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Perforator flaps

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https://www.readbyqxmd.com/read/29034512/superficial-temporal-artery-perforator-flap-anatomic-study-of-number-and-reliability-of-distal-branches-of-the-superficial-temporal-artery-and-clinical-applications-in-three-cases
#1
Achille Aveta, Beniamino Brunetti, Stefania Tenna, Francesco Segreto, Paolo Persichetti
BACKGROUND: Limited information is available about the anatomical feasibility and clinical applications of flaps based on distal divisions of the superficial temporal artery (STA). The aim of this study was to investigate the anatomy of the STA, focusing on the number and reliability of distal branches and to show representative cases for the use of such flaps for zygomatic, parieto-frontal and occipital reconstructions. METHODS: Fifty volunteers were examined bilaterally by Doppler to investigate the presence and variability of the distal divisions of STA branches...
October 16, 2017: Microsurgery
https://www.readbyqxmd.com/read/29032878/the-anterolateral-thigh-perforator-flap-in-pharyngo-esophageal-reconstruction
#2
M K De Frémicourt, S Temam, F Janot, F Kolb, Q Qassemyar
Today's customary techniques for pharyngo-esophageal reconstruction are jejunum and radial forearm free flaps. In this type of reconstruction, the jejunum flap is considered as the reference, but when its harvesting is not possible, the radial forearm flap is used. Since perforator flaps have begun to be developed, the anterolateral thigh flap (ATF) has become increasingly prominent in pharyngo-esophageal reconstruction. The aim of our study was to describe the use of the anterolateral perforator flap in pharyngo-esophageal reconstruction (indications, harvesting method, flap design) and to discuss its advantages and drawbacks as regards oral feeding and esophageal speech...
October 9, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29026826/the-superficial-femoral-artery-flap-a-3-dimensional-anatomical-study
#3
Hadal El-Hadi, Steven Morris, Ali Alkhawaji
BACKGROUND: The superficial femoral artery perforator (SFAP) flap offers advantages for pedicled transfer including consistent perforators and vascular territory, well-hidden donor site scar, and hairless flap skin. This article provides a historical overview of the SFAP flap and describes the vascular anatomy of the SFAP by 3-dimensional analysis and angiography. METHODS: Ten fresh cadavers were injected using the lead oxide technique through the femoral artery...
August 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29026825/the-keystone-flap-a-case-series-demonstrating-practical-design-use-and-applications
#4
Stahs Pripotnev, Colin White
INTRODUCTION: The keystone design perforator island flap is a trapezoidal-shaped random perforator island flap with many advantages over primary closure, skin grafting, and other local flaps for soft tissue reconstruction commonly encountered with cancer excisions. METHODS: This case series of 39 keystone flaps in 37 patients reviews the practical design, use, and applications of the flap while highlighting certain important considerations. Keystone flaps were designed as in the original description, with a minor modification in the lower extremity where a higher flap to defect width ratio was used...
August 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29025216/assisted-salvage-of-ischemic-fasciocutaneous-flap-using-adipose-derived-mesenchymal-stem-cells-in-situ-revascularization
#5
Michael H Carstens, Mauricio Mendieta, Cecilia Pérez, Esperanza Villareal, Rodolfo Garcia
Adipose-derived mesenchymal stem cells (ASCs) have been shown to produce vascular endothelial growth factor (VEGF) and can increase perfusion in patients with critical limb ischemia. We will show that this concept can be applied to augment blood flow in zones of flap ischemia. We presented a case study of a 26-year-old man with a complex hand injury covered by a reverse radial perforator fasciocutaneous flap, which developed ischemic necrosis and was treated by debridement, transplantation of ASCs to enhance vascular support, and saline dressings...
July 1, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29024231/chimeric-thoracoacromial-artery-perforator-flap-for-one-staged-reconstruction-of-complex-pharyngoesophageal-defects-a-single-unit-experience
#6
Dajiang Song, Georgios Pafitanis, Luis Eduardo Parra Pont, Peng Yang, Isao Koshima, Yixin Zhang, Takuya Iida, Xiao Zhou, Zan Li
BACKGROUND: Circumferential hypopharyngeal defects with anterior neck skin loss often require double-stacked or chimeric flaps to achieve good surgical outcomes. The thoracoacromial artery perforator (TAAP) flap is a simple and reliable method for hypopharyngeal defect reconstruction. METHODS: From March 2012 to February 2015, 19 male patients with an average age of 62 years (range 42-81 years) underwent complex pharyngoesophageal defect reconstruction with chimeric TAAP flaps...
