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https://www.readbyqxmd.com/read/28930925/conical-modification-of-forearm-free-flaps-for-single-stage-reconstruction-after-total-orbital-exenteration
#1
Chad A Purnell, Elbert E Vaca, Marco F Ellis
BACKGROUND: Orbital exenteration is a significant reconstructive challenge for plastic surgeons. Options described for these defects range from healing by secondary intention to free tissue transfer. The authors present our preferred reconstruction of orbital defects with free forearm-based flaps, which provides quality soft tissue and orbital contouring in 1 stage to consistently allow placement of bone-anchored implants for eventual orbital prosthesis. METHODS: This conical shape of the orbit is deconstructed into a "Pac-Man" type shaped flap that leaves adequate depth for a prosthesis...
September 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28921946/biomimetic-magnetosomes-as-versatile-artificial-antigen-presenting-cells-to-potentiate-t-cell-based-anticancer-therapy
#2
Qianmei Zhang, Wei Wei, Peilin Wang, Liping Zuo, Feng Li, Jin Xu, Xiaobo Xi, Xiaoyong Gao, Guanghui Ma, Hai-Yan Xie
Adoptive T-cell transfer for cancer therapy relies on both effective ex vivo T-cell expansion and in vivo targeting performance. One promising but challenging method for accomplishing this purpose is to construct multifunctional artificial antigen-presenting cells (aAPCs). We herein developed biomimetic magnetosomes as versatile aAPCs, wherein magnetic nanoclusters were coated with azide-engineered leucocyte membranes and then decorated with T-cell stimuli through copper-free click chemistry. These nano aAPCs not only exhibited high performance for antigen-specific cytotoxic T-cell (CTL) expansion and stimulation but also visually and effectively guided reinfused CTLs to tumor tissues through magnetic resonance imaging and magnetic control...
September 20, 2017: ACS Nano
https://www.readbyqxmd.com/read/28918934/reconstructive-microsurgical-approach-for-the-treatment-of-pyoderma-gangrenosum
#3
Karl Schwaiger, Elisabeth Russe, Hassan Kholosy, Michaela Hladik, Klemens Heinrich, Laurenz Weitgasser, Thomas Schoeller, Gottfried Wechselberger
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare type of autoimmune disease that results in progressive ulcers with or without previous trauma. However, PG is not well understood to date, and its treatment therefore remains a challenge. Because of the disease's systemic characteristic and the unpredictability of the clinical course, no gold standard treatment is available, especially concerning the surgical procedures to treat pyodermic lesions. Often, PG is not recognized during routine clinical practice, and standard ulcer treatment (conservative wound care, debridement, skin grafting, and local flap coverage) is initiated; this induces an autoinflammatory response, resulting in disastrous ulcers, thereby making free flap coverage necessary...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28916260/primary-facial-reanimation-in-head-and-neck-cancer
#4
REVIEW
Axel Sahovaler, David Yeh, John Yoo
Facial Paralysis (FP) profoundly impairs the life of individuals, both functionally and psychosocially. Surgical approaches to treat this condition are myriad, but the ultimate goal is to restore symmetry and movement. Ablative surgery for tumors of the head and neck region are amongst the most common etiologies causing FP and this group of patients represents unique challenges. Surgical defects may have multiple competing reconstructive requirements and addressing the FP must be considered in this context...
September 12, 2017: Oral Oncology
https://www.readbyqxmd.com/read/28913317/reconstruction-of-a-complex-scalp-defect-after-the-failure-of-free-flaps-changing-plans-and-strategy
#5
Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha Kim
The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neurosurgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft...
June 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28910625/role-of-soil-to-leaf-tritium-transfer-in-controlling-leaf-tritium-dynamics-comparison-of-experimental-garden-and-tritium-transfer-model-results
#6
Masakazu Ota, Nana-Owusua A Kwamena, Steve Mihok, Volodymyr Korolevych
Environmental transfer models assume that organically-bound tritium (OBT) is formed directly from tissue-free water tritium (TFWT) in environmental compartments. Nevertheless, studies in the literature have shown that measured OBT/HTO ratios in environmental samples are variable and generally higher than expected. The importance of soil-to-leaf HTO transfer pathway in controlling the leaf tritium dynamics is not well understood. A model inter-comparison of two tritium transfer models (CTEM-CLASS-TT and SOLVEG-II) was carried out with measured environmental samples from an experimental garden plot set up next to a tritium-processing facility...
