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Perforator flaps

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https://www.readbyqxmd.com/read/28333309/positive-margin-re-excision-following-immediate-autologous-breast-reconstruction-morbidity-cosmetic-outcome-and-oncologic-significance
#1
Oscar Ochoa, Constantine Theoharis, Steven Pisano, Minas Chrysopoulo, Peter Ledoux, Gary Arishita, Chet Nastala
Background: Acquisition of negative resection margins is paramount in the surgical management of operable breast cancer. Management of positive margins following mastectomy and immediate breast reconstruction is presently poorly defined. Objectives: The present study aims at defining morbidity and cosmetic sequela of re-excision procedures aimed at clearing involved mastectomy margins in the setting of immediate autologous breast reconstruction. Oncologic outcomes are recorded...
March 17, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28328628/unilateral-versus-bilateral-breast-reconstruction-is-less-really-more
#2
Lauren V Kuykendall, Bugra Tugertimur, Corin Agoris, Sara Bijan, Ambuj Kumar, Deniz Dayicioglu
OBJECTIVE: Over the recent years, there has been an increase in prophylactic mastectomies with an associated increase in bilateral breast reconstruction. We aimed to compare outcomes in terms of patient satisfaction with unilateral versus bilateral breast reconstruction after deep inferior epigastric perforator (DIEP) flap and implant-based reconstruction. METHODS: Patients who underwent breast reconstruction by a single surgeon between July 2011 and July 2015 were surveyed using the independently validated BREAST-Q questionnaire...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28321378/hemi-transseptal-approach-for-pituitary-surgery-a-follow-up-study
#3
Naif Fnais, Salvatore Di Maio, Susan Edionwe, Anthony Zeitouni, Denis Sirhan, Constanza J Valdes, Marc A Tewfik
Objectives The hemi-transseptal (Hemi-T) approach was developed to overcome the potential drawbacks of the nasoseptal flap (NSF) in endoscopic endonasal transsphenoidal skull base surgery. In this study, we describe further refinements on the Hemi-T approach, and report long-term outcomes as compared with traditional methods of skull base reconstruction. Design A retrospective case-control study. Setting Montreal Neurological Institute and Jewish General Hospital, Montreal, Canada. Participants Patients who underwent endoscopic endonasal transsphenoidal approach to skull base pathology...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28319327/bilateral-breast-reconstruction-with-deep-inferior-epigastric-perforator-flaps-in-slim-patients
#4
Maria Mani, Samer Saour, Kelvin Ramsey, Kieran Power, Paul Harris, Stuart James
BACKGROUND: Slim women are not always considered candidates for bilateral autologous breast reconstruction. The study aims to assess the volume considerations and complications of deep inferior epigastric perforator (DIEP) flap in bilateral breast reconstruction among slim patients. METHODS: All patients undergoing bilateral DIEP breast reconstruction at the Royal Marsden Hospital, London, September 2007-March 2015, were reviewed. Flap weight was compared to mastectomy weight (weight ratio) and complications were recorded...
March 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28314066/comparison-of-propeller-perforator-flap-and-venous-supercharged-propeller-perforator-flap-in-reconstruction-of-lower-limb-soft-tissue-defect-a-prospective-study
#5
Benoit Chaput, Nicolas Bertheuil, Jean-Louis Grolleau, Farid Bekara, Raphael Carloni, Jerome Laloze, Christian Herlin
INTRODUCTION: In lower limbs, reliability of propeller perforator flaps (PPF) remains uncertain. The main complication is venous congestion, which can lead to distal necrosis. We aim to highlight if venous supercharging of PPF could substantially limit complications in lower limb coverage. METHODS: Between 2011 and 2016, we developed a standardized procedure of venous supercharging in the lower limb reconstruction with PPF using saphenous veins anastomosis. Then, we prospectively compared a consecutive series of 30 PPF to cover lower limbs defect, with a consecutive series of 30 venous-supercharged PPF (vsPPF)...
March 17, 2017: Microsurgery
https://www.readbyqxmd.com/read/28302367/lateral-thigh-perforator-flap-for-breast-reconstruction-computed-tomographic-angiography-analysis-and-clinical-series
#6
Marco A Maricevich, Michael R Bykowski, M Asher Schusterman, Evan B Katzel, Michael L Gimbel
PURPOSE: Although abdominal-based flaps remain the first choice for autologous breast reconstruction, alternative donor sites are necessary when the abdomen is unavailable. Abdominal donor site suitability is determined, at times, according to deep inferior epigastric perforator (DIEP)-protocol computed tomographic angiography (CTA) results. CTA provides information about the pelvis/upper thigh that can be used to evaluate the suitability of other donor sites. This study aimed to examine the utility of DIEP-protocol CTA in the assessment of a lateral thigh perforator (LTP) flap...
