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https://www.readbyqxmd.com/read/28820844/a-new-method-for-reconstruction-of-vermilion-deficiency-in-cleft-lip-deformity-the-bi-winged-myomucosa-switch-flap
#1
KyungHoon Chung, Lun-Jou Lo
BACKGROUND: This study reviewed the method of using "Bi-winged myomucosa switch flap" for correction of secondary cleft lip deformity in patients with vermilion mucosa deficiency, lack of the central tubercle and disproportionate lip projection, obviating the conventional Abbé flap when the prolabium has acceptable philtrum and Cupid's bow definition. METHODS: The technique was applied to adult patients with secondary vermilion deficiency after primary bilateral cleft lip repair...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28819607/a-gustilo-type-3b-open-tibial-fracture-treated-with-a-proximal-flexor-hallucis-longus-flap-a-case-report
#2
Tomohiro Yasuda, Masayuki Arai, Kaoru Sato, Koji Kanzaki
INTRODUCTION: In the treatment of Gustilo Type 3B open tibial fractures, it is important to perform soft tissue reconstruction and bone reconstruction simultaneously. Gastrocnemius muscle and soleus muscle flaps are generally used as rotational flaps for the tibia. The distal third of the tibia can often not be covered with the gastrocnemius muscle and soleus muscle flaps. Treatment distal to the distal third of the tibia is difficult because fewer flap options are available. In the present report, we describe our experience with a Gustilo Type 3B open tibial fracture treated by gastrocnemius muscle and soleus muscle flaps, along with an additional proximally based flexor hallucis longus flap, which is a rare procedure...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28816718/double-composite-tissue-z-plasty-technique-for-anatomical-restoration-of-severe-nasal-deformity-in-secondary-unilateral-cleft-lip
#3
Jiao Wei, Tanja Herrler, Hua Xu, Qingfeng Li, Chuanchang Dai
BACKGROUND: Patients with secondary unilateral cleft lip are regularly affected by serious nasal deformities especially of the alar and nasal floor. A large number of techniques for correction have been published, but symmetrical restoration of severe nasal deformation is difficult to achieve. We propose an innovative approach for anatomical restoration for this entity of nasal deformities to achieve long-term symmetrical appearance and muscular function. METHODS: A total of 68 patients with severe nasal deformity due to secondary unilateral cleft lip underwent reconstructive surgery using a double composite tissue Z-plasty technique for anatomical restoration of cartilage, muscle, and soft tissue layers...
August 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28807934/a-novel-bounding-gait-in-swimming-turtles-implications-for-aquatic-locomotor-diversity
#4
Christopher J Mayerl, Richard W Blob
Turtles are an iconic lineage in studies of animal locomotion, typifying the use of slow, alternating footfalls during walking. Alternating movements of contralateral limbs are also typical during swimming gaits for most freshwater turtles. Here, we report a novel gait in turtles, in which the pleurodire Emydura subglobosa swims using a bounding gait that coordinates bilateral protraction of both forelimbs with bilateral retraction of both hindlimbs. Use of this bounding gait is correlated with increased limb excursion and decreased stride frequency, but not increased velocity when compared to standard swimming strokes...
August 14, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28807000/necrotizing-streptococcal-myositis-of-the-upper-extremity-a-case-report
#5
Johannes C Reichert, Götz Habild, Paul Simon, Ulrich Nöth, Jan B Krümpelmann
BACKGROUND: Necrotizing myositis is a rare but life-threatening soft-tissue infection characterized by rapidly spreading inflammation and subsequent necrosis of the affected tissue. The myositis is often caused by toxin-producing, virulent bacteria such as group A β-hemolytic streptococcus and associated with severe systemic toxicity. It is rapidly fatal unless diagnosed promptly and treated aggressively. However, necrotizing myositis is often initially misdiagnosed as a more benign soft-tissue infection as such fulminant, invasive muscle infections are rare with no more than 30 cases reported over the last century...
