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https://www.readbyqxmd.com/read/28527396/breast-oedema-following-free-flap-breast-reconstruction
#1
Jennifer Greenhowe, Christopher Stephen, Liusaidh McClymont, D Alex Munnoch
OBJECTIVES: Breast oedema causes significant morbidity and is historically difficult to quantify. The aim of this study was to identify changes in breast tissue water content from pre-operative levels in the native breast to post-operative levels in mastectomy skin flaps and free flaps in the reconstructed breast. MATERIALS AND METHODS: One hundred patients undergoing unilateral mastectomy and immediate free flap breast reconstruction were examined pre-operatively and at three post-operative appointments...
May 17, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28526905/effectiveness-of-acellular-dermal-matrix-on-autologous-split-thickness-skin-graft-in-treatment-of-deep-tissue-defect-esthetic-subjective-and-objective-evaluation
#2
Yoo Jung Lee, Myong Chul Park, Dong Ha Park, Hyung Min Hahn, Sue Min Kim, Il Jae Lee
BACKGROUND: A split-thickness skin graft (STSG) is performed to cover a large full-thickness skin defect. Esthetic and functional deficits can result, and many studies have sought to overcome them. This study compared the effectiveness of the acellular dermal matrix (ADM) graft and STSG concerning esthetic and functional effectiveness of ADM on scar quality. METHODS: Of the patients who underwent anterolateral thigh free flap from 2011 to 2015, patients who received skin graft only (n = 10) or skin graft with ADM (n = 20) for coverage of the donor site were enrolled...
May 19, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28522300/primary-reconstructive-method-for-tracheal-defect-from-invasion-by-differentiated-thyroid-carcinoma
#3
Atsumori Hamahata, Takeshi Beppu, Takashi Yamaki, Hiroyuki Sakurai
Differentiated thyroid carcinoma is not highly malignant, and thus surgical resection is the most common treatment even if the carcinoma has invaded the trachea. Although some cases exist in which the carcinoma invades the trachea, using the tracheal window resection method allows complete resection of the carcinoma. Yet these patients must often control a large tracheocutaneous wound until reconstructive surgery is performed because such surgery occurs secondarily. Our hospital admitted three patients for which tracheally invasive, differentiated thyroid carcinoma was surgically resected...
May 15, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28520896/laser-assisted-indocyanine-green-dye-angiography-for-postoperative-fistulas-after-salvage-laryngectomy
#4
Erin J Partington, Lindsay S Moore, Russel Kahmke, Jason M Warram, William Carroll, Eben L Rosenthal, Benjamin J Greene
Importance: Pharyngocutaneous fistula formation is an unfortunate complication after salvage laryngectomy for head and neck cancer that is difficult to anticipate and related to a variety of factors, including the viability of native pharyngeal mucosa. Objective: To examine whether noninvasive angiography with indocyanine green (ICG) dye can be used to evaluate native pharyngeal vascularity to anticipate pharyngocutaneous fistula development. Design, Setting, and Participants: This cohort study included 37 patients enrolled from June 1, 2013, to June 1, 2016, and follow-up was for at least 1 month postoperatively...
May 18, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28516962/design-of-a-customised-bridging-mandibular-prosthesis-for-complex-reconstruction-a-pilot-study
#5
A Tarsitano, S Battaglia, A Sandi, C Marchetti
The gold standard for mandibular reconstruction is universally recognised and consists of the replacement of the bony part of the mandible with a bony microvascular free flap supported by a reconstructive plate. Although this procedure is feasible and reproducible in most patients, at times poor oncological prognosis or poor performance status force surgeons to consider other reconstructive solutions. In these cases, the main alternative in reconstructing a mandibular defect is represented by bridging plates combined with soft tissue flaps...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28514343/-effect-of-dexmedetomidine-on-perfusion-of-free-flaps-transferred-to-head-and-neck
#6
A S Dobrodeev, S A Rabinovich, I F Malykhina
The paper presents the impact of perioperative care on feasibility of free fibula flap transfer for facial reconstruction. Flaps vitality was measured by means of somatic oximetry in 85 patients aged 20-74 years receiving reconstruction procedures in midfacial and lower facial areas. The patients were divided in three groups according to sedation agent used postoperatively. It has been demonstrated that dexmedetomidine postoperative sedation significantly improved free fibula flaps perfusion compared to propofol sedation...
2017: Stomatologii︠a︡
https://www.readbyqxmd.com/read/28514018/salvage-of-postcranioplasty-implant-exposure-using-free-tissue-transfer
#7
Pang-Yun Chou, Cheng-Hung Lin, Chung-Chen Hsu, Wei-Hsun Yang, Alex A Kane, Chih-Hung Lin
BACKGROUND: Refractory implant exposure is frustrating after cranioplasty. The purpose of this study was for the authors to present their experience with free tissue transfer for salvage of postcranioplasty implant exposure. METHODS: A retrospective medical chart review was conducted on all free tissue transfers performed for exposed implant coverage after cranioplasty between January 2004 and February 2016. RESULTS: Twelve free flaps were performed in 11 patients who underwent postcranioplasty with implant exposure, and whose attempted implant coverage using locoregional flaps had failed...
