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Microsurgical reconstruction

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https://www.readbyqxmd.com/read/28521345/superficial-temporal-artery-distal-posterior-cerebral-artery-bypass-through-the-subtemporal-approach-technical-note-and-pilot-surgical-cases
#1
Akitsugu Kawashima, Hugo Andrade-Barazarte, Behnam Rezai Jahromi, Minna Oinas, Ahmed Elsharkawy, Juri Kivelev, Yuichi Kubota, Takakazu Kawamata, Juha A Hernesniemi
BACKGROUND: Posterior cerebral artery (PCA) aneurysms are rare and the majority are fusiform in shape. Proximal occlusion of PCA represents a treatment option for these lesions. However, this procedure carries a high risk of ischemic complications. OBJECTIVE: To describe the technique of trapping a fusiform PCA aneurysm and revascularization of the distal PCA using a superficial temporal artery (STA) graft through the same microsurgical approach. METHODS: From September 2012 to October 2014, we retrospectively identified 3 patients harboring a fusiform PCA aneurysm (P2 segment aneurysm) who underwent trapping of the aneurysm and reconstruction of the distal PCA through the same subtemporal approach...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28509443/hemodynamically-stimulated-and-in-vivo-generated-axially-vascularized-soft-tissue-free-flaps-for-closure-of-complex-defects-evaluation-in-a-small-animal-model
#2
Volker J Schmidt, Johanna O Wietbrock, Nico Leibig, Jochen F Hernekamp, Dominic Henn, Christian A Radu, Ulrich Kneser
The arteriovenous (AV) loop model permits the creation of significant volumes of axially vascularized tissue that represents an alternative to conventional free flaps, circumventing their common limitations. However, such AV-loop-based flaps have never before been examined in standardized animal models with respect to their suitability for reconstruction of critical bone exposing defects. In the course of our preliminary studies, we implemented a novel defect model in rats that provides standardized and critical wound conditions and evaluated whether AV-loop-generated flaps are suitable for free microsurgical transfer and closure of composite defects...
May 16, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28507850/distally-based-sural-artery-peroneus-flap-dbspf-for-foot-and-ankle-reconstruction
#3
Ahmed Ali Ebrahiem, Raj Kumar Manas, Gustavo Vinagre
BACKGROUND: Reconstruction of soft-tissue defects in lower third of leg, ankle, and foot has been a challenge and reconstructive surgeons have been trying to innovate different flaps. To solve this issue, we propose a distally based sural artery peroneus flap (DBSPF) in which we include superficial portion of the peroneus brevis muscle and its blood supply with the peroneal artery distally. The aim of this study was to evaluate the functional outcome and its usefulness over conventional distal sural artery flap or other local options available...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28495027/medial-femoral-condyle-microvascular-bone-transfer-as-a-treatment-for-capitate-avascular-necrosis-surgical-technique-and-case-report
#4
Nikolas H Kazmers, Joshua C Rozell, Kevin M Rumball, Scott H Kozin, Dan A Zlotolow, L Scott Levin
Avascular necrosis (AVN) of the capitate is a rare clinical entity for which a variety of treatment options have been described, ranging from immobilization to microvascular bone transfer. Outcomes following medial femoral condyle corticocancellous free flap reconstruction have not been reported for this specific pathology. We present the case of a 16-year-old girl with posttraumatic capitate AVN who was treated with curettage and medial femoral condyle corticocancellous vascularized bone grafting. At 18 months after surgery, the patient remains pain-free and had resumed all activities including lifeguarding by 6 months after surgery...
