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https://www.readbyqxmd.com/read/28738446/single-stage-versus-two-stage-arteriovenous-loop-microsurgical-reconstruction-a-meta-analysis-of-the-literature
#1
REVIEW
Rebecca Knackstedt, Rachel Aliotta, James Gatherwright, Risal Djohan, Brian Gastman, Graham Schwarz, Mark Hendrickson, Raffi Gurunluoglu
BACKGROUND: Arteriovenous (AV) loops can be utilized in a single- or two-stage approach in free flap reconstruction when proper vessels are not available. However, there exists no consensus on which method leads to superior microsurgical and patient outcomes. The purpose of this article was to review single- versus two-stage AV loops utilized in free flap reconstruction with a focus on complications and overall outcomes. METHODS: A systematic review of AV loops for autologous free tissue transfer was conducted...
July 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28738337/the-history-of-sleep-surgery
#2
Kathleen Yaremchuk, Laura Garcia-Rodriguez
Snoring and the subsequent diagnosis of obstructive sleep apnea (OSA) was a life-threatening medical condition with no available treatment until the late 20th century. An early description of OSA was provided by Charles Dickens in his 1836 novel Pickwick Papers with the description of a "fat boy" who was thought to be lazy and always falling asleep but likely displayed hypersomnolence from OSA. It was not until 1976 that Ikematsu first described uvulopalatopharyngoplasty (UPPP) as an alternative surgical treatment of "snoring," with a reported cure rate of 81%...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738192/maxillary-reconstruction-using-submental-artery-island-flap-and-sagittal-mandibular-ramus-coronoid-process-graft-pedicled-with-temporalis-muscle
#3
W H Wang, Z R Zou, B Xu, W Q Wang, S Y Shen
PURPOSE: The purpose of this study is to describe maxillary reconstruction using the submental artery island flap and the sagittal mandibular ramus and coronoid process graft pedicled with the temporalis muscle through the modified lateral lip and submandibular approach. MATERIALS AND METHODS: From May 2013 to September 2016, 11 patients with maxillary defects secondary to maxillary cancer ablation who underwent maxillary reconstruction using a submental artery island flap and a sagittal mandibular ramus and coronoid process graft pedicled with the temporalis muscle through the modified lateral lip and submandibular approach were enrolled in this prospective study...
June 29, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28737559/complex-reconstruction-after-sarcoma-resection-and-the-role-of-the-plastic-surgeon-a-case-series-of-298-patients-treated-at-a-single-center
#4
Jonathan I Leckenby, Rachel Deegan, Adriaan O Grobbelaar
BACKGROUND: More than 1000 new patients present to the London Sarcoma Unit each year and between 5% and 10% require plastic surgery intervention. Advancements in radiotherapy and chemotherapy protocols combined with higher expectations for limb preservation has led to increased reconstructive challenges. Frequently, primary closure is achievable; however, larger tumors often require specialist reconstruction. STUDY DESIGN: A retrospective chart review of all referred patients from the London Sarcoma Unit requiring reconstruction between February 2006 and January 2015 was performed...
July 22, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28737557/human-and-autologous-adipose-derived-stromal-cells-increase-flap-survival-in-rats-independently-of-host-immune-response
#5
Navid Mohamadpour Toyserkani, Charlotte Harken Jensen, Ditte Caroline Andersen, Søren Paludan Sheikh, Jens Ahm Sørensen
INTRODUCTION: There is a rising interest in adipose-derived stromal cells for clinical use; however, it is unknown whether freshly isolated stromal cells (SVF) or culture-expanded cells (ASCs) are more efficacious. We therefore aimed to compare the 2 cellular therapies in an in vivo model of angiogenesis, the ischemic flap in rats, which induces acute ischemia. We also aimed to determine the importance of cell presence and the host immune response. METHODS: A total of 96 rats (n = 12 in each group) were used, and in each rat, a caudally based random flap measuring 2 × 7 cm was made...
