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microvascular free tissue

Michael V DeFazio, James M Economides, Ersilia L Anghel, Eshetu A Tefera, Karen K Evans
AIM:  No consensus exists regarding the optimal strategy for perioperative thromboprophylaxis in high-risk microsurgical populations. We present our experience with lower extremity free tissue transfer (FTT) in thrombophilic patients and compare outcomes between non-stratified and risk-stratified anticoagulation protocols. METHODS:  Between January 2013 and December 2017, 57 patients with documented thrombophilia underwent FTT for non-traumatic, lower extremity reconstruction by a single surgeon...
October 16, 2018: Journal of Reconstructive Microsurgery
Alain Joe Azzi, Sarah Zhou, Tyler Safran, Liqin Xu, Nayif Alnaif, Teanoosh Zadeh
INTRODUCTION: Radiation therapy (RT) is recommended for appropriately selected sarcoma patients to minimize the risk of local recurrence and to maximize outcomes of disease-free survival and function. The purpose of this study was to confirm the safety of vascularized tissue reconstruction in recently irradiated sarcoma defects. METHODS: A retrospective review of all patients treated by the senior author for sarcoma reconstruction from January 2005 to July 2017 was performed...
October 15, 2018: Annals of Plastic Surgery
Raimund H M Preidl, Patrick Möbius, Manuel Weber, Kerstin Amann, Friedrich W Neukam, Marco Kesting, Carol-Immanuel Geppert, Falk Wehrhan
BACKGROUND: Microvascular free flap reconstruction has become a standard technique in head and neck reconstructive surgery. Pre-operative radiotherapy is associated with a higher incidence of free flap malperfusion and the need for operative revision. Irradiated vessels present characteristic histomorphological and structural changes. Alterations in endothelial cells of irradiated arteries remain incompletely investigated especially with regard to long-term changes in endothelial dysfunction supporting an intraluminal pro-thrombotic and pro-inflammatory milieu...
October 15, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Mohammad Ali Alessa, Sang Hyun Kwak, Young Woo Lee, Mi-Lan Kang, Hak-Joon Sung, Soon Hyun Ahn, Eun Chang Choi, Won Shik Kim
Live models that resemble surgical conditions of humans are needed for training free-flap harvesting and anastomosis. Animal models for training purposes have been available for years in many surgical fields. We used the female (because they are easy to handle for the procedure) Yorkshire pigs for the head and neck reconstruction by harvesting the deep inferior epigastric artery perforator or the superior epigastric artery perforator flap. The anastomosis site (neck skin defect or tracheal wall defect) was prepared via the dissection of the common carotid artery and the internal jugular vein, in which 3...
September 29, 2018: Journal of Visualized Experiments: JoVE
Valentin Demidov, Xiao Zhao, Olga Demidova, Hilary Y M Pang, Costel Flueraru, Fei-Fei Liu, I Alex Vitkin
Radiation therapy (RT) is widely and effectively used for cancer treatment but can also cause deleterious side effects, such as a late-toxicity complication called radiation-induced fibrosis (RIF). Accurate diagnosis of RIF requires analysis of histological sections to assess extracellular matrix infiltration. This is invasive, prone to sampling limitations, and thus rarely used; instead, current practice relies on subjective clinical surrogates, including visual observation, palpation, and patient symptomatology questionnaires...
October 2018: Journal of Biomedical Optics
Jeremy Bechelli, Leoncio Vergara, Claire Smalley, Tetyana P Buzhdygan, Sean Bender, William Zhang, Yan Liu, Vsevolod L Popov, Jin Wang, Nisha Garg, Seungmin Hwang, David H Walker, Rong Fang
Rickettsiae can cause life-threatening infections in humans. Macrophages are one of the initial targets for rickettsiae after inoculation by ticks. However, it remains poorly understood how rickettsiae remain free in macrophages prior to establishing their infection in microvascular endothelial cells. Here, we demonstrated that the concentration of Rickettsia australis was significantly greater in infected tissues of Atg5flox/flox mice compared to the counterparts of Atg5flox/flox Lyz- Cre mice, in association with a reduced level of IL-1β in serum...
October 8, 2018: Infection and Immunity
D Zweifel, M G Bredell, H Essig, T Gander, M Lanzer, C Rostetter, M Rücker, S Studer
The Surgical reconstruction of defects of the face is challenging. Local and regional flaps have an important part to play, but large defects of bone and soft tissue are a greater problem. Microvascular tissue transfer has become the standard for such patients, and preoperative planning of bony reconstructions is now common. To use these preplanning tools best the implants should be placed in the prosthetically ideal place, and the bone positioned to surround the implants - that is, truly backward planning of the position of the bone...
