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https://www.readbyqxmd.com/read/29222966/optimizing-functional-outcomes-in-mandibular-condyle-reconstruction-with-the-free-fibula-flap-using-computer-aided-design-and-manufacturing-technology
#1
Z-Hye Lee, Tomer Avraham, Casian Monaco, Ashish A Patel, David L Hirsch, Jamie P Levine
PURPOSE: Mandibular defects involving the condyle represent a complex reconstructive challenge for restoring proper function of the temporomandibular joint (TMJ) because it requires precise bone graft alignment for full restoration of joint function. The use of computer-aided design and manufacturing (CAD/CAM) technology can aid in accurate reconstruction of mandibular condyle defects with a vascularized free fibula flap without the need for additional adjuncts. The purpose of this study was to analyze clinical and functional outcomes after reconstruction of mandibular condyle defects using only a free fibula graft with the help of virtual surgery techniques...
November 15, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29221853/venous-thromboembolism-events-after-breast-reconstructions-with-diep-free-flaps-in-192-consecutive-case
#2
A Modarressi, A-V Schettini, E M Rüegg, B Pittet-Cuénod
BACKGROUND: Patient candidates for breast reconstruction with free deep inferior epigastric perforator flap (DIEP) may present several risk factors for venous thromboembolism (VTE). Risk identification is essential for appropriate VTE prophylaxis measures to be put in place. This study aims to investigate VTE incidence after DIEP flap breast reconstruction and to assess the accuracy of the Caprini Risk Assessment Model (RAM), which is the unique score validated to assess the VTE risk for plastic surgery procedures and identify patients at high VTE risk...
December 5, 2017: Annales de Chirurgie Plastique et Esthétique
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
#3
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/29218849/reconstruction-of-full-thickness-cheek-defect-with-chimeric-facial-artery-free-flap-a-case-report
#4
Olindo Massarelli, Luigi Angelo Vaira, Roberta Gobbi, Giovanni Dell'aversana Orabona, Giacomo De Riu
Full-thickness cheek defects represent a difficult challenge for reconstructive surgeons. Multiple techniques have been described, including local, regional, and free flaps. In this report, the reconstruction of a through and through left cheek defect, resulting from a self-inflicted gunshot injury, with a chimeric facial artery free flap is presented. The patient underwent reconstruction with a chimeric full-thickness facial artery free flap, with 9 × 3 cm diameter skin paddle and a 6 × 5 cm myomucosal paddle, was harvested on the contralateral cheek with a 7-cm length of facial pedicle...
December 8, 2017: Microsurgery
https://www.readbyqxmd.com/read/29218804/impact-of-diabetes-on-free-flap-surgery-of-the-head-and-neck-a-nsqip-analysis
#5
Jacob S Brady, Aparna Govindan, Meghan M Crippen, Andrey Filimonov, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVE: Diabetes is associated with microvascular pathology and may predispose patients undergoing microvascular surgery to complications. This study assesses diabetes as a risk factor for complications following free flap surgery of the head and neck. PATIENTS AND METHODS: In this retrospective cohort study, data on free flap surgeries of the head and neck between 2005 and 2014 was collected from the National Surgical Quality Improvement Program (NSQIP) database...
December 8, 2017: Microsurgery
https://www.readbyqxmd.com/read/29218284/how-much-can-we-do-by-reverse-superficial-sural-artery-flap-to-potentiate-its-effects-introducing-spout-sural-flap-as-a-new-modification
#6
Jalaluddin Khoshnevis, Terifeh Dashti, Eznollah Azargashb, Mohamad Reza Kalantar Motamedi
BACKGROUND: Due to shortage of local donor tissue and unreliable blood supply, free flaps were the mainstay of treatment for tissue defects in the lower leg and foot region, but it requires a qualified microvascular surgeon. Recently, attention has been paid to reverse superficial sural artery flap (RSSAF) and its modifications as a good alternative to pave the way to simple and friendly techniques. METHODS: Excluding each patient with septic and severely ischemic foot, every patient with tissue defect in distal leg and proximal foot region were studied...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29218281/palate-mucoperosteum-an-usefull-adjunct-in-buccal-mucosa-reconstruction
#7
K N Manjunath, Veena P Waiker
Background: Palate is a complex structure separating oro- and nasopharynx. However, reconstruction of the defects of palate is much simpler because of the versatile mucoperiosteal flaps. Here, we present our experience of palatal mucoperiosteal flap used in different situations. Methods: Fifteen patients of palatal as well as buccal mucosa defects were reconstructed using either free or pedicled mucoperiosteum. Results: All patients recovered well...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29209690/prosthetic-rehabilitation-involving-the-use-of-implants-following-a-fibula-free-flap-reconstruction-in-the-treatment-of-osteosarcoma-of-the-maxilla-a-case-report
#8
E Brauner, A Quarato, F De Angelis, G Pompa, S Jamshir, V Valentini, S Di Carlo
INTRODUCTION: Osteosarcoma is an aggressive primary bone tumor composed of connective tissue cells directly producing osteoid and bone. Prosthetic rehabilitations in post-oncological patients after bone reconstruction are not substantially different than those of patients affected by severe atrophy of upper or lower jaw after bone reconstruction. The treatment for patients with a malignant neoplasia of the oral cavity requires multidisciplinary approach by a team of different specialists that follow the patient through the phases of diagnosis, therapy and oral rehabilitation...
