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Microsurgical reconstruction

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https://www.readbyqxmd.com/read/28688657/umbilical-necrosis-rates-after-abdominal-based-microsurgical-breast-reconstruction
#1
Joseph A Ricci, Parisa Kamali, Babette E Becherer, Daniel Curiel, Winona Wu, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: Umbilical stalk necrosis represents a rare, yet important complication after abdominal-based microsurgical breast reconstruction, which is both underrecognized and understudied in the literature. Once identified, umbilical reconstruction can be an extremely challenging problem. METHODS: All consecutive breast free flaps at a single institution from February 2004 to February 2016 were reviewed, excluding non-abdominal-based flaps. Patients were divided based on the development of umbilical necrosis postoperatively...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28673620/microsurgical-flaps-in%C3%A2-repair-and-reconstruction-of-the-hand
#2
REVIEW
Shimpei Ono, Sandeep J Sebastin, Hiroyuki Ohi, Kevin C Chung
The authors' strategy for soft-tissue coverage of the hand is presented. The concept of replacing like with like and reconstruction with similar adjacent tissue enhances functional and aesthetic outcomes. In this viewpoint, the pedicle perforator flap is an ideal flap. A decision-making algorithm to select an ideal flap for a particular hand defect is challenging, requiring experiential consideration of functional outcome, appearance, donor-site morbidity, and patient satisfaction. To assist surgeons in determining the most appropriate flap with more evidence, studies are necessary to compare the outcomes of each flap by evaluating hand function, aesthetics, donor site morbidity, and patient satisfaction...
August 2017: Hand Clinics
https://www.readbyqxmd.com/read/28657946/reconstruction-repair-of-iatrogenic-biliary-injuries-is-the-robot-offering-a-new-option-short-clinical-report
#3
Pier Cristoforo Giulianotti, Pablo Quadri, Samarth Durgam, Francesco Maria Bianco
OBJECTIVE: The aim of this study is to analyze perioperative outcomes of robotic reconstruction of iatrogenic biliary injuries and describe the surgical technique in detail. BACKGROUND: Iatrogenic bile duct injuries (BDIs) continue to be a major concern in open and laparoscopic cholecystectomy. In the past decade, robotic surgery has been applied to many different procedures showing technical advantages, especially in microsurgical fields. Few cases of robotic BDI reconstructions have been described in the literature so far...
June 27, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28657669/does-the-use-of-arteriovenous-loops-increase-complications-rates-in-posttraumatic-microsurgical-lower-extremity-reconstruction-a-matched-pair-analysis
#4
Arash Momeni, Michael A Lanni, Lawrence S Levin, Stephen J Kovach
INTRODUCTION: The use of arteriovenous (AV) loops in microsurgical lower extremity reconstruction is a controversial topic. The objective of the present study was to assess the impact of AV loops on complication rates following microsurgical reconstruction of posttraumatic lower extremity defects. PATIENTS AND METHODS: Patients who underwent free flap coverage of posttraumatic defects in combination with an AV loop (Group 1) were identified and matched for age, body mass index (BMI), tobacco use, defect location, and flap type with patients who underwent reconstruction without vein grafts (Group 2)...
June 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28648581/is-long-term-post-operative-monitoring-of-microsurgical-flaps-still-necessary
#5
Giovanni Zoccali, Alexandra Molina, Jian Farhadi
Autologous microsurgical flap reconstruction has become commonplace in most plastic surgery units, and the success rates of this procedure have markedly increased over recent years. However, the possibility of flap failure still needs to be considered. A review of the literature reveals that the critical period for flap-threatening complications is the first 24-48 post-operative hours; however, the window for the onset of these complications remains open for up to 7 days post-operatively. In this study, we focus on the timing of flap complications, aiming to elucidate the time period over which meticulous flap monitoring can positively contribute to flap salvage rates...
June 1, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28648003/-curative-effect-analysis-of-15-cases-of-cervical-intra-and-extra-spinal-tumors-by-microsurgical-resection
#6
Y Han, X L Zheng, L Li, Z Q Jiang, F Y Lou, S J Zhang
Objective: To explore the curative effect of microsurgical treatment of cervical intra- and extra-spinal tumors. Methods: The clinical data of 15 patients with cervical intra-and extra-spinal tumors in Department of Neurosurgery, the First Affiliated Hospital of Bengbu Medical College from January 2013 to February 2017 were retrospectively analyzed. According to Shaw's tumor stage: 6 cases in stage Ⅰ, 5 cases in stage Ⅱ, 3 cases in stage Ⅲ, and 1 case in stage Ⅳ. About the surgical methods: 9 cases were treated via posterior median semi-laminectomy approach, of which were internal fixation in 2 cases, and via posterior median approach spinous process and vertebral plate complex orthotopic replantation to spinal canal plasty in 3 cases, other 3 cases were operated via anterior cervical approach, including internal fixation in 1 case...
