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Latissimus dorsi flap reconstruction

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https://www.readbyqxmd.com/read/29341038/-the-use-of-deep-inferior-epigastric-vessels-to-revascularise-free-flaps-for-reconstruction-of-complex-oncosurgical-defects-of-the-thigh-and-the-abdomen
#1
F Simunovic, U Wittel, B Passlick, S Wiesemann, M Czerny, M Südkamp, G B Stark, H Bannasch
BACKGROUND: The resection of large soft-tissue sarcoma requires reconstruction with free flaps. The choice of recipient vessels is crucial for the success of surgery. PATIENTS: We report four cases with large soft-tissue sarcomas with complex anatomical relationships: two tumors of the thigh surrounding the femoral neurovascular structures and two tumors of the abdomen with infiltration of the thorax and the abdomen. All cases received multimodal interdisciplinary treatment...
January 16, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29334788/latissimus-dorsi-flap-in-breast-reconstruction-recent-innovations-in-the-workhorse-flap
#2
Rachita Sood, Jeena M Easow, Geoffrey Konopka, Zubin J Panthaki
BACKGROUND: Surgeons employ the latissimus dorsi flap (LDF) for reconstruction of a large variety of breast cancer surgery defects, including quadrantectomy, lumpectomy, modified radical mastectomy, and others. The LDF may be used in delayed or immediate reconstruction, in combination with tissue expanders for a staged reconstruction, with implant-based immediate reconstruction, or alone as an autogenous flap. METHODS: The authors discuss the historical uses and more recent developments in the LDF...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/29324933/brachytherapy-in-soft-tissue-tumours-an-interdisciplinary-challenge
#3
Silvanie Volz, Konstantinos Kalousis, Jung In Song, Tobias Kisch, Eike Wenzel, Peter Mailänder
OBJECTIVE: Interdisciplinary work including surgery and additive radiotherapy is often needed for the therapy of tumours. Beneath this, brachytherapy is an important part of the radiotherapy. It was first used over 100 years ago and is in regular use after the development of afterload technology in the early 1970s. Today it is often used in different tumour therapies, for example in soft tissue sarcoma or breast tumours, in order to decrease the risk of local recurrence. Concerning its benefits, higher doses could be used because of the localized effect with equivalent local control rate and less toxicity of treatment...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29302492/breast-reconstruction-of-an-unusual-configuration-using-two-paranemic-implants
#4
Naohiro Ishii, Jiro Ando, Michiko Harao, Masaru Takemae
Implant-based breast reconstruction can be performed using a choice of various types of breast implants. However, cases where the breast shapes are unsuitable for implant-based reconstruction method are occasionally encountered. We present two patients with wide trunks who underwent breast reconstruction using an unusual configuration that involved a latissimus dorsi myocutaneous flap combined with two paranemic implants.
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29283179/a-comparison-study-between-endoscope-assisted-and-the-standard-approach-in-the-harvesting-of-the-free-rectus-femoris-muscle-flap
#5
Jiunn-Tat Lee, Honda Hsu, Chih-Ming Lin, Chieh-Chi Huang, Sou-Hsin Chien
BACKGROUND: Endoscopic harvesting of muscle flaps is well described for gracilis, latissimus dorsi, gastrocnemius, and pectoralis major amongst others. So far there has been no description of endoscopic harvesting of the rectus femoris muscle as a free flap. The purpose of this study was to compare the perioperative outcomes of harvesting the free rectus femoris muscle flap endoscopically as compared to the standard approach. METHODS: Fifty patients with lower limb defects reconstructed with free rectus femoris muscle flap between January 2014 and December 2016 were included in this study...
December 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/29239797/autologous-breast-reconstruction-using-the-immediately-lipofilled-extended-latissimus-dorsi-flap
#6
N Johns, N Fairbairn, M Trail, A Ewing, L Yong, C Raine, J M Dixon
BACKGROUND: The latissimus dorsi flap is a popular choice for autologous breast reconstruction. To dramatically improve volume, we report our experience of using the immediately lipofilled extended latissimus dorsi (ELD) flap and show it as a valid option for autologous breast reconstruction. METHODS: Patients undergoing the procedure between December 2013 and June 2016 were included. Demographic, clinical and operative factors were analysed, together with in-hospital morbidity and duration of postoperative hospital stay...
