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https://www.readbyqxmd.com/read/29346711/early-assessment-of-post-surgical-outcomes-with-pre-pectoral-breast-reconstruction-a-literature-review-and-meta-analysis
#1
Abhishek Chatterjee, Maurice Y Nahabedian, Allen Gabriel, David Macarios, Mousam Parekh, Fang Wang, Leah Griffin, Steven Sigalove
BACKGROUND: Pre-pectoral breast reconstruction is an emerging surgical approach. This study provides an early assessment of outcomes with the technique. METHODS: A comprehensive literature review was performed through searches of PubMed® /MEDLINE® to identify studies on pre-pectoral reconstruction. Patient characteristics and outcomes were extracted from studies and pooled. Linear relationships between complication rates and patient characteristics with pre-pectoral reconstruction were analyzed...
January 18, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29346567/epithelial-grafting-of-a-decellularized-whole-tracheal-segment-an-in-vivo-experimental-model
#2
Margot Den Hondt, Bart M Vanaudenaerde, Eric K Verbeken, Jan J Vranckx
OBJECTIVES: Prerequisites for successful trachea transplantation include the use of a biocompatible construct, submucosal vascularization and an epithelial covering. Implantation of non-epithelialized tracheal scaffolds may lead to stenosis. However, epithelial grafting or seeding can only be attempted onto a well-vascularized submucosal bed. Our aim was to investigate a method to prevent stenosis during prelamination of non-epithelialized, gently decellularized rabbit tracheae and to evaluate whether grafting of revascularized constructs with buccal mucosa is feasible...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29346148/vertical-profunda-artery-perforator-flap-for-plantar-foot-wound-closure-a-new-application
#3
Allyson R Alfonso, James L Mayo, Vishal K Sharma, Robert J Allen, Ernest S Chiu
BACKGROUND: Plantar foot reconstruction requires special consideration of both form and function. There are several fasciocutaneous flap options, each with indications and reservations. CASE STUDY: This case presents a new application of the vertical profunda artery perforator flap for definitive closure of a neuropathic foot ulcer in a young woman with spina bifida. The postoperative course was uneventful, and the flap survived completely. The surgical and donor sites were without wound recurrence at 5-month follow-up...
February 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29345722/morphometric-properties-of-the-tensor-fascia-lata-muscle-in-human-fetuses
#4
Orhan Beger, Turan Koç, Burhan Beger, Deniz Uzmansel, Zeliha Kurtoğlu
In neonatal and early childhood surgeries such as meningomyelocele repairs, closing deep wounds and oncological treatment, tensor fasciae lata (TFL) flaps are used. However, there are not enough data about structural properties of TFL in fetuses, which can be considered as the closest to neonates in terms of sampling. This study's main objective is to gather data about morphological structures of TFL in human fetuses to be used in newborn surgery. Fifty formalin-fixed fetuses (24 Male - 26 Female) with gestational age ranging from 18 - 30 weeks (mean 22...
January 18, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29344982/experience-with-pharmacologic-leeching-with-bivalirudin-for-adjunct-treatment-of-venous-congestion-of-head-and-neck-reconstructive-flaps
#5
Aisha Harun, Rachel M Kruer, Andrew Lee, Kofi Boahene, Patrick J Byrne, Jeremy D Richmon
OBJECTIVES: The goal of this study was to review the feasibility of local bivalirudin injection for adjunct treatment of venous congestion of head and neck reconstructive flaps. METHODS: A retrospective chart review of patients who underwent bivalirudin treatment for venous congestion of head and neck reconstructive flaps in a single institution from September 1, 2012 to September 1, 2015 was undertaken. Individuals were treated with variable number of intradermal injections directly into the flap followed by a small skin incision to allow extended passive bleeding...
