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Perforator flaps

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https://www.readbyqxmd.com/read/28097499/automating-perforator-flap-mra-and-cta-reporting
#1
Christopher J Lange, Nanda Deepa Thimmappa, Srikanth R Boddu, Silvina P Dutruel, Mengchao Pei, Zerwa Farooq, Ashkan Heshmatzadeh Behzadi, Yi Wang, Ramin Zabih, Martin R Prince
Surgical breast reconstruction after mastectomy requires precise perforator coordinates/dimensions, perforator course, and fat volume in a radiology report. Automatic perforator reporting software was implemented as an OsiriX Digital Imaging and Communications in Medicine (DICOM) viewer plugin. For perforator analysis, the user identifies a reference point (e.g., umbilicus) and marks each perforating artery/vein bundle with multiple region of interest (ROI) points along its course beginning at the muscle-fat interface...
January 17, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#2
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28092333/reply-free-style-pedicled-perforator-flaps-applying-the-reconstructive-ladder-to-optimize-outcomes
#3
M Saint-Cyr, A T Mohan, Y J Sur, L Zhu, M Morsy, P S Wu, S L Moran, S Mardini
No abstract text is available yet for this article.
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28092332/free-style-pedicled-perforator-flaps-applying-the-reconstructive-ladder-to-optimize-outcomes
#4
Beniamino Brunetti, Igor Poccia, Stefania Tenna, Gabriella Cassotta, Paolo Persichetti
No abstract text is available yet for this article.
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28079533/national-and-regional-differences-in-32-248-postmastectomy-autologous-breast-reconstruction-using-the-updated-national-inpatient-survey
#5
Parisa Kamali, Marek A Paul, Ahmed M S Ibrahim, Pieter G L Koolen, Winona Wu, Marc L Schermerhorn, Bernard T Lee, Samuel J Lin
BACKGROUND: The incidence of breast cancer (BC) cases has increased significantly. The number of breast reconstruction (BR) procedures performed has mirrored this trend. Although implant-only procedures remain the most commonly used type of immediate BR, autologous techniques involving donor sites account for approximately 20%. The aim of this study was to assess national and regional trends in different types of autologous BR. METHODS: Using the Nationwide Inpatient Sample database (2008 to 2012), data on BC and mastectomy rates, type of autologous BR, and sociodemographics were obtained and analyzed...
January 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28072992/-comparison-of-free-anterolateral-thigh-perforator-flaps-versus-free-forearm-flap-for-reconstruction-in-elderly-patients-undergoing-glossectomy
#6
N Gao, K Fu, W H Lou
Objective: To evaluate the quality of life (QOL) in elderly patients with tongue cancer who underwent immediate free flap reconstruction surgery. In addition, the efficacy of the anterolateral thigh perforator free flap (ALTFF) and the radial free forearm flap (RFFF) for reconstruction was compared in patients with glossectomy. Methods: Ninty-eight patients undergoing complete or partial glossectomy and reconstruction with free flaps were grouped according to flap type. Oral functions were assessed using The University of Washington Quality of Life (UW-QOL), and the 14-item Oral Health Impact Profile questionnaires (OHIP-14) at 6 and 12 months after reconstructive surgery...
January 9, 2017: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
https://www.readbyqxmd.com/read/28069080/role-of-circumferential-subannular-tympanoplasty-in-anterior-and-subtotal-perforations
#7
G B Singh, S Ranjan, R Arora, S Kumar
OBJECTIVE: This study aimed to evaluate the surgical success of a modified inlay tympanoplasty technique, known as circumferential subannular tympanoplasty, for anterior and subtotal perforations. METHODS: This prospective study was performed in a tertiary care teaching hospital between October 2013 and April 2016. A total of 58 adult patients of both sexes with anterior or subtotal perforations underwent circumferential subannular tympanoplasty under local anaesthesia...
January 10, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28065405/fingertip-reconstruction-with-a-posterior-interosseous-artery-perforator-flap-a-minimally-invasive-procedure-for-donor-and-recipient-sites
#8
Satoshi Usami, Mutsumi Okazaki
BACKGROUND: A posterior interosseous artery perforator flap is used for small defects and leaves no functional disturbance at the flap donor site. This report aimed to describe our experience with the transfer of this flap for fingertip defects and the evaluation of postoperative function. METHODS: In total, 11 flaps were used for 13 fingertip reconstructions in 11 patients. Two patients had two finger defects simultaneously covered with one bridge flap, and five flaps were harvested in true perforator flap style...
