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Microsurgical reconstruction

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https://www.readbyqxmd.com/read/29642922/an-anterolateral-thigh-chimeric-flap-for-dynamic-facial-and-esthetic-reconstruction-after-oncological-surgery-in-the-maxillofacial-region-a-case-report
#1
Zoltán Lóderer, Tamás Vereb, Róbert Paczona, Ágnes Janovszky, József Piffkó
BACKGROUND: The surgical management of malignant tumors in the head and neck region often leads to functional and esthetic defects that impair the quality of life of the patients. Reconstruction can be solved with prostheses in these cases, but various types of microsurgical free flaps can provide a better clinical outcome. CASE PRESENTATION: In this case report, the tumor and parts of the involved facial muscles and nerve were excised surgically from a 42-year-old patient after a third relapse of basal cell carcinoma in the left midface...
April 11, 2018: Head & Face Medicine
https://www.readbyqxmd.com/read/29627114/partial-medial-second-toe-pulp-free-flap-and-dermal-substitute-with-skin-graft-for-salvage-reconstruction-of-a-complete-skin-envelope-degloving-of-the-small-finger
#2
V Calafat, C Strugarek, D Montoya-Faivre, F Dap, G Dautel
Skin envelope degloving of fingers are rare injuries that require rapid care and surgical treatment. Mostly caused by ring finger injuries, these traumas include bone, tendon and neurovascular pedicle damage. The authors present an unusual case of finger degloving limited exclusively to the skin envelope, without skeletal, tendinous or vascular lesion. This rare case of skin envelope degloving rendered microsurgical revascularization impossible. The authors report the results at 12 months following salvage reconstruction combining a partial second toe pulp free flap for the volar side and a dermal substitute with a thin skin graft for the dorsum...
April 4, 2018: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29623932/evaluation-of-nerve-transfer-options-for-treating-total-brachial-plexus-avulsion-injury-a-retrospective-study-of-73-participants
#3
Kai-Ming Gao, Jing-Jing Hu, Jie Lao, Xin Zhao
Despite recent great progress in diagnosis and microsurgical repair, the prognosis in total brachial plexus-avulsion injury remains unfavorable. Insufficient number of donors and unreasonable use of donor nerves might be key factors. To identify an optimal treatment strategy for this condition, we conducted a retrospective review. Seventy-three patients with total brachial plexus avulsion injury were followed up for an average of 7.3 years. Our analysis demonstrated no significant difference in elbow-flexion recovery between phrenic nerve-transfer (25 cases), phrenic nerve-graft (19 cases), intercostal nerve (17 cases), or contralateral C7 -transfer (12 cases) groups...
March 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29622476/total-penile-reconstruction-a-systematic-review
#4
REVIEW
A Yao, M J Ingargiola, C D Lopez, P Sanati-Mehrizy, N M Burish, E M Jablonka, P J Taub
BACKGROUND: Phalloplasty poses a unique challenge to the plastic and reconstructive surgeon. The development of advanced microsurgical techniques has greatly augmented the range of surgical approaches available. METHODS: A systematic review of the MEDLINE and Cochrane databases was performed to identify clinical studies of total penile reconstruction published within the last 10 years using the search algorithm: "(phallus or penis or penile) and (reconstruction or phalloplasty or transplant)"...
February 14, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29608158/a-rat-model-of-orthotopic-liver-transplantation-using-a-novel-magnetic-anastomosis-technique-for-suprahepatic-vena-cava-reconstruction
#5
Lifei Yang, Jianwen Lu, Yue Wang, Mei Zhang, Yuan Shi, Shasha Wei, Peng Liu, Zheng Wu, Yi Lv, Rongqian Wu
The rat model of orthotopic liver transplantation (OLT) is essential for transplant research. It is a very sophisticated animal model and requires a steep learning curve. The introduction of the cuff technique for anastomosis of the portal vein (PV) and infrahepatic vena cava (IHVC) has significantly simplified the transplant procedure in rats. However, due to the short anterior wall of the recipients' suprahepatic vena cava (SHVC), the cuff technique is very difficult to use for the reconstruction of the SHVC...
March 19, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29605953/does-cigarette-smoking-harm-microsurgical-free-flap-reconstruction
#6
Denis Ehrl, Paul I Heidekrueger, Elisabeth M Haas, Michaela Coenen, Riccardo Giunta, Milomir Ninkovic, P Niclas Broer
BACKGROUND:  Free tissue transfers can successfully address a wide range of reconstructive requirements. While the negative influence of cigarette smoking is well documented, its effects in the setting of microsurgical free flap reconstruction remain debated. This study evaluates the impact of cigarette smoking on microsurgical reconstructions. METHODS:  Over a 7-year period, 897 patients underwent 969 microvascular free flap reconstructions at a single surgical center...
