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Microvascular anastomosis

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https://www.readbyqxmd.com/read/29037204/thoracodorsal-artery-perforator-flap-as-an-autologous-alternative-to-acellular-dermal-matrix
#1
Tarek Hashem, Ahmed Farahat
BACKGROUND: Thoracodorsal artery perforator (TDAP) flap is one of the relatively new techniques in breast reconstruction. This pedicled flap retains the benefits of perforator flaps as regards minimal donor site morbidity without the need for microvascular anastomosis. Its role in partial breast reconstruction has been well documented. However, there are few reports about the role of this flap in total breast reconstruction. METHODS: This study included 47 cases who presented to the breast unit of the National Cancer Institute of Cairo University from 2013 to 2015...
October 16, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29030029/improving-free-flap-survival-using-intra-operative-heparin-ritualistic-practice-or-evidence-base-medicine-a-systematic-review
#2
C Couteau, K Rem, D Guillier, V Moris, M Revol, S Cristofari
INTRODUCTION: The failure rate of free flaps is approximately 5%, mostly due to thrombosis of microvascular anastomosis. A number of pharmacological agents have been tested in order to enhance the patency of microvascular anastomosis and so to as extend the survival of free flaps. One of them is heparin, a very commonly used anticoagulant. However, there exists no consensus on its use in microsurgery as concerns time of introduction (pre-, intra- or post-operative), recommended dosage, or duration of utilization...
October 10, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29019586/continuous-versus-interrupted-suture-technique-in-microvascular-anastomosis-in-rats
#3
Rui Sergio Monteiro de Barros, Rafael Aquino Leal, Renan Kleber Costa Teixeira, Vitor Nagai Yamaki, Daniel Haber Feijó, Eduardo Henrique Herbster Gouveia, André Lopes Valente, Denilson José Silva, Luan Teles Ferreira de Carvalho
PURPOSE: To compare the continuous and interrupted suture technique on femoral artery on rats after vessel repair and 14 days after. METHODS: Twenty rats were operated randomly divided into two group matched according to the suture technique used: interrupted or continuous. We performed a femoral anastomosis on the right femoral artery. We analyzed weight, arterial caliber, anastomosis time and patency after vessel repair and 14 days after. RESULTS: There was no significant difference between groups in the weight (p=0...
September 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28963799/-airborne-suture-tying-technique-simple-steps-to-make-it-easy
#4
Mouchammed Agko, Pedro Ciudad, Hung-Chi Chen
A multitude of microsurgical suture techniques have been described. Although accurate apposition and eversion of the vessel ends is paramount for the patency of anastomosis, rapidity is usually of secondary importance. However, in situations in which either multiple anastomoses are required or timely revascularization is crucial, speed becomes a determinant factor for eventual success. "Airborne" suture tying is aimed at decreasing operative time by streamlining the microvascular anastomosis. Over the years, several considerations have emerged as key points for achieving mastery of this helpful maneuver...
September 30, 2017: Head & Neck
https://www.readbyqxmd.com/read/28910897/-the-application-of-microvascular-anastomotic-coupler-in-vascular-anastomosis-of-free-tissue-flap-for-reconstruction-of-defect-after-head-and-neck-cancer-resection
#5
Y J Zhang, Z H Wang, C H Li, J Chen
Objective: To investigate the application and operation skills in vein anastomosis by microvascular anastomotic coupler (MAC) in reconstruction of defects after head and neck cancer resection. Methods: From August 2015 to July 2016, in Department of Head and Neck Surgery, Sichuan Cancer Hosipital, 17 cases underwent the reconstruction of defects after head and neck cancer resection with free tissue flaps, including forearm flaps in 11 casess, anterolateral flaps in 4 casess and fibula flaps in 2 casess. Totally 17 MAC were used, including 14 MAC for end-to-end anastomosis and 3 MAC for end-to-side anastomosis...
