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https://www.readbyqxmd.com/read/29676403/combined-endoscopic-transorbital-and-endonasal-repair-of-high-flow-orbital-apex-middle-fossa-cerebrospinal-fluid-leak-with-a-nasoseptal-flap
#1
Brandon Lucke-Wold, Gustavo Mendez, David Cua, Paul Akins, Haley Gillham, Jeremy Ciporen
Background and importance: High flow orbital apex or middle fossa cerebrospinal fluid (CSF) leaks can be life threatening and complex to repair. These leaks associated with large dural defects are most commonly repaired with an open temporalis muscle patch or free flaps, but these flaps do not always stop the leak. Clinical Presentation: A 65-year-old patient presented two years after orbital exenteration and radiation for squamous cell carcinoma. He developed multi-organism meningitis and pneumocephalus secondary to a large high-flow orbital apex/middle fossa CSF leak...
2018: Journal of neuroinflammation and neurodegenerative diseases
https://www.readbyqxmd.com/read/29675214/controllable-extension-of-hairpin-structured-flaps-to-allow-low-background-cascade-invasive-reaction-for-a-sensitive-dna-logic-sensor-for-mutation-detection
#2
Yun-Long Liu, Hai-Ping Wu, Qiang Zhou, Qin-Xin Song, Jian-Zhong Rui, Xiao-Xiang Guan, Guo-Hua Zhou, Bing-Jie Zou
A DNA logic sensor was constructed for gene mutation analysis based on a novel signal amplification cascade by controllably extending a hairpin-structured flap to bridge two invasive reactions. The detection limit was as low as 0.07 fM, and the analytical specificity is high enough to unambiguously pick up 0.02% mutants from a large amount of wild-type DNA. Gene mutations related to the personalized medicine of gefitinib, a typical tyrosine kinase inhibitor, were analyzed by the DNA logic sensor with only a 15 minute response time...
February 14, 2018: Chemical Science
https://www.readbyqxmd.com/read/29674733/the-use-of-dental-implants-cast-bars-and-sleeve-overdentures-in-oral-cancer-patients
#3
R Ali, A Al-Khayatt, C Barclay
Surgical resection of an oral tumour (and the associated free flap reconstruction) can significantly alter the oral anatomy. The lack of sulcus depth, alveolar ridge, presence of a mobile flap and limited tongue movement can make it impossible for patients to control a removable prosthesis. To help this cohort of patients, dental implants can be invaluable. The Oral Rehabilitation Team at Central Manchester University Dental Hospital have used dental implants to rehabilitate oral cancer patients for over thirty years...
April 20, 2018: British Dental Journal
https://www.readbyqxmd.com/read/29672785/-tissue-engineering-of-adipose-tissue-with-biodegradable-biomaterials-for-soft-tissue-reconstruction
#4
Silvan Klein, Thiha Aung, Robert Michael Haas, Fabian Medved, Stefan M Schiller, Oliver Felthaus, Jürgen H Dolderer
Soft tissue defects resulting from injuries, tumor resection, congenital anomalies or chronic wounds pose a great challenge to reconstructive surgery. The current gold standard in therapy of such defects is the tissue transplantation in terms of free or local flaps. Unfortunately, donor site morbidity remains a considerable risk of flap surgery. Therefore, tissue engineering of autologous vascularized long term stable adipose tissue constructs could enrich the therapeutic possibilities of soft tissue defects...
April 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29672783/-smartphone-based-thermography-for-perforator-localisation-in-microvascular-breast-reconstruction
#5
Leonard Walle, Hisham Fansa, Onno Frerichs
BACKGROUND: Thermography permits non-invasive examination and presentation of cutaneous temperature differences. When planning microvascular flaps, thermography may illustrate these differences and may portray patterns of blood circulation near to perforators. As an additional tool, thermography may enhance quality and diversity in free flaps. PATIENTS AND METHODS: In this prospective study, we examined 10 patients with 13 free DIEP-flaps for breast reconstruction...
April 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29672777/diep-flap-breast-reconstruction-complication-rate-in-previously-irradiated-internal-mammary-nodes
#6
Shirley Shechter, Ehud Arad, Amir Inbal, Or Friedman, Eyal Gur, Yoav Barnea
BACKGROUND:  Postmastectomy radiation therapy (PMRT) is a widely accepted treatment for locally advanced breast cancer. Some patients require additional boost radiation to the internal mammary nodes as the part of regional nodal irradiation (RNI). Delayed breast reconstruction with an autologous free flap using the internal mammary vessels for microvascular flap anastomosis is a common practice for these patients. The aim of our study was to evaluate the effect of RNI on autologous microvascular breast reconstruction...
April 19, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29672776/postoperative-monitoring-of-free-diep-flap-in-breast-reconstruction-with-near-infrared-spectroscopy-variables-affecting-the-regional-oxygen-saturation
#7
Marzia Salgarello, Domenico Pagliara, Marco Rossi, Giuseppe Visconti, Liliana Barone-Adesi
BACKGROUND:  The timing of surgical reexploration in microanastomotic thrombosis is directly related to the salvage rate of free flap. Near-infrared spectroscopy (NIRS) is a noninvasive technique, which allows a continuous bedside monitoring of flap oxygenation. The current literature is lacking in the assessment of variables able to modify the NIRS monitoring. The aim of this study is to identify patient and flap-related variables that can affect regional oxygen saturation (rSO2 )...
