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https://www.readbyqxmd.com/read/28544917/effective-and-safe-mannitol-administration-in-patients-undergoing-supratentorial-tumor-surgery-a-prospective-randomized-and-double-blind-study
#1
Eren Fatma Akcil, Ozlem Korkmaz Dilmen, Esra Sultan Karabulut, Serdar Selcuk Koksal, Fatis Altindas, Yusuf Tunali
OBJECTIVES: Although osmotic diuresis with mannitol is commonly used to provide brain relaxation, there is no consensus regarding its optimal dose and combination with loop diuretics. The aim of the present study is to evaluate the effects of mannitol and combination of furosemide with different doses of mannitol on brain relaxation and on blood electrolytes, lactate level, urine output, fluid balance and blood osmolarity in patients undergoing supratentorial tumor surgery. PATIENTS AND METHODS: This prospective, randomized, double blind, placebo-controlled study included 51 patients (ASA I-III) scheduled for elective supratentorial craniotomy...
May 15, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28544511/computational-fluid-dynamics-evaluation-of-posterior-septectomy-as-a-viable-treatment-option-for-large-septal-perforations
#2
Bradley A Otto, Chengyu Li, Alexander A Farag, Benjamin Bush, Jillian P Krebs, Ryan D Hutcheson, Kanghyun Kim, Bhakthi Deshpande, Kai Zhao
BACKGROUND: Numerous surgical techniques exist to treat nasal septal perforation (NSP). The surgical closure of large NSPs (>2 cm) is still challenging. Posterior septectomy has been reported as a simple alternative to treat large NSP, yet its mechanisms for symptom relief are not clear, and if failed, its consequence cannot be easily reversed. METHODS: Ten NSP patients were recruited: 5 underwent posterior septectomy and 5 underwent conventional flap or button repair...
May 23, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28544074/single-stage-aesthetic-and-functional-reconstruction-of-composite-facial-gunshot-wound-with-a-chimeric-functioning-muscle-and-fibular-osseous-flap-case-report-and-review-of-the-literature
#3
Andreas Gravvanis, Konstantinos Apostolou, Dimitrios Anterriotis, Dimosthenis Tsoutsos
The current concepts in the aesthetic and functional reconstruction of complex oromandibular defects are presented with a case of a patient with self-inflicted gunshot wound to the face. The patient presented with a 6 cm composite mandibular defect; the buccomandibular and suborbital aesthetic zones of the cheek along with the mucosa lining, and the ipsilateral facial musculature were missing. A rapid prototyping model of the facial skeleton was used to assist in preoperative planning. A single stage reconstruction with two free flaps was planned; a free fibula osseous flap to reconstruct the mandibular defect, and a free chimeric ALT/functioning vastus lateralis muscle...
May 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28543692/the-impact-of-resident-involvement-in-breast-reconstruction-surgery-outcomes-by-modality-an-analysis-of-4-500-cases
#4
Kevin T Jubbal, Anthony Echo, Aldona J Spiegel, Shayan A Izaddoost
BACKGROUND: The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. METHODS: We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28543381/ileocecal-vascularized-lymph-node-transfer-for-the-treatment-of-extremity-lymphedema-a-case-report
#5
Pedro Ciudad, Oscar J Manrique, Mouchammed Agko, En-Wei Liu, Wei-Ling Chang, Matthew Sze-Wei Yeo, Tony Chieh-Ting Huang, Ram M Chilgar, Hung-Chi Chen
Vascularized lymph node (VLN) transfer has been of high interest in the past decade for the treatment of lymphedema, since it has been shown to be effective in reducing limb volumes, decreasing infectious episodes and improving quality of life. Multiple donor sites have been described in the quest for the optimal one. Herein, we describe a novel lymph node flap option based on the ileocolic artery and vein. The ileocecal vascularized lymph node (IC-VLN) flap was used in the management of a 33-year-old male patient with lower extremity lymphedema secondary to left inguinal trauma...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28543068/single-port-approach-to-endoscopic-pericranial-scalp-flap-for-anterior-cranial-fossa-closure
#6
Alfredo García-Fernández
No abstract text is available yet for this article.
May 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28543027/the-vascularized-groin-lymph-node-flap-vgln-anatomical-study-and-flap-planning-using-multi-detector-ct-scanner-the-golden-triangle-for-flap-harvesting
#7
Assaf A Zeltzer, Alexander Anzarut, Delphine Braeckmans, Katrin Seidenstuecker, Benoit Hendrickx, Eddy Van Hedent, Moustapha Hamdi
INTRODUCTION: A growing number of surgeons perform lymph node transfers for the treatment of lymphedema. When harvesting a vascularized lymph node groin flap (VGLNF) one of the major concerns is the potential risk of iatrogenic lymphedema of the donor-site. This article helps understanding of the lymph node distribution of the groin in order to minimize this risk. MATERIALS AND METHODS: Fifty consecutive patients undergoing abdominal mapping by multi-detector CT scanner were included and 100 groins analyzed...