April 1, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29603352/comparison-of-symmetry-after-smile-reconstruction-for-flaccid-facial-paralysis-with-combined-fascia-lata-grafts-and-functional-gracilis-transfer-for-static-suspension-or-gracilis-transfer-alone
#7
Jurij Kiefer, David Braig, Jan R Thiele, Holger Bannasch, G Björn Stark, Steffen U Eisenhardt
PURPOSE: Facial paralysis has a profound impact on functionality and esthetics of the oral region. In patients with strong skin laxity and soft tissue ptosis, functional smile reconstruction is challenging due to the accentuated asymmetry at rest. Thus, the purpose of the study was to analyze facial symmetry in this patient clientele following a combination of dynamic reanimation with fascial strips for static suspension compared to functional gracilis transfer alone. METHODS: In 2014, we altered the single-stage approach for microsurgical smile reconstruction in patients with significant soft tissue ptosis by adding fascia lata grafts for static support...
March 30, 2018: Microsurgery
https://www.readbyqxmd.com/read/29600267/epineural-sleeve-reconstruction-technique-for-median-nerve-complete-transection
#8
Spyridon P Galanakos, Andreas F Mavrogenis, Christos Vottis, George A Macheras, Ioannis Ignatiadis
In microsurgical nerve repair, the epineural sleeve technique can be used to bridge short nerve defects and to cover the coaptation site with the epineurium of the nerve stump. The epineurium serves as a mechanical aid to reduce gap size, and increase repair strength, effectively assisting nerve regeneration. This article presents a 32-year-old patient who experienced complete transection of the median nerve at the distal forearm, which was treated with the epineural sleeve graft reconstruction technique. Nerve regeneration was followed-up for 18 months and evaluated with the Rosén and Lundborg scoring system...
March 2018: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29580168/photocrosslinkable-gelatin-tropoelastin-hydrogel-adhesives-for-peripheral-nerve-repair
#9
Jonathan R Soucy, Ehsan Shirzaei Sani, Roberto Portillo Lara, David Diaz, Felipe Dias, Anthony S Weiss, Abigail N Koppes, Ryan Koppes, Nasim Annabi
Suturing peripheral nerve transections is the predominant therapeutic strategy for nerve repair. However, the use of sutures lead to scar tissue formation, hinder nerve regeneration, and prevent functional recovery. Fibrin-based adhesives have been widely used for nerve reconstruction, but their limited adhesive and mechanical strength, and inability to promote nerve regeneration hampers their utility as a stand-alone intervention. To overcome these challenges, we engineered composite hydrogels that are neuro-supportive and possess strong tissue adhesion...
March 27, 2018: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/29575166/anatomy-of-medial-plantar-superficial-branch-artery-perforators-facilitation-of-medial-plantar-superficial-branch-artery-perforator-mpap-flap-harvesting-and-design-for-finger-pulp-reconstruction
#10
Suphalerk Lohasammakul, Chairat Turbpaiboon, Kongkrit Chaiyasate, Parin Tatsanavivat, Supin Chompoopong, Ali Roham, Rosarin Ratanalekha, Chongdee Aojanepong
BACKGROUND: Medial plantar artery perforator (MPAP) flap was proposed as proper option for finger pulp reconstruction. To provide the previously unavailable vessel information required for this small flap design, this study aimed to gather all necessary anatomy of MPA, MPAP, and their territories of blood supply to apply in clinical MPAP flap reconstruction minimizing perforator injury. METHODS: Dissection of 30 Thai cadaveric feet for visualizing superficial branch of MPA and its perforators (MPAP) using acrylic dye cannulation were performed...
March 25, 2018: Microsurgery
https://www.readbyqxmd.com/read/29543536/a-new-refined-technique-for-myogenic-ptosis-correction-with-resection-of-myotarsal-flap-by-conjunctival-approach
#11
Hemant K Mehta
The purpose is to present a new refined surgical technique for mild-to-severe acquired myogenic ptosis correction under local anaesthesia (LA) as day cases with resection of myotarsal (MT) flap and demonstrate the safety and efficacy of the technique. MT flap consists of 2 mm tarsal strip with attached levator complex - levator muscle, its aponeurosis, and Müller muscle. This is a retrospective personal series of 400+ patients, who underwent surgical correction with MT flap resection of 8-24 mm under LA mostly as day cases...
March 15, 2018: Orbit
https://www.readbyqxmd.com/read/29537997/autologous-breast-reconstruction-using-a-tensor-fascia-lata-anterior-lateral-thigh-freestyle-flap-after-extensive-electric-burn-a-case-report
#12
Dorothee Boehm, Konstantin Bergmeister, Emre Gazyakan, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
AIMS: Reconstruction of breasts and chest wall deformities in female patients after severe burn injury is a challenge for reconstructive surgeons. In these patients, neither implant-based procedures nor standard free flaps are sometimes applicable because of limited skin quality and unavailability of donor sites at the abdomen, back, buttock, or medial thigh. METHODS: We present a case of a young female patient with a history of 80 % total body surface area burn after electric high-voltage injury...
