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Latissimus dorsi flap reconstruction

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https://www.readbyqxmd.com/read/29135896/vertical-skin-paddle-orientation-for-the-latissimus-dorsi-flap-in-breast-reconstruction-a-modification-to-simultaneously-correct-inferior-pole-constriction-and-improve-projection
#1
Megan Fracol, Michelle Grim, Steven Lanier, Neil A Fine
The latissimus dorsi myocutaneous flap (LDMF) is a reliable and frequently used option to bring vascularized skin and soft tissue to improve the stability and aesthetic result in breast reconstruction. Standard techniques with skin paddle inset in a horizontal or oblique fashion preferentially improve anterior projection (when inset at the mastectomy scar) or lower pole and infra-mammary fold (IMF) constriction (when inset into the IMF). Here, we describe a modification for inset of the LDMF that improves both anterior projection and lower pole/IMF constriction, while also allowing the latissimus muscle to fan out and provide complete implant coverage...
November 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29124855/reconstructive-options-for-large-back-free-flap-donor-sites
#2
Arshia Azizeddin, Peter F M Choong, Damien Grinsell
BACKGROUND: Reconstruction of posterior thoracic and trunk defects can prove challenging even to the most seasoned surgeons. Many commonly used techniques for closing back defects include primary closure and split skin grafts. Often times, however, other techniques are needed in order to give the patient the best aesthetic and functional outcome. In this study, we focus on and evaluate donor site closure techniques for defects in the back created by harvesting scapular and parascapular flaps...
November 9, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29108083/-pedicled-omentum-flaps-in-the-management-of-deep-sternal-wound-infections
#3
Nick Spindler, Christian Etz, Martin Misfeld, Christoph Josten, Michael Borger, Friedrich Wilhelm Mohr, Stefan Langer
Aim Coverage of a deep sternal wound infection with a greater omentum flap. Due to a persistent infection caused by an infected aortic prosthesis, the primarily performed reconstruction with a latissimus dorsi flap had to be revised, and an alternative solution had to be found. Indication A deep sternal wound infection is a rare but devastating complication following median sternotomy. If the commonly used muscle flap is not sufficient and artificial material is still present in the wound, for instant drivelines or a vascular prosthesis, the greater omentum flap is a useful option due to its immunologic capacity...
November 6, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29106507/pedicled-and-free-flaps-for-intrathoracic-fistula-management
#4
Alba Fricke, Holger Bannasch, Henriette F Klein, Sebastian Wiesemann, Patrick Samson-Himmelstjerna, Bernward Passlick, Friedhelm Beyersdorf, Jens Hoeppner, Vincenzo Penna, Steffen U Eisenhardt, Björn G Stark, Georgios Koulaxouzidis
OBJECTIVES: Intrathoracic fistulae are among the potential sequelae of radiation therapy, empyema and abscess clearance and surgical tumour resections. Interdisciplinary plastic-reconstructive flap surgery is a helpful tool for the successful treatment of intrathoracic fistulae. METHODS: From February 2006 to April 2016, 13 patients (3 females and 10 males) underwent flap surgery for bronchial ( n  = 5), tracheal ( n  = 2), oesophageal ( n  = 2), post-pneumonectomy bronchopleural fistula ( n  = 2), tracheo-oesophageal ( n  = 1), gastrobronchial ( n  = 1) and oesophagobronchial ( n  = 1) fistulae...
July 4, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29080662/indications-and-controversies-for%C3%A2-complete-and-implant-enhanced-latissimus-dorsi-breast-reconstructions
#5
REVIEW
Oren P Mushin, Paige L Myers, Howard N Langstein
This article describes the use of implant-enhanced and total-autologous latissimus dorsi myocutaneous flaps in breast reconstruction. It addresses the indications for use of this reconstruction alternative, which have recently been expanded thanks to the advent of high-volume fat grafting. Given its straightforward dissection, reliable vascular pedicle, variety of approaches, and potential for excellent aesthetic results, use of latissimus dorsi flaps may be considered among first-line options in selected patients...