December 14, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28063278/combined-anterolateral-thigh-and-tensor-fasciae-latae-flaps-an-option-for-reconstruction-of-large-head-and-neck-defects
#9
Ramzey Tursun, Hisham Marwan, J Marshall Green, Fawaz Alotaibi, Andre LeDoux
PURPOSE: The advent of microvascular free tissue transfer has provided the reconstructive surgeon with an enormous array of treatment options for reconstruction of large head and neck defects. However, when indicated by defect size, the need for more than 1 flap not only increases surgical complexity but also patient morbidity. The combination of the anterolateral thigh (ALT) flap and the tensor fascia latae (TFL) flap can be used to reconstruct such complex head and neck defects, thereby minimizing any additional morbidity that would be imposed by an additional flap harvest site...
December 26, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28059854/perforator-phase-contrast-angiography-of-deep-inferior-epigastric-perforators-a-better-preoperative-imaging-tool-for-flap-surgery-than-computed-tomographic-angiography
#10
Xiangyu Yang, Michael J Miller, Harry T Friel, Allison Slijepcevic, Michael V Knopp
OBJECTIVE: The aim of this study was to demonstrate the feasibility of in vivo perforator visualization by a newly proposed magnetic resonance-based perforator phase contrast angiography (pPCA) technique for deep inferior epigastric perforator (DIEP) flap surgery and to prospectively compare its image quality and clinical value with computed tomographic angiography (CTA), the state-of-the-art perforator imaging technique. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained...
January 4, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28052404/perineal-reconstruction-with-multiple-perforator-flaps-based-on-anatomical-divisions
#11
Joon P Hong, Chang G Kim, Hyun S Suh, Hoon Kim, Chi S Yoon, Kyu N Kim
PURPOSE: Reconstruction of perineal defects remains a challenge because such defects can be extensive, complex, and three-dimensional. This report presents a retrospective review of our past 5 years of experience in perineal reconstruction, and suggests a simple algorithmic approach according to anatomical divisions with multiple pedicled perforator flaps for extensive perineal defects. METHODS: From January 2011 to December 2015, 16 patients, including 5 men and 11 women, underwent reconstruction of extensive perineal defects...
January 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/28052381/the-lateral-calcaneal-artery-as-an-alternative-recipient-vessel-option-for-heel-and-lateral-foot-reconstruction
#12
Kyong-Je Woo, Jin-Woo Park, Goo-Hyun Mun
BACKGROUND: Clinical outcomes of consecutive use of the lateral calcaneal artery (LCA) as a recipient vessel for microsurgical reconstruction have not been reported. This study aimed to evaluate the feasibility and safety of the LCA as a recipient vessel for microsurgical foot reconstruction based on anatomical study of CT angiography and clinical results of using this vessel as the recipient. METHODS: Anatomic study was performed using CT angiography of 61 lower extremities (31 patients)...
January 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/28052051/deep-inferior-epigastric-perforator-versus-free-transverse-rectus-abdominis-myocutaneous-flap-complications-and-resource-utilization
#13
Yasmina Zoghbi, David J Gerth, Jun Tashiro, Samuel Golpanian, Seth R Thaller
INTRODUCTION: Abdominal based breast reconstruction exists in a continuum from pedicled transverse rectus abdominis myocutaneous (TRAM) flap to deep inferior epigastric perforator (DIEP) free flap. DIEP flap has the advantage of complete rectus abdominis sparing during harvest, thus decreasing donor site morbidity. Aim of this study is to determine whether the surgical advantages of the DIEP flap impact postoperative outcomes versus the free TRAM flap (fTRAM). METHODS: We reviewed the Nationwide Inpatient Sample database (2010-2011) for all cases of DIEP and fTRAM breast reconstruction...
November 3, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28045826/free-hand-perforator-concept-in-osteocutaneous-free-fibula-flap-through-posterior-approach
#14
Yigit Ozer Tiftikcioglu, Ersin Gur, Tahir Gurler
BACKGROUND: The fibula flap is a workhorse flap for bony reconstruction of oro-mandibular area and can be modified to include soft tissue for reconstruction of composite defects. However, the design of a reliable skin paddle that can be used for composite tissue reconstruction remains a challenge. The authors described the applicability of perforator concept for a more reliable free osteomusculocutaneous fibula flap. METHODS: Between 2013 and 2015, 29 patients underwent free fibula osteocutaneous flap reconstruction...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28041765/-the-thin-alt-perforator-flap-for-oropharyngeal-robotic-assisted-reconstruction
#15
Q Qassemyar, P Aguilar, S Temam, F Kolb, P Gorphe
Since a few years, the transoral robotic surgery reduced the morbidity of oropharyngeal tumors excision. Large posterior tumors can now be removed without any scar visible on the face. In this context and to respect the thinness required for reconstructions at the junction of the upper aerodigestive tract, the free radial forearm flap still remains the solution of choice. However, if the transoral robotic surgery respects the anatomy and the aesthetics of patients at the visible and social area that represents the face, the forearm flap provides visible scars on the other region of social interaction that represents the upper limb...