October 4, 2018: British Journal of Oral & Maxillofacial Surgery
Frederik W Fried, Justus P Beier, Christopher Bohr, Heinrich Iro, Raymund E Horch, Andreas Arkudas
Although free flap reconstruction has already gained widespread acceptance in pediatric patients, little is known about the outcome of free tissue transfer in head and neck reconstruction in pediatric patients. We present a case of a 6-month-old boy with a large volume deficit in the right temporal fossa after resection of a teratoma. This led to a large volume deficit with widely undermined skin margins. Therefore, we provided volume augmentation by microsurgical free latissimus dorsi myocutaneous flap transplantation...
October 2, 2018: Annals of Plastic Surgery
Chu-Yu Jing, Yi-Peng Fu, Jin-Long Huang, Mei-Xia Zhang, Yong Yi, Wei Gan, Xin Xu, Hu-Jia Shen, Jia-Jia Lin, Su-Su Zheng, Juan Zhang, Jian Zhou, Jia Fan, Zheng-Gang Ren, Shuang-Jian Qiu, Bo-Heng Zhang
BACKGROUND: Fibrotic tumor stroma (FTS) has been implicated in cancer promotion in several neoplasms. The histological features of FTS are convenient and easily accessible in clinical routine in intrahepatic cholangiocarcinoma (ICC) specimens. The goal of this study was to explore prognostic impacts of the quantity and maturity of FTS on surgical ICC patients. Moreover, we aimed to propose an efficient prognostic nomogram for postoperative ICC patients. MATERIALS AND METHODS: The clinical profiles of 154 consecutive postoperative ICC patients were retrospectively analyzed...
September 26, 2018: Oncologist
Peng Sheng Yi, Bin Wu, Da Wei Deng, Guang Nian Zhang, Jian Shui Li
The objective of the present study was to investigate the association between zinc finger protein (ZNF) 689 expression and the clinicopathological features and prognosis of hepatocellular carcinoma (HCC). A total of 102 paired HCC and paired non-cancerous tissues, and 16 normal liver tissues were collected. ZNF689 expression was examined in HCC tissues, paired-noncancerous tissues, and normal liver tissues using RT-qPCR and immunohistochemistry analysis, and the association between ZNF689 expression and HCC prognosis was analyzed using the Kaplan-Meier method...
October 2018: Oncology Letters
Mofiyinfolu Sokoya, Aurora G Vincent, Rohan Joshi, Sameep Kadakia, Scott Kohlert, Thomas S Lee, Masoud Saman, Yadranko Ducic
OBJECTIVES/HYPOTHESIS: Microvascular free tissue transfer is often employed to reconstruct significant facial defects from ballistic injuries. Herein, we present our comparison of complications between self-inflicted and non-self-inflicted gunshot wounds after microvascular free tissue transfer. STUDY DESIGN: Retrospective case review. METHODS: Approval was obtained from the JPS institutional review board. We performed a retrospective review of cases of ballistic facial injuries between October 1997 and September 2017 that underwent vascularized free tissue transfer for reconstruction...
September 24, 2018: Laryngoscope
Fares Samra, Christopher Bibbo, L Scott Levin, Stephen J Kovach
Introduction: The anterolateral thigh (ALT) flap allows for healthy, reliable, vascularized, soft-tissue coverage of extremity or axial defects of traumatic or acquired deformities. Indications & Contraindications: <AbstractText Label="Step 1 Positioning and Markings" NlmCategory="UNASSIGNED">Place the patient in the supine position, which allows for flap harvest and typically does not require any position changes (Fig. 1), and then mark the septum between the vastus lateralis and rectus femoris, which facilitates harvest of this flap (Video 1)...
September 28, 2017: JBJS Essential Surgical Techniques
Dmitry Zavlin, Vishwanath Chegireddy, Kevin T Jubbal, Nikhil A Agrawal, Aldona J Spiegel
BACKGROUND:  Maintaining optimal coagulation is vital for successful microvascular tissue transfer. The viscoelastic thromboelastography (TEG) is a modern and dynamic method to assess a patient's coagulation status. The aim of this study was to evaluate its diagnostic capabilities of identifying microvascular complications. METHODS:  A retrospective chart review was conducted for the most recent 100 cases of abdominal free flap breast reconstruction of a single surgeon...
