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Latissimus dorsi flap reconstruction

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https://www.readbyqxmd.com/read/28096323/pyoderma-gangrenosum-following-complex-reconstruction-of-a-large-scale-lower-limb-defect-by-combined-parascapular-and-latissimus-dorsi-flap
#1
Tomke Cordts, Amir K Bigdeli, Leila Harhaus, Christoph Hirche, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
A female patient with a critical soft tissue defect after elective knee replacement surgery was transferred to our department for reconstruction. As wounds were rapidly progressing, necrotizing fasciitis was initially suspected but eventually ruled out by histopathological analysis. A 50 × 15 cm defect was then reconstructed by means of a combined Parascapular and latissimus dorsi flap before, a couple days later, the patient developed tender pustules and ulcers involving the flap as well as the donor site...
January 17, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28079533/national-and-regional-differences-in-32-248-postmastectomy-autologous-breast-reconstruction-using-the-updated-national-inpatient-survey
#2
Parisa Kamali, Marek A Paul, Ahmed M S Ibrahim, Pieter G L Koolen, Winona Wu, Marc L Schermerhorn, Bernard T Lee, Samuel J Lin
BACKGROUND: The incidence of breast cancer (BC) cases has increased significantly. The number of breast reconstruction (BR) procedures performed has mirrored this trend. Although implant-only procedures remain the most commonly used type of immediate BR, autologous techniques involving donor sites account for approximately 20%. The aim of this study was to assess national and regional trends in different types of autologous BR. METHODS: Using the Nationwide Inpatient Sample database (2008 to 2012), data on BC and mastectomy rates, type of autologous BR, and sociodemographics were obtained and analyzed...
January 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28045814/recalcitrant-invasive-skin-cancer-of-the-scalp-combined-extirpation-and-microsurgical-reconstruction-without-cranioplasty
#3
Gerald J Cho, Frederick Wang, Steven M Garcia, Jennifer Viner, William Y Hoffman, Michael W McDermott, Jason H Pomerantz
BACKGROUND: Recurrent invasive skin cancer of the scalp and calvarium is a difficult problem for which universally accepted treatment protocols have not been established. The authors present their 10-year experience with treatment of this specific subset of scalp reconstruction patients and present a successful treatment algorithm that is well suited to this patient population. METHODS: The authors retrospectively reviewed all patients of microsurgical scalp reconstruction performed from 2005 to 2015 that involved invasive cutaneous malignancies of the scalp and calvarium...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28033508/pathological-complete-response-in-invasive-breast-cancer-treated-by-skin-sparing-mastectomy-and-immediate-reconstruction-following-neoadjuvant-chemotherapy-and-radiation-therapy-comparison-between-immunohistochemical-subtypes
#4
J Barrou, M Bannier, M Cohen, E Lambaudie, A Gonçalves, P Bertrand, M Buttarelli, P Opinel, N Sterkers, A Tallet, C Zinzindohoué, G Houvenaeghel
CONTEXT: Even if neoadjuvant chemotherapy (NACT) and oncoplastic techniques have increased the breast conserving surgery rate, mastectomy is still a standard for multifocal or extensive breast cancers (BC). In the prospect of increasing breast reconstruction, an alternative therapeutic protocol was developed combining NACT with neoadjuvant radiation therapy (NART), followed by mastectomy with immediate breast reconstruction (IBR). The oncological safety of this therapeutic plan still needs further exploration...
December 26, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28018904/3d-volumetric-modeling-and-microvascular-reconstruction-of-irradiated-lumbosacral-defects-after-oncologic-resection
#5
Emilio Garcia-Tutor, Marco Romeo, Michael P Chae, David J Hunter-Smith, Warren Matthew Rozen
BACKGROUND: Locoregional flaps are sufficient in most sacral reconstructions. However, large sacral defects due to malignancy necessitate a different reconstructive approach, with local flaps compromised by radiation and regional flaps inadequate for broad surface areas or substantial volume obliteration. In this report, we present our experience using free muscle transfer for volumetric reconstruction, in such cases, and demonstrate three-dimensional (3D) haptic models of the sacral defect to aid preoperative planning...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/28018805/three-dimensional-custom-made-titanium-ribs-for-reconstruction-of-a-large-chest-wall-defect
#6
Isabel Simal, Maria Antonia García-Casillas, Julio Arturo Cerdá, Óscar Riquelme, Concepción Lorca-García, Laura Pérez-Egido, Beatriz Fernández-Bautista, Manuel de la Torre, Juan Carlos de Agustín
Reconstruction of large chest wall defects always demand surgeons of having lots of means available (both materials and resourceful) to apply a cover to chest wall defects which can range from a few centimeters to the lack of a few entire ribs. In this study, we present the case of a teenager who suffered from a complete resection of three ribs because of Ewing sarcoma dependent on the sixth rib. Given the size of the defect, a multidisciplinary approach was chosen to provide rigid and soft tissue coverage and minimal functional and aesthetic impact...
