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Free tissue transfer

Sheng Yan, Hangyan Shi, Da Chen, Jincai Guo, Yi Sun, Sufan Wu
The reconstruction of large full-thickness scalp defects remains a surgical challenge, especially when the skull is exposed completely without periosteum. Surgical technique options for wound coverage have included tissue expansion, skin grafting, local or regional flaps, and microvascular free tissue transfer. In recent years, some authors have reported to use biological material as an alternative for repairing complex wounds. The authors report the successful reconstruction of a large defect with bare skull in bilateral temporal regions of a 3-year-old child...
March 14, 2018: Journal of Craniofacial Surgery
Mark L Urken, Ansley M Roche, Kimberly J Kiplagat, Eliza H Dewey, Cathy Lazarus, Ilya Likhterov, Daniel Buchbinder, Devin J Okay
BACKGROUND: Palatomaxillary defects were historically restored with a prosthetic obturator; however, advances in local and free tissue transfer has provided a viable alternative for appropriately selected patients with palatomaxillary defects. METHODS: A retrospective chart review of patients who underwent palatomaxillary reconstruction by the lead author between 1998 and 2016 was conducted. Patients who were restored with a palatal obturator were excluded. RESULTS: One hundred forty patients were reconstructed with a total of 159 local, regional, and free flaps with a 96...
March 14, 2018: Head & Neck
Katharine M Hinchcliff, Jessica Crockett, Steven W Thorpe, Christopher O Bayne
Long ischemia times adversely affect free flap survival, and large muscle flaps are particularly vulnerable. Hypothermic machine perfusion (HMP) is a well-established method of organ preservation, and recent literature has detailed the use of HMP to extend free flap ischemia times, predominantly in the laboratory setting. One limitation in the study and adoption of free flap HMP has been the availability of standardized perfusion machinery, as thus far institutions have built their own devices. We present a case of a 75-year-old woman with dedifferentiated chondrosarcoma of her right proximal femur...
March 14, 2018: Microsurgery
Raquel Bernardelli Iamaguchi, Renan Lyuji Takemura, Gustavo Bersani Silva, Jairo Andre de Oliveira Alves, Luciano Ruiz Torres, Alvaro Baik Cho, Teng Hsiang Wei, Marcelo Rosa de Rezende, Rames Mattar
INTRODUCTION: Indication of free tissue transfer for limb reconstruction continues to grow, and despite the good results with this treatment option, complications can impair the functional results and cause a raise in health costs, with prolonged hospitalization. Therefore, peri-operative surgical information and comorbidities were described and analyzed, for identification of independent risk factors for complications of free flaps results for traumatic wounds. For our knowledge, intraoperative ischemia time of free flap was not previously studied for post-traumatic limb reconstruction, which could influence results, in these traumatic cases, with the highest rates of complications among microsurgical flap reconstructions...
March 13, 2018: International Orthopaedics
Talha Maqbool, Adam Binhammer, Paul Binhammer, Oleh M Antonyshyn
PURPOSE: Titanium mesh is used to reconstruct the neurocranium in cranioplasties. Though it is generally well-tolerated, erosion of the overlying soft tissue with exposure of the implant is a complication that adversely affects patient outcomes. The purpose of this study is to investigate potential risk factors for titanium mesh exposure. METHODS: This study comprises all consecutive patients who underwent titanium mesh cranioplasty between January 2000 and July 2016...
March 12, 2018: Journal of Craniofacial Surgery
Emilio Wagner, Pablo Wagner, Diego Zanolli, Rubén Radkievich, Gunther Redenz, Rodrigo Guzman
BACKGROUND: Tibialis posterior tendon transfer is performed when loss of dorsiflexion has to be compensated. We evaluated the circumtibial (CT), above-retinaculum transmembranous (TMAR), and under-retinaculum transmembranous (TMUR) transfer gliding resistance and foot kinematics in a cadaveric foot model during ankle range of motion (ROM). METHODS: Eight cadaveric foot-ankle distal tibia specimens were dissected free of soft tissues on the proximal end, applying an equivalent force to 50% of the stance phase to every tendon, except for the Achilles tendon...
March 1, 2018: Foot & Ankle International
Christine C Helms, Mark T Gladwin, Daniel B Kim-Shapiro
Erythrocytes regulate vascular function through the modulation of oxygen delivery and the scavenging and generation of nitric oxide (NO). First, hemoglobin inside the red blood cell binds oxygen in the lungs and delivers it to tissues throughout the body in an allosterically regulated process, modulated by oxygen, carbon dioxide and proton concentrations. The vasculature responds to low oxygen tensions through vasodilation, further recruiting blood flow and oxygen carrying erythrocytes. Research has shown multiple mechanisms are at play in this classical hypoxic vasodilatory response, with a potential role of red cell derived vasodilatory molecules, such as nitrite derived nitric oxide and red blood cell ATP, considered in the last 20 years...
