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Latissimus dorsi flap reconstruction

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https://www.readbyqxmd.com/read/29746277/skin-paddles-improve-muscle-flap-salvage-rates-after-microvascular-compromise-in-lower-extremity-reconstruction
#1
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...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29746274/combined-autologous-and-prosthetic-breast-reconstruction-defining-the-upper-limits-of-safe-expansion-in-obesity
#2
Joshua H Choo, Thomas J Lee, Steven A Schulz, Mitchell Buller, Bradon J Wilhelmi
BACKGROUND: Combined latissimus dorsi and prosthetic reconstruction is a useful reconstructive option in patients with a history of breast radiation who are not good candidates for abdominally based autologous reconstruction. One difficulty, particularly in obese patients, is that the thickness of the flap can impair port localization, increasing the risk of inadvertent puncture during expansion. The authors sought to investigate the upper limits of tissue thickness at which tissue expansion can be reliably performed...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29738107/feasibility-safety-and-clinical-outcomes-following-latissimus-dorsi-flap-reconstruction-in-breast-cancer-an-institutional-study
#3
Srinivas Kodaganur, Ulhas Paga, Amritanshu Ram, Anand Krishna, Amarendra Shankarappa, Shivanand Swamy, Gopinath Kodaganur
No abstract text is available yet for this article.
May 8, 2018: Breast Journal
https://www.readbyqxmd.com/read/29737002/lower-limb-reconstruction-with-chimeric-flaps-the-quad-flap
#4
Solomon M Azouz, Nikki A Castel, Aparna Vijayasekaran, Alanna M Rebecca, Salvatore C Lettieri
Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. We describe 2 cases of lower-extremity crush injuries salvaged with the quad flap. This novel flap consists of parascapular, scapular, serratus, and latissimus dorsi free flaps in combination on one pedicle...
May 7, 2018: Microsurgery
https://www.readbyqxmd.com/read/29724621/shoulder-related-donor-site-morbidity-and-patient-reported-satisfaction-after-delayed-breast-reconstruction-with-pedicled-flaps-from-the-back-a-comparative-analysis
#5
Mikkel Børsen Rindom, Gudjon L Gunnarsson, Marianne D Lautrup, René D Christensen, Jens A Sørensen, Jørn B Thomsen
BACKGROUND: We report a study evaluating and comparing shoulder-related morbidity associated with delayed breast reconstruction using either the conventional latissimus dorsi (LD) flap or the thoracodorsal artery perforator (TAP) flap. MATERIAL & METHODS: We conducted a retrospective cohort study of women over 18 years of age who had a unilateral, delayed breast reconstruction by either an LD or TAP flap at one center over a 56-month period. Shoulder function was assessed using the Constant Shoulder Score (CSS), which evaluated pain, activity of daily life (ADL), range of motion (ROM), and strength...
April 13, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29723399/outcomes-of-microvascular-flap-reconstruction-of-the-head-and-neck-in-patients-receiving-systemic-immunosuppressive-therapy-for-organ-transplantation
#6
Mark V Schaverien, Riley A Dean, Jeffrey N Myers, Lin Fang, Rene D Largo, Peirong Yu
BACKGROUND: For organ transplant recipients, cancer secondary to immunosuppressive therapy threatens long-term survival. The associated multiple comorbidities make major free flap reconstruction following cancer surgery a complicated event. This study evaluates the outcomes of free flap reconstruction in this population. METHODS: A retrospective chart review of all head and neck free flap cases in patients with a history of organ transplantation receiving systemic immunosuppressive therapy between 2005 and 2017 at a single-institution was conducted...
May 3, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29718823/wound-bed-preparation-for-capsulectomy-using-a-hydrosurgery-system
#7
Yushi Suzuki, Masaki Yazawa, Kazuo Kishi
INTRODUCTION: Wound bed preparation is necessary for proper wound healing. CASE REPORT: The case of a 75-year-old man with good outcomes after using a hydrosurgery system for capsulectomy is presented. At a 2-month follow-up visit, a fistula measuring 15 cm x 10 cm was found to have developed in the patient's left scapular region after the first wide-excision surgery for soft tissue sarcoma and reconstruction of the defect using a local flap. The wound had fluid collection and a capsule that was then debrided with a hydrosurgery system...
April 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29707452/pedicled-descending-branch-latissimus-dorsi-mini-flap-for-repairing-partial-mastectomy-defect-a-new-technique
#8
Ruizhao Cai, Zeming Xie, Lihuan Zhou, Jin Wang, Xing Li, Junhao Huang, Yan Wang, Mingtian Yang, Edward I Chang, Jun Tang
Volume loss is 1 of the major factors influencing cosmetic outcomes of breast after partial mastectomy (PM), especially for smaller breasts, and therefore, volume replacement is critical for optimizing the final aesthetic outcome. We present a novel technique of raising a pedicled descending branch latissimus dorsi (LD) mini-flap for reconstruction of PM defects via an axillary incision. After PM, the LD mini-flap is harvested through the existing axillary incision of the axillary dissection or the sentinel lymph node biopsy...