December 2016: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28007257/temporary-banking-of-the-jejunal-flap-for-a-difficult-esophageal-reconstruction
#7
Ömer Özkan, Özlenen Özkan, Matteo Amoroso
In this report, we describe a case of difficult esophageal reconstruction using temporary banking of a jejunal free flap. This flap was temporarily placed on the patient's chest wall using the internal mammary vessels (IMVs) as recipient vessels. After 15 days, the jejunal flap was transferred to the neck region, and permanent coverage was provided using a pedicled latissimus dorsi musculocutaneous flap.
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28005736/management-of-the-repeatedly-failed-cranioplasty-following-large-postdecompressive-craniectomy-establishing-the-efficacy-of-staged-free-latissimus-dorsi-transfer-tissue-expansion-custom-polyetheretherketone-implant-reconstruction
#8
Gerhard S Mundinger, Kerry Latham, Jeffery Friedrich, Otway Louie, Hakim Said, Craig Birgfeld, Richard Ellenbogen, Richard A Hopper
BACKGROUND: Postdecompressive craniotomy defect management following failed prior cranioplastyis challenging. The authors describe a staged technique utilizing free muscle transfer, tissue expansion, and custom polyetheretherketone (PEEK) implants for the management of previously failed cranioplasty sites in patients with complicating local factors. METHODS: Consecutive patients with previously failed cranioplasties following large decompressive craniectomies underwent reconstruction of skull and soft tissue defects with staged free latissimus muscle transfer, tissue expansion, and placement of custom computer-aided design and modeling PEEK implants with a 'temporalis-plus' modification to minimize temporal hollowing...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27998663/reconstruction-with-soft-tissue-free-flaps-for-large-defects-after-the-resection-of-giant-facial-neurofibroma
#9
L Hu, Y Xi, Y Wang, L Jiannan, J Han, Y Miao, S Gokavarapu, C Zhang, L Xu
Giant facial neurofibroma leads to disfigurement and functional and neurological deficits. Surgical resection is the mainstay of treatment and poses a great challenge to the surgeon with regard to the restoration of the defects arising from tumour resection. The cases of three male and three female patients diagnosed with giant facial neurofibroma, who underwent radical resection and reconstruction with soft tissue free flaps between 2008 and 2015, were analyzed retrospectively. Clinical data including patient sex, age, preoperative embolization of the nutrient artery, volume of blood loss, type and size of flaps used for reconstruction, and complications were recorded...
December 17, 2016: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27975020/divided-and-sliding-superficial-temporal-artery-flap-for-primary-donor-site-closure
#10
Yuta Sugio, Tateki Kubo, Shien Seike, Ko Hosokawa
Superficial temporal artery (STA) flaps are often used for reconstruction of hair-bearing areas. However, primary closure of the donor site is not easy when the size of the necessary skin island is relatively large. In such cases, skin grafts are needed at the donor site, resulting in baldness. We have solved this issue by applying the divided and sliding flap technique, which was first reported for primary donor-site closure of a latissimus dorsi musculocutaneous flap. We applied this technique to the hair-bearing STA flap, where primary donor-site closure is extremely beneficial for preventing baldness consequent to skin grafting...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27975006/primary-fat-grafting-to-the-pectoralis-muscle-during-latissimus-dorsi-breast-reconstruction
#11
Jeremy Niddam, Luciano Vidal, Barbara Hersant, Jean Paul Meningaud
BACKGROUND: Latissimus dorsi flap is one of the best options for immediate and delayed breast reconstruction. However, this technique is limited by the tissue volume provided by the flap. To improve breast volume while reducing complications, fat grafting is now very often used in addition to latissimus dorsi flap. To the best of our knowledge, fat grafting was always performed as a second-line surgery, at least a few months after the flap procedure. We aimed to report our experience with an associated breast reconstruction technique combining musculocutaneous latissimus dorsi flap with intrapectoral lipofilling for totally autologous breast reconstruction...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27971147/reconstruction-of-major-lower-extremity-amputation-stump-with-a-free-latissimus-dorsi-flap
#12
J P Repo, R P Roine, H Sintonen, E J Tukiainen
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27909467/invasive-squamous-cell-carcinoma-of-the-scalp-and-calvarium-a-multidisciplinary-approach
#13
Jennifer Stark, Silvio Podda, Karen Szymanski
Objective: The correlation between immunosuppression-associated skin cancer and lymphoma has been well established. This includes squamous cell carcinoma and chronic lymphocytic leukemia. When a lesion requires excision, reconstruction can be challenging based on the depth and size of the tumor. We present a patient with chronic lymphocytic leukemia and invasive squamous cell carcinoma of the scalp that extended through the calvarium to the dura mater. His tumors were badly neglected for a long period of time and presented at an advanced stage...
