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Free flaps

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https://www.readbyqxmd.com/read/28550641/a-fascia-lata-free-flap-in-pelvic-exenteration-for-fournier-gangrene-due-to-advanced-rectal-cancer-a-case-report
#1
Hiroshi Sawayama, Nobutomo Miyanari, Hidetaka Sugihara, Shiro Iwagami, Takao Mizumoto, Tatsuo Kubota, Yoshio Haga, Hideo Baba
BACKGROUND: Fournier gangrene due to advanced rectal cancer is a rapidly progressive gangrene of the perineum and buttocks. Emergency surgical debridement of necrotic tissue is crucial, and secondary surgery to resect tumors is necessary for wound healing. However, pelvic exenteration damages the pelvic floor, increasing the likelihood of herniation of internal organs into the infectious wound. The management of pelvic exenteration for rectal cancer with Fournier gangrene has not yet been established...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28544074/single-stage-aesthetic-and-functional-reconstruction-of-composite-facial-gunshot-wound-with-a-chimeric-functioning-muscle-and-fibular-osseous-flap-case-report-and-review-of-the-literature
#2
Andreas Gravvanis, Konstantinos Apostolou, Dimitrios Anterriotis, Dimosthenis Tsoutsos
The current concepts in the aesthetic and functional reconstruction of complex oromandibular defects are presented with a case of a patient with self-inflicted gunshot wound to the face. The patient presented with a 6 cm composite mandibular defect; the buccomandibular and suborbital aesthetic zones of the cheek along with the mucosa lining, and the ipsilateral facial musculature were missing. A rapid prototyping model of the facial skeleton was used to assist in preoperative planning. A single stage reconstruction with two free flaps was planned; a free fibula osseous flap to reconstruct the mandibular defect, and a free chimeric ALT/functioning vastus lateralis muscle...
May 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28543692/the-impact-of-resident-involvement-in-breast-reconstruction-surgery-outcomes-by-modality-an-analysis-of-4-500-cases
#3
Kevin T Jubbal, Anthony Echo, Aldona J Spiegel, Shayan A Izaddoost
BACKGROUND: The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. METHODS: We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28542343/bone-marrow-cell-extract-promotes-the-regeneration-of-irradiated-bone
#4
Guillaume Michel, Pauline Blery, Michaël Henoux, Jérôme Guicheux, Pierre Weiss, Sophie Brouard, Olivier Malard, Florent Espitalier
Mandibular osteoradionecrosis is a severe side effect of radiotherapy after the treatment of squamous cell carcinomas of the upper aerodigestive tract. As an alternative to its treatment by micro-anastomosed free-flaps, preclinical tissular engineering studies have been developed. Total bone marrow (TBM) associated with biphasic calcium phosphate (BCP) significantly enhanced bone formation in irradiated bone. One mechanism, explaining how bone marrow cells can help regenerate tissues like this, is the paracrine effect...
2017: PloS One
https://www.readbyqxmd.com/read/28542070/collagen-elastin-and-collagen-glycosaminoglycan-scaffolds-promote-distinct-patterns-of-matrix-maturation-and-axial-vascularization-in-arteriovenous-loop-based-soft-tissue-flaps
#5
Volker J Schmidt, Johanna O Wietbrock, Nico Leibig, Torsten Gloe, Dominic Henn, J Frederik Hernekamp, Leila Harhaus, Ulrich Kneser
INTRODUCTION: Autologous free flaps are the criterion standard for reconstructions of complex soft tissue defects; however, they are limited by donor-site morbidities. The arteriovenous (AV) loop model enables the generation of soft tissue constructs based on acellular dermal matrices with a functional microvasculature and minimal donor site morbidity. The ideal scaffold for AV loop-based tissue engineering has not been determined. METHODS: AV loops were placed into subcutaneous isolation chambers filled with either a collagen-elastin scaffold or a collagen-glycosaminoglycan scaffold in the thighs of rats...
May 25, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28540229/ushering-in-the-era-of-penile-transplantation
#6
REVIEW
Alison M Rasper, Ryan P Terlecki
Penile transplantation is a novel approach to management of penile loss in the developing field of composite tissue allotransplantation (CTA). Prior management for significant penile loss has been free flap phalloplasty with issues related to function, cosmesis, and functional loss from the location of flap harvest. Transplantation has been an evolving field with advancement in CTA over the past several decades leading to the option of penile transplant. Management of penile injury with replantation provided some preliminary groundwork on the technical aspects for penile transplantation...
April 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28538066/radial-forearm-osteocutaneous-free-flap-for-reconstruction-of-hard-palate-with-alveolar-defect
#7
Euicheol C Jeong, Sehoon Yoon, Young Ho Jung
The radial forearm free flap is beneficial for reconstruction of large palatal defect with oronasal fistula.A 51-year-old male patient who had anterior palate defect including alveolus after the radiation therapy of malignant cancer on the nasopharyngeal area undertook the radial forearm osteocutaneous free flap to close the oronasal fisula and restore the alveolar arch. The small radial bone segment was fixed in the alveolar defect and vascular anastomoses were performed with facial vessels in neck. The donor site was closed with split thickness skin graft...