May 17, 2017: Head & Neck
https://www.readbyqxmd.com/read/28512866/medial-sural-artery-perforator-free-flap-for-the-reconstruction-of-leg-foot-and-ankle-defect-an-excellent-option
#8
Jyoshid R Balan
BACKGROUND: The defects over the leg, foot and ankle are best covered with a thin pliable flap. The use of muscle flap for the reconstruction of these defects leaves a grafted, aesthetically inferior result. The medial sural artery perforator (MSAP) free flap gives a thin pliable tissue for the reconstruction with better aesthesis. METHODS: The study design was retrospective case analysis over a period of 2 years. All the patients who underwent flap for leg, foot and ankle defect reconstruction in the form of MSAP free flap were included in the study...
May 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28509695/a-novel-augmented-reality-based-navigation-system-in-perforator-flap-transplantation-a-feasibility-study
#9
Taoran Jiang, Ming Zhu, Tao Zan, Bin Gu, Qingfeng Li
BACKGROUND: In perforator flap transplantation, dissection of the perforator is an important but difficult procedure because of the high variability in vascular anatomy. Preoperative imaging techniques could provide substantial information about vascular anatomy; however, it cannot provide direct guidance for surgeons during the operation. In this study, a navigation system (NS) was established to overlie a vascular map on surgical sites to further provide a direct guide for perforator flap transplantation...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28509443/hemodynamically-stimulated-and-in-vivo-generated-axially-vascularized-soft-tissue-free-flaps-for-closure-of-complex-defects-evaluation-in-a-small-animal-model
#10
Volker J Schmidt, Johanna O Wietbrock, Nico Leibig, Jochen F Hernekamp, Dominic Henn, Christian A Radu, Ulrich Kneser
The arteriovenous (AV) loop model permits the creation of significant volumes of axially vascularized tissue that represents an alternative to conventional free flaps, circumventing their common limitations. However, such AV-loop-based flaps have never before been examined in standardized animal models with respect to their suitability for reconstruction of critical bone exposing defects. In the course of our preliminary studies, we implemented a novel defect model in rats that provides standardized and critical wound conditions and evaluated whether AV-loop-generated flaps are suitable for free microsurgical transfer and closure of composite defects...
May 16, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28509409/soft-tissue-reconstruction-and-salvage-of-infected-fixation-hardware-in-lower-extremity-trauma
#11
Hyuma A Leland, Alexis D Rounds, Karen E Burtt, Daniel J Gould, Geoffrey S Marecek, Ram K Alluri, Ketan M Patel, Joseph N Carey
BACKGROUND: Tibial fracture management may be complicated by infection of internal fixation hardware (iIFH) resulting in increased morbidity and amputation rate. When iIFH removal is not possible, salvage of the lower extremity is attempted through debridement, antibiotics, and vascularized soft tissue coverage. This study investigates lower extremity salvage with retention of iIFH. METHODS: Demographics, outcomes, and bacterial speciation in patients with tibial fractures at a level 1 trauma center from 2007 to 2014 were reviewed...
May 16, 2017: Microsurgery
https://www.readbyqxmd.com/read/28507909/open-vesicocalicostomy-for-the-management-of-transplant-ureteral-stricture
#12
Margaret M Higgins, Jonathan P Walker, Michael F Daily, Shubham Gupta
A 59-year-old male developed a proximal stricture of his transplant ureter ten years after a living donor renal transplant. Endoscopic management was unsuccessful, and the patient was temporized with percutaneous nephrostomy tubes for months. Eventually, it became clear he would require surgical revision. Intraoperatively, complete fibrosis of the renal hilum, and intrarenal location of the pelvis precluded the planned pyelovesicostomy. A successful open vesicocalicostomy was performed, anastomosing a bladder flap to a lower pole calix...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28507874/a-10-year-follow-up-of-a-free-vascularized-fibula-flap-clavicle-reconstruction-in-an-adult
#13
Louie Ye, G Ian Taylor
The free vascularized fibula flap has been widely used for clavicle reconstruction. Limited evidence exists for the long-term outcome of clavicle reconstruction using the free vascularized fibula flap in adults. We report the functional and aesthetic outcome in a 52-year old man a decade after clavicle reconstruction using a free vascularized fibula flap in combination with a modified Richardson Hook Plate. At the 10-year follow-up, panoramic shoulder X-ray showed the modified Richardson Hook Plate had remained firmly in place with the fibula and the hook positioned beneath the acromion...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507873/inferior-limb-salvage-by-combined-free-tissue-transfer-and-the-crane-principle-revisited
#14
Alessandro Thione, Pedro C Cavadas