May 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28489206/lower-extremity-reconstruction-epidemiology-management-and-outcomes-of-patients-of-the-federal-district-north-wing-regional-hospital
#5
Jefferson Lessa Soares Macedo, Simone Corrêa Rosa, Daniel Lobo Botelho, Clendes Pereira Dos Santos, Murilo Neves DE Queiroz, Tabatha Gonçalves Andrade Castelo Branco Gomes
Objective: to evaluate the management of lower limbs complex traumatic injuries by analyzing their characteristics, types, conduct and evolution, with emphasis on surgical treatment. Methods: we conducted a prospective study of patients treated by Plastic Surgery at a regional hospital of the Federal District during a one-year period. We collected data through serial evaluations and telephone contact records. Results: we studied 40 patients, with a mean age of 25...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28488211/calf-augmentation-and-restoration-long-term-results-and-the-review-of-the-reported-complications
#6
Igor Niechajev, Christen Krag
BACKGROUND: Augmentation or reconstruction of the calves is indicated in patients with thin legs, for bodybuilders, or when there is a defect after an injury or illness. The principle of placing implants under the investing crural fascia was worked out in the 1980s. The senior author (I.N.) introduced many technical modifications and improvements for this operation, among them the new instrument, an inserter for the calf implants. Presented patient material is unique in that the more challenging reconstructive cases almost equal the numbers of the aesthetic cases...
May 9, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28468146/microsurgical-replantation-of-total-avulsed-scalp-extending-the-limits
#7
Yunbo Jin, Chen Hua, Xiaojie Hu, Hui Chen, Gang Ma, Yun Zou, Bin Chen, Dongze Lyu, Mathias Tremp, Xiaoxi Lin
BACKGROUND: Avulsion of the scalp is a rare but severe trauma and challenging to the reconstructive surgeon. It poses not only physical concussion but also significant persisting psychological distress to the patients. METHODS: Medical records from 5 patients who suffered scalp avulsion were reviewed retrospectively. The following data and methods were assessed: age, number of vessels repaired, method of replantation, vein grafts required, blood transfusion, ischemia time, total operating time, and percentage of scalp survival...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28458967/improved-head-and-neck-free-flap-outcome-effects-of-a-treatment-protocol-adjustment-from-pre-to-postoperative-radiotherapy
#8
Martin Halle, Bjorn O Eriksson, Ann-Charlott Docherty Skogh, Pehr Sommar, Lalle Hammarstedt, Caroline Gahm
BACKGROUND: The impact of preoperative radiotherapy on microvascular reconstructive surgery outcome has been a subject of debate. However, data are conflicting and often dependent on local treatment protocols. We have studied the effects of radiotherapy in a unique, single-center setting where a treatment protocol change was undertaken from pre- to postoperative radiotherapy administration for microsurgical head and neck reconstructions. METHODS: A cohort study was conducted for 200 consecutive head and neck free flap cases, where 100 were operated on before and 100 after the treatment protocol adjustment in 2006...
March 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28456428/-phalloplasty-microsurgical-options-and-management-algorithm
#9
F Boucher, S Brosset, A A Mojallal, F Braye, J Chateau, N Morel Journel
The free radial forearm flap is considered as the gold standard in penile reconstruction for good functional and aesthetic results. The scar on donor site could be considered as pathognomonic of their situation by transsexual patients. The development of microsurgical flaps provides new therapeutic options. This options are discussed and a therapeutic algorithm is presented. The main techniques used are the pedicled anterolateral thigh perforator flap and free muscle sparing latissimus dorsi flap. Principal criteria are listed, the choice of patient and the local anatomical conditions are the most important...
April 26, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28453337/venous-bridge-arterial-grafting-for-thumb-replantation
#10
Eric R Wagner, Allen T Bishop, Alexander Y Shin
BACKGROUND: The purpose of this study is to describe a novel technique using an interposition vein graft for thumb replantation in these severe avulsion injuries. METHODS: From 2002 to 2012, 8 patients underwent interposition venous bridge grafting from the dorsal radial artery at the anatomic snuffbox to the ulnar digital artery of the thumb. All patients had a traumatic thumb amputation with a severe injury to the ulnar digital artery. The technique began with bony stabilization; the radial artery at the anatomic snuffbox is exposed, vein graft harvested, and microsurgical end-to-side (proximally) and end-to-end (distally) anastomoses are carried out...
