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https://www.readbyqxmd.com/read/28210557/desmoid-tumor-following-abdominally-based-free-flap-breast-reconstruction
#1
Christine Oh, Ziyad S Hammoudeh, Brian T Carlsen
Desmoid tumors are fibroblastic connective tissue tumors that most commonly develop within the anterior abdominal wall. The etiology of desmoid tumors has not been well defined; however, hereditary, hormonal, traumatic, and surgery-related causes have been implicated. Desmoid tumors are believed to arise from musculoaponeurotic structures. Development in the breast is very rare. Several reports of desmoid tumors arising in the vicinity of the fibrous capsule of a breast implant have been described, but to date, the authors are not aware of any published cases following autologous breast reconstruction...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28210412/reconstruction-of-a-combined-maxillectomy-and-segmental-mandibulectomy-defect-in-a-seven-year-old-with-a-single-free-fibula-osteocutaneous-flap
#2
Shawn T Joseph, Krishnakumar Thankappan, Subramania Iyer
Combined upper alveolectomy and segmental mandibulectomy are complex defects. Reconstruction of these defects is usually suboptimal. We describe the case of a pediatric patient with vessel-depleted neck with recurrent vascular malformation involving the ramus and coronoid process of mandible and a previous history of maxillectomy and a reconstruction with anterolateral thigh flap. The patient underwent wide resection. The defects involving the upper alveolus and mandible were simultaneously reconstructed with a single free fibula flap...
March 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28207463/implantation-of-thickened-artificial-bone-for-reduction-of-dead-space-and-prevention-of-infection-between-implant-and-dura-in-secondary-reconstruction-of-the-skull
#3
Mine Ozaki, Keigo Narita, Masakazu Kurita, Yuki Iwashina, Akihiko Takushima, Kiyonori Harii
For the treatment of skull defect compensation after neurosurgery, a customized artificial bone is often employed owing to its toughness and the relative ease of producing cosmetically good result. However, implants are vulnerable to infection and removal of implant is sometimes necessary. Several other treatment options such as autologous bone graft or free flap are likely to be considered for the secondary reconstruction to avoid reinfection; however, reimplantation of artificial bone is beneficial for the patients, being not concerned with donor site morbidity...
February 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28207197/changing-the-surgical-dogma-in-frontal-sinus-trauma-transnasal-endoscopic-repair
#4
Jessica W Grayson, Hari Jeyarajan, Elisa A Illing, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
BACKGROUND: Management of frontal sinus trauma includes coronal or direct open approaches through skin incisions to either ablate or obliterate the frontal sinus for posterior table fractures and openly reduce/internally fixate fractured anterior tables. The objective of this prospective case-series study was to evaluate outcomes of frontal sinus anterior and posterior table trauma using endoscopic techniques. METHODS: Prospective evaluation of patients undergoing surgery for frontal sinus fractures was performed...
February 16, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28205468/vascularized-medial-femoral-condyle-bone-graft-for-resistant-nonunion-of-the-distal-radius
#5
Mark Henry
BACKGROUND: Nonunion involving the metaphyseal region of the distal radius is exceedingly rare, usually involving co-morbidity. Patients that have failed multiple prior conventional surgical interventions represent an even more difficult subset to treat; this investigation examined the utility of a specially designed free vascularized medial femoral condyle flap consisting of a central structural block graft with an extended corticoperiosteal sleeve to wrap around the junctions. METHODS: Six patients (5 males, 1 female) with a mean age of 52 years had failed to achieve union involving the distal radius metaphysis after a mean of 3...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28204931/postero-inferior-pedicle-surgical-technique-for-the-treatment-of-grade-iii-gynecomastia
#6
Sophie Thiénot, Nicolas Bertheuil, Raphaël Carloni, Cécile Méal, Sylvie Aillet, Christian Herlin, Eric Watier
INTRODUCTION: Surgical treatment of Grade III gynecomastia generally utilizes mastectomy techniques and free transplantation of the nipple-areola complex. Moreover, with rising obesity rates and the development of bariatric surgery, an increasing demand for correctional surgery for pseudogynecomastia has been observed, which is comparable to Grade III gynecomastia in terms of its surgical management. Here, we describe an innovative technique to deal with these new demands: fascio-cutaneous flap by postero-inferior pedicle...
