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https://www.readbyqxmd.com/read/27914123/extending-the-indications-for-autologous-breast-reconstruction-using-a-two-stage-modified-goldilocks-procedure-a-case-report
#1
Jean-Claude D Schwartz, Piotr P Skowronksi
Post-mastectomy reconstruction is performed using implant-based or autologous techniques. Many women refuse or are poor candidates for implant-based reconstruction. We previously described a single-stage autologous technique that was most applicable in obese women with significant ptosis that made use of the mastectomy skin flap and subcutaneous tissue to reconstruct a breast mound. Here, we extend this technique to smaller breasted women by incorporating a second stage of skin tailoring and fat grafting. This technique does not require donor site surgery nor extended operative and recovery times...
December 3, 2016: Breast Journal
https://www.readbyqxmd.com/read/27913969/laser-photobiomodulation-830-and-660%C3%A2-nm-in-mast-cells-vegf-fgf-and-cd34-of-the-musculocutaneous-flap-in-rats-submitted-to-nicotine
#2
Lais Mara Siqueira das Neves, Gabriella de Paula Marcondes Ferreira Leite, Alexandre Marcio Marcolino, Carlos Eduardo Pinfildi, Sérgio Britto Garcia, João Eduardo de Araújo, Elaine Caldeira de Oliveira Guirro
The aim of this study was to investigate the effect of laser photobiomodulation (PBM) on the viability of the transverse rectus abdominis musculocutaneous (TRAM) flap in rats subjected to the action of nicotine. We evaluated 60 albino Wistar rats, divided into six groups of ten animals. Group 1 (saline) underwent the surgical technique to obtain a TRAM flap; group 2 (laser 830 nm) underwent the surgical technique and was irradiated with a laser 830 nm; group 3 (laser 660 nm) underwent the surgical technique and was irradiated with a laser 660 nm; group 4 was treated with nicotine subcutaneously (2 mg/kg/2×/day/4 weeks) and underwent surgery; group 5 (nicotine + laser 830 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 830 nm; group 6 (nicotine + laser 660 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 660 nm...
December 2, 2016: Lasers in Medical Science
https://www.readbyqxmd.com/read/27913719/surgical-site-infections-in-major-head-and-neck-surgeries-involving-pedicled-flap-reconstruction
#3
Neerav Goyal, Bharat B Yarlagadda, Daniel G Deschler, Kevin S Emerick, Derrick T Lin, Debbie L Rich, James W Rocco, Marlene L Durand
OBJECTIVE: To evaluate surgical site infections (SSI) after pedicled reconstruction in head and neck surgery. METHODS: Records of patients with pedicled flap reconstructions between 2009 and 2014 at Massachusetts Eye and Ear were reviewed. Onset of SSI or fistula ≤30 days postoperatively was noted. A free flap cohort was reviewed for comparison. RESULTS: Two hundred and eight pedicled reconstructions were performed for cancer (83%), osteoradionecrosis (7%), and other reasons (10%)...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27912770/endometriosis-associated-clear-cell-carcinoma-arising-in-caesarean-section-scar-a-case-report-and-review-of-the-literature
#4
Gabriella Ferrandina, Eleonora Palluzzi, Francesco Fanfani, Stefano Gentileschi, Anna Lia Valentini, Maria Vittoria Mattoli, Ilaria Pennacchia, Giovanni Scambia, Gianfranco Zannoni
BACKGROUND: Malignant transformation has been reported in approximately 1% of the endometriosis cases; herein, we report a case of clear cell endometrial carcinoma arising from endometriosis foci located within a caesarean section scar. CASE PRESENTATION: In November 2014, a Caucasian, 44-year-old woman was transferred to our institution because of severe respiratory failure due to massive lung embolism and rapid enlargement of a subcutaneous suprapubic mass. Abdomino-pelvic magnetic resonance showed a 10...
