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Perforator flaps

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https://www.readbyqxmd.com/read/29683203/risk-of-recurrence-and-death-in-patients-with-breast-cancer-after-delayed-deep-inferior-epigastric-perforator-flap-reconstruction
#1
H Adam, A C Docherty Skogh, Å Edsander Nord, I Schultz, J Gahm, P Hall, J Frisell, M Halle, J de Boniface
BACKGROUND: Postmastectomy reconstruction using a deep inferior epigastric perforator (DIEP) flap is increasingly being performed in patients with breast cancer. The procedure induces extensive tissue trauma, and it has been hypothesized that the release of growth factors, angiogenic agonists and immunomodulating factors may reactivate dormant micrometastasis. The aim of the present study was to estimate the risk of breast cancer recurrence in patients undergoing DIEP flap reconstruction compared with that in patients treated with mastectomy alone...
April 23, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29672783/-smartphone-based-thermography-for-perforator-localisation-in-microvascular-breast-reconstruction
#2
Leonard Walle, Hisham Fansa, Onno Frerichs
BACKGROUND: Thermography permits non-invasive examination and presentation of cutaneous temperature differences. When planning microvascular flaps, thermography may illustrate these differences and may portray patterns of blood circulation near to perforators. As an additional tool, thermography may enhance quality and diversity in free flaps. PATIENTS AND METHODS: In this prospective study, we examined 10 patients with 13 free DIEP-flaps for breast reconstruction...
April 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29672777/diep-flap-breast-reconstruction-complication-rate-in-previously-irradiated-internal-mammary-nodes
#3
Shirley Shechter, Ehud Arad, Amir Inbal, Or Friedman, Eyal Gur, Yoav Barnea
BACKGROUND:  Postmastectomy radiation therapy (PMRT) is a widely accepted treatment for locally advanced breast cancer. Some patients require additional boost radiation to the internal mammary nodes as the part of regional nodal irradiation (RNI). Delayed breast reconstruction with an autologous free flap using the internal mammary vessels for microvascular flap anastomosis is a common practice for these patients. The aim of our study was to evaluate the effect of RNI on autologous microvascular breast reconstruction...
April 19, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29672776/postoperative-monitoring-of-free-diep-flap-in-breast-reconstruction-with-near-infrared-spectroscopy-variables-affecting-the-regional-oxygen-saturation
#4
Marzia Salgarello, Domenico Pagliara, Marco Rossi, Giuseppe Visconti, Liliana Barone-Adesi
BACKGROUND:  The timing of surgical reexploration in microanastomotic thrombosis is directly related to the salvage rate of free flap. Near-infrared spectroscopy (NIRS) is a noninvasive technique, which allows a continuous bedside monitoring of flap oxygenation. The current literature is lacking in the assessment of variables able to modify the NIRS monitoring. The aim of this study is to identify patient and flap-related variables that can affect regional oxygen saturation (rSO2 )...
April 19, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29672775/free-or-perforator-pedicled-propeller-flaps-in-lower-extremity-reconstruction-defining-the-coverage-failure
#5
Farid Bekara, Christian Herlin, Antoine De Runz, David Boccara, Benoit Chaput
No abstract text is available yet for this article.
April 19, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29668632/outcomes-of-using-a-modified-anteromedial-thigh-perforator-flap-for-repairing-the-anterolateral-thigh-free-flap-donor-site-a-retrospective-clinical-review
#6
Xiao Zhou, Jin Wang, Li Qiang, Yongjun Rui, Mingyu Xue
The anterolateral thigh (ALT) flap plays an essential part in plastic and reconstructive surgery. However, repair of the anterolateral donor site has not been the focus of the clinicians.To assess the clinical value and feasibility of using a modified anteromedial thigh (AMT) perforator flap for repairing the ALT free flap donor site.In this retrospective study, 16 ALT flaps were transferred to resurface large soft-tissue defects (ranged from 7 × 5 to 13 × 8 cm) in the foot or hand from June 2012 to March 2013...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29668510/gauze-impregnated-with-quaternary-ammonium-salt-reduces-bacterial-colonization-of-surgical-drains-after-breast-reconstruction
#7
Amy L Strong, Emily T Wolfe, Nina Shank, Abigail E Chaffin, David A Jansen
Surgical site infection after breast reconstruction is associated with increased length of hospital stay, readmission rates, cost, morbidity, and mortality. Identifying methods to reduce surgical site infection without the use of antibiotics may be beneficial at reducing antimicrobial resistance, reserving the use of antibiotics for more severe cases. Quaternary ammonium salts have previously been shown to be a safe and effective antimicrobial agent in the setting of in vitro and in vivo animal experiments...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29668509/a-description-of-the-vascular-anatomy-of-the-tensor-fascia-lata-perforator-flap-using-computed-tomography-angiography