January 2018: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/29076313/selection-of-oncoplastic-surgery-in-asian-breast-cancer-patients
#6
Eui Sun Shin, Hyo In Kim, Seung Yong Song, Dae Hyun Lew, Dong Won Lee
Background: Oncoplastic surgery is increasingly performed in Korean women; however, unlike Westerners, Korean women usually have small- to moderate-sized breasts. To achieve better outcomes in reconstructed breasts, several factors determining the optimal surgical method should be considered. Methods: A total of 108 patients who underwent oncoplastic surgery from January 2013 to December 2016 were retrospectively investigated. We used various methods, including glandular tissue reshaping, latissimus dorsi (LD) flap transposition, and reduction oncoplasty to restore the breast volume and symmetry...
October 27, 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29074315/basal-cell-carcinoma-of-the-scalp-with-destruction-and-invasion-into-the-calvarium-and-dura-mater-report-of-7-cases-and-review-of-literature
#7
Churl-Su Kwon, Omar Al Awar, Valeria Ripa, Ghassan Said, Saulius Rocka
Basal cell carcinoma (BCC) is the most common skin malignancy in humans. Giant BCC is a rarer entity that is characterised by aggressive biological behaviour. Intracranial invasion by a BCC on the scalp is extremely rare. The gold standard treatment of BCCs is represented by surgical excision with a wide variety of reconstructive techniques. In this paper, we describe the largest series to date of recurrent BCCs with intracranial extension involving the dura mater. We report recurrent giant BCC of the scalp with dura mater invasion in 7 patients...
October 23, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29073726/reconstruction-of-extensive-thoracic-wall-defect-using-the-external-oblique-myocutaneous-flap-an-analysis-on-20-chinese-patients-with-locally-advanced-soft-tissue-sarcoma
#8
Chun-Meng Wang, Ruming Zhang, Peng Luo, Zhiqiang Wu, Biqiang Zheng, Yong Chen, Yingqiang Shi
BACKGROUND: Soft tissue sarcomas are rare neoplasms that can occur in the thoracic wall, abdominal wall, extremities, and inguinal region. Wide local resection, with precise histological margin control, results in large skin defects that are challenging to close. Various repair procedures, such as vertical rectus abdominis flaps (VRAM), latissimus dorsi flaps, and tensor fascia lata (TFL) flaps are used to cover broad thoracic wall defects. Although the cosmetic reconstruction results of using these flaps are often excellent, each has significant drawbacks...
October 26, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29064918/updated-evidence-on-the-oncoplastic-approach-to-breast-conservation-therapy
#9
Albert Losken, Alexandra M Hart, Abhishek Chatterjee
The oncoplastic approach to breast conservation therapy has become a useful and popular option for women with breast cancer who wish to preserve their breast. The initial driving forces were aimed at minimizing the potential for a breast conservation therapy deformity; however, various other benefits have been identified that include broadening the indications for breast conservation therapy in some patients and improved margin control. The various techniques can be categorized into glandular rearrangement techniques such as breast reductions usually in patients with larger breasts or flap reconstruction such as the latissimus dorsi muscle usually in patients with smaller breasts...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29062663/free-neurovascular-latissimus-dorsi-muscle-transplantation-for-reconstruction-of-hip-abductors
#10
Sergi Barrera-Ochoa, Jose Manuel Collado-Delfa, Andrea Sallent, Alejandro Lluch, Roberto Velez
Resection of tumors affecting the hip abductors can cause significant decrease in muscle strength and may lead to abnormal gait and poor function. We present a case report showing full functional recovery after resection of a synovial sarcoma affecting the right gluteus medius and minimus muscles with reconstruction free neurovascular latissimus dorsi muscle transplantation. The latissimus dorsi muscle was harvested following standard technique and fixed to the ilium and the greater trochanter. Receptor vessels were end-to-end anastomosed to the subscapular vessels followed by an end-to-end epineural suture between the superior gluteal nerve and the thoracodorsal nerve...
