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https://www.readbyqxmd.com/read/29777840/negative-pressure-wound-therapy-to-promote-fixation-and-remodeling-of-omental-flap-in-patients-with-revascularized-limbs-a-case-series
#1
Nicla Settembre, Mario D'oria, Charbel Saba, Zakariyae Bouziane, Sergueï Malikov
We present our experience with five patients with CLTI treated with distal revascularization and omental flap coverage. We decided to investigate the efficacy and safety of NPWT (negative-pressure wound therapy) in promoting the fixation and remodeling of the omental flap as there is some evidence in the literature about the optimization of results for skin graft and dermal substitutes. Surgical revascularization was always the first procedure attempted; wound coverage was realized 3-5 days after the primary procedure (omental free-flap in three patients and omental flow-through flap in two patients)...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29776771/association-between-pain-severity-and-clinicohistopathologic-findings-in-the-mandibular-canal-and-inferior-alveolar-nerve-of-patients-with-advanced-mandibular-osteoradionecrosis
#2
Yujiro Hiraoka, Masaya Akashi, Satoshi Wanifuchi, Junya Kusumoto, Manabu Shigeoka, Takumi Hasegawa, Kazunobu Hashikawa, Hiroto Terashi, Takahide Komori
OBJECTIVE: Pain is one of the most problematic symptoms in patients with osteoradionecrosis of the jaws. This study investigated the associations between pain severity and morphologic alterations of the mandibular canal and inferior alveolar nerve, in respective computerized tomography images and resected specimens of mandibular osteoradionecrosis. STUDY DESIGN: We assessed 14 lesions in 13 patients who underwent segmental mandibulectomy for surgical debridement and simultaneous reconstruction with free fibula flap (1 patient exhibited bilateral lesions)...
April 16, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29775983/classification-and-microvascular-flap-selection-for-anterior-cranial-fossa-reconstruction
#3
James D Vargo, Wojciech Przylecki, Paul J Camarata, Brian T Andrews
BACKGROUND:  Microvascular reconstruction of the anterior cranial fossa (ACF) creates difficult challenges. Reconstructive goals and flap selection vary based on the defect location within the ACF. This study evaluates the feasibility and reliability of free tissue transfer for salvage reconstruction of low, middle, and high ACF defects. METHODS:  A retrospective review was performed. Reconstructions were anatomically classified as low (anterior skull base), middle (frontal bar/sinus), and high (frontal bone/soft tissue)...
May 18, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29773240/perioperative-risk-factors-that-predict-complications-of-radial-forearm-free-flaps-in-oral-and-maxillofacial-reconstruction
#4
C Wang, G Fu, F Liu, L Liu, M Cao
The aim of the study was to find out what perioperative risk factors predicted complications in patients having reconstructions with radial forearm free flaps (RFFF). We organised a retrospective study of 169 patients (mean (range) age 54 (22-86) years, 100 of whom were female) who had oral and maxillofacial tumours resected, and reconstructed with RFFF, from January 2011-December 2016. We recorded predictive variables, subdivided into: personal and clinical (sex, age, weight, coexisting conditions, history of smoking, radiotherapy, and primary lesions); haemodynamic (perioperative concentrations of haemoglobin and albumin, blood loss, blood transfusion, urinary output (ml), and rate (ml/kg/hour), and infusion rates for crystalloids and colloids (ml/kg/hour, and volumes given intraoperatively and postoperatively for 24hours); and anaesthetic and surgical (American Society of Anesthesiologists(ASA) grade, visual analogue pain score (VAS), and duration of tourniquet and operation)...
May 14, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29772322/free-omental-flap-for-tissue-defect-coverage-after-resection-of-complicated-venous-malformation-in-the-area-of-the-knee
#5
Nicla Settembre, Mario D'Oria, Lucie DekerlE, Charbel Saba, Zakariyae Bouziane, Serguei Malikov
Venous malformations are the most common slow-flow vascular malformations; they are not prone to volume decrease over time and invasive treatment is usually required. There are two main techniques to address the definitive therapy of these lesions: sclerotherapy and surgical excision, each with its own advantages and disadvantages. We report the case of a 56 year-old man who came to our attention with persistent pain after multiple unsuccessful attempts to treat a large venous malformation located in the area of the right knee...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29771356/versatility-of-dorsal-metacarpal-artery-flaps-for-hand-burns
#6
Jennel M Carreras, Catherine McGee, Faisal Al-Mufarrej
Burns to the hands can be devastating injuries and early debridement and coverage can prevent these chronic problems. Reconstructive options for these defects include skin grafts, local, regional and distant flaps as well as free flaps. In this series we set out to demonstrate the versatility, durability and effectiveness of dorsal metacarpal artery flaps for primary soft tissue coverage This study involves a review of all consecutive patients who underwent acute soft tissue coverage using dorsal metacarpal artery flaps at our institution from December 2014 to December 2017...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29768632/lower-extremity-limb-salvage-with-cross-leg-pedicle-flap-cross-leg-free-flap-and-cross-leg-vascular-cable-bridge-flap
#7
Oscar J Manrique, Sarah N Bishop, Pedro Ciudad, Kian Adabi, Jorys Martinez-Jorge, Steven L Moran, Tony Huang, Aparna Vijayasekaran, Shih-Heng Chen, Hung-Chi Chen
BACKGROUND:  Lower extremity salvage following significant soft tissue loss can be complicated by lack of recipient vessel for free tissue transfer. We describe our experience in lower limb salvage for patients with no recipient vessels with the use of pedicle, free and cable bridge flaps. METHODS:  A retrospective review from 1985 to 2017 of patients undergoing lower limb salvage using a contralateral pedicle cross leg (PCL) flaps, free cross leg (FCL) flaps, or free cable bridge (FCB) flaps was conducted...