Aggressive treatment of ischemia of the lower extremities has decreased the number of amputations in both diabetic and nondiabetic patients; combined vascular reconstruction and microvascular free-flap transfer has been used to improve distal perfusion and cover large tissue defects caused by the critical limb ischemia during the past 30 years. We present our experience with a 71-year-old diabetic patient who underwent revascularization with a vascular bypass and a simultaneous microvascular flap reconstruction for limb salvage after domestic trauma...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507870/intraoperative-change-in-defect-size-during-maxillary-reconstruction-using-surgical-guides-created-by-cad-cam
#15
Daiki Morita, Toshiaki Numajiri, Hiroko Nakamura, Shoko Tsujiko, Yoshihiro Sowa, Makoto Yasuda, Shigeru Hirano
Surgical osteotomy guides created by computer-aided design/computer-aided manufacturing (CAD/CAM) have been developed and are now widely used in maxillofacial reconstruction. However, there are no standard procedures for dealing with an intraoperative change in defect size. We report on a case in which we used our CAD/CAM guides to deal with an intraoperative change in defect size in a maxillary reconstruction. We planned the maxillary reconstruction using a free fibula flap because of left maxillary sinus cancer in a 73-year-old man...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507861/absence-of-ulnar-artery-inflow-detected-by-allen-s-test-prior-to-radial-forearm-free-flap
#16
Benjamin A Taylor, Faisal Alzahrani, Eric Levi, S Mark Taylor, Matthew H Rigby, Jonathan Trites, Robert D Hart
Radial forearm free flaps are commonly used for soft-tissue reconstruction after resection of head and neck cancer. It is perfused by the radial artery, leaving the ulnar artery for perfusion of the hand and digits. The absence of distal ulnar artery and associated superficial palmar arch, however, has not been reported in cadaveric dissection. We report a case of unilateral ulnar artery flow absence, detected by Allen's test, during preoperative preparation for a radial forearm free flap. Based on the simplicity, safety, and ease, we recommend Allen's test to be performed preoperatively on every patient for whom such a flap is a consideration...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507858/reconstructing-discontinuous-facial-defects-with-simultaneous-ulnar-perforator-free-flaps
#17
Carissa M Thomas, Mofiyinfolu Sokoya, Frederic W-B Deleyiannis
Multiple, simultaneous skin cancers of the face are common. This is the first description of reconstructing discontinuous facial defects (i.e., separate sites of the face) with simultaneous ulnar perforator flaps. The distinct innovations of this multiple flap design are the ability to restrict the harvest site to one extremity, to obtain vein and arterial grafts from the same extremity, and to create multiple flaps with minimal hirsutism and bulk. We present a case of a 57-year-old male with multiple basal cell carcinomas who underwent wide local excisions of the right upper lip and cheek and of the left lower eyelid and infraorbital cheek...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507857/greater-omental-lymph-node-flap-for-upper-limb-lymphedema-with-lymph-nodes-depleted-patient
#18
Yu-Ying Chu, Robert J Allen, Ting-Jung Wu, Ming-Huei Cheng
BACKGROUND: The greater omentum is supplied by the right, middle, and left omental arteries, which arise from the right and left gastroepiploic arteries. All or part of the greater omentum can be harvested based on this blood supply for free tissue transfer. It has stimulated new interest in its use as the donor site in the treatment of lymphedema. For patients who have failed other management options or have limited peripheral lymph node donor sites, the greater omental lymph node flap may offer the best chance for lymphedema treatment...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28506450/utility-and-versatility-of-the-supraclavicular-artery-island-flap-in-head-and-neck-reconstruction
#19
José A González-García, Carlos M Chiesa-Estomba, Jon A Sistiaga, Ekhiñe Larruscain, Leire Álvarez, Xabier Altuna
INTRODUCTION: The supraclavicular island flap is a rotational pedicled flap and may have some advantages in head and neck reconstruction compared with free-tissue transfer when this kind of reconstruction is not affordable or recommended. MATERIAL AND METHODS: We present our experience during the year 2016 in the application of the supraclavicular island flap in five cases as an alternative to microvascular reconstruction in several defects after resection of head and neck tumours...
May 12, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28505418/how-mutations-can-resist-drug-binding-yet-keep-hiv-1-protease-functional
#20
Rajeswari Appadurai, Sanjib Senapati
HIV-1 protease is an important drug target for AIDS therapy. Nearly ten small molecule drugs have been approved by FDA. However, prolonged usage of these drugs produced protease mutants that are insusceptible to many of these drugs. The mutated proteases however continue to cleave the substrate peptides and thus remain largely functional. This poses a major challenge in the treatment strategies. Thus it has become imperative to understand how these mutations induce drug resistance while maintaining the enzymatic activity of this protein...
May 15, 2017: Biochemistry
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