May 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28542372/revision-of-encapsulated-blebs-after-trabeculectomy-long-term-comparison-of-standard-bleb-needling-and-modified-needling-procedure-combined-with-transconjunctival-scleral-flap-sutures
#8
P Laspas, P D Culmann, F H Grus, V Prokosch-Willing, A Poplawksi, N Pfeiffer, E M Hoffmann
PURPOSE: To compare two surgical approaches for treating encapsulated blebs after trabeculectomy with mitomycin C, in terms of the development of intraocular pressure and progression of glaucoma in a long-term follow up: 1. bleb needling alone vs. 2. a combined approach of needling with additional transconjunctival scleral flap sutures, to prevent early ocular hypotony. METHODS: Forty-six patients with failing blebs after trabeculectomy with mitomycin C were enrolled in this study...
2017: PloS One
https://www.readbyqxmd.com/read/28542343/bone-marrow-cell-extract-promotes-the-regeneration-of-irradiated-bone
#9
Guillaume Michel, Pauline Blery, Michaël Henoux, Jérôme Guicheux, Pierre Weiss, Sophie Brouard, Olivier Malard, Florent Espitalier
Mandibular osteoradionecrosis is a severe side effect of radiotherapy after the treatment of squamous cell carcinomas of the upper aerodigestive tract. As an alternative to its treatment by micro-anastomosed free-flaps, preclinical tissular engineering studies have been developed. Total bone marrow (TBM) associated with biphasic calcium phosphate (BCP) significantly enhanced bone formation in irradiated bone. One mechanism, explaining how bone marrow cells can help regenerate tissues like this, is the paracrine effect...
2017: PloS One
https://www.readbyqxmd.com/read/28542071/vertical-rectus-abdominis-myocutaneous-versus-alternative-flaps-for-perineal-repair-after-abdominoperineal-excision-of-the-rectum-in-the-era-of-laparoscopic-surgery
#10
Mark Scott Johnstone
AIMS: Plastic surgical reconstruction of the perineum is often required after abdominoperineal excision of the rectum. Options for this reconstruction include a vertical rectus abdominis myocutaneous (VRAM) flap, gluteal fasciocutaneous flap, and gracilis myocutaneous flap. Although the VRAM flap is well established at most centers, less experience exists with the gluteal and gracilis flaps. In the era of laparoscopic colorectal resection, plastic surgeons are being forced to use gluteal and gracilis flaps because the VRAM flap must be tunnelled intra-abdominally requiring laparotomy...
May 25, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28542070/collagen-elastin-and-collagen-glycosaminoglycan-scaffolds-promote-distinct-patterns-of-matrix-maturation-and-axial-vascularization-in-arteriovenous-loop-based-soft-tissue-flaps
#11
Volker J Schmidt, Johanna O Wietbrock, Nico Leibig, Torsten Gloe, Dominic Henn, J Frederik Hernekamp, Leila Harhaus, Ulrich Kneser
INTRODUCTION: Autologous free flaps are the criterion standard for reconstructions of complex soft tissue defects; however, they are limited by donor-site morbidities. The arteriovenous (AV) loop model enables the generation of soft tissue constructs based on acellular dermal matrices with a functional microvasculature and minimal donor site morbidity. The ideal scaffold for AV loop-based tissue engineering has not been determined. METHODS: AV loops were placed into subcutaneous isolation chambers filled with either a collagen-elastin scaffold or a collagen-glycosaminoglycan scaffold in the thighs of rats...
May 25, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28541880/reconstruction-of-a-large-leg-defect-with-a-combined-hatchet-flap-technique
#12
Roberto Cecchi, Laura Bartoli, Luigi Brunetti, Giovanni Troiano
The repair of lower leg defects, not amenable to primary closure, may be challenging, since the skin at this level is scarcely elastic and difficult to mobilize. Local skin flaps are generally utilized only to restore moderately sized losses, whereas grafting becomes a realistic choice in presence of larger wounds. We present the case of a 70-year-old man with a wide defect on his right leg following the surgical excision of a squamous cell carcinoma. The wound was successfully closed with a combination of three hatchet flaps...
April 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28541853/treatment-options-for-pilonidal-disease
#13
Denis Ehrl, Cornelia Choplain, Paul Heidekrueger, Holger C Erne, Horst-Guenter Rau, P Niclas Broer
Pilonidal disease can be treated medically; however, surgical excision remains the gold standard. Nonetheless, all current surgical approaches are still associated with potential for tissue loss, wound healing disorders, and high rates of recurrence. Aim of this study is to assess the long-term outcomes of the minimal-invasive pit-picking operation in comparison to the well-established technique of Karydakis flap-closure. Medical records of all patients undergoing either Karydakis flap-closure or the pit-picking operation for pilonidal disease at our department were reviewed retrospectively...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28540229/ushering-in-the-era-of-penile-transplantation
#14
REVIEW
Alison M Rasper, Ryan P Terlecki
Penile transplantation is a novel approach to management of penile loss in the developing field of composite tissue allotransplantation (CTA). Prior management for significant penile loss has been free flap phalloplasty with issues related to function, cosmesis, and functional loss from the location of flap harvest. Transplantation has been an evolving field with advancement in CTA over the past several decades leading to the option of penile transplant. Management of penile injury with replantation provided some preliminary groundwork on the technical aspects for penile transplantation...
