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https://www.readbyqxmd.com/read/28822648/cyclooxygenase-2-inhibitors-and-free-flap-complications-after-autologous-breast-reconstruction-a-retrospective-cohort-study
#1
Christian Bonde, Hoda Khorasani, Jens Hoejvig, Henrik Kehlet
BACKGROUND: A key component of modern analgesics is the use of multimodal opioid-sparing analgesia (MOSA). In the past, our analgesic regime after autologous breast reconstruction (ABR) included either NSAID or a selective cyclooxygenase-2 (COX-2) inhibitor. COX-2 inhibitors are superior to NSAIDs because of the well-known side effects of NSAID treatment (bleeding/gastrointestinal ulcers). However, COX-2 inhibitors have been suggested to increase flap failure rates. We report our experience in using COX-2 inhibitors as part of our post-operative MOSA after ABR using free flaps...
June 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28820839/smaller-diameter-anastomotic-coupling-devices-have-higher-rates-of-venous-thrombosis-in-microvascular-free-tissue-transfer
#2
Summer E Hanson, Matthew B Mitchell, Nihanth Palivela, S Andrew Peng, Lei Feng, Rene D Largo, Charles E Butler, Patrick B Garvey
BACKGROUND: Smaller anastomotic coupling devices may increase the risk of complications in free flap reconstructions; however, the relationship between coupler size and venous thrombosis rates has not been adequately evaluated. We hypothesized that smaller-diameter coupling devices are associated with higher rates of venous thrombosis than larger diameter devices in free tissue transfer. METHODS: We retrospectively reviewed data prospectively entered into a central departmental database for all patients who underwent microsurgical free tissue transfer at our institution in 2001-2013...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28820834/super-thin-scip-flap-for-reconstruction-of-subungual-melanoma-aesthetic-functional-surgery
#3
Kyeong-Tae Lee, Bo Young Park, Eun-Ji Kim, Jung-Han Kim, Kee-Taek Jang, Sang-Hee Choi, Dong-Youn Lee, Goo-Hyun Mun
BACKGROUND: This study aimed to use a super-thin, free superficial circumflex iliac artery perforator (SCIP) flap in the functional surgery for treating subungual melanoma and to evaluate its outcomes. METHODS: Forty-one patients with primary subungual melanoma of ≤ 2-mm thickness who were treated with functional surgery were prospectively enrolled. Following oncologic resection, a thin SCIP flap was harvested along the trans-superficial fat layer and transferred to the defect with further thinning by primary defatting...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28817126/principles-for-vertical-ridge-augmentation-in-the-atrophic-posterior-mandible-a-technical-review
#4
Istvan A Urban, Alberto Monje, Jaime Lozada, Hom-Lay Wang
Guided bone regeneration has become more predictable due to advances in material sciences. Nevertheless, vertical ridge augmentation (VRA) remains a potential challenge due to the complexity of soft tissue management. This becomes more complicated in the posterior atrophic mandible due to limited access and poorer blood supply. As such, a number of critical elements must be taken into consideration in treatment planning. Anatomical structures potentially jeopardize intraoperative adverse events such as bleeding or neurosensory disturbances...
September 2017: International Journal of Periodontics & Restorative Dentistry
https://www.readbyqxmd.com/read/28816410/new-insights-into-the-cellular-makeup-and-progenitor-potential-of-palatal-connective-tissues
#5
Emoke Pall, Mihai Cenariu, Adrian Kasaj, Adrian Florea, Andrada Soancă, Alexandra Roman, Carmen Georgiu
The present study investigated the regenerative potential of connective tissues harvested from two palatal areas widely used as donor sites for muco-gingival surgical approaches. Connective tissue grafts (CTGs) were obtained by de-epithelialisation of a free gingival graft (deCTG) and by a split flap approach from a previous donor site (reCTG). Two types of mesenchymal stem cell (MSCs) were isolated and were named de-epithelialised MSCs (deMSCs) and re-entry MSCs (reMSCs). The cells were characterised and cellular functionality was investigated...
