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Greater omentum free flap

Felix J Paprottka, Nicco Krezdorn, Ramin Ipaktchi, Christine Radtke, Peter M Vogt
BACKGROUND AND AIM: Large skull base defects are extremely difficult to treat and have a severe impact on patients' physical appearance and functional aspects. These extensive defect zones are mainly caused by trauma, surgical interventions, or wide tumor excision. High-level microsurgical techniques are necessary to provide sufficient treatment. The aim of this study is to describe successful reconstructive strategies for surgical treatment. METHODS: Nine patients with skull base defects were treated in our department from 2008 to 2014 (n = 9)...
September 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Nicla Settembre, Sergueï Malikov
BACKGROUND: The omental flow-through flap (OFTF) is based on the use of an anatomic unit composed of the right gastro-omental artery (bypass) with its omental branch or branches supplying the greater omentum (flap). The greater omentum flap is known for its capacity of resistance to infection, for its use in the treatment of ischemic lesions and as a high-flow tissue. Several hypotheses regarding the hemodynamic behavior of a distal bypass with a flap were discussed in the literature...
October 2016: Annals of Vascular Surgery
Jose M Lasso, Carmen Pinilla, Michele Castellano
Lymphedema is a chronic debilitating disease, affecting a considerable part of the population; it results from impairment of the lymphatic system. It is highly prevalent among patients subjected to axillary and groin nodal dissection after surgery for breast cancer, abdominopelvic surgery, and lymphadenectomy after melanoma surgery. Interestingly, among the surgical treatment options for lymphedema, groin lymph node transfer is gaining popularity; however, in some cases, dissection at this site can cause significant morbidity, including possible development of iatrogenic lymphedema...
May 2015: Plastic and Reconstructive Surgery. Global Open
Alexander Meyer, Katja Goller, Raymund E Horch, Justus P Beier, Christian D Taeger, Andreas Arkudas, Werner Lang
OBJECTIVE: Combined vascular reconstruction and free flap transfer has been established in centers as a feasible therapeutic option in cases with critical limb ischemia (CLI) and large tissue defects otherwise destined for major amputation. However, the number of patients treated with this combined approach is limited, and data regarding long-term follow-up and functional outcome are scarce. We therefore report our 10-year experience in free flap transplantation after vascular reconstruction as a last attempt for limb salvage, with special emphasis of complication rate, limb salvage, and postoperative mobility...
May 2015: Journal of Vascular Surgery
(no author information available yet)
The experience of 127 microsurgical autotransplantations of skin-muscular flaps in 93 patients with severe radiation skin injuries was analyzed. As free revascularized flaps the greater omentum, the skin-muscular thoracodorsal flap, the scapular, the radial flap, including flaps with a part of the radial bone, the deltoideus, the rotated skin-muscular flap of the abdominal rectus muscle, the scapular and/or serratus anterior fascia were used. The transplants' acception was registered in all cases. 31 patients demonstrated the development of late radiation ulcers during the long term follow up period, requiring further dissection and replantation...
2012: Khirurgiia
Kosuke Nakazato, Kazuhiro Toriyama, Masashi Hishida, Keisuke Takanari, Shunjiro Yagi, Yoriko Yamashita, Shinya Akatsuka, Akemi Hayakawa, Yuzuru Kamei
Because omental flaps are useful for flap prefabrication and the cambium layer of the periosteum can be osteogenic, we examined whether calvarial periosteum grafted onto greater omentum of rats was osteogenic and suitable for a flap. Distal omentum was wrapped with calvarial periosteum and so the cambium faced the omentum. Grafted omentum was harvested at 1 to 9 days. In other rats, grafted omentum was elevated as a pedicled flap and moved to the abdominal subcutis, to be harvested later at 1 to 5 months after the initial surgery...
December 2011: Annals of Plastic Surgery
Darren Ng, Cheuk B Tang, Sritharan S Kadirkamanathan, Makarand Tare
We report a case of Fournier's gangrene, where we used the greater omentum as a free flap for scrotal reconstruction and outline the advantages over previously described methods. The greater omentum was harvested using a standard open technique. The deep inferior epigastric vessels were passed through the inguinal canal into the scrotal area as recipient vessels. The detached greater omental flap was prefabricated into a three-dimensional sac prior to inset and microvascular anastomoses. The flap was then covered by skin graft...