March 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29707442/the-functional-impact-of-breast-reconstruction-an-overview-and-update
#9
Jonas A Nelson, Iris T Lee, Joseph J Disa
As rates of bilateral mastectomy and immediate reconstruction rise, the aesthetic and psychosocial benefits of breast reconstruction are increasingly well understood. However, an understanding of functional outcome and its optimization is still lacking. This endpoint is critical to maximizing postoperative quality of life. All reconstructive modalities have possible functional consequences. Studies demonstrate that implant-based reconstruction impacts subjective movement, but patients' day-to-day function may not be objectively hindered despite self-reported disability...
March 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29684804/aesthetic-considerations-in-flap-reconstruction-of-the-burnt-face-in-males-a-demonstrative-case-report
#10
Abdullah E Kattan, Mohammad M Al-Qattan
INTRODUCTION: The face is unique because functional and aesthetic considerations are equally important. Extensive deep chemical burns of the face are usually reconstructed with flaps. In males, the use of the hair - bearing superficial temporal artery flap has the advantage of achieving a satisfactory outcome with regards to both function and aesthetics. PRESENTATION OF CASE: A 49-year-old man sustained a deep chemical burn to the right side of the face and neck...
April 16, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29664831/design-of-mini-latissimus-dorsi-flap-based-on-thoracodorsal-vascular-patterns
#11
Ehab Mostafa Elzawawy, Melad Naim Kelada, Ahmed Farouk Al Karmouty
INTRODUCTION: Latissimus dorsi (LD) flap has been used for reconstructive purposes in oncoplastic breast surgery. Using large part of the muscle as a flap leads to a residual functional loss. Muscle sparing and mini LD flaps can be used with no functional sequelae. However, the design of such flap presents a challenge. METHODS: Twenty cadavers were dissected on both sides to identify the different vascular patterns of the thoracodorsal (TD) pedicle. The vessels were counted, and the following measurements were taken: diameter, length, distance from inferior angel of scapula, and vertebral level...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29644315/limb-salvage-and-reconstruction-following-a-zebra-attack
#12
Jacob T Carlson, James C Yuen, Matthew R Smeds
Animal bites are fairly rare events but can cause devastating traumatic injuries to the victim. In addition to the soft tissue, vascular, and orthopedic trauma inflicted by these occurrences, bite injuries also have the potential to introduce an inoculum of microbes, which may progress to an infection if not treated properly and expeditiously. We present the case of a healthy male who sustained multiple bite wounds from a domestic zebra to his left upper extremity. This attack caused severe damage, including devascularization of the arm at the brachial artery, disruption of the distal biceps and brachialis, stripping of the forearm nerves, and shearing of the overlying soft tissue...
June 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29622476/total-penile-reconstruction-a-systematic-review
#13
REVIEW
A Yao, M J Ingargiola, C D Lopez, P Sanati-Mehrizy, N M Burish, E M Jablonka, P J Taub
BACKGROUND: Phalloplasty poses a unique challenge to the plastic and reconstructive surgeon. The development of advanced microsurgical techniques has greatly augmented the range of surgical approaches available. METHODS: A systematic review of the MEDLINE and Cochrane databases was performed to identify clinical studies of total penile reconstruction published within the last 10 years using the search algorithm: "(phallus or penis or penile) and (reconstruction or phalloplasty or transplant)"...
February 14, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29594336/a-rare-case-of-atypical-thoracodorsal-artery-a-challenge-for-flap-reconstruction
#14
Naveen Kumar, Ashwini P Aithal, Satheesha B Nayak, Ravi Bhaskar
The thoracodorsal artery mainly supplies the latissimus dorsi muscle. Anatomical details pertaining to the origin and distribution of thoracodorsal artery are important because the latissimus dorsi myocutaneous flap is one of the most reliable and versatile flaps used in reconstructive surgery. Atypical origin and course of the thoracodorsal artery is, therefore, a challenge for flap reconstruction surgeries. In the present case, we report multiple variations in the branching pattern of axillary artery. The thoracodorsal artery had an unusual origin from the second part of axillary artery...
