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https://www.readbyqxmd.com/read/29443832/one-barrel-microsurgical-fibula-flap-for-reconstruction-of-large-defects-of-the-femur
#1
Jung Eun Lee, Min Bom Kim, Do Hwan Han, Sung Hee Pyo, Young Ho Lee
Various methods for reconstructing large femur bone defects after tumor resection have been introduced. In this study, we reviewed the clinical outcomes of using a 1-barrel free vascularized fibular graft (FVFG) protected by a lateral locking plate for large femoral defects not involving the knee joint.Between August 2007 and August 2013, we treated 7 patients with large femoral bone defects after tumor resection. The mean age of the patients was 19 years (range, 12-36 years), and 3 were women. All defects were free of infection before the procedure...
February 13, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29443757/various-surgical-techniques-to-create-an-aesthetic-appearance-at-the-donor-site-of-anterolateral-thigh-free-flaps-based-on-the-oblique-branch-twenty-one-clinical-case-reports
#2
Chengliang Deng, Hai Li, Zairong Wei, Wenhu Jin, Kaiyu Nie, Shujun Li, Bihua Wu, Dali Wang
RATIONALE: Reducing the morbidity associated with anterolateral thigh (ALT) donor sites by performing aesthetic restoration has become a popular research topic. Various surgical techniques have been developed allowing for direct closure of the donor site. However, closure techniques for ALT donor sites based on the oblique branch have not been systematically reported. PATIENT CONCERNS: Data from 21 patients (18 males, 3 females) undergoing operative reconstruction with an ALT free flap between January 2016 and December 2016...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29443415/comprehensive-assessment-of-the-donor-site-of-the-anterolateral-thigh-flap-a-prospective-study-in-33-patients
#3
Shuang Bai, Zhi-Qiang Zhang, Zhi-Qiang Wang, Zhong-Fei Xu, Wei-Yi Duan, Fa-Yu Liu, Xue-Xin Tan, Chang-Fu Sun
BACKGROUND: The anterolateral thigh (ALT) free flap has been an extremely versatile flap. The purpose of this study was to propose comprehensive functional assessments of the donor site. METHODS: A total of 33 ALT flaps were enrolled prospectively. Objective assessments included isokinetic testing of the knee, and electromyographic examination of the lateral femoral cutaneous nerve (LFCN). The Patient and Observer Scar Assessment Scale (POSAS) was used to subjectively assess the donor-site scar...
February 14, 2018: Head & Neck
https://www.readbyqxmd.com/read/29438212/maxillo-mandibular-reconstruction-in-pediatric-patients-how-to-do-it
#4
Valentino Valentini, Luigi Califano, Andrea Cassoni, Della Monaca Marco, Ingrid Raponi, Paolo Priore, Maria Teresa Fadda, Giovanni Dell'Aversana Orabona, Valentina Terenzi
Maxillo-mandibular reconstruction in pediatric patients involves particular functional and cosmetic implications. Attention is required for the craniofacial growth over time, involvement of the permanent dentition, facial symmetry, and donor site morbidity. Our aim is to identify the best reconstructive options for maxilla-mandibular defects in children (<18 years) based on our experience with 25 pediatric patients. We believe that reconstruction has to be performed at the same time as resection in pediatric patients...
February 12, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29437500/use-of-the-sphenoid-flap-in-repair-of-the-wide-cleft-palate
#5
Khurram Khan, Joseph Hardwicke, Rimante Seselgyte, Paul Morris, Guy Thorburn, Loshan Kangesu, Marc C Swan, Bruce Richard
OBJECTIVE: In wide palatal defects, closure of the nasal layer can prove a considerable challenge. Mobilizing nasal flaps posteriorly usually facilitates soft palate closure. However, the defect is often too wide within the hard palate; hence, bilateral vomerine flaps are frequently required. Despite this, there is often a small defect in the nasal layer at the posterior septum (typically equating to the hard-soft palate junction), which has to be left to heal by secondary intention with the resulting increased risk of fistula formation and the potential deleterious long-term effect on speech due to cicatricial migration of the reconstructed levator sling anteriorly...
