it may be cost-effective for some hospitals to develop in-house programs. This study provides the first cost analysis comparison among traditional (no CASS), commercial CASS, and in-house CASS for head and neck reconstruction. METHODS:  The costs of three-dimensional (3D) pre-operative planning for mandibular and maxillary reconstructions were obtained from an in-house CASS program at our large tertiary care hospital in Northern Virginia, as well as a commercial provider (Synthes, Paoli, PA)...
February 20, 2018: Journal of Reconstructive Microsurgery
Rowena Sudario-Lumague, Yuan-Cheng Chiang, Tsan-Shiun Lin
BACKGROUND: Perceived gender-related differences in surgical skills could limit opportunities available for any aspiring surgeon. There should be more available literature and logical analysis of these observations. The objective of this study is to evaluate the microsurgical skills of male and female medical students using a standard scale in the laboratory. METHODS: This study included medical students enrolled in the Kaohsiung Chang Gung Memorial Hospital from 2002 to 2015 who were evaluated by a senior consultant for their microsurgical skills...
February 16, 2018: Journal of Reconstructive Microsurgery
Ian C Sando, Jeffrey S Plott, Brendan M McCracken, Mohamad H Tiba, Kevin R Ward, Jeffrey H Kozlow, Paul S Cederna, Adeyiza O Momoh
BACKGROUND:  A novel arterial everter device was engineered to simplify microvascular coupling of arteries by reliably securing the stiff, muscular wall of arteries over coupler pins. We compare microvascular coupling with the everter device to manual suturing for arterial anastomoses in a live large animal model. METHODS:  In this preliminary study, bilateral external femoral arteries of five male swine were exposed and sharply divided. Arteries were anastomosed using either interrupted sutures ( n  = 5) or the everter device and Synovis Coupler ( n  = 5)...
February 16, 2018: Journal of Reconstructive Microsurgery
Qing Zhao Ruan, Shawn Diamond, Scott Zimmer, Matthew L Iorio
BACKGROUND: Perioperative pain, increased sympathetic tone, and peripheral vasospasm may be safely managed with regional nerve blockade during microvascular reconstruction in the lower extremity. Limited reports exist in this setting; therefore, we evaluated our use of peripheral nerve catheters (PNCs) during microvascular limb salvage to determine safety and efficacy for both patient and flap. METHODS: A single-institution, retrospective review of a prospectively maintained database on all patients with lower extremity free tissue transfers between 2012 and 2017 was completed...
February 16, 2018: Journal of Reconstructive Microsurgery
Alvin C Kwok, Kyle Edwards, Daniel P Donato, Eric Tatro, Yizhe Xu, Angela P Presson, Jayant P Agarwal
BACKGROUND:  There is an increasing trend toward bilateral breast reconstruction. Using the National Surgical Quality Improvement Program (NSQIP) database, we sought to understand the association between unilateral and bilateral free flap breast reconstruction and operative time and flap failure. METHODS:  We selected a cohort of patients undergoing free flap breast reconstruction using the 2005 to 2010 NSQIP database. Cases were divided into unilateral and bilateral reconstruction...
February 16, 2018: Journal of Reconstructive Microsurgery
Reuben A Falola, Chrisovalantis Lakhiani, Jocelyn Green, Siya Patil, Brandon Jackson, Rachel Bratescu, Ersilia Anghel, John S Steinberg, Paul J Kim, Christopher E Attinger, Karen K Evans
BACKGROUND: Free tissue transfer is one option for preservation of form and function in the native limb, in the setting of soft tissue paucity. However, the data on patient functionality after microvascular intervention is inconsistently reported. The Lower Extremity Function Scale (LEFS) measures patient-reported difficulty in carrying out 20 physical activities, on a Likert scale, the sum of which correlates with descriptive functional stages of 1-5. We assess limb functionality in this cohort of microvascular patients using the LEFS survey...
February 16, 2018: Journal of Reconstructive Microsurgery
Erica L Bartlett, Dmitry Zavlin, Zachery K Menn, Aldona J Spiegel
BACKGROUND:  Flap congestion is a frequently described intraoperative complication during autologous breast reconstruction with abdominal perforator flaps, which, if not addressed, can lead to detrimental results such as flap failure. Here, we describe our institution's algorithm of intraoperative salvage of congested flaps and present their outcomes. METHODS:  All patient charts from 2002 to 2016 of a single plastic surgeon were reviewed for patients who underwent deep inferior epigastric perforator flap breast reconstruction resulting in 602 patients and 831 flaps...
February 16, 2018: Journal of Reconstructive Microsurgery
Siba Haykal, Mélissa Roy, Ashit Patel
BACKGROUND:  In 1986, Marko Godina published his seminal work regarding the timing of free-flap reconstruction for traumatic extremity defects. Early reconstruction, compared with delayed and late reconstruction resulted in significant decreases in free-flap failure rate, post-operative infections, hospitalization time, bone healing time, and number of additional anesthesias. The objective of this manuscript was to evaluate whether these principles continue to apply. METHODS:  A meta-analysis was performed analyzing articles from Medline, Embase, and Pubmed...
February 2, 2018: Journal of Reconstructive Microsurgery
Chenlong Liao, Min Yang, Pengfei Liu, Wenxiang Zhong, Wenchuan Zhang
BACKGROUND: Preclinical studies involving animal models are essential for understanding the underlying mechanisms of diabetic neuropathic pain. METHODS: Rats were divided into four groups: two controls and two experimental. Diabetes mellitus was induced by streptozotocin (STZ) injection in two experimental groups. The first group involved one sham operation. The second group involved one latex tube encircling the sciatic nerve. The vehicle-injection rats were used as two corresponding control groups: sham operation and encircled nerves...
February 2, 2018: Journal of Reconstructive Microsurgery
Soo-Ha Kwon, Che-Hsiung Lee, Angela Ting-Wei Hsu, Mark Shafarenko, Usama Farghaly Omar, Chieh-Han John Tzou, Julia Roka-Palkovits, Aldo G Beltrán P, Dimitri Liakos, Tommy Nai-Jen Chang
BACKGROUND: The best reconstructive strategy for upper lip defects is still in debate. The purpose of this study was to analyze the decisions made by international microsurgeons, who were participated through online questionnaire, distributed by email and social media network. MATERIALS AND METHODS: A case of a two-thirds upper lip oncologic defect was presented via an online questionnaire and 402 microsurgeons replied their treatment options. The data were then analyzed according to the geographic area, microsurgical fellowship, seniority, and subspecialty...
February 2, 2018: Journal of Reconstructive Microsurgery
Robert R Hagan, Joseph A Ricci, Kyle R Eberlin
Thoracic outlet syndrome (TOS) is a cause of upper extremity and shoulder dysfunction. TOS can present with a wide range of symptoms due to compression of the brachial plexus or its branches during their passage through the cervicothoracobrachial region or scalene triangle. There are three types of TOS: arterial, venous, and neurogenic. Neurogenic TOS (nTOS) is by far the most frequent type and represents more than 95% of all cases. Historically, surgical intervention for all types of TOS has evolved based on the treatment for a vascular etiology and has typically included a first rib resection...
February 2, 2018: Journal of Reconstructive Microsurgery
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