August 15, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28806290/-clinical-and-quantitative-isokinetic-comparison-of-abdominal-morbidity-and-dynamics-following-diep-versus-muscle-sparing-free-tram-flap-breast-reconstruction
#6
Hirokazu Uda, Hideaki Kamochi, Syunji Sarukawa, Ataru Sunaga, Yasusih Sugawara, Kotaro Yoshimura
BACKGROUND: The deep inferior epigastric perforator (DIEP) flap, which is a modification of the muscle-sparing free transverse rectus abdominis musculocutaneous (msTRAM) flap, is being more frequently used in an effort to reduce postoperative abdominal morbidity. However, there is no consensus as to which of these flaps is superior. We aimed to compare quantitative measurements of abdominal function obtained with an isokinetic dynamometer after DIEP and msTRAM flap elevation. METHODS: Patients who underwent unilateral single-pedicled DIEP (n = 42) or msTRAM flap (n = 36) breast reconstruction performed by a single surgeon were included in this study...
August 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28801298/-application-of-3d-visualization-technique-in-breast-cancer-surgery-with-immediate-breast-reconstruction-using-laparoscopically-harvested-pedicled-latissimus-dorsi-muscle-flap
#7
Pu-Sheng Zhang, Li-Kun Wang, Yun-Feng Luo, Fu-Jun Shi, Lin-Yun He, Cheng-Bing Zeng, Yu Zhang, Chi-Hua Fang
OBJECTIVE: To study the value of 3D visualization technique in breast-preserving surgery for breast cancer with immediate breast reconstruction using laparoscopically harvested pedicled latissimus dorsi muscle flap. METHODS: From January, 2015 to May, 2016, 30 patients with breast cancer underwent breast-preserving surgery with immediate breast reconstruction using pedicled latissimus dorsi muscle flap. The CT data of the arterial phase and venous phase were collected preoperatively and imported into the self-developed medical image 3D visualization system for image segmentation and 3D reconstruction...
August 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28801079/re-raising-muscle-flaps-a-randomised-controlled-animal-study
#8
K Bradshaw, M Wagels
BACKGROUND: In the experience of our centre, 33% of reconstructed compound lower limb injuries will need an orthopaedic revision.(1) A flap may be re-raised through numerous methods, and historically, the approach of choice has been based on the principle of protecting the vascular pedicle rather than the inset. Our aim was to determine whether a marginal versus a split approach to re-raising inferred a higher risk of flap necrosis and whether more attention should be paid to protecting the inset of the flap, particularly at the distal portion...
July 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28796100/single-stage-reconstruction-of-eyebrow-defect-using-a-v-y-advancement-pedicle-flap-based-on-the-orbicularis-oculi-muscle
#9
Hai-Peng Liu, Ying Shao, Duo Zhang
Eyebrows play an important role in face expression and facial mimics by virtue of muscle contraction. Defects or deformity of the eyebrows result in abnormal facial expressions, and may lead to aesthetic issues for patients. The objective of this study is to report the case of a patient, with a congenital skin pigmented nevus at the right side of the eyebrow treated with direct surgical resection and followed by immediate reconstruction of the eyebrow with a V-Y advancement pedicle flap based on the orbicularis oculi muscle...
