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Latissimus dorsi flap reconstruction

Malgorzata Banys-Paluchowski, Eike Burandt, Joanna Banys, Stefan Geist, Guido Sauter, Natalia Krawczyk, Peter Paluchowski
Breast cancer (BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented with a newly diagnosed large, symptomatic mass in his left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation...
October 10, 2016: World Journal of Clinical Oncology
Milan V Stevanovic, Vanessa G Cuéllar, Alidad Ghiassi, Frances Sharpe
: In the upper extremity, the latissimus dorsi muscle can be used as an ipsilateral rotational muscle flap for soft-tissue coverage or functional reconstruction of arm and elbow. Patients who have both major soft-tissue loss and functional deficits can be successfully treated with a single-stage functional latissimus dorsi rotational muscle transfer that provides simultaneous soft-tissue coverage and functional reconstruction. METHODS: Our data base was queried for all patients undergoing a rotational latissimus dorsi muscle transfer for simultaneous soft-tissue coverage and functional reconstruction of elbow flexion...
September 2016: Plastic and Reconstructive Surgery. Global Open
Summer E Hanson, Benjamin D Smith, Jun Liu, Geoffrey L Robb, Steven J Kronowitz, Patrick B Garvey
: The most commonly chosen flaps for delayed breast reconstruction after postmastectomy radiation therapy (PMRT) are abdominal-based free flaps (ABFFs) and pedicled latissimus dorsi (LD) musculocutaneous flaps. The short-and long-term advantages and disadvantages of delayed ABFFs versus LD flaps after PMRT remain unclear. We hypothesized that after PMRT, ABFFs would result in fewer postoperative complications and a lower incidence of revision surgery than LD flaps. METHODS: We retrospectively reviewed a prospectively maintained database of consecutive patients who underwent unilateral, delayed breast reconstruction after PMRT using ABFFs or pedicled LD flaps with implants at the MD Anderson Cancer Center between January 1, 2001, and December 31, 2011...
September 2016: Plastic and Reconstructive Surgery. Global Open
Shimpei Miyamoto, Masahide Fujiki, Fumihiko Nakatani, Eisuke Kobayashi, Masanobu Sakisaka, Minoru Sakuraba
BACKGROUND: Complex groin defects after sarcoma resection require reconstruction of multiple vital structures that can include the major vessels, the overlying skin, the abdominal wall, and the hip joint. We investigated the feasibility of limb preservation after complex groin reconstruction. METHODS: The subjects were 12 consecutive patients who underwent complex groin reconstruction after sarcoma resection. In all patients, the defect included a major artery (external iliac or femoral) and overlying skin...
October 6, 2016: Annals of Plastic Surgery
Arzu Ozcan Akcal, Kerim Ünal, Tahsin Gorgulu, Mehmet Akif Akcal, Zekiye Bigat
In this report we present two cases of gunshot injury related midfoot defects, reconstructed with a chimeric partial scapula and latissimus dorsi muscle flap and short perforator-based skin flap. The first case, a 14 years old male, had 10 × 8 cm medial plantar and 6 × 4 cm dorsal foot defects and the second case, a 55 years old female, had only 8 × 6 cm dorsal foot defect. In both cases the defects were associated with fractures, one with lateral cuneiform and cuboid with 90% bone loss and the other with navicular bone, respectively...
October 2016: Microsurgery
Jordan J Allensworth, Scott H Troob, Tyler S Weaver, Javier D Gonzalez, Daniel Petrisor, Mark K Wax
OBJECTIVE: Acute invasive fungal sinusitis (AIFS) is a frequently fatal infection for which extensive and debilitating surgical debridement is a mainstay of therapy. Resulting defects are often composite in nature, mandating free tissue-transfer reconstruction. Outcomes data for free flap reconstruction are limited. The purpose of this study was to examine surgical outcomes and survival in patients undergoing free flap transfer following invasive fungal sinusitis. STUDY DESIGN: Retrospective case series...
