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Microsurgical reconstruction

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https://www.readbyqxmd.com/read/27898199/microsurgical-reconstruction-in-patients-greater-than-80-years-old
#1
Paul I Heidekrueger, Albrecht Heine-Geldern, Milomir Ninkovic, Frank Herter, Daniel Schmauss, Thiha Aung, P Niclas Broer
BACKGROUND: Demographic change implies that the human population is getting older and the elderly are living longer. Consequently, achieving good functional and aesthetic outcomes in microvascular procedures, especially in very old patients with higher incidence of atherosclerosis and vessel calcifications, constitutes a microsurgical challenge. This study evaluates the feasibility of microsurgical procedures in a very old patient cohort. PATIENTS AND METHODS: Between 2009 and 2015, 754 patients underwent 838 free flap reconstructions...
November 29, 2016: Microsurgery
https://www.readbyqxmd.com/read/27898195/cost-effectiveness-of-microsurgical-reconstruction-for-head-and-neck-defects-after-oncologic-resection
#2
Lin Lin Gao, Marten Basta, Suhail K Kanchwala, Joseph M Serletti, David W Low, Liza C Wu
BACKGROUND: Microvascular free tissue transfer has become the main technique used for head and neck reconstruction. We assessed the cost-effectiveness of free flap reconstruction for head and neck defects after oncologic resection for squamous cell carcinoma (SCC). METHODS: We developed a Markov model of the cost, quality of life, survival, and incremental cost-effectiveness of reconstruction with free tissue transfer compared with locoregional flaps. Health state probabilities and quality of life scores were determined from literature...
November 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/27894916/reliability-of-extended-dorsal-intercostal-artery-perforator-propeller-flaps-for-reconstruction-of-large-myelomeningocele-defects
#3
Goktekin Tenekeci, Yavuz Basterzi
Reconstruction of large myelomeningocele defects using extended (elongated beyond the lateral margin of the latissimus dorsi muscle) dorsal intercostal artery perforator (DICAP) propeller flaps is not recommended by previous studies. However, to provide tension-free and successful closure of a defect, the DICAP propeller flaps must sometimes be elongated beyond this margin. Our experience and results in this issue are discussed. In this article, reconstruction of 11 consecutive cases, with large myelomeningocele defects in which standard DICAP propeller flaps were incapable to close the defect, was achieved using extended DICAP propeller flaps between June 2013 and November 2015...
November 15, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27894155/increased-lower-extremity-venous-stasis-may-contribute-to-deep-venous-thrombosis-formation-after-microsurgical-breast-reconstruction-an-ultrasonographic-study
#4
Arash Momeni, Michael G Tecce, Michael A Lanni, Shagun Aggarwal, Christopher Pannucci, Stephen J Kovach, Suhail K Kanchwala, Liza C Wu, Joseph M Serletti
Background Despite guideline-compliant prophylaxis, an increased rate of deep venous thrombosis (DVT) formation has been reported following autologous versus implant-based breast reconstruction. We hypothesized that tight abdominal fascia closure might decrease lower extremity venous return and promote venous stasis. Methods An observational crossover study of patients who underwent autologous breast reconstruction using transverse rectus abdominis musculocutaneous/deep inferior epigastric artery perforator flaps was conducted...
November 28, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27893637/timing-of-presentation-of-pediatric-compartment-syndrome-and-its-microsurgical-implication-a-retrospective-review
#5
Natalia I Ziolkowski, Leanne Zive, Emily Ho, Ronald Zuker
BACKGROUND: Forearm compartment syndrome in the pediatric population can lead to severe functional disability. Although it is known that earlier presentation with decompression leads to better outcomes, it is not known when presentation post-injury leads to significant loss of function requiring microsurgical intervention. AIM: To describe the rate of microsurgical reconstruction after forearm compartment syndrome in pediatric patients as related to timing of presentation...