December 3, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27911477/vascularized-appendicular-lymph-node-transfer-for-treatment-of-extremity-lymphedema-a-case-report
#5
Pedro Ciudad, Oscar J Manrique, Shivprasad Date, Wei-Ling Chang, Fabio Nicoli, Stamatis Sapountzis, Hsu-Tang Cheng, Agko Mouchammed, Hung-Chi Chen
Vascularized lymph node transfer has demonstrated promising results for the treatment of extremity lymphedema. In an attempt to find the ideal donor site, several vascularized lymph nodes have been described. Each has a common goal of decreasing morbidity and avoiding iatrogenic lymphedema while obtaining good clinical results. Herein, we present the preliminary clinical outcomes of an intra-abdominal lymph node flap option based on the appendicular artery and vein used for the treatment of extremity lymphedema...
December 2, 2016: Microsurgery
https://www.readbyqxmd.com/read/27911448/inverted-internal-limiting-membrane-flap-technique-as-a-useful-procedure-for-macular-hole-associated-retinal-detachment-in-highly-myopic-eyes
#6
H Sasaki, A Shiono, J Kogo, R Yomoda, Y Munemasa, M Syoda, H Otake, H Kurihara, Y Kitaoka, H Takagi
PurposeTo determine whether the inverted internal limiting membrane (ILM) flap technique contributes to high reattachment and closure rates in patients with macular hole-associated retinal detachment (MHRD).Patients and methodsIn all, 15 eyes of 15 patients with MHRD undergoing 25-gauge pars plana vitrectomy with the inverted ILM flap technique or ILM peeling. The patients were divided into the inverted ILM flap technique group (6 eyes) and ILM peeling group (9 eyes). The logarithm of minimal angle of resolution best-corrected visual acuity (BCVA) and retinal attachment and macular hole closure rates were compared between the two groups before and after surgery...
December 2, 2016: Eye
https://www.readbyqxmd.com/read/27909467/invasive-squamous-cell-carcinoma-of-the-scalp-and-calvarium-a-multidisciplinary-approach
#7
Jennifer Stark, Silvio Podda, Karen Szymanski
Objective: The correlation between immunosuppression-associated skin cancer and lymphoma has been well established. This includes squamous cell carcinoma and chronic lymphocytic leukemia. When a lesion requires excision, reconstruction can be challenging based on the depth and size of the tumor. We present a patient with chronic lymphocytic leukemia and invasive squamous cell carcinoma of the scalp that extended through the calvarium to the dura mater. His tumors were badly neglected for a long period of time and presented at an advanced stage...
2016: Eplasty
https://www.readbyqxmd.com/read/27908574/reconstruction-of-a-post-traumatic-maxillary-ridge-using-a-radial-forearm-free-flap-and-immediate-tissue-engineering-bone-morphogenetic-protein-bone-marrow-aspirate-concentrate-and-cortical-cancellous-bone-case-report
#8
James C Melville, Ramzey Tursun, J Marshall Green, Robert E Marx
The purpose of this article is to describe reconstruction of the maxillary alveolar ridge by use of a microvascular free flap combined with an immediate tissue-engineered bone graft. This novel surgical technique involved the use of a radial forearm free flap and immediate allogeneic avascular bone graft augmented with bone morphogenetic protein and bone marrow aspirate concentrate. A poly-d,l-lactic acid mesh was used a containment unit for the bone graft. The patient was successfully treated with a viable radial forearm free flap for soft tissue and regeneration of bone with adequate height and width, which allowed the placement of 3 dental implants with excellent arch coordination...