March 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29433986/surgical-and-oncological-outcomes-in-patients-after-vascularised-flap-reconstruction-for-locoregionally-advanced-penile-cancer
#6
Sarah R Ottenhof, Andrew Leone, Rosa S Djajadiningrat, Mounsif Azizi, Kamran Zargar, Laura C Kidd, Gregory Diorio, Gerard Mosiello, Niels M Graafland, Philippe E Spiess, Simon Horenblas
BACKGROUND: Treatment of locoregionally advanced penile squamous cell carcinoma (LAPSCC) is challenging. The exact role (in terms of oncological benefit) of extensive surgery is not well established. Moreover, surgery invariably leads to large defects requiring reconstructive surgery. Rectus abdominis myocutaneous (RAM) and abdominal advancement flaps have an independent and constant blood supply, are easily harvested, and provide substantial skin coverage and soft tissue. OBJECTIVE: To determine the surgical and oncological outcomes in patients with LAPSCC undergoing surgical resection with RAM flaps...
February 9, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29433140/-colour-duplex-sonography-and-power-duplex-in-perforator-surgery-improvement-of-patients-safety-by-efficient-planning
#7
Adrien Daigeler, Cornelius Schubert, Tobias Hirsch, Björn Behr, Marcus Lehnhardt
INTRODUCTION: There are many techniques to identify vessels in perforator surgery, each with specific disadvantages. Handheld Dopplers are easy to use, but inaccurate with respect to the exact localisation of the perforator. Angio-CT is invasive, time consuming, and expensive. In contrast, duplex sonography is a reliable, easy-to-use and availabe alternative for pre-, intra-, and postoperative visualisation of vessels. Power Doppler further increases sensitivity and allows visualisation of vessels smaller than 0...
February 12, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29428686/reconstruction-of-a-complex-foot-injury-with-free-remodeled-fibular-osteocutaneous-flap-a-case-report-and-literature-review
#8
Liangsong Song, Zhixin Zhang, Yang Wang, Yang Liu, Zhigang Liu, Lei Chen, Laijin Lu
Management of complex foot injuries, which involve open fractures and severe trauma to soft tissues, represent a challenge to orthopedic clinicians. In the present case report, we treated a complex foot injury with a remodeled fibular osteocutaneous free flap to reconstruct the anterior and lateral areas of the foot. The flap survived completely. At the 9-month follow-up examination, bony union of the graft bone was identified by radiographic examination. The reconstructed foot could bear body weight, and the patient could maintain a bipedal gait without discomfort...
February 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29427442/nose-resurfacing-with-free-fasciocutaneous-flaps-in-burns-patients
#9
Cheng-I Yen, Jui-Yung Yang, Chun-Shin Chang, Jung-Ju Huang, Chih-Wei Wu, Hung-Chang Chen, Shih-Yi Yang, Shu-Yin Chang, Shiow-Shuh Chuang, Yen-Chang Hsiao
BACKGROUND: Nasal reconstruction after burn injury can be challenging due to limited availability of local flaps. We present our experience of free flap reconstruction for full-thickness nasal defect after severe facial burn injury. METHODS: Between August 1998 and September 2015, six patients underwent nasal reconstruction with seven free flaps after burn injury. Among them, flame burn occurred in two patients, chemical burn in two, explosive burn in one, and contact thermal burn in one patient...
February 10, 2018: Microsurgery
https://www.readbyqxmd.com/read/29421070/chimeric-free-vascularized-metatarsophalangeal-joint-with-toe-fillet-flap-a-technique-for-reconstruction-of-the-posttraumatic-metacarpophalangeal-joint-with-concomitant-soft-tissue-defect
#10
REVIEW
Marco Pappalardo, Vincent G Laurence, Yu-Te Lin
For painful, dysfunctional, posttraumatic metacarpophalangeal (MCP) joints, the free vascularized toe joint transfer may represent a good solution. Successful reconstruction is potentially limited, however, by 2 features of the traditional vascularized metatarsophalangeal (MTP) transfer: inadequate arc of flexion and insufficient soft tissue coverage. The solution to both of these dilemmas lies in the manner of utilizing the donor site. Because of its innate hyperextensibility, rotating the MTP 180° volar to dorsal provides the greatest arc of flexion in the reconstructed MCP...