September 11, 2017: Journal of Environmental Radioactivity
https://www.readbyqxmd.com/read/28910400/293texosome-mediated-mir-146a-transfer-suppresses-type-i-interferon-response-and-facilitates-ev71-infection
#7
Yuxuan Fu, Li Zhang, Fang Zhang, Ting Tang, Qi Zhou, Chunhong Feng, Yu Jin, Zhiwei Wu
Exosomes can transfer genetic materials between cells. Their roles in viral infections are beginning to be appreciated. Researches have shown that exosomes released from virus-infected cells contain a variety of viral and host cellular factors that are able to modulate recipient's cellular response and result in productive infection of the recipient host. Here, we showed that EV71 infection resulted in upregulated exosome secretion and differential packaging of the viral genomic RNA and miR-146a into exosomes...
September 14, 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28903078/derivation-of-reliable-empirical-models-describing-lead-transfer-from-metal-polluted-soils-to-radish-raphanus-sativa-l-determining-factors-and-soil-criteria
#8
Sha Zhang, Jing Song, Yinwen Cheng, Peter Christie, Jian Long, Lingfei Liu
Reliable models describing Pb transfer from soils to food crops are useful in the improvement of soil protection guidelines. This study provides mechanistic insights from in-situ soil solution measurement on the Pb uptake in the root tissues (RF) of radish, grown in 25 representative Pb-contaminated agricultural soils. Lead speciation and regression analysis indicate that >88.6% of the variation in RF Pb is attributable to free Pb(2+) activity (aPb(2+)) in the soil solution, which is predominantly controlled by pH and DOC...
September 10, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28894667/dual-vascular-free-anterolateral-thigh-flap
#9
Toshiaki Numajiri, Daiki Morita, Shoko Tsujiko, Hiroko Nakamura, Yoshihiro Sowa, Akihito Arai, Matsui Masahiro, Hiroshi Nakano, Shigeru Hirano
BACKGROUND: The optimum number of microvascular anastomoses for safe free tissue transfer is controversial. Although the case for 2 venous anastomoses versus 1 anastomosis has been argued, the use of an additional arterial anastomosis has not been examined in detail. METHODS: Twelve patients who underwent 2 arterial anastomoses for a free flap transfer were identified retrospectively from the medical records of patients undergoing reconstruction for head and neck cancer...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28894663/deltopectoral-and-pectoralis-musculocutaneous-flap-technique-for-cervical-esophageal-reconstruction-after-free-jejunal-flap-necrosis
#10
Hajime Matsumine, Kazuyuki Kubo, Atsumori Hamahata, Hiroyuki Sakurai
BACKGROUND: Free jejunal transfer has a high success rate, but if vascular thrombosis occurs, the salvage of failing flap with reanastomosis is difficult. This study described a combined deltopectoral (DP) and pectoralis major musculocutaneous (PMMC) flap 2-step technique for cervical esophageal reconstruction after free-jejunal-flap necrosis. METHODS: In step 1, the detection of free jejunal flap with the subsequent debridement of necrotic and infected tissue was followed by the construction of external fistula on the pharyngeal side with the hole in cervical skin and the construction of another external fistula on the esophageal side and tracheal stoma with a single or double DP flap...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28892496/effectiveness-of-food-supplements-in-increasing-fat-free-tissue-accretion-in-children-with-moderate-acute-malnutrition-a-randomised-2-%C3%A3-2-%C3%A3-3-factorial-trial-in-burkina-faso
#11
RANDOMIZED CONTROLLED TRIAL
Christian Fabiansen, Charles W Yaméogo, Ann-Sophie Iuel-Brockdorf, Bernardette Cichon, Maren J H Rytter, Anura Kurpad, Jonathan C Wells, Christian Ritz, Per Ashorn, Suzanne Filteau, André Briend, Susan Shepherd, Vibeke B Christensen, Kim F Michaelsen, Henrik Friis
BACKGROUND: Children with moderate acute malnutrition (MAM) are treated with lipid-based nutrient supplement (LNS) or corn-soy blend (CSB). We assessed the effectiveness of (a) matrix, i.e., LNS or CSB, (b) soy quality, i.e., soy isolate (SI) or dehulled soy (DS), and (c) percentage of total protein from dry skimmed milk, i.e., 0%, 20%, or 50%, in increasing fat-free tissue accretion. METHODS AND FINDINGS: Between September 9, 2013, and August 29, 2014, a randomised 2 × 2 × 3 factorial trial recruited 6- to 23-month-old children with MAM in Burkina Faso...