October 12, 2016: Laryngoscope
Gül Alço, Sefik Igdem, Sait Okkan, Maktav Dincer, Dauren Sarsenov, Ahmet Serkan Ilgun, Filiz Agacayak, Filiz Elbüken, Tulay Ercan, Derya Selamoglu, Vahit Ozmen
The aim of the present study was to evaluate the geographic variability of the tumor bed following oncoplastic breast-conserving surgery (OP-BCS), and to assess its relevance for radiotherapy planning. In this prospective study, pre- and postoperative computerized tomography (CT) scans of 22 patients with early-stage breast cancer were fused. The preoperative gross tumor volume or excisional biopsy cavity were contoured under the guidance of preoperative radiological images. Postoperative lumpectomy cavities were contoured under the guidance of surgical clips...
October 2016: Molecular and Clinical Oncology
Gui-Yong Park, Eul-Sik Yoon, Hee-Eun Cho, Byung-Il Lee, Seung-Ha Park
BACKGROUND: The objective of this paper was to describe a novel technique for improving the maintenance of nipple projection in primary nipple reconstruction by using acellular dermal matrix as a strut in one of three different configurations, according to the method of prior breast reconstruction. The struts were designed to best fill the different types of dead spaces in nipple reconstruction depending on the breast reconstruction method. METHODS: A total of 50 primary nipple reconstructions were performed between May 2012 and May 2015...
September 2016: Archives of Plastic Surgery
H Keil, M Kreinest, U Kneser, T Kremer, M Schnetzke, P A Grützner, S Matschke
This article presents the case of a high-grade deformity of the thoraco-lumbar spine. The patient suffered from a sarcoma that was radically resected. Due to adjuvant radiation, the patient suffered from a radiation injury with chronic fistula. In a two-stage approach, the deformity was corrected by a closing-wedge osteotomy of L3 with elongation of the present dorsal spondylodesis (Th10-L4) to Th8 and the iliac bone. Soft-tissue reconstruction was achieved by a free latissimus dorsi flap that was anastomosed to an axillary arterio-venous loop...
September 14, 2016: Der Unfallchirurg
Jeong Tae Kim, Youn Hwan Kim, Sang Wha Kim
INTRODUCTION: Fibrin sealants have had applications in hemostasis, cohesion, and promotion of healing in plastic surgery. In this article, we review cases where fibrin sealant was used to stabilize microvascular pedicles and compared with previous free flaps performed without fibrin sealant. METHODS: Between 2008 and 2010, 62 consecutive patients underwent free tissue transfer for reconstruction; this involved 33 latissimus dorsi perforator flaps, 14 thoracodorsal artery perforator flaps, 9 latissimus dorsi myocutaneous flaps, 3 lateral thoracic artery perforator flaps, and 3 transverse rectus abdominis myocutaneous flaps, used in head and neck reconstruction, lower limb reconstructions, breast reconstructions, and facial palsy reconstruction...
September 16, 2016: Microsurgery
Ushio Hanai, Tadashi Akamatsu, Megumi Kobayashi, Yotaro Tsunoda, Kenichi Hirabayashi, Tanehumi Baba, Hideki Atsumi, Mitsunori Matsumae
INTRODUCTION: The prognosis of malignant peripheral nerve sheath tumor (MPNST) with neurofibromatosis type 1 (NF-1) is worse than that of a solitary MPNST, because of the tumor size and location difficult to resect completely. We experienced a case of MPNST in the occipital region with NF-1. CASE REPORT: A 59-year-old woman presented with NF-1 and an MPNST of the occipital region. We performed wide excision involving the occipital bone, and reconstructed with a titanium plate and a free latissimus dorsi muscle flap...
2016: Tokai Journal of Experimental and Clinical Medicine
Carlos Olvera-Caballero, Abel Ortiz-Dominguez
A 15-year-old patient harmed himself upon firing a shotgun that he was carrying when he slipped and fell, causing a destructive wound in the right arm with a medial entry hole and a posterolateral exit hole. The biceps, coracobrachialis, triceps, deltoids, skin cover, and humerus were injured; however, the blood vessels and major nerves of the area were surprisingly not affected. The residual skin muscle defect after debridements was 16 × 5 cm medially and posteriorly, and the bone loss was 7 cm. The wound was reconstructed during a single surgery with a free fibula flap and a pedicled flap of latissimus dorsi...
August 2016: Plastic and Reconstructive Surgery. Global Open
A de Runz, D Boccara, F Bekara, M Chaouat, M Mimoun
BACKGROUND: Delayed breast reconstruction with tissue expansion may be risky after radiotherapy, due to the poor skin quality. To permit the use of the tissue expansion procedure, we propose a scarless latissimus dorsi flap to bring tissue trophicity, by a healthy vascularized muscular interface with no donor scar and no patch effect. The objective of this study is to assess the outcome of the tissue expansion technique with scarless latissimus dorsi flap after post-mastectomy radiotherapy...