February 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29420749/prospective-randomized-investigation-implementing-immunonutritional-therapy-using-a-nutritional-supplement-with-a-high-blend-ratio-of-%C3%AF-3-fatty-acids-during-the-perioperative-period-for-head-and-neck-carcinomas
#11
Nobuhiro Hanai, Hoshino Terada, Hitoshi Hirakawa, Hidenori Suzuki, Daisuke Nishikawa, Shintaro Beppu, Yasuhisa Hasegawa
Objectives: The purpose of this study is to evaluate whether a nutritional supplement with a high blend ratio of ω-3 fatty acids can minimize weight loss and attenuate increases in inflammatory marker levels during the perioperative period in patients undergoing surgery for head and neck carcinoma. Methods: Patients with ≥5% weight loss within 6 months were considered as targets for aggressive nutritional intervention. Among these patients, those with head and neck squamous cell carcinoma, who underwent major invasive surgery with free flap reconstruction were included in the present study...
February 6, 2018: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29416246/effect-of-lactate-versus-acetate-based-intravenous-fluids-on-acid-base-balance-in-patients-undergoing-free-flap-reconstructive-surgeries
#12
Sunil Rajan, Soumya Srikumar, Pulak Tosh, Lakshmi Kumar
Background and Aims: Use of lactated intravenous fluids during long surgeries could cause lactate accumulation and lactic acidosis. Acetate-based solutions could be advantageous as they are devoid of lactate. The primary aim of the study was to assess the effect of use of an acetated solution or Ringer's lactate (RL) as intraoperative fluid on lactate levels in patients without hepatic dysfunction undergoing prolonged surgeries. Material and Methods: This was a prospective, randomized, controlled trial involving sixty patients belonging to American Society of Anesthesiologists Physical Status I to II undergoing major head and neck surgeries with free flap reconstruction...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29415251/supercharged-free-omental-flap-plombage-for-empyema-in-a-patient-with-an-artificial-pericardium
#13
Isao Matsumoto, Kenji Iino, Hirofumi Takemura
Cavernostomy and fenestration were performed in a patient who developed a lung abscess and empyema in the left lung, which was damaged after multimodality therapy for advanced thymoma. The hospitalized patient suddenly experienced cardiopulmonary arrest due to major bleeding from the left main pulmonary artery. We immediately performed the main pulmonary arterial embolization, and the patient was resuscitated. Subsequently, the patient underwent supercharged free omental flap plombage performed in the following manner: first, laparoscopic harvesting of the omentum was performed in the supine position...
February 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29415198/extended-surgery-using-anterior-mediastinal-tracheostomy-for-recurrent-mediastinal-liposarcoma
#14
Masaru Takenaka, Yoshinobu Ichiki, Akihiro Taira, Fumihiro Tanaka
Mediastinal liposarcoma is an extremely rare malignancy with a poor prognosis. We report the case of a 73-year-old man who presented with severe respiratory distress. He had previously been diagnosed with mediastinal liposarcoma, which had been treated with extirpation 6 years ago. The histological type was a well-differentiated liposarcoma. Three years ago, he experienced respiratory distress due to postoperative recurrence of mediastinal liposarcoma. To establish an airway, tracheotomy was urgently performed...
