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Diep flap surgery

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https://www.readbyqxmd.com/read/27798949/impact-of-time-interval-between-radiation-and-free-autologous-breast-reconstruction
#1
Aaron B Mull, Ali A Qureshi, Ema Zubovic, Yuan J Rao, Imran Zoberi, Ketan Sharma, Terence M Myckatyn
BACKGROUND: To evaluate whether the timing of surgery after radiation in autologous breast reconstruction affects major complications. METHODS: We performed a retrospective review of 454 free flaps (331 patients) for breast reconstruction at a single institution from 2003 to 2014. Charts were reviewed for age, BMI, laterality, flap type (TRAM, msTRAM, DIEP), surgeon, donor vessels (IMA, TD), chemotherapy, smoking, diabetes, hypertension, DVT, venous anastomoses, vein size, and time from radiation (none, < 12 months, or ≥ 12 months)...
October 31, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27622090/predictors-of-reoperations-in-deep-inferior-epigastric-perforator-flap-breast-reconstruction
#2
Dmytro Unukovych, Camilo Hernandez Gallego, Helena Aineskog, Andres Rodriguez-Lorenzo, Maria Mani
BACKGROUND: The deep inferior epigastric perforator (DIEP) procedure is regarded a safe option for autologous breast reconstruction. Reoperations, however, may occur, and there is no consensus in the literature regarding the risk factors. The aim of this study was to identify factors associated with reoperations in DIEP procedure. PATIENTS AND METHODS: A retrospective study of consecutive patients undergoing DIEP breast reconstruction 2007 to 2014 was performed and included a review of 433 medical charts...
August 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27579248/diep-flap-for-breast-reconstruction-using-epidural-anesthesia-with-the-patient-awake
#3
Miguel de la Parra, Marco Camacho, Jonatan de la Garza
BACKGROUND: Many articles have been published about breast reconstruction using the deep inferior epigastric perforator (DIEP) flap; however, few articles have been published in plastic/reconstructive surgery journals describing the difference between anesthetic techniques and recovery in microsurgical patients. METHODS: We analyzed 16 patients who underwent DIEP flap for breast reconstruction. Patients were divided into 2 groups: group 1: general anesthesia (n = 9); group 2: epidural block with the patient awake (n = 7)...
May 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27542592/contralateral-breast-symmetrisation-in-unilateral-diep-flap-breast-reconstruction
#4
Ryckie G Wade, Francesco Marongiu, Elaine M Sassoon, Richard M Haywood, Rozina S Ali, Andrea Figus
INTRODUCTION: Women undergoing unilateral deep inferior epigastric artery perforator (DIEP) flap breast reconstruction may be offered a contralateral symmetrisation either at the time of reconstruction (simultaneous/immediate) or at a later stage (delayed). Simultaneous contralateral breast symmetrisation may be more beneficial to patients and healthcare institutions by avoiding staged surgery, although there is limited evidence on which to base practice. This deficit formed the rationale for our study...
October 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27464608/postmastectomy-reconstruction-outcomes-after-intraoperative-evaluation-with-indocyanine-green-angiography-versus-clinical-assessment
#5
Gustave K Diep, Jane Yuet Ching Hui, Schelomo Marmor, Bruce L Cunningham, Umar Choudry, Pamela R Portschy, Todd M Tuttle
BACKGROUND: Mastectomy flap necrosis is a major complication in patients undergoing tissue expander-based reconstruction. This study compared the complication rates following mastectomy and immediate reconstruction with intraoperative indocyanine green (ICG) angiography evaluation to those with clinical assessment only. METHODS: We performed a single-institution retrospective study of mastectomy patients who underwent immediate tissue expander-based reconstruction between September 2009 and December 2013...
November 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27411505/erratum-to-failed-pneumoperitoneum-for-laparoscopic-surgery-following-autologous-deep-inferior-epigastric-perforator-diep-flap-breast-reconstruction-a-case-report
#6
Daniel M Balkin, Quan-Yang Duh, Gabriel M Kind, David S Chang, Mary H McGrath
No abstract text is available yet for this article.
2016: BMC Surgery
https://www.readbyqxmd.com/read/27391834/the-profunda-artery-perforator-pap-flap-experience-for-breast-reconstruction
#7
Robert J Allen, Z-Hye Lee, James L Mayo, Joshua Levine, Christina Ahn, Robert J Allen
BACKGROUND: The profunda artery perforator (PAP) flap was first introduced as a modality for breast reconstruction in 2010. Herein, we analyze the results of all PAP flaps performed by our group thus far to demonstrate that it is a reliable option for breast reconstruction. METHODS: A retrospective review was completed of consecutive PAP flaps performed by the senior author from 2010-2014. Patient demographics, indications, operative techniques, flap specifics, complications and number of operations were recorded...