August 17, 2017: Microscopy Research and Technique
https://www.readbyqxmd.com/read/28816143/radiation-therapy-versus-no-radiation-therapy-to-the-neo-breast-following-skin-sparing-mastectomy-and-immediate-autologous-free-flap-reconstruction-for-breast-cancer-patient-reported-and-surgical-outcomes-at-1-year-a-mastectomy-reconstruction-outcomes-consortium
#6
MULTICENTER STUDY
Andrew L Cooke, Julian Diaz-Abele, Tom Hayakawa, Ed Buchel, Kimberly Dalke, Pascal Lambert
PURPOSE: To determine whether adjuvant radiation therapy (RT) is associated with adverse patient-reported outcomes and surgical complications 1 year after skin-sparing mastectomy and immediate autologous free flap reconstruction for breast cancer. METHODS AND MATERIALS: We compared 24 domains of patient-reported outcome measures 1 year after autologous reconstruction between patients who received adjuvant RT and those who did not. A total of 125 patients who underwent surgery between 2012 and 2015 at our institution were included from the Mastectomy Reconstruction Outcomes Consortium study database...
September 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28812933/use-of-bilayer-matrix-wound-dressing-in-the-exenterated-socket
#7
Leon Rafailov, Roger E Turbin, Paul D Langer
To describe the novel use of a bilayer dermal substitute to reconstruct exenterated orbits. A retrospective chart review was performed in the practices of two surgeons (RET and PDL) of all patients who had undergone orbital exenteration between April 2014 and June 2016 and whose subsequent reconstruction included lining the socket with Integra bilayer. Patient demographics, pathologic diagnoses, surgical and post-operative complications, graft integrity, and patient acceptance were recorded. The charts of 7 patients (4 men and 3 women, ages 60-87 years) were reviewed...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28807000/necrotizing-streptococcal-myositis-of-the-upper-extremity-a-case-report
#8
Johannes C Reichert, Götz Habild, Paul Simon, Ulrich Nöth, Jan B Krümpelmann
BACKGROUND: Necrotizing myositis is a rare but life-threatening soft-tissue infection characterized by rapidly spreading inflammation and subsequent necrosis of the affected tissue. The myositis is often caused by toxin-producing, virulent bacteria such as group A β-hemolytic streptococcus and associated with severe systemic toxicity. It is rapidly fatal unless diagnosed promptly and treated aggressively. However, necrotizing myositis is often initially misdiagnosed as a more benign soft-tissue infection as such fulminant, invasive muscle infections are rare with no more than 30 cases reported over the last century...
August 15, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28806291/revisiting-the-abdominal-donor-site-introducing-a-novel-nomenclature-for-autologous-breast-reconstruction
#9
Jason M Weissler, Frank P Albino, Martin J Carney, Liza C Wu
As abdominally-based free flaps for breast reconstruction continue to evolve, significant effort has been invested in minimizing donor-site morbidity. The impact on the donor-site remains a prevailing principle for breast reconstruction, and thus must be adequately reflected when classifying what is left behind following flap harvest. Although successful in describing the type of flap harvested, the existing nomenclature falls short of incorporating certain critical variables, such as degree of muscular preservation, fascial involvement, mesh implantation, and segmental nerve anatomy...
August 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28806290/-clinical-and-quantitative-isokinetic-comparison-of-abdominal-morbidity-and-dynamics-following-diep-versus-muscle-sparing-free-tram-flap-breast-reconstruction
#10
Hirokazu Uda, Hideaki Kamochi, Syunji Sarukawa, Ataru Sunaga, Yasusih Sugawara, Kotaro Yoshimura
BACKGROUND: The deep inferior epigastric perforator (DIEP) flap, which is a modification of the muscle-sparing free transverse rectus abdominis musculocutaneous (msTRAM) flap, is being more frequently used in an effort to reduce postoperative abdominal morbidity. However, there is no consensus as to which of these flaps is superior. We aimed to compare quantitative measurements of abdominal function obtained with an isokinetic dynamometer after DIEP and msTRAM flap elevation. METHODS: Patients who underwent unilateral single-pedicled DIEP (n = 42) or msTRAM flap (n = 36) breast reconstruction performed by a single surgeon were included in this study...
