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Perforator flaps

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https://www.readbyqxmd.com/read/29227815/meta-analysis-of-flap-perfusion-and-donor-site-complications-for-breast-reconstruction-using-pedicled-versus-free-tram-and-diep-flaps
#1
REVIEW
Woonhyeok Jeong, Seongwon Lee, Junhyung Kim
OBJECTIVES: The transverse rectus abdominis musculocutaneous (TRAM) flap is an important option for breast reconstruction. Several studies have recently evaluated whether a greater number of complications result from the use of pedicled TRAM (pTRAM) flaps versus either free TRAM (fTRAM) flaps or deep inferior epigastric artery perforator (DIEP) flaps. To clarify the evidence regarding this issue, we performed an objective meta-analysis of published studies. MATERIALS AND METHODS: A literature search of articles published between January 1, 1990, to January 1, 2017 was performed using the PubMed, EMBASE, Scopus, and Cochrane databases...
December 8, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29224822/head-and-neck-reconstruction-with-free-flaps-based-on-the-thoracodorsal-system
#2
John Edward O'Connell, Mandeep S Bajwa, Andrew G Schache, Richard J Shaw
The advent or micro-vascular free tissue transfer has facilitated the reconstruction of increasingly complex head and neck defects. There are multiple donor sites available, each with its' own advantages and disadvantages. However, the subscapular system, including the thoracodorsal system, provides the widest array of soft tissue and osseous flaps, as well as chimeric options. Its advantages include a long pedicle, independently mobile tissue components, relative sparing from atherosclerosis, and minimal donor site morbidity...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29223224/combined-interface-tattooing-and-fibrin-glue-assisted-sutureless-corneal-resurfacing-with-donor-lenticule-obtained-from-small-incision-lenticule-extraction-for-limbal-dermoid
#3
Soosan Jacob, Smita Narasimhan, Amar Agarwal, Athiya Agarwal, Saijimol Ai
We describe a technique of small-incision lenticule extraction (SMILE)-assisted sutureless corneal resurfacing with interface tattooing for superficial limbal dermoids. After excision at a plane minimally below surrounding normal cornea and sclera, a corneal tattoo powder is carefully applied within an inked circular outline of the intended corneal margin. Circularity and cosmesis are assessed in natural light with the microscope light off. Fibrin glue-assisted corneal resurfacing is performed with the lenticule...
November 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29221853/venous-thromboembolism-events-after-breast-reconstructions-with-diep-free-flaps-in-192-consecutive-case
#4
A Modarressi, A-V Schettini, E M Rüegg, B Pittet-Cuénod
BACKGROUND: Patient candidates for breast reconstruction with free deep inferior epigastric perforator flap (DIEP) may present several risk factors for venous thromboembolism (VTE). Risk identification is essential for appropriate VTE prophylaxis measures to be put in place. This study aims to investigate VTE incidence after DIEP flap breast reconstruction and to assess the accuracy of the Caprini Risk Assessment Model (RAM), which is the unique score validated to assess the VTE risk for plastic surgery procedures and identify patients at high VTE risk...
December 5, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29218386/anatomical-study-of-medial-sural-artery-and-its-perforators-in-nepalese-an-aid-to-reconstructive-surgery
#5
Laju Maya Basnet, Samit Kumar Ghosh, Sunara Shrestha, Shaligram Dhungel
OBJECTIVE: The present study was undertaken to know the anatomical basis of medial sural artery (MSA) and its perforators in Nepalese. METHODS: The popliteal arteries of 16 preserved cadaveric lower limbs were injected with a mixture of red ink and glycerine. The number, location, diameter of perforators; length and intramuscular course of pedicle; the branching pattern of MSA were observed and measured. RESULTS: The mean of 2.2 ± 1.2 perforators (range 0-4) was observed...
December 7, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29215367/interperforator-flow-pattern-and-clinical-application-of-distal-extended-peroneal-artery-perforator-flaps
#6
Chengliang Deng, Bihua Wu, Zairong Wei, Hai Li, Tianhua Zhang, Dali Wang
INTRODUCTION: Peroneal artery perforator flaps are the most widely used pedicled flaps for soft tissue defects of the distal lower extremity. Most research regarding peroneal artery flaps focuses on the location, diameter, and number of peroneal artery perforators. However, there is little literature regarding interperforator flow patterns within the peroneal artery perforator flaps. The aims of the present study were to describe interperforator flow patterns of the distally based extended peroneal artery perforator flaps through digital subtraction angiography and review their clinical application...
December 5, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29203066/-the-sural-medial-perforator-flap-anatomical-bases-surgical-technique-and-indications-in-head-and-neck-reconstruction
#7
S Struk, J-B Schaff, Q Qassemyar
INTRODUCTION: The medial sural artery perforator (MSAP) flap is defined as a thin cutaneo-adipose perforator flap harvested on the medial aspect of the leg. The aims of this study were to describe the anatomical basis as well as the surgical technique and discuss the indications in head and neck reconstructive surgery. MATERIAL AND METHODS: We harvested 10 MSAP flap on 5 fresh cadavers. For each case, the number and the location of the perforators were recorded...
