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https://www.readbyqxmd.com/read/28079700/the-chimera-flap-a-quarter-century-odyssey
#1
Geoffrey G Hallock
Incredibly complicated multidimensional defects have always strained the ingenuity of the reconstructive surgeon. Secondary perhaps to vascularized composite allotransplantation as a solution to this dilemma, the compound flap has been developed to be a more useful and available alternative. Their greatest versatility has been proven by its subtype, the chimera flap. The chimera flap itself consists of multiple flaps, the latter possibly composed of bone, skin, muscle, and so on, where each part has an independent vascular supply, and each part is independent of any physical interconnection whatsoever with the other components, except where joined ultimately only to a common vascular pedicle...
February 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28079533/national-and-regional-differences-in-32-248-postmastectomy-autologous-breast-reconstruction-using-the-updated-national-inpatient-survey
#2
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/28078171/could-revision-of-the-embryology-influence-our-cesarean-delivery-technique-towards-an-optimized-cesarean-delivery-for-universal-use
#3
Michael Stark, Ospan Mynbaev, Yuri Vassilevski, Patrick Rozenberg
Until today, there is no standardized Cesarean Section method and many variations exist. The main variations concern the type of abdominal incision, usage of abdominal packs, suturing the uterus in one or two layers, and suturing the peritoneal layers or leaving them open. One of the questions is the optimal location of opening the uterus. Recently, omission of the bladder flap was recommended. The anatomy and histology as results from the embryological knowledge might help to solve this question. The working thesis is that the higher the incision is done, the more damage to muscle tissue can take place contrary to incision in the lower segment, where fibrous tissue prevails...
July 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28074465/effects-of-alpha-lipoic-acid-on-ischemia-reperfusion-injury-in-rat-hindlimb-ischemia-model
#4
Arif Aydın, Alpagan Mustafa Yıldırım
BACKGROUND: This study was performed to evaluate the effect of alpha lipoic acid (ALA) on prevention of ischemia-reperfusion (IR) injury in rat hindlimb ischemia model. METHODS: Forty male Sprague Dawley rats weighing between 250 and 300 g were divided into 4 groups of 10 rats. Hindlimb composite island flaps were raised in all rats. Clamps were applied to femoral vessels of all subjects, but immediately released without causing ischemia in Group 1. In Group 2, after 4 hours of ischemia, 24 hours of reperfusion was performed...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28067972/single-innervated-segmented-vastus-lateralis-for-midfacial-reanimation-during-radical-parotidectomy
#5
Lauren Sh Chong, Timothy J Eviston, Bruce Ashford, Ardalan Ebrahami, Jonathan R Clark
BACKGROUND: Innervated free muscle transfer using the gracilis muscle or temporalis myoplasty has been successfully utilized for facial reanimation in chronic facial palsy. These techniques are less suited to immediate facial reconstruction in the setting of radical parotidectomy, in which the complexity of the defect, patient age, postoperative radiotherapy, and limited life expectancy pose particular challenges. METHODS: We present a novel description of the use of a chimeric anterolateral thigh (ALT) flap and innervated vastus lateralis to achieve midface static suspension and dynamic reanimation in the setting of radical parotidectomy...
January 9, 2017: Head & Neck
https://www.readbyqxmd.com/read/28066661/omental-flap-for-treatment-of-dead-space-after-left-upper-lobectomy-due-to-aspergilloma
#6
Joonho Jung, Seong Yong Park, Seokjin Haam
Dead space formation in the thoracic cavity as a result of lung parenchymal resection is particularly prone to intra-thoracic infections, which are often hard to treat with systemic antibiotics; secondary interventions, such as thoracoplasty, eloesser flap, or muscle flap may be required to treat this complication. Alternatively, use of an omental flap represents an attractive option in cases of surgical cavities, due to the volumetric and immunologic advantages associated with the omentum. A 55-year-old male patient, who underwent left upper lobectomy due to an aspergilloma, was left with a surgical cavity that became infected with Pseudomonas aeruginosa...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28063277/straightforward-method-for-coverage-of-major-vessels-after-modified-radical-neck-dissection
#7
Raúl González-García, Carlos Moreno-García, Manuel Moreno-Sánchez, Leticia Román-Romero
A new method for covering the internal jugular vein and carotid artery after exposure of the cervical vascular axis subsequent to neck dissection is presented. To cover the most caudal part of the vascular axis, a platysma coli muscle flap is harvested from its most medial and inferior part of the neck in a caudally based fashion and is slightly rotated posteriorly up to 45°. In addition, a superiorly based sternocleidomastoid muscle flap involving the posterior half of the muscle after detachment of the clavicle head is harvested and rotated 45° anteriorly to cover the upper two thirds of the vascular axis...
