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Microsurgical reconstruction

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
March 21, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28363300/microsurgical-reconstruction-of-the-burned-hand-and-upper-extremity
#9
REVIEW
Mauricio De la Garza, Michael Sauerbier, Germann Günter, Curtis L Cetrulo, Reuben A Bueno, Robert C Russell, Michael W Neumeister
Improvements in critical care and burn victim resuscitation have led to increased survival of burned patients. Initial resuscitation, early excision of burned tissues, prevention of burn wound sepsis, and wound coverage remain mainstays of care. Many burn wounds require complex reconstruction. This is particularly important in the hand. Coverage of tendons, ligaments, joints, vessels, nerves, and bones of the hand requires healthy vascularized tissue to maintain viability and function. Local flaps or regional flaps may be within the burn zone of injury...
May 2017: Hand Clinics
https://www.readbyqxmd.com/read/28350684/current-concepts-in-the-surgical-management-of-lymphedema
#10
Theodore A Kung, Manish C Champaneria, Jeffrey H Maki, Peter C Neligan
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Discuss the key points in diagnosing lymphedema. 2. Understand the imaging modalities that facilitate diagnosis and surgical planning. 3. Appreciate the indications for both physiologic and ablative procedures. 4. Recognize the potential role of lymphaticovenular anastomosis and vascularized lymph node transfer in the treatment of patients with lymphedema. SUMMARY: Lymphedema is an incurable disease caused by insufficient lymphatic drainage leading to abnormal accumulation of interstitial fluid within the soft tissues...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28347681/endovascular-treatment-of-ruptured-tiny-%C3%A2-3mm-intracranial-aneurysms-in-the-setting-of-subarachnoid-hemorrhage-a-case-series-of-20-patients-and-literature-review
#11
Miracle C Anokwute, John A Braca, Bradley Bohnstedt, Andrew DeNardo, John Scott, Aaron Cohen-Gadol, Daniel H Sahlein
Successful endovascular coiling of ruptured tiny saccular intracranial aneurysms (⩽3mm) is technically challenging and traditionally has been associated with technical failures, as well as morbidity related to thromboembolic events and high intraoperative rupture rates. This study analyzes the feasibility, technical efficacy, and clinical outcomes of coil embolization of ruptured tiny intracranial aneurysms using current coil and microcatheter technology and techniques. We performed a retrospective review of 20 patients with 20 ruptured tiny aneurysms treated with endovascular coil embolization from 2013 to 2016 at a single high-volume academic tertiary care practice...
March 24, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28340673/the-advent-of-vascularized-composite-allotransplantation
#12
REVIEW
Curtis L Cetrulo, Zhi Yang Ng, Jonathan M Winograd, Kyle R Eberlin
Modern microsurgical techniques have made possible a broad spectrum of novel means for the reconstruction of complex bone and soft tissue defects. These techniques, in combination with developments in transplant immunology, have led to successful hand and facial allotransplantation and achievement of the highest rung in the reconstructive ladder - truly replacing like with like. The utilization of contemporary microsurgical technique in the context of vascularized composite allotransplantation (VCA) (1) permits successful technical execution and feasibility of VCA, (2) facilitates the study of immunologic tolerance in VCA preclinical models, and (3) optimizes functional VCA outcomes...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340672/new-frontiers-in-robotic-assisted-microsurgical-reconstruction
#13
REVIEW
Amir E Ibrahim, Karim A Sarhane, Jesse C Selber
Robotic surgery has revolutionized minimally invasive surgery. Owing to its unique features and key advantages, robotic surgery is being used for complex cases across surgical specialties. It has been introduced into reconstructive surgery, and is being applied in microsurgery. Robotic surgery combines properties of conventional microsurgery, endoscopic surgery, and telesurgery. It holds great promise in expanding the boundaries of reconstructive microsurgery. However, there are constraints that limit its widespread use...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340667/microsurgical-tissue-transfer-in-breast-reconstruction
#14
REVIEW
Nakul Gamanlal Patel, Venkat Ramakrishnan
Autologous breast reconstructions have grown in popularity because of their durability, aesthetic outcomes, symmetry, increase in external beam radiotherapy use, and potential aesthetic enhancement at the donor site. Increasing patient expectations for predictable high aesthetic outcomes with minimal complications or need for further procedures has been met by refinement in the use of flaps. The authors' microsurgical breast reconstruction center aims to provide this while delivering efficient service. The deep inferior epigastric flaps form 85% and transverse upper gracilis and profunda artery perforator flaps account for 10%; lumbar artery perforator flaps are a new addition to the authors' armamentarium...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340666/innovations-and-future-directions-in-head-and-neck-microsurgical-reconstruction