May 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29763499/flap-management-in-alveolar-ridge-preservation-a-systematic-review-and-meta-analysis
#8
Jungwon Lee, Jun-Beom Lee, Ki-Tae Koo, Yang-Jo Seol, Yong-Moo Lee
PURPOSE: This systematic review aimed to identify the effects of certain flap management procedures on ridge preservation on the basis of existing literature. MATERIALS AND METHODS: Electronic (MEDLINE, EMBASE, and Cochrane Central Register of controlled trials) and manual searches of the literature were conducted until February 2017. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), and prospective cohort studies that involved at least 10 subjects were eligible for this systematic review...
May 2018: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/29762451/modified-design-of-anterolateral-thigh-flap-for-total-pharyngolaryngectomy-reconstruction-a-single-center-experience
#9
Li-Yen Cheng, Cha-Chun Chen, Hwang-Chi Lin, Chu-Hsu Jeng, Shang-Hsi Lin, Wei-Nung Jim Chen, Yu-Hsien Lin, Sheng-Po Hao
BACKGROUND: Defects after total pharyngolaryngectomy for hypopharyngeal cancer often require reconstruction via free tissue transfer. Recently, anterolateral thigh (ALT) flap has become the gold standard in many centers because of its advantages with respect to versatility, minimal donor-site morbidity, good speech quality, and relatively low fistula and anastomotic leakage rates. Moreover, ALT allows 2 surgical teams to work simultaneously. However, the height of the parallelogram in the ALT design for neoesophagus reconstruction is usually set at a minimum of 9...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762448/pectoralis-major-musculocutaneous-flap-with-a-midline-sternal-skin-paddle-for-head-and-neck-reconstruction-a-new-design
#10
Jeongseok Oh, Hee Chang Ahn, Seungki Youn, Kyung Tae
PURPOSE: The pectoralis major musculocutaneous (PMMC) flap is a classic flap for head and neck reconstruction, relatively unpopular with the advancement of microsurgery and free flaps. The classic parasternal paddle design provided a thick flap with a small rotation arch leaving objectionable scarring. Our new symmetric midsternal design overcomes these problems. METHODS: Chart review was done from the years 2000 to 2017. Flap skin paddle was placed symmetrically on both sides of the midsternal line...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762442/postburn-neck-reconstruction-with-preexpanded-upper-back-perforator-flaps-free-style-design-and-an-update-of-treatment-strategies
#11
Haizhou Li, Zi Wang, Bin Gu, Yashan Gao, Feng Xie, Hainan Zhu, Qingfeng Li, Tao Zan
BACKGROUND: For extensive postburn neck deformities, the preexpanded flaps in the upper back region were used and gained a uniform skin appearance and esthetic contours. Free-style perforator-based free-tissue transfer that represents the most recent advance in reconstructive surgery may provide more versatility of these flaps. METHODS: We retrospectively reviewed 31 patients treated at our institution for postburn neck contracture from March 2010 to May 2016. Various upper back flaps were designed according to the dominant perforators and the shape of the defect after fully releasing the neck contracture...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762440/reconstruction-of-extensive-post-electric-burn-scalp-defects-with-exposed-bones-a-study-of-12-cases
#12
Periakaruppan Jeyakumar, Alia T Hussain, Ashik R Ahamed
The scalp is a unique part of the human body with respect to its shape and position. It is the part of the body that is usually exposed in its original form, with no covering by any means of clothing. In workplaces, especially in the electrical industry in the area of electrical substations and power transmission lines it is this part of the body that can easily come in contact with high tension electrical wires. Others who can be prone to suffer such injuries are pedestrians, people working on heights, ladies hanging clothes on terraces...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762438/venous-anastomoses-in-anterolateral-thigh-flaps-for-the-lower-extremity-vessel-selection-in-lieu-of-obligatory-number
#13
David Mattos, Shawn Diamond, Anmol S Chattha, Johanna N Riesel, Matthew L Iorio
BACKGROUND: Dual venous drainage for anterolateral thigh flaps has been proposed to protect against flap-related complications in head and neck applications. Here we report our experience with single vs dual venous anastomosis during lower extremity free-tissue transfer. METHODS: All free anterolateral thigh flaps for lower extremity reconstruction from 2011 to 2017 were retrospectively reviewed. An algorithm was used to determine the type and number of venous anastomoses, emphasizing patient anatomy, venous quality, and size match...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762436/preoperative-analysis-of-venous-anatomy-before-deep-inferior-epigastric-perforator-free-flap-breast-reconstruction-using-ferumoxytol-enhanced-magnetic-resonance-angiography
#14
John Dortch, Antonio J Forte, Candice Bolan, Pujan Kandel, Galen Perdikis