September 19, 2018: Journal of Reconstructive Microsurgery
Eric I Chang, Carrie K Chu, Edward I Chang
The use of preoperative imaging has become routine for many reconstructive microsurgeons to help localize perforators for planning of microvascular free flaps. However, with advancements in imaging technology, perforator mapping represents only one potential benefit as virtual planning and medical modeling, and flap tissue perfusion are also rapidly becoming commonplace and the standard of care for many surgeons who perform high-volume free flap reconstruction for the breast, head and neck, torso, and the extremities...
October 2018: Journal of Surgical Oncology
Kevin J Kovatch, John E Hanks, Jayne R Stevens, Chaz L Stucken
OBJECTIVES/HYPOTHESIS: Despite major advances in the field of head and neck microvascular free tissue transfer (MFTT) over the past several decades, there are no standardized perioperative regimens for the care of patients undergoing free flap reconstructive surgery, and continued variation in practice exists. This study aimed to report current trends in the field of MFTT performed by otolaryngologists, including surgeon training, institutional operative practices, and perioperative management...
September 8, 2018: Laryngoscope
Romain Appay, Emeline Tabouret, Mehdi Touat, Catherine Carpentier, Carole Colin, François Ducray, Ahmed Idbaih, Karima Mokhtari, Emmanuelle Uro-Coste, Caroline Dehais, Dominique Figarella-Branger
Diffuse gliomas are classified according to the 2016 WHO Classification of Tumors of the Central Nervous System, which now defines entities by both histology and molecular features. Somatostatin receptor subtype 2A (SSTR2A) expression has been reported in various solid tumors as associated with favorable outcomes. Its expression has been reported in gliomas with uncertain results regarding its prognostic value. The objective of this study was to assess the prognostic impact of SSTR2A protein expression in a large cohort of grade III and IV gliomas classified according to the updated 2016 WHO classification...
September 7, 2018: Acta Neuropathologica Communications
María Dolores López-Lucas, Gisela Pachón-Peña, Ana María García-Hernández, Antonio Parrado, Darío Sánchez-Salinas, David García-Bernal, Maria Del Carmen Algueró, Francisca Iniesta Martinez, Miguel Blanquer, Valentín Cabañas-Perianes, Mar Molina-Molina, Cira Asín-Aguilar, José M Moraleda, Robert Sackstein
BACKGROUND: The regenerative and immunomodulatory properties of human mesenchymal stromal cells (hMSCs) have raised great hope for their use in cell therapy. However, when intravenously infused, hMSCs fail to reach sites of tissue injury. Fucose addition in α(1,3)-linkage to terminal sialyllactosamines on CD44 creates the molecule known as hematopoietic cell E-/L-selectin ligand (HCELL), programming hMSC binding to E-selectin that is expressed on microvascular endothelial cells of bone marrow (BM), skin and at all sites of inflammation...
August 29, 2018: Cytotherapy
Gerardo Pellegrino, Achille Tarsitano, Agnese Ferri, Giuseppe Corinaldesi, Alberto Bianchi, Claudio Marchetti
BACKGROUND: Dental rehabilitation with conventional prostheses after microvascular jaw reconstruction is often unsuccessful because of the altered oral anatomy and the lack of adequate dentition for fixation. PURPOSE: This retrospective study evaluated the long-term outcomes of patients who underwent jaws reconstruction with a fibula free flap and subsequent rehabilitation with implant-supported prostheses. MATERIALS AND METHODS: In total, 21 patients were enrolled; 108 osseointegrated dental implants, positioned on 21 fibular free flaps were assessed...
August 24, 2018: Clinical Implant Dentistry and related Research
Anna Marseglia, Laura Fratiglioni, Grégoria Kalpouzos, Rui Wang, Lars Bäckman, Weili Xu
INTRODUCTION: The impact of prediabetes and diabetes on cognitive decline and the potential underlying mechanisms remain unclear. We investigated whether prediabetes and diabetes accelerate cognitive decline and brain aging, and the initial pathological changes linked to microvascular processes. METHODS: Nine-year longitudinal data from the Swedish National Study on Aging and Care-Kungsholmen (n = 2746, age ≥60 years) and the magnetic resonance imaging subsample (n = 455) were used...
August 13, 2018: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Baber Khatib, Ashish Patel, Eric J Dierks, Allen Cheng
The radial forearm flap is a versatile reconstructive option for oral cavity defects with highly reliable success rates. We encountered more than one flap compromise when we used a radial forearm flap to reconstruct the soft tissue and provide coverage over the mandible, after a marginal mandibulectomy. From this observation, we modified our technique for radial forearm harvest and inset to avoid placing the pedicle in compression against the mandible. The purpose of this article is to present the cases that led to this observation, and present the technique modification in design and execution that we have used...
July 20, 2018: Journal of Oral and Maxillofacial Surgery
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