April 19, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29672775/free-or-perforator-pedicled-propeller-flaps-in-lower-extremity-reconstruction-defining-the-coverage-failure
#8
Farid Bekara, Christian Herlin, Antoine De Runz, David Boccara, Benoit Chaput
No abstract text is available yet for this article.
April 19, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29668632/outcomes-of-using-a-modified-anteromedial-thigh-perforator-flap-for-repairing-the-anterolateral-thigh-free-flap-donor-site-a-retrospective-clinical-review
#9
Xiao Zhou, Jin Wang, Li Qiang, Yongjun Rui, Mingyu Xue
The anterolateral thigh (ALT) flap plays an essential part in plastic and reconstructive surgery. However, repair of the anterolateral donor site has not been the focus of the clinicians.To assess the clinical value and feasibility of using a modified anteromedial thigh (AMT) perforator flap for repairing the ALT free flap donor site.In this retrospective study, 16 ALT flaps were transferred to resurface large soft-tissue defects (ranged from 7 × 5 to 13 × 8 cm) in the foot or hand from June 2012 to March 2013...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29668509/a-description-of-the-vascular-anatomy-of-the-tensor-fascia-lata-perforator-flap-using-computed-tomography-angiography
#10
Jeremy M Powers, Mariana Martinez, Shuhao Zhang, Santosh S Kale
BACKGROUND: The perforator anatomy of the tensor fascia lata (TFL) flap has been studied using cadaver dissection; however, exact descriptions of location, size, and origin of perforator vessels using preoperative imaging modalities remain limited. The aims of this study are to describe TFL perforator anatomy using high-resolution computed tomography angiography (CTA) and to correlate these findings with landmarks for the anterolateral thigh flap to facilitate flap planning. METHODS: We identified 33 patients who previously underwent bilateral lower extremity CTAs for preoperative planning of free-flap reconstruction...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29665804/immediate-implant-replacement-with-diep-flap-a-single-stage-salvage-option-in-failed-implant-based-breast-reconstruction
#11
Miguel De La Parra Marquez, Ricardo Fernandez-Riera, Hector Vela Cardona, Jesus María Rangel Flores
BACKGROUND: Implant-based immediate breast reconstruction after skin-sparing mastectomy has shown a significant improvement in patients' quality of life, making the procedure steadily more popular year after year. However, this technique has a high morbidity rate, including skin necrosis and implant exposure. METHODS: A retrospective review of a prospectively held database for autologous breast reconstruction in our institution of the last 5 years found eight cases with exposed implants after nipple-sparing mastectomy and immediate reconstruction...
April 17, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29664829/nipple-sparing-mastectomy-and-immediate-breast-reconstruction-with-a-deep-inferior-epigastric-perforator-flap-a-study-of-patient-satisfaction
#12
Jerry Levy, Romain Bosc, Noel Warren, Sabban Rebecca, Thu Ha Dao, Barbara Hersant, Jean-Paul Meningaud
INTRODUCTION: The morphological result of nipple-areola complex (NAC) reconstruction may be disappointing for patients who undergo skin-sparing mastectomies and immediate breast reconstruction, followed by secondary reconstruction of the nipple-areola complex.The aim of this study was to analyze patient satisfaction after nipple-sparing mastectomy and immediate breast reconstruction with a deep inferior epigastric perforator flap. MATERIALS AND METHODS: Our retrospective study involved all patients who underwent an immediate breast reconstruction after unilateral mastectomy with conservation of the NAC...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29664828/modified-2-stage-method-for-auricular-reconstruction
#13
Tengxiao Ma, Feng Xie, Zhengwen Zhang
BACKGROUND: Auricular reconstruction is one of the most challenging procedures in the field of plastic surgery. The aims of this study were to apply the modified 2-stage method to perform auricular reconstruction and to summarize the clinical experience in the past 10 years. METHODS: Auricular reconstruction was performed in 243 patients (total 254 ears) of congenital microtia using autologous costal cartilage. The whole procedure is divided into 2 stages. Stage I: the individualized framework fabricated with autologous costal cartilage is inserted into subcutaneous pocket in the mastoid region, and then the earlobe was transposed backward to connect with the lower part of the framework...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29664802/free-thoracoacromial-artery-perforator-flap-for-skin-defects-of-the-dorsal-hand
#14
Satoshi Kodaira, Keizo Fukumoto, Naoki Kato
Various flaps are used for skin defects of the dorsal hand and fingers. A sensory flap is not essential, but a thin and good color-matched flap is suitable, and donor site mobility of the flap should be considered. A reverse or free posterior interosseous artery perforator flap is one of the standard flaps. This flap requires no major arterial sacrifice, but direct closure of the donor site is difficult when the width of the flap is >3 cm, and there is also the risk of posterior interosseous nerve injury, especially the motor branch of the extensor carpi ulnaris muscle...
