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https://www.readbyqxmd.com/read/28444768/implantable-doppler-monitoring-of-buried-free-flaps-during-vascularized-lymph-node-transfer
#1
Chad M Teven, Adrian S H Ooi, Amir Inbal, David W Chang
BACKGROUND AND OBJECTIVES: Reliable flap monitoring is crucial to the success of free tissue transfer, including vascularized lymph node transfer (VLNT). However, no large-scale study has examined implantable Doppler monitoring in VLNT. We aimed to determine whether an implantable Doppler system can reliably monitor flap perfusion during VLNT and also to calculate the sensitivity and specificity of this system for detecting compromise in the monitored vessel. METHODS: An analysis of prospectively collected data of patients who underwent buried VLNT with implantable Doppler monitoring between 2014 and 2015 was performed...
April 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28441805/-free-medial-thigh-chimeric-myocutaneous-perforator-flap-for-the-reconstruction-of-tongue-defect-after-tongue-carcinoma-resection
#2
D J Song, Z Li, X Zhou, Y X Zhang, X W Peng, B Zhou, C L Lyu, W Peng, X Wang, Y Ou
Objective: To investigate the application of free medial thigh chimeric myocutaneous perforator flap in the reconstruction of tongue defect after radical resection of tongue carcinoma. Methods: From June 2013 to November 2015, 17 cases with tongue carcinoma underwent radical resection and tongue and mouth floor defects after surgery were reconstructed with medial thigh chimeric myocutaneous perforator flaps at the same stage. These 17 cases included tongue carcinoma on lingual margin (n=9), ventral tongue (n=7) and mouth floor (n=1)...
April 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28441303/surgical-techniques-for-closure-of-a-scalp-defect-after-resection-of-skin-malignancy
#3
Maciej Rysz, Dariusz Grzelecki, Maciej Mazurek, Stanisław Starościak, Romuald Krajewski
BACKGROUND: Surgery for scalp malignancies is aimed at the complete resection and a good aesthetic outcome. The goal was to develop an algorithm for scalp reconstruction based on the authors' surgical experience. METHODS: This is a retrospective analysis of 123 procedures of scalp malignancies in 105 patients. Twenty eight procedures were for resection of squamous cell carcinoma, 54 for basal cell carcinoma, and 41 for suspected melanomas. RESULTS: Primary closure (27 procedures), local flap (LF; 19), split-thickness skin graft (SG; 64), rotated LF and SG (9), and free vascularized flaps (4) were used...
May 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28439444/airway-management-of-patients-undergoing-oral-cancer-surgery-a-retrospective-analysis-of-156-patients
#4
Sapna Annaji Nikhar, Ashima Sharma, Mahesh Ramdaspally, Ramachandran Gopinath
OBJECTIVE: Oral cancer patients have a potentially difficult airway, but if managed properly during the perioperative period, morbidity and mortality can be reduced or avoided. METHODS: The medical records of 156 patients who were operated for oral cancers were reviewed for airway management during the perioperative period. RESULTS: The surgical procedures ranged from excisions, wide local excisions with split skin graftings, hemiglossectomies and radical neck nodes dissections to pectoralis major myocutaneous or free fibular flaps...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28438396/the-versatile-use-of-revisited-de-epithelialization-concept-in-superficial-circumflex-iliac-and-anterolateral-thigh-perforator-free-flap-for-head-and-neck-reconstructions
#5
Jong Woo Choi, Young Chul Kim, Tae Suk Oh, Kyung S Koh, Woo Shik Jeong
BACKGROUND: Although the perforator free flap is now a standard choice for head and neck reconstruction, problems such as microvascular complications, insufficient volume support for the defect, and fistula formation occur. We revisited a de-epithelialized concept for superficial circumflex iliac artery and anterolateral thigh perforator free flap to overcome these problems. METHODS: We applied the de-epithelized perforator free flaps in 35 cases among 761 microsurgical head and neck reconstructions and investigated flap characteristics (length gain of pedicle, flap size, and volumetric analysis) and outcomes (flap failure, partial flap necrosis, hematoma, infection, and fistula)...
February 20, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28433213/three-dimensional-surgical-modelling-with-an-open-source-software-protocol-study-of-precision-and-reproducibility-in-mandibular-reconstruction-with-the-fibula-free-flap
#6
L Ganry, J Quilichini, C M Bandini, P Leyder, B Hersant, J P Meningaud
Very few surgical teams currently use totally independent and free solutions to perform three-dimensional (3D) surgical modelling for osseous free flaps in reconstructive surgery. This study assessed the precision and technical reproducibility of a 3D surgical modelling protocol using free open-source software in mandibular reconstruction with fibula free flaps and surgical guides. Precision was assessed through comparisons of the 3D surgical guide to the sterilized 3D-printed guide, determining accuracy to the millimetre level...
