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https://www.readbyqxmd.com/read/28346687/itade-flap-after-mastectomy-for-locally-advanced-breast-cancer-a-good-choice-for-mid-sized-defects-of-the-chest-wall-based-on-a-systematic-review-of-thoracoabdominal-flaps
#1
René Aloisio da Costa Vieira, Katia Mathias Teixeira da Silva, Idam de Oliveira-Junior, Marcos Alves de Lima
BACKGROUND: Locally advanced breast cancer (LABC) is still a common problem in developing countries. Extensive resections are aimed at local control and improving quality of life. Dermofat flaps are an option for medium-sized defects. OBJECTIVES: Evaluate the results of a new thoracoabdominal flap (TAF). METHODS: We describe and evaluate an ipsilateral, thoracoabdominal horizontal, dermofat (ITADE) flap performed in patients submitted to mastectomy and immediate reconstruction...
March 27, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28346508/most-women-recover-from-psychological-distress-after-postoperative-complications-following-implant-or-diep-flap-breast-reconstruction-a-prospective-long-term-follow-up-study
#2
Reinier Timman, Jessica P Gopie, J Nick Brinkman, Annelies Kleijne, Caroline Seynaeve, Marian B E Menke-Pluymers, Moniek M Ter Kuile, Aad Tibben, Marc A M Mureau
BACKGROUND: Substantial complication rates after postmastectomy breast reconstruction (BR) in breast cancer patients have been reported. Few studies have reported on the resulting psychological distress (PD) and satisfaction with the aesthetic result in relation to postoperative complications after completion of implant or DIEP flap BR. The present study investigated whether women were able to recover from complication related distress in the long term. METHODS: PD was prospectively measured using questionnaires regarding anxiety, depression and cancer distress...
2017: PloS One
https://www.readbyqxmd.com/read/28346311/latissimus-dorsi-flap-breast-reconstruction-a-nationwide-inpatient-sample-review
#3
Michael R DeLong, Vickram J Tandon, George H Rudkin, Andrew L Da Lio
INTRODUCTION: The latissimus dorsi (LD) myocutaneous flap has been a long term standard for breast reconstruction. The variable indications for the LD flap have not been statistically examined because of the relative infrequency of its use by any single surgeon or institution. METHODS: The Nationwide Inpatient Sample data set was queried for all patient encounters involving a LD myocutaneous flap procedure. The study population was further restricted to female patients with a history of breast cancer or previous mastectomy...
March 24, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28345420/peroneal-perforator-pedicle-propeller-flap-for-lower-leg-soft-tissue-defect-reconstruction-clinical-applications-and-treatment-of-venous-congestion
#4
Lifeng Shen, Yiyang Liu, Chun Zhang, Qiaofeng Guo, Wenhua Huang, Kelvin Kian Loong Wong, Shimin Chang
Objective To describe the characteristics of the perforator vessel in the peroneal artery of the lower leg and to explore the use of perforator pedicle propeller flaps to repair soft tissue defects in the lower leg, heel and foot. Methods This retrospective study enrolled patients with soft tissue defects of the distal lower leg, heel and foot who underwent surgery using peroneal perforator-based propeller flaps. The peroneal artery perforators were identified preoperatively by colour duplex Doppler ultrasound...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28345371/ewma-document-negative-pressure-wound-therapy
#5
Jan Apelqvist, Christian Willy, Ann-Mari Fagerdahl, Marco Fraccalvieri, Malin Malmsjö, Alberto Piaggesi, Astrid Probst, Peter Vowden
1. Introduction Since its introduction in clinical practice in the early 1990's negative pressure wounds therapy (NPWT) has become widely used in the management of complex wounds in both inpatient and outpatient care.(1) NPWT has been described as a effective treatment for wounds of many different aetiologies(2,3) and suggested as a gold standard for treatment of wounds such as open abdominal wounds,(4-6) dehisced sternal wounds following cardiac surgery(7,8) and as a valuable agent in complex non-healing wounds...
March 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28345267/color-duplex-ultrasonography-versus-handheld-doppler-to-plan-anterior-lateral-thigh-flaps
#6
Bernd Lethaus, Christina Loberg, Anita Kloss-Brandstätter, Alexander K Bartella, Timm Steiner, Ali Modabber, Frank Hölzle, Jan Teichmann
BACKGROUND: The anterior lateral thigh flap (ALT) has become increasingly important in reconstructive surgery in the head and neck region. To cope with the problem of anatomical variability in the supplying blood vessels, preoperative evaluation is desirable. Purpose of the study is to compare the most commonly used Doppler devices Handheld Doppler (HD) and Color Doppler Ultrasonography (CDU) for their clinical reliability. METHODS: Forty five consecutive head and neck cancer patients (mean age 66...