October 11, 2017: Head & Neck
https://www.readbyqxmd.com/read/29019862/complications-and-patient-reported-outcomes-after-abdominal-based-breast-reconstruction-results-of-the-mastectomy-reconstruction-outcomes-consortium-mroc-study
#7
Jessica Erdmann-Sager, Edwin G Wilkins, Andrea L Pusic, Ji Qi, Jennifer B Hamill, Hyungjin Myra Kim, Gretchen E Guldbrandsen, Yoon S Chun
BACKGROUND: Abdominal flap reconstruction is the most popular form of autologous breast reconstruction. The current study compared complications and patient-reported outcomes (PROs) after pedicled transverse rectus abdominis myocutaneous (PTRAM), free TRAM (FTRAM), deep inferior epigastric perforator (DIEP), and superficial inferior epigastric artery (SIEA) flaps. METHODS: Patients having abdominal-based breast reconstruction at 11 centers were prospectively evaluated for abdominal donor-site and breast complications...
October 10, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29019861/the-lateral-thigh-perforator-ltp-flap-for-autologous-breast-reconstruction-a-prospective-analysis-of-138-flaps
#8
Stefania M H Tuinder, Jop Beugels, Arno Lataster, Michiel W de Haan, Andrzej Piatkowski, Michel Saint-Cyr, René R W J van der Hulst, Robert J Allen
BACKGROUND: The septocutaneous tensor fasciae latae (sc-TFL) or lateral thigh perforator (LTP) flap was previously introduced by our group as an alternative flap for autologous breast reconstruction when the abdomen is not suitable as a donor site. The aim of this study was to analyze our experience with the LTP flap and to present the surgical refinements that were introduced. METHODS: A prospective study was conducted of all LTP flap breast reconstructions performed since September 2012...
October 10, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29017734/anatomy-of-the-vasculature-of-the-lower-leg-and-harvest-of-a-fibular-flap-a-systematic-review
#9
REVIEW
A K Abou-Foul, A Fasanmade, S Prabhu, F Borumandi
The fibular free flap (FFF) is based on the peroneal artery, which has a consistent anatomy and makes a minimal contribution to the pedal circulation. However, certain anatomical variations in the vasculature of the leg might leave the peroneal artery with a major role in the perfusion of the foot, and to raise a FFF could lead to ischaemic complications. Our aim was to review the implications of anatomical variants on planning and harvest of a FFF. We systematically reviewed all relevant publications, and included 28 cases that described a dominant peroneal artery and FFF...
October 7, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28990694/suprafascial-versus-traditional-harvesting-technique-for-free-antero-lateral-thigh-flap-a-case-control-study-to-assess-the-best-functional-and-aesthetic-result-in-extremity-reconstruction
#10
Michele Maruccia, Nefer Fallico, Emanuele Cigna, Pedro Ciudad, Fabio Nicoli, Emilio Trignano, Eleonora Nacchiero, Giuseppe Giudice, Diego Ribuffo, Hung-Chi Chen
Clinical applications of ALT flap have currently extended to extremity (hand and foot) as well as oral cavity reconstruction. In these anatomical areas, the traditional harvesting technique presents a few disadvantages such as bulkiness of the recipient site and potential donor site morbidity including damage to the deep fascia and skin graft adhesions. The purpose of the present study was to compare the functional and aesthetic outcomes of upper and lower extremity reconstruction with either suprafascial or subfascial harvested anterolateral (ALT) flaps...
October 9, 2017: Microsurgery
https://www.readbyqxmd.com/read/28990692/functional-results-of-free-tissue-transfer-for-complex-heel-calcaneal-defects
#11
Chang-Yi Chou, Hao-Yu Chiao, Chi-Yu Wang, Yu-Shan Sun, Chin-Ta Lin, Niann-Tzyy Dai, Shyi-Gen Chen, Shun-Cheng Chang
BACKGROUND: Loss of soft tissue in heel-calcaneal region is frequently caused by trauma, infection, or tumors. Limited availability of similar tissue becomes challenging, therefore, the use of free tissue transfer offers a solution. Our aim is to describe long term functional outcome of different free tissue transfers for these defects. PATIENTS AND METHODS: We retrospectively reviewed 24 consecutive cases of the heel-calcaneal defect between January 2009 and December 2014...
October 9, 2017: Microsurgery
https://www.readbyqxmd.com/read/28987067/reconstruction-of-severe-atherosclerotic-and-obstructive-diabetic-feet-using-thoracodorsal-artery-perforator-flaps-with-long-vascular-pedicles
#12
Sang Wha Kim, Il Hoon Sung, Youn Hwan Kim
BACKGROUND: Foot ulcers in diabetic patients often require free flaps. A long vascular pedicle is mandatory so that more proximal vessels can be used as recipient vessels, especially when the flap is used to reconstruct distal foot defects. We evaluated the outcome of diabetic foot defect that were reconstructed using thoracodorsal artery perforator (TDAP) flaps with long vascular pedicles. PATIENTS AND METHODS: We reconstructed the foot defects of 22 diabetic patients...
October 7, 2017: Microsurgery
https://www.readbyqxmd.com/read/28985637/retrospective-analysis-in-lower-limb-reconstruction-propeller-perforator-flaps-versus-free-flaps
#13
Marta Cajozzo, Francesca Toia, Alessandro Innocenti, Massimiliano Tripoli, Giovanni Zabbia, Salvatore D'Arpa, Adriana Cordova
No abstract text is available yet for this article.
