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Perforator flaps

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https://www.readbyqxmd.com/read/29464784/total-nasal-reconstruction-with-3d-custom-made-porous-titanium-prosthesis-and-free-thoracodorsal-artery-perforator-flap-a-case-report
#1
Quentin Qassemyar, Nathaniel Assouly, Yoni Madar, Stéphane Temam, Frédéric Kolb
Total nasal reconstruction is a challenging surgical procedure which usually involves a free flap, forehead flap, and cartilage grafts. In certain failure situations where patients do not accept the idea of anaplastology, possibilities become very limited. We report the case of a patient who underwent several reconstruction steps with multiple failures including free and local flaps and cartilage harvests which showed recurrent episodes of necrosis and infection leading to melting and collapse of reconstructed structures...
February 21, 2018: Microsurgery
https://www.readbyqxmd.com/read/29464169/enhanced-preoperative-deep-inferior-epigastric-artery-perforator-flap-planning-with-a-3d-printed-perforasome-template-technique-and-case-report
#2
Michael P Chae, David J Hunter-Smith, Marie Rostek, Julian A Smith, Warren Matthew Rozen
Optimizing preoperative planning is widely sought in deep inferior epigastric artery perforator (DIEP) flap surgery. One reason for this is that rates of fat necrosis remain relatively high (up to 35%), and that adjusting flap design by an improved understanding of individual perforasomes and perfusion characteristics may be useful in reducing the risk of fat necrosis. Imaging techniques have substantially improved over the past decade, and with recent advances in 3D printing, an improved demonstration of imaged anatomy has become available...
January 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29464165/reexploring-the-anatomy-of-the-distal-humerus-for-its-role-in-providing-vascularized-bone
#3
Logan W Carr, Sebastian M Brooke, T Shane Johnson, Brett F Michelotti
Background: The lateral arm flap is used for composite defects in need of vascularized soft tissue, skin, and bone. From its original description, the distal humeral metaphysis can be included with the flap, supplied by the periosteal extensions of the posterior branch of the radial collateral artery. We sought to reexplore the anatomy of the lateral arm to determine its utility as a donor site for vascularized bone. Methods: Twelve fresh, silicone-injected cadaver dissections were performed...
January 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29464151/the-pedicled-licap-flap-combined-with-a-free-abdominal-flap-in-autologous-breast-reconstructions
#4
Thomas Sjøberg, Louis de Weerd
Background: Previous surgery or slim body configuration can limit the size of the available abdominal flap in autologous breast reconstruction. However, redundant skin and subcutaneous tissue lateral to the mastectomy site can be utilized as the pedicled lateral intercostal artery perforator (LICAP) flap. This study evaluates the combination of a free abdominal flap and a pedicled LICAP flap to achieve increased breast size and improved cosmetic outcome. Methods: Patients undergoing secondary autologous breast reconstruction were included in a prospective study...
January 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29464149/microsurgical-engineering-bilateral-deep-inferior-epigastric-artery-perforator-flap-with-flow-through-intraflap-anastomosis
#5
Ian R Wisecarver, Gerhard S Mundinger, Michael S Tarakji, Hugo St Hilaire
Squamous cell carcinoma (SCC) of the head and neck affects a significant number of people around the world every year. Treatment generally entails surgical resection, radiotherapy, chemotherapy, or some combination of the three. Following resection, microsurgical reconstruction can provide definitive coverage, replace many tissue types simultaneously, and bring healthy tissue to irradiated wound beds. Microsurgical engineering, the manipulation and reorganization of native vascular tissue, can further augment the adaptability of free tissue transfer to complex, compromised wound beds...
January 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29456673/full-thickness-conjunctival-flap-covering-surgery-combined-with-amniotic-membrane-transplantation-for-severe-fungal-keratitis
#6
Jing Zhong, Bowen Wang, Saiqun Li, Yuqing Deng, Haixiang Huang, Ling Chen, Jin Yuan
Fungal keratitis is a severe and common ocular infectious disease. The present study evaluated the efficiency of full-thickness conjunctival flap covering surgery with amniotic membrane transplantation (FCCS + AMT) as a transitional surgery for severe fungal keratitis. A total of 17 patients with severe fungal keratitis without corneal perforation underwent FCCS + AMT between January 2010 and December 2015. The pathogenic factors, preoperative diagnosis and postoperative prognosis of FCCS + AMT at 3 months were evaluated...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29452717/evaluation-of-the-mobility-of-the-shoulder-and-quality-of-life-after-perforator-flaps-for-recalcitrant-axillary-hidradenitis
#7
R Nail-Barthelemy, N Stroumza, Q Qassemyar, M Delage, A Nassif, M Atlan
BACKGROUND: Hidradenitis suppurativa is a very debilitating disease, treated by antibiotics and excision. The reconstruction is usually done by secondary wound healing and/or split-thichness skin graft. The aim of this study was to evaluate the reconstruction of the axilla with local perforator flaps as a single stage surgical treatment. METHODS: This was a monocentric retrospective study conducted between November 2013 and June 2015. We included the patients with a severe axillary localization of the disease...