November 9, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27908370/graft-use-in-bulbar-urethroplasty
#9
REVIEW
Mya E Levy, Sean P Elliott
The gold standard for bulbar urethroplasty has been excision and primary anastomosis. Application of this approach is generally limited to strictures that are 2 cm or less in the bulbar urethra due to penile shortening. Strictures greater than 2 cm are successfully treated with augmentation urethroplasty wherein the narrowed segment is not excised but widened with the use of a skin flap or a tissue graft. Buccal mucosa is the most prevalent tissue for bulbar urethral stricture repair for strictures greater than 2 cm...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908367/use-of-alternative-techniques-and-grafts-in-urethroplasty
#10
REVIEW
Brendan Michael Browne, Alex J Vanni
The current management for complex urethral strictures commonly uses open reconstruction with buccal mucosa urethroplasty. However, there are multiple situations whereby buccal mucosa is inadequate (eg, pan-urethral stricture or prior buccal harvest) or inappropriate for utilization (eg, heavy tobacco use or oral radiation). Multiple options exist for use as alternatives or adjuncts to buccal mucosa in complex urethral strictures. This article reviews the current state of alternate techniques for urethral stricture treatment besides buccal mucosa, including injectable antifibrotic agents, augmentation urethroplasty with skin flaps, lingual mucosa, colonic mucosa, and new developments in tissue engineering for urethral graft material...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908364/management-of-urethral-strictures-after-hypospadias-repair
#11
REVIEW
Warren T Snodgrass, Nicol C Bush
Strictures of the neourethra after hypospadias surgery are more common after skin flap repairs than urethral plate or neo-plate tubularizations. The diagnosis of stricture after hypospadias repair is suspected based on symptoms of stranguria, urinary retention, and/or urinary tract infection. It is confirmed by urethroscopy during anticipated repair, without preoperative urethrography. The most common repairs for neourethra stricture after hypospadias surgery are single-stage dorsal inlay graft and 2-stage labial mucosa replacement urethroplasty...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27906851/silk-ligation-delay-for-the-random-pattern-flap
#12
Lei Liu, Chen Zhang, Haizhou Tong, Tao Song, Ningbei Yin, Haidong Li, Zhenmin Zhao
OBJECTIVE: The purpose of this study is to explore a silk ligation delay for the expanded and unexpanded random flaps to improve the vascularization and survival length of the flap. METHODS: Marked incision points 2 to 3 cm at every interval along the design line with methylene blue, each incision was about 3 mm long. A subepidermal tunnel was formed on the superfacial layer of dermis between every adjacent incision; another gap was done on the surface of the expander...
November 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27905335/incidence-of-short-term-complications-and-associated-factors-after-primary-trabeculectomy-in-chiang-mai-university-hospital
#13
Thidarat Leeungurasatien, Preeyanuch Khunsongkiet, Kassara Pathanapitoon, Damrong Wiwatwongwana
BACKGROUND: To determine the incidence of early postoperative complications and associated factors after primary trabeculectomy in Thai glaucoma patients. DESIGN: This was a retrospective observational study performed in Chiang Mai University Hospital. PARTICIPANTS: One hundred and eighteen glaucoma patients participated in the study. METHODS: All glaucoma patients underwent primary trabeculectomy with mitomycin C (MMC) using fornix-based conjunctival flap technique between December 2011 and May 2013...
October 2016: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/27904754/polymethylmethacrylate-imbedded-with-antibiotics-cranioplasty-an-infection-solution-for-moderate-and-large-defects-reconstruction
#14
Paulo Valdeci Worm, Tobias Ludwig do Nascimento, Fabricio do Couto Nicola, Eduardo Farias Sanches, Carlos Fernando Dos Santos Moreira, Luiz Pedro Willimann Rogério, Marcelo Martins Dos Reis, Guilherme Finger, Marcus Vinicius Martins Collares
BACKGROUND: In cases where autologous bone graft reconstruction is not possible (such as comminuted fractures, bone graft reabsorption, or infection) and the use of synthetic material is required, polymethylmethacrylate (PMMA) use is a safe and efficient solution. Studies comparing the incidence of postoperative complications between autologous and synthetic cranioplasty are heterogeneous, not allowing a conclusion of which is the best material for skull defects reconstruction. Current medical literature lacks prospective well-delineated studies with long-term follow-up that analyze the impact of antibiotic use in PMMA cranial reconstruction of moderate and large defects...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27904753/skin-flap-complications-after-decompressive-craniectomy-and-cranioplasty-proposal-of-classification-and-treatment-options
