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Omental free flaps

Alexander T Nguyen, Hiroo Suami, Matthew M Hanasono, Veda A Womack, Franklin C Wong, Edward I Chang
BACKGROUND: The free vascularized omental lymphatic flap provides an option without the risk for iatrogenic donor site lymphedema that plagues alternative lymph node transfer donor sites. The omental flap has been associated with significant morbidity in the past; however, with modern techniques and advanced in technology, a minimally invasive approach to flap harvest is feasible. We present the long-term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema...
July 20, 2016: Journal of Surgical Oncology
Eyup Burak Sancak, Egemen Avci, Tibet Erdogru
Persistent pain after vaginal mesh surgery is a rare and agonizing entity that has devastating consequences for the patient's quality of life. Many etiologies have been blamed including nerve injuries and entrapments. Pudendal neuralgia is a rare chronic neuropathic pain syndrome in the anatomical territory of the pudendal nerve. Various treatment options, such as medication management, physiotherapy, nerve blocks, decompression surgery and neuromodulation, have been used, but the most appropriate treatment for pudendal neuralgia has not yet been determined...
September 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Nicla Settembre, Sergueï Malikov
OBJECTIVES: The omentum flap bypass (OFB) is based on the use of an anatomical unit composed of the right gastro-omental artery (bypass) with its omental branch or branches supplying the greater omentum (flap). The greater omentum flap is known for its capacity of resistance to infection, for its use in the treatment of ischemic lesions and as a high flow tissue. Several hypotheses regarding the hemodynamic behavior of a distal bypass with a flap were discussed in the literature. We made the assumption that the OFB was a low peripheral resistance flap and that the greater omentum did not induce a steal phenomenon...
May 26, 2016: Annals of Vascular Surgery
Mohamed Boshnaq, Amit Thakrar, Iana Martini, Samer Doughan
An 83-year-old woman presented to the emergency department with sudden onset of severe abdominal pain. She had a background of ulcerative colitis managed surgically at the age of 18 years with panproctocolectomy and permanent ileostomy. On admission, clinical assessment suggested a visceral perforation and an urgent CT scan demonstrated a perforated prepyloric ulcer. Emergency laparotomy was performed and confirmed a 3 cm perforated pre-pyloric ulcer. Repair of the defect was challenging due to the absence of omental fat to patch the perforation...
April 21, 2016: BMJ Case Reports
Ulf Dornseifer, Charlotte Kleeberger, Denis Ehrl, Frank Herter, Milomir Ninkovic, Igors Iesalnieks
Background Sternal defects following deep wound infections are predominantly reconstructed using local and regional flaps. The lack of appropriate recipient vessels after cardiac surgery may explain the minor role of free flaps. To date, arteriovenous loops have been the leading solution to enable microsurgical closure of these defects. However, the related surgical effort and the risk of flap failure are increased. We reviewed our experiences with the right gastroepiploic vessels as alternative recipient vessels for free flap reconstructions...
September 2016: Journal of Reconstructive Microsurgery
S Dast, N Assaf, L Dessena, H Almousawi, C Herlin, P Berna, R Sinna
Classically, muscular or omental flaps are the gold standard in the management of thoracic defects following radionecrosis debridement. Their vascular supply and antibacterial property was supposed to enhance healing compared with cutaneous flaps. The evolution of reconstructive surgery allowed us to challenge this dogma. Therefore, we present five consecutive cases of thoracic radionecrosis reconstructed with cutaneous perforator flaps. In four patients, we performed a free deep inferior epigastric perforator (DIEP) flap and one patient had a thoracodorsal perforator (TDAP) flap...
June 2016: Annales de Chirurgie Plastique et Esthétique
Kyra Sierakowski, Nicholas S Solanki, Peter Riddell
No abstract text is available yet for this article.