February 3, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29409421/treatment-of-hand-allodynia-resulting-from-wrist-cutting-with-radial-and-ulnar-artery-perforator-adipofascial-flaps
#15
Hideto Irifune, Nobuyuki Takahashi, Suguru Hirayama, Eichi Narimatsu, Toshihiko Yamashita
In this article, we report two cases in which recurrent adhesive hand neuropathy with allodynia were successfully treated with radial and ulnar artery adipofascial perforator flap coverage. Treatment of recurrent neuropathy, such as recurrent carpal tunnel syndrome and re-adhesion after neurolysis using free and pedicle flaps to cover the nerves, has been reported to show good results. However, for severe painful nerve disorders, such as complex regional pain syndrome, the efficacy of this treatment was unclear...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29406605/salvage-skull-base-reconstruction-in-the-endoscopic-era-vastus-lateralis-free-tissue-transfer
#16
Stephen Y Kang, Antoine Eskander, Ralph Abi Hachem, Enver Ozer, Theodoros N Teknos, Matthew O Old, Daniel M Prevedello, Ricardo L Carrau
BACKGROUND: When locoregional flaps fail to reconstruct the skull base, the microvascular surgeon faces several reconstructive challenges. We present our technique and results of salvage anterior skull base reconstruction utilizing the vastus lateralis free tissue transfer (VLFTT). METHODS: Four patients with anterior skull base defects after previous locoregional flap failure underwent free tissue transfer reconstruction with VLFTT. RESULTS: The success rate of free tissue transfer was 100%...
February 6, 2018: Head & Neck
https://www.readbyqxmd.com/read/29406384/reconstruction-of-defects-in-the-weight-bearing-plantar-area-using-the-innervated-free-medial-plantar-instep-flap
#17
Jonas Gustafsson Löfstrand, Chih-Hung Lin
BACKGROUND: Defects in the weight-bearing heel or forefoot are commonly derived from chronic wounds, acute trauma, or tumor excision. Reconstruction of such defects pose a significant challenge to provide a flap that is stable, durable, and sensate. Several flaps have been described for reconstruction of plantar defects, but recurrent ulcerations and/or the need of additional procedures are common. This article provides the approach and outcomes of innervated free medial plantar flap for weight-bearing plantar defects reconstruction...
March 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29406260/skull-base-erosion-resulting-from-primary-tumors-of-the-temporomandibular-joint-and-skull-base-region-our-classification-and-reconstruction-experience
#18
Min-Jie Chen, Chi Yang, Ji-Si Zheng, Guo Bai, Zi-Xiang Han, Yi-Wen Wang
PURPOSE: We sought to introduce our classification and reconstruction protocol for skull base erosions in the temporomandibular joint and skull base region. PATIENTS AND METHODS: Patients with neoplasms in the temporomandibular joint and skull base region treated from January 2006 to March 2017 were reviewed. Skull base erosion was classified into 3 types according to the size of the defect. RESULTS: We included 33 patients, of whom 5 (15...
January 3, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29405833/evidence-based-use-of-perioperative-antibiotics-in-otolaryngology
#19
Priyesh N Patel, Asitha D L Jayawardena, Rachel L Walden, Edward B Penn, David O Francis
Objective To identify and clarify current evidence supporting and disputing the effectiveness of perioperative antibiotic use for common otolaryngology procedures. Data Sources PubMed, Embase (OVID), and CINAHL (EBSCO). Review Methods English-language, original research (systematic reviews/meta-analyses, randomized control trials, prospective or retrospective cohort studies, case-control studies, or case series) studies that evaluated the role of perioperative antibiotic use in common otolaryngology surgeries were systematically extracted using standardized search criteria by 2 investigators independently...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29405476/endoscope-assisted-conservative-resection-and-reconstruction-in-recurrent-subglottic-carcinoma
#20
Shawn T Joseph, Jose Tharayil, Mohan T Mihir, B S Naveen
BACKGROUND: Very few cases of conservative laryngectomy in recurrent carcinoma of subglottis postradiotherapy have been reported. Technical aspects of conservative resection and reconstruction in subglottic carcinoma have not been well described. METHODS: Herein, we present a case of recurrent carcinoma of subglottis for which conservative resection with adequate margins was done with endoscope assistance and defect reconstructed by buccal mucosa, conchal cartilage, and temporoparietal free flap...
February 5, 2018: Head & Neck
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