February 13, 2018: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29452438/algorithmic-approach-for-intraoperative-salvage-of-venous-congestion-in-diep-flaps
#8
Erica L Bartlett, Dmitry Zavlin, Zachery K Menn, Aldona J Spiegel
BACKGROUND: Flap congestion is a frequently described intraoperative complication during autologous breast reconstruction with abdominal perforator flaps, which, if not addressed, can lead to detrimental results such as flap failure. Here, we describe our institution's algorithm of intraoperative salvage of congested flaps and present their outcomes. METHODS: All patient charts from 2002 to 2016 of a single plastic surgeon were reviewed for patients who underwent deep inferior epigastric perforator flap breast reconstruction resulting in 602 patients and 831 flaps...
February 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29450450/technique-to-repair-total-septal-perforation-with-a-pericranial-flap-the-money-box-approach
#9
Isam Alobid, Cristobal Langdon, Alfonso Santamaría
No abstract text is available yet for this article.
February 15, 2018: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29443757/various-surgical-techniques-to-create-an-aesthetic-appearance-at-the-donor-site-of-anterolateral-thigh-free-flaps-based-on-the-oblique-branch-twenty-one-clinical-case-reports
#10
Chengliang Deng, Hai Li, Zairong Wei, Wenhu Jin, Kaiyu Nie, Shujun Li, Bihua Wu, Dali Wang
RATIONALE: Reducing the morbidity associated with anterolateral thigh (ALT) donor sites by performing aesthetic restoration has become a popular research topic. Various surgical techniques have been developed allowing for direct closure of the donor site. However, closure techniques for ALT donor sites based on the oblique branch have not been systematically reported. PATIENT CONCERNS: Data from 21 patients (18 males, 3 females) undergoing operative reconstruction with an ALT free flap between January 2016 and December 2016...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29433140/-colour-duplex-sonography-and-power-duplex-in-perforator-surgery-improvement-of-patients-safety-by-efficient-planning
#11
Adrien Daigeler, Cornelius Schubert, Tobias Hirsch, Björn Behr, Marcus Lehnhardt
INTRODUCTION: There are many techniques to identify vessels in perforator surgery, each with specific disadvantages. Handheld Dopplers are easy to use, but inaccurate with respect to the exact localisation of the perforator. Angio-CT is invasive, time consuming, and expensive. In contrast, duplex sonography is a reliable, easy-to-use and availabe alternative for pre-, intra-, and postoperative visualisation of vessels. Power Doppler further increases sensitivity and allows visualisation of vessels smaller than 0...
February 12, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29428586/the-pedicled-internal-pudendal-artery-perforator-pipap-flap-for-ischial-pressure-sore-reconstruction-technique-and-long-term-outcome-of-a-cohort-study
#12
Catherine M Legemate, Monique van der Kwaak, David Gobets, Menno Huikeshoven, Paul P M van Zuijlen
BACKGROUND: The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. We developed a practical and safe pedicled flap for reconstruction of ischial pressure sores based on the rich available perforators from the internal pudendal artery and the surplus of skin at the infragluteal fold. METHODS: A retrospective cohort study was conducted in all patients who underwent ischial pressure ulcer reconstruction using the PIPAP flap between March 2010 and March 2017...
February 7, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29428585/distally-based-anteromedial-thigh-flaps-pedicled-on-the-rectus-femoris-branch-of-the-lateral-circumflex-femoral-artery-for-reconstruction-of-soft-tissue-defect-of-the-knee
#13
Shan Zhu, Mengqing Zang, Shengji Yu, Boyang Xu, Yuanbo Liu
BACKGROUND: Anteromedial thigh flaps are far less clinically appealing than their anterolateral counterparts, and are occasionally considered as an alternative to the anterolateral thigh flap. Herein, we report the study of soft-tissue defects reconstruction in the knee using a distally based anteromedial thigh flap pedicled on the rectus femoris branch of the descending branch of the lateral circumflex femoral artery. PATIENTS AND METHODS: Between July 2008 and September 2016, a distally based anteromedial thigh flap was used to reconstruct soft-tissue defects of the knee in 5 patients (3 males, 2 females; age range at surgery 4-55 years old)...
February 7, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29427442/nose-resurfacing-with-free-fasciocutaneous-flaps-in-burns-patients
#14
Cheng-I Yen, Jui-Yung Yang, Chun-Shin Chang, Jung-Ju Huang, Chih-Wei Wu, Hung-Chang Chen, Shih-Yi Yang, Shu-Yin Chang, Shiow-Shuh Chuang, Yen-Chang Hsiao
BACKGROUND: Nasal reconstruction after burn injury can be challenging due to limited availability of local flaps. We present our experience of free flap reconstruction for full-thickness nasal defect after severe facial burn injury. METHODS: Between August 1998 and September 2015, six patients underwent nasal reconstruction with seven free flaps after burn injury. Among them, flame burn occurred in two patients, chemical burn in two, explosive burn in one, and contact thermal burn in one patient...
