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https://www.readbyqxmd.com/read/28089863/prevention-of-thrombosis-in-hypercoagulable-patients-undergoing-microsurgery-a-novel-anticoagulation-protocol
#1
Jonas A Nelson, Cyndi U Chung, Andrew R Bauder, Liza C Wu
BACKGROUND: Hypercoagulable conditions are often considered relative contraindications to free flap reconstruction. This paper presents and critically examines a novel anticoagulation regimen developed to address this disease state. METHODS: Hypercoagulable patients who underwent free tissue transfer between 2007 and 2015 were identified. From 2011, all such patients were subjected to a novel anticoagulation protocol involving an intravenous bolus of 2000 U of unfractionated heparin prior to microvascular pedicle anastomosis, followed by a heparin infusion at 500 U/h, which was postoperatively increased to therapeutic levels...
December 18, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28089170/iliolumbar-artery-a-useful-pedicle-for-the-iliac-crest-free-flap-in-maxillofacial-reconstruction
#2
T Singh, K Andi
The iliac crest free flap is commonly used in maxillofacial reconstruction, and is typically supplied by the deep circumflex iliac artery (DCIA). However, the iliolumbar artery is an alternative blood supply that can potentially be used in such reconstructions. We describe the anatomy of the iliolumbar artery and review publications about its clinical use. We raised four cadaveric iliac crest free flaps using both the DCIA and the iliolumbar artery to illustrate its use in reconstructing maxillofacial defects...
January 11, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28062176/characteristics-and-surgical-management-of-flap-compromise-caused-by-thrombosis-of-the-internal-jugular-vein
#3
Bin Yang, Yi Qu, Ming Su, Jinzhong Li, Hua Li, Rudong Xing, Zhengxue Han
BACKGROUND: A principal reason for flap compromise in oral and maxillofacial head and neck surgery, and failure of a free flap transfer, is thrombosis of a drainage vein such as the internal jugular vein. This study characterized flap compromise caused by internal jugular vein thrombosis after a free flap transfer, and its management. PATIENTS AND METHODS: A retrospective clinical study was conducted of 306 consecutive microvascular free flaps performed for 305 patients with head and neck cancer from March 2003 to March 2013 at the Department of Oral and Maxillofacial Surgery at Beijing Stomatological Hospital, Capital Medical University...
December 18, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28059901/conservative-surgery-for-laryngeal-chondrosarcoma-a-review-of-the-most-recently-proposed-approaches
#4
Cesare Piazza, Alberto Paderno, Piero Nicolai
PURPOSE OF REVIEW: The aim of this study was to describe the most recent technical nuances for resection and reconstruction of Grade 1 and 2 laryngeal chondrosarcomas, with a special emphasis on those located at the level of the cricoid plate, which is the site of origin of the vast majority of these rare tumours. RECENT FINDINGS: Even though inherently based on retrospective small clinical series or anecdotal case reports, a number of studies have been recently published focusing on conservative transoral and open-neck surgical procedures aimed at an oncologically sound removal of the tumour together with organ and function preservation...
January 3, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28039007/pedicle-orientation-in-free-flap-microvascular-maxillofacial-reconstruction
#5
Daniel M Cummins, Beomjune Kim, Arshad Kaleem, Waleed Zaid
Oncologic and traumatic defects of the maxilla can pose a challenge to patients, reconstructive surgeons, and maxillofacial prosthodontists in an attempt to provide satisfactory treatment. Oral-nasal and oral-antral fistulas are frequently treated with soft tissue flaps, osteocutaneous flaps, or a maxillofacial obturator. Often, surgical reconstruction is preferred for patient quality of life and definitive restoration. Surgical reconstruction also avoids the difficulties encountered with fabricating an obturator in an irradiated field with the often-resultant microstomia...
December 10, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27995558/is-there-benefit-to-free-over-pedicled-vascularized-grafts-in-augmenting-tibial-intercalary-allograft-constructs
#6
Marco Manfrini, Srimanth Bindiganavile, Ferhat Say, Marco Colangeli, Laura Campanacci, Massimiliano Depaolis, Massimo Ceruso, Davide Donati
BACKGROUND: Intercalary reconstruction of tibial sarcomas with vascularized fibula autografts and massive bone allografts is reliable with predictable long-term results. However, inadequate data exist comparing free and pedicled vascularized fibula autografts in combination with a massive bone allograft in patients undergoing intercalary tibia reconstructions. QUESTIONS/PURPOSES: Among patients undergoing large-segment intercalary allografting, we sought to compare supplemental free vascularized fibular autografts with supplemental pedicled vascularized fibular autografts, in terms of (1) oncologic results, (2) complications associated with surgery, (3) Musculoskeletal Tumor Society (MSTS) scores, and (4) surgical time...