February 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28295381/upper-lateral-cartilage-composite-flap-for-closure-of-complicated-septal-perforations
#7
David F Smith, Monirah Albathi, Andrew Lee, Linda N Lee, Kofi D Boahene
OBJECTIVES/HYPOTHESIS: To present a novel technique for the repair of large complicated nasal septal perforations using an upper lateral cartilage composite flap. STUDY DESIGN: This is a case series of five patients with large septal perforations seen at an academic tertiary care center, who have failed previous treatment measures and were selected to undergo this novel reconstruction for closure of their defects. METHODS: Patients were followed clinically to determine the success of the repair...
March 14, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28293513/the-number-of-perforators-included-in-reversed-flow-posterior-interosseous-artery-flap-does-it-affect-the-incidence-of-venous-congestion
#8
Khaled A Reyad, Ayman A Shaker, Amir S Elbarbary, Mohamed A Sayed, Mohamed A Elghareeb
BACKGROUND: The purpose of this study is to decrease the incidence of venous congestion occurring in the reversed flow posterior interosseous artery flap used for coverage of hand defects. METHODS: This may be achieved by studying the incidence of venous congestion in flaps including only 1 perforator and comparing the results with others including more than 1 perforator both in small and large sized flaps. RESULTS: This study showed that inclusion of only 1 perforator in the flap decreased the incidence of venous congestion with complete flap loss in flaps to 5%...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293504/an-appraisal-of-internal-mammary-artery-perforators-as-recipient-vessels-in-microvascular-breast-reconstruction-an-analysis-of-515-consecutive-cases
#9
Felix H Vollbach, Christoph D Heitmann, Hisham Fansa
BACKGROUND: The usage of internal mammary artery perforators (IMAPs) has been described in autologous breast reconstruction although IMAPS are not yet considered standard recipient vessels. It remains unclear if these vessels can be safely used in large flaps after radiation therapy or in delayed breast reconstruction. METHODS: Over a 2-year period, 515 free flaps for autologous breast reconstruction were performed on 419 patients by 2 surgeons (S1 and S2). In a retrospective analysis, time of reconstruction, ischemia time, flap weight, diameter of couplers, and complications were analyzed...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293496/closure-of-a-large-thoracolumbar-myelomeningocele-using-a-modified-bilateral-keystone-flap
#10
Hytham Jamjoom, Hatem Alnoman, Yasser Almadani
The keystone flap, an emerging reconstructive option that can be used in many parts of the body, is gaining popularity among reconstructive surgeons. These reliable and versatile flaps can be used for large myelomeningocele closure. A modified bilateral keystone flap was used to achieve tension-free closure of a large thoracolumbar myelomeningocele associated with severe kyphosis in a newborn girl. The flap was modified by undermining in the subfascial plane in the medial aspect of the middle third. This undermining was performed to facilitate flap movement while preserving random musculocutaneous perforators captured within the island of tissues...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293489/a-novel-strategy-to-supercharge-a-deep-inferior-epigastric-artery-perforator-flap-after-port-a-cath-removal
#11
Chad M Teven, Adrian S H Ooi, David W Chang, David H Song
Autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEP) flap has become increasingly popular because of its unique advantages. However, compared with some other forms of abdominal-based autologous reconstruction, DIEP flaps are associated with an increased risk of venous congestion. Many techniques-or lifeboats-have been introduced to diagnose and treat this potentially devastating complication. In this case report, we describe a novel strategy to augment venous drainage when venous congestion is encountered...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28292569/indocyanine-green-applications-in-plastic-surgery-a-review-of-the-literature
#12
Pierre Burnier, Jérémy Niddam, Romain Bosc, Barbara Hersant, Jean-Paul Meningaud
INTRODUCTION: Use of indocyanine green (ICG) near-infrared fluorescence as a dye to assess tissue vascularization is now well standardized. The aim of this literature review was to review and resume the most recent recommendations for ICG use in its plastic surgery applications. METHODS: A systematic literature review was performed using Medline, EMBASE, and PubMed databases to obtain the latest recommendations for ICG in plastic surgery. Inclusion criteria were all articles written in English language that evaluated pre-, intra-, or postoperative ICG applications in surgical procedures usually performed by plastic surgeons...
February 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28289617/perforator-flaps-for-reconstruction-of-lower-limb-defects
#13
Mir Yasir, Adil Hafeez Wani, Haroon Rashid Zargar
BACKGROUND: Reconstruction of soft tissue defects in the lower third of the leg remains challenging. Anatomical constraints limit the local options available for complex defects especially lower third of leg. Local flaps based on perforator vessels are raising interest in reconstructive surgery of the limbs. We present our experience with perforator flaps for reconstruction of soft tissue defects in the lower limb. METHODS: The study was carried prospectively and 23 patients with lower limb defects treated with various perforator flaps (both elective as well as emergency) were included in the study...
