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Perforator flaps

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https://www.readbyqxmd.com/read/27931170/abdominoplasty-and-gluteoplasty-after-massive-weight-loss-an-all-in-one-technique
#1
Britt Colebunders, Koenraad Van Landuyt
INTRODUCTION: Patients requesting body-contouring surgery after massive weight loss often present with abdominal and lumbar skin excess as well as gluteal ptosis and loss of gluteal projection. In order to restore gluteal projection a circular abdominoplasty in combination with an autologous gluteal augmentation (all-in-one technique) can be performed. OBJECTIVE: To compare outcomes for patients who underwent a circular abdominoplasty with or without autologous gluteal augmentation...
December 8, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27923534/rapid-prototyped-patient-specific-guiding-implants-in-critical-mandibular-reconstruction
#2
Patricia Stoor, Anni Suomalainen, Karri Mesimäki, Risto Kontio
Large tumours of the mandible need immediate reconstruction to provide continuity of the mandible, satisfactory function of the jaw, as well as an acceptable aesthetic outcome. In this prospective study we described the immediate reconstruction of the mandible using computer aided design and 15 rapid prototyped patient specific implants (PSI) in 14 patients suffering from benign or malignant tumours demanding continuity resection of the mandible. The scaffold PSI was filled with β-tricalcium phosphate granules and autologous bone...
November 5, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27919616/supermicrosurgery-assisted-venous-supercharging-of-a-reverse-flow-angular-artery-perforator-flap-for-nasal-reconstruction
#3
R Vijayan, F Al-Aswad, R Y Kannan
The centre ground in the world of flaps have over time, gradually shifted from tubed pedicled, random-pattern, axial-pattern, pedicled, free and currently, to free-styled flaps. These concepts are broadly based on the angiosome-perforasome concept. In this case report, we illustrate how the concept of venosome capture can be transposed onto reverse-flow flaps with the aid of venous supercharging. Moreover, if this is seen from the free-styled flap perspective, it requires supermicrosurgical expertise. This case report hence, serves as a fusion of all the above concepts...
November 24, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27919596/chimeric-anterolateral-thigh-free-flap-for-reconstruction-of-complex-cranio-orbito-facial-defects-after-skull-base-cancers-resection
#4
Mario Cherubino, Mario Turri-Zanoni, Paolo Battaglia, Marco Giudice, Igor Pellegatta, Federico Tamborini, Francesca Maggiulli, Luca Guzzetti, Danilo Di Giovanna, Maurizio Bignami, Carolina Calati, Paolo Castelnuovo, Luigi Valdatta
Complex cranio-orbito-facial defects after skull base cancers resection entail a functional and esthetic reconstruction. The introduction of endoscopic assisted techniques for excision surgery with the advances in reconstructive surgery and anesthesiology allowed to improve the management of such critical patients. We report a series of chimeric anterolateral thigh (ALT) flaps used to reconstruct complex cranio-orbital-facial defects after skull base surgery. A retrospective review of patients that underwent cranio-orbito-facial reconstruction using a chimeric ALT flap from March 2013 to October 2015 at a single tertiary care referral Institute was performed...
November 2, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27919113/analysis-of-flap-weight-and-postoperative-complications-based-on-flap-weight-in-patients-undergoing-microsurgical-breast-reconstruction
#5
Gretl Lam, Katie E Weichman, Patrick L Reavey, Stelios C Wilson, Jamie P Levine, Pierre B Saadeh, Robert J Allen, Mihye Choi, Nolan S Karp, Vishal D Thanik
Background Higher body mass index (BMI) has been shown to increase postoperative complications in autologous breast reconstruction. However, the correlation with flap weight is unknown. Here, we explore the relationship of flap weights and complication rates in patients undergoing microvascular breast reconstruction. Methods Retrospective chart review identified all patients undergoing microvascular breast reconstruction with abdominally based flaps at a single institution between November 2007 and April 2013...
December 5, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27912770/endometriosis-associated-clear-cell-carcinoma-arising-in-caesarean-section-scar-a-case-report-and-review-of-the-literature
#6
Gabriella Ferrandina, Eleonora Palluzzi, Francesco Fanfani, Stefano Gentileschi, Anna Lia Valentini, Maria Vittoria Mattoli, Ilaria Pennacchia, Giovanni Scambia, Gianfranco Zannoni
BACKGROUND: Malignant transformation has been reported in approximately 1% of the endometriosis cases; herein, we report a case of clear cell endometrial carcinoma arising from endometriosis foci located within a caesarean section scar. CASE PRESENTATION: In November 2014, a Caucasian, 44-year-old woman was transferred to our institution because of severe respiratory failure due to massive lung embolism and rapid enlargement of a subcutaneous suprapubic mass. Abdomino-pelvic magnetic resonance showed a 10...