March 29, 2018: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29564032/postmastectomy-breast-reconstruction-with-the-totally-autologous-latissimus-dorsi-flap-in-the-thin-small-breasted-woman-give-it-more-thought
#15
Fawz Kazzazi, Rosanna C Ching, Charles M Malata
Introduction: Thin women have fewer autologous tissue breast reconstructive options than their higher body mass index counterparts-due to a lack of adequate donor sites. They are therefore usually offered expander/implant techniques. The total autologous latissimus dorsi flap is generally used in "well-padded" individuals, as they have enough fat on their back on which a completely autologous reconstruction could be based. When implant-based reconstruction is contraindicated (for instance due to planned adjuvant radiotherapy) or unacceptable to the patient, the total autologous latissimus dorsi flap can provide adequate tissue volume by utilizing the additional back fat deposits even in the thin, small-breasted patient...
2018: Eplasty
https://www.readbyqxmd.com/read/29506826/nonresponse-bias-in-survey-research-lessons-from-a-prospective-study-of-breast-reconstruction
#16
Nicholas L Berlin, Jennifer B Hamill, Ji Qi, Hyungjin M Kim, Andrea L Pusic, Edwin G Wilkins
BACKGROUND: Survey-based research is essential for evaluating the outcomes of health care in an era of patient-centered care. However, many such studies are hampered by poor response rates in completion of study questionnaires, thus limiting the generalizability of any findings. The objectives of this analysis were to identify independent variables associated with nonresponse to surveys following breast reconstruction to improve future patient-reported outcomes research. MATERIALS AND METHODS: The Mastectomy Reconstruction Outcomes Consortium is a prospective cohort study involving 11 leading medical centers from the United States and Canada...
April 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29504150/reconstruction-of-diabetic-lower-leg-and-foot-soft-tissue-defects-using-thoracodorsal-artery-perforator-chimeric-flaps
#17
Il Hoon Sung, Dong Woo Jang, Se Wan Kim, Youn Hwan Kim, Sang Wha Kim
BACKGROUND: Reconstruction of complicated diabetic lower leg and foot defects involving multiple tissue components remains a challenge. The purpose of this report is to introduce thoracodorsal artery perforator (TDAP) chimeric flaps for reconstructing diabetic lower leg and foot soft tissue defects. PATIENTS AND METHODS: Between April 2010 and August 2016, 17 patients with multiple diabetic lower leg and foot defects underwent reconstruction with TDAP chimeric flaps...
March 5, 2018: Microsurgery
https://www.readbyqxmd.com/read/29476562/functional-lower-lip-reconstruction-with-the-partial-latissimus-dorsi-muscle-free-flap-without-nerve-coaptation
#18
Özlenen Özkan, Ömer Özkan, Anı Çinpolat, Mehmet Can Ubur, Gamze Bektaş, Adil Jumshudov, Hilmi Uysal
BACKGROUND: The repair of extensive lower lip defects is difficult due to the presence of both functional and esthetic requirements. This report describes functional lip repair using the partial latissimus dorsi free flap without nerve coaptation. METHODS: Reconstruction of the lower lip due to subtotal and total tissue defects was performed using latissimus dorsi free flap on twelve patients, between 2013 and 2017. The etiology was squamous cell carcinoma in six patients, malignant melanoma in one, firearm injury in three and microstomia in two...
February 23, 2018: Microsurgery
https://www.readbyqxmd.com/read/29464176/latissimus-dorsi-and-immediate-fat-transfer-lift-for-complete-autologous-breast-reconstruction
#19
James M Economides, David H Song
Background: Despite the popularity of latissimus dorsi (LD) flap in breast reconstruction, a breast implant is often necessary to achieve sufficient volume. Prior reports describe fat grafting to the LD flap as a secondary procedure to correct contour deformities and improve volume. Our institution has instituted autologous breast reconstruction with an LD flap and immediate fat transfer (LIFT). Methods: A retrospective review of all patients undergoing the LIFT procedure was undertaken...
January 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29464162/hinge-flap-with-triangular-extension-for-reconstruction-of-pharyngocutaneous-and-laryngocutaneous-fistulas
#20
Ryuichi Azuma, Shimpo Aoki, Masahiro Kuwabara, Tetsushi Aizawa, Hisato Nagano, Tomoharu Kiyosawa
Hinge flaps are commonly used for closure of a pharyngocutaneous fistula (PCF) or laryngocutaneous fistula. These flaps are employed to augment the wall of the pharynx or larynx, but the junction between the reconstructed and native lumens can eventually become narrow and irregular after reconstruction with standard hinge flaps. We devised a method of adding a triangular extension to the end of either or both flaps and used it to treat 3 patients. In 1 patient who developed a PCF (4 × 10 cm) after laryngectomy followed by radiotherapy, the fistula was closed with 2 hinge flaps...
January 2018: Plastic and Reconstructive Surgery. Global Open
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