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Microvascular free tissue transfer

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https://www.readbyqxmd.com/read/30099733/limb-salvage-and-functional-outcomes-following-free-tissue-transfer-for-the-treatment-of-recalcitrant-diabetic-foot-ulcers
#1
Jocelyn Lu, Michael V DeFazio, Chrisovalantis Lakhiani, Michel Abboud, Morgan Penzler, Tammer Elmarsafi, Paul J Kim, Christopher E Attinger, Karen K Evans
BACKGROUND:  Recent evidence documenting high success rates following microvascular diabetic foot reconstruction has led to a paradigm shift in favor of more aggressive limb preservation. The primary aim of this study was to examine reconstructive and functional outcomes in patients who underwent free tissue transfer (FTT) for recalcitrant diabetic foot ulcers (DFUs) at our tertiary referral center for advanced limb salvage. METHODS:  Between June 2013 and June 2016, 29 patients underwent lower extremity FTT for diabetic foot reconstruction by the senior author (K...
August 12, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/30098772/perioperative-considerations-in-free-flap-surgery-a-review-of-pressors-and-anticoagulation
#2
Mark K Wax, James Azzi
Given the high stakes for microvascular reconstruction, the majority of reconstructive surgeons have developed paradigms for pre, intra, and postoperative management that have proven to result in individual high success rates. Much has been done to identify and avoid perioperative factors that could potentially increase flap failure rates. Two example of this practice has been the generalized use of anticoagulation in free tissue transfer and the prohibition against vasopressor use in patients that are undergoing free tissue transfer...
August 2018: Oral Oncology
https://www.readbyqxmd.com/read/30072141/detection-of-thrombosis-in-microvessels-with-indocyanine-green-videoangiography
#3
T Mücke, C Wolff, A M Fichter, M von Düring, A Kanatas, L M Ritschl
Atherosclerosis is a systemic condition that is responsible for many diseases, and becomes a problem in cases where plaques form at several sites. The formation of a thrombotic embolus may jeopardise vascular operations, including microvascular anastomoses in replantation procedures or free tissue transfers. A mobile imaging tool for the detection of thrombosis preoperatively or intraoperatively would be valuable. An intimal injury, simulating removal of atherosclerotic plaques, was made microsurgically in 60 rat aortas, and results were analysed macroscopically, histologically, and with intraoperative indocyanine green (ICG) videoangiography immediately postoperatively...
July 30, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/30067528/medial-arm-flap-an-unexplored-option-for-autologous-breast-reconstruction-in-the-setting-of-morbid-obesity
#4
Miguel de la Parra Marquez, Ricardo Fernandez-Riera
Currently, deep inferior epigastric perforator flap is undoubtedly the first choice for autologous breast reconstruction for most surgeons; however, there are instances where lower abdominal tissue is unavailable for microvascular transfer. In these cases, most surgeons choose gluteal or lower-extremity territories as donor sites.In the setting of morbid obesity, there is an increased risk of flap and donor site complications, as well as increased blood loss, surgical time, and risk of deep venous thrombosis, not to mention a more challenging surgical technique...
July 31, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/30060705/a-clinical-care-pathway-to-reduce-icu-usage-in-head-and-neck-microvascular-reconstruction
#5
Elliot Morse, Cara Henderson, Tracy Carafeno, Jacqueline Dibble, Peter Longley, Edwin Chan, Benjamin Judson, Wendell G Yarbrough, Clarence Sasaki, Saral Mehra
Objective To design and implement a postoperative clinical care pathway designed to reduce intensive care usage on length of stay, readmission rates, and surgical complications in head and neck free flap patients. Methods A postoperative clinical care pathway detailing timelines for patient care was developed by a multispecialty team. In total, 108 matched patients receiving free tissue transfer for reconstruction of head and neck defects in the year before (prepathway), year after (early pathway), and second year after (late pathway) pathway implementation were compared based on postoperative length of stay, 30-day readmission rate, intensive care unit (ICU) admission, and rates of medical/surgical complications...
July 31, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/30028496/reconstruction-of-extensive-scalp-defects-with-anterolateral-thigh-flap
#6
Altuğ Altınkaya, Şükrü Yazar, İbrahim Sağlam, Kaan Gideroğlu
BACKGROUND: Extensive scalp defects caused by various etiologies often require free-tissue transfer. We aimed to review our experience in the reconstruction of extensive scalp defects with free anterolateral flaps. METHODS: A retrospective analysis was performed on all patients with extensive scalp defects that were reconstructed with free anterolateral thigh flaps from November 2007 to April 2015. Eleven patients with a mean age of 44 years were included in this study...