October 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28972286/foot-and-ankle-reconstruction-with-vertically-designed-deep-inferior-epigastric-perforator-flap
#14
Osman Akdag, Mehtap Karamese, Gokce Unal Yıldıran, Mustafa Sutcu, Zekeriya Tosun
INTRODUCTION: The deep inferior epigastric perforator (DIEP) flap is one of the most commonly utilized flaps of reconstructive surgery. Although the horizontal flap design is the most commonly used, this flap can be vertically designed to avoid drawbacks such as excessive tissue dissection, relatively reduced flap perfusion, and scarification of the contralateral flap opportunity. The aim of this report is to present our case series for foot and ankle reconstruction with vertical designed DIEP flap...
October 3, 2017: Microsurgery
https://www.readbyqxmd.com/read/28968314/reconstruction-of-an-alar-defect-with-a-fusiform-nasolabial-turnover-flap-with-a-proximal-superiorly-tapered-apex
#15
Constantin El Habr, Gian Vinelli, Adam Tinklepaugh, David Ciocon
The nasolabial turnover flap was first described by Spear et al in 1987 for the coverage of full thickness defects of the lateral ala. It offered a single-stage repair that recreated the internal nasal lining, the external nasal valve, and the rounded contour of the ala without requiring a cartilage graft. A frequently encountered problem with the execution of Spear's original design is elevation of the ipsilateral commissure of the adjacent lip due to its broad proximal pedicle. Here, the authors describe a fusiform-type design with a proximal, superiorly tapered apex that relies on anteriorly coursing perforators from the underlying angular artery...
September 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28966964/anterior-tibial-artery-perforator-plus-flaps-role-in-coverage-of-posttumor-excision-defects-around-the-knee-joint-and-upper-leg
#16
Harshvardhan Sahijwani, Vikas Warikoo, Abhijeet Ashok Salunke, Jaymin Shah, Preetish Bhavsar, Rahul Wagh, Subodh Pathak
OBJECTIVE: Posttumor excision defects can be very large, and many do require postoperative radiotherapy. It is therefore important to provide stable and durable wound coverage to provide ability to withstand radiotherapy as well as providing cover to vital structures. METHODS: Between July 2014 and June 2016, eight females and six male patients with defects around the knee were operated upon using a perforator plus flap from the anterior tibial artery perforator...
October 2017: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28964620/-fasciocutaneous-flap-reliable-by-deep-femoral-artery-perforator-for-the-treatment-of-ischial-pressure-ulcers
#17
L Gebert, F Boucher, A Lari, F Braye, A Mojallal, M Ismaïl
INTRODUCTION: The surgical management of pressure ulcers in the paraplegic or quadriplegic population is marked by the high risk of recurrence in the long-term. In the current era of perforator flaps, newer reconstructive options are available for the management of pressure ulcers, decreasing the need to use the classically described muscular or musculocutaneous locoregional flaps. The coverage of ischial sores described in this article by a pedicled flap based on a deep femoral artery perforator, appears to be an effective first-line reconstructive option for the management of limited size pressure ulcers...
September 27, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28953748/the-use-of-perforator-flaps-in-lower-extremity-traumatic-defect-reconstruction-in-the-pediatric-population
#18
Christian Herlin, Raphael Sinna, Farid Bekara, Marion Delpont, Swany Dast, Benoit Chaput
No abstract text is available yet for this article.
October 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28953725/the-functional-angiosome-clinical-implications-of-the-anatomical-concept
#19
G Ian Taylor, Russell J Corlett, Mark W Ashton
BACKGROUND: The angiosome is a three-dimensional block of tissue supplied by a source vessel with its boundary outlined either by an anastomotic perimeter of reduced-caliber choke vessels or by true anastomoses with no reduction of vessel caliber. This article focuses on the role of these anastomotic vessels in defining flap survival or the necrotic pattern seen in fulminating meningococcal septicemia. METHODS: Experiments in pigs, dogs, guinea pigs, and rabbits over the past 46 years were reviewed, focusing on the necrosis line of flaps, the effects of various toxins in vivo, and correlating these results in the clinical setting...
October 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28938363/reconstruction-of-the-heel-middle-foot-sole-and-plantar-forefoot-with-the-medial-plantar-artery-perforator-mpap-flap-clinical-experience-with-28-cases
#20
Mario F Scaglioni, Daniel Rittirsch, Pietro Giovanoli
INTRODUCTION: Defects in the weight-bearing region of the foot sole can represent a substantial restriction in quality of life and pose a challenge for reconstructive plastic surgery.The purpose of this article is to report our experience with the use of medial plantar artery perforator (MPAP) flap for reconstruction of defects of the foot sole in 3 different regions: heel, middle foot sole and plantar forefoot. PATIENTS AND METHODS: From January 2003 to May 2016, 28 patients (13 males and 15 females) with an average age of 54 years (range 12 to 84 y...
September 15, 2017: Plastic and Reconstructive Surgery
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