September 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29058926/-breast-angiosarcoma-induced-by-radiotherapy-surgical-treatment-options-and-review-of-literature
#11
O Kubala, J Prokop, L Petráš, P Ihnát, P Jelínek, P Ostruszka
INTRODUCTION: Radiation-induced angiosarcoma is a rare but very aggressive tumour. The highest risk of sarcoma development is in patients after breast-conserving surgery.Case 1: The 66 years old patient underwent radical mastectomy with axillary dissection because of ductal carcinoma with consequent radiotherapy, chemotherapy and hormonal therapy. After 6 years, high-grade angiosarcoma was diagnosed and resected with negative resection margins. Within subsequent 24 months, additional three radical re-excisions were performed because of repeated sarcoma recurrence...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29051048/reconstruction-of-soft-tissue-defects-of-the-distal-third-of-the-arm-using-a-muscle-sparing-latissimus-dorsi-musculocutaneous-flap
#12
J Château, F Boucher, F Braye, L Erhard, A Mojallal
Use of a latissimus dorsi (LD) flap has been widely described for upper limb reconstruction. However, donor site sequelae have led to the development of muscle-sparing techniques for the LD flap. We present the technical principles of a muscle-sparing LD flap and its use as a pedicled flap to reconstruct the distal third of the arm.
October 16, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/29039118/a-systematic-review-of-flap-fixation-techniques-in-reducing-seroma-formation-and-its-sequelae-after-mastectomy
#13
REVIEW
J van Bastelaar, L van Roozendaal, R Granzier, G Beets, Y Vissers
BACKGROUND: Seroma formation is a common complication after mastectomy. This review aims to elucidate which surgical techniques are most effective in reducing the dead space and therefore seroma formation in patients undergoing mastectomy. METHODS: A literature search was performed to identify clinical studies comparing any form of flap fixation to conventional closure technique in patients undergoing mastectomy with or without axillary clearance. Studies were eligible for inclusion if outcome was described in terms of seroma formation and/or complications of seroma formation...
October 16, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28953152/secondary-maxillary-and-orbital-floor-reconstruction-with-a-free-scapular-flap-using-cutting-and-fixation-guides-created-by-computer-aided-design-computer-aided-manufacturing
#14
Daiki Morita, Toshiaki Numajiri, Shoko Tsujiko, Hiroko Nakamura, Ryo Yamochi, Yoshihiro Sowa, Makoto Yasuda, Shigeru Hirano
Computer-aided design/computer-aided manufacturing (CAD/CAM) guides are now widely used in maxillofacial reconstruction. However, there are few reports of CAD/CAM guides being used for scapular flaps. The authors performed the secondary maxillary and orbital floor reconstruction using a free latissimus dorsi muscle, cutaneous tissue, and scapular flap designed using CAD/CAM techniques in a 72-year-old man who had undergone partial maxillectomy four years previously. The patient had diplopia, the vertical dystopia of eye position, and a large oral-nasal-cutaneous fistula...
November 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28936374/helical-tomotherapy-for-postmastectomy-radiotherapy-after-immediate-left-breast-reconstruction-a-case-study
#15
Dominique Mathieu, Nazanin Shahvary, Nicolas Côté, Kerianne Boulva, Léamarie Meloche-Dumas, Toni Vu, Erica Patocskai, Christina Bernier, David Roberge, Israel Fortin
A 43-year-old premenopausal female presented with a multicentric infiltrating lobular carcinoma of the left breast with axillary nodes metastasis. She underwent modified radical mastectomy with axillary lymph node dissection (level I and II) followed by a mixed autologous latissimus dorsi flap reconstruction with the addition of prosthesis. The final pathological analysis revealed a 6 cm invasive lobular carcinoma pT3N2aM0, grade III/III, estrogen and progesterone positive, human epidermal growth factor receptor 2 (HER2) negative, with 5/16 positive lymph nodes...
