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Latissimus dorsi flap breast reconstruction

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https://www.readbyqxmd.com/read/29746274/combined-autologous-and-prosthetic-breast-reconstruction-defining-the-upper-limits-of-safe-expansion-in-obesity
#1
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
#2
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/29724621/shoulder-related-donor-site-morbidity-and-patient-reported-satisfaction-after-delayed-breast-reconstruction-with-pedicled-flaps-from-the-back-a-comparative-analysis
#3
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/29707452/pedicled-descending-branch-latissimus-dorsi-mini-flap-for-repairing-partial-mastectomy-defect-a-new-technique
#4
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
#5
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/29664831/design-of-mini-latissimus-dorsi-flap-based-on-thoracodorsal-vascular-patterns
#6
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/29564032/postmastectomy-breast-reconstruction-with-the-totally-autologous-latissimus-dorsi-flap-in-the-thin-small-breasted-woman-give-it-more-thought
#7
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
#8
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/29464176/latissimus-dorsi-and-immediate-fat-transfer-lift-for-complete-autologous-breast-reconstruction
#9
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/29402546/reconstruction-of-an-anterior-chest-wall-radionecrosis-defect-by-a-contralateral-latissimus-dorsi-flap-a-case-report
#10
A Vairinho, A Al Hindi, M Revol, A Legras, K Rem, Y Guenane, S Cristofari, T Sorin
INTRODUCTION: Soft tissue and bone radionecrosis are rare but serious complications may occur late after radiotherapy. CASE REPORT: We report the case of an 86-year-old woman with a history an infiltrating ductal carcinoma of the left breast, treated by total mastectomy, left axillary dissection and adjuvant radiotherapy. Eighteen years later, the first radionecrosis lesions appeared and grew progressively in a 6-month period. These lesions are deep, involving the anterior aspect of the 4th to the 6th ribs and infiltrating the chest wall to the left cardio-thoracic space communicating largely with the pericardium...
April 2018: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29372268/outcomes-of-fat-augmented-latissimus-dorsi-fald-flap-versus-implant-based-latissimus-dorsi-flap-for-delayed-post-radiation-breast-reconstruction
#11
Efterpi C Demiri, Dimitrios D Dionyssiou, Antonios Tsimponis, Christina-Olga Goula, Leonidas C Pavlidis, Georgia-Alexandra Spyropoulou
BACKGROUND: Although free abdominal flaps constitute the gold standard in post-radiation delayed breast reconstruction, latissimus dorsi-based methods offer alternative reconstructive options. This retrospective study aims to compare outcomes of delayed breast reconstruction using the fat-augmented latissimus dorsi (FALD) autologous reconstruction and the latissimus dorsi-plus-implant reconstruction in irradiated women. METHODS: We reviewed the files of 47 post-mastectomy irradiated patients (aged 29-73 years), who underwent delayed latissimus dorsi-based breast reconstruction between 2010 and 2016...
January 25, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29369108/safety-of-microsurgery-under-loupes-versus-microscope-a-head-to-head-comparison-of-2-surgeons-with-similar-experiences
#12
Tosan Ehanire, Dhruv Singhal, Bruce Mast, Mark Leyngold
BACKGROUND: Microsurgery is performed using either the operating microscope or loupe magnification. Use of the operating microscope is considered the "criterion standard"; however, loupes are emerging as a safe and reliable technique to perform microsurgery. The purpose of this study was to analyze the safety of microsurgery under loupe magnification compared with the microscope. Previous studies discussing the safety of loupe magnification during microsurgery have been published; however, this is the first study to compare free flap outcomes from 2 surgeons at the same institution, each using their respective technique...
January 24, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29334788/latissimus-dorsi-flap-in-breast-reconstruction-recent-innovations-in-the-workhorse-flap
#13
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
#14
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
#15
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/29239797/autologous-breast-reconstruction-using-the-immediately-lipofilled-extended-latissimus-dorsi-flap
#16
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...
February 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29184727/preliminary-study-of-pga-fabric-for-seromas-at-latissimus-dorsi-flap-donor-sites
#17
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/29135896/vertical-skin-paddle-orientation-for-the-latissimus-dorsi-flap-in-breast-reconstruction-a-modification-to-simultaneously-correct-inferior-pole-constriction-and-improve-projection
#18
Megan Fracol, Michelle Grim, Steven T Lanier, Neil A Fine
The latissimus dorsi myocutaneous flap 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 inframammary fold constriction (when inset into the inframammary fold). Here, the authors describe a modification for inset of the latissimus dorsi myocutaneous flap that improves both anterior projection and lower pole/inframammary fold constriction, and also allows the latissimus muscle to fan out and provide complete implant coverage...
March 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29080662/indications-and-controversies-for-complete-and-implant-enhanced-latissimus-dorsi-breast-reconstructions
#19
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-surgical-technique-in-asian-breast-cancer-patients
#20
Eui Sun Shin, Hyo In Kim, Seung Yong Song, Dae Hyun Lew, Dong Won Lee
BACKGROUND: Oncoplastic surgery is being 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 should be considered to determine the optimal surgical method. 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...
January 2018: Archives of Plastic Surgery
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