2018: Frontiers in Physiology
Lucie Bracq, Maorong Xie, Serge Benichou, Jérôme Bouchet
While HIV-1 infection of target cells with cell-free viral particles has been largely documented, intercellular transmission through direct cell-to-cell contact may be a predominant mode of propagation in host. To spread, HIV-1 infects cells of the immune system and takes advantage of their specific particularities and functions. Subversion of intercellular communication allows to improve HIV-1 replication through a multiplicity of intercellular structures and membrane protrusions, like tunneling nanotubes, filopodia, or lamellipodia-like structures involved in the formation of the virological synapse...
2018: Frontiers in Immunology
Dragana Dekanski, Biljana Spremo-Potparević, Vladan Bajić, Lada Živković, Dijana Topalović, Dušan N Sredojević, Vesna Lazić, Jovan M Nedeljković
The acute toxicity of surface-modified TiO2 nanoparticles (NPs) with caffeic acid (CA) was compared with those of its separate constituents (free CA and bare TiO2 NPs) upon their oral administration in laboratory mice. Prior to in vivo experiments, the interfacial charge transfer (ICT) complex between surface Ti atoms and CA is thoroughly characterized. Composition and stability constants of ICT complex were determined using Job's method and Banesi-Hildebrand analysis, respectively. The experimental data were supported with quantum chemical calculations based on density functional theory (DFT)...
March 3, 2018: Food and Chemical Toxicology
Sarifuddin, Prashanta Kumar Mandal
Angioplasty with drug-coated balloons (DCBs) using excipients as drug carriers is emerging as a potentially viable strategy demonstrating clinical efficacy and proposing additional compliance for the treatment of obstructive vascular diseases. An attempt is made to develop an improved computational model where attention has been paid to the effect of interstitial flow, that is, plasma convection and internalization of bound drug. The present model is capable of capturing the phenomena of the transport of free drug and its retention, and also the internalization of drug in the process of endocytosis to atherosclerotic vessel of heterogeneous tissue composition comprising of healthy tissue, as well as regions of fibrous cap, fibro-fatty, calcified and necrotic core lesions...
March 5, 2018: Cardiovascular Engineering and Technology
Akshay V Patel, Jason E Thuener, Kate Clancy, Mustafa Ascha, Nauman F Manzoor, Chad A Zender
OBJECTIVES: The submental artery island flap (SIF) has recently been described in temporal bone defects. At our institution we have broadened the application of the SIF and modified the harvest technique for complex lateral facial and skull base defects. Our primary aim is to evaluate the outcomes of patients undergoing complex lateral facial soft tissue, parotidectomy, and temporal bone defects who are reconstructed with the SIF to a similar cohort undergoing free tissue transfer reconstruction...
March 2018: Oral Oncology
Mirosława Panasiuk, Michał Rychłowski, Natalia Derewońko, Krystyna Bieńkowska-Szewczyk
Various types of intercellular connections that are essential for communication between cells are often utilized by pathogens. Recently, a new type of cellular connection, long, thin, actin-rich membrane extensions named tunneling nanotubes (TNTs), have been shown to play an important role in cell-to-cell spread of HIV and influenza virus. In the present report, we show that TNTs are frequently formed by cells infected by an alpha-herpesvirus BoHV-1 (bovine herpesvirus 1). Viral proteins, such as envelope glycoprotein gE, capsid protein VP26 and tegument protein Us3, as well as cellular organelles (mitochondria) were detected by immunofluorescence and live cell imaging of nanotubes formed by bovine primary fibroblasts and oropharynx cells (KOP)...
February 28, 2018: Journal of Virology
Leslie E Cohen, Kerry A Morrison, Erin Taylor, Julia Jin, Jason A Spector, Salvatore Caruana, Christine H Rohde
BACKGROUND: Traditional free flap reconstruction of complex intraoral defects often uses large lip-splitting incisions. To reduce morbidity and preserve aesthetics, we have adopted a more technically demanding visor technique obviating an incision through the lower lip through which the resection and reconstruction are performed. METHODS: A retrospective review was performed of patients who underwent free flap reconstruction of intraoral defects over 7 years by a single plastic surgeon (C...