December 15, 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
#8
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/28045826/free-hand-perforator-concept-in-osteocutaneous-free-fibula-flap-through-posterior-approach
#9
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/28042220/internal-carotid-artery-fibromuscular-dysplasia-in-a-child-incidental-postmortem-finding-after-head-injury
#10
Arulselvi Subramanian, Garima Aggarwal, Deepak Agarwal, Sanjeev Lalwani
Fibromuscular dysplasia (FMD) is a rare, segmental, nonatheromatous, and noninflammatory arterial disease of unknown etiology. It predominantly involves renal artery (60-75%) followed by extracranial part of the internal carotid artery and vertebral arteries (25-30%). The disease typically affects middle-aged women and involves intermediate-sized arteries throughout the body. There are rare case reports of extracranial FMD compounding a trauma case. A patient was brought to trauma center emergency with a history of fall from height...
January 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28033633/rhytidoplasty-smas-imbrication-vector-comparison
#11
Fernando Pedroza, Luis Fernando Pedroza, Daniel Correal Gentry, Juan Guillermo Erazo Cordoba, Guillermo Arturo Landinez Cepeda
To determine if there are aesthetic differences in patients who have undergone a SMAS lifting with predominantly oblique-horizontal vectors versus predominantly oblique-vertical vectors. To determine if there are aesthetic differences in the results of the neck using sutures placed in specific areas of the platysmal muscle versus randomly placed sutures for platysmal plication to the mastoid. Comparative, retrospective, blind, and randomized study. Evaluation of preoperative and postoperative photographs of 54 patients who underwent predominantly oblique-horizontal SMAS lifting versus 53 patients who underwent predominantly oblique-vertical traction of the SMAS flap, reviewed by three external, unbiased facial plastic surgeons in a blind study...
December 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28033186/continuous-validity-of-temporalis-muscle-flap-in-reconstruction-of-postablative-palatomaxillary-defects
#12
Ahmed Gaber Hassanein
INTRODUCTION: Postablative palatomaxillary defects (PAPMDs) represent a challenging reconstructive problem. Temporalis muscle flap (TMF) has been widely used for reconstruction of these defects with minimal morbidity and satisfactory outcome. AIM OF THE STUDY: To presents the authors' experience in the reconstruction of PAPMDs with TMF and to evaluate the validity of TMF in the reconstruction of such defects. METHODS: This prospective study was conducted between July 2011 and July 2016 on selected patients for primary reconstruction of PAPMDs with TMF...
December 28, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28032155/serratus-anterior-fascia-flap-versus-muscular-flap-for-expander-coverage-in-two-stage-breast-reconstruction-following-mastectomy-early-post-operative-outcomes
#13
Daniele Bordoni, Pierfrancesco Cadenelli, Nicola Rocco, Ariel Tessone, Giuseppe Falco, Cesare Magalotti
INTRODUCTION: The demand for reconstructive breast surgery after mastectomy is increasing among women and the two-stage option remains the most commonly performed technique. We conducted a self-controlled prospective clinical trial comparing the use of the serratus anterior fascia with the serratus anterior detached fibers to cover the inferolateral aspect of the expander in immediate two-stage breast reconstruction following conservative mastectomies as oncological or risk-reducing procedures...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28029602/use-of-both-antegrade-and-retrograde-internal-mammary-vessels-in-the-bipedicled-deep-inferior-epigastric-perforator-flap-for-unilateral-breast-reconstruction
#14
Jonatan Hernandez Rosa, Rami D Sherif, Philip J Torina, Marco A Harmaty
BACKGROUND: Autologous abdominal tissue transfer is a well-established method of breast reconstruction. The deep inferior epigastric perforator (DIEP) flap has the additional benefit of minimal donor site morbidity as it spares the muscle and fascia. Conventional DIEP flaps may not provide adequate volume in cases where the patient is thin, has midline abdominal scars, and/or has a large volume of tissue to replace. One solution is to use a bipedicled DIEP flap, incorporating all the available abdominal tissue...