February 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28203515/curvilinear-segmental-mandibular-reconstruction-utilizing-distraction-osteogenesis-and-early-open-callus-manipulation
#7
Alberto Rocha Pereira, Paulo Neves, José Rosa, Scott Bartlett
The authors present a new technique for reconstruction of large curvilinear mandibular defects with distraction osteogenesis and early open callus manipulation. In phase 1, transport disks are created from mandibular bone and distracted across the entire length of the defect, without the restriction from a mandible plate fixation. This allows for full-length distraction until enough regenerate is obtained to reconstruct the defect without the need for additional bone grafts. Taking advantage of the soft moldable regenerate, the second and final operative procedure allows for the manipulation, repositioning, and fixation of the transported segments in the ideal position creating perfect tridimensional form and symmetry of the mandible arch...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203503/prostaglandin-e1-increases-microcirculation-in-random-pattern-flaps-on-rats-measured-with-laser-doppler-perfusion-imaging
#8
Kim Alexander Tønseth, Christian Sneistrup, Thomas Moe Berg
BACKGROUND: Reconstructive procedures with pedicled and free flaps are associated with a risk of ischemia. Prostaglandin E1 (PGE1) is a hormone-like substance with known antiischemic and tissue-protective effects. The aim of this study was to evaluate the effect of PGE1 on the microcirculation in random pattern skin flaps on rats. METHODS: Twenty-four rats were divided into 2 groups: an intervention group given PGE1 for 6 hours and a control group given saline. The flap (2 × 10 cm) was created on the back of the rats, and the microcirculation was monitored with laser Doppler perfusion imaging in 5 different zones (1, proximal; 5, distal) before surgery and after 60, 180, and 360 minutes postoperatively...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203501/partial-breast-reconstruction-with-goldilocks-technique-after-excision-of-giant-fibroadenoma-a-case-report
#9
Ryan P Ter Louw, Sara B Bruce, Maurice Y Nahabedian
Giant juvenile fibroadenomas are relatively rare, accounting for less than 1% fibroadenomas. Large breast tumors create significant asymmetry and provide unique reconstructive challenges after removal. In this case, we describe a 21-year-old female with delayed presentation of a giant fibroadenoma of the right breast. This represents an unusual presentation of benign breast disease requiring reduction of the skin envelope, extensive glandular resection, lower pole reconstruction, and free nipple grafting to achieve symmetry with the opposite breast...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203500/reconstructive-surgery-for-bronchopleural-fistula-and-empyema-new-application-of-free-fascial-patch-graft-combined-with-free-flap
#10
Minoru Sakuraba, Hiroki Umezawa, Shimpei Miyamoto, Masahide Fujiki, Takuya Higashino, Azusa Oshima, Masahiro Tsuboi
BACKGROUND: Postoperative bronchopleural fistula (BPF) and empyema are not uncommon after lung cancer surgery. Some patients require reconstructive surgery to achieve wound healing. In this report, we describe a novel method of reconstructive surgery for BPF and empyema. METHODS: From 1996 through 2014, we performed reconstructive surgery for the treatment of BPF and empyema in 13 cases. BPF or a pulmonary fistula was present in 11 patients at the time of reconstruction...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28202996/-surgical-reconstruction-of-maxillary-defects-using-a-computer-assisted-techniques
#11
W B Zhang, Y Yu, Y Wang, X J Liu, C Mao, C B Guo, G Y Yu, X Peng
The maxilla is the most important bony support of the mid-face skeleton and is critical for both esthetics and function. Maxillary defects, resulting from tumor resection, can cause severe functional and cosmetic deformities. Furthermore, maxillary reconstruction presents a great challenge for oral and maxillofacial surgeons. Nowadays, vascularized composite bone flap transfer has been widely used for functional maxillary reconstruction. In the last decade, we have performed a comprehensive research on functional maxillary reconstruction with free fibula flap and reported excellent functional and acceptable esthetic results...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28201829/impact-of-continuous-two-team-approach-in-autologous-breast-reconstruction
#12
A J Bauermeister, A Zuriarrain, M Newman, S A Earle, M A Medina
Background Autologous breast reconstruction has been noted in the literature to provide superior aesthetic outcomes and patient satisfaction. Additionally, free perforator flap tissue transfer has the potential for lower abdominal donor site morbidity. However, it has been noted that the percentage of women who are undergoing autologous breast reconstruction in the United States is decreasing. Factors related to the technical difficulty, prolonged operative times, and decreasing reimbursement have been implicated as the causes...
February 15, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28199294/flow-induced-microvascular-network-formation-of-therapeutic-relevant-arteriovenous-av-loop-based-constructs-in-response-to-ionizing-radiation
#13
Volker J Schmidt, Jennifer M Covi, Christoph Koepple, Johannes G Hilgert, Elias Polykandriotis, Amir K Bigdeli, Luitpold V Distel, Raymund E Horch, Ulrich Kneser
BACKGROUND The arteriovenous (AV) loop model enables axial vascularization to gain a functional microcirculatory system in tissue engineering constructs in vivo. These constructs might replace surgical flaps for the treatment of complex wounds in the future. Today, free flaps are often exposed to high-dose radiation after defect coverage, according to guideline-oriented treatment plans. Vascular response of AV loop-based constructs has not been evaluated after radiation, although it is of particular importance...
February 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28198770/should-immediate-autologous-breast-reconstruction-be-considered-in-women-who-require-post-mastectomy-radiation-therapy-a-prospective-analysis-of-outcomes
#14
Jessica Billig, Reshma Jagsi, Ji Qi, Jennifer B Hamill, Hyungjin M Kim, Andrea L Pusic, Edward Buchel, Edwin G Wilkins, Adeyiza O Momoh
BACKGROUND: In women who require post-mastectomy radiation therapy, immediate autologous breast reconstruction is often discouraged. We aim to prospectively evaluate postoperative morbidity and satisfaction reported by women undergoing delayed or immediate autologous breast reconstruction in the setting of post-mastectomy radiation therapy. METHODS: Patients enrolled in the Mastectomy Reconstruction Outcomes Consortium Study, who received post-mastectomy radiotherapy and had immediate or delayed free abdominal-based autologous breast reconstruction were identified...