July 5, 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27350267/abdominal-morbidity-after-single-versus-double-pedicled-deep-inferior-epigastric-perforator-flap-use
#8
Hirokazu Uda, Yoko Katsuragi Tomioka, Syunji Sarukawa, Ataru Sunaga, Hideaki Kamochi, Yasusih Sugawara, Kotaro Yoshimura
BACKGROUND AND AIM: The reduced incidence of donor site morbidity after deep inferior epigastric perforator (DIEP) flap is because the rectus muscle and its fascia are preserved. However, no study has proved that trunk flexion recovers not by the compensatory effect of the contralateral rectus muscle but by reinnervation of the ipsilateral rectus muscle. We hypothesized that if sufficient reinnervation occurs, patients who undergo single-pedicled DIEP (S-DIEP) flap or double-pedicled DIEP (D-DIEP) flap breast reconstruction would have similar levels of preoperative trunk flexion...
September 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27125256/smoking-increases-donor-site-complications-in-breast-reconstruction-with-diep-flap
#9
Stina Klasson, Johan Nyman, Henry Svensson, Patrik Velander
OBJECTIVE: Reconstruction with deep inferior epigastric perforator flap (DIEP) is considered to be the first choice for autologous breast reconstruction. The primary aims of this retrospective study were to find out if differences in smoking habits and BMI are useful predictors for postoperative complications in DIEP surgery. METHODS: Three hundred and one patients were included. Data regarding smoking habits, BMI, age at surgery, total and final flap weight, abdominal scars, parity, number of perforators, chemotherapy, post mastectomy radiation therapy, and preoperative mapping of perforators with either Computer Tomography Angiography or hand-held ultra sound Doppler were collected...
April 29, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27120999/failed-pneumoperitoneum-for-laparoscopic-surgery-following-autologous-deep-inferior-epigastric-perforator-diep-flap-breast-reconstruction-a-case-report
#10
Daniel M Balkin, Quan-Yang Duh, Gabriel M Kind, David S Chang, Mary H McGrath
BACKGROUND: Laparoscopic abdominal surgery may prove difficult in patients who have undergone previous abdominal procedures. No reports in the medical literature have presented an aborted laparoscopic procedure for failed pneumoperitoneum following autologous flap-based breast reconstruction. CASE PRESENTATION: A 55-year-old woman presented with recurrent invasive lobular carcinoma of the right breast as well as a history of ductal carcinoma in situ of the left breast...
April 27, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27069312/diep-flap-salvage-by-cannula-venesection-of-the-superficial-inferior-epigastric-vein
#11
Puttan Wongtriratanachai, Abbe Michelle Martin, Kongkrit Chaiyasate
: The deep inferior epigastric perforator (DIEP) flap is a technique of autologous breast reconstruction that is gaining popularity. The main advantage of the DIEP flap over the traditional transverse rectus abdominis myocutaneous (TRAM) flap is that there is a lower incidence of abdominal wall donor-site morbidity with the DIEP flap. However, venous congestion is the most dreaded complication of DIEP flap surgery which requires prompt intervention. In this case report, we present a simple but effective procedure to salvage the congested DIEP flap...
2016: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/27051398/first-report-of-pyoderma-gangrenosum-after-surgery-of-breast-cancer-related-lymphedema-with-transfer-of-vascularized-free-lymph-nodes-of-the-groin-and-simultaneous-diep-flap
#12
Angela A García-Ruano, Esther Deleyto, Jose Maria Lasso
BACKGROUND: Pyoderma gangrenosum (PG) is a rare cutaneous ulcerative disease that does not respond to antibiotics and worsens with surgical manipulation. This is the first report in the literature revealing that this disease complicates total microsurgical breast reconstruction associated with the transfer of free lymph nodes. CASE REPORT: We report the case of a female patient who underwent left-breast microsurgical reconstruction with a deep inferior epigastric perforator (DIEP) flap and simultaneous transfer of vascularized free lymph nodes for the surgical treatment of secondary left upper-limb lymphedema, and who developed a severe PG of both the skin of the flap and the donor zone on postoperative day 7...
February 2016: Breast Care
https://www.readbyqxmd.com/read/27049776/myosonographic-study-of-abdominal-wall-dynamics-to-assess-donor-site-morbidity-after-microsurgical-breast-reconstruction-with-a-diep-or-an-ms-2-tram-flap
#13
K Seidenstuecker, U Legler, B Munder, C Andree, A Mahajan, C Witzel
BACKGROUND: Currently, autologous breast reconstruction with a free tissue transfer from the lower abdomen is considered to be a safe method that provides a stable long-term solution. The DIEP-flap and the ms-2-TRAM-flap reconstructions have helped reduce donor site morbidity. In order to assess the potential differences between these techniques, we carried out myosonographic evaluations that assessed the muscle dynamics pre- and post-operatively. In addition to investigating the properties of the rectus abdominis muscle post-operatively, this prospective study also allowed us to analyse the muscle preoperatively and to investigate the prospects for harvesting a DIEP-flap as opposed to a TRAM-flap...