April 16, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29664694/immediate-use-of-uncuffed-tracheostomy-after-free-flap-reconstruction-of-the-head-and-neck
#15
Priyesh N Patel, Al C Valmadrid, Daniel Y Hong, David O Francis, Michael W Sim, Sarah L Rohde
Objective To determine if immediate postoperative uncuffed tracheostomy placement following oral cavity or oropharyngeal head and neck free flap reconstruction is associated with shorter hospital length of stay and higher inpatient decannulation rates without an increase in respiratory complications, as compared with immediate placement of cuffed tracheostomy. Study Design Retrospective cohort. Setting Tertiary referral center. Subjects and Methods Patients were included if they underwent free flap reconstruction for oral cavity or oropharyngeal squamous cell carcinoma and had an intraoperative tracheostomy placed between 2005 and 2016...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29661662/multimodal-analysis-using-flowmeter-analysis-laser-doppler-spectrophotometry-and-indocyanine-green-videoangiography-for-the-detection-of-venous-compromise-in-flaps-in-rats
#16
Lucas M Ritschl, Leonard H Schmidt, Andreas M Fichter, Alexander Hapfelmeier, Klaus-Dietrich Wolff, Thomas Mücke
Venous congestion results in tissue damage and remains the most common failure of free microvascular transfer if it is not recognized early. The purpose of this experimental study was to evaluate venous congestion and describe the findings with two different monitoring tools. A standardized epigastric flap was raised, and total occlusion of the draining vein was temporarily applied for 4, 5, 6, or 7 h. Blood flow measurements, including laser-Doppler flowmetry, and tissue spectrophotometry (O2C) and indocyanine green (ICG) videoangiography using the FLOW® 800 tool, were performed systematically after each surgical step, an interval of venous occlusion, and 1 week of clinical observation...
March 30, 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29660924/vasopressor-support-vs-liberal-fluid-administration-in-deep-inferior-epigastric-perforator-diep-free-flap-breast-reconstruction-a-randomized-controlled-trial
#17
A M Anker, L Prantl, C Strauss, V Brébant, N Heine, P Lamby, S Geis, F Schenkhoff, M Pawlik, S M Klein
BACKGROUND: Perioperatively, patients' hemodynamics are modulated predominantly by intravenous fluid administration and vasoactive pharmacological support. Vasopressor agents are suspected to be detrimental on free flap survival by the cause of vasoconstriction of the pedicle with consecutive reduced overall flap perfusion and by aggravation of flap dissection. OBJECTIVE: A novel, standardized fluid restrictive perioperative hemodynamic management was assessed for its feasibility in clinical practice in free flap patients undergoing breast reconstruction...
April 7, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29660909/the-effect-of-trimetazidine-in-reducing-the-ischemia-reperfusion-injury-in-rat-epigastric-skin-flaps
#18
Laura Petrovics, Tibor Nagy, Peter Hardi, Laura Bognar, Gabor Pavlovics, Gyorgy Tizedes, Ildiko Takacs, Gabor Jancso
BACKGROUND: Ischemia-reperfusion injury may lead to insufficient microcirculation and results in partial flap loss during the free flap surgeries. OBJECTIVE: This study aimed to investigate the effect of trimetazidine (TMZ) on oxidative stress, inflammation and histopathological changes, using the epigastric skin flap model in rats. METHODS: 40 male Wistar rats were used, that were divided into four groups. Control group, non-treated ischemic (I/R)-group and two trimetazidine treated groups (preischemically, postischemically) were established...
April 13, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29660760/racial-disparities-in-postmastectomy-breast-reconstruction-national-trends-in-utilization-from-2005-to-2014
#19
Sherise Epstein, Bao N Tran, Justin B Cohen, Samuel J Lin, Dhruv Singhal, Bernard T Lee
BACKGROUND: Evidence of racial disparities in the receipt of postmastectomy breast reconstruction is well documented. The objective of this study was to describe trends in racial disparities overall and by reconstructive technique. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify women who underwent mastectomy and/or breast reconstruction from 2005 to 2014. Patient demographics were recorded, and cases were grouped by reconstructive status and technique...
April 16, 2018: Cancer
https://www.readbyqxmd.com/read/29660746/free-versus-pedicled-perforator-flaps-for-lower-extremity-reconstruction-a-multicenter-comparison-of-institutional-practices-and-outcomes
#20
Keith Koh, Terence L H Goh, Christopher Tam Song, Hyun Suk Suh, Peter V Rovito, Joon-Pio Hong, Geoffrey G Hallock
BACKGROUND:  Of all body regions, lower extremity wounds have been and remain the greatest challenge. Perforator free flaps have been accepted as a reasonable option to solve this dilemma but require the complexity of microsurgery. As a consequence, the possibility that pedicled perforator flaps could supplant even perforator free flaps has recently gained intense enthusiasm. METHODS:  A retrospective investigation was undertaken to compare the validity for the use of perforator flaps of all types at three dissimilar institutions, that is, a university, a regional center, and a community hospital...
April 16, 2018: Journal of Reconstructive Microsurgery
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