September 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28888307/microsurgical-burn-reconstruction
#12
REVIEW
Akhil K Seth, Jonathan S Friedstat, Dennis P Orgill, Julian J Pribaz, Eric G Halvorson
The treatment of burn-related wounds requires consideration of several factors, including defect size, available donor sites, exposure of critical structures, and the ultimate functional and aesthetic result of reconstruction. Although skin grafts and locoregional flaps are workhorses in burn reconstruction, they have inherent limitations that can directly impact reconstructive outcomes. Microsurgical free tissue transfer represents a viable option for the reconstruction of burn-related wounds in certain patients...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28885214/breast-sensitivity-after-mastectomy-and-autologous-reconstruction
#13
Norbert Heine, Christoph Koch, Vanessa Brebant, Andreas Kehrer, Alexandra Anker, Lukas Prantl
BACKGROUND: Breast Carcinoma is the most common malign tumor disease in women. 20-30% of these tumors have to be treated by removing all of the breast tissue. After that kind of therapeutic procedure, most of the women are severely traumatized and ask for reconstruction. The goldstandard of breast reconstruction is the free perforator flap from the lower abdomen (DIEAP-flap), which can provide body-own tissue and natural shape for the reconstructed breast.Many studies evaluate the shape of the reconstructed breast but neglect the skin sensitivity...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28885211/postoperative-control-of-functional-muscle-flaps-for-facial-palsy-reconstruction-ultrasound-guided-tissue-monitoring-using-contrast-enhanced-ultrasound-ceus-and-ultrasound-elastography
#14
A Kehrer, V Mandlik, C Taeger, S Geis, L Prantl, E M Jung
BACKGROUND AND OBJECTIVES: Facial paralysis causes excruciating impairments including facial asymmetry, limited eye closure, oral incontinence and social dysfunction. Modern plastic surgical reconstructions render favorable results with well-perfused dynamic muscle flaps. Post-operative tissue monitoring is a critical determinant for success. Contrast-enhanced Ultrasound (CEUS) and elastography have proven superior properties to evaluate tissue perfusion in various organs. We evaluated their role for functional muscle flaps positioned at the sub-skin level in facial palsy patients...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28884452/microsurgical-reconstruction-following-oncologic-resection-in-pediatric-patients-a-15-year-experience
#15
Margaret J Starnes-Roubaud, Matthew M Hanasono, Michael E Kupferman, Jun Liu, Edward I Chang
BACKGROUND: Free tissue transfer in the pediatric population is a challenging endeavor, even for experienced microsurgeons. Some surgeons argue these cases can be limited by vessel size and spasticity and should be undertaken only when absolutely necessary. We present a 15-year experience examining outcomes of free tissue transfer in pediatric oncologic patients. METHODS: All free flaps performed at a single institution in pediatric patients (age range 3-17) between January 2000 and December 2014 were reviewed...
