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venous collateral circulation in flaps

Han-Song Sheng, Fang Shen, Jian Lin, Guang-Hui Bai, Fen-Chun Lin, Dan-Dong Li, Nu Zhang
RATIONALE: The superior sagittal sinus (SSS) is the major dural sinuses that receive a considerable amount of venous drainage. Interruption of its posterior third has been suggested to cause intracranial hypertension and lead to potentially fatal consequences. PATIENT CONCERNS: We presented a 22-year-old man with a severe headache and scalp bleeding after a head chop wound. Physical examination identified a 20-cm straight laceration in his parietooccipital scalp...
June 2017: Medicine (Baltimore)
David A Staffenberg, James T Goodrich
The separation of craniopagus conjoined twins is a very rare and complex challenge. As with many rare challenges, it presents initially as a deceptively simple problem requiring only the most basic clinical techniques. As in many reconstructive problems, this paradigm mandates that the neurosurgical team performs the separation with the plastic surgeons providing closure at the end of the separation. Historically, these approaches have included, as with the separation of many other types of conjoined twins, the use of tissue expansion before separation followed by separation surgery...
November 2012: Journal of Craniofacial Surgery
Tadahiro Sasajima, Nobuyoshi Azuma, Hisashi Uchida, Hidenori Asada, Masashi Inaba, Nobuyuki Akasaka
BACKGROUND: We evaluated the mid-term outcome of distal venous arterialization (DVA) and the role of a combined free flap as a bridgehead for blood supply. METHODS: In the past 5 years, nine patients with extensive tissue loss and lacking graftable distal arteries underwent DVA. These consisted of four primary DVAs, three combined DVA and free flap procedures, and two adjuvant DVAs for hemodynamically failed distal bypasses. After nine primary DVAs, three redo DVAs were performed for early failure...
April 2010: Annals of Vascular Surgery
Martijn P J Loonen, Moshe Kon, Arnold H Schuurman, Ronald L A W Bleys
BACKGROUND: Little is known about the necessary dimensions of the neurovascular pedicle of the sural flap for inclusion of the concomitant bypass veins of the small saphenous vein to secure sufficient retrograde venous flow. Therefore, the authors evaluated the anatomical basis for venous outflow of the sural flap and were able to give recommendations as to the necessary pedicle width for the flap to be transferred safely. METHODS: The collateral bypass pathway of the small saphenous vein was studied in five formalin-preserved cadaver legs...
December 2007: Plastic and Reconstructive Surgery
J Joris Hage, Leonie A E Woerdeman
The large and potentially sensate skin territory, the reliability, and the versatility of the anterolateral thigh flap have led to its use for the reconstruction of soft-tissue defects of the head and neck region, extremities, and trunk. Most authors describe the functional disturbances in the donor site as minimal and, to date, no cases of circulatory disturbance of the lower limb as a result of anterolateral thigh flap transplantation have been described. The authors report a patient with partial necrosis of the foot and calf caused by the interruption of the descending branch of the lateral circumflex femoral artery, which acted as a critical collateral for the obstructed superficial femoral artery...
March 2004: Annals of Plastic Surgery
Oliver Scheufler, Klaus Exner, Reimer Andresen
Near-infrared reflection spectroscopy, used experimentally for investigation of tissue hemoglobin content and oxygenation in various flaps, was tested in the pedicled transverse rectus abdominis musculocutaneous (TRAM) flap, chosen as a simple clinical model because of its well-known vascular anatomy and clinical relevance. The study intended to answer the following questions: Does the near-infrared reflection spectroscopy system used in this study measure tissue hemoglobin content and oxygenation in the superficial skin layers only, as proposed by the manufacturer? Is near-infrared reflection spectroscopy able to detect differences of tissue hemoglobin content and oxygenation in distinct zones of the TRAM flap skin before, early, and late after surgery? Does tissue hemoglobin content and oxygenation correspond to blood flow in the supplying superior epigastric artery and to clinical signs of TRAM flap perfusion and viability? In 11 patients, tissue hemoglobin content and oxygenation in the lower abdomen/TRAM flap, mastectomy skin flap, and contralateral breast were measured by a new near-infrared reflection spectroscopy system preoperatively, early postoperatively, and late postoperatively...
January 2004: Plastic and Reconstructive Surgery
G A Pazos, D W Leonard, J Blice, D H Thompson
The primary objective of this review of the literature is to identify the probable causes of blindness after bilateral radical neck dissections. This case report and literature review also discusses possible preventive measures that may avert this catastrophic outcome. Cases of blindness after bilateral radical neck dissection were identified by an electronic literature search, as well as cross-checking all references of the above-identified papers. Eleven previous cases of blindness after bilateral neck dissection were identified...
September 1999: American Journal of Otolaryngology
J Chen, X Hao, S Luo
In order to investigate the survival mechanism and the role of venous drainage in arterialized venous skin flap, 60 rabbits' ears were used for research and clinical application of the flap was performed subsequently in two cases. The rabbits were divided into 4 groups. Experimental group was standard arterialized venous skin flap, control 1 group was venous skin flap, control 2 group was arterialized venous skin flap with only one drainage vein and control 3 group was normal skin flap. The process of survival of the flaps was observed by hemodynamic and histological method...