July 22, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28737505/androgen-mediated-sex-bias-impairs-efficiency-of-leukotriene-biosynthesis-inhibitors-in-males
#6
Simona Pace, Carlo Pergola, Friederike Dehm, Antonietta Rossi, Jana Gerstmeier, Fabiana Troisi, Helmut Pein, Anja M Schaible, Christina Weinigel, Silke Rummler, Hinnak Northoff, Stefan Laufer, Thorsten J Maier, Olof Rådmark, Bengt Samuelsson, Andreas Koeberle, Lidia Sautebin, Oliver Werz
Proinflammatory leukotrienes (LTs) are produced by 5-lipoxygenase (5-LO) aided by 5-LO-activating protein (FLAP). LT biosynthesis inhibitors are currently under clinical investigation as treatments for respiratory and cardiovascular diseases. Here, we have revealed a sex bias in the efficiency of clinically relevant LT biosynthesis inhibitors, showing that their effects are superior in females. We found that androgens cause these sex differences by impeding the LT-biosynthetic 5-LO/FLAP complex assembly. Lower doses of the FLAP inhibitor MK886 were required to reduce LTB4 levels in exudates of female versus male mice and rats...
July 24, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28737044/book-review-flaps-practical-reconstructive-surgery-shokrollahi-kayvan-whitaker-iain-naha-foad-eds-flaps-practical-reconstructive-surgery-new-york-thieme-2017-hard-cover-illustrated-711-pages
#7
Annika Meyer, Joshua Rosenberg
No abstract text is available yet for this article.
July 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28736958/intraoperative-indocyanine-green-fluorescent-angiography-assisted-modified-superior-gluteal-artery-perforator-flap-for-reconstruction-of-sacral-pressure-sores
#8
Chun-Kai Chang, Chien-Ju Wu, Chun-Yu Chen, Chi-Yu Wang, Tzi-Shiang Chu, Kuo-Feng Hsu, Han-Ting Chiu, Hung-Hui Liu, Chang-Yi Chou, Chih-Hsin Wang, Chin-Ta Lin, Niann-Tzyy Dai, Yuan-Sheng Tzeng
Pressure sores are often observed in patients who are bedridden. They can be a severe problem not only for patients and their caregivers but also for plastic surgeons. Here, we describe a new method of superior gluteal artery perforator flap harvesting and anchoring with the assistance of intraoperative indocyanine green fluorescent angiography. In this report, we describe the procedure and outcomes for 19 patients with grades III and IV sacral pressure sores who underwent the operation between September 2015 and November 2016...
July 23, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28736943/risk-factors-for-wound-complications-in-head-and-neck-reconstruction-773-free-jejunal-reconstruction-procedures-after-total-pharyngolaryngoesophagectomy
#9
Narushi Sugiyama, Soshi Takao, Etsuji Suzuki, Yoshihiro Kimata
BACKGROUND: Most studies that examined risk factors for wound complications after head and neck reconstruction analyzed various complications collectively. Moreover, they included a wide variety of resection areas and reconstruction materials. To overcome these limitations, both the resection area and reconstruction method were constrained in the present study. METHODS: Patients who underwent free jejunal graft reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal cancer were enrolled...
July 24, 2017: Head & Neck
https://www.readbyqxmd.com/read/28735877/dose-comparison-between-tg-43-based-calculations-and-radiochromic-film-measurements-of-the-freiburg-flap-applicator-used-for-high-dose-rate-brachytherapy-treatments-of-skin-lesions
#10
Saad Aldelaijan, Hamed Bekerat, Ivan Buzurovic, Phillip Devlin, Francois DeBlois, Jan Seuntjens, Slobodan Devic
PURPOSE: Current high-dose-rate brachytherapy skin treatments with the Freiburg flap (FF) applicator are planned with treatment planning systems based on the American Association of Physicists in Medicine TG-43 data sets, which assume full backscatter conditions in dose calculations. The aim of this work is to describe an experimental method based on radiochromic film dosimetry to evaluate dose calculation accuracy during surface treatments with the FF applicator at different depths and bolus thicknesses...