May 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27047777/preoperative-computed-tomography-angiography-for-planning-diep-flap-breast-reconstruction-reduces-operative-time-and-overall-complications
#14
Edmund Fitzgerald O'Connor, Warren Matthew Rozen, Muhammad Chowdhry, Bassam Band, Venkat V Ramakrishnan, Matthew Griffiths
BACKGROUND: The approach and operative techniques associated with breast reconstruction have steadily been refined since its inception, with abdominal perforator-based flaps becoming the gold standard reconstructive option for women undergoing breast cancer surgery. The current study comprises a cohort of 632 patients, in whom specific operative times are recorded by a blinded observer, and aims to address the potential benefits seen with the use of computer tomography (CT) scanning preoperatively on operative outcomes, complications and surgical times...
April 2016: Gland Surgery
https://www.readbyqxmd.com/read/27047776/the-microvascular-anastomotic-coupler-for-venous-anastomoses-in-free-flap-breast-reconstruction-improves-outcomes
#15
Edmund Fitzgerald O'Connor, Warren Matthew Rozen, Muhammad Chowdhry, Nakul Gamanlal Patel, Whitney T H Chow, Matthew Griffiths, Venkat V Ramakrishnan
BACKGROUND: Venous couplers are ubiquitous around the world and are a useful tool for the reconstructive microsurgeon. A systematic review of coupler performance studies demonstrated a thrombosis rate range of 0% to 3%, whilst the average time of using the device is 5 minutes. There is sparse published data on cost analysis and the impact of operator experience on the anastomotic coupler device success. Improvements in outcomes other than time benefits have also not been shown. This study aims to address these deficiencies in the literature...
April 2016: Gland Surgery
https://www.readbyqxmd.com/read/27016179/-breast-reconstruction-with-profunda-artery-perforator-flap-a-prospective-study-of-30-consecutive-cases
#16
K Haddad, V Hunsinger, D Obadia, M Hivelin, L Lantieri
INTRODUCTION: Many flaps have been described in autologous breast reconstruction, the most common being the deep inferior epigastric perforator (DIEP) flap. This flap cannot be harvested in a certain range of patients. The profunda artery perforator (PAP) flap, based on perforators from profunda femoral artery, is therefore a good option. OBJECTIVE: The goal was to highlight technical tips, particularities, and complications of our series of the 30 first PAP flaps for breast reconstruction in our department...
June 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/26946931/a-new-strategy-for-prophylactic-surgery-in-brca-women-combined-mastectomy-and-laparoscopic-salpingo-oophorectomy-with-immediate-reconstruction-by-double-diep-flap
#17
V Hunsinger, A C Marchac, M Derder, M Hivelin, F Lecuru, A-S Bats, L Lantieri
BACKGROUND: Prophylactic surgery remains the most effective modality for reducing both breast and ovarian cancer rate in woman at high risk, such as BRCA1 or BRCA2. Autologous breast reconstruction with bilateral deep inferior epigastric perforator (DIEP) flap allows predictable and durable results. However, existing two-step approach separating salpingo-oophorectomy and reconstruction could even make DIEP flap impossible, or make insufflation more difficult during laparoscopy. Other authors described one-step procedure but with open laparotomy...
June 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/26910655/surgically-treated-hernia-following-abdominally-based-autologous-breast-reconstruction-prevalence-outcomes-and-expenditures
#18
MULTICENTER STUDY
Valeriy Shubinets, Justin P Fox, Jonathan R Sarik, Stephen J Kovach, John P Fischer
BACKGROUND: Donor-site hernia is one of the most feared complications following abdominally based autologous breast reconstruction. The authors aim to assess the incidence of surgically repaired abdominal hernia across different types of abdominally based breast reconstruction, identify predictive perioperative factors, and estimate the health care charges associated with this morbidity. METHODS: Using inpatient and ambulatory surgery data from four states in the United States, the authors identified adult women who underwent pedicled transverse rectus abdominis muscle (TRAM), free TRAM, or deep inferior epigastric perforator (DIEP) flap breast reconstruction between 2008 and 2012...
March 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/26855905/conservative-mastectomies-and-immediate-delayed-autologous-ideal-breast-reconstruction-the-diep-flap
#19
Maximilian Otte, Carolin Nestle-Krämling, Sonia Fertsch, Mazen Hagouan, Beatrix Munder, Philip Richrath, Peter Stambera, Alina Abu-Ghazaleh, Christoph Andree
BACKGROUND: With the development of conservative mastectomies, there are an increasing number of women seeking immediate implant based and autologous breast reconstruction. Despite the oncologic safety of the procedures, the focus will be on the timing of reconstruction. METHODS: Our plastic surgery unit is focused primarily on autologous breast reconstruction and is part of an interdisciplinary breast center. We offer immediate breast reconstruction (IBR) with autologous tissue for patients with positive BRCA 1 and 2, ductal carcinoma in situ (DCIS), invasive cancer without margin problems to the skin, as well as to correct poor oncologic and aesthetic breast conserving therapy (BCT) outcomes...
February 2016: Gland Surgery
https://www.readbyqxmd.com/read/26831037/change-of-paradigm-in-thoracic-radionecrosis-management
#20
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
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