August 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28805958/large-orbital-defect-reconstruction-in-the-setting-of-globe-sparing-maxillectomy-the-titanium-hammock-and-layered-fibula-technique
#11
Samuel J Trosman, Timothy M Haffey, Rafael A Couto, Michael A Fritz
INTRODUCTION: The purpose of our study was to describe a novel technique for reconstruction of orbital defects after maxillectomy using a non-anatomic titanium mesh suspension of orbital contents for both support and volume correction. This construct is then articulated with a layered fibula osteocutaneous free flap that restores orbital rim, zygoma, and maxillary alveolus. We herein present our application of this technique, including refinements over time and long-term outcomes. METHODS: A retrospective review was performed on 12 patients who underwent reconstruction of Brown class III orbitopalatomaxillary defects with extensive orbital involvement (at minimum complete orbital floor and rim absent) with titanium mesh sling and a layered fibula free flap...
August 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/28805282/autologous-breast-reconstruction-in-sickle-cell-trait-a-fine-line-between-success-failure
#12
Danny A Young-Afat, Marije J Hoornweg, Martine A van Huizum
Autologous breast reconstructions are increasingly being performed. While increased risks for flap loss after free tissue transfer (FTT) in sickle cell patients are known to most plastic surgeons, risks for patients with sickle cell trait (SCT) are less known. Unfortunately, recommendations to prevent complications after FTT in SCT are still scarce. We present additional and novel surgical measures that we took aiming to enhance probabilities for successful FTT in a SCT patient undergoing autologous breast reconstruction...
August 14, 2017: Breast Journal
https://www.readbyqxmd.com/read/28804686/a-comparative-study-of-tissue-expansion-and-free-parascapular-flaps-in-extensive-facial-burn-scar-reconstruction
#13
G S Kalra, Mitesh Bedi, Vipin Kumar Barala
BACKGROUND: Large post burn scars are a very difficult problem to treat. Available methods include skin grafts and tissue expansion. The reconstructive method used should be tailored according to individual patient rather than following a textbook approach in each. PATIENTS AND METHODS: A retrospective analysis was done of cases with extensive facial burn scars in whom secondary reconstruction was done with either free parascapular flap cover or tissue expansion and flap advancement following facial burn scar excision by a single surgeon (GSK) in Department of Burns, Plastic and reconstructive surgery...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/28803639/atrial-fibrillation-and-stroke-as-initial-manifestations-of-painless-type-a-aortic-dissection
#14
Claudia Stöllberger, Lilian Schäffl-Doweik, Maria Korn, Josef Finsterer
Aortic dissection is diagnostically challenging, especially in pain-free patients. Detection of acute ischemic stroke secondary to painless aortic dissection is a challenge for emergency physicians and neurologists. We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. Perfusion CT-imaging showed a dilatation of the aortic arch and intraluminal structures indicating an intima flap of aortic dissection...
July 21, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28802984/free-grafts-and-microvascular-anastomoses
#15
REVIEW
Valery F Scharf
Skin grafts and free skin flaps are useful options for closure of wounds in which primary closure or use of traditional skin flaps is not feasible. Grafts are classified by their morphology and host-donor relationship. Free skin flaps with microvascular anastomoses are developed from previously described axial pattern flaps and have the added advantage of reestablishing robust vascular supply to the flap, but require specialized equipment and a high degree of technical expertise. Despite intensive perioperative care and the risk of graft or flap failure, skin grafts and free skin flaps can serve as rewarding methods of closing difficult wounds...
August 9, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28802886/-lumbar-artery-perforator-flap-for-breast-reconstruction
#16
J-F Honart, N Leymarie, B Sarfati, H Alknashnam, K Rem, F Rimareix, F Kolb
Even though DIEP-SIEA flaps or latissimus dorsi musculocutaneous flap are the most frequently used, a wide variety of flaps have been described for autologous breast reconstruction. Concerning the choice of donor-site, the aim is to prevent and to limit the morbidity. That is why the donor-site should be carefully chosen, according to the morphology of the patient. Lumbar artery perforator flap (LAP) is an option for breast reconstruction, but it is not well known and its use is limited. This study summarizes the authors' early experience with free LAP flap for breast reconstruction...