May 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28446938/minimally-invasive-surgery-for-resection-of-ossification-of-the-ligamentum-flavum-in-the-thoracic-spine
#11
Wei Zhao, Chaoxiong Shen, Ranze Cai, Jianfeng Wu, Yuandong Zhuang, Zhaowen Cai, Rui Wang, Chunmei Chen
INTRODUCTION: Thoracic ossification of the ligamentum flavum (TOLF) is a common cause of progressive thoracic myelopathy. Surgical decompression is commonly used to treat TOLF. AIM: To evaluate the clinical outcomes of microsurgical decompression of TOLF via a paraspinal approach, using a percutaneous tubular retractor system. MATERIAL AND METHODS: First, three-dimensional (3D) image reconstruction and printed models were made from thin computed tomography scans for each patient...
2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/28444647/-partial-fasciectomy-and-options-of-reconstruction-using-local-flaps-in-cases-of-dupuytren-s-disease
#12
N Spindler, C Josten, S Langer
Aim: Partial fasciectomy in cases of grade III-IV Dupuytren's contracture and coverage of the defect with local flaps. Indication: Dupuytren's contracture is a progressive disease of the hand associated with the formation of fascial cords, which may result in flexion and adduction contractures of the fingers leading up to complete dysfunction of the hands. Method: If several fingers are affected, partial fasciectomy is the gold standard in the treatment of Dupuytren's contracture. Ideally, the fingers reach the neutral position after the fibres causing the contracture are resected and arthrolysis is performed as needed...
April 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28438396/the-versatile-use-of-revisited-de-epithelialization-concept-in-superficial-circumflex-iliac-and-anterolateral-thigh-perforator-free-flap-for-head-and-neck-reconstructions
#13
Jong Woo Choi, Young Chul Kim, Tae Suk Oh, Kyung S Koh, Woo Shik Jeong
BACKGROUND: Although the perforator free flap is now a standard choice for head and neck reconstruction, problems such as microvascular complications, insufficient volume support for the defect, and fistula formation occur. We revisited a de-epithelialized concept for superficial circumflex iliac artery and anterolateral thigh perforator free flap to overcome these problems. METHODS: We applied the de-epithelized perforator free flaps in 35 cases among 761 microsurgical head and neck reconstructions and investigated flap characteristics (length gain of pedicle, flap size, and volumetric analysis) and outcomes (flap failure, partial flap necrosis, hematoma, infection, and fistula)...
February 20, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28437267/reconstruction-of-pediatric-scalp-avulsion-injuries-after-dog-bites
#14
Zhi Yang Ng, Kyle R Eberlin, Tianyu Lin, Peter T Masiakos, Curtis L Cetrulo
Dog bite injuries are common and the head and neck is most frequently involved in pediatric patients. In severe cases, the combination of crushing, tearing, and puncturing can result in scalp avulsion. Currently, microsurgical replantation of the avulsed scalp remains the gold standard but may not always be possible. The authors present their treatment algorithm with 2 patient examples. In Patient 1, the scalp was deemed unsuitable for replantation due to extensive soft tissue injury; in Patient 2, the scalp was not available on presentation...
April 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28422392/hepatic-artery-reconstruction-in-living-donor-liver-transplantation-using-surgical-loupes-achieving-low-rate-of-hepatic-arterial-thrombosis-in-consecutive-741-recipients-tips-and-tricks-to-overcome-the-poor-hepatic-arterial-flow
#15
Ping-Chun Li, Ashok Thorat, Long-Bin Jeng, Horng-Ren Yang, Ming-Li Li, Chun-Chieh Yeh, Te-Hung Chen, Shih-Chao Hsu, Kin-Shing Poon
BACKGROUND: The reconstruction of hepatic artery (HA) is most complex step in living donor liver transplantation (LDLT) due to smaller diameter of the artery and increased risk of HA related complications. Due to smaller diameter of the HA, many centres use microsurgical technique with interrupted sutures for arterial anastomosis. Aim of our study was to retrospectively investigate the outcomes after HA reconstruction performed under magnifying loupes using "parachute technique". MATERIALS AND METHODS: From August 2002 to 31(st) August 2016, LDLT was performed in 766 recipients...
