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Microsurgical reconstruction

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https://www.readbyqxmd.com/read/28201829/impact-of-continuous-two-team-approach-in-autologous-breast-reconstruction
#1
A J Bauermeister, A Zuriarrain, M Newman, S A Earle, M A Medina
Background Autologous breast reconstruction has been noted in the literature to provide superior aesthetic outcomes and patient satisfaction. Additionally, free perforator flap tissue transfer has the potential for lower abdominal donor site morbidity. However, it has been noted that the percentage of women who are undergoing autologous breast reconstruction in the United States is decreasing. Factors related to the technical difficulty, prolonged operative times, and decreasing reimbursement have been implicated as the causes...
February 15, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28194796/the-utility-of-the-musculocutaneous-anterolateral-thigh-flap-in-pharyngolaryngeal-reconstruction-in-the-high-risk-patient
#2
Adrian S H Ooi, Chad M Teven, Amir Inbal, David W Chang
BACKGROUND AND OBJECTIVES: Prior radiotherapy leads to increased wound complication rates for microsurgical reconstruction of pharyngolaryngeal (PL) defects. Incorporating vastus lateralis muscle together with anterolateral thigh flap (ALT) skin in defect reconstruction is useful in protecting vital structures and reinforcing irradiated neck skin and suture lines. This study shows the utility of the musculocutaneous ALT (MC ALT) in PL reconstruction in previously irradiated patients. METHODS: A single-surgeon, retrospective chart review of all patients with defects of the PL region where an MC ALT was used for reconstruction from February 2014 to May 2016...
February 14, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28191601/the-maxillary-artery-and-its-variants-an-anatomical-study-with-neurosurgical-applications
#3
Jorge E Alvernia, Joaquin Hidalgo, Marc P Sindou, Chad Washington, Gustavo Luzardo, Eddie Perkins, Remi Nader, Patrick Mertens
BACKGROUND: The maxillary artery (MA) has gained attention in neurosurgery particularly in cerebral revascularization techniques, intracranial endonasal approaches and endovascular procedures. OBJECTIVES: To describe and illustrate the anatomy of the MA and its neurosurgical importance in a detailed manner. METHODS: Six cadaveric heads (12 MAs) were injected with latex. The arteries and surrounding structures were dissected and studied using microsurgical techniques...
February 13, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28186451/techniques-and-outcomes-of-microsurgical-management-of-ruptured-and-unruptured-fusiform-cerebral-aneurysms
#4
Sam Safavi-Abbasi, M Yashar S Kalani, Ben Frock, Hai Sun, Kaan Yagmurlu, Felix Moron, Laura A Snyder, Randy J Hlubek, Joseph M Zabramski, Peter Nakaji, Robert F Spetzler
OBJECTIVE Fusiform cerebral aneurysms represent a small portion of intracranial aneurysms; differ in natural history, anatomy, and pathology; and can be difficult to treat compared with saccular aneurysms. The purpose of this study was to examine the techniques of treatment of ruptured and unruptured fusiform intracranial aneurysms and patient outcomes. METHODS In 45 patients with fusiform aneurysms, the authors retrospectively reviewed the presentation, location, and shape of the aneurysm; the microsurgical technique; the outcome at discharge and last follow-up; and the change in the aneurysm at last angiographic follow-up...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28166139/novel-injury-site-targeted-fusion-protein-comprising-annexin-v-and-kunitz-inhibitor-domains-ameliorates-ischemia-reperfusion-injury-and-promotes-survival-of-ischemic-rat-abdominal-skin-flaps
#5
Victor Bong-Hang Shyu, Chung En Hsu, Chih-Jen Wen, Tze-Chein Wun, Rui Tang, Samuel Achilefu, Fu-Chan Wei, Hui-Yun Cheng
: Appropriate antithrombotic therapy is critical for successful outcomes in reconstructive microsurgical procedures involving free tissue transfer. The annexin V-6L15 (ANV-6L15) fusion protein was developed as a targeted antithrombotic reagent. Annexin V specifically binds to exposed phosphatidylserine on apoptotic or injured cells, and prevents coagulation and cell adhesion, whereas 6L15 inhibits tissue factor-VIIa pathway within the coagulation cascade. The treatment efficacy of ANV-6L15 on rat island muscle and pedicled abdominal fasciocutaneous flaps following ischemic injury and ischemia-reperfusion injury (IRI) was evaluated...
February 4, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28160906/thumb-reconstruction-with-thin-proximal-ulnar-perforator-free-flap
#6
REVIEW
Mario Cherubino, Martina Corno, Luigi Valdatta, Roberto Adani
Soft tissue defects of the thumb with exposure of tendons, periosteum, or neurovascular bundles require a complex reconstruction aimed at restoring both skin coverage and the essential function of pinching and manipulation. When large defects are involved, a free tissue transfer is indicated. The proximal ulnar perforator flap represents an interesting solution without the drawbacks of other more widespread free flaps. This report describes the case of a patient with a squamous cell carcinoma of the thumb that required circumferential resection of the soft tissue of the distal phalanx and the interphalangeal joint...