August 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28795882/medial-gastrocnemius-muscle-flap-for-the-reconstruction-of-unhealed-amputation-stumps
#10
B Tosun, O Selek, U Gok, O Tosun
OBJECTIVE: Unhealed amputation stumps after transtibial amputation are common and often require reamputation futher up the leg. The aim of our study is to describe our experience with medial gastrocnemius muscle flap coverage following a transtibial amputation. METHOD: We retrospectively examined the records of patients who had an unhealed transtibial amputation stump who were then treated with a medial gastrocnemius muscle flap. RESULTS: We identified seven patients, all had diabetes mellitus and an initial amputation by the long posterior flap technique...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28794226/asymmetry-costs-effects-of-wing-damage-on-hovering-flight-performance-in-the-hawkmoth-manduca-sexta
#11
María José Fernández, M Ellis Driver, Tyson L Hedrick
Flight performance is fundamental to the fitness of flying organisms. Whilst airborne, flying organisms face unavoidable wing wear and wing area loss. Many studies have tried to quantify consequences of wing area loss to flight performance with varied results; suggesting that not all types of damage are equal and different species may have different means compensating for some forms of wing damage with little to no cost. Here, we investigate the cost of control during hovering flight with damaged wings, specifically wings with asymmetric and symmetric reductions in area, by measuring maximum load lifting capacity and the metabolic power of hovering flight in hawkmoths (Manduca sexta)...
August 9, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28790930/it-takes-time-to-be-cool-on-the-relationship-between-hyperthermia-and-body-cooling-in-a-migrating-seaduck
#12
Magella Guillemette, Elias T Polymeropoulos, Steven J Portugal, David Pelletier
The large amount of energy expended during flapping flight is associated with heat generated through the increased work of the flight muscles. This increased muscle work rate can manifest itself in core body temperature (Tb) increase of 1-2°C in birds during flight. Therefore, episodic body cooling may be mandatory in migratory birds. To elucidate the thermoregulatory strategy of a short-distance migrant, common eiders (Somateria mollissima), we implanted data loggers in the body cavity of wild birds for 1 year, and report information on Tb during their entire migration for 19 individuals...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28764951/reconstruction-of-the-bony-chin-using-sagittal-split-osteotomies-of-the-remaining-mandible-a-new-technique-for-a-special-indication-case-report
#13
Berthold H Hell
There are several indications for resecting the bony chin, such as squamous cell carcinoma, sarcoma, or benign tumors of the jaw such as ameloblastoma. Several techniques for reconstruction of the bony chin, such as the use of metal plates and also revascularized free bone grafts of the iliac crest, fibula, or scapula, are common. In the case of poor vascular supply, however, alternative techniques may be necessary. In this report, a new technique is described using pedicled bone flaps from both sagittally split mandibular stumps following chin resection...
June 16, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28756380/a-case-of-deep-infection-after-instrumentation-in-dorsal-spinal-surgery-the-management-with-antibiotics-and-negative-wound-pressure-without-removal-of-fixation
#14
Mauro Dobran, Fabrizio Mancini, Davide Nasi, Massimo Scerrati
Until today the role of spinal instrumentation in the presence of a wound infection has been widely discussed and recently many authors leave the hardware in place with appropriate antibiotic therapy. This is a case of a 65-year-old woman suffering from degenerative scoliosis and osteoporotic multiple vertebral collapses treated with posterior dorsolumbar stabilisation with screws and rods. Four months later, skin necrosis and infection appeared in the cranial wound with exposure of the rods. A surgical procedure of debridement of the infected tissue and package with a myocutaneous trapezius muscle flap was performed...
July 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28753118/delayed-compression-of-the-common-peroneal-nerve-following-rotational-lateral-gastrocnemius-flap-case-report
#15
Benjamin T Himes, Thomas J Wilson, Andres A Maldonado, Naveen S Murthy, Robert J Spinner
The authors present a case of delayed peroneal neuropathy following a lateral gastrocnemius rotational flap reconstruction. The patient presented 1.5 years after surgery with a new partial foot drop, which progressed over 3 years. At operation, a fascial band on the deep side of the gastrocnemius flap was compressing the common peroneal nerve proximal to the fibular head, correlating with preoperative imaging. Release of this fascial band and selective muscle resection led to immediate improvement in symptoms postoperatively...