BACKGROUND: Venous congestion after deep inferior epigastric artery perforator (DIEP) flap breast reconstruction is a complication that may be partially attributable to variations in venous abdominal wall anatomy. In previous work, we have shown that ferumoxytol may be used as a bloodpool contrast agent to perform high-resolution venous imaging. Our current aim was to use this technology to perform a detailed analysis of the venous anatomy among patients undergoing DIEP flap breast reconstruction...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762280/long-term-outcomes-of-pedicled-gastrocnemius-flaps-in-total-knee-arthroplasty
#15
Matthew T Houdek, Eric R Wagner, Cody C Wyles, William S Harmsen, Arlen D Hanssen, Michael J Taunton, Steven L Moran
BACKGROUND: Deficient soft tissue following total knee arthroplasty (TKA) can jeopardize outcome. The gastrocnemius flap is an important means of providing coverage of a knee with deficient soft tissue. There is a paucity of long-term studies on the use of the gastrocnemius flap in the setting of TKA. The purpose of this study was to review the outcomes after the use of pedicled gastrocnemius flaps for coverage of a soft-tissue defect at the time of TKA. METHODS: Eighty-three patients in whom a gastrocnemius flap had been used to cover the site of a primary (n = 18) or revision (n = 65) TKA over a 25-year period were identified...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29758368/infections-following-cranial-neurosurgery-prospective-cohort-of-103-episodes-treated-according-to-a-standardized-algorithm
#16
Nora Renz, Burcin Özdirik, Tobias Finger, Peter Vajkoczy, Andrej Trampuz
OBJECTIVE: The optimal surgical and antimicrobial treatment for intracranial infections following neurosurgery is unknown. We investigated the clinical, laboratory and microbiological characteristics of intracranial infections following neurosurgery. In addition, treatment outcome in patients treated according to a standardized algorithm was evaluated. METHODS: Consecutive patients with extradural, intradural and device-related infections following cranial neurosurgery were prospectively included...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29756364/free-jejunal-flap-transfer-with-multiple-vascular-pedicles-for-safe-and-reliable-pharyngoesophageal-reconstruction
#17
Tomoyuki Kurita, Tateki Kubo, Hiroki Tashima, Takashi Fujii
BACKGROUND: In pharyngoesophageal reconstruction, we transferred a long jejunum flap containing multiple pedicles to achieve a 100% flap survival rate, and used the redundant mesentery to cover important tissues and fill in the dead space to reduce common postoperative complications, such as surgical site infections and fistula formation. METHODS: A total of 243 jejunal flap transfers with multiple vascular anastomoses were reviewed to examine flap survival and rates of early postoperative complications, such as surgical site infections and fistula formation, perioperative mortality, and donor site morbidity...
May 13, 2018: Head & Neck
https://www.readbyqxmd.com/read/29756302/velopharyngeal-dysfunction-from-intranasal-substance-abuse-case-series-and-review-of-literature
#18
Peng You, Linda Chow, Anne Dworschak-Stokan, Murad Husein
OBJECTIVE: Intranasal substance abuse with cocaine or opioids can result in complications involving the midline nasal and oral structures. When the defect involves the velopharyngeal musculature, this leads to velopharyngeal dysfunction (VPD). This article aims to illustrate this clinical entity through a series of four patients and a review of the literature. METHODS: A series of four cases of VPD due to intranasal narcotic use and their management are discussed...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29754975/endoscopic-endonasal-double-flap-technique-for-reconstruction-of-large-anterior-skull-base-defects-technical-note
#19
Ricardo Landini Lutaif Dolci, Alexandre Bossi Todeschini, Américo Rubens Leite Dos Santos, Paulo Roberto Lazarini
INTRODUCTION: One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base. OBJECTIVE: Describe the technique of performing endoscopic double flap multi-layered reconstruction of the anterior skull base without craniotomy...
April 19, 2018: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29753451/single-stage-reconstruction-of-post-traumatic-and-post-excisional-composite-perigenual-defects-using-chimeric-pedicled-propelled-osteomyocutaneous-fibula-flap
#20
T M Balakrishnan, Sruthi Sridhar, J Jaganmohan, Hemantha Kumar Govinda Rajan, Singaravadivelu Vaidyanathan
INTRODUCTION: Composite perigenual defects (CPGDs) are exacting the expertise of the reconstructive surgeons. Segmental skeletal defects continue to be a challenge for both orthopedic and plastic surgeons. There are many techniques available for the reconstruction of segmental skeletal defects in the perigenual region. This study explores the outcomes of pedicled chimeric propelled osteomyocutaneous fibula flap reconstruction of post traumatic and post excisional composite perigenual defects (CPGDs) MATERIALS AND METHODS: It was a retrospective study conducted from 2011 to 2016 including 16 patients (5 post excisional defects and 11 post traumatic defects)...
April 27, 2018: Injury
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