July 2010: Microsurgery
Junzo Shimizu, Yoshihiko Arano, Iwao Adachi, Chikako Ikeda, Norihiko Ishikawa, Hiroshi Ohtake
A 68-year-old man, complaining of fever and puriform sputum, was referred to our hospital. A giant abscess was detected in the upper lobe of the right lung. Percutaneous drainage of a lung abscess was carried out. When the pus collected was cultured, Candida was 1+ and Escherichia coli was 2+. Later, it became difficult to control the abscess by drainage, and cavernostomy was selected. The contents of the abscess cavity were removed, and the cavity was opened, followed by exchange of gauze every day. For 14 months after cavernostomy, once-weekly gauze exchange was continued at the outpatient clinic to clean the abscess cavity...
November 2009: General Thoracic and Cardiovascular Surgery
F Sury, D Orry, J Parmentier, D Goga, B Laure
INTRODUCTION: Microdialysis allows postoperative monitoring of free flaps. It allows determining their cellular metabolism in vivo by measuring glucose, lactate, and pyruvate. We report an application on a greater omentum free flap. CASE REPORT: A 77 year old female patient was operated for a vertex angiosarcoma. A large loss of vertex substance (175cm(2)) was rebuilt with a greater omentum free flap. Monitoring included hourly clinical observation (color, temperature, aspect), and flap surveillance using microdialysis CMA 60((R)) catheter...
April 2010: Revue de Stomatologie et de Chirurgie Maxillo-faciale
T S Aukema, N S Russell, J Wesseling, E J Rutgers
INTRODUCTION: Locoregional breast cancer recurrence can be detected at an advanced stage of the disease. To achieve local control for these larger local breast cancer recurrences, wide soft tissue resections with autologous tissue coverage of the defect is an option. The aim of this study was to assess the local control and morbidity of surgical salvage of patients with advanced local breast cancer recurrence using autologous tissue closure of the defect. MATERIAL AND METHODS: Eighty-eight patients were treated with wide soft tissue resections with autologous tissue coverage from 1993 to 2006...
May 2009: European Journal of Surgical Oncology
Nuria Novoa, Pablo Benito, Marcelo F Jiménez, Ana de Juan, José Luis Aranda, Gonzalo Varela
We review our experience in the treatment of complex large chest-wall defects needing a multidisciplinary approach due to primary or secondary neoplasms. Non-small cell lung cancer with chest-wall invasion cases are excluded. Fifteen patients underwent whole thickness resection of the chest wall due to lesions affecting at least three ribs, sternum, clavicle or thoracic spine and the surrounding soft tissue. Previously operated breast cancer and sarcoma were the most frequent diagnoses. Partial or total sternectomy plus rib resection was performed in 8 patients...
June 2005: Interactive Cardiovascular and Thoracic Surgery
Raymund E Horch, Thomas Horbach, Werner Lang
Microvascular transfer of the omentum provides well-vascularized and pliable tissue but has not widely been used in vascular extremity reconstruction because of the potentially high donor site morbidity caused by the necessary laparotomy. Laparoscopic minimally invasive harvest of a free greater omentum flap and microsurgical transfer of this tissue with split skin grafts on top and connected to sequential vein bypasses may be a an interesting new modality when other reconstructive options are absent or scarce...
April 2007: Journal of Vascular Surgery
Yu-Ming Shen, Zu-Yao Shen
OBJECTIVE: To evaluate the clinical efficacy of greater omentum in reconstruction of refractory wounds. METHODS: From August 1988 to May 2001, 20 patients with refractory wound underwent pedicle or microvascular free transfer of the greater omentum. Indications of surgery were electrical injury of the wrist and hand in 9 patients, electrical injury of the scalp and cranial bones in 3, avulsion injury of the scalp in 2, radiation-related ulcer of the chest wall in 2, ulcer and osteomyelitis following resection of the sternum sarcoma in 1, electrical injury of the abdomen in 1, bone and soft tissue defects following compound fracture of the leg in 1, and extensive scar and ulcer of the leg and footdrop following trauma in 1...