August 9, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28802488/characterization-of-surgical-procedures-in-the-spanish-mohs-surgery-registry-regesmohs-for-2013-2015
#17
E de Eusebio Murillo, A Martín Fuentes, V Ruiz-Salas, J R Garcés, R Miñano Medrano, J L López-Estebaranz, T Alonso-Alonso, M Á Rodríguez-Prieto, Y Delgado Jiménez, V Morales, P Redondo Bellón, E Manubens-Mercadé, O Sanmartín-Jiménez, C Guillén Barona, R Cabeza, N Cano, A Toll-Abelló, R Navarro Tejedor, J L Artola Igarza, I Allende Markixana, A Alfaro Rubio, C Ciudad Blanco, H Vázquez-Veiga, L Barchino Ortiz, M A Descalzo, I García-Doval
INTRODUCTION: The Spanish Mohs Surgery Registry is used to collect data on the use and outcomes of Mohs micrographic surgery (MMS) in Spain. The aim of this study was to describe perioperative and intraoperative data recorded for MMS procedures performed between July 2013 (when the registry started) and January 2016. MATERIAL AND METHODS: Prospective cohort study of data from 18 hospitals. The data collected included type of anesthesia, surgical technique, hospital admission, number of Mohs stages, management of preoperative risk factors, additional treatments, previous treatments, type of tumor, operating time, and complications...
August 9, 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/28799442/the-use-of-innervated-radial-artery-superficial-palmar-branch-perforator-free-flap-for-complex-digital-injuries-reconstruction
#18
Zhenglin Chi, Georgios Pafitanis, Luis Eduardo Parra Pont, Roshan Vijayan, Stefano Marcelli, Weiyang Gao, Zan Li, Xiao Zhou, Dajiang Song, Peng Yang
Loco-regional flaps have been widely used for the reconstruction of digital injuries without requiring microvascular anastomosis, however, they result in scarring and compromised functional outcomes. This study demonstrates our experience utilizing the innervated radial artery superficial palmar branch (RASPB) perforator free flap for complex digital injury reconstruction. From May 2007 to March 2014, the innervated RASPB perforator free flap was used to reconstruct 79 distal complex hand and digital soft tissue defects of which 14 were used to re-vascularise the distal digit in a flow-through fashion...
August 11, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28796101/use-of-the-ipsilateral-anteromedial-thigh-flap-for-immediate-rescue-of-nonviable-anterolateral-thigh-flaps-in-head-and-neck-cancer-reconstruction
#19
Hsu-Tang Cheng, Jin-Yi Tian, Yung-Chang Hsu, Hsin-Han Chen, Sophia Chia-Ning Chang
BACKGROUND: It is not always possible to use the anatomically variable free anterolateral thigh (ALT) flap for reconstructive surgery. An anteromedial thigh (AMT) flap serves as a good alternative, and shares the same vascular pedicle as the ALT flap. METHODS: Of 698 reconstructions performed in 2006 to 2013 following head and neck tumor ablation surgery, ALT flaps were used in 653 patients. Eighteen free AMT flaps were harvested to replace variant nonviable ALT flaps...
August 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28796099/radiotherapy-and-smoking-history-are-significant-independent-predictors-for-osteosynthesis-associated-late-complications-in-vascular-free-fibula-reconstruction-of-mandible
#20
YiMing Chen, JiaLing Wu, Sandhya Gokavarapu, Qingcheng Shen, Tong Ji
BACKGROUND: The vascular fibula flap is an ideal choice for function and appearance reconstruction of mandible. Despite the high success rate, "late complications" such as Ti plate exposure and local infection related to osteosynthesis are not uncommon. PATIENTS AND METHOD: A retrospective cohort of patients who received vascular fibula reconstruction for mandible from January 2011 to December 2013 from the Department of Oral and Maxillofacial Oncology in a tertiary hospital were charted: clinical, pathological, and therapeutic factors were analyzed for late complications in univariate and multivariate analyses...
August 8, 2017: Journal of Craniofacial Surgery
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