February 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28197297/reconstruction-of-an-anterior-cervical-necrotizing-fasciitis-defect-using-a-biodegradable-polyurethane-dermal-substitute
#15
Marcus Jd Wagstaff, Yugesh Caplash, John E Greenwood
Introduction: Although we have previously described the use of a novel polyurethane biodegradable dermal substitute in the reconstruction of 20 free flap donor sites, and extensive cutaneous defects, including a large area of exposed calvarium secondary to burn injury, our experience with this material now extends to 35 free flap donor site reconstructions and 13 major or complex burns. Methods: The polyurethane material (NovoSorb BTM; PolyNovo Biomaterials Pty Ltd, Port Melbourne, Victoria, Australia) was recently employed in another complex wound scenario, implanted into a large anterior cervical cutaneous and soft-tissue defect remaining after serial radical debridement for necrotizing fasciitis...
2017: Eplasty
https://www.readbyqxmd.com/read/28196200/assessment-of-surgical-learning-curves-in-transoral-robotic-surgery-for-squamous-cell-carcinoma-of-the-oropharynx
#16
William G Albergotti, William E Gooding, Mark W Kubik, Mathew Geltzeiler, Seungwon Kim, Umamaheswar Duvvuri, Robert L Ferris
Importance: Transoral robotic surgery (TORS) is increasingly employed as a treatment option for squamous cell carcinoma of the oropharynx (OPSCC). Measures of surgical learning curves are needed particularly as clinical trials using this technology continue to evolve. Objective: To assess learning curves for the oncologic TORS surgeon and to identify the number of cases needed to identify the learning phase. Design, Setting, and Participants: A retrospective review of all patients who underwent TORS for OPSCC at the University of Pittsburgh Medical Center between March 2010 and March 2016...
February 9, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28195893/functional-outcomes-and-complications-of-robot-assisted-free-flap-oropharyngeal-reconstruction
#17
Yueh-Chi Tsai, Shih-An Liu, Chih-Sheng Lai, Yen-Wei Chen, Chen-Te Lu, Jung-Hsing Yen, I-Chen Chen
BACKGROUND: Robotic surgical systems provide a clear, magnified 3-dimensional visualization as well as precise, stable instrumental movement, thereby minimizing technical difficulties that may be encountered in the surgical treatment of oropharyngeal tumors. This study assessed the outcomes of robotic-assisted free flap oropharyngeal reconstruction compared with those of conventional free flap reconstruction. MATERIALS AND METHODS: A retrospective review of 47 patients who underwent reconstructive operations using a free radial forearm fasciocutaneous flap for oropharyngeal defects was conducted over a 20-month period (May 2013-December 2014)...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28195891/simple-skin-stretching-device-in-assisted-tension-free-wound-closure
#18
Li-Fu Cheng, Jiunn-Tat Lee, Honda Hsu, Meng-Si Wu
BACKGROUND: Numerous conventional wound reconstruction methods, such as wound undermining with direct suture, skin graft, and flap surgery, can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28195888/a-novel-application-of-double-paddle-peroneal-chimeric-flap-as-external-sentinel-monitor-in-hypopharyngeal-reconstruction
#19
Jung-Hua Hsueh, Yu-Hsuan Hsieh, Ying-Sheng Lin, Yaoh-Shiang Lin, Kuo-Chung Yang, Wen-Chung Liu
OBJECTIVES: Monitoring the viability of buried free flaps in hypopharyngeal reconstruction is difficult. Various methods have been proposed to monitor these buried flaps, but limitations remain. METHOD: We present a method of using double-paddle chimeric peroneal flaps that permanently externalizes a flap skin paddle as a monitoring paddle in hypopharyngeal reconstructions. This study was performed in a medical center in southern Taiwan; between 2013 and 2015, 10 patients underwent double-paddle chimeric peroneal flap reconstruction in advanced stages of hypopharyngeal cancer...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28195002/coverage-of-tendon-exposure-after-radial-forearm-free-flap-by-the-dorsoulnar-artery-perforator-flap
#20
Rémi Foissac, Marc Benatar, Olivier Dassonville, Alexandre Bozec, Gilles Poissonnet, Olivier Camuzard
Objective This study was designed to assess the effectiveness of an alternative technique using a perforator flap to manage secondary tendon exposure after a radial forearm free flap in head and neck oncologic surgery. Study Design Prospective cohort study. Setting Plastic Reconstructive Surgery Unit, Nice University Hospital, Pasteur 2 Hospital, France. Subjects and Methods Despite its numerous advantages, the radial forearm free flap is associated with significant donor site morbidity and the risk of secondary tendon exposure...
February 1, 2017: Otolaryngology—Head and Neck Surgery
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