July 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/30024418/functional-considerations-in-oral-cavity-reconstruction
#7
Patrik Pipkorn, Kelsey Rosenquist, Joseph Zenga
PURPOSE OF REVIEW: The treatment of oral cavity cancer may impair speech and swallowing function. Optimizing posttreatment function may lead to significant improvement of quality of life. RECENT FINDINGS: Although oncologic control remains the main goal of treatment for oral cavity cancer, posttreatment function for surviving patients has over the last decades been recognized as an important secondary outcome. Reconstruction of oral cavity defects range from primary closure to advanced microvascular reconstruction, including multiple tissue types...
July 17, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29992336/focus-on-anatomical-aspects-of-soft-tissue-coverage-options-in-elbow-reconstruction-an-updating-review
#8
Silvia Gandolfi, Isabelle Auquit-Auckbur, Yoann Poirot, Albane Bonmarchand, Jordane Mouton, Raphael Carloni, Iad Nseir, Fabrice Duparc
INTRODUCTION: The elbow joint is particularly exposed to soft tissue injuries associated with fractures and dislocations. Different coverage options within the past decades for recovering loss of soft tissue defects around the elbow region have been proposed based on anatomical research. Our aim was to make an updated focus on the anatomical basis of different techniques of coverage of loss of tissues around the elbow. MATERIALS AND METHODS: The main procedures of flaps were defined: local random, axial fasciocutaneous, local muscle pedicle, propeller and free microvascular flaps...
July 10, 2018: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29975233/long-term-outcomes-after-pediatric-free-flap-reconstruction
#9
Lee W T Alkureishi, Chad A Purnell, Patricia Park, Bruce S Bauer, Neil A Fine, Mark Sisco
INTRODUCTION: Whereas free tissue transfer has evolved to minimize morbidity in adults, less is known about outcomes after free flaps in children. This study sought to assess short- and long-term outcomes after microvascular reconstruction in the pediatric population. METHODS: Short- and long-term outcomes of free tissue transfer were assessed using chart-review and quality-of-life surveys. The Pediatric Outcomes Data Collection Instrument was used to evaluate overall health, pain, and ability to participate in normal daily and more vigorous activities...
July 2, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29965916/-smaller-diameter-anastomotic-coupling-devices-have-higher-rates-of-venous-thrombosis-in-microvascular-free-tissue-transfer
#10
Alberto Ruiz-Cases, Enrique Salmerón-González, Alberto Pérez-García, Juan R Esteban-Vico, Elena García-Vilariño
No abstract text is available yet for this article.
June 22, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29965913/smaller-diameter-anastomotic-coupling-devices-have-higher-rates-of-venous-thrombosis-in-microvascular-free-tissue-transfer
#11
Summer E Hanson, Patrick B Garvey
No abstract text is available yet for this article.
June 22, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29965906/bridging-the-gap-a-20-year-experience-with-vein-grafts-for-free-flap-reconstruction-the-odds-for-success
#12
Amir Inbal, Amanda K Silva, Laura S Humphries, Chad M Teven, Lawrence J Gottlieb
BACKGROUND: Successful free tissue transfer requires tension-free microvascular anastomoses. Vein grafts are utilized when this cannot be obtained, which increases microsurgical complexity and the chance of vessel thrombosis. Previous studies on vein grafts are limited to low numbers and selected techniques, making it difficult to draw conclusions. METHODS: A retrospective chart review was performed for all patients who underwent vein grafts in free flap reconstruction from 1995 to 2015...
June 22, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29908709/shorter-interval-between-radiation-therapy-and-salvage-laryngopharyngeal-surgery-increases-complication-rates-following-microvascular-free-tissue-transfer
#13
Eric J Formeister, A Sean Alemi, Ivan El-Sayed, Jonathan R George, Patrick Ha, P Daniel Knott, William R Ryan, Rahul Seth, Matthew L Tamplen, Chase M Heaton
PURPOSE: To evaluate how the interval between radiation and salvage surgery for advanced laryngeal cancer with free tissue transfer reconstruction influences complication rates. MATERIALS AND METHODS: This is a retrospective series of 26 patients who underwent salvage laryngectomy or laryngopharyngectomy with vascularized free tissue reconstruction (anterolateral thigh or radial forearm) following radiation or chemoradiation between 2012 and 2017 at a single academic center...
June 6, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29892322/thromboprophylaxis-in-head-and-neck-microvascular-reconstruction
#14
REVIEW
Manoj Abraham, Arvind Badhey, Shirley Hu, Sameep Kadakia, J K Rasamny, Augustine Moscatello, Yadranko Ducic
Head and neck patients undergoing microvascular reconstruction are at high risk for thromboembolism. While the prevention of thromboembolism has become an essential aspect of care, within the field of microsurgery, concern for anastomotic complications have hindered the creation of an accepted regimen. The aim of this review was to evaluate the risks and benefits of prophylactic agents for thromboprophylaxis. A literature search was conducted in MEDLINE, Cochrane Library, and PubMed/NCBI databases. Articles discussing thromboprophylaxis in otolaryngology, head and neck surgery, or microvascular reconstruction were considered in the review from the past 30 years...