April 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28399026/the-effects-of-music-on-microsurgical-technique-and-performance-a-motion-analysis-study
#16
Afaaf Shakir, Arhana Chattopadhyay, Laurence S Paek, Rory B McGoldrick, Matthew D Chetta, Kenneth Hui, Gordon K Lee
BACKGROUND: Music is commonly played in operating rooms (ORs) throughout the country. If a preferred genre of music is played, surgeons have been shown to perform surgical tasks quicker and with greater accuracy. However, there are currently no studies investigating the effects of music on microsurgical technique. Motion analysis technology has recently been validated in the objective assessment of plastic surgery trainees' performance of microanastomoses. Here, we aimed to examine the effects of music on microsurgical skills using motion analysis technology as a primary objective assessment tool...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28392073/combined-multi-lobed-flaps-a-series-of-39-extensive-hand-and-multi-digit-injuries-one-staged-reconstructions-using-modified-designs-of-alt-dpa-and-chimeric-linking-flaps
#17
Liang Tang, Georgios Pafitanis, Peng Yang, Zan Li, Ming Jia, Isao Koshima, Dajiang Song, Zhenglin Chi
INTRODUCTION: The use of multiple small flaps linked in a "chain-linked" flap microanastomosed chimeric system is recommended in distal hand and digital defects reconstruction. The aim of this study is to demonstrates our experience utilizing microsurgical fabrication, multi-lobed and linking combined flaps for the reconstruction of hand degloving injuries with complex multidigit soft tissue defects. METHODS: Microanastomosed chimeric flap systems using ALT and DPA modified designed flaps were combined in five selections to cover extensive soft tissue defects involving the hands and multiple digits of 39 patients (M:F - 36:3) from October 2009 to February 2013...
March 31, 2017: Injury
https://www.readbyqxmd.com/read/28391079/efficacy-of-the-postoperative-management-after-microsurgical-free-tissue-transfer
#18
N Sigaux, P Philouze, F Boucher, M Jacquemart, P Frobert, P Breton
INTRODUCTION: The physical and medical postoperative measures after free flap reconstruction vary substantially between surgical units. The objective of this review was to identify the postoperative measures which proved a significant positive effect on free flap survival. METHOD: A review was conducted in the MEDLINE database on the English and French literature. RESULTS AND DISCUSSION: Twenty-eight articles were retained. A meta-analysis of 4984 patients who were given antithrombotics (viz...
April 5, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28380642/erratum-to-breast-reconstruction-in-elderly-patients-risk-factors-clinical-outcomes-and-aesthetic-results-j-reconstr-microsurg-efirst-ahead-of-print
#19
Rosaria Laporta, Michail Sorotos, Benedetto Longo, Fabio Santanelli di Pompeo
No abstract text is available yet for this article.
April 5, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28366791/restoration-of-basic-hand-function-following-devastating-hand-injuries-using-a-microsurgically-fabricated-chimeric-iliac-osteocutaneous-flap
#20
Zhao Hui Pan, Ping Ping Jiang, Shan Xue, Hongfei Li, Jian Li Wang
Reconstruction following devastating hand injuries, with amputations of the thumb plus multiple digits, is challenging. Double flap or combined flap transfers may be options in such cases. Between 2012 and 2014, 6 patients underwent hand reconstruction following devastating injuries with amputations of the thumb and multiple digits. Sensate anterolateral thigh free flaps and superficial circumflex iliac artery osteocutaneous flaps were microsurgically fabricated as sequential chimeric flaps. Basic hand function, including pulp-to-palm distance, pinch strength, sensation recovery and modified DASH scores, were evaluated...
June 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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