#15
REVIEW
Marissa Suchyta, Samir Mardini
Head and neck reconstructive microsurgery is constantly innovating because of a combination of multidisciplinary advances. This article examines recent innovations that have affected the field as well as presenting research leading to future advancement. Innovations include the use of virtual surgical planning and three-dimensional printing in craniofacial reconstruction, advances in intraoperative navigation and imaging, as well as postoperative monitoring, development of minimally invasive reconstructive microsurgery techniques, integration of regenerative medicine and stem cell biology with reconstruction, and the dramatic advancement of face transplant...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340665/pediatric-microsurgery-a-global-overview
#16
REVIEW
Ali Izadpanah, Steven L Moran
As microsurgical expertise has improved, allowing for the safe transfer of smaller and more refined flaps, free tissue transfer has continued to gain popularity for the management of pediatric soft tissue and bony defects. For the past 2 decades pediatric microsurgery has been shown to be technically feasible and reliable. The major advantage of free tissue transfer in children is the ability to reconstruct defects in a single stage, avoiding the historic treatments of skin grafting, tissue expansion, and pedicled flaps...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340664/complex-microsurgical-reconstruction-after-tumor-resection-in-the-trunk-and-extremities
#17
REVIEW
Omar N Hussain, M Diya Sabbagh, Brian T Carlsen
Reconstruction of soft tissue defects following tumor ablation procedures in the trunk and extremities can challenge the microsurgeon. The goal is not just to provide adequate soft tissue coverage but also to restore form and function and minimize donor site morbidity. Although the principles of the reconstructive ladder still apply in the trunk and extremities, free tissue transfer is used in many cases to optimally restore form and function. Microsurgery has changed the practice in soft tissue tumors, and amputation is less frequently necessary...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340659/exploring-new-frontiers-of-microsurgery-from-anatomy-to-clinical-methods
#18
REVIEW
Zeng Tao Wang, You Mao Zheng, Lei Zhu, Li Wen Hao, Ya Bin Zhang, Chao Chen, Li Feng Xia, Lin Feng Liu
This article presents the authors' understanding and experience concerning anatomic studies and clinical methods in microsurgical hand reconstruction. The 4 parts of this article include anatomic study of the hand for developing new flaps; application of miniflaps from the hand, including clinical experience with 8 unique flaps in the hand; anatomic and clinical considerations concerning several flaps from other parts of the human body; And our experience with vascularized free toe joint transfer.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28328635/a-systematic-review-of-the-use-of-telemedicine-in-plastic-and-reconstructive-surgery-and-dermatology
#19
Krishna S Vyas, H Rhodes Hambrick, Afaaf Shakir, Shane D Morrison, Duy C Tran, Keon Pearson, Henry C Vasconez, Samir Mardini, Amanda A Gosman, Marek Dobke, Mark S Granick
BACKGROUND: Telemedicine, the use of information technology and telecommunication to provide healthcare at a distance, is a burgeoning field with applications throughout medicine. Given the visual nature of plastic surgery and dermatology, telemedicine has a myriad of potential applications within the field. METHODS: A comprehensive literature review of articles published on telemedicine since January 2010 was performed. Articles were selected for their relevance to plastic and reconstructive surgery and dermatology, and then reviewed for their discussion of the applications, benefits, and limitations of telemedicine in practice...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28319440/markers-of-blood-coagulation-and-fibrinolysis-in-patients-with-early-and-delayed-microsurgical-reconstructions-in-the-lower-extremities
#20
Oliver Kloeters, Dalibor Vasilic, Pieter Hupkens, Dietmar Ulrich
BACKGROUND: In this study, markers of coagulation and fibrinolysis were assessed during early and delayed microsurgical reconstruction in patients with traumatic defects of their lower legs to analyse whether an imbalance of the hemostasis after trauma might predispose the development of vascular complications. METHODS: The prospective study included 70 patients. In 35 patients, surgery was performed within 72 hours after injury. In 35 other patients, delayed free flap transfer was performed between 14-21 days after trauma...
March 20, 2017: Journal of Plastic Surgery and Hand Surgery
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