September 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28894667/dual-vascular-free-anterolateral-thigh-flap
#6
Toshiaki Numajiri, Daiki Morita, Shoko Tsujiko, Hiroko Nakamura, Yoshihiro Sowa, Akihito Arai, Matsui Masahiro, Hiroshi Nakano, Shigeru Hirano
BACKGROUND: The optimum number of microvascular anastomoses for safe free tissue transfer is controversial. Although the case for 2 venous anastomoses versus 1 anastomosis has been argued, the use of an additional arterial anastomosis has not been examined in detail. METHODS: Twelve patients who underwent 2 arterial anastomoses for a free flap transfer were identified retrospectively from the medical records of patients undergoing reconstruction for head and neck cancer...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28882491/anatomic-and-high-resolution-computed-tomographic-angiography-study-of-the-lateral-femoral-condyle-flap-implications-for-surgical-dissection
#7
Mohamed Morsy, Yoo Joon Sur, Osman Akdag, Amr Eisa, Tarek A El-Gammal, Nirusha Lachman, Steven L Moran
BACKGROUND: The lateral femoral condyle (LFC) flap is a vascularized bone flap based on the superior lateral genicular artery (SLGA). Harvest technique for this flap has not yet been demonstrated. The purpose of this study was to better delineate the blood supply to the bone and skin of this flap to allow for a safe and effective harvest. MATERIALS AND METHODS: Twenty-three lower extremities were injected with latex or a mixture of latex and barium sulfate. The SLGA was identified and dissected, documenting the course, diameter, anatomical relations, length, and branches...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28877537/sutureless-microvascular-anastomosis-using-intravascular-stenting-and-cyanoacrylate-adhesive
#8
Tetsushi Aizawa, Masahiro Kuwabara, Satoshi Kubo, Takashi Domoto, Shimpo Aoki, Ryuichi Azuma, Tomoharu Kiyosawa
No abstract text is available yet for this article.
September 6, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28873495/-defect-coverage-of-the-hand-using-a-rare-siamese-combined-flap
#9
Itai Pasternak, Urs Hug, Eva Meia Rüegg, Elmar Fritsche
We report 2 cases of extensive soft tissue defects simultaneously affecting the palm and dorsum of the hand. The defect was covered with a Siamese flap combination consisting of a free, distally extended lateral upper arm flap with microvascular anastomosis, and a posterior interosseous artery flap. We discuss possible indications, the operative technique and advantages versus disadvantages of this rarely applied flap combination.
October 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28867319/transfer-of-learning-from-practicing-microvascular-anastomosis-on-silastic-tubes-to-rat-s-abdominal-aorta
#10
Pooneh Mokhtari, Ali Tayebi Meybodi, Michael T Lawton, Andre Payman, Arnau Benet
OBJECT: Learning to perform microvascular anastomosis is difficult. Laboratory practice models using artificial vessels are frequently used for this purpose. However, the efficacy of such practice models has not been objectively assessed on the performance of microvascular anastomosis during live surgical settings. This study was carried out to assess the transfer of learning from practicing microvascular anastomosis on tubes to anastomosing rat's abdominal aorta. METHODS: Ten surgeons without any experience in microvascular anastomosis were randomly assigned to an experimental or a control group...
August 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28831362/autologous-latissimus-dorsi-breast-reconstruction-flap-salvage-microvascular-anastomosis-with-serratus-branch
#11
Victoria Kuta, Martin LeBlanc
Autologous breast reconstruction has become a standard option during the recovery of breast cancer survivors. Although pedicle damage is a rare complication of this procedure, extensive torsion or tension can lead to partial or total flap failure. We report a case of partial flap salvage after accidental transection of the pedicled blood supply within the intramuscular course of a latissimus dorsi musculocutaneous flap. This salvage technique involved microvascular anastomosis between the remaining vasculature of the latissimus dorsi pedicle and the serratus branch of the thoracodorsal artery and vein...
July 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28831350/intimal-surface-suture-line-end-product-assessment-of-end-to-side-microvascular-anastomosis
#12
Georgios Pafitanis, Damjan Veljanoski, Ali M Ghanem, Simon Myers
Microsurgery simulation courses increasingly use assessment methodologies to evaluate the quality of microvascular anastomosis and to provide constructive feedback in competency-based training. Assessment tools evaluating the "journey" of skill acquisition in anastomosis have evolved, including global rating scores, hand motion analysis, and evaluation of the final outcome, that is, "end-product" assessment. Anastomotic patency is the gold standard end-product in clinical microvascular surgery, and in vivo end-to-side anastomosis, which can be confirmed using the Acland-test...