May 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28536044/free-tissue-transfer-for-necrotizing-fasciitis-reconstruction-a-case-series
#8
Justin Peter Gawaziuk, Tianyi Liu, Leif Sigurdson, Edward Buchel, Thomas Edward Jo Hayakawa, Sarah Shiga, Sarvesh Logsetty
BACKGROUND: Necrotizing fasciitis (NF) is a life-threatening infection requiring extensive debridement that may necessitate amputation. Free tissue transfer (FTT) is an option for reconstruction in difficult cases. Currently, only case reports have described FTT in the setting of NF, and comprehensive evidence on flap outcomes is lacking. The present study characterizes outcomes in patients with FTT following NF. METHODS: All patients admitted with NF between January 1, 2005 and December 31, 2011 to our level 1 burns/trauma referral center were retrospectively reviewed...
May 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28532969/lip-reconstruction-using-a-functioning-serratus-anterior-free-flap-preliminary-study
#9
A O Gundeslioglu, E C Karadag, I Inan, L Jasharllari, M N Selimoglu, F Guney, B Yuruten, M Bekerecioglu
Reconstructive surgery to the lips requires the replacement of defective tissues with similarly functioning tissues. While non-dynamic free tissue transfers provide adequate lower lip reconstruction, improved benefits may be obtained with innervated free muscle flaps. This study reports the use of innervated serratus anterior muscle free flaps for lip reconstruction in five patients. All patients had squamous cell carcinoma of either the upper or lower lip. After resection of the tumours, the resultant defects comprised two-thirds of the lips...
May 19, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28530627/-laparoscopic-treatment-of-retroperitoneal-fibrosis
#10
Carlos Hernández Fernández, David Subirá Rios, Mercedes Moralejo Gárate, Elena Rodríguez Fernández, Jorge Caño Velasco, Felipe Herranz Amo
Retroperitoneal fibrosis is a disease that may condition a severe involvement of various organs, mainly upper urinary tract, even causing renal insufficiency. It was first described by Albarran in 1905 and it is also known as Ormonds disease. The correct diagnosis includes, in many cases, the performance of one or more tests: CT scan, MRI, renal scan, etc. It is often necessary the insertion of double J catheters on percutaneous nephrostomy tubes with the aim to preserve renal function. Initial treatment is medical, based on corticoids, and , less frequent, immunosuppressive or chemotherapy drugs...
May 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28529384/the-pelskin-project-part-v-towards-the-control-of-the-flow-around-aerofoils-at-high-angle-of-attack-using-a-self-activated-deployable-flap
#11
Marco E Rosti, Laura Kamps, Christoph Bruecker, Mohammad Omidyeganeh, Alfredo Pinelli
During the flight of birds, it is often possible to notice that some of the primaries and covert feathers on the upper side of the wing pop-up under critical flight conditions, such as the landing approach or when stalking their prey (see Fig. 1) . It is often conjectured that the feathers pop up plays an aerodynamic role by limiting the spread of flow separation . A combined experimental and numerical study was conducted to shed some light on the physical mechanism determining the feathers self actuation and their effective role in controlling the flow field in nominally stalled conditions...
2017: Meccanica
https://www.readbyqxmd.com/read/28529045/influence-of-preoperative-imaging-on-fibula-free-flap-harvesting
#12
R Gryseleyn, M Schlund, P Pigache, T Wojcik, G Raoul, J Ferri
INTRODUCTION: The fibula free flap (FFF) is the gold standard for the reconstruction of large maxillofacial defects. Magnetic resonance angiography (MRA) seems to supersede digital subtraction angiography (DSA) as the reference in preoperative evaluation, being non-invasive and having equivalent diagnostic results. The aim of this study was to assess the impact of preoperative MRA versus DSA on the viability of FFF and its success rate. MATERIAL AND METHODS: A total of 216 patients, who underwent mandibular or maxillary FFF reconstruction from January 1995 to January 2011, were retrospectively included in the study...
May 18, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28527396/breast-oedema-following-free-flap-breast-reconstruction
#13
Jennifer Greenhowe, Christopher Stephen, Liusaidh McClymont, D Alex Munnoch
OBJECTIVES: Breast oedema causes significant morbidity and is historically difficult to quantify. The aim of this study was to identify changes in breast tissue water content from pre-operative levels in the native breast to post-operative levels in mastectomy skin flaps and free flaps in the reconstructed breast. MATERIALS AND METHODS: One hundred patients undergoing unilateral mastectomy and immediate free flap breast reconstruction were examined pre-operatively and at three post-operative appointments...