April 19, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28430347/hypopharyngeal-squamous-cell-carcinoma-and-laryngeal-neuroendocrine-carcinoma-colliding-in-the-aryepiglottic-fold-a-case-report
#7
Roberta Marangoni, Simone Mauramati, Giulia Bertino, Antonio Occhini, Marco Benazzo, Patrizia Morbini
PURPOSE: A collision tumor consists of 2 different histologically distinct and topographically independent tumors merging in the same mass. In the head and neck region they are rare, with only 4 cases reported in the larynx. CASE REPORT: A 60-year-old heavy smoker complained of a left submandibular lesion in October 2014. The lesion was excised and showed a poorly differentiated carcinoma, suggestive for adenocarcinoma. After a positron emission tomography-computed tomography scan showed increased metabolic activity in the left laterocervical region and right vocal cord, the patient underwent endoscopic biopsy of the lesion of the left piriform sinus, which was positive for moderately differentiated squamous cell carcinoma (SCC)...
April 14, 2017: Tumori
https://www.readbyqxmd.com/read/28427105/optimizing-outcomes-in-free-flap-breast-reconstruction-in-the-community-hospitals-setting-a-stepwise-approach-to-diep-siea-flap-procedures-with-banking-a-hemiabdominal-flap
#8
Alberto Okada, Diego Daniel Pereira, Eduardo Montag, Marcelo Portocarrero, Carlos Felício, Eduardo Gustavo Arruda, Alexandre Fonseca, Rolf Gemperli, Alexandre Mendonça Munhoz
No abstract text is available yet for this article.
April 20, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28426572/nonhealing-ulcers-in-patients-with-tophaceous-gout-a-systematic-review
#9
Gretl Lam, Frank L Ross, Ernest S Chiu
GENERAL PURPOSE: To provide information from a review of the literature about chronic ulcers associated with tophaceous gout. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1. Identify the pathophysiology of tophaceous gout, its presentation, phases, and common comorbidities...
May 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28422883/transverse-rectus-abdominis-myocutaneous-flap-for-postpneumonectomy-bronchopleural-fistula-a-case-report
#10
Jen-Wu Huang, Yi-Ying Lin, Nai-Yuan Wu, Chien-Ho Tsai
RATIONALE: Numerous types of flap coverage have been reported to prevent or to repair bronchopleural fistulas. Most of the flaps were harvested from chest area. However, these pedicled flaps might not be optimal for the patient who has undergone previous radiotherapy on pulmonary parenchyma because the pedicle artery of the flap might have been injured by irradiation. Therefore, an alternative flap outside of the chest area is necessary. PATIENT CONCERNS: A 61-year-old male was diagnosed of squamous cell carcinoma in right upper lobe lung (cT3N2M0, stage IIIa)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28420035/prospective-series-of-reconstruction-of-complex-composite-mandibulectomy-defects-with-double-island-free-fibula-flap
#11
Edward I Chang, Peirong Yu
BACKGROUND: A double island free fibula (DIFF) flap can be used for reconstruction of through-and-through or complex mandibulectomy defects, but prospective studies are lacking. METHODS: Prospective analysis of all double skin paddle fibula flaps performed from 2010 to 2016. RESULTS: Overall, 16 patients underwent reconstruction with a DIFF flap (average age: 59.1 years). One patient, who underwent a DIFF flap and developed osteoradionecrosis, requiring a second flap...
April 18, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28419844/triple-cut-computer-aided-design-computer-aided-modeling-more-oncologic-safety-added-to-precise-mandible-modeling
#12
Vittorio Ramella, Alberto Franchi, Stefano Bottosso, Giancarlo Tirelli, Federico Cesare Novati, Zoran Marij Arnež
PURPOSE: Computer-aided design-computer-aided modeling (CAD-CAM) has become standard in mandibular reconstruction because it offers better outcomes. Occasionally, the reconstructive plans need to be changed intraoperatively and the custom-made prefabricated devices may become inadequate. We present an efficient adjunct to the standard CAD-CAM technique that resolves this problem. MATERIALS AND METHODS: Customized surgical devices with our "triple-cut" concept were used in 5 patients for mandibular reconstruction with free fibula flap (4 after mandibular resection for squamous cell carcinoma and 1 after mandibular osteoradionecrosis)...