2015: Eplasty
Brijesh Mishra, Abhijeet Chandra, Somashekar Gejje, M Noushif, Divya N Upadhyay, Nalini Mishra
Background Surgical removal of the anal canal and sphincter for carcinoma results in end-stage fecal incontinence (ESFI) and requires a permanent colostomy resulting in significant impact on quality of life. Presently, there are limited options for EFSI. The successful use of pedicled antropyloric valve (APV) based on left gastroepiploic artery as an alternative to permanent colostomy has previously been described. It is based on a long omental pedicle which at times is risky and is difficult to perform. A free APV flap could be the only solution in such cases...
March 2016: Journal of Reconstructive Microsurgery
Anna Luan, Michael G Galvez, Gordon K Lee
Despite the options currently available for chest wall reconstruction, patients with complex composite defects may still pose a significant challenge for the reconstructive surgeon when only using conventional methods. In particular, prior radiotherapy and/or large en bloc resection may leave inadequate regional flaps and recipient vessels for free tissue transfer. Here, we describe a case in which we reconstruct a 14 cm × 18 cm complex chest wall defect, secondary to tumor resection and infected sternum debridement, with a pedicled flow-through omental flap to a 14 cm × 22 cm free anterolateral thigh flap using the omental gastroepiploic vessels as recipient vessels...
January 2016: Microsurgery
Xianan Li, Zhengxiao Ouyang, Shuo Yang, Zanjing Zhai, Haowei Li, Zhong-Cheng Kang, Zan Li
Cutaneous squamous cell carcinoma (SCC) is an major health issue due to the significant health costs and marked disfigurement following surgical excision. The conventional reconstructive options may not be suitable for patients with large SCCs of the lower part of the leg, due to the regional tissue damage and ischemic environment. The omental transposition flap is a highly vascularized tissue that is resistant to infection and provides a recipient bed for skin grafts. This is the case report of a male patient with a large SCC in the lower part of his right leg, which was treated with extensive resection...
June 2015: Oncology Letters
Alexander T Nguyen, Hiroo Suami
UNLABELLED: Advances in microsurgery have displayed promising results for the treatment of lymphedema. The use of vascularized lymph node transfers has increased in popularity but incurs the potential risk for donor-site lymphedema. The omentum has been previously described for the treatment of lymphedema but has been overlooked because of presumed high morbidity, including the need for celiotomy and pedicled complications. The authors present a novel technique and early results of the laparoscopic free omental lymphatic flap for the management of lymphedema...
July 2015: Plastic and Reconstructive Surgery
Philip J Hanwright, Chad A Purnell, Gregory A Dumanian
BACKGROUND: Esophageal injury following anterior cervical discectomy and fusion (ACDF) poses a significant reconstructive challenge. Buttressing flap repairs have proven beneficial; however, there remains a paucity of evidence to guide optimal flap selection. METHODS: A retrospective chart review was performed for patients who presented to the senior author with esophageal perforations after ACDF from 1995 until present. Demographic, clinical, and postoperative details were collected...
May 2015: Plastic and Reconstructive Surgery. Global Open
Jose M Lasso, Carmen Pinilla, Michele Castellano
Lymphedema is a chronic debilitating disease, affecting a considerable part of the population; it results from impairment of the lymphatic system. It is highly prevalent among patients subjected to axillary and groin nodal dissection after surgery for breast cancer, abdominopelvic surgery, and lymphadenectomy after melanoma surgery. Interestingly, among the surgical treatment options for lymphedema, groin lymph node transfer is gaining popularity; however, in some cases, dissection at this site can cause significant morbidity, including possible development of iatrogenic lymphedema...
May 2015: Plastic and Reconstructive Surgery. Global Open
Lei Chu, Jian-Jun Wang, Li Li, Xiao-Wen Tong, Bo-Zhen Fan, Yi Guo, Huai-Fang Li
OBJECTIVE: To investigate the clinical efficacy of laparoscopic repair of iatrogenic vesicovaginal fistulas (VVF) and rectovaginal fistulas. METHODS: Seventeen female patients with iatrogenic fistulas (11 cases of VVF and 6 cases of high rectovaginal fistulas) were included. All patients were hospitalized and underwent laparoscopic fistula repair in our hospital between 2008 and 2012. The mean age of the patients was 44.8 ± 9.1 years. The fistulas and scar tissue were completely excised by laparoscopy, orifices were tension-free closed using absorbable sutures, omental flaps were interposed between the vagina and the bladder or rectum, and drainage was kept after repair...