February 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28160323/recipient-vessels-for-microsurgical-flaps-to-the-abdomen-a-systematic-review
#7
REVIEW
Raffi Gurunluoglu, Michael J Rosen
BACKGROUND: Large soft tissue defects of the abdominal wall resulting from various reasons may require free tissue transfer. METHODS: A literature search of PubMed and Cochrane electronic databases was conducted to identify articles involving abdominal wall reconstruction (AWR) with microsurgical flap. Number of cases, etiology, and reconstruction site, type of microsurgical flap and recipient vessels were analyzed. RESULTS: Thirty-eight articles published between 1983 and 2016 reported on 149 patients undergoing free flap AWR...
February 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/28151027/end-to-end-versus-end-to-side-anastomoses-in-free-flap-reconstruction-single-centre-experiences
#8
Paul I Heidekrueger, Milomir Ninkovic, Albrecht Heine-Geldern, Frank Herter, P Niclas Broer
BACKGROUND: The choice of microsurgical anastomotic technique, end-to-end (ETE) or end-to-side (ETS), is a relevant point in free tissue transfer. The decision-making process of choosing ETE or ETS technique depends on several clinical and perioperative factors. This study evaluates the outcomes of microvascular procedures in a large single centre patient series, focusing on ETE vs ETS arterial anastomoses. MATERIALS AND METHODS: Between January 2009 and June 2015, 838 patients underwent free flap surgery for reconstruction after trauma, infection, or malignancies...
February 2, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28139472/microsurgical-tunica-albuginea-transplantation-in-an-animal-model
#9
Salvatore Sansalone, Carla Loreto, Rosario Leonardi, Giuseppe Vespasiani, Giuseppe Musumeci, Claudia Lombardo, Sergio Castorina, Venera Cardile, Rosario Caltabiano
Several andrological diseases require surgical repair or reconstruction of tunica albuginea, which envelops the corpora cavernosa penis. Despite intense research efforts involving a variety of biological materials, such as skin, muscle aponeurosis, human dura mater, tunica vaginalis, and pericardium, engineered tunica albuginea suitable for graft use is yet to be obtained. The study investigates microsurgical tunica albuginea allotransplantation in an animal model with the purpose of creation of an organ-specific tissue bank to store penile tissue, from cadaveric donors and male-to-female trans-sexual surgery, for allogeneic transplantation...
January 24, 2017: Asian Journal of Andrology
https://www.readbyqxmd.com/read/28121853/the-impact-of-two-operating-surgeons-on-microsurgical-breast-reconstruction
#10
Katie E Weichman, Gretl Lam, Stelios C Wilson, Jamie P Levine, Robert J Allen, Nolan S Karp, Mihye Choi, Vishal D Thanik
BACKGROUND: Given the complexity of microsurgical breast reconstruction, there are many opportunities to improve both surgical efficiency and outcomes. The use of two operating surgeons has been employed, but the outcomes are unproven. In this study, the authors compare the outcomes of patients undergoing microsurgical breast reconstruction with one operating surgeon to those with two surgeons. METHODS: A retrospective review of all patients undergoing microsurgical breast reconstruction between July of 2011 and January of 2014 at a single academic institution was conducted...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28118232/transversus-abdominis-plane-block-and-free-flap-abdominal-tissue-breast-reconstruction-is-there-a-true-reduction-in-postoperative-narcotic-use
#11
Cedric Hunter, Afaaf Shakir, Arash Momeni, Anna Luan, Lauren Steffel, Jean-Louis Horn, Dung Nguyen, Gordon K Lee
INTRODUCTION: The use of the transversus abdominis plane (TAP) block is increasing in abdominally based autologous tissue breast reconstruction as a method to provide postoperative donor site analgesia. The purpose of this study was to evaluate the efficacy of the TAP block in the immediate postoperative period. METHODS: A retrospective analysis of all patients who underwent autologous microsurgical breast reconstruction over a 2-year period (2013-2015) was conducted...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28118229/hospital-transfer-of-open-tibial-fractures-requiring-microsurgical-reconstruction-negatively-impacts-clinical-outcomes
#12
Christopher S Crowe, Anna Luan, Gordon K Lee
INTRODUCTION: Open tibial fractures are orthopedic emergencies that may present with severe soft tissue damage. Free tissue transfer is often required when local tissues are insufficient and patients may require hospital transfer to tertiary care centers for this purpose. Although the negative impact of inter-facility transfer has been well demonstrated in trauma patients, less is known regarding transfers for lower extremity injury patients. This study investigates differences in outcomes based on transfer status after open tibial fracture...