November 21, 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27892447/a-study-on-variations-of-nutrient-foramen-of-humerus-with-its-clinical-implications
#6
D I Mansur, P Manandhar, M K Haque, D K Mehta, S Duwal, B Timalsina
Background Nutrient foramen is an opening into shaft of humerus which gives passage to the blood vessels of medullary cavity. The knowledge of nutrient foramen is important in surgical procedures like bone grafting and more recently in microsurgical vascularized bone transplantation. Objective To determine the number, location and direction of nutrient foramen and whether the nutrient foramens obey the rule of ossification, that is directed away from the growing end of the bone or not. Method The present study consisted of 253 (108 right and 145 left) dried humeri excluding any fracture or pathological abnormalities during the period of 15th December 2014 - 14th February 2015...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27889116/total-phallic-reconstruction-using-radial-forearm-free-flap-after-iatrogenic-penile-amputation
#7
J C Angulo, I Arance, C Gómez-Llorens, C Esquinas, C Gómez-Martín, J L Fernández-Cañamaque
INTRODUCTION: The iatrogenic loss of the penis is a rare situation. We present a challenging case of deferred total penile reconstruction in a genetic male. MATERIAL AND METHODS: A 57-year-old man with the loss of the penis due to a penile abscess and necrosis secondary to penile curvature surgery. The reconstruction was performed over several operations using a radial forearm free flap (RFFF) and placement of a customised inflatable prosthesis a year later. RESULTS: During the first operation, the penile abscess was drained, the necrotic residues were debrided and placement of hypogastric drainage...
November 23, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27878799/microsurgery-robots-addressing-the-needs-of-high-precision-surgical-interventions
#8
Leonardo S Mattos, Darwin G Caldwell, Giorgio Peretti, Francesco Mora, Luca Guastini, Roberto Cingolani
Robotics has a significant potential to enhance the overall capacity and efficiency of healthcare systems. Robots can help surgeons perform better quality operations, leading to reductions in the hospitalisation time of patients and in the impact of surgery on their postoperative quality of life. In particular, robotics can have a significant impact on microsurgery, which presents stringent requirements for superhuman precision and control of the surgical tools. Microsurgery is, in fact, expected to gain importance in a growing range of surgical specialties as novel technologies progressively enable the detection, diagnosis and treatment of diseases at earlier stages...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27873519/use-of-three-dimensional-curved-multiplanar-reconstruction-images-for-sylvian-dissection-in-microsurgery-of-middle-cerebral-artery-aneurysms
#9
Taek Kyun Nam, Yong Sook Park, Jun Soo Byun, Seung Won Park, Jeong Taik Kwon
PURPOSE: The purpose of this study was to introduce a method of using three-dimensional (3D) curved-multiplanar reconstruction (MPR) images for sylvian dissection during microsurgical treatment of middle cerebral artery (MCA) aneurysms. MATERIALS AND METHODS: Forty-nine patients who had undergone surgery for MCA aneurysms were enrolled. We obtained the 3D curved-MPR images along the sphenoid ridge using OsiriX MD™ imaging software, compared sylvian dissection time according to several 3D MPR image factors, and investigated the correlations between these images and intraoperative findings...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27855467/less-is-more-impact-of-single-venous-anastomosis-on-the-intrinsic-transit-time-of-free-flaps
#10
Ulf Dornseifer, Charlotte Kleeberger, Michael Kimelman, Lukas Kargl, Charlotte Holm, Philipp Moog, Milomir Ninkovic
Background The number of venous anastomoses advisable for a free flap continues to be controversial. Intrinsic transit time (ITT) is the time it takes dye during indocyanine green (ICG) microangiography to travel from the arterial to the venous anastomosis. ITT provides information on blood flow velocity and can predict postoperative circulatory complications. This study investigated the effect of the number of venous anastomoses on ITT. Methods The study enrolled 126 patients who had undergone microsurgical reconstruction and intraoperative ICG microangiography...