April 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28539482/multi-cored-vortices-support-function-of-slotted-wing-tips-of-birds-in-gliding-and-flapping-flight
#15
Marco KleinHeerenbrink, L Christoffer Johansson, Anders Hedenström
Slotted wing tips of birds are commonly considered an adaptation to improve soaring performance, despite their presence in species that neither soar nor glide. We used particle image velocimetry to measure the airflow around the slotted wing tip of a jackdaw (Corvus monedula) as well as in its wake during unrestrained flight in a wind tunnel. The separated primary feathers produce individual wakes, confirming a multi-slotted function, in both gliding and flapping flight. The resulting multi-cored wingtip vortex represents a spreading of vorticity, which has previously been suggested as indicative of increased aerodynamic efficiency...
May 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28538893/lower-lip-reconstruction-using-a-skin-mucosa-abbe-estlander-flap-after-squamous-cell-carcinoma-excision
#16
Husein Husein-ElAhmed, Rafael Armijo-Lozano
Lips are structures that play an essential role in aesthetics and in different functions such as nutrition and speech. The complex anatomy of the lips - with three different layers composed of skin, mucosa, and muscles - makes surgical management of this area a therapeutic challenge. The use of flaps for the reconstruction of large defects with low risk of necrosis is possible given the abundant blood supply of the lips. We report a case of surgical reconstruction of the lower lip after the excision of a severe squamous cell carcinoma using a skin-mucosa Abbe-Estlander flap with a satisfactory final outcome...
March 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28538892/giant-congenital-melanocytic-nevi-40-years-of-experience-with-the-serial-excision-technique
#17
Lais de Abreu Mutti, Marta Regina Machado Mascarenhas, João Marcos Goes de Paiva, Ronaldo Golcman, Mauro Yoshiaki Enokihara, Benjamin Golcman
Although giant congenital melanocytic nevus is a rare lesion, it causes significant deformity and carries a risk of malignant degeneration. Different surgical techniques for the lesion removal are described, including serial resection, resection with skin grafting, and resection and coverage with expanded skin flap (skin expanders). The aim of this study is to report the author's 40 years of experience with cases requiring at least 4 serial excisions to complete the treatment. Serial resection is an effective, safe, and simple technique that requires a lot of patience...
March 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28538888/verrucous-carcinoma-of-the-vulva-diagnosis-and-treatment
#18
Adriana Bittencourt Campaner, Fernanda de Araujo Cardoso, Gustavo Leme Fernandes, John Verrinder Veasey
Vulvar cancer accounts for less than 1% of malignancies in women. Verrucous carcinoma of the vulva is a rare histological variation, comprising less than 1% of vulvar cancer cases. Although it is characterized as being locally invasive, the condition is not associated with metastatic spreading. Lesions present in the form of a verrucous, ulcerated, and bleeding tumor that can reach large dimensions. This type of tumor can be mistaken for condylomata, both macroscopically and microscopically. We report the case of an 81-year-old patient with a large vulvar tumor presented for eight years, initially considered as a Buschke-Löwenstein tumor...
March 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28538802/the-effect-of-intradermal-administration-of-inactive-platelet-rich-plasma-on-flap-viability-in-rats
#19
Erkan Orhan, Ahmet Çağrı Uysal, Engin Başer, Dürdane Keskin, Çiğdem Demiroğlu-Yakut
Purpose: To evaluate the effect of inactive form of platelet rich plasma (PRP) on the flap viability. Methods: Thirty six rats were used. Rats were divided into six groups then 9x3 cm random pattern skin flaps were elevated from dorsum of all rats. For precluding vascularization from the base, a silicone layer was placed under the flap in groups 2(only flap+silicone), 4(saline+silicone) and 6(PRP+silicone). In groups 1(only flap), 2(only flap+silicone) nothing was done except flap surgery...
April 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28538580/what-s-new-in-cleft-palate-and-velopharyngeal-dysfunction-management
#20
Sanjay Naran, Matthew Ford, Joseph E Losee
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Have a clear understanding of the evolution of concepts of velopharyngeal dysfunction, especially as it relates to patients with a cleft palate. 2. Explain the subjective and objective evaluation of speech in children with velopharyngeal dysfunction. 3. On the basis of these diagnostic findings, be able to classify types of velopharyngeal dysfunction. 4. Develop a safe, evidence-based, patient-customized treatment plan for velopharyngeal dysfunction founded on objective considerations...
June 2017: Plastic and Reconstructive Surgery
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