December 19, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27975009/effect-of-previous-irradiation-on-vascular-thrombosis-of-microsurgical-anastomosis-a-preclinical-study-in-rats
#7
Sergi Barrera-Ochoa, Irene Gallardo-Calero, Alba López-Fernández, Cleofe Romagosa, Ramona Vergés, Marius Aguirre-Canyadell, Francisco Soldado, Roberto Velez
BACKGROUND: The objective of the present investigation was to compare the effect of neoadjuvant irradiation on the microvascular anastomosis in cervical bundle using an experimental model in rats. METHODS: One hundred forty male Sprague-Dawley rats were allocated into 4 groups: group I, control, arterial microanastomosis; group II, control, venous microanastomosis; group III, arterial microanastomosis with previous irradiation (20 Gy); and group IV, venous microanastomosis with previous irradiation (20 Gy)...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27939908/sutureless-microvascular-anastomosis-with-the-aid-of-heparin-loaded-poloxamer-407
#8
Fırat Özer, Mustafa Nişancı, Çetin Taş, Jayakumar Rajadas, Doğan Alhan, Yalçın Bozkurt, Armağan Günal, Serdar Demirtaş, Selçuk Işık
BACKGROUND: Anastomosis with tissue adhesives is an alternative method for conventional anastomosis. However, this method has several technical challenges. It requires the use of suture to prevent leakage into lumen and precise application onto all surfaces of the anastomosis site. To solve these problems, poloxamer 407 (P 407) was previously used as a stent. In this study, we made heparinized P 407 (h-P 407) as a new formula. We aimed to successfully use h-P 407 as a stent in sutureless anastomosis in a rat abdominal aorta model...
November 12, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27930679/reconstruction-of-the-foot-and-ankle-using-pedicled-or-free-flaps-perioperative-flap-survival-analysis
#9
Xiucun Li, Jianli Cui, Suraj Maharjan, Laijin Lu, Xu Gong
OBJECTIVE: The purpose of this study is to determine the correlation between non-technical risk factors and the perioperative flap survival rate and to evaluate the choice of skin flap for the reconstruction of foot and ankle. METHODS: This was a clinical retrospective study. Nine variables were identified. The Kaplan-Meier method coupled with a log-rank test and a Cox regression model was used to predict the risk factors that influence the perioperative flap survival rate...
2016: PloS One
https://www.readbyqxmd.com/read/27929602/facial-reanimation-according-to-the-postresection-defect-during-lateral-skull-base-surgery
#10
John P Leonetti, Sahar Nadimi, Sam J Marzo, Douglas Anderson, Darl Vandevender
The vast majority of benign tumors of the cerebellopontine angle, temporal bone, and parotid gland can be successfully resected without permanent injury to the facial nerve. Malignant tumors or recurrent disease may require facial nerve sacrifice, especially if preoperative facial paresis is present. This article will present case examples of the various methods to reconstruct facial animation after lateral skull base resections that require sacrifice of cranial nerve VII, and the associated mimetic facial musculature...
December 2016: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/27919471/microvascular-coupling-devices-neglected-resource-with-a-short-learning-curve
#11
W R Thompson, A Burns, S Endersby, M Nugent
Microvascular couplers have a record of efficiency and efficacy. They have been used in anastomoses in the head and neck in Sunderland since November 2013, where we have investigated the time taken for anastomosis, patency, and cost. We also completed a national survey of the use of couplers in the United Kingdom, in which we recorded the time of anastomosis. The mean (range) time was 4minutes (2minutes 40seconds - 4minutes 10seconds). One flap partially failed. This shows that couplers can save time, they have successful outcomes, and the technique is quick and easy to learn...
December 2, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/27801401/-perfusion-criteria-of-the-eicma-efficacy-in-patients-with-symptomatic-occlusion-of-the-internal-carotid-artery
#12
V A Lukshin, D Yu Usachev, I N Pronin, A D Akhmedov, E I Shul'ts
AIM: To investigate changes in cerebral perfusion in patients with unilateral internal carotid artery occlusion before and after surgical revascularization of the brain, depending on the clinical efficacy of surgical treatment. MATERIAL AND METHODS: The study included 60 patients with unilateral ICA occlusions who underwent placement of an extra-intracranial microvascular anastomosis (EICMA). All patients underwent a CT perfusion study before and after cerebral revascularization...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27789210/a-pilot-study-demonstrating-the-feasibility-of-supermicrosurgical-end-to-side-anastomosis-onto-large-recipient-vessels-in-head-and-neck-reconstruction
#13
Takuya Iida, Hidehiko Yoshimatsu, Takumi Yamamoto, Isao Koshima
In head and neck reconstruction using free flaps, microvascular anastomosis is commonly performed in an end-to-end fashion to relatively sizable arteries including the superficial temporal, facial, and superior thyroid arteries. With the recent developments of less invasive perforator flaps such as the superficial circumflex iliac artery perforator flap, anastomosis of smaller vessels of less than 0.8 mm diameter has become necessary; however, appropriate recipient arteries for end-to-end anastomosis are often absent...