September 20, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28027262/evidence-based-medicine-management-of-acute-lower-extremity-trauma
#15
Roberto D Lachica
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Select and design flaps for the acutely injured lower limb based on wound location, size, and complexity. 2. Select and design tissue-specific flaps based on the functional demand of the zone of injury. 3. Understand the indications for using a flap with a skin component versus a muscle-only flap. 4. Understand the preoperative vascular assessment for lower extremity flap reconstruction. 5. Recognize and manage risk factors to decrease complications and improve flap survival...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28027251/evidence-based-medicine-a-graded-approach-to-lower-lid-blepharoplasty
#16
Ahmed M Hashem, Rafael A Couto, Joshua T Waltzman, Richard L Drake, James E Zins
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Define the anatomy of the lower eyelid tarsoligamentous framework and the related periorbital retaining ligaments, and cite their surgical relevance. 2. Perform a systematic functional and aesthetic evaluation of the lower eyelid focusing on the lid-cheek junction, and clinical tests that predict the need for lateral canthal tightening. 3. Enumerate the different approaches to lower eyelid rejuvenation and discuss their merits/limitations...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28027247/optimizing-outcomes-in-pharyngoesophageal-reconstruction-and-neck-resurfacing-10-year-experience-of-294-cases
#17
Basel Sharaf, Amy Xue, Mario G Solari, Olivier Boa, Jun Liu, Matthew M Hanasono, Roman Skoracki, Peirong Yu, Jesse C Selber
BACKGROUND: Pharyngoesophageal reconstruction is a complex endeavor that poses many challenges. This 10-year series examines factors impacting the need for neck skin resurfacing and evaluates the impact of reconstructive modalities on outcomes. METHODS: A review identified 294 patients who underwent pharyngoesophageal reconstruction from 2002 to 2012. Patients were divided based on neck skin resurfacing requirements. Patients undergoing neck resurfacing were further subdivided into reconstructive technique, including a second skin paddle or muscle component from the same free flap pedicle, a local flap, or a second free flap...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28024305/lower-extremity-reconstruction-with-free-gracilis-flaps
#18
Michael J Franco, Michael C Nicoson, Rajiv P Parikh, Thomas H Tung
Background There have been significant advancements in lower extremity reconstruction over the last several decades, and the plastic surgeon's armamentarium has grown to include free muscle and fasciocutaneous flaps along with local perforator and propeller flaps. While we have found a use for a variety of techniques for lower extremity reconstruction, the free gracilis has been our workhorse flap due to the ease of harvest, reliability, and low donor site morbidity. Methods This is a retrospective review of a single surgeon's series of free gracilis flaps utilized for lower extremity reconstruction...
December 26, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28018904/3d-volumetric-modeling-and-microvascular-reconstruction-of-irradiated-lumbosacral-defects-after-oncologic-resection
#19
Emilio Garcia-Tutor, Marco Romeo, Michael P Chae, David J Hunter-Smith, Warren Matthew Rozen
BACKGROUND: Locoregional flaps are sufficient in most sacral reconstructions. However, large sacral defects due to malignancy necessitate a different reconstructive approach, with local flaps compromised by radiation and regional flaps inadequate for broad surface areas or substantial volume obliteration. In this report, we present our experience using free muscle transfer for volumetric reconstruction, in such cases, and demonstrate three-dimensional (3D) haptic models of the sacral defect to aid preoperative planning...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/28008899/-surgery-for-non-small-cell-lung-carcinoma-after-previous-chemoradiotherapy-alone
#20
O V Pikin, A B Ryabov, V A Glushko, K I Kolbanov, A M Amiraliev, D A Vursol, V A Bagrov, V V Barmin
AIM: To investigate early and remote results of surgery in patients with recurrent non-small cell lung carcinoma (NSCLC) after previous chemoradiotherapy alone. MATERIAL AND METHODS: The retrospective study included 14 NSCLC patients (10 men and 4 women, mean age 52.6 years) who were operated in thoracic department for the period June 2008 - December 2013. Histologically squamous cell carcinoma prevailed (64.3%). Prior to surgery stage IIB was diagnosed in 2 patients, IIIA in 11 and IIIB in 1 patient...
2016: Khirurgiia
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