March 13, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29536455/meta-analysis-of-timing-for-microsurgical-free-flap-reconstruction-for-lower-limb-injury-evaluation-of-the-godina-principles
#13
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
https://www.readbyqxmd.com/read/29536126/peri-operative-risk-factors-for-complications-of-free-flaps-in-traumatic-wounds-a-cross-sectional-study
#14
Raquel Bernardelli Iamaguchi, Renan Lyuji Takemura, Gustavo Bersani Silva, Jairo Andre de Oliveira Alves, Luciano Ruiz Torres, Alvaro Baik Cho, Teng Hsiang Wei, Marcelo Rosa de Rezende, Rames Mattar
INTRODUCTION: Indication of free tissue transfer for limb reconstruction continues to grow, and despite the good results with this treatment option, complications can impair the functional results and cause a raise in health costs, with prolonged hospitalization. Therefore, peri-operative surgical information and comorbidities were described and analyzed, for identification of independent risk factors for complications of free flaps results for traumatic wounds. For our knowledge, intraoperative ischemia time of free flap was not previously studied for post-traumatic limb reconstruction, which could influence results, in these traumatic cases, with the highest rates of complications among microsurgical flap reconstructions...
March 13, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29506333/a-rare-approach-microsurgical-breast-reconstruction-after-severe-burns
#15
Laurenz Weitgasser, Ali Bahsoun, Amro Amr, Michael Brandstetter, Friedrich Knam, Thomas Schoeller
Breast deformity, in post-burn patients, is a common problem leading to lower self-esteem and reclusive behavior that impairs quality of life. The authors present the course of treatment of an 18-year-old immigrant girl who suffered second- to third-degree burns over approximately 20% of her total body surface area in her early childhood. The second- to third-degree burns were located on her right trunk and abdomen, as well as her right shoulder, neck, and right groin area. Since it was not offered in her home country, reconstructive surgery, including microsurgical breast reconstruction, was sought abroad...
March 5, 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29501044/sphenoid-meningioma-enplaque-with-proptosis-surgical-excision-reconstruction-and-outcome
#16
Abdelhakeem A Essa, Ali R Hamdan
OBJECTIVE: To evaluate surgical outcome and reconstruction of bone defects after excision of sphenoid meningioma enplaque. PATIENT AND METHODS: Between June 2012 and May 2016, a series of 15 patients presented by proptosis attended to neurosurgery departments, Assiut university hospital, Qena university hospital, South Valley University and, These patients were diagnosed with sphenoid meningioma enplaque by fulfilling its criteria by neuroimaging (sheet-like meningioma and hyperostosis)...
February 21, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29499911/mra-of-the-skin-mapping-for-advanced-breast-reconstructive-surgery
#17
REVIEW
N D Thimmappa, J V Vasile, C Y Ahn, J L Levine, M R Prince
Autologous breast reconstruction using muscle-sparing free flaps are becoming increasingly popular, although microvascular free flap reconstruction has been utilised for autologous breast reconstructions for >20 years. This innovative microsurgical technique involves meticulous dissection of artery-vein bundle (perforators) responsible for perfusion of the subcutaneous fat and skin of the flap; however, due to unpredictable anatomical variations, preoperative imaging of the donor site to select appropriate perforators has become routine...
February 27, 2018: Clinical Radiology
https://www.readbyqxmd.com/read/29489543/complex-intraoral-reconstruction-using-a-single-free-anterolateral-thigh-flap-and-supermicrosurgery-after-corrosive-ingestion-in-a-14-month-old-child
#18
Mohammed H El Fahar
Oral chemical burn injuries induce more damage to the underlying tissues with extensive scarring. It is very well known that alkali causes severe liquefaction necrosis and injury to the deeper tissues. Pediatric facial burns must be managed thoroughly and always require complex reconstruction, which is a challenging process. So, any reconstructive surgeon must be aware of all the deformities that may have significant functional and aesthetic impact on the burn survivors especially children. Few medical studies addressed pediatric microsurgical reconstruction for oral burn injuries induced by chemical materials...
February 27, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29481410/detection-of-perforators-for-free-flap-planning-using-smartphone-thermal-imaging-a-concordance-study-with-computed-tomographic-angiography-in-120-perforators
#19
Nicolás Pereira, Diego Valenzuela, Günther Mangelsdorff, Matías Kufeke, Ricardo Roa
Design and preoperative planning of microsurgical flaps are fundamental steps for successful surgery. Currently, computed tomographic angiography is considered the gold standard, and new technologies such as thermography could complement its usefulness. The aim of this study was to determine the concordance between thermographic images obtained with a smartphone thermal camera and computed tomographic angiography for detecting perforators using the anterolateral thigh flap area as a model. A concordance study of diagnostic tests was performed in patients who underwent limb reconstruction in 2016...
March 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29464176/latissimus-dorsi-and-immediate-fat-transfer-lift-for-complete-autologous-breast-reconstruction
#20
James M Economides, David H Song
Background: Despite the popularity of latissimus dorsi (LD) flap in breast reconstruction, a breast implant is often necessary to achieve sufficient volume. Prior reports describe fat grafting to the LD flap as a secondary procedure to correct contour deformities and improve volume. Our institution has instituted autologous breast reconstruction with an LD flap and immediate fat transfer (LIFT). Methods: A retrospective review of all patients undergoing the LIFT procedure was undertaken...
January 2018: Plastic and Reconstructive Surgery. Global Open
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