September 7, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28873059/traction-assisted-internal-negative-pressure-wound-therapy-with-bridging-retention-sutures-to-facilitate-staged-closure-of-high-risk-wounds-under-tension
#16
Michael V DeFazio, James M Economides, Ersilia L Anghel, Ryan K Mathis, John R Barbour, Christopher E Attinger
BACKGROUND/OBJECTIVE: Loss of domain often complicates attempts at delayed wound closure in regions of high tension. Wound temporization with traction-assisted internal negative pressure wound therapy (NPWT), using bridging retention sutures, can minimize the effects of edema and elastic recoil that contribute to progressive tissue retraction over time. The investigators evaluated the safety and efficacy of this technique for complex wound closure. MATERIALS AND METHODS: Between May 2015 and November 2015, 18 consecutive patients underwent staged reconstruction of complex and/or contaminated soft tissue defects utilizing either conventional NPWT or modified NPWT with instillation and continuous dermatotraction via bridging retention sutures...
July 26, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28867912/deep-inferior-epigastric-perforator-free-flaps-for-use-in-complicated-groin-wound-repair-a-case-report-of-severe-groin-scar-contracture-and-review-of-pedicled-and-free-flaps-in-groin-wound-repair
#17
James D Kotick, Roger S Sandelin, Richard D Klein
The use of pedicled and free flaps for tissue transfer and coverage has become a common practice in modern plastic surgery. An area that presents considerable challenge for tissue coverage is the groin. Defects in this area are complicated by issues such as prior surgery; scar contracture; extension of the defect beyond the borders of the groin; radiation damage; high probability of infection; and involvement of vital underlying structures, the genitalia, and perineal and perianal area. Therefore, the choice of donor site and flap usage is often difficult...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28864313/toe-to-finger-combined-with-free-flap-transfer-for-primary-one-stage-post-traumatic-reconstruction-of-the-complex-fingerless-hand
#18
Hua Chen, Chaoyin Jiang, Yaozeng Xu, Yangbai Sun
Toe-to-finger transplantation is intimately related to the development of microsurgical free tissue transplantation, which is one of the most important advances in the history of reconstructive surgery. It is also generally acknowledged that a mangled hand with massive tissue loss and amputation of multiple digits presents a challenge for plastic and reconstructive surgeons. In this retrospective study we reviewed 11 cases of primary one-stage post-traumatic reconstruction of complex fingerless hands using a combination of toe-to-finger and free tissue transplantation performed in Shanghai Jiao Tong University affiliated Sixth People's Hospital and Shanghai Jiao Tong University School of Medicine affiliated Ninth People's Hospital from January 2001 to November 2014...
August 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28843763/metastatic-basal-cell-adenocarcinoma-of-submandibular-gland-to-the-spine-an-extremely-rare-condition-a-case-report
#19
Tinnakorn Pluemvitayaporn, Sombat Kunakornsawat, Chaiwat Piyaskulkaew, Pritsanai Pruttikul, Warongporn Pongpinyopap
Basal cell adenocarcinomas (BCACs) are rare malignant neoplasms of salivary glands, accounting for less than 1% of salivary gland tumors. Few cases of distant metastases have been reported. To our knowledge, metastases to the spine have not been previously reported in the literature. We presented an unusual case of a 50-year-old Thai male, who was diagnosed as basal cell adenocarcinoma of submandibular gland with pulmonary and cervical spine metastases with progressive myelopathy, treated with wide surgical resection of the soft tissue tumor and modified radical neck dissection, anterior cervical total corpectomy with fusion combined with posterior decompression and fusion of the cervical spine and surgical wound coverage by anterolateral thigh free tissue transfer, followed by adjuvant radiotherapy...
August 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28841623/associations-of-surgeon-and-hospital-volumes-with-outcome-for-free-tissue-transfer-by-using-the-national-taiwan-population-health-care-data-from-2001-to-2012
#20
Elham Mahmoudi, Yiwen Lu, Shu-Chen Chang, Chia-Yu Lin, Yi-Chun Wang, Chee Jen Chang, Ming-Huei Cheng, Kevin C Chung
BACKGROUND: Greater hospital case volumes are associated with improved outcomes for high-risk procedures. The hospital-outcome association for complex but low-mortality procedures and the association between surgeon versus hospital case volume and surgical outcomes have been less explored. The authors examined the association between surgeon and hospital volume and the success for free tissue transfer (free flap) surgery. The authors hypothesized that there would be positive associations between hospital and surgeon volume and the success of free flap surgery...
September 2017: Plastic and Reconstructive Surgery
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