January 18, 2018: Microsurgery
https://www.readbyqxmd.com/read/29344785/laparoscopic-intracorporeal-rectus-aponeuroplasty-lira-technique-a-step-forward-in-minimally-invasive-abdominal-wall-reconstruction-for-ventral-hernia-repair-lvhr
#6
Julio Gómez-Menchero, Juan Francisco Guadalajara Jurado, Juan Manuel Suárez Grau, Juan Antonio Bellido Luque, Joaquin Luis García Moreno, Isaías Alarcón Del Agua, Salvador Morales-Conde
BACKGROUND: Closing the defect (CD) during laparoscopic ventral hernia repair began to be performed in order to decrease seroma, to improve the functionality of the abdominal wall, and to decrease the bulging effect. However, tension at the incision after CD in large defects is related to an increased rate of pain and recurrence. We present the preliminary results of a new technique for medium midline hernias as an alternative to conventional CD. METHODS: A prospective controlled study was conducted from January 2015 to January 2017 to evaluate an elective new procedure (LIRA) performed on patients with midline ventral hernias (4-10 cm width)...
January 17, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29343899/flap-cover-in-a-patient-with-severe-haemophilia-type-a
#7
Narender Manickavachakan, Sunderraj Ellur, Vijay Thomas Mattyoo Joseph, Jonathan Victor, Cecil R Ross
Haemophilia A is a rare haematological disorder due to deficiency of Factor VIII, causing an abnormal coagulation response to injury. In severe haemophilia A, Factor VIII level is < 1%, often manifesting with spontaneous bleeding into joints. Judicious use of recombinant Factor VIII therapy to maintain adequate levels in the intraoperative, immediate and late post-operative periods, together with adjuvant pro-coagulants, can ensure a safe outcome following surgery. We describe the successful management of one such patient suffering from Marjolin's ulcer of the right gluteal region, who needed wide local excision followed by flap cover...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29343897/contralateral-lumbo-umbilical-flap-a-versatile-technique-for-volar-finger-coverage
#8
Akram Hussain Bijli, Sheikh Adil Bashir, Altaf Rasool, Mir Yasir, Adil Hafeez Wani, Tanveer Ahmad, Mushtaq Ahmad
Background: While contemplating any difficult soft tissue reconstruction, patient comfort and compliance is of paramount importance. Reconstruction of the volar aspect of fingers and hand by the ipsilateral pedicled flaps (groin flap, abdominal flaps) is demanding as the flap inset is difficult for the surgeon and very uncomfortable for the patient. This often leads to flap complications. For the comfort of the patient, better compliance and ease of complete inset, we planned to manage soft tissue defects of the volar aspect of fingers and hand by a new contralateral pedicled lumbo-umbilical flap...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29343895/why-borrow-from-peter-when-paul-can-afford-it-reverse-homodigital-artery-flap-for-fingertip-reconstruction
#9
Narayanamurthy Sundaramurthy, Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj
Background: Fingertip injuries that are complicated by pulp loss, bone or tendon exposure will need a flap cover. Cross finger flap is commonly used to cover such defects. However, patients are apprehensive about injuring the uninjured finger as a donor site. Reverse homodigital artery flap (RHAF) can provide reliable vascularised cover to such defects. Aims: This study aims to assess the functional and aesthetic outcomes along with the patient satisfaction of RHAFs done for fingertip defects...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29343893/assessment-of-perfusion-of-free-flaps-used-in-head-and-neck-reconstruction-using-pulsatility-index
#10
Akshay Kapoor, Malay Karmakar, Collin Roy, Kaushal Priya Anand
Objective: To detect venous or arterial obstruction in the pedicle of a free flap we can monitor resistance in the flap bed which is reflected in Pulsatility Index (PI) Therefore if we detect change in the values of the PI in these flaps then we can detect complications in flap due to vascular insufficiency early. Materials and Methods: Seven patients of Free Fibular Flap Reconstruction and ten patients of Free Radial Forearm Flap reconstruction were evaluated over a period of 18 months...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29343890/first-two-bilateral-hand-transplantations-in-india-part-2-technical-details