November 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/29209513/can-we-predict-necrosis-intra-operatively-real-time-optical-quantitative-perfusion-imaging-in-surgery-study-protocol-for-a-prospective-observational-in-vivo-pilot-study
#9
Sanne M Jansen, Daniel M de Bruin, Mark I van Berge Henegouwen, Simon D Strackee, Denise P Veelo, Ton G van Leeuwen, Suzanne S Gisbertz
Background: Compromised perfusion as a result of surgical intervention causes a reduction of oxygen and nutrients in tissue and therefore decreased tissue vitality. Quantitative imaging of tissue perfusion during reconstructive surgery, therefore, may reduce the incidence of complications. Non-invasive optical techniques allow real-time tissue imaging, with high resolution and high contrast. The objectives of this study are, first, to assess the feasibility and accuracy of optical coherence tomography (OCT), sidestream darkfield microscopy (SDF), laser speckle contrast imaging (LSCI), and fluorescence imaging (FI) for quantitative perfusion imaging and, second, to identify/search for criteria that enable risk prediction of necrosis during gastric tube and free flap reconstruction...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29209151/endoscopic-repair-of-lateral-sphenoid-encephaloceles-a-case-series
#10
Mitchell R Gore
Background: Lateral sphenoid encephaloceles present a surgical challenge. These encephaloceles may be difficult to access given their lateral location and proximity to the neural and vascular structures of the sphenoid floor, pterygopalatine fossa, and lateral and superior sphenoid walls. Additionally, many patients have idiopathic intracranial hypertension, increasing the risk of recurrence. When untreated or undiscovered, these encephaloceles increase the risk of meningitis. Methods: All consecutive endoscopic repairs of lateral sphenoid encephaloceles by a single surgeon from 2012 to 2017 were analyzed for method of repair, complications, and recurrence rate...
2017: BMC Ear, Nose, and Throat Disorders
https://www.readbyqxmd.com/read/29202648/an-algorithm-to-improve-outcomes-of-radial-forearm-flap-donor-site
#11
Salvatore D'arpa, Michele Cillino, Walter Mazzucco, Matteo Rossi, Sergio Mazzola, Francesco Moschella, Adriana Cordova
Abstarct Background: Due to the high rate of donor site complications the Radial Forearm Flap (RFF) has lost ground in favor of the Antero-lateral tight flap (ALT) and other flaps. We have designed a reconstruction algorithm for reconstruction of its donor site. The goal of this study was to retrospectively evaluate the impact of this algorithm on RFF donor site complication rates. METHODS: The authors analyzed retrospectively 31 patients who underwent free radial forearm flap reconstruction between November 2009 and May 2013...
December 5, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29202348/upper-lip-reconstruction-using-a-pedicel-superficial-temporal-artery-flap
#12
Mohammad M Al-Qattan, Abdullah E Kattan
INTRODUCTION: The hair-bearing superficial temporal artery free flap has been used in men for total upper lip reconstruction. In this paper we present a case of a partial upper lip defect in a man that was reconstructed with a pedicle superficial temporal artery flap. PRESENTATION OF CASE: Following a car accident, a 35-year old man sustained a partial upper defect. The defect included the entire "outer lamella" (i.e. the skin and red lip) of the right hemi-lip as well as the outer part of the muscle (i...