January 23, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28117814/a-model-of-free-tissue-transfer-the-rat-epigastric-free-flap
#13
Diogo Casal, Diogo Pais, Inês Iria, Eduarda Mota-Silva, Maria-Angélica Almeida, Sara Alves, Cláudia Pen, Ana Farinho, Luís Mascarenhas-Lemos, José Ferreira-Silva, Mário Ferraz-Oliveira, Valentina Vassilenko, Paula A Videira, João Gory O'Neill
Free tissue transfer has been increasingly used in clinical practice since the 1970s, allowing reconstruction of complex and otherwise untreatable defects resulting from tumor extirpation, trauma, infections, malformations or burns. Free flaps are particularly useful for reconstructing highly complex anatomical regions, like those of the head and neck, the hand, the foot and the perineum. Moreover, basic and translational research in the area of free tissue transfer is of great clinical potential. Notwithstanding, surgical trainees and researchers are frequently deterred from using microsurgical models of tissue transfer, due to lack of information regarding the technical aspects involved in the operative procedures...
January 15, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28116258/recurrent-gct-of-distal-femur-treated-with-resection-arthrodesis-with-non-vascularized-bilateral-fibular-graft-and-a-custom-made-interlock-nail
#14
Tuteja Sanesh, Kale Sachin, Chaudhari Prasad, Dhar Sanjay B
INTRODUCTION: Giant Cell Tumors commonly occur around the knee joint in the age group of 20-30 years. They are treated with intra-lesional curettage or local resection and limb reconstruction. Management of large bone defects after resection is a challenge and is of ten complicated with non-union of grafts, infection and delayed weight bearing. CASE PRESENTATION: A 37-year-old male presented with an aggressive recurrent giant cell tumor of the distal femur. He was and was diagnosed with a GCT of the left distal femur 2 years ago for which he was treated with an intralesional curettage and Poly methylmetacrylate implantation...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28108960/dual-acting-biofunctionalised-scaffolds-for-applications-in-regenerative-medicine
#15
Camilo Chaves, Chuanyu Gao, Jerome Hunckler, Moustafa Elsawy, Josette Legagneux, Gilles Renault, Alain Charles Masquelet, Achala de Mel
Off the shelf scaffolds for replacing ultra-small diameter vascular grafts are valuable for reconstruction of diseased or damaged vessels. The limitations for such grafts include optimal handling with ready availability of varied lengths of grafts, graft patency with the ability to replace the function of active cellular mechanisms and adequate mechanical properties to maintain physicochemical function. We used a well-established, solvent casting method for potential tissue replacement scaffold fabrication with incorporated bioactive molecules, which we have previously explored to confer haemocompatibility...
February 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#16
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28061519/does-a-standalone-cancer-center-improve-head-and-neck-microsurgical-outcomes
#17
Matthew L Tamplen, Jesse Tamplen, Vanessa Torrecillas, Rahul Seth, Santo Ricceri, Shirin Hemmat, Chase Heaton, William R Ryan, P Daniel Knott
Objectives To evaluate the role of hospital setting (standalone cancer center vs. large multidisciplinary hospital) on free tissue transfer (FTT) outcomes for head and neck reconstruction. Methods Medical records were reviewed of 180 consecutive patients undergoing FTT for head and neck reconstruction. Operations occurred at either a standalone academic cancer center (n = 101) or a large multidisciplinary academic medical center (n = 79) by the same surgeons. Patient outcomes, operative comparisons, and hospital costs were compared between the hospital settings...
January 6, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28057874/pregnancy-and-live-birth-rates-after-microsurgical-vasoepididymostomy-for-azoospermic-patients-with-epididymal-obstruction
#18
Jing Peng, Zhichao Zhang, Yiming Yuan, Wanshou Cui, Weidong Song
STUDY QUESTION: Can microsurgical vasoepididymostomy (MVE) be an effective treatment for azoospermic men with epididymal obstruction? SUMMARY ANSWER: MVE is an effective treatment for epididymal obstruction, with overall patency and live birth rates of 76.3% and 34.8%, respectively. WHAT IS KNOWN ALREADY: We showed that MVE was an effective treatment for non-vasectomized patients with epididymal obstruction and prior failed sperm retrieval for ICSI...
February 2017: Human Reproduction
https://www.readbyqxmd.com/read/28056334/immediate-microsurgical-bone-and-nerve-reconstruction-in-the-irradiated-patient-a-case-report
#19
Ramzey Tursun, J Marshall Green
Microsurgical reconstructive techniques have revolutionized the treatment of large head and neck defects. These defects were once forever life altering because of the considerable morbidity to both the form and function of the patient. As time has progressed, microsurgical technique has improved dramatically and has become institutionalized in our training programs. Free flap outcomes in head and neck reconstruction have improved dramatically, and optimization of these outcomes is now key. One overlooked area has been neurosensory reconstruction...
December 11, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28052381/the-lateral-calcaneal-artery-as-an-alternative-recipient-vessel-option-for-heel-and-lateral-foot-reconstruction
#20
Kyong-Je Woo, Jin-Woo Park, Goo-Hyun Mun
BACKGROUND: Clinical outcomes of consecutive use of the lateral calcaneal artery (LCA) as a recipient vessel for microsurgical reconstruction have not been reported. This study aimed to evaluate the feasibility and safety of the LCA as a recipient vessel for microsurgical foot reconstruction based on anatomical study of CT angiography and clinical results of using this vessel as the recipient. METHODS: Anatomic study was performed using CT angiography of 61 lower extremities (31 patients)...
January 4, 2017: Microsurgery
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