2015: International Journal of Clinical and Experimental Medicine
Iris A Seitz, Phillip Siwinski, Dana Rioux-Forker, Lucio Pavone, Loren S Schechter
No abstract text is available yet for this article.
October 2014: Plastic and Reconstructive Surgery
F J Pérez Lara, R Marín, A del Rey, H Oliva
Covering a large hiatal hernia with a mesh has become a basic procedure in the last few years. However, mesh implants are associated with high complication rates (esophageal erosion, perforation, fistula, etc.). We propose using a synthetic resorbable mesh supported with an omental flap as a possible solution to this problem. A 54-year-old female patient with a large hiatal defect (9 cm) was laparoscopically implanted with a synthetic resorbable mesh supported with an omental flap. The surgical procedure was successful and the patient was discharged on postoperative day 2...
September 2014: International Surgery
John P Tutela, Jonathan C Banta, Travis G Boyd, Sean S Kelishadi, Saeed Chowdhry, Jarrod A Little
OBJECTIVE: Osteomyelitis of the skull is a rare condition that can lead to systemic illness, bone loss, intracranial complications, and mortality. Osteomyelitis of the skull typically presents as the boney invasion of an overlying infection of the scalp or sinuses, and it is typically treated with antibiotics and proper wound care. Surgical debridement of the affected bone in the form of a craniectomy may be initiated to stop the progression of the infection when antibiotics fail and the underlying bone becomes grossly eroded...
2014: Eplasty
Joan Maria Viñals Viñals, Tiago André Gomes Rodrigues, Cristian Carrasco Lopez, Josep Maria Serra Payro, José Antonio Palacin Porté, Diana Perez Sildenikova, Mike Dewever, Pau Tarrus Bozal
BACKGROUND: In the case of salvage laryngopharyngectomy, replacement of the pharyngoesophageal segment is mostly performed with fasciocutaneous or jejunal flaps. However, these options do not represent the best surgical technique of reconstruction in some occasions. Thus, the gastro-omental free flap could serve as an alternative procedure. METHODS: A retrospective review was conducted on patients who underwent pharyngoesophageal reconstruction using gastro-omental free flap after salvage laryngopharyngectomy for recurrent pharyngeal or laryngeal carcinoma between 1992 and 2012 at Bellvitge Universitary Hospital...
August 20, 2014: Annals of Plastic Surgery
Manpreet Kaur, Steven Joniau, André D'Hoore, Ignace Vergote
PURPOSE OF REVIEW: To review recently published literature presenting an overview of the current insights and (clinical and technical) developments on pelvic exenterative surgery for gynecological malignancies. RECENT FINDINGS: Lateral recurrences, positive pelvic node status, age and high body mass index should be abandoned as contraindications for pelvic exenteration. F-fluorodeoxyglucose positron emission tomography-computed tomography is a valuable imaging tool, especially for the detection of enlarged lymph nodes and for distinguishing fibrosis from recurrence...
September 2014: Current Opinion in Oncology
Predrag Kovacević, Asen Velickov, Danilo Stojiljković, Aleksandra Velickov, Zoran Ceranić
INTRODUCTION: Reconstruction of a full thickness abdominal wall defect is a demanding procedure for general and also for plastic surgeons, requiring vigorous planning and reconstruction of three layers. CASE OUTLINE: We present a case of a 70-year-old patient with a huge abdominal wall tumor with 40 years evolution. Surgery was performed under general anesthesia. Full thickness abdominal defect appeared after the tumor resection. Reconstruction followed in the same act...
May 2014: Srpski Arhiv za Celokupno Lekarstvo
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