July 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28820839/smaller-diameter-anastomotic-coupling-devices-have-higher-rates-of-venous-thrombosis-in-microvascular-free-tissue-transfer
#13
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/28812257/robotic-assisted-microvascular-surgery-skill-acquisition-in-a-rat-model
#14
Nicholas S Clarke, Johnathan Price, Travis Boyd, Stefano Salizzoni, Kenton J Zehr, Alejandro Nieponice, Pietro Bajona
Microsurgery is a technically demanding field with long learning curves. Robotic-assisted microsurgery has the ability to decrease these learning curves. We, therefore, sought to assess the feasibility of robotic-assisted microvascular surgery in a rat model, and whether this could be translated into a worthwhile skills acquisition exercise for residents. Twenty-eight rats underwent microvascular anastomosis. Procedures were performed by a trained microvascular surgeon with no robotic experience (n = 14), or a trained robotic surgeon with no microvascular experience (n = 14)...
August 10, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28806848/comparison-of-live-rat-femoral-artery-model-with-intraoperative-microvascular-anastomosis
#15
Mark V Schaverien, Charles E Butler, Hiroo Suami, Jun Liu, Jesse C Selber
No abstract text is available yet for this article.
August 14, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28799442/the-use-of-innervated-radial-artery-superficial-palmar-branch-perforator-free-flap-for-complex-digital-injuries-reconstruction
#16
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/28742116/sutureless-microvascular-anastomosis-assisted-by-an-expandable-shape-memory-alloy-stent
#17
Noriko Saegusa, Shunji Sarukawa, Kunihiro Ohta, Kensuke Takamatsu, Mitsuhiro Watanabe, Takashi Sugino, Masahiro Nakagawa, Yasuto Akiyama, Masatoshi Kusuhara, Kazuo Kishi, Keita Inoue
Vascular anastomosis is the highlight of cardiovascular, transplant, and reconstructive surgery, which has long been performed by hand using a needle and suture. However, anastomotic thrombosis occurs in approximately 0.5-10% of cases, which can cause serious complications. To improve the surgical outcomes, attempts to develop devices for vascular anastomosis have been made, but they have had limitations in handling, cost, patency rate, and strength at the anastomotic site. Recently, indwelling metal stents have been greatly improved with precise laser metalwork through programming technology...
2017: PloS One
https://www.readbyqxmd.com/read/28739457/distal-ulnar-artery-aneurysm-repair-by-end-to-end-technique-a-case-report
#18
Attilio Cotroneo, David Barillà, Felice Armienti, Gian Luca Martinelli, Marco Diena
We report the case of a 33-year-old man presented with a post-traumatic 20mm left ulnar artery aneurysm without intraluminal thrombus in the left hypotenar eminence. The patient reported left hand paraesthesia. Because of symptoms and the embolic risk we decide to plan an aneurysm resection and an interposition graft with inverted basilic vein for adequacy diameter (∼ 2mm), but an end-to-end anastomosis was performed instead. We think that the post traumatic distal artery aneurysm could be treated without a by-pass but, after a meticulous anatomic dissection, with a microvascular anastomosis between the artery stumps...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28728324/the-chicken-thigh-adductor-profundus-free-muscle-flap-a-novel-validated-non-living-microsurgery-simulation-training-model
#19
Georgios Pafitanis, Yasmine Serrar, Maria Raveendran, Ali Ghanem, Simon Myers
BACKGROUND: Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28699660/binding-of-indocyanine-green-in-polycaprolactone-fibers-using-blend-electrospinning-for-in-vivo-laser-assisted-vascular-anastomosis
#20
Annemarie Schönfeld, Zacharia Mbäıdjol Kabra, Mihai Constantinescu, Dieter Bosshardt, Michael H Stoffel, Kirsten Peters, Martin Frenz
BACKGROUND AND OBJECTIVE: The clinical application of laser-assisted vascular anastomosis is afflicted by unreliable and low bonding strengths as well as tedious handling during microvascular surgery. The challenge to be met arises from the flow-off of the chromophore during soldering that changes the absorption and stains the surrounding tissue, leading to an uncontrollable thermal damage zone. In this study, we investigated the feasibility to produce an indocyanine green (ICG)-loaded patch by electrospinning and tested its applicability to both in vitro and in vivo microvascular laser soldering...
July 12, 2017: Lasers in Surgery and Medicine
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