November 17, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27833334/mandibular-reconstruction-overview
#11
REVIEW
Batchu Pavan Kumar, V Venkatesh, K A Jeevan Kumar, B Yashwanth Yadav, S Ram Mohan
INTRODUCTION: Mandibular reconstruction has changed significantly over the years and continues to evolve with the introduction of newer technologies and techniques. PURPOSE: This article reviews the history of oromandibular reconstruction, biomechanics of mandible, summarizes the reconstruction options available for mandible with defect classification, goals in reconstruction, the various donor sites, current reconstructive options, dental rehabilitation and persistent associated problems...
December 2016: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/27809693/clinical-outcome-and-health-related-quality-of-life-following-microsurgical-reconstruction-in-patients-with-oral-and-oropharyngeal-cancer
#12
Shems Al-Hayder, Jens Jørgen Elberg, Birgitte Charabi
CONCLUSION: Radial forearm free flap (RFFF) and fibula free flap (FFF) provide high safety and reliability with low incidence of free flap failure and an acceptable level of complications and health-related quality-of-life (HRQoL). OBJECTIVES: To determine the clinical outcomes and long-term HRQoL in patients with oral or oropharyngeal cancer following free flap reconstruction. METHODS: A retrospective review of medical records and self-administered HRQoL questionnaires, EORTC QLQ-C30, and -H&N35...
November 4, 2016: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27801399/-the-modern-role-of-microsurgery-in-treatment-of-large-and-giant-aneurysms-of-the-internal-carotid-artery
#13
O D Shekhtman, Sh Sh Eliava, S B Yakovlev, Yu V Pilipenko, An N Konovalov
INTRODUCTION: Large (1.5-2.5 cm) and giant (>2.5 cm in diameter) aneurysms of the internal carotid artery (ICA) remain one of the complex neurosurgical pathologies in terms of microsurgery. In recent years, endovascular techniques for treatment of paraclinoid aneurysms, in particular ICA reconstruction using flow-diverting stents, have become a priority. However, surgery of flow stents has a number of limitations, therefore the choice of treatment in each case is individual. PURPOSE: To analyze the results of direct surgery in patients with large and giant aneurysms of the ICA and to determine the role and place of modern microsurgical techniques in the treatment of this vascular disease...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27801394/-the-history-of-surgery-for-brain-and-spinal-cord-vascular-pathology-at-the-burdenko-neurosurgical-institute-to-the-50th-anniversary-of-foundation-of-the-first-neurovascular-department
#14
Sh Sh Eliava, L B Likhterman, T P Tissen, S B Yakovlev, D Yu Usachev, O D Shekhtman, Yu V Pilipenko, An N Konovalov
The Vascular Department of the Burdenko Neurosurgical Institute is one of the country's first dedicated departments engaged in treatment of patients with cerebrovascular diseases. The modern vascular service of the Institute is represented by several departments and groups: the Department of Microsurgical Treatment of Vascular Diseases, a group of Reconstructive Brachiocephalic Surgery, and the Department of Endovascular Surgery and Neurodiagnosis that is also engaged in intra-arterial chemotherapy and angiographic diagnosis...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27798947/laser-assisted-indocyanine-green-angiography-aids-in-the-reconstruction-of-gustilo-grade-iiib-open-lower-limb-fractures
#15
Seijiro Koshimune, Akira Shinaoka, Tomoyuki Ota, Satoshi Onoda, Yoshihiro Kimata
BACKGROUND: Worldwide obesity has more than doubled since 1980. Given this epidemic change, surgical and medical care has become more complex as obesity is a known risk factor for complications. Consequently, one could expect a higher prevalence of medical and surgical complications in an obese patient collective in the setting of free tissue transfer. Goal of this study was to evaluate whether this assumption holds true. MATERIAL AND METHODS: Between January 2009 and June 2015, 838 patients underwent free tissue transfers at a single institution...