December 1, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29203042/-treatment-of-radiation-induced-iliofemoral-arterial-complications-with-groin-radionecrosis
#8
J-M Fichelle
Long-term iliofemoral complications induced by radiation include vascular (arterial and venous) lesions, nervous lesions and soft tissue loss that can be cutaneous and subcutaneous and potentially lead to radionecrosis with vessel exposure. We present five cases of groin radionecrosis. There were three men and two women (age 30-73 years). Radiotherapy had been delivered 15 years earlier in three cases, and 2 years earlier in two cases. Symptoms were intermittent claudication (n=1), critical ischemia (n=1), and septic hemorrhage (n=1)...
December 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29199268/a-rare-case-of-giant-basal-cell-carcinoma-of-the-abdominal-wall-excision-and-immediate-reconstruction-with-a-pedicled-deep-inferior-epigastric-artery-perforator-diep-flap
#9
Sara Di Lorenzo, Giovanni Zabbia, Bartolo Corradino, Massimiliano Tripoli, Roberto Pirrello, Adriana Cordova
BACKGROUND Basal cell carcinoma (BCC) greater than 5 cm in diameter is called giant basal cell carcinoma (GBCC), or super giant basal cell carcinoma if it has a diameter larger than 20 cm. Giant BCC only accounts for 0.5% of BCCs and super giant BCC is exceedingly rare. On account of their rarity, there are no established guidelines for GBCC treatment. CASE REPORT We describe a peculiar case of an 82-year-old woman with a GBCC carcinoma of the lower abdominal wall. The tumor was surgically removed with ipsilateral inguinal lymph nodes and the abdominal wall was reconstructed immediately with a pedicled deep inferior epigastric artery perforator (DIEP) flap...
December 4, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29198704/ischemic-flap-survival-improvement-by-composition-selective-fat-grafting-with-novel-adipose-tissue-derived-product-stromal-vascular-fraction-gel
#10
Pan Zhang, Jingwei Feng, Yunjun Liao, Junrong Cai, Tao Zhou, Mingliang Sun, Jianhua Gao, Kai Gao
BACKGROUND: Flap necrosis due to insufficient blood supply is a common postoperative complication in random pattern flaps. Stem cell therapies have emerged as promising biologics for tissue ischemia. A novel fat derived product, stromal vascular fraction gel (SVF-gel), can be prepared with lipoaspirate through simple mechanical processing, removing only the lipid content. SVF-gel enriches adipose-derived stem cells and potentially beneficial for flap necrosis. METHODS: Nude mice ischemic flaps were treated with human SVF-gel, stromal vascular fraction (SVF) cell suspension or saline (n = 10)...
November 30, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29194266/total-cheek-reconstruction-using-the-pre-expanded-medial-arm-flap-with-functional-and-aesthetic-donor-site-closure
#11
Bingjian Xue, Yuanbo Liu, Shan Zhu, Mengqing Zang, Bo Chen, Shanshan Li
This clinical study aimed at introducing a reconstructive method for total cheek soft tissue defects using the pre-expanded medial arm flap and to maximally reduce donor site morbidities simultaneously. A retrospective review of data was performed for 3 patients requiring the pre-expanded medial arm flap to reconstruct total cheek defects. The donor site in the medial arm was primarily closed using a pedicle parascapular or thoracodorsal artery perforator flap. All patients had a total unilateral cheek defect after lesion removal...
November 20, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29193255/evaluation-of-the-single-medial-circummuscular-perforator-diep-flap-outcomes-and-comparison-to-traditional-transmuscular-single-perforator-flap
#12
Jessica F Rose, Dmitry Zavlin, Amanda E Garrett, Vishwanath Chegireddy, Warren A Ellsworth
INTRODUCTION: Successful breast reconstruction using deep inferior epigastric perforator (DIEP) flaps depends on optimal perforator choice. Circummuscular wraparound medial perforators allow for no rectus dissection and minimal fascial incisions, often presenting as an ideal option. The aim of our study is to evaluate outcomes of the single medial wraparound perforator flap in comparison to more traditional transmuscular single-perforator DIEP flaps. PATIENTS AND METHODS: A retrospective chart review was conducted of all DIEP flaps performed by the senior author from 2011 to 2016, yielding 269 flaps on 157 patients...
November 29, 2017: Microsurgery
https://www.readbyqxmd.com/read/29191377/distally-based-sural-neuro-fasciocutaneous-perforator-flap-for-foot-and-ankle-reconstruction-surgical-modifications-for-flap-pedicle-and-donor-site-closure-without-skin-graft
#13
Zhenglin Chi, Yiheng Chen, Tinggang Chu, Weiyang Gao, Zhijie Li, Hede Yan, Yonghuan Song
BACKGROUND: The conventional procedure of the sural neuro-fasciocutaneous flap enables the supply of blood and venous drainage by increasing the width of the adipofascial tissue and preserving tiny venous return routes. Moreover, skin graft is a common method for donor site closure, which may lead to some complications and influence the aesthetic appearance. We report modifications for a distally based sural neuro-fasciocutaneous perforator flap and a relaying flap for donor site closure without skin graft...