November 24, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29224822/head-and-neck-reconstruction-with-free-flaps-based-on-the-thoracodorsal-system
#7
John Edward O'Connell, Mandeep S Bajwa, Andrew G Schache, Richard J Shaw
The advent or micro-vascular free tissue transfer has facilitated the reconstruction of increasingly complex head and neck defects. There are multiple donor sites available, each with its' own advantages and disadvantages. However, the subscapular system, including the thoracodorsal system, provides the widest array of soft tissue and osseous flaps, as well as chimeric options. Its advantages include a long pedicle, independently mobile tissue components, relative sparing from atherosclerosis, and minimal donor site morbidity...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29219854/reconstruction-of-the-scapula-in-pediatric-and-adolescent-patients-after-total-scapulectomy-a-report-of-10-patients-treated-by-extracorporeal-irradiation-and-reimplantation-of-the-scapula
#8
Ahmed M El Ghoneimy, Mohamed S Zaghloul, Iman Zaky, Hala Taha, Ahmed Elgammal, Magdy El Sherbiny, Nehal Kamal
BACKGROUND: Ewing sarcoma of the scapula is uncommon. Restoration of shoulder function after total scapulectomy is challenging. Extracorporeal irradiation and reimplantation is a well-known method of biological reconstruction in orthopaedic oncology; yet very few reports in the literature describe its specific use in tumors of the scapula. PATIENTS AND METHODS: Ten patients with the diagnosis of Ewing sarcoma of the scapula were surgically treated by total scapulectomy and extracorporeal irradiation and reimplantation of the scapula...
December 6, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29194976/the-effect-of-adjuvant-radiotherapy-on-radial-forearm-free-flap-volume-after-soft-palate-reconstruction-in-13-patients
#9
Georg Haymerle, Elisabeth Enzenhofer, Wolfgang Lechner, Markus Stock, Annemarie Schratter-Sehn, Erich Vyskocil, Barbara Bachtiary, Edgar Selzer, Boban M Erovic
Treatment options for squamous cell carcinoma of the soft palate include surgical resection followed by radiotherapy or primary radiotherapy. In most cases sufficient resection margins require reconstruction of the defect with free flaps. The most common flaps used in oropharyngeal carcinoma are the radial forearm free flap and the anterolateral thigh and latissimus dorsi free flap. According to the magnitude of the resection defect, surgeons estimate the size and volume of soft tissue transfer needed for an optimal esthetic and in particular functional outcome...
December 1, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29184727/preliminary-study-of-pga-fabric-for-seromas-at-latissimus-dorsi-flap-donor-sites
#10
Yoshihito Itani, Akeo Hagiwara, Takahiro Hashimoto, Noritaka Isogai, Hirohisa Kusuhara
Background: Seroma formation is a major complication following latissimus dorsi (LD) flap transfer for breast reconstruction. We implanted a nonwoven polyglycolic acid (PGA) fabric-a biodegradable polymer-in the LD flap donor site and examined its effect on postoperative seroma formation and resolution in a comparative study on 38 patients undergoing primary 1-stage breast reconstruction by LD flap. Method: A PGA treatment group had a PGA fabric placed in the donor wound (PGA group, n = 20), whereas a second group was treated with standard donor site closure (control group, n = 18)...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29174551/surgical-management-of-severe-osteoradionecrosis-of-the-mandibular-bone-by-using-double-free-flap-reconstruction
#11
Niklas Rommel, Marco Rainer Kesting, Nils Hagen Rohleder, Klaus-Dietrich Wolff, Jochen Weitz
PURPOSE: Osteoradionecrosis (ORN) of the jaws represents one of the most severe complications after primary or adjuvant radiation therapy (RT) of large head and neck tumors. In advanced ORN cases, surgical management is generally considered the therapy of choice. However, in several severe ORN patients with extensive bone and soft tissue defects, functional and aesthetic reconstruction represents a huge challenge for any surgeon, with an increased risk of post-operative wound healing disorders...
November 2, 2017: Journal of Cranio-maxillo-facial Surgery
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
#12
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
#13
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
#14
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
#15
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...
December 1, 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
#16
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
#17
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
#18
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
#19
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
#20
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
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