June 20, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28611938/anatomic-study-of-the-vascular-perfusion-of-the-sternum-and-its-clinical-relevance-in-deep-sternal-wound-infection
#7
Nick Spindler, Florian Kaatz, Christine Feja, Christian Etz, Friedrich-Wilhelm Mohr, Ingo Bechmann, Christoph Josten, Stefan Langer, Sabine Loeffler
Introduction: Deep sternal wound infections (DSWI) are a rare but devastating complication after median sternotomy. Minor perfusion in bone and soft tissue, especially after recruiting the internal mammary artery for bypass supports the development of wound infection and nonunion of the sternal bone. The aim of the study was the macroscopic and radiological presentation of the vascular system supplying the sternum, in particular the compensating blood supply routes in the event that the internal mammary artery is no longer available after use as a bypass vessel...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/28607852/microsurgical-hepatic-artery-reconstruction-using-ikuta-a-ii-double-clamp
#8
Masayuki Okochi, Hiromi Okochi, Takao Sakaba, Masanori Momiyama, Kazuki Ueda
We performed hepatic artery (HA) reconstruction on 24 patients between January 2010 and October 2016. Six of 24 patients used an Ikuta type A-II vascular clamp (A-II group). The mean age was 38.0 years (range, 1-61 years). There was no blood leakage at the anastomosed site in any of the patients. No patients required an additional vascular clamp, and none developed HA thrombosis. Eighteen of 24 patients used a conventional vascular clamp. The mean age was 36.1 years (range, 1-65 years; conventional group). Sixteen of 18 patients required an additional vascular clamp due to blood leakage from the HA...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28604380/microsurgical-scia-siea-flap-for-facial-contour-correction-in-patient-with-hemifacial-microsomia
#9
Andrea Battisti, Andrea Cassoni Cassoni, Davina Bartoli, Marco Della Monaca, Giorgio Barbera, Edoardo Cerbelli, Valentino Valentini
AIM: We propose our experience in soft tissue reconstruction in Hemifacial microsomia using a free fascioadiposal flap. MATERIAL OF STUDY: Hemifacial microsomia (HFM) is a congenital disorder characterized by craniofacial malformation of one or both sides of the lower face. A 18-year-old female presented with hemifacial microsomia involving the left side. A free SCIA/SIEA fascioadiposal flap was transferred to the left face for soft tissue augmentation. RESULTS: The immediate postoperative course of the patient was uneventful, with no complication and adequate augmentation in contour deformity was achieved...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28594742/outcomes-of-lymphedema-microsurgery-for-breast-cancer-related-lymphedema-with-or-without-microvascular-breast-reconstruction
#10
Holger Engel, Chia-Yu Lin, Jung-Ju Huang, Ming-Huei Cheng
OBJECTIVE: This study investigated the outcome of lymphedema microsurgery with or without microsurgical breast reconstruction for breast cancer-related lymphedema (BCRL). BACKGROUND: Complete decongestive therapy, lymphovenous anastomosis, and vascularized lymph node flap transfer are the 3 major treatment modalities for BCRL. Releasing axillary contracture and transferring a free flap may potentially improve the BCRL. METHODS: Between 2004 and 2015, 124 patients with BCRL who underwent 3 treatment modalities without or with microsurgical breast reconstruction were included in this study as groups I and II, respectively...
June 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28574948/five-operations-that-give-the-best-results-after-brachial-plexus-injury
#11
Andrés A Maldonado, Allen T Bishop, Robert J Spinner, Alexander Y Shin
Treatment of brachial plexus injuries has slowly improved over the last 45 years. Changes in strategy, techniques, microsurgical equipment and technology have expanded the surgical options to reconstruct these life altering, highly complex injuries. The surgical armamentarium includes neurolysis, nerve repair, nerve grafting, nerve transfers, tendon transfer, muscle transfer and other soft tissue and bony procedures. In this article we have selected five surgical procedures (Oberlin's procedure, Leechavengvongs' procedure, free functional muscle transfer, radial nerve tendon transfers and C5-C6 nerve grafting in obstetrical birth palsy) that have consistently given us good results in our patients who require surgical reconstruction...
May 31, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28573680/the-effect-of-age-on-microsurgical-free-flap-outcomes-an-analysis-of-5-951-cases
#12
Kevin T Jubbal, Dmitry Zavlin, Ahmed Suliman
BACKGROUND: The growing elderly population necessitates a greater number of aging patients requiring complex reconstructive surgery involving free tissue transfer. The purpose of this study was to assess the safety, efficacy, and outcomes of microsurgical free tissue transfer in elderly patients using a national multi-institutional database. METHODS: We performed a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to identify patients undergoing free tissue transfer...
June 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28573100/vascular-augmentation-in-renal-transplantation-supercharging-and-turbocharging
#13
Euicheol C Jeong, Seung Hwan Hwang, Su Rak Eo
The most common anatomic variant seen in donor kidneys for renal transplantation is the presence of multiple renal arteries, which can cause an increased risk of complications. Accessory renal arteries should be anastomosed to the proper source arteries to improve renal perfusion via the appropriate vascular reconstruction techniques. In microsurgery, 2 kinds of vascular augmentation methods, known as 'supercharging' and 'turbocharging,' have been introduced to ensure vascular perfusion in the transferred flap...
May 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28571928/free-tissue-flaps-in-head-and-neck-reconstruction-clinical-application-and-analysis-of-93-patients-of-a-single-institution
#14
Jiwang Liang, Tao Yu, Xu Wang, Yuejiao Zhao, Fengqin Fang, Wei Zeng, Zhendong Li
INTRODUCTION: Reconstruction with a free flap is routine in head and neck surgery because of better functional outcomes, improved esthetics, and generally higher success rates. OBJECTIVE: To evaluate the clinical outcomes in patients undergoing different microvascular free flap reconstructions. METHODS: This was a retrospective study of 93 patients undergoing reconstructions with free flaps from 2007 to 2015. Four types of free flap were performed: Anterolateral Thigh (76...
May 13, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28521345/superficial-temporal-artery-distal-posterior-cerebral-artery-bypass-through-the-subtemporal-approach-technical-note-and-pilot-surgical-cases
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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