#8
Jeremy M Powers, Mariana Martinez, Shuhao Zhang, Santosh S Kale
BACKGROUND: The perforator anatomy of the tensor fascia lata (TFL) flap has been studied using cadaver dissection; however, exact descriptions of location, size, and origin of perforator vessels using preoperative imaging modalities remain limited. The aims of this study are to describe TFL perforator anatomy using high-resolution computed tomography angiography (CTA) and to correlate these findings with landmarks for the anterolateral thigh flap to facilitate flap planning. METHODS: We identified 33 patients who previously underwent bilateral lower extremity CTAs for preoperative planning of free-flap reconstruction...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29668508/ultrasound-and-plastic-surgery-clinical-applications-of-the-newest-technology
#9
John P Miller, Martin J Carney, Soobin Lim, John T Lindsey
BACKGROUND: Color Doppler ultrasound (CDUS) has not been routinely used in plastic and reconstructive surgery. Barriers to use have included large, cumbersome equipment, low-definition images, cost, and availability. In addition, programs in plastic surgery have not included training with ultrasound (US); thus, many current-day practitioners are unfamiliar with and reluctant to use this technology. Nevertheless, recent studies have demonstrated the utility of US in surgical planning. With the miniaturization, clearer imaging, and decreased costs of the latest US technology, previous barriers to use have largely been eliminated...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29664829/nipple-sparing-mastectomy-and-immediate-breast-reconstruction-with-a-deep-inferior-epigastric-perforator-flap-a-study-of-patient-satisfaction
#10
Jerry Levy, Romain Bosc, Noel Warren, Sabban Rebecca, Thu Ha Dao, Barbara Hersant, Jean-Paul Meningaud
INTRODUCTION: The morphological result of nipple-areola complex (NAC) reconstruction may be disappointing for patients who undergo skin-sparing mastectomies and immediate breast reconstruction, followed by secondary reconstruction of the nipple-areola complex.The aim of this study was to analyze patient satisfaction after nipple-sparing mastectomy and immediate breast reconstruction with a deep inferior epigastric perforator flap. MATERIALS AND METHODS: Our retrospective study involved all patients who underwent an immediate breast reconstruction after unilateral mastectomy with conservation of the NAC...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29664826/repeated-use-of-gluteal-fold-flaps-for-post-oncologic-vulvoperineal-reconstruction
#11
J Joris Hage, Maurits Lange, Henry J Zijlmans, Marc van Beurden
BACKGROUND AND AIM: Because of the associated high recurrence rate, future reconstructive options should be reckoned with during surgical treatment of primary or recurrent (pre)malignant vulvoperineal lesions. One of the claimed advantages of the gluteal fold flap is the possibility of repeated use of the flap in case of recurrence. We present our experience with such reuse of gluteal fold flaps to illustrate this possibility. METHODS: A mean of 27 months after initial use, 10 subcutaneously pedicled or perforator-based V-Y advancement or propeller-rotation flaps were elevated from previously used gluteal fold flaps in 9 women presenting with recurrent vulvoperineal (pre)malignancy...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29664802/free-thoracoacromial-artery-perforator-flap-for-skin-defects-of-the-dorsal-hand
#12
Satoshi Kodaira, Keizo Fukumoto, Naoki Kato
Various flaps are used for skin defects of the dorsal hand and fingers. A sensory flap is not essential, but a thin and good color-matched flap is suitable, and donor site mobility of the flap should be considered. A reverse or free posterior interosseous artery perforator flap is one of the standard flaps. This flap requires no major arterial sacrifice, but direct closure of the donor site is difficult when the width of the flap is >3 cm, and there is also the risk of posterior interosseous nerve injury, especially the motor branch of the extensor carpi ulnaris muscle...
April 16, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29660924/vasopressor-support-vs-liberal-fluid-administration-in-deep-inferior-epigastric-perforator-diep-free-flap-breast-reconstruction-a-randomized-controlled-trial
#13
A M Anker, L Prantl, C Strauss, V Brébant, N Heine, P Lamby, S Geis, F Schenkhoff, M Pawlik, S M Klein
BACKGROUND: Perioperatively, patients' hemodynamics are modulated predominantly by intravenous fluid administration and vasoactive pharmacological support. Vasopressor agents are suspected to be detrimental on free flap survival by the cause of vasoconstriction of the pedicle with consecutive reduced overall flap perfusion and by aggravation of flap dissection. OBJECTIVE: A novel, standardized fluid restrictive perioperative hemodynamic management was assessed for its feasibility in clinical practice in free flap patients undergoing breast reconstruction...