June 2018: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29878995/changes-in-cutaneous-gene-expression-after-microvascular-free-tissue-transfer-in-parry-romberg-disease
#15
Jenny Tzujane Chen, Brian Eisinger, Corinne Esquibel, Samuel O Poore, Kevin Eliceiri, John W Siebert
PURPOSE: Parry Romberg's Disease (PRD) is an enigmatic craniofacial disorder characterized by progressive facial atrophy. The pathogenesis and molecular mechanisms governing PRD have never before been described. The purpose of our current study was two fold; 1) to begin to elucidate the pathophysiology of this disease using next gen RNA sequencing and 2) evaluate the effect of surgical treatment on gene expression. METHODS: Patients with PRD underwent microvascular free tissue transfer (MVFF) to the face to address contour deformity in both active and burned out disease...
June 5, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29775983/classification-and-microvascular-flap-selection-for-anterior-cranial-fossa-reconstruction
#16
James D Vargo, Wojciech Przylecki, Paul J Camarata, Brian T Andrews
BACKGROUND:  Microvascular reconstruction of the anterior cranial fossa (ACF) creates difficult challenges. Reconstructive goals and flap selection vary based on the defect location within the ACF. This study evaluates the feasibility and reliability of free tissue transfer for salvage reconstruction of low, middle, and high ACF defects. METHODS:  A retrospective review was performed. Reconstructions were anatomically classified as low (anterior skull base), middle (frontal bar/sinus), and high (frontal bone/soft tissue)...
May 18, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29747901/use-of-a-microvascular-coupler-device-for-end-to-side-venous-anastomosis-in-oral-and-maxillofacial-reconstruction
#17
W-M Wang, L Huang, X Gao, Y-X Yuan, X-Q Chen, X-C Jian
The aim of this study was to compare the use of a microvascular coupler device (MCD) for end-to-side venous anastomosis (ETS group) and phleboplasties combined with MCD for end-to-end venous anastomosis (ETE group) in free tissue transfer for oral and maxillofacial reconstruction, with regard to the anastomosis time and occurrence of postoperative vascular crisis. The ETS group included 22 patients and the ETE group included 40 patients. Patient demographic data, anastomotic time, coupler size, microvascular complications, and flap survival rates were collected and analyzed...
May 7, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29746277/skin-paddles-improve-muscle-flap-salvage-rates-after-microvascular-compromise-in-lower-extremity-reconstruction
#18
John T Stranix, Adam Jacoby, Z-Hye Lee, Lavinia Anzai, Pierre B Saadeh, Vishal Thanik, Jamie P Levine
PURPOSE: Free tissue transfer after lower extremity trauma is associated with notoriously high complication rates. Theoretically, the inclusion of a cutaneous paddle on muscle free flaps may improve clinical flap monitoring. The effect of skin paddle presence on muscle free flap salvage outcomes after take-back was examined. METHODS: Retrospective query of our institutional free-flap registry (1979-2016) identified 362 muscle-based flaps performed for soft tissue coverage after below-knee trauma...
July 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29730059/nasotracheal-intubation-the-preferred-airway-in-oral-cavity-microvascular-reconstructive-surgery
#19
Jordan Gigliotti, Godwin Cheung, Omar Suhaym, Ramanakumar V Agnihotram, Michel El-Hakim, Nicholas Makhoul
PURPOSE: We aimed to describe the safety and effectiveness of nasotracheal intubation (NTI) in a cohort of patients undergoing reconstruction of oral cavity defects with free tissue transfer (FTT). MATERIALS AND METHODS: We implemented a retrospective cohort study and enrolled a sample composed of consecutive patients undergoing FTT reconstruction of oral cavity, maxillary, or mandibular defects between 2013 and 2017. These patients were all subject to a newly developed enhanced recovery-after-surgery protocol...
April 11, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29729609/virtual-surgical-planning-and-three-dimensional-printing-in-multidisciplinary-oncologic-chest-wall-resection-and-reconstruction-a-case-report
#20
Basel Sharaf, M Diya Sabbagh, Aparna Vijayasekaran, Mark Allen, Jane Matsumoto
INTRODUCTION: Primary sarcomas of the sternum are extremely rare and present the surgical teams involved with unique challenges. Historically, local muscle flaps have been utilized to reconstruct the resulting defect. However, when the resulting oncologic defect is larger than anticipated, local tissues have been radiated, or when preservation of chest wall muscles is necessary to optimize function, local reconstructive options are unsuitable. PRESENTATION OF CASE: Virtual surgical planning (VSP) and in house three-dimensional (3D) printing provides the platform for improved understanding of the anatomy of complex tumours, communication amongst surgeons, and meticulous pre-operative planning...
2018: International Journal of Surgery Case Reports
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