March 27, 2017: Microsurgery
https://www.readbyqxmd.com/read/28344538/surgical-excision-of-mycosis-fungoides-using-thumb-sparing-reconstruction
#7
Giancarlo McEvenue, Ashley Kim, Paul Binhammer
Background: The differential for soft tissue tumors of the hand and upper limb is broad. Hematologic malignancy remains quite low on the differential for soft tissue tumors involving the hand, and there is little in the literature describing surgical management of such cutaneous manifestations. When the tumor is large or involves the thumb, careful consideration of reconstructive options is required. Methods: We present a rare case of an aggressively enlarging mycosis fungoides, a cutaneous T-cell lymphoma tumor, involving the thumb...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28344527/reverse-radial-forearm-flap-to-provide-arterial-inflow-to-a-toe-transfer
#8
Joohak Kim, Alfred P Yoon, Neil F Jones
Background: Toe-to-thumb transfer has become the gold standard for thumb reconstruction, but in badly mutilated hands, additional soft tissue coverage may be required or a suitable recipient artery may not be available. There are only 3 case reports describing the successful use of a reverse radial forearm flap for coverage of a soft tissue defect around the thumb as well as providing arterial inflow for a toe transfer, performed either simultaneously or secondarily. Methods: A single surgeon's experience of all toe-to-hand transfers performed in conjunction with a reverse radial forearm flap between 1995 and 2014 was reviewed, including patient demographics, type of toe transfer and vascular pedicle, whether immediate or secondary, follow-up, and complications...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28343783/how-reliable-is-the-vomer-flap-in-early-hard-palate-repair
#9
James D Martin-Smith, Louise Fitzgerald, David J A Orr
Hard palate closure with a vomer flap at the time of lip repair has been widely adopted. A recent study by Deshpande et al. showed a high rate of failure of the vomer flap and led the authors to abandon the technique. We conducted a retrospective study of vomer flap healing in a consecutive series of cases performed by the senior author (D.O.). The case records of 71 patients who underwent repair of unilateral cleft lip and palate with a vomer flap at the time of lip repair were studied. Vomer flap healing was assessed and documented by the senior author at the time of definitive palate closure, and this was recorded...
March 10, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28342884/oral-cancer-reconstruction-using-the-supraclavicular-artery-island-flap-comparison-to-free-radial-forearm-flap
#10
Christian Welz, Martin Canis, Sabina Schwenk-Zieger, Jennifer L Spiegel, Bernhard G Weiß, Yiannis Pilavakis
PURPOSE: To evaluate whether the pedicled supraclavicular artery island flap (SCAIF) is a sufficient alternative to the fasciocutaneous radial forearm free flap (RFFF) for oral reconstruction in cancer surgery. PATIENTS AND METHODS: The authors designed and implemented a retrospective cohort study composed of all consecutive patients who underwent head and neck reconstruction after cancer surgery at their tertiary university hospital from 2013 to 2016. Demographics and peri- and postoperative information were recorded and statistically analyzed...
March 2, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28341956/improvement-on-the-neo-umbilicoplasty-technique-and-review-of-the-literature
#11
Valderi Vieira da Silva Júnior, Francis Régis Soares de Sousa
INTRODUCTION: The umbilicus is an important component of body esthetics, and its absence or dysmorphia may give rise to psychological discomfort, making it a common concern in surgical planning. Many techniques of umbilicus reconstruction have been proposed, each with its own limitations in terms of esthetics, risk of stenosis or final positioning. Reconstruction techniques may involve skin grafting, cartilage, purse-string suture and flaps. One of the most promising approaches is scarless neo-umbilicoplasty...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28341953/giant-rhinophyma-a-rare-case-of-total-nasal-obstruction-and-restitutio-ad-integrum
#12
Andreas Wolter, Till Scholz, Jutta Liebau
Rhinophyma is considered the end stage in the development of rosacea, accompanied by hypertrophy of the sebaceous glands, which causes an enlargement of the nose. It is an uncommon condition that often results in both functional and cosmetic impairment. A large variety of surgical and nonsurgical treatments have been published to treat it. Closure is usually obtained by wound granulating in by secondary intention, skin grafting or local flaps. Rarely these lesions can attain a giant size and pose a challenge in surgical treatment...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28341507/endovascular-aortic-repair-for-progressive-chronic-thoracoabdominal-aortic-dissections
#13
Vito Mantese, Shameem Kunhammed
BACKGROUND: Ascending and thoracic aortic dissections progress into thoracoabdominal aneurysms 20-40% of the time, due to the initial aortic injury with associated weakness of the aortic wall. The increased firmness of the intimal flap usually results in a collapsed true lumen that does not spontaneously re-expand even with progressive dilatation of the aorta. In an effort to identify a safe and effective treatment path for this complex disease process, we present 4 cases illustrating successful sequential thoracic endovascular aortic repair (TEVAR) and fenestrated endovascular aortic repair (FEVAR)...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341070/severe-hand-injuries-from-fireworks-injury-patterns-%C3%A2-outcomes-and-fireworks-types
#14
Brinkley K Sandvall, Kari A Keys, Jeffrey B Friedrich
PURPOSE: The purpose of this study was to characterize injury patterns and outcomes of fireworks-related hand injuries and determine if there was an association with certain fireworks types. METHODS: A retrospective cohort study was conducted on patients treated at a trauma center between 2005 and 2015. A total of 105 patients sustaining operative hand injuries due to fireworks were identified. Medical records were reviewed to identify injury patterns, treatment outcomes, and fireworks types...