2016: Eplasty
https://www.readbyqxmd.com/read/27896193/multidisciplinary-approach-to-an-extended-pressure-sore-at-the-lumbosacral-area
#14
Sehoon Yoon, Euicheol Jeong, Hudson Alex Lázaro
A pressure sore wound is often extensive or complicated by local infection involving adjacent soft tissue and bone. In this case, a regional flap after simple debridement is not adequate. Here, we present a case of an extensive pressure sore in the sacral area with deep tissue infection. A 43-year-old female patient with a complicated sore with deep tissue infection had a presacral abscess, an iliopsoas abscess, and an epidural abscess in the lumbar spine. After a multidisciplinary approach performed in stages, the infection had subsided and removal of the devitalized tissue was possible...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27894916/reliability-of-extended-dorsal-intercostal-artery-perforator-propeller-flaps-for-reconstruction-of-large-myelomeningocele-defects
#15
Goktekin Tenekeci, Yavuz Basterzi
Reconstruction of large myelomeningocele defects using extended (elongated beyond the lateral margin of the latissimus dorsi muscle) dorsal intercostal artery perforator (DICAP) propeller flaps is not recommended by previous studies. However, to provide tension-free and successful closure of a defect, the DICAP propeller flaps must sometimes be elongated beyond this margin. Our experience and results in this issue are discussed. In this article, reconstruction of 11 consecutive cases, with large myelomeningocele defects in which standard DICAP propeller flaps were incapable to close the defect, was achieved using extended DICAP propeller flaps between June 2013 and November 2015...
January 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27866670/-shift-the-skin-paddle-in-an-additional-incision-improves-the-result-study-of-a-series-of-82-breast-reconstructions-by-latissimus-dorsi-flap-and-prosthesis-implantation-at-10-years
#16
S Chiriac, C Dissaux, C Bruant-Rodier, Z Djerada, F Bodin, C François
: The position of the skin paddle on the breast area is a fundamental element for the breast reconstructions by latissimus dorsi flap and prosthesis implantation. Should, as Millard advocated, to recreate the initial defect and include it in the mastectomy scar or is it better in an additional incision as have others authors. This study compares the long-term morphological results of these two attitudes, with or without additional incision. PATIENTS AND METHODS: Eighty-two breast reconstructions by latissimus dorsi flap and prosthesis implantation, with a mean follow-up of 9...
November 17, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/27864561/incidence-of-deep-vein-thrombosis-in-patients-undergoing-breast-reconstruction-with-autologous-tissue-transfer
#17
Hisato Konoeda, Takashi Yamaki, Atsumori Hamahata, Masakazu Ochi, Atsuyoshi Osada, Yuki Hasegawa, Miho Kirita, Hiroyuki Sakurai
BACKGROUND: Breast reconstruction is associated with multiple risk factors for venous thromboembolism. However, the incidence of deep vein thrombosis in patients undergoing breast reconstruction is uncertain. OBJECTIVE: The aim of this study was to prospectively evaluate the incidence of deep vein thrombosis in patients undergoing breast reconstruction using autologous tissue transfer and to identify potential risk factors for deep vein thrombosis. METHODS: Thirty-five patients undergoing breast reconstruction were enrolled...
November 17, 2016: Phlebology
https://www.readbyqxmd.com/read/27861385/novel-technique-for-laparoscopic-harvesting-of-latissimus-dorsi-flap-with-prosthesis-implantation-for-breast-reconstruction-a-preliminary-study-with-2-case-reports
#18
Shuman Xu, Peng Tang, Xianchun Chen, Xi Yang, Qinwen Pan, Yu Gui, Li Chen
BACKGROUD: An important drawback of the traditional technique for harvesting latissimus dorsi (LD) myocutaneous flap is a long, posterior donor-site incision. Current techniques involve endoscopic or robotic harvesting via a combined approach of open and closed surgery, which necessitates an open axillary incision and the use of special retractors. In this paper, we introduce a fully enclosed laparoscopic technique for harvesting LD flap (LDF) using only 3 small trocar ports. This technique eliminates the need for axillary and donor-site incisions and specialized retractors and considerably reduces the incision size...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27847703/treatment-of-post-latissimus-dorsi-flap-breast-reconstruction-pain-with-continuous-paravertebral-nerve-blocks-a-retrospective-review
#19
Jonathan T Unkart, Jennifer A Padwal, Brian M Ilfeld, Anne M Wallace
OBJECTIVES: The addition of a perioperative continuous paravertebral nerve block (cPVB) to a single-injection thoracic paravertebral nerve block (tPVB) has demonstrated improved analgesia in breast surgery. However, its use following isolated post-mastectomy reconstruction using a latissimus dorsi flap (LDF) has not previously been examined. METHODS: We performed a retrospective review of patients who underwent salvage breast reconstruction with a unilateral LDF by a single surgeon...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27832006/reconstruction-outcomes-following-lateral-skull-base-resection
#20
Nicholas J Thompson, Joseph P Roche, Nathan M Schularick, Kristi E Chang, Marlan R Hansen
OBJECTIVE: Compare reconstruction outcomes for various lateral skull base closure techniques. STUDY DESIGN: Retrospective medical records review. SETTING: University-based tertiary referral center. PATIENTS: Patients who underwent resections of tumors involving the lateral skull base requiring reconstruction beyond primary closure. INTERVENTION(S): Reconstructive techniques, from rotational flaps to free tissue transfer...
November 9, 2016: Otology & Neurotology
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