December 3, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27896661/erratum-to-breast-reconstruction-using-free-medial-circumflex-femoral-artery-perforator-flaps-intraoperative-anatomic-study-and-clinical-results
#7
Mai Shibuya, Toshihiko Satake, Reiko Nakasone, Marina Ogawa, Mayu Muto, Kazutaka Narui, Kazunori Yasumura, Takashi Ishikawa, Jiro Maegawa
No abstract text is available yet for this article.
November 28, 2016: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/27896196/microdissected-prefabricated-flap-an-evolution-in-flap-prefabrication
#8
Süleyman Taş
When traditional flap techniques are not feasible, we apply flap prefabrication, which is more complicated and sophisticated but supplies large and thin flaps. There are some disadvantages to the technique that require improvement, such as venous congestion after flap transfer, which requires months for neoangiogenesis and necessitates a vascular carrier. Here, the author presents a new technique, called as 'microdissected prefabricated flap,' to successfully produce a safe, large, and thin flap. This technique is based on the microdissection of the perforators to the greatest extent possible, spreading them out into the subdermal level and using them as a carrier...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27894916/reliability-of-extended-dorsal-intercostal-artery-perforator-propeller-flaps-for-reconstruction-of-large-myelomeningocele-defects
#9
Goktekin Tenekeci, Yavuz Basterzi
Reconstruction of large myelomeningocele defects using extended (elongated beyond the lateral margin of the latissimus dorsi muscle) dorsal intercostal artery perforator (DICAP) propeller flaps is not recommended by previous studies. However, to provide tension-free and successful closure of a defect, the DICAP propeller flaps must sometimes be elongated beyond this margin. Our experience and results in this issue are discussed. In this article, reconstruction of 11 consecutive cases, with large myelomeningocele defects in which standard DICAP propeller flaps were incapable to close the defect, was achieved using extended DICAP propeller flaps between June 2013 and November 2015...
November 15, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27894588/pre-expanded-perforator-flaps
#10
EDITORIAL
Lee L Q Pu, Chunmei Wang
No abstract text is available yet for this article.
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894587/pre-expanded-paraumbilical-perforator-flap
#11
REVIEW
Yuanbo Liu, Mengqing Zang, Shan Zhu, Bo Chen, Qiang Ding
The paraumbilical perforator flap is the first and the most famous perforator flap. Pre-expansion increases the flap dimension and reduces the flap thickness and donor site morbidities, making the paraumbilical perforator flap a more effective option for upper extremity reconstruction. Pre-expanded pedicled paraumbilical perforator flaps can achieve excellent function and aesthetic outcomes in patients with extensive scar contracture and giant melanocytic nevi in the upper extremity. Although this technique requires multiple procures, each operation is relatively simple and has a low complication rate, when properly planned and performed...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894586/pre-expanded-thoracodorsal-artery-perforator-flap
#12
REVIEW
Yalcin Kulahci, Cihan Sahin, Huseyin Karagoz, Fatih Zor
The size of the thoracodorsal artery perforator (TDAP) flap or pedicle, in general, may be found to be inadequate. Pre-expansion of the flap before harvest can be a solution to increase the size of the TDAP flap in such instances. The pre-expanded TDAP flap can be used to reconstruct large-sized defects with the advantage of primary closure of the donor site. This article presents details on the surgical technique and provides discussion of the authors' experiences.