April 7, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29660746/free-versus-pedicled-perforator-flaps-for-lower-extremity-reconstruction-a-multicenter-comparison-of-institutional-practices-and-outcomes
#14
Keith Koh, Terence L H Goh, Christopher Tam Song, Hyun Suk Suh, Peter V Rovito, Joon-Pio Hong, Geoffrey G Hallock
BACKGROUND:  Of all body regions, lower extremity wounds have been and remain the greatest challenge. Perforator free flaps have been accepted as a reasonable option to solve this dilemma but require the complexity of microsurgery. As a consequence, the possibility that pedicled perforator flaps could supplant even perforator free flaps has recently gained intense enthusiasm. METHODS:  A retrospective investigation was undertaken to compare the validity for the use of perforator flaps of all types at three dissimilar institutions, that is, a university, a regional center, and a community hospital...
April 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29659449/evolution-in-monitoring-of-free-flap-autologous-breast-reconstruction-after-nipple-sparing-mastectomy-is-there-a-best-way
#15
Jordan D Frey, John T Stranix, Michael V Chiodo, Michael Alperovich, Christina Y Ahn, Robert J Allen, Mihye Choi, Nolan S Karp, Jamie P Levine
BACKGROUND: Free flap monitoring in autologous reconstruction after nipple-sparing mastectomy (NSM) remains controversial. We therefore examined outcomes in NSM with buried free flap reconstruction versus free flap reconstruction incorporating a monitoring skin paddle. METHODS: Autologous free flap reconstructions with NSM performed from 2006 to 2015 were identified. Demographics and operative results were analyzed and compared between buried flaps and those with a skin paddle for monitoring...
January 20, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29659448/sural-nerve-splitting-in-reverse-sural-artery-perforator-flap-anatomical-study-in-40-cadaver-legs
#16
Hyeonwoo Kim, Julong Hu, Hak Chang, Byung Jun Kim
No abstract text is available yet for this article.
January 20, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29658670/-effect-of-exogenous-l-arginie-on-survival-of-extended-dorsal-perforator-flaps-in-rats
#17
Wenbo Li, Dingding Jia, Fei Wang, Chao Zhang, Jie Shi, Hong Zhang, Lujia Wu, Qiuming Gao
<b>Objective:</b> To investigate the effect of exogenous L-Arg on the survival of extended perforator flap in rats. <b>Methods:</b> Sixteen male Sprague Dawley rats were randomly divided into L-Arg group (<i>n</i>=8) and control group(<i>n</i>=8). The extended dorsal three-vascular territory perforator flaps were made in rats. L-Arg (400 mg·kg<sup>-1</sup>·d<sup>-1</sup>) was injected intraperitoneally in L-Arg group 1d before operation, immediately and 1-7 d after operation, while the same volume of saline was injected intraperitoneally in control group at the same time points...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/29655664/a-retrospective-investigation-of-abdominal-visceral-fat-body-mass-index-bmi-and-active-smoking-as-risk-factors-for-donor-site-wound-healing-complications-after-free-diep-flap-breast-reconstructions
#18
Floyd W Timmermans, Pèdrou B Westland, Stefan Hummelink, Joep Schreurs, Marijn Hameeteman, Dietmar J O Ulrich, Nicholas J Slater
BACKGROUND: The deep inferior epigastric artery perforator (DIEP) flap is one of the most common techniques for breast reconstruction. Body mass index (BMI) is considered as an important predictor of donor site healing complications such as wound dehiscence. The use of computed tomography (CT) proved to be a precise and objective method to assess visceral adipose tissue. It remains unclear whether quantification of visceral fat provides more accurate predictions of abdominal wound healing complications than BMI...
March 28, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29653454/how-does-autologous-breast-reconstruction-impact-downtime
#19
Giovanni Zoccali, Daniel Simon Rais, Jian Farhadi
BACKGROUND:  Although autologous breast reconstruction is technically quite demanding, it offers the best outcomes in terms of durable results, patient perceptions, and postoperative pain. Many studies have focused on clinical outcomes and technical aspects of such procedures, but few have addressed the impact of various flaps on patient recovery times. This particular investigation entailed an assessment of commonly used flaps, examining the periods of time required to resume daily activities...
April 13, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29650262/triple-flap-technique-for-vulvar-reconstruction
#20
R Mercut, R Sinna, R Vaucher, P A Giroux, N Assaf, A Lari, S Dast
OBJECTIVE: Perineal defects are encountered ever more frequently, in the treatment of vulvar cancers or abdominoperineal resection. The surgical treatment of vulvar cancer leads to significant skin defect. The aim of the reconstruction is not to provide volume but rather to resurface perineum. We propose a new solution to cover the extensive skin defect remaining after excision. METHODS: We report 3 patients who underwent large excision for vulvar cancer, with lymph node dissection...
April 9, 2018: Annales de Chirurgie Plastique et Esthétique
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