April 2003: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Z Shen, D Xiang, N Wang
OBJECTIVE: To reduce amputation rate of most severe pattern (Type III) of electrical burns of wrist. METHODS: Early wrist decompression followed by selective transfusion of dextran, PGE1, low molecule heparin to prevent thrombosis of injured radial and ulnar arteries, vascular bridging across the distal forearm and wrist to the hand soon after the appearance of circulatory failure to the hand. Free tissue transfer, especially the use of greater omentum and the innovated abdominal flaps, to repair the circumferential wounds of the wrists are recommended...
March 1999: Chinese Journal of Plastic Surgery and Burns
E M Genden, M R Kaufman, B Katz, A Vine, M L Urken
BACKGROUND: Malignant lesions of the pharyngoesophagus often require total laryngopharyngectomy and mediastinal dissection. As a result of the current treatment paradigms for advanced laryngopharyngeal cancers, it is common that the surgical field has been previously irradiated or exposed to systemic chemotherapy, resulting in fistula rates as high as 78% and mortality as high as 8%. The free vascularized tubed gastric antrum and the accompanying greater omentum offer a single-staged method of pharyngoesophageal reconstruction, with the added benefit of protection of the great vessels, the tracheal stump, and the mediastinal contents in a high-risk surgical field...
July 2001: Archives of Otolaryngology—Head & Neck Surgery
Iglesias, P Butrón, E Cortés, A Angeles, J A Robles, F Vargas-Vorackova
Taking into account the angiogenic properties of the omentum to revascularize ischemic tissues, this experimental, longitudinal, prospective, double-blind study in rabbits was designed to revascularize and preserve the mobility of a digital osteotendinous structure surgically devascularized in advance and to compare such omental angiogenic ability with that of the muscle and the panniculus carnosus. Thirty New Zealand rabbits were used. Three toes from the hind feet were surgically amputated from each rabbit...
October 2000: Plastic and Reconstructive Surgery
A S Nikonenko, A V Gubka, V I Pertsov, V V Osaulenko, E V Ermolaev
Anatomo--morphological peculiarities of greater omentum (GO) in 63 patients, in whom its flap was applied for revascularization of ischemized tissues of extremities, myocardium and the brain, were studied up. Microsurgical transplantation of the GO free flap was performed in 41 patient, omentocardiopexy without the break of the GO vascular pedicle--in 22. Possibilities of the GO application for the ischemized organs revascularization were estimated.
2000: Klinichna Khirurhiia
P Prowans
The paper presents method of restoration of protective sensation after major hand injuries primarily treated with great omental flap. Existing methods have been modified on assumption that free end of transplanted sural nerve might act as sensation receptor. Two patients were operated on. Several months after surgery patients reported paresthesiae at skin compression. Function improvement is seemingly indicated by objects less frequently falling of out of the hand.
1999: Chirurgia Narzadów Ruchu i Ortopedia Polska
A A Vishnevskiĭ, V V Golovteev, V I Perepechin
Transsternal approach is commonly used in majority of operations in heart surgery. In 0.5-5.9% of patients after median sternotomy osteomyelitis of the sternum and the ribs develops. The authors set forth their experience in surgical treatment of 182 such patients. In 97% of them total resection of the sternum was combined with simultaneous resection of costal cartilages which were involved in pyogenous inflammatory process. Costal cartilages were resected during subtotal resection of the sternum in 95% of cases and ribs--in 25%...
1999: Khirurgiia
G Maiwald, C Müller, H Fürst, S Arbogast, R G Baumeister
Patients suffering from long-untreated malignomas of the chest or abdominal wall may require plastic surgery due to extensive defects after tumor resection. Despite a variety of pedicled or free myocutaneous flaps, there are defects in which these reconstructional options may not be indicated. In these patients, the omental flaps are a valid alternative. Since a secondary split skin graft is mandatory with the omentum flap, antibacterial and granulation-enhancing xerodressings are required for wound bed conditioning...
May 1999: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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