October 31, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27798946/extending-the-limits-of-microsurgical-reconstruction-in-patients-with-moderate-to-very-severe-obesity-single-center-6-year-experiences
#16
Paul I Heidekrueger, Albrecht Heine-Geldern, Milomir Ninkovic, Frank Herter, Camillo Mueller, P Niclas Broer
Background Worldwide obesity has more than doubled since 1980. Given this epidemic change, surgical and medical care has become more complex as obesity is a known risk factor for complications. Consequently, one could expect a higher prevalence of medical and surgical complications in an obese patient collective in the setting of free tissue transfer. Goal of this study was to evaluate whether this assumption holds true. Material and Methods Between January 2009 and June 2015, 838 patients underwent free tissue transfers at a single institution...
October 31, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27781975/ifssh-scientific-committee-on-skin-coverage-2015-report
#17
T Giesen, R Adani, S Carmes, C Dumontier, D Elliot, M Calcagni
Skin coverage in hand reconstruction is a challenging and vast chapter in hand surgery; covering every aspect of it in a report is simply not feasible. Therefore, this report focuses on a few specific topics. The coverage of anatomical regions like the fingertips is common ground for hand surgeons worldwide, but in the last 10 years, various refinements have been published in order to optimize the reconstruction of this organ. Nevertheless, in many emergency departments, the amputation of badly injured fingertips, including the thumb, remains the preferred treatment...
October 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27771041/one-versus-two-venous-anastomoses-in-microvascular-lower-extremity-reconstruction-using-gracilis-muscle-or-anterolateral-thigh-flaps
#18
Paul I Heidekrueger, Denis Ehrl, Albrecht Heine-Geldern, Milomir Ninkovic, P Niclas Broer
INTRODUCTION: Free tissue transfers are a highly reliable procedure routinely performed for reconstruction of a wide range of defects. Main complication in free flap surgery is usually venous thrombosis. Many technical controversies exist regarding the technical details of the microvascular anastomosis in order to prevent occurrence of thrombosis and optimize outcomes. We therefore evaluated our results regarding the execution of one versus two venous anastomoses in a variety of free flaps (fasciocutaneous- or muscle free flap) utilized for lower limb reconstruction...
December 2016: Injury
https://www.readbyqxmd.com/read/27770576/improved-pocket-control-in-immediate-microsurgical-breast-reconstruction-with-simultaneous-implant-placement-through-the-use-of-mesh
#19
Arash Momeni, Suhail K Kanchwala
BACKGROUND: Autologous breast reconstruction is associated with long-term patient satisfaction that is superior to implant-based approaches. Occasionally, however, patients who desire autologous reconstruction present with inadequate donor-site volume. A hybrid approach, combining free flap reconstruction with simultaneous implant placement, is a solution. We present our experience with the use of mesh for improved pocket control using this reconstructive modality. METHODS: A retrospective analysis of a prospectively maintained database of patients undergoing autologous breast reconstruction was performed...
October 22, 2016: Microsurgery
https://www.readbyqxmd.com/read/27769605/intratissular-expansion-mediated-serial-fat-grafting-a-step-by-step-working-algorithm-to-achieve-3d-biological-harmony-in-autologous-breast-reconstruction
#20
Filip B J L Stillaert, Casper Sommeling, Salvatore D'Arpa, David Creytens, Koenraad Van Landuyt, Herman Depypere, Rudy Van den Broecke, Stan Monstrey, Phillip N Blondeel, Wayne A Morrison
BACKGROUND: Breast reconstruction involves the use of autologous tissues or implants. Occasionally, microsurgical reconstruction is not an option because of insufficient donor tissues. Fat grafting has become increasingly popular in breast surgery. The challenge with this technique is how to reconstruct a stable and living "scaffold" that resembles a breast. METHODS: Breast reconstruction (n = 7) was performed using intratissular expansion with serial deflation-lipofilling sessions...
December 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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