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894585/pre-expanded-intercostal-perforator-super-thin-skin-flap
#13
REVIEW
Yunjun Liao, Yong Luo, Feng Lu, Hiko Hyakusoku, Jianhua Gao, Ping Jiang
This article introduces pre-expanded super-thin intercostal perforator flaps, particularly the flap that has a perforator from the first to second intercostal spaces. The key techniques, advantages and disadvantages, and complications and management of this flap are described. At present, the thinnest possible flap is achieved by thinning the pre-expanded flap that has a perforator from the first to second intercostal spaces. It is used to reconstruct large defects on the face and neck, thus restoring function and cosmetic appearance...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894584/pre-expanded-internal-mammary-artery-perforator-flap
#14
REVIEW
Stacy Wong, James D Goggin, Nicholas D Webster, Michel H Saint-Cyr
Internal mammary artery (IMA)-based pedicled perforator flaps can be used to reconstruct defects of the neck and anterior chest wall. Pre-expansion causes a possible delay phenomenon, improves flap survival, and decreases donor site morbidity. It also increases the area that can be covered. Pre-expanding can allow for perforator flaps that require a shorter arc of rotation. The pre-expanded internal mammary artery perforator (IMAP) flap is an excellent option for patients who have undergone multiple failed reconstructions and require large amounts of soft tissue while lacking other donor sites...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894583/pre-expanded-supraclavicular-artery-perforator-flap
#15
REVIEW
Norbert Pallua, Bong-Sung Kim
The supraclavicular artery perforator (SAP) flap is a versatile flap for the reconstruction of head and neck defects. Recently, the authors have modified the SAP flap by using an anterior branch of the transverse cervical artery. The anterior SAP flap allows the harvest of a tissue island in the deltopectoral fossa, which is even thinner, is more pliable, and shows a superior color match to the face and neck compared with the original SAP flap. Pre-expansion increases flap size considerably, enabling the coverage of extended defects without the need of microsurgery...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894582/pre-expanded-transverse-cervical-artery-perforator-flap
#16
REVIEW
Huifeng Song, Jiake Chai
The face and neck are important areas for function and appearance. High-quality skin flaps should be used to reconstruct defects in the cervicofacial region. This article introduces the pre-expanded transverse cervical artery perforator flap, which can be used for cervicofacial reconstruction after burns, trauma, and tumor resection with excellent results. This perforator flap is one of the best options for cervicofacial reconstruction in terms of color and texture match, and has fewer flap complications. With regard to the expanded flap, the donor site can be sutured directly leaving only an inconspicuous linear scar...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894581/pre-expanded-super-thin-skin-perforator-flaps
#17
REVIEW
Chunmei Wang, Sifen Yang, Lee L Q Pu
Patients with severe postburn scar contractures underwent reconstruction of skin defects after scar excision with pre-expanded super-thin skin perforator flaps supplied primarily by perforators via the "bridging effect" from the branches of the adjacent arteries as 2-stage procedures. Pre-expansion is an innovative technique and may improve the anastomoses between subdermal vascular plexuses and extend the supplying area of these vessels to the flap. Such a flap becomes super thin, but with a prefabricated blood supply it can be used for reconstruction of skin defects of the face, neck, or other body part with improved functional and cosmetic outcomes...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894580/imaging-studies-for-preoperative-planning-of-perforator-flaps-an-overview
#18
REVIEW
Shimpei Ono, Hiromitsu Hayashi, Hiroyuki Ohi, Rei Ogawa
The vascular anatomy of perforators varies between individuals; thus, accurate preoperative assessment of perforators is essential for safely planning perforator flaps. Perforator computed tomographic angiography (P-CTA) with multidetector-row computed tomography (MDCT) is one of the best available methods to precisely reveal the 3-dimensional anatomic details of perforators. The aim of this report is to describe the authors' experience using P-CTA with MDCT for detecting the perforating vessel preoperatively and a step-by-step approach to harvest perforator flaps based on this technique...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894579/future-perspectives-of-pre-expanded-perforator-flaps
#19
REVIEW
Lee L Q Pu, Chunmei Wang
Although clinical application of a pre-expanded perforator flap is primarily focused on face and neck reconstructions, such a flap has also been used to reconstruct defects in the trunk, extremities, or hands. With better understanding of the improved blood supply to the flap and the mechanism on the prefabrication of blood supply within the flap, the pre-expanded perforator flap will definitely play a more important role in reconstructive surgery and can be used in selected patients by many plastic surgeons worldwide with good reconstructive and cosmetic outcomes...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894578/pre-expanded-and-prefabricated-abdominal-superthin-skin-perforator-flap-for-total-hand-resurfacing
#20
REVIEW
Chunmei Wang, Junyi Zhang, Sifen Yang, Ping Song, Lun Yang, Lee L Q Pu
Reconstruction of the postburn hand remains a challenge for surgeons. For cosmetic and functional requirements, the desired flap should be thin enough to ensure the flexibility of the hand. Conventional perforator flaps serve as a viable option when reconstructing the postburn hand to regain functionality. However, limitations include the discrepancy in tissue thickness and the difficulty with donor site closure. Thus, a preexpanded superthin skin perforator flap is an ideal choice for postburn hand reconstruction, with the trade-off being a longer treatment course (3-4 months), but with results that satisfy both patients and their surgeons...
January 2017: Clinics in Plastic Surgery
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