January 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28286397/perforator-peroneal-artery-flap-for-tongue-reconstruction
#14
Shubhra Chauhan, Sachin Chavre, Naveen Hedne Chandrashekar, Naveen B S
INTRODUCTION: Reconstruction has evolved long way from primary closure to flaps. As time evolved, better understanding of vascularity of flap has led to the development of innovative reconstructive techniques. These flaps can be raised from various parts of the body for reconstruction and have shown least donor site morbidity. We use one such peroneal artery perforator flap for tongue reconstruction with advantage of thin pliable flap, minimal donor site morbidity and hidden scar. MATERIALS AND METHODS: Our patient 57yrs old lady underwent wide local excision with selective neck dissection...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28286279/management-of-esophageal-and-pharyngeal-perforation-as-complications-of-anterior-cervical-spine-surgery
#15
Moo Sung Kang, Kyung Hyun Kim, Jeong Yoon Park, Sung Uk Kuh, Dong Kyu Chin, Byung Ho Jin, Keun Su Kim, Yong Eun Cho
OBJECTIVE: To describe our experience in treating esophageal and pharyngeal perforation after anterior cervical spine surgery. METHODS: Six patients with esophageal injury and one patient with pharyngeal injury after anterior cervical spinal surgery, managed at our department between 2000 and 2015, were retrospectively analyzed. RESULTS: During the study period, seven patients (six male and one female; mean age, 45 years) presented with esophageal perforation...
March 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28283212/-identification-of-perforating-vessels-by-augmented-reality-application-for-the-deep-inferior-epigastric-perforator-flap
#16
R Bosc, A Fitoussi, F Pigneur, V Tacher, B Hersant, J-P Meningaud
The augmented reality on smart glasses allows the surgeon to visualize three-dimensional virtual objects during surgery, superimposed in real time to the anatomy of the patient. This makes it possible to preserve the vision of the surgical field and to dispose of added computerized information without the need to use a physical surgical guide or a deported screen. TECHNIQUE: The three-dimensional objects that we used and visualized in augmented reality came from the reconstructions made from the CT-scans of the patients...
March 7, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28280676/the-telemark-breast-score-a-valid-method-for-evaluation-of-outcome-after-breast-surgery
#17
Anadi Begic, Birgit Stark
BACKGROUND: "Telemark Breast Score" (TBS) has been developed at Telemark Hospital in Norway for evaluation of results after breast surgery based on standardized patients' photographs taken as a part of daily routine. Its reliability has recently been tested and approved. The external validity of the TBS was assessed by matching its data against the internationally recognized Breast-Q (BQ) questionnaire as a further step to study the validity of this new tool. METHODS: The ideal distribution of breast volume is 45% of the total volume above and 55% below the nipple, and a 40° slope line at the upper pole...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28280657/vertical-pap-flap-simultaneous-longitudinal-profunda-artery-perforator-flaps-for-bilateral-breast-reconstructions
#18
Carlos M Rivera-Serrano, Hattan A Aljaaly, Jerry Wu, Ming-Huei Cheng
Supplemental Digital Content is available in the text.
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28272123/reconstruction-of-moderate-sized-hand-defects-using-a-superficial-lateral-sural-artery-perforator-flap
#19
Xiao-Qing He, Yue-Liang Zhu, Jia-Zhang Duan, Xi Yang, Fanzhe Feng, Yong-Qing Xu
BACKGROUND: The skin on the lower leg has abundant perforators and, thus, is an excellent donor site for transplant tissue flaps. However, due to vascular variations and body positions, tissue flaps at the posterolateral proximal portion of the lower leg are rarely used for transplantation. This study reports our experience with the use of superficial lateral sural artery perforator (SLSAP) flaps in the repair of moderate-sized hand wounds. METHODS: From March 2012 to April 2015, the hand wounds of 15 patients were planned for repair using a superficial sural artery perforator flap...
April 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28268056/the-role-of-thoracodorsal-artery-perforator-flap-in-oncoplastic-breast-surgery
#20
Ayman A Amin, Mohamed Rifaat, Ahmed Farahat, Tarek Hashem
BACKGROUND AND AIM: Thoracodorsal artery perforator flap (TDAP) is one of the relatively new techniques in breast reconstruction. In this study, we try to evaluate the outcome of this flap in oncoplastic procedures. METHODS: This study included 40 patients of stage II breast cancer who underwent partial mastectomy with skin excision at the National Cancer Institute of Cairo University between 2011 and 2014. The resultant defects were immediately reconstructed using the thoracodorsal artery perforator flap...
March 3, 2017: Journal of the Egyptian National Cancer Institute
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