#11
Mohit Sharma, Subramania Iyer, P Kishore, Jimmy Mathew, Raghuveer Reddy, Janarthanan Ramu, Sundeep Vijayaraghavan, Abhijeet Wakure, S M Mali Chetan, Visakh Varma, Ashish Chaudhari, Swapnil Dhake, Akshay Omkumar, Jerry Paul, Sunil Rajan, Ayyappan Nair, Druvan Shaji
Introduction: This article deals with two patients who underwent bilateral hand transplantation following amputation of both upper limbs at the distal third of the foream. Materials and Methods: The first patient had a history of loss of hands in a train accident , with possiblity of a run over element during the injury. The second patient lost his both hands in a mine blast. The preoperative work up included detailed clinical and psychological evaluation. The donor retrieval was similar in both the cases and the donors were housed in our own instittution...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29343888/medial-femoral-condyle-vascularised-corticoperiosteal-graft-a-suitable-choice-for-scaphoid-non-union
#12
Samir Kumta, Sudhir Warrier, Leena Jain, Rani Ummal, Manik Menezes, Shrirang Purohit
Introduction: Scaphoid fractures are not very common and frequently remain undiagnosed, presenting in non-union and persistent wrist pain. Options for scaphoid fracture treatment have been described over several decades, however, none with an optimal solution to achieve union along with good hand function. We describe here, the use of vascularised corticoperiosteal bone grafts from the medial femoral condyle (MFC) as a solution for the difficult problem of scaphoid fracture non-union...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29343709/experimental-and-numerical-investigation-on-dragonfly-wing-and-body-motion-during-voluntary-take-off
#13
Qiushi Li, Mengzong Zheng, Tianyu Pan, Guanting Su
We present a detailed analysis of the voluntary take-off procedure of a dragonfly. The motions of the body and wings are recorded using two high-speed cameras at Beihang University. The experimental results show that the dragonfly becomes airborne after approximately one wingbeat and then leaves the ground. During this process, the maximum vertical acceleration could reach 20 m/s2. Evidence also shows that acceleration is generated only by the aerodynamic force induced by the flapping of wings. The dragonfly voluntary take-off procedure is divided into four phases with distinctive features...
January 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29341294/topical-nitroglycerin-for-the-treatment-of-intraoperative-microsurgical-vasospasm
#14
Joseph A Ricci, Dhruv Singhal, Eugene Y Fukudome, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: Papaverine remains a popular agent to treat intraoperative microsurgical vasospasm. However, the recent shortage has forced surgeons to trial antispasmodic agents unproven in microsurgery, but commonly used in other areas. During this shortage we have trialed topical nitroglycerin to break intraoperative vasospasm. This study aims to analyze the outcomes of this medication on flap complications compared with papaverine. METHODS: All consecutive free flaps performed for breast reconstruction at a single institution were reviewed...
January 17, 2018: Microsurgery
https://www.readbyqxmd.com/read/29341249/reconstruction-of-an-upper-posterior-thigh-extensive-defect-with-a-free-split-anterolateral-thigh-s-alt-flap-by-perforator-to-perforator-anastomosis-a-case-report
#15
Mario F Scaglioni, Andrè A Barth, Pietro Giovanoli
The anterolateral thigh (ALT) flap is one of the most commonly used flap worldwide in reconstructive surgery, as both free flap and pedicled local flap. Here, we report the use of a free split anterolateral thigh (s-ALT) flap for reconstruction of a 14 cm × 16 cm soft tissue defect of the left upper posterior thigh region due to sarcoma resection in a patient. The ALT flap was harvested based on two musculocutaneous perforators from the right thigh and anastomosed to the contralateral descending branch of the lateral circumflex femoral artery (LCFA) in perforator-to-perforator manner, in order to gain more pedicle length and being able to cover the posterior thigh defect...