March 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28340671/unique-techniques-or%C3%A2-approaches-in-microvascular-and-microlymphatic-surgery
#15
REVIEW
Jin Bo Tang, Luis Landín, Pedro C Cavadas, Alessandro Thione, Jing Chen, Gemma Pons, Jaume Masià
Several methods can be used for identifying tissues for transfer in donor-site-depleted patients. A fillet flap can be temporarily stored in other parts of the body and transferred back to the site of tissue defect, including covering the amputated stump of the lower extremity. Human arm transplant is rare and has some unique concerns for the surgery and postsurgical treatment. Cosmetics of the narrow neck of transferred second toes can be improved with insertion of a flap. Lymphedema of the breast after cancer treatment can be diagnosed with several currently available imaging techniques and treated surgically with lymphaticovenous anastomosis...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340670/keystone-and-pedicle-perforator-flaps-in-reconstructive-surgery-new-modifications-and-applications
#16
REVIEW
Jasson T Abraham, Michel Saint-Cyr
Pedicle perforator flaps and keystone perforator island flaps are additional tools for reconstructive surgeons. Advances in understanding of vascular anatomy, the dynamic nature of perforator perfusion, inter-perforator flow and the hot-spot principle have led to reconstructive techniques that allow innovative autologous tissue transfer while limiting donor site morbidity. Further modifications of the pedicle perforator flap have led to a multitude of freestyle pedicle perforator flap options, as well as freestyle free flaps for soft tissue reconstruction...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340669/maximizing-the-utility-of-the-pedicled-anterolateral-thigh-flap-for-locoregional-reconstruction-technical-pearls-and-pitfalls
#17
REVIEW
Aparna Vijayasekaran, Waleed Gibreel, Brian T Carlsen, Steven L Moran, Michel Saint-Cyr, Karim Bakri, Basel Sharaf
The pedicled anterolateral thigh (PALT) flap is an underutilized flap for locoregional reconstruction largely because methods to maximize its reach are neither universally implemented nor fully understood. In addition, most of the available literature has focused on the utility of the free anterolateral thigh flap with less emphasis on the PALT flap. Moreover, flap design concepts to maximize its utility and reach and optimize outcomes have not been comprehensively described. In an effort to address this knowledge gap, the authors sought to review their institution's experience with the PALT flap for locoregional reconstruction...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340668/anastomosis-of-the-superficial-inferior-epigastric-vein-to-the-internal-mammary-vein-to-augment-deep-inferior-artery-perforator-flaps
#18
REVIEW
Aparna Vijayasekaran, Anita Mohan, Lin Zhu, Basel Sharaf, Michel Saint-Cyr
Use of the retrograde limb of the internal mammary vein has been described previously as a lifeboat for venous congestion but not prophylactically. Maximizing the length of the deep inferior artery perforator (DIEP) flap pedicle, identifying and dissecting the superficial inferior epigastric vein proximally in every patient, and taking advantage of the retrograde internal mammary vein are all technical details that facilitate the additional venous anastomosis and flap inset. Performing a second venous anastomosis routinely using the superficial inferior epigastric vein to the retrograde internal mammary vein helps with flap inset...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340667/microsurgical-tissue-transfer-in-breast-reconstruction
#19
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/28340665/pediatric-microsurgery-a-global-overview
#20
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
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