November 2, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29184752/anatomical-analysis-of-cutaneous-perforator-distribution-in-the-forearm
#14
Tomomi Kimura, Shogo Ebisudani, Ikuko Osugi, Kiichi Inagawa
Background: Few reports describe the distribution of cutaneous perforators from the radial and ulnar arteries in the forearm. This study aimed to map the location of the cutaneous perforators that arise directly from the radial and ulnar arteries in cadavers. Methods: Twenty-nine human cadaveric forearms were dissected. All radial and ulnar arteries cutaneous perforators were analyzed for total number and distribution. To define the distribution of each cutaneous perforator, the forearm was divided into 10 sections, with the sections labeled as 10%, 20%, 30%, and so on, beginning at the wrist...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29184750/long-term-patency-of-twisted-vascular-pedicles-in-perforator-based-propeller-flaps
#15
Rafael G Jakubietz, Aljoscha Nickel, Iva Neshkova, Karsten Schmidt, Fabian Gilbert, Rainer H Meffert, Michael G Jakubietz
Background: Propeller flaps require torsion of the vascular pedicle of up to 180 degrees. Contrary to free flaps, where the relevance of an intact vascular pedicle has been documented, little is known regarding twisted pedicles of propeller flaps. As secondary surgeries requiring undermining of the flap are common in the extremities, knowledge regarding the necessity to protect the pedicle is relevant. The aim of this study was a long-term evaluation of the patency of vascular pedicle of propeller flaps...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29184749/pedicle-to-perforator-bypass-using-supermicrosurgical-technique-for-deep-inferior-epigastric-artery-perforator-flap-salvage
#16
Michael V DeFazio, Olivia A Abbate, Chrisovalantis Lakhiani, David H Song
No abstract text is available yet for this article.
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29184736/the-reconstruction-of-the-donor-site-of-dp-flap-using-thoracodorsal-artery-perforator-flap
#17
Masayuki Okochi, Hiromi Okochi, Takao Sakaba, Kazuki Ueda
We performed a new procedure for reconstruction of donor site of a deltopectoral (DP) flap. A 58-year-old man presented with a wide subcutaneous abscess, which was caused by acute mandibular osteomyelitis due to dental caries. On admission, the patient received a neck incision for drainage. However, necrosis of the neck skin was observed after drainage. The patient had an 8 × 10 cm skin and soft-tissue defect, which we covered with a DP flap (15 × 7 cm). The DP flap donor site was reconstructed using a 16 × 8 cm pedicled thoracodorsal artery perforator (TDAP) flap...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29184731/tracheocutaneous-fistula-closure-with-turnover-flap-and-polydioxanone-plate
#18
Justin R Bryant, Thanapoom Boonipat, Kongkrit Chaiyasate
An alternative surgical treatment is proposed for closure of tracheocutaneous fistulas. The authors present a new technique for reconstruction of persistent tracheocutaneous fistula resultant from temporary tracheostomy. The single-stage closure under local anesthesia involves a fistulous tract turnover flap with a perforated 0.15 mm polydioxanone plate between the flap and the subcutaneous closure. This article presents 3 cases of persistent tracheocutaneous fistula treated by this method. At follow-up examination after follow-up, no recurrent fistula formation had occurred, and no respiratory deformity was present...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29184728/diep-flap-breast-reconstruction-in-patients-with-breast-ptosis-2-stage-reconstruction-using-3-dimensional-surface-imaging-and-a-printed-mold
#19
Koichi Tomita, Kenji Yano, Mifue Taminato, Michiko Nomori, Ko Hosokawa
Background: Autologous breast reconstruction can be performed for breasts with ptosis to a certain extent, but if patients desire to correct ptosis, mastopexy of the contralateral breast is indicated. However, accurate prediction of post-mastopexy breast shape is difficult to make, and symmetrical breast reconstruction requires certain experience. We have previously reported the use of three-dimensional (3D) imaging and printing technologies in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29183137/-thoracodorsal-artery-perforator-fasciocutaneous-flap-in-the-treatment-of-chronic-hidradenitis-suppurativa-of-axilla
#20
Balázs Mohos, Gábor Sándor, Gábor Bognár, Máté Csucska, Zoltán Lóderer
BACKGROUND: The only definitive treatment of chronic axillar hidradenitis suppurativa (HS) that prevents relapses is 'in toto' excision of the infected glandular tissue. This way a deficiency emerges, which needs to be restored. Reconstruction with split skin graft (SSG) is a most common way of recovery, but thoracodorsal artery perforator (TDAP) fasciocutneous flap delivers better functional and aesthetic results. METHOD: Between May 2014 and July 2016, 14 patients underwent reconstructive surgery after excision of axillary HS, 2 of them had bilateral lesion...
December 2017: Magyar Sebészet
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