January 17, 2018: Microsurgery
https://www.readbyqxmd.com/read/29341038/-the-use-of-deep-inferior-epigastric-vessels-to-revascularise-free-flaps-for-reconstruction-of-complex-oncosurgical-defects-of-the-thigh-and-the-abdomen
#16
F Simunovic, U Wittel, B Passlick, S Wiesemann, M Czerny, M Südkamp, G B Stark, H Bannasch
BACKGROUND: The resection of large soft-tissue sarcoma requires reconstruction with free flaps. The choice of recipient vessels is crucial for the success of surgery. PATIENTS: We report four cases with large soft-tissue sarcomas with complex anatomical relationships: two tumors of the thigh surrounding the femoral neurovascular structures and two tumors of the abdomen with infiltration of the thorax and the abdomen. All cases received multimodal interdisciplinary treatment...
January 16, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29339717/complex-reconstruction-with-flaps-after-abdominoperineal-resection-and-groin-dissection-for-anal-squamous-cell-carcinoma-a-difficult-case-involving-many-specialities
#17
Claudia Reali, Richard Guy, Christopher R Darby, Lucy Cogswell, Roel Hompes
BACKGROUND Anal squamous cell carcinoma accounts for about 2-4% of all lower gastrointestinal malignancies, with a distant disease reported in less than 5%. Although surgical treatment is rarely necessary, this often involve large dissections and difficult reconstructive procedures. CASE REPORT We present a complex but successful case of double-flap reconstruction after abdominoperineal resection and groin dissection for anal squamous cell carcinoma (cT3N3M0) with metastatic right inguinal lymph nodes and ipsilateral threatening of femoral vessels...
January 17, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29336816/traumatic-thoracic-rib-cage-hernias-operative-management-and-proposal-for-a-new-anatomic-based-grading-system
#18
John Kuckelman, Riyad Karmy-Jones, Elizabeth Windell, Seth Izenberg, Jean-Stephane David, William Long, Matthew J Martin
BACKGROUND: Traumatic Rib Cage Hernias (TRCH) requiring operative repair are rare and there is currently no literature to guiding surgical management. METHODS: Perioperative review of TRCH over 32 years. Five operative grades were developed based on extent of tissue/bone damage, size, and location. RESULTS: Twenty-four patients (20 blunt, 4 penetrating) underwent operative repair. Lung was the herniated organ in 88% with a median of 4 rib fractures and average size of 60...
January 5, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29336371/in-vitro-flow-perfusion-maintaining-long-term-viability-of-the-rat-groin-fat-flap-a-novel-model-for-research-on-large-scale-engineered-tissues
#19
Yang An, Fang-Fei Nie, Ze-Lian Qin, Hong-Yu Xue, Lu-Jia Chen, Bi Li, Dong Li
BACKGROUND: Large-scale muscle tissue engineering remains a major challenge. An axial vascular pedicle and perfusion bioreactor are necessary for the development and maintenance of large-scale engineered muscle to ensure circulation within the construct. We aimed to develop a novel experimental model of a large-scale engineered muscle flap from an existing rat groin fat flap. METHODS: A fat flap based on the superficial inferior epigastric vascular pedicle was excised from rats and placed into a perfusion bioreactor...
January 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29336293/using-the-nasoseptal-flap-for-reconstruction-after-endoscopic-debridement-of-radionecrosis-in-nasopharyngeal-carcinoma
#20
Gwanghui Ryu, Yoon Kyoung So, Min Young Seo, Woori Park, Hyo Yeol Kim, Hun-Jong Dhong, Seung-Kyu Chung, Sang Duk Hong
BACKGROUND: Radionecrosis is a complication of nasopharyngeal carcinoma (NPC) that is difficult to treat. Endoscopic debridement is the first-line treatment for radionecrosis. After debridement, however, either bone or the internal carotid artery is exposed and requires mucosal coverage. OBJECTIVES: This study sought to demonstrate the effectiveness of a nasoseptal flap (NSF) after endoscopic debridement of radionecrosis in the reconstruction of nasopharyngeal or skull base defects...
January 25, 2018: American Journal of Rhinology & Allergy
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