July 12, 2017: Curēus
https://www.readbyqxmd.com/read/28932726/comparison-of-morbidity-related-seroma-formation-following-conventional-latissimus-dorsi-flap-versus-muscle-sparing-latissimus-dorsi-flap-breast-reconstruction
#16
Yoshihiro Sowa, Toshiaki Numajiri, Katsuhiko Nakatsukasa, Koichi Sakaguchi, Tetsuya Taguchi
PURPOSE: The pedicled, descending-branch muscle-sparing latissimus dorsi (MSLD) flap has been widely used for breast reconstruction following total mastectomy. However, the superiority of the MSLD flap compared to the conventional latissimus dorsi (CLD) flap in preventing seroma formation has not been demonstrated. This study compares the morbidities related to seroma formation following pedicled MSLD flap and CLD flap breast reconstruction. METHODS: A total of 15 women who underwent partial mastectomy and immediate partial breast reconstruction with MSLD flaps were compared with 15 women under identical conditions with CLD flap breast reconstruction...
September 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28918997/tolerance-of-latissimus-dorsi-in-immediate-breast-reconstruction-without-implant-to-radiotherapy
#17
G Berthet, C Faure, M A Dammacco, C Vermesch, E Delay, C Ho Quoc, N Carrabin
INTRODUCTION: Immediate breast reconstruction (IBR) improves the quality of life of patients who undergo mastectomy. The latissimus dorsi flap (LDF) method provides particularly good aesthetic results, but its tolerance to subsequent radiotherapy remains unclear. We thus sought to assess tolerance and esthetic results and satisfaction, as reported by patients who underwent IBR by LDF with or without subsequent radiotherapy. MATERIALS AND METHODS: We performed a retrospective case-control study in a population of women who were diagnosed with breast cancer between January 1999 and January 2014 and who had mastectomies with IBR by LDF without prostheses...
August 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28917935/trends-in-post-mastectomy-breast-reconstruction-types-at-a-breast-cancer-tertiary-referral-centre-before-and-after-introduction-of-acellular-dermal-matrices
#18
Hadyn K N Kankam, George J M Hourston, Laura J Fopp, John R Benson, Sarah L Benyon, Michael S Irwin, Amit Agrawal, Parto Forouhi, Charles M Malata
BACKGROUND: Reconstructive breast surgery has continued to evolve over the last decade with a key change being the adoption of acellular dermal matrices (ADMs) as an adjunct for implant-based procedures. This retrospective observational study assesses the effect of ADMs on post-mastectomy reconstructive practice performed in a single institution. METHODS: We conducted a review of all patients undergoing breast reconstruction at a University Teaching Hospital for an 18-month period before and after adopting ADMs...
August 31, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28904708/-latissimus-dorsi-flap-in-reconstruction-following-treatment-of-giant-tumor-of-the-abdominal-wall-about-a-rare-case
#19
Karim Bourra, Samir El Mazouz
We report the case of a 16-year old patient presenting with giant, multinodular, mesenchymal tumor of the abdominal wall occupying the left abdominal region and measuring 25 cm on the vertical axis, 20 cm on the transverse axis, mobile when compared with the deep structures and gradually increasing in volume over childhood and neglected. After small biopsy, which showed desmoid tumor, the patient underwent complete surgical resection of the tumor with immediate reconstruction by free muscolo skin flap of the latissimus dorsi attached to the large blood vessels of the inguinal fold (left iliac artery and left external iliac vein), connected by termino lateral anastomosis...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28882492/assessing-the-effort-associated-with-teaching-residents
#20
Kelli R Aibel, Tracy Truong, Ronnie L Shammas, Eugenia H Cho, Kate J Buretta, Gina-Maria Pomann, Scott T Hollenbeck
BACKGROUND: Intraoperative resident education is an integral mission of academic medical centers and serves as the basis for training the next generation of surgeons. The actual effort associated with teaching residents is unknown as it pertains to additional operative time. Using a large validated multi-institutional dataset, this study aims to quantify the effect of having a resident present in common plastic surgery procedures on operative time. Future directions for developing standardized methods to record and report teaching time are proposed, which can help inform prospective studies...
August 5, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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