September 1997: Chinese Journal of Reparative and Reconstructive Surgery
H Shangkuan, W Xinghai, Z Shizhen, W Zengxing, J Shiying, G Jiasong
The aim of this work was to study the role of the venous drainage of the tongue in tongue inspection in traditional Chinese medicine and tongue-flap surgery. Thirty-two adult cadavers were observed, including 7 venous corrosivecast specimens. The decreasing order of venous drainage of the tongue, based on the diameter of the vein and size of its drainage area, was the accompanying v. of the hypoglossal n., the epiglottic valleculate v., the accompanying v. of the lingual n., the lingual root v. and the accompanying v...
1998: Surgical and Radiologic Anatomy: SRA
S H Woo, S E Kim, T H Lee, J H Jeong, J H Seul
The purpose of this study was to evaluate further factors that could explain the survival mechanism in the arterialized venous flap. The authors used 16 canines to investigate the survival rate and pattern of the arterialized venous flap and compared the results with those of the conventional saphenous flap. The number and distribution of draining veins in the arterialized venous flap group were varied to observe their impact on the survival rate and pattern. Gross examination of venous network, blood gas, venogram, blood pressure, and histologic study were also carried out...
April 1998: Plastic and Reconstructive Surgery
R Lange, M Thielmann, K G Schmidt, R Bauernschmitt, H Jakob, B Hasper, H Ulmer, S Hagl
OBJECTIVE: In recurrent coarctation collateral circulation may not be sufficient to maintain adequate perfusion of the lower body during the period of surgical repair. Different techniques such as interposition of a Gott-shunt, use of left heart bypass or hypothermic cardiocirculatory arrest are used to prevent spinal cord injury. METHODS: Twenty-eight operations for recurrent coarctation were performed in 26 patients following end-to-end anastomosis (58%), patch plasty (21%), subclavian flap aortoplasty (14%) and graft interposition (7%)...
April 1997: European Journal of Cardio-thoracic Surgery
G G Hallock
Skin loss about the foot and ankle is notorious for creating a difficult challenge for limb salvage. Local tissue rearrangements rarely prove satisfactory, so a free flap as a solution can be readily justified. Distally based flaps utilizing unviolated ipsilateral proximal lower limb donor territories offer new possibilities in lieu of the complexity of microsurgery. Yet some unique disadvantages must be acknowledged particularly for island flaps, depending on retrograde circulation via major collateral source vessels, where venous congestion can occur and risk of limb devascularization may be unacceptable...
June 1996: Foot & Ankle International
M Beyer, U Beyer, S Mierdl, J Sirch, H von Behren, A Hannekum
It has been shown in previous studies that grafting a free skeletal muscle flap onto the heart of the dog produces myocardial revascularization. In order to evaluate the functional aspect of these neovessels, an Ameroid constrictor was implanted into the LADs (left anterior descending coronary artery) of five dogs. At the same time, the free muscle flap was grafted onto the anterior wall of the heart. The arterial anastomosis was achieved with the internal mammary artery. Venous flow was drained into the right atrium...
1994: European Journal of Cardio-thoracic Surgery
D N Thompson, R D Hayward, W J Harkness, R M Bingham, B M Jones
The authors describe the clinical, radiological, and postmortem findings of a case of cloverleaf skull syndrome. The presence of hindbrain herniation, abnormal cervical segmentation, and atlantoaxial subluxation illustrate the anatomical complexity of the skull base and the craniocervical junction that may coexist in this condition. Unavoidable division of occipital emissary veins during elevation of the skin flap at the time of vault remodeling surgery led to an acute and, ultimately, fatal rise in intracranial pressure...
June 1995: Journal of Neurosurgery
K Satoh, M Le Danvic, D Groslière, D S Pétoin, J M Servant
No abstract text is available yet for this article.
1988: Annales de Chirurgie Plastique et Esthétique
M Beyer, H Hoffer, T Eggeling, A Goertz, S Mierdl, A Hannekum
In diffuse small-vessel coronary heart disease, heart transplantation may be indicated for intractable angina. As an alternative, a free striated muscle flap can constitute a source of neovessels. Those extraintracardial collaterals develop only 4 weeks after transplantation of the flap as shown by the following experiments with seven dogs. In those animals a myocardial infarction of the anterior wall was selectively produced by the Judkins technique for the injection of Sephadex microspheres. Four weeks later a free pectoralis muscle flap was transplanted onto the anterior wall of the heart...
July 1992: Journal of Heart and Lung Transplantation
J H Lim, J H Park, Y H Auh
OBJECTIVE: Membranous or segmental obstruction of the inferior vena cava is one of the common causes of chronic Budd-Chiari syndrome. In this study, the venographic findings are compared with the results of sonography and CT in order to ascertain their role in the management of these cases. MATERIALS AND METHODS: Fifteen patients with membranous (n = 8) or segmental (n = 7) obstruction of the inferior vena cava who had been examined with sonography and CT were studied retrospectively...
September 1992: AJR. American Journal of Roentgenology
V M Grishkevich, V Iu Moroz, N V Ostrovskiĭ, I A Mikhaĭlov
Operations were conducted on 22 patients with defects in soft tissues and trophic ulcers of cicatrix in the region of the calcaneal tendon. In 16 patients with extensive cicatricial lesions occupying two distal thirds or the whole region, an L-shaped flap of skin and fat was used, it was formed on the postero-lateral distal third of the leg, in the zone of the lateral malleolus and the lateral surface of the foot. The flap measured 20-22 cm in length and 6-7 cm in width. The ratio of the vertical part of the flap to the horizontal part was 3:1, 2:1, or 1:1 depending on the level of the defect and the area of the wound...
July 1992: Khirurgiia
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