July 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28750798/functional-pectoralis-minor-myocutaneous-flap-transplantation-for-reconstruction-of-thumb-opposition-an-anatomic-study-with-clinical-applications
#16
Yong-Qing Zhuang, Hong-Tao Xiong, Qiang Fu, Xuan Zhang, Hao-Li Jiang, Xi-Chi Fang
OBJECTIVE: To develop a myocutaneous flap for reconstruction of thumb opposition function in patients with loss of the thenar muscles and skin. METHODS: An anatomic experiment on the dimensions of the pectoralis minor muscle and its neurovascular supply in 10 adult human cadavers was conducted to evaluate the feasibility of microsurgical transplantation using part of the muscle for thumb opposition reconstruction. Based on these results, we performed surgical thenar reconstruction with a pectoralis minor myocutaneous flap in seven patients (34...
July 24, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28747264/free-flap-surgical-correction-of-facial-deformity-after-anteromedial-maxillectomy
#17
Shunji Sarukawa, Hideaki Kamochi, Tadahide Noguchi, Ataru Sunaga, Hirokazu Uda, Yoshiyuki Mori, Hiroshi Nishino, Kotaro Yoshimura
Anteromedial maxillectomy is typically performed in conjunction with low-dose radiotherapy and intraarterial chemotherapy. In doing so, the extent of surgical defects is reduced. However, nasal deviation and oral incompetence may ensue, due to cicatricial contracture of wounds, and may be distressing to these patients. Herein, we report a series of eight free perforator flap procedures (anterolateral thigh [ALT] flap, 6; thoracodorsal artery perforator [TAP] flap, 2) used to correct such deformities. The TAP flap was combined with scapular tip [ST] osseous flap in patients with added zygomatic prominence defects...
July 6, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28746241/upper-lip-reconstruction
#18
Edward A Luce
Reconstruction of an aesthetically acceptable and functional upper lip requires a careful consideration of the transverse and vertical soft tissue, muscle and skin, deficiency. This review focuses on the reconstructive aspects of the upper lip.The functional anatomy of the upper lip is considerably complex and includes paired muscles in addition to the orbicularis, elevators of both the upper lip and commissure. The muscular action of facial expression recruits different sets of these paired muscles. Unlike the aesthetic uniform appearance of the lower lip commissure to commissure, the upper lip aesthetics can be divided into a central, the philtrum unit, and a lateral upper lip unit...
July 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28740793/donor-site-complications-and-remnant-of-rectus-abdominis-muscle-status-after-transverse-rectus-abdominis-myocutaneous-flap-reconstruction
#19
Prakasit Chirappapha, Noppadol Trikunagonvong, Duangkamon Prapruttam, Sasiprapa Rongthong, Panuwat Lertsithichai, Thongchai Sukarayothin, Monchai Leesombatpaiboon, Rujira Panawattanakul, Panya Thaweepworadej
BACKGROUND: Transverse rectus abdominis myocutaneous (TRAM) flap reconstruction after mastectomy in breast cancer patients has become one of the milestones in breast reconstruction. There are several techniques that have been used in an attempt to minimize untoward complications. We present the whole muscle with partial sheath-sparing technique that focuses on the anatomy of arcuate line and the closure of the anterior abdominal wall techniques with mesh and determine factors associated with its complications and outcomes...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740770/versatility-of-the-latissimus-dorsi-free-flap-during-the-treatment-of-complex-postcraniotomy-surgical-site-infections
#20
Nobutaka Yoshioka
BACKGROUND: Some intractable cases of postcraniotomy infection, which can involve compromised skin, an open frontal air sinus, and residual epidural dead space, have been reported. In such cases, reconstructing the scalp and skull is challenging. METHODS: Between 2009 and 2016, the author treated 12 patients with recalcitrant postcraniotomy surgical site infections with latissimus dorsi (LD) free flaps. The patients' ages ranged from 37 to 79 years (mean, 63.5 years), and their underlying diseases included subarachnoid hemorrhaging (n = 5), brain tumors (n = 4), and cerebral arteriovenous malformations (n = 3)...
June 2017: Plastic and Reconstructive Surgery. Global Open
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