September 28, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27771041/one-versus-two-venous-anastomoses-in-microvascular-lower-extremity-reconstruction-using-gracilis-muscle-or-anterolateral-thigh-flaps
#14
Paul I Heidekrueger, Denis Ehrl, Albrecht Heine-Geldern, Milomir Ninkovic, P Niclas Broer
INTRODUCTION: Free tissue transfers are a highly reliable procedure routinely performed for reconstruction of a wide range of defects. Main complication in free flap surgery is usually venous thrombosis. Many technical controversies exist regarding the technical details of the microvascular anastomosis in order to prevent occurrence of thrombosis and optimize outcomes. We therefore evaluated our results regarding the execution of one versus two venous anastomoses in a variety of free flaps (fasciocutaneous- or muscle free flap) utilized for lower limb reconstruction...
December 2016: Injury
https://www.readbyqxmd.com/read/27769094/a-comparison-of-the-minimal-touch-technique-and-the-eversion-technique-for-microvascular-anastomosis-in-a-rat-model
#15
Collin W Blackburn, Sarah R Vossoughi, Bukola Ojo, Prakash Gorroochurn, Charles C Marboe, Yelena Akelina, Robert J Strauch
Background During microvascular anastomosis, needle placement is facilitated by inserting the tips of the forceps into the lumen of the vessel, rather than grasping and everting the luminal wall, to minimize trauma to the vessel. This study examines whether the vessel wall can be grasped and everted during microvascular anastomosis without compromising surgical outcomes. Methods A total of 20 Sprague-Dawley rats weighing between 252 and 483 g were used. Bilateral anastomoses of the animals' femoral arteries (mean size: 0...
October 21, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27765339/erratum-to-microvascular-stent-anastomosis-using-n-fibroin-stents-feasibility-ischemia-time-and-complications-oral-surg-oral-med-oral-pathol-oral-radiol-2016-121-e97-e103
#16
(no author information available yet)
No abstract text is available yet for this article.
November 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/27756552/free-flap-rescue-using-an-extracorporeal-perfusion-device
#17
Andreas M Fichter, Lucas M Ritschl, Andrea Rau, Claudia Schwarzer, Achim von Bomhard, Stefan Wagenpfeil, Klaus-Dietrich Wolff, Thomas Mücke
The warm ischaemia time of microvascular free flaps is limited. Incalculable events, such as lack of adequate recipient vessels or intraoperative medical emergencies, can lead to prolonged ischaemia and potentially to flap loss. In this study, critically perfused ischaemic or congested flaps were temporarily perfused with an extracorporeal perfusion system until anastomosis could be commenced. Temporary extracorporeal perfusion was performed in 8 radial forearm flaps for 147 ± 52 (range 77-237) minutes. Flap perfusion was assessed using Indocyanine Green fluorescence angiography and combined laser Doppler flowmetry and remission spectroscopy...
December 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27753100/salvage-arterial-anastomosis-using-a-microvascular-coupler-in-head-and-neck-free-flap-reconstruction
#18
Dane J Genther, Andrew T Day, Kanika Rana, Jeremy D Richmon
No abstract text is available yet for this article.
October 18, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27752208/a-comparative-study-on-microvascular-anastomosis-of-vascularised-free-fibular-flap-with-couplers-and-suturing-in-mandibular-reconstruction
#19
Senthil Murugan, Reena Rachel John, V B Krihnakumar Raja, Ajay Mohan, Lokesh Bhanumurthy
INTRODUCTION: Successful outcome of any vascularised free flap basically depends upon the successful restoration of circulation in the flap after anastomosis. As the flap ischemic time is the significant factor which determines the outcome of any free flaps, due consideration is given to reduce the time for anastomosis for reperfusion. The present study compares and evaluates whether the usage of microvascular couplers with the conventional suturing reduce the ischemic time of the free flaps...
September 2016: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/27704608/direct-thrombectomy-as-a-salvage-technique-in-free-flap-breast-reconstruction
#20
Ki Yong Hong, Lan Sook Chang, Hak Chang, Kyung Won Minn, Ung Sik Jin
BACKGROUND: Breast reconstruction with microvascular free tissue transfer has become a widely used method. Despite a high rate of success, a compromised flap necessitating re-exploration can occur. Here, we introduce direct thrombectomy as a flap salvage technique, and compared the results with conventional thrombectomy. METHODS: A total of 488 patients who underwent breast reconstruction using a free transverse rectus abdominis myocutaneous flap between March 2009 and February 2014 were retrospectively analyzed...
October 5, 2016: Microsurgery
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