July 20, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28735639/free-flap-reconstruction-for-patients-aged-85-years-and-over-with-head-and-neck-cancer-clinical-considerations-for-comprehensive-care
#11
X F Chen, Y M Chen, S Gokavarapu, Q C Shen, T Ji
We aimed to identify and evaluate the clinical challenges involved in microvascular flap reconstructions of defects caused by resection of head and neck cancer among patients aged 85 and over. We designed a retrospective study of patients who were treated in the head and neck department of a tertiary referral centre from 2005 to 2015, and all patients aged 85 years and over who had reconstructions with microvascular flaps for head and neck cancer were entered into the study. A total of 24 patients fulfilled the criteria, of whom 15 were men and nine were women...
July 20, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28735422/baerveldt%C3%A2-glaucoma-implant-surgery-with-the-double-scleral-flap-technique-to-prevent-hoffman-elbow-exposure
#12
Naoki Tojo, Tomoko Ueda-Consolvo, Shuichiro Yanagisawa, Atsushi Hayashi
OBJECTIVE: To compare the efficacy and safety of the Baerveldt® glaucoma implant (BGI) between a preserved donor scleral patch alone and double scleral flaps, comprising a preserved donor scleral patch and an autologous scleral pedicle flap. METHODS: This was an open-label retrospective study. We analyzed the cases of 52 consecutive patients (56 eyes) who underwent BGI surgery with the Hoffman elbow (#BG 102-350, Abbott) and were followed up for >1 year. Twenty-one eyes underwent BGI surgery with a preserved donor scleral patch alone (donor-patch group), and the other 35 eyes underwent BGI surgery with a preserved donor scleral patch and an autologous scleral pedicle flap (double-flap group)...
July 22, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28734993/esthetically-favorable-surgical-alternative-for-the-removal-of-sinonasal-malignant-tumors-the-modified-facial-degloving-technique
#13
REVIEW
Gábor Vass, Zsolt Bella, Zoltán Tóbiás, Attila Nagy, László Iván, László Rovó
PURPOSE: The widely used external approach (Weber-Fergusson incision) for the removal of maxillary ethmoid tumors leaves stigmatizing scars and deformities on the patient's face. As an alternative technique, the scarless facial degloving approach was first described in the 1970s; since then, several modifications have been developed. PATIENTS AND METHODS: The authors have been using a modified facial degloving technique for 7 years to remove maxillary ethmoid tumors...
June 29, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28734752/long-term-effect-of-oncoplastic-breast-conserving-surgery-using-latissimus-dorsi-miniflaps-on-mammographic-surveillance-and-the-detection-of-local-recurrence
#14
S Mele, D Wright, N Paramanathan, S Laws, L Peiris, R Rainsbury
INTRODUCTION: Latissimus dorsi miniflap is a breast-conserving volume replacement technique for the reconstruction of large breast defects. While mammographic features of miniflap reconstruction have been described, little is known about the incidence, mode of presentation and size of local recurrence after this procedure. This study aimed to investigate the impact of latissimus dorsi miniflap reconstruction on the frequency, presentation and detection of local recurrence. METHODS: Clinical, radiological and pathological data were reviewed in 261 patients...
June 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28734659/comparative-effectiveness-study-between-negative-pressure-wound-therapy-and-conventional-wound-dressing-on-perforator-flap-at-the-chinese-tertiary-referral-teaching-hospital
#15
Regis Ernest Mendame Ehya, Yong Zhao, Xun Zheng, Wanrong Yi, Guy-Armel Bounda, Zonghuan Li, Weidong Xiao, Aixi Yu
BACKGROUND: Perforator flap techniques with conventional wound dressing have being extensively used in the management of soft-tissue defects. However; the flap's survival rate is not always guaranteed and the wound healing time always long. The aim of this study was to investigate the clinical effectiveness use of a freshly transplanted perforator flap in conjunction with Vacuum-assisted closure (VAC) for better clinical outcomes. METHODS: A prospective, randomized, effectiveness study comparing the clinical outcomes of VAC versus traditional wrap and bandages for the treatment of open wounds that required hospital admission and operative debridement using perforator flaps, was carried out from March 1, 2014 to March 31, 2016 at Wuhan University Zhongnan Hospital...