#15
Alessandro Di Rienzo, Pier Paol Pangrazi, Michele Riccio, Roberto Colasanti, Ilaria Ghetti, Maurizio Iacoangeli
BACKGROUND: The list of complications reported after decompressive craniectomy (DC) and cranioplasty is progressively increasing. Nonetheless, the exact incidence of these events is still ill-defined. Problems affecting skin flaps after DC and cranioplasty have never been accurately analyzed in papers and their impact on patients' prognosis is largely underestimated. METHODS: In a 10-year time, we treated by DC 450 patients, 344 of whom underwent cranioplasty, either with autologous bone or artificial implants (hydroxyapatite, polyetheretherketone, titanium, polymethylmethacrylate)...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27904728/reconstruction-of-postburn-contracture-of-the-forefoot-using-the-anterolateral-thigh-flap
#16
Sang Hyun Lee, Sung Jin An, Nu Ri Kim, Um Ji Kim, Jeung Il Kim
BACKGROUND: Severe forefoot deformities, particularly those involving the dorsum of the foot, cause inconvenience in daily activities of living including moderate pain on the dorsal aspect of the contracted foot while walking and difficulty in wearing nonsupportive shoes due to toe contractures. This paper presents clinical results of reconstruction of severe forefoot deformity using the anterolateral thigh (ALT) free flap. METHODS: Severe forefoot deformities were reconstructed using ALT flaps in 7 patients (8 cases) between March 2012 and December 2015...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27904649/fasciocutaneous-flap-reinforcement-of-ventral-onlay-buccal-mucosa-grafts-enables-neophallus-revision-urethroplasty
#17
Stelios C Wilson, John T Stranix, Kiranpreet Khurana, Shane D Morrison, Jamie P Levine, Lee C Zhao
BACKGROUND: Urethral strictures or fistulas are common complications after phalloplasty. Neourethral defects pose a difficult reconstructive challenge using standard techniques as there is generally insufficient ventral tissue to support a graft urethroplasty. We report our experience with local fasciocutaneous flaps for support of ventrally-placed buccal mucosal grafts (BMGs) in phalloplasty. METHODS: A retrospective review of patients who underwent phalloplasty and subsequently required revision urethroplasty using BMGs between 2011 and 2015 was completed...
December 2016: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/27904429/there-are-no-differences-between-factors-determining-graft-infection-in-autologous-bone-flap-replacement-and-acrylic-cranioplasty-a-prospective-observational-study-at-hospital-kuala-lumpur
#18
Siti Azleen Mohamad, Mohd Safari Mohd Haspani, Badrisyah Idris
OBJECTIVES: This study, conducted in 2012, was performed to determine the incidence of graft infection after cranioplasty procedures and factors affecting the graft infection rate at Hospital Kuala Lumpur (HKL). METHODOLOGY: This was an observational cross-sectional case study of patients who have undergone cranioplasty at HKL over a period of one year (2012). One hundred seventy-two patients were included in the study. A total of 105 (61.8%) cases were autologous bone flap replacements, and 67 (38...
September 2016: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/27903119/the-learning-curve-in-endoscopic-endonasal-resection-of-craniopharyngiomas
#19
Varun R Kshettry, Hyunwoo Do, Khaled Elshazly, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
OBJECTIVE There is a paucity of literature regarding the learning curve associated with performing endoscopic endonasal cranial base surgery. The purpose of this study was to determine to what extent a learning curve might exist for endoscopic endonasal resection in cases of craniopharyngiomas. METHODS A retrospective review was performed for all endoscopic endonasal craniopharyngioma resections performed at Thomas Jefferson University from 2005 to 2015. To assess for a learning curve effect, patients were divided into an early cohort (2005-2009, n = 20) and a late cohort (2010-2015, n = 23)...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27903020/dynamic-decompressive-craniotomy-with-a-novel-reversibly-expandable-plate
#20
Rohit Khanna
Objective To assess the feasibility of a dynamic craniotomy procedure with the use of a novel reversibly expandable cranial bone flap fixation plate. The expandable plate allows outward bone flap migration with an increase in intracranial volume or intracranial pressure (ICP). Methods Dynamic craniotomy intracranial hypertension compliance was evaluated in a skull model with progressive increase in intracranial volume and compared with the standard craniotomy with fixed plates. Results Dynamic craniotomy provided significant control of ICP with increasing intracranial volume compared with the standard craniotomy...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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