November 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29201373/free-anterolateral-thigh-full-thickness-skin-flap-with-vascularized-lateral-femoral-cutaneous-nerve-for-the-reconstruction-of-facial-nerve-and-external-auditory-canal-after-the-resection-of-facial-nerve-schwannoma
#13
Ryo Karakawa, Mitsunaga Narushima, Shinya Ogishima, Hisako Hara, Shotaro Karino, Takuya Iida, Akinobu Kakigi, Isao Koshima
The complex reconstruction of nerves and soft tissue in the head and neck region is still challenging, especially in cases requiring external auditory canal reconstruction with facial nerve reconstruction. We report a case of left facial schwannoma extending into the external auditory canal beyond the tympanic membrane with facial paralysis in which the reconstruction of both the facial nerve and external auditory canal was successfully performed using an anterolateral thigh flap as a super-thin full-thickness skin flap, including vascularized lateral femoral cutaneous nerve...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29201370/salvage-of-mangled-upper-extremity-using-the-masquelet-technique-in-a-child-a-case-report
#14
Nabil Alassaf, Amro Alhoukail, Abdullah Alsahli, Ghazi Althubaiti
Aim: To report our experience with the Masquelet concept in a pediatric upper extremity following an open injury to the elbow. Methods: A case report and literature review. Results: An 11-year-old boy was transferred to our institution after a motor vehicle collision. There was a primary loss of the ulnohumeral articulation and the surrounding soft tissues as well as the ulnar nerve. Reconstruction used the Masquelet-induced membrane technique and a soft tissue flap...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29200885/treatment-of-complex-regional-pain-syndrome-using-free-flap-surgery-a-case-report
#15
Dong-Kyo Seo, Ho-Seong Lee, Joon Pio Hong, Jeong-Ho Seo, Jin Woo Shin
Complex regional pain syndrome is a chronic progressive illness with sensory, autonomic, trophic, and motor abnormalities. Treatment is difficult and controversial. We report the results of free-flap and vein wrapping of the superficial peroneal nerve surgery to treat complex regional pain syndrome.
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29198704/ischemic-flap-survival-improvement-by-composition-selective-fat-grafting-with-novel-adipose-tissue-derived-product-stromal-vascular-fraction-gel
#16
Pan Zhang, Jingwei Feng, Yunjun Liao, Junrong Cai, Tao Zhou, Mingliang Sun, Jianhua Gao, Kai Gao
BACKGROUND: Flap necrosis due to insufficient blood supply is a common postoperative complication in random pattern flaps. Stem cell therapies have emerged as promising biologics for tissue ischemia. A novel fat derived product, stromal vascular fraction gel (SVF-gel), can be prepared with lipoaspirate through simple mechanical processing, removing only the lipid content. SVF-gel enriches adipose-derived stem cells and potentially beneficial for flap necrosis. METHODS: Nude mice ischemic flaps were treated with human SVF-gel, stromal vascular fraction (SVF) cell suspension or saline (n = 10)...
November 30, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29194976/the-effect-of-adjuvant-radiotherapy-on-radial-forearm-free-flap-volume-after-soft-palate-reconstruction-in-13-patients
#17
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/29194743/optimizing-venous-outflow-in-reconstruction-of-gustilo-iiib-lower-extremity-traumas-with-soft-tissue-free-flap-coverage-are-two-veins-better-than-one
#18
John T Stranix, Z-Hye Lee, Lavinia Anzai, Adam Jacoby, Tomer Avraham, Pierre B Saadeh, Jamie P Levine, Vishal D Thanik
PURPOSE: The dependent nature of the lower extremity predisposes to venous congestion, especially following significant trauma. The benefit of a second venous anastomosis, however, remains unclear in lower extremity trauma free flap reconstruction. This study investigated the effect of an additional venous anastomosis on flap outcomes in lower extremity trauma reconstruction. METHODS: Retrospective review between 1979 and 2016 identified 361 soft tissue flaps performed for Gustilo IIIB/C coverage meeting inclusion criteria...
November 30, 2017: Microsurgery
https://www.readbyqxmd.com/read/29194256/repair-of-the-nasal-floor-by-the-cleft-margin-flap-in-bilateral-complete-cleft-lip
#19
Jumpei Tsumoto, Keisuke Imai, Cheng Chun Wu
Bilateral complete cleft lip deformity has been the most challenging to plastic surgeons, and lots of methods of repair have been described in the literature. The basic principles are to achieve continuity of the orbicularis oris muscle, a balanced Cupid's bow with nasal ala, and a complete reconstruction of the nasal floor. The last one is, however, easily neglected. A well-reconstructed nasal floor serves as a good support of the nasal cartilage, which minimizes secondary deformity. In addition, a nasal floor with sufficient soft tissue and minimal contracture makes bone grafting easier in the future...
November 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29193942/-perioperative-management-protocol-of-patients-undergoing-microsurgical-flaps-in-main-healthcare-centers
#20
Alejandro Cruz-Segura, Pedro Grajeda-López
Microsurgery is one of the most fertile and innovative area in reconstructive surgery. Today it is considered an indispensable technique in plastic surgery with flaps survival rates over 95% in main healthcare centers. The factors involved in achieving these results are: the improvement of the surgical technique, adequate patient selection and careful perioperative care. Perioperative care starts at the initial assessment of the patient where it's very important to consider the indications and contraindications of these procedures...
September 2017: Revista Médica del Instituto Mexicano del Seguro Social
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