March 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28419812/defining-quality-in-head-and-neck-reconstruction
#13
Peter M Vila, Jason T Rich, Shaun C Desai
Microvascular free flap reconstruction has now become the standard of care in the reconstruction of selected head and neck defects. Although uncommon, flap failure is a catastrophic event that results in significant patient morbidity, extended length of hospitalization, and increased cost. However, there is currently no gold standard for measuring the quality of a reconstructive center. Structure and process outcomes have recently been developed, but outcome measures are still lacking. Areas for future research include preoperative nutrition, preoperative flap planning, intraoperative fluid management, appropriate thromboembolism prophylaxis, consistent perioperative antibiotic regimens, skilled ancillary staff, and clear outcome measures for performance measurement...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28419402/autologous-free-internal-limiting-membrane-flap-for-optic-nerve-head-pit-with-maculopathy
#14
Palmeera D'Souza, Upendra Babu, Venkatapathy Narendran
Optic disc pits (ODPs) are associated with serous macular detachment (SMD), which causes visual loss in 25% to 75% patients with ODPs. There are various modalities of noninvasive and invasive treatment options; however, the best method of treatment is to seal the optic disc to prevent further egress of fluid into the subretinal space. The authors report a technique that involves sealing of ODPs with autologous free flap of the internal limiting membrane (ILM). After trans pars plana vitrectomy, the ILM was peeled and plugged into the ODP...
April 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28418783/locoregional-flaps-for-oral-cavity-reconstruction-a-review-of-modern-options
#15
Urjeet A Patel, Gregory K Hartig, Matthew M Hanasono, Derrick T Lin, Jeremy D Richmon
Objective To review state-of-the-art modifications and advances in soft tissue local and regional flap reconstruction of the oral cavity and to determine the role these techniques play in current practice. Data Sources Review of the literature regarding oral cavity reconstruction. Review Methods The authors describe advances in locoregional reconstructive options and assimilate data from the literature that compare recent advances to the historic standards. Conclusions Modern advances in regional reconstruction of the oral cavity offer outstanding results and demonstrate potential advance over free tissue transfer...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28416356/risk-factors-for-free-flap-failure-a-retrospective-analysis-of-881-free-flaps-for-head-and-neck-defect-reconstruction
#16
W Zhou, W-B Zhang, Y Yu, Y Wang, C Mao, C-B Guo, G-Y Yu, X Peng
The aim of this study was to identify the risk factors for free flap failure after head and neck reconstructive surgery. The data of 881 consecutive patients who underwent free flap surgery at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, between January 2013 and November 2016, were reviewed retrospectively. All surgeries were performed by a single head and neck surgical team. Patient demographic and surgical data that may have an influence on free flap outcomes were recorded...
April 14, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28410953/spontaneous-cerebrospinal-fluid-fistula-in-the-clivus
#17
A Codina Aroca, J R Gras Cabrerizo, M De Juan Delago, H Massegur Solench
INTRODUCTION: Spontaneous cerebrospinal fluid (CSF) fistulas are infrequent and only 10 cases in the literature have been located in the clivus. We describe two new cases of CSF fistulas in this site and review the literature. CASE REPORT: The first patient was a 52-year-old woman referred to our centre for intermittent rhinorrhea that had been diagnosed after an episode of meningitis. The second case was a 69-year-old man who was visited for rhinorrhea of one-year duration; he also developed meningitis during the preoperative study...
April 11, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28410938/preservation-of-devitalized-bone-in-necrotic-digits-following-crush-injury-with-free-tissue-transfer
#18
Fei Song, Yongwei Pan, Zhe Zhao, Jiuzheng Deng, Changjiao Sun
Traditional management of necrotic digits has been to allow demarcation between viable and nonviable tissues to occur, and thus to indicate the level of amputation required. In this case report, the phalangeal length of the necrotic thumb was maintained in 2 patients who had sustained crush injury. After nonviable soft tissues were debrided, the devitalized bones were covered with soft tissue flaps. All wounds healed without infection. Both cosmetic and functional results of the reconstructed thumbs were satisfactory...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28407317/reconstruction-of-quadriceps-function-with-composite-free-tissue-transfers-following-sarcoma-resection
#19
Kempland C Walley, Erin M Taylor, Megan Anderson, Santiago Lozano-Calderon, Matthew L Iorio
BACKGROUND AND OBJECTIVES Wide margin resection of a soft tissue sarcoma (STS) may require extensive removal of quadriceps muscle with or without the knee extensor mechanism. The objective of this study is to present present the use of a combined functional muscle transfer and soft tissue coverage through the use of chimeric anterolateral thigh flaps. METHODS: Patients were retrospectively reviewed who underwent deep STS resection of the anterior compartment of the thigh with functional reconstruction of knee extension using a contralateral free anterolateral thigh (ALT) flap...
April 13, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28404211/intraoperative-real-time-assessment-of-blood-flow-using-indocyanine-green-angiography-after-anastomoses-in-free-flap-reconstructions
#20
T Eguchi, K Kawaguchi, A Basugi, I Kanai, Y Hamada
No abstract text is available yet for this article.
April 9, 2017: British Journal of Oral & Maxillofacial Surgery
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