December 29, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28041753/modified-reversed-superficial-peroneal-artery-flap-in-the-reconstruction-of-ankle-and-foot-defects-following-severe-burns-or-trauma
#16
Shi-Ji Li, Hao Cheng, Xu Fang, Jian-Yang Xu, Fei Wang, Sheng Liu, Xu-Lin Chen, Xiong-Wen Lv
OBJECTIVE: Challenges persist in the reconstruction of the ankle and the foot with exposed tendons, joints, and bones as a result of severe burns and trauma. In flap elevation involving the sensitive superficial nerve, the local nerve was always sacrificed to obtain an anesthetic donor site; however, such a procedure introduced the possibility of painful neuromas. In this study, we present a desired clinical application of a modified reversed superficial peroneal artery flap, in which the superficial peroneal nerve is preserved...
December 29, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28040322/mucosectomy-impairs-ileal-microcirculation-and-results-in-flap-contraction-after-experimental-ileocystoplasty
#17
Raimondo M Cervellione, Daniel Hajnal, Gabreilla Varga, George Rakoczy, Jozsef Kaszaki, David Keene, Anju Goyal, Alan Dickson, Tamas Cserni
INTRODUCTION: Bladder augmentation with demucosalized ileal flap is a promising alternative approach for mucus free bladder augmentation; however, the contraction of the flap is still a major concern. It has been hypothesized that mucosectomy causes ischemic damage, but no direct histological evidence has been found and attention is now focused on the urothelium cover to prevent the exposure of the denuded surface to urine or the use of balloons to keep the flaps distended. OBJECTIVE: Our aim was to study the effect of mucosectomy on the microcirculation of ileal flaps during reverse clam ileocystoplasty using direct intraoperative imaging of the ileum...
November 29, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28032690/free-profunda-femoris-artery-perforator-flap-as-a-first-line-choice-of-reconstruction-for-partial-glossectomy-defects
#18
Ricardo Fernández-Riera, Shao-Yu Hung, Jerry Chih-Wei Wu, Chung-Kan Tsao
BACKGROUND: Free profunda artery perforator (PAP) flap has recently been brought back for head and neck reconstruction. During the course of 1 year, we performed this procedure for reconstruction of partial glossectomy defects with excellent results. METHODS: From January through December 2015, 21 patients underwent partial glossectomy reconstruction with PAP flaps. Demographics, surgical technique, anatomic variations, success rates, complications, and characteristics are described...
December 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/28032573/a-new-lateral-thoracic-artery-perforator-flap-design-with-multiple-vascular-territories-in-rats
#19
Seçkin Aydın Savaş, Tahsin Gorgulu, Cumhur İbrahim Başsorgun, Arzu Akcal
BACKGROUND: To describe a new design for an extended lateral thoracic artery (LTA) perforator flap and investigate its anatomical, dynamic, and potential territories. MATERIALS AND METHODS: To assess vascular territories, rats were randomized according to LTA perforator flap type into the surgical groups A, hemidorsal island flap; B, entire dorsal island flap; and C, reduced-size dorsal island flap. RESULTS: On postsurgical day 7, the surviving flap areas were 95%, 92%, and 89% in groups A, B, and C, respectively...
August 26, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28032178/comparison-of-aesthetic-outcomes-between-vertical-and-horizontal-flap-insets-in-breast-reconstruction-with-the-tram-or-diep-flaps
#20
Woo Shik Jeong, Wooyeon Han, Jin Sup Eom
BACKGROUND: Tissue transfer, such as use of the transverse rectus abdominis myocutaneous (TRAM) or deep inferior epigastric artery perforator (DIEP) free flaps, is considered a standard method. However, outcomes may vary among inset methods. Here we compared the aesthetic outcomes of breast reconstructions using vertical and horizontal flap inset methods. METHODS: We, respectively, reviewed 274 patients who underwent unilateral post-mastectomy breast reconstruction using TRAM or DIEP free flaps between April 2006 and December 2013...
December 28, 2016: Aesthetic Plastic Surgery
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