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https://www.readbyqxmd.com/read/28529663/the-modified-dunn-procedure-for-slipped-capital-femoral-epiphysis-the-bernese-experience
#1
M Tannast, L M Jost, T D Lerch, F Schmaranzer, K Ziebarth, K A Siebenrock
PURPOSE: Based on previous investigations on the vascular blood supply to the femoral head, a technique for anatomical reduction after slipped capital femoral epiphysis was developed. This technique is a modification of the original technique by Dunn using a retinacular soft-tissue flap. This allows the visual control of the epiphyseal vascular blood supply. We report the experience at the inventor's institution with a critical discussion of the available literature. METHODS: Using a trochanteric osteotomy for surgical dislocation of the hip, a retinacular soft tissue flap is created containing the deep branch of the medial femoral circumflex artery, the external rotators and the capsule...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529662/femoral-and-acetabular-re-alignment-in-slipped-capital-femoral-epiphysis
#2
M Leunig, H M Manner, L Turchetto, R Ganz
NEW PATHOPHYSIOLOGICAL INSIGHTS: Based on improved knowledge of the vascular supply of the proximal femur, a safe surgical dislocation of the hip joint was established allowing direct insights to the pathomorphological malfunctioning of the joint. One insight was that slipped capital femoral epiphysis (SCFE) impingement leads to substantial damage of the chondrolabral rim area, even in the presence of minor slips. A further surgical development was the extended retinacular flap allowing for correction of the deformity with calculable risk for iatrogenic necrosis...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28509698/a-meta-analysis-of-studies-comparing-outcomes-of-diverse-acellular-dermal-matrices-for-implant-based-breast-reconstruction
#3
Kyeong-Tae Lee, Goo-Hyun Mun
BACKGROUND: The current diversity of the available acellular dermal matrix (ADM) materials for implant-based breast reconstruction raises the issue of whether there are any differences in postoperative outcomes according to the kind of ADM used. The present meta-analysis aimed to investigate whether choice of ADM products can affect outcomes. METHODS: Studies that used multiple kinds of ADM products for implant-based breast reconstruction and compared outcomes between them were searched...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28508001/closing-a-tracheal-defect-with-an-omental-pedicled-gastric-flap-a-technical-note
#4
Holger Rupprecht, Marius Ghidau, Katharina Gaab
Due to an adenocarcinoma of the right upper lobe with infiltration of the main bronchus a 49-years-old female patient underwent an upper bilobectomy with sleeve resection. After two completed chemotherapy bouts and signs of sepsis another thoracotomy was inevitable.  As a complicating factor a supracarinal, necrotic and perforating lesion of the trachea appeared. The defect can be initially repaired with a suture and covered with azygos vein material. However surgical revision showed an enlargement of the tracheal necrosis...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28507876/prediction-of-skin-necrosis-after-mastectomy-for-breast-cancer-using-indocyanine-green-angiography-imaging
#5
Katsuya Gorai, Keita Inoue, Noriko Saegusa, Ryo Shimamoto, Meisei Takeishi, Mutsumi Okazaki, Masahiro Nakagawa
BACKGROUND: In immediