keyword
https://read.qxmd.com/read/38530145/free-flap-reconstruction-of-elbow-soft-tissue-defects-lessons-learned-from-15%C3%A2-years-of-experience
#1
J Reed McGraw, Reena S Sulkar, Corey M Bascone, Sammy Othman, Jaclyn T Mauch, Hani I Naga, L Scott Levin, Stephen J Kovach
BACKGROUND: The elbow is a complex joint that is vital for proper function of the upper extremity. Reconstruction of soft tissue defects over the joint space remains challenging, and outcomes following free tissue transfer remain underreported in the literature. The purpose of this analysis was to evaluate the rate of limb salvage, joint function, and clinical complications following microvascular free flap coverage of the elbow. METHODS: This retrospective case series utilized surgical logs of the senior authors (Stephen J Kovach and L Scott Levin) to identify patients who underwent microvascular free flap elbow reconstruction between January 2007 and December 2021...
May 2024: Microsurgery
https://read.qxmd.com/read/38524062/an-unexpected-late-recurrence-of-breast-irradiation-induced-angiosarcoma-following-autologous-microvascular-breast-reconstruction
#2
Mohammed Herieka, Kavit Amin, Damir Kosutic
The authors present the case of a 68-year-old female who developed recurrent angiosarcoma, a rare but recognized complication after breast irradiation therapy in the treatment of breast cancer. Microvascular breast reconstruction was performed after the completion of 10 years of disease-free clinical surveillance. Abdominal tissue was harvested and transferred onto the chest wall with restoration of its blood supply using microsurgical techniques to recreate the breast. Unexpectedly, local recurrence of irradiation-induced angiosarcoma was confirmed in the reconstructed breast 12 years later, a unique finding, given the long latent period and recruitment of tissues from a distant site...
February 2024: Curēus
https://read.qxmd.com/read/38513513/indications-and-versatility-of-the-posterior-tibial-artery-flap-in-head-and-neck-reconstruction
#3
JOURNAL ARTICLE
Jonathan L Harper, Thomas J Gal
UNLABELLED: Importance Free tissue transfer for reconstruction of the head and neck requires complicated repair of complex anatomy. The posterior tibial flap is a free tissue flap that has viability and versatility to be used for complex reconstructions that is not offered by other free flaps. OBJECTIVE: The posterior tibial artery flap is a perforator flap which is found between the flexor digitorum longus and the soleus. It has been described as both a pedicled flap for lower extremity reconstruction as well as a free flap, including for head and neck reconstruction...
February 27, 2024: American Journal of Otolaryngology
https://read.qxmd.com/read/38450592/novosorb%C3%A2-biodegradable-temporising-matrix-btm-in-the-reconstruction-of-cutaneous-malignancies-in-a-major-cancer-centre-a-case-series
#4
JOURNAL ARTICLE
Maxim Devine, Mark Edmondson, Peter Gearing, Elizabeth Concannon, Michael Findlay, Richard Zinn, Angela Webb
BACKGROUND: Non-graftable or composite defect reconstruction represents a major challenge to the reconstructive surgeon, with many wounds requiring local flap or free microvascular tissue transfer approaches. The recent advent of synthetic skin substitutes such as Biodegradable Temporizing Matrix (BTM) have revolutionized the management of complex defects including those caused by burns, trauma and infection, with low-morbidity and low-complexity surgery. However, limited data exist supporting their use in cancer reconstruction in Australia...
March 7, 2024: ANZ Journal of Surgery
https://read.qxmd.com/read/38445792/postoperative-inpatient-surgical-complications-following-head-and-neck-microvascular-free-tissue-transfer
#5
JOURNAL ARTICLE
Hasan Abdulbaki, Patrick K Ha, Philip D Knott, Andrea M Park, Rahul Seth, Chase M Heaton, Katherine C Wai
BACKGROUND: Complications following head and neck microvascular free tissue transfer (MFTT) are common. Less is known about when they occur. METHOD: Retrospective study of patients with primary or recurrent head and neck cancer undergoing MFTT reconstruction at a tertiary care institution. MFTT reconstructions with inpatient postoperative complications were included. The Kruskal-Wallis test was used to compare median postoperative day (POD) onset of complication by flap type...
March 6, 2024: Head & Neck
https://read.qxmd.com/read/38415862/outcomes-of-head-and-neck-free-tissue-transfer-requiring-vein-grafting-systematic-review-and-meta-analysis
#6
REVIEW
Sharwani Kota, Najm S Khan, Kassie Bollig, Matthew Bridgeman, Craig A Bollig
OBJECTIVE: To systematically review the literature to determine the prevalence of free flap failure in head and neck free flaps requiring vein grafting. DATA SOURCES: Search strategies created in collaboration with a medical librarian were implemented using PubMed, Cochrane, Scopus, Web of Science, and Google Scholar from inception to August 2022. REVIEW METHODS: The population of interest included adult and pediatric patients undergoing reconstruction of oncologic or traumatic head and neck defects with a free flap requiring a vein graft that presents the success/failure rate...
February 28, 2024: Otolaryngology—Head and Neck Surgery
https://read.qxmd.com/read/38386356/patient-experience-of-head-and-neck-surgery-with-free-flap-reconstruction
#7
JOURNAL ARTICLE
Lillian W Dattilo, Trinity I Russell, Chloe B Warinner, Heather Starmer, Donald J Annino, Laura A Goguen, Rosh K V Sethi, Ravindra Uppaluri, Melina J Windon, Regan W Bergmark, Eleni M Rettig
IMPORTANCE: Major head and neck surgery with microvascular free tissue transfer reconstruction is complex, with considerable risk of morbidity. Little is known about patients' experiences, including decision-making prior to, and regret following, free flap surgery. OBJECTIVE: To characterize patient experiences and decision regret of patients undergoing head and neck reconstructive free flap surgery. DESIGN, SETTING, AND PARTICIPANTS: This mixed-methods cohort study comprising semistructured interviews was conducted June to August 2021 at a single tertiary academic cancer center...
February 22, 2024: JAMA Otolaryngology—Head & Neck Surgery
https://read.qxmd.com/read/38371218/can-the-malnutrition-universal-screening-tool-must-predict-healing-complications-following-microvascular-reconstruction-of-the-head-and-neck
#8
JOURNAL ARTICLE
Camilo Mosquera, Marina Morante Silva, Ashleigh M Weyh, Michael A Malik, Rui Fernandes
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Malnutrition has been found to have negative effects on the immune system and inflammatory responses, impairing the wound healing process. Free flap failure is a serious complication in patients undergoing microvascular reconstruction, as it increases patient morbidity, length of stay in the hospital, patient, and hospital costs, as well as causes the need for further surgical interventions1 . Malnutrition is estimated to be present in 35-50% of head and neck cancer patients with higher rates in those experiencing hypo-oropharyngeal disease...
March 2024: Craniomaxillofacial Trauma & Reconstruction
https://read.qxmd.com/read/38369394/soft-tissue-non-osteogenic-distraction-of-the-mandible-and-lower-face-in-bilateral-hemifacial-microsomia-technical-report
#9
JOURNAL ARTICLE
Artur Nixon-Martins, Diogo Conduto, Ana R Gomes, Bruno G Rosa, Gaizka Ribeiro, Carlos Pinheiro, Filipe Pagaimo, Francisco Azevedo-Coutinho, Victor Santos-Fernandes, José Guimarães-Ferreira
The aim of this study is to present a sequential strategy of soft-tissue, non-osteogenic distraction with a novel device, followed by microvascular bony reconstruction for severe cases of mandibular hypoplasia. The case of a 21-year-old woman with Goldenhar syndrome is presented, whose mandible remained severely hypoplastic despite previous attempts at distraction and was not suitable for further osteogenic distraction. Soft tissue deficiency and pin track scarring prevented free fibular transfers. A personalized distractor, anchored to the cranium and the mandibular symphysis, was designed to expand the soft tissues while allowing for physiological temporomandibular joint (TMJ) movement without compression forces...
February 14, 2024: Journal of Cranio-maxillo-facial Surgery
https://read.qxmd.com/read/38319995/superficial-temporal-artery-posterior-branch-flap-for-reconstruction-of-composite-oral-perioral-defects
#10
JOURNAL ARTICLE
Semih Baghaki, Can E Yalcin, Ugur Celik, Fatih Cinar
PURPOSE: Defects involving total lower and/or upper lip often extend to intraoral and/or perioral areas. Flaps based on superficial temporal artery, either as pedicled or free flaps, can be used for reconstruction of various head and neck defects. In this clinical study, we tried to demonstrate the application of a pedicled flap based on the posterior branch of superficial temporal artery in 3-dimensional reconstruction of these composite oral/perioral defects as a successful alternative in cases where microvascular tissue transfer cannot be performed...
January 9, 2024: Annals of Plastic Surgery
https://read.qxmd.com/read/38313578/exploring-the-supremacy-of-microvascular-coupling-devices-for-arterial-anastomosis-in-terms-of-added-expeditiousness-safety-concerns-a-systematic-review
#11
REVIEW
Ajit Kumar Vishwakarma, Naresh Kumar Sharma, Neeraj Kumar Dhiman, Shankar Singh, Chandresh Jaiswara, Sadhana Swaraj
BACKGROUND: Arterial anastomoses are still most commonly performed using orthodox hand sewing technique. Various rationale such as non-pliable, atherosclerotic, thick-walled or irradiated vessels limit the competency of coupler devices for arterial micro-anastomosis. Microvascular coupling devices (MCD) are well known for venous anastomoses but arterial MCD have relatively been less navigated in reported literatures. This review outlines the current applications, troubleshooting, safety and efficiency of arterial MCD in free flaps...
2024: Journal of Oral Biology and Craniofacial Research
https://read.qxmd.com/read/38288031/multidisciplinary-management-of-total-anterior-skull-base-osteoradionecrosis
#12
Aatin K Dhanda, Sean P McKee, David Z Allen, Omar G Ahmed, Kurt A Yaeger, Laura Minhui Kim, Joshua J Kain
Cases of delayed osteoradionecrosis (ORN) of the anterior skull base have unique management considerations. A 59-year-old woman with a history of basaloid squamous cell carcinoma of the sinonasal cavity with intracranial extension through the anterior skull base developed delayed radiation sequelae of anterior skull base ORN. She underwent an initial endoscopic resection in 2011 with persistent disease that required an anterior craniofacial resection with left medial maxillectomy in 2012. She had a radiologic gross total resection with microscopic residual disease at the histologic margins prompting adjuvant chemoradiotherapy to target volume doses of 66 to 70 Gy with concurrent cisplatin chemotherapy...
January 2024: Journal of Neurological Surgery Reports
https://read.qxmd.com/read/38278774/perforator-based-chimeric-ulnar-forearm-microvascular-free-tissue-transfer-reconstruction-of-post-radiated-tracheoesophageal-puncture-fistulae
#13
JOURNAL ARTICLE
Ray Wang, Victoria Manon, Andrew T Huang
Tracheoesophageal puncture (TEP) performed during total laryngectomy in the primary treatment of laryngeal cancer is the standard method for voice restoration. Following adjuvant radiotherapy, the TEP site can experience complications resulting in a tracheoesophageal fistula (TEF) with chronic leakage making oral alimentation unsafe due to aspiration. Here, we describe a technique using chimeric ulnar artery perforator forearm free flaps (UAPFF) in the reconstruction of these complex deformities. Four patients underwent chimeric UAPFF reconstruction of TEP site TEFs following primary TL with TEP and adjuvant radiotherapy...
January 26, 2024: Head & Neck
https://read.qxmd.com/read/38212165/comparison-of-the-microvascular-anastomotic-coupler%C3%A2-system-with-hand-sewn-suture-for-end-to-end-veno-venous-anastomosis-for-head-and-neck-reconstruction-with-free-flap-transfer-medico-economic-retrospective-case-control-study
#14
JOURNAL ARTICLE
Charline Mourgues, David Balayssac, Aurélien Mulliez, Claire-Marie Planeix, Gabrielle Feydel, Adrien Biard, Véra Alaux-Boïko, Charles Irthum, Nicolas Saroul, Nathalie Pham Dang
The aim of this study was to assess the medico-economic impact of the MACD Coupler™ system in comparison with HSA for end to end veno-venous anastomosis during free flap transfer. A retrospective case-control study was performed in an academic institution, from March 2019 through July 2021, to analyze medical and economic outcomes of patients managed for head and neck reconstruction with free flap transfer. 43 patients per group were analyzed. Rates of initial success, re-intervention, complications and flap transfer failure were not different between groups...
January 1, 2024: Journal of Cranio-maxillo-facial Surgery
https://read.qxmd.com/read/38205684/microvascular-surgery-using-surgical-loupes-versus-operating-microscope-a-single-head-and-neck-reconstructive-surgeon-s-experience
#15
JOURNAL ARTICLE
Jeewanjot S Grewal, Amy M Williams, Uthman Alamoudi, Mohamed Shama, Tamer A Ghanem
BACKGROUND: This prospective randomized study evaluates surgical outcomes of head and neck free tissue transfer surgery performed by a single head and neck reconstructive surgeon comparing the use of surgical loupes and the operating microscope. METHODS: Cases using surgical loupes were performed under ×3.5 magnification, whereas cases using the microscope were done using the standard operating microscope. Patient demographics, comorbidities, operative details, surgical outcomes, and flap failure were assessed...
January 11, 2024: Head & Neck
https://read.qxmd.com/read/38194889/virtual-surgical-planning-for-mandibular-reconstruction-in-an-abbreviated-admission-pathway
#16
JOURNAL ARTICLE
Olivia E Speed, Kaersti Rickells, Soroush Farsi, Tyler Merrill, J Reed Gardner, Deanne King, Jumin Sunde, Emre Vural, Mauricio A Moreno
OBJECTIVES: Virtual Surgical Planning (VSP) creates individualized surgical plans for free flap reconstruction of mandibular defects. Prior studies indicate that VSP can offer cost benefits due to reduced operative time and length of stay (LOS). We assessed the impact of VSP in the context of a validated postoperative abbreviated LOS clinical pathway. METHODS: This study assessed patients undergoing VSP vs conventional fibular free flap reconstruction for mandibular defects (12/2015-10/2020) and their operative time, ischemia time, and LOS were evaluated...
December 6, 2023: American Journal of Otolaryngology
https://read.qxmd.com/read/38162533/postoperative-outcomes-of-aspirin-in-microvascular-free-tissue-transfer-surgery-a-systematic-review-and-meta-analysis
#17
REVIEW
Sahal A Khan, Ramah K Tayeb
Microvascular free tissue transfer surgery is a frequently used technique for head and neck reconstruction involving anticoagulants, and the present study aimed to analyse the postoperative outcomes of aspirin use in conjunction with this procedure. We searched databases for articles published between 2007 and 2022 on microvascular free tissue transfer surgery using aspirin and assessed them for primary and secondary outcomes. Odds ratios (ORs) and 95 % confidence intervals (CIs) were determined through analyses, followed by constructing a forest plot for complication rates...
March 2024: JPRAS Open
https://read.qxmd.com/read/38158599/pedicled-peroneus-brevis-muscle-flaps-as-an-alternative-to-fasciocutaneous-rotational-flaps-for-lower-extremity-soft-tissue-defects
#18
JOURNAL ARTICLE
Merlin Antúnez, Cormac Huyen, Rafael Neiman
OBJECTIVE: To report our experience using a peroneus brevis flap for soft tissue defects of the distal third of the tibia, ankle, and hindfoot in resource challenged environments. DESIGN: Retrospective review. SETTING: Rural outpatient surgical facility in Honduras. PATIENT SELECTION CRITERIA: Patients who sustained tibia, ankle, or hindfoot fractures or traumatic degloving, with critical sized soft tissue defects treated with either a proximally based or distally based pedicled peroneus brevis flap (PBF) to achieve coverage of the middle and distal third of the leg, ankle, and/or hindfoot...
December 26, 2023: Journal of Orthopaedic Trauma
https://read.qxmd.com/read/38149718/trends-in-free-flap-reconstruction-of-the-head-and-neck-a-single-surgeon-series-of-1027-free-tissue-transfers
#19
JOURNAL ARTICLE
Michael J Papanikolas, Jonathan R Clark
BACKGROUND: Free tissue transfer has fundamentally changed head and neck surgery, enabling reliable reconstruction of large defects with better function and aesthetics. This study assesses two decades of trends in free flap reconstruction, and how disease incidence, survival, surgeon caseload, team approach, and technology have impacted practice. METHODS: Retrospective analysis of 1027 head and neck free flaps from 2006 to 2022. Outcomes examined include chronological changes in flap selection, indication, length of stay, incorporation of virtual surgical planning (VSP), annual caseload, survival, and their associations with the single versus multi-team approach...
December 27, 2023: ANZ Journal of Surgery
https://read.qxmd.com/read/38130246/prolonged-operative-time-predicts-postoperative-deep-venous-thrombosis-in-head-and-neck-cancer-patients-who-undergo-free-flap-reconstruction
#20
JOURNAL ARTICLE
Kevin C Lee, Nicholas A Waring, Victoria X Yu, Ogoegbunam Okolo, Salvatore M Caruana, Scott H Troob, Anuraag S Parikh
OBJECTIVE: This study sought to quantify the deep venous thrombosis (DVT) incidence in head and neck cancer (HNC) patients undergoing free tissue transfer and to identify independent predictors of postoperative DVT. MATERIALS AND METHODS: This is a cross-sectional study of the National Surgical Quality Improvement Program database from 2010 through 2020. The sample included all HNC surgical patients treated with free flap reconstruction. The study outcome was the presence of a DVT requiring treatment within 30 days of surgery...
December 2023: Laryngoscope Investigative Otolaryngology
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