September 7, 2016: Annales de Chirurgie Plastique et Esthétique
Eugene Y Fukudome, Deepak R Bharadia, Douglas L Helm, Indranil Sinha
Large posterior upper trunk defects can be challenging to reconstruct. Trapezius or latissimus dorsi myocutaneous flaps are principally utilized for reconstruction; however, some defects may not be amenable to this standard approach. Here, we describe a patient with a full-thickness skin and subcutaneous tissue loss of the upper back and inferior cervical region after dermatofibrosarcoma protuberans resection. A large, extended V-Y flap was used for closure of this wound secondary to its location, size, and orientation...
May 2016: Plastic and Reconstructive Surgery. Global Open
Joseph I Chen, Camille G Cash, Al-Haj Iman, Aldona J Spiegel, Ernest D Cronin
Nipple-areola reconstruction is often one of the final but most challenging aspects of breast reconstruction. However, it is an integral and important component of breast reconstruction because it transforms the mound into a breast. We performed 133 nipple-areola reconstructions during a period of 4 years. Of these reconstructions, 76 of 133 nipple-areola complexes were reconstructed using the keyhole flap technique. The tissue used for the keyhole dermoadipose flap technique include transverse rectus abdominus myocutaneous flaps (60/76), latissimus dorsi flaps (15/76), or mastectomy skin flaps after tissue expanders (1/76)...
May 2016: Plastic and Reconstructive Surgery. Global Open
E Delay, S La Marca, S Guerid
Breast deformity of Poland syndrome is a malformation known to be difficult to treat. Numerous descriptions of surgical corrections have been published but none achieved to correct severe cases before description of lipomodeling technique. The aim of this article is to present thoraco-mammary deformity of Poland syndrome, corrections techniques already available and therapeutical indications in primary and secondary cases. Constant anomaly of Poland syndrome is agenesis of sternocostal part of pectoralis major muscle but other muscular anomalies can be associated...
October 2016: Annales de Chirurgie Plastique et Esthétique
Michael Mirmanesh, Dan Mazzaferro, Zachary Borab, Lee L Q Pu
No abstract text is available yet for this article.
2016: Eplasty
Pierfrancesco Cadenelli, Daniele Bordoni, Matteo Ornelli, Stefano Radaelli
Reconstruction of large soft tissue defects in the upper arm represents a challenge for the reconstructive surgeon. The latissimus dorsi flap is widely used and preferred for this latter type of reconstruction due to its reliability and versatility, although sacrificing the entire muscle can lead to higher incidences of postoperative seroma and functional disability. The recent introduction of the perforator-based flap concept has led to an evolution in upper extremity reconstruction by significantly reducing donor-site morbidity and simultaneously ensuring optimal soft tissues coverage...
2016: BMJ Case Reports
Ozay Ozkaya Mutlu, Ozlem Colak, Mert Canli, Ayberk Akcay
INTRODUCTION: Cutis verticis gyrata is a rare skin disorder characterized by formation of thick skin folds and grooves. Because of the risk of malignant transformation, these lesions must be surgically excised. In this study, the authors aimed to present a successful reconstruction of scalp with free latissimus dorsi musculocutaneous flap after total excision of giant cerebriform intradermal nevus that causes cutis verticis gyrata. PATIENT REPORT: An 18-year-old male patient attended to our clinic with a large tumor that covers almost 80% of his scalp...
September 2016: Journal of Craniofacial Surgery
Elena Irene Jordán-Palomar, Etelvina Javierre, José Rey-Vasalo, Víctor Alfaro-Santafé, María José Gómez-Benito
Most pedobarographic studies of microsurgical foot reconstruction have been retrospective. In the present study, we report the results from a prospective pedobarographic study of a patient after microsurgical reconstruction of her foot with a latissimus dorsi flap and a cutaneous paddle, with a 42-month follow-up period. We describe the foot reconstruction plan and the pedobarographic measurements and analyzed its functional outcome. The goal of the present study was to demonstrate that pedobarography could have a role in the treatment of foot reconstruction from a quantitative perspective...
August 11, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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