May 17, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28526905/effectiveness-of-acellular-dermal-matrix-on-autologous-split-thickness-skin-graft-in-treatment-of-deep-tissue-defect-esthetic-subjective-and-objective-evaluation
#14
Yoo Jung Lee, Myong Chul Park, Dong Ha Park, Hyung Min Hahn, Sue Min Kim, Il Jae Lee
BACKGROUND: A split-thickness skin graft (STSG) is performed to cover a large full-thickness skin defect. Esthetic and functional deficits can result, and many studies have sought to overcome them. This study compared the effectiveness of the acellular dermal matrix (ADM) graft and STSG concerning esthetic and functional effectiveness of ADM on scar quality. METHODS: Of the patients who underwent anterolateral thigh free flap from 2011 to 2015, patients who received skin graft only (n = 10) or skin graft with ADM (n = 20) for coverage of the donor site were enrolled...
May 19, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28522300/primary-reconstructive-method-for-tracheal-defect-from-invasion-by-differentiated-thyroid-carcinoma
#15
Atsumori Hamahata, Takeshi Beppu, Takashi Yamaki, Hiroyuki Sakurai
Differentiated thyroid carcinoma is not highly malignant, and thus surgical resection is the most common treatment even if the carcinoma has invaded the trachea. Although some cases exist in which the carcinoma invades the trachea, using the tracheal window resection method allows complete resection of the carcinoma. Yet these patients must often control a large tracheocutaneous wound until reconstructive surgery is performed because such surgery occurs secondarily. Our hospital admitted three patients for which tracheally invasive, differentiated thyroid carcinoma was surgically resected...
May 15, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28520896/laser-assisted-indocyanine-green-dye-angiography-for-postoperative-fistulas-after-salvage-laryngectomy
#16
Erin J Partington, Lindsay S Moore, Russel Kahmke, Jason M Warram, William Carroll, Eben L Rosenthal, Benjamin J Greene
Importance: Pharyngocutaneous fistula formation is an unfortunate complication after salvage laryngectomy for head and neck cancer that is difficult to anticipate and related to a variety of factors, including the viability of native pharyngeal mucosa. Objective: To examine whether noninvasive angiography with indocyanine green (ICG) dye can be used to evaluate native pharyngeal vascularity to anticipate pharyngocutaneous fistula development. Design, Setting, and Participants: This cohort study included 37 patients enrolled from June 1, 2013, to June 1, 2016, and follow-up was for at least 1 month postoperatively...
May 18, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28516962/design-of-a-customised-bridging-mandibular-prosthesis-for-complex-reconstruction-a-pilot-study
#17
A Tarsitano, S Battaglia, A Sandi, C Marchetti
The gold standard for mandibular reconstruction is universally recognised and consists of the replacement of the bony part of the mandible with a bony microvascular free flap supported by a reconstructive plate. Although this procedure is feasible and reproducible in most patients, at times poor oncological prognosis or poor performance status force surgeons to consider other reconstructive solutions. In these cases, the main alternative in reconstructing a mandibular defect is represented by bridging plates combined with soft tissue flaps...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28514343/-effect-of-dexmedetomidine-on-perfusion-of-free-flaps-transferred-to-head-and-neck
#18
A S Dobrodeev, S A Rabinovich, I F Malykhina
The paper presents the impact of perioperative care on feasibility of free fibula flap transfer for facial reconstruction. Flaps vitality was measured by means of somatic oximetry in 85 patients aged 20-74 years receiving reconstruction procedures in midfacial and lower facial areas. The patients were divided in three groups according to sedation agent used postoperatively. It has been demonstrated that dexmedetomidine postoperative sedation significantly improved free fibula flaps perfusion compared to propofol sedation...
2017: Stomatologii︠a︡
https://www.readbyqxmd.com/read/28514018/salvage-of-postcranioplasty-implant-exposure-using-free-tissue-transfer
#19
Pang-Yun Chou, Cheng-Hung Lin, Chung-Chen Hsu, Wei-Hsun Yang, Alex A Kane, Chih-Hung Lin
BACKGROUND: Refractory implant exposure is frustrating after cranioplasty. The purpose of this study was for the authors to present their experience with free tissue transfer for salvage of postcranioplasty implant exposure. METHODS: A retrospective medical chart review was conducted on all free tissue transfers performed for exposed implant coverage after cranioplasty between January 2004 and February 2016. RESULTS: Twelve free flaps were performed in 11 patients who underwent postcranioplasty with implant exposure, and whose attempted implant coverage using locoregional flaps had failed...
May 17, 2017: Head & Neck
https://www.readbyqxmd.com/read/28512866/medial-sural-artery-perforator-free-flap-for-the-reconstruction-of-leg-foot-and-ankle-defect-an-excellent-option
#20
Jyoshid R Balan
BACKGROUND: The defects over the leg, foot and ankle are best covered with a thin pliable flap. The use of muscle flap for the reconstruction of these defects leaves a grafted, aesthetically inferior result. The medial sural artery perforator (MSAP) free flap gives a thin pliable tissue for the reconstruction with better aesthesis. METHODS: The study design was retrospective case analysis over a period of 2 years. All the patients who underwent flap for leg, foot and ankle defect reconstruction in the form of MSAP free flap were included in the study...
May 16, 2017: ANZ Journal of Surgery
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