July 12, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28734534/elbow-vascularized-composite-allotransplantation-surgical-anatomy-and-technique
#16
Zvi Steinberger, Heng Xu, Nikolas H Kazmers, Stephanie Thibaudeau, Russel G Huffman, L Scott Levin
BACKGROUND: Elbow reconstruction with vascularized composite allotransplantation (VCA) may hold promise in treating end-stage arthritis as no current treatment is both functional and durable. We describe the vascular and gross anatomy of the elbow in the context of VCA procurement and propose a step-by-step surgical technique for human elbow VCA. METHODS: We injected latex in the arterial tree of 16 fresh adult cadaveric upper extremities. We identified and measured arteries and nerves and their branch points relative to the medial epicondyle...
August 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28734457/total-lower-lip-and-chin-reconstruction-with-radial-forearm-free-flap-a-novel-approach
#17
Eliza H Dewey, Ansley M Roche, Cathy L Lazarus, Mark L Urken
BACKGROUND: The management of large chin and lower lip defects is challenging due to this facial subunit's tremendous functional and aesthetic importance. Specific methods for total lower lip and mentum reconstruction are not well chronicled. Aesthetic and functional goals of this reconstruction include restoration of oral competence by maintaining lower lip height, vermilion reestablishment, color-matched skin introduction to the chin, sensation restoration, and ideally restoration of dynamic activity to the lower lip...
July 8, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28734429/ascending-aorta-stenting-after-off-pump-aortic-wrapping-in-stanford-a-retrograde-aortic-dissection
#18
Dorian Verscheure, Ramzi Ramadan, Alexandre Azmoun, Julien Guihaire, Claude Angel, Philippe Brenot, Philippe Deleuze
We report 4 cases of off-pump ascending aorta wrapping combined with ascending aorta stenting in retrograde Stanford A acute aortic dissection (SAAD). Since 2008, 18 patients have undergone wrapping of the ascending aorta at our institution. Four patients had a persistent circulating false lumen in the ascending aorta after wrapping, with a threat to the aortic root. We chose an endovascular approach with ascending aorta stenting. Follow-up computed tomography showed a reapplication of the intimal flap in the reinforced aorta...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28733572/lower-eyelid-reconstruction-following-a-traumatic-full-thickness-loss
#19
W J Tang, A Z Mat Saad
Eyelid reconstruction is complex and challenging since it is not only for structural and functional restoration, but also for an acceptable aesthetic result. In full thickness eyelid injuries, it will involve both anterior and posterior lamella. Therefore, when reconstructing the defect, it requires at least two layers; one will be a flap with blood supply, and the other can be a free graft. In this case, a rotational advancement cheek flap and composite graft were used to reconstruct the lower eyelid.
June 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28732800/histological-case-control-study-of-peeling-induced-skin-changes-by-different-peeling-agents-in-surgically-subcutaneous-undermined-skin-flaps-in-facelift-patients
#20
P Gonser, S Kaestner, P Jaminet, K Kaye
A histological evaluation of peeling-induced skin changes in subcutaneous undermined preauricular facial skin flaps of nine patients was performed. There were three treatment groups: Trichloroacetic acid (TCA) 25%, TCA 40% and phenol/croton oil; one group served as control. Two independent evaluators determined the epidermal and dermal thickness and the depth of necrosis (micrometre). The percentual tissue damage due to the peeling was calculated, and a one-sample t-test for statistical significance was performed...
June 27, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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