February 10, 2018: Microsurgery
https://www.readbyqxmd.com/read/29419689/surgical-reconstruction-of-the-fascia-lata-and-posterior-tibial-artery-perforator-flap-to-treat-children-with-simultaneous-injury-to-the-achilles-tendon-and-heel-skin
#15
Chu-Zhao Lin, Xue Xia, Hu Wang, Dong-Xin Liu
Children with simultaneous injury to the Achilles tendon and heel skin remain a challenge for clinicians. The purpose of this study is to evaluate a combined surgical procedure involving use of the fascia lata to reconstruct the Achilles tendon, and the posterior tibial artery perforator flap to cover the accompanying heel skin injury.Between February 2010 and February 2013, 8 children (3 females and 5 males) between 3 and 12 years of age, with a median age of 7.5 years, were hospitalized in the First Affiliated Hospital of Shantou University Medical College...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29409421/treatment-of-hand-allodynia-resulting-from-wrist-cutting-with-radial-and-ulnar-artery-perforator-adipofascial-flaps
#16
Hideto Irifune, Nobuyuki Takahashi, Suguru Hirayama, Eichi Narimatsu, Toshihiko Yamashita
In this article, we report two cases in which recurrent adhesive hand neuropathy with allodynia were successfully treated with radial and ulnar artery adipofascial perforator flap coverage. Treatment of recurrent neuropathy, such as recurrent carpal tunnel syndrome and re-adhesion after neurolysis using free and pedicle flaps to cover the nerves, has been reported to show good results. However, for severe painful nerve disorders, such as complex regional pain syndrome, the efficacy of this treatment was unclear...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29406342/the-medial-sural-artery-perforator-flap-the-first-choice-for-soft-tissue-reconstruction-about-the-knee
#17
Barbara M Ling, Reto Wettstein, Daniel Staub, Dirk J Schaefer, Daniel F Kalbermatten
BACKGROUND: The gastrocnemius muscle flap may be considered the first choice in many cases of soft-tissue reconstruction about the knee. Limited arc of rotation and reach of the flap as well as unsightly muscle bulk are major disadvantages and were the impetus to look for a local alternative. The aim of this study is to present a consecutive series of patients with a reconstruction about the knee involving the medial sural artery perforator flap (MSAPF). METHODS: A consecutive series of 17 cases of defect reconstructions about the knee using the MSAPF is described, with an emphasis on early postoperative complications...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29406297/sacral-pressure-ulcer-induced-fournier-s-gangrene-extending-to-the-retroperitoneum-a-case-report
#18
Kiyoko Fukui, Masaki Fujioka, Satoko Ishiyama
INTRODUCTION: Fournier's gangrene (FG) is a type of necrotizing fasciitis of the perineum and scrotum that is characterized by very rapid progression. Sacral pressure ulcers are one of the causes of FG. CASE REPORT: An 85-year-old man was referred to the National Hospital Organization Nagasaki Medical Center (Ohmura City, Japan) with a diagnosis of FG extending to the retroperitoneum caused by a sacral pressure ulcer. Immediate debridement was performed; however, it was not possible to remove all necrotic tissue from the pelvis...
January 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29399731/complications-following-immediate-compared-to-delayed-deep-inferior-epigastric-artery-perforator-flap-breast-reconstructions
#19
J Beugels, L Bod, S M J van Kuijk, S S Qiu, S M H Tuinder, E M Heuts, A Piatkowski, R R W J van der Hulst
PURPOSE: As more breast cancer patients opt for immediate breast reconstruction, the incidence of complications should be evaluated. The aim of this study was to analyze the recipient-site complications and flap re-explorations of immediate compared to delayed deep inferior epigastric artery perforator (DIEP) flap breast reconstructions. METHODS: For this multicenter retrospective cohort study, the medical records of all patients who underwent DIEP flap breast reconstruction in three hospitals in the Netherlands between January 2010 and June 2017 were reviewed...
February 5, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29398784/reconstruction-of-acquired-ischiatic-and-perineal-defects-an-anatomical-and-clinical-comparison-between-gluteal-thigh-and-inferior-gluteal-perforator-flaps
#20
Eduardo Montag, Thiago Ueda, Alberto Okada, Bruno Onishi, Rolf Gemperli
Background: Flap coverage is the gold standard in treating pressure sores, and due to the high recurrence rate, the possibility of multiple surgical procedures should be considered during flap selection. The gluteal thigh (GT) flap has become a workhorse for ischiatic pressure sore treatment at our hospital. Follow-up revealed a group of patients presenting recurrence of the pressure sore that needed a second flap. The inferior gluteal artery perforator (IGAP) flap was chosen in this series...
2018: European Journal of Plastic Surgery
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