February 28, 2018: Annals of Plastic Surgery
Satoshi Usami, Kohei Inami, Yuichi Hirase
BACKGROUND: Reconstruction of the finger and thumb dorsum has been considered difficult because of the need for a thin and flexible flap, and the surrounding tissue is sometimes insufficient for a local flap. The purpose of this report is to describe our concept for finger and thumb dorsum reconstruction with free-style perforator flaps and our clinical experience with transfer of various perforator flaps. METHODS: Thirty-two finger dorsum defects in 32 patients were covered with pedicled free-style perforator flaps...
February 13, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Özlenen Özkan, Ömer Özkan, Anı Çinpolat, Mehmet Can Ubur, Gamze Bektaş, Adil Jumshudov, Hilmi Uysal
BACKGROUND: The repair of extensive lower lip defects is difficult due to the presence of both functional and esthetic requirements. This report describes functional lip repair using the partial latissimus dorsi free flap without nerve coaptation. METHODS: Reconstruction of the lower lip due to subtotal and total tissue defects was performed using latissimus dorsi free flap on twelve patients, between 2013 and 2017. The etiology was squamous cell carcinoma in six patients, malignant melanoma in one, firearm injury in three and microstomia in two...
February 23, 2018: Microsurgery
Jennifer Kollmer, Thorsten Kästel, Johann M E Jende, Martin Bendszus, Sabine Heiland
BACKGROUND AND PURPOSE: Magnetization transfer contrast imaging provides indirect information on the concentration of "bound" water protons and their interactions with "free" water molecules. The purpose of this study is to analyze location- and age-dependent changes in the magnetization transfer ratio (MTR) of lower extremity nerves. MATERIALS AND METHODS: Ten younger (20-32 years) and 5 older (50-63 years) healthy volunteers underwent magnetization transfer contrast imaging at 3 Tesla Two 3-dimensional gradient echo sequences with and without an off-resonance saturation pulse (repetition time: 58 milliseconds; echo time: 2...
February 21, 2018: Investigative Radiology
Daniel Del Vecchio, Simeon Wall
INTRODUCTION: Despite rapid growth, gluteal fat transplantation is an operation in search of science and a teachable technique. Long operating times, tedious syringe transfers, inability to shape the recipient site and the risk of fat embolism all headline as impediments to clinical adoption of the procedure. Expansion Vibration Lipofilling - EVL - is a syringe-free surgical strategy which is a logical extension of SAFE® liposuction. In EVL, there is simultaneous disruption of recipient site connective tissue, internal expansion using exploded-tip cannulas and backfilling of these spaces with roller pump-propelled fat...
February 9, 2018: Plastic and Reconstructive Surgery
Koichiro Kiya, Tateki Kubo, Shien Seike, Ko Hosokawa
Microvascular free tissue transfer is one of the most common techniques of reconstruction for complex head and neck surgical defects. Generally, venous thrombosis is more likely to occur than arterial thrombosis in vascular anastomosis. Thus, recipient veins must be chosen carefully. Although the internal jugular vein is preferred as a recipient vein by many microsurgeons, internal jugular vein thrombosis is a potential complication, as shown in our report. Therefore, we consider that the external jugular vein still is an option as a recipient for venous anastomosis and that it is better to perform multiple vein anastomoses with 2 different venous systems, such as the internal and external jugular systems, than anastomoses within the same venous system...
January 2018: Plastic and Reconstructive Surgery. Global Open
Ian R Wisecarver, Gerhard S Mundinger, Michael S Tarakji, Hugo St Hilaire
Squamous cell carcinoma (SCC) of the head and neck affects a significant number of people around the world every year. Treatment generally entails surgical resection, radiotherapy, chemotherapy, or some combination of the three. Following resection, microsurgical reconstruction can provide definitive coverage, replace many tissue types simultaneously, and bring healthy tissue to irradiated wound beds. Microsurgical engineering, the manipulation and reorganization of native vascular tissue, can further augment the adaptability of free tissue transfer to complex, compromised wound beds...
January 2018: Plastic and Reconstructive Surgery. Global Open
Johnny I Efanov, Andrée-Anne Roy, Ke N Huang, Daniel E Borsuk
Objective: Over the past few years, virtual surgical planning (VSP) has evolved into a useful tool for the craniofacial surgeon. Virtual planning and computer-aided design and manufacturing (CAD/CAM) may assist in orthognathic, cranio-orbital, traumatic, and microsurgery of the craniofacial skeleton. Despite its increasing popularity, little emphasis has been placed on the learning curve. Methods: A retrospective analysis of consecutive virtual surgeries was done from July 2012 to October 2016 at the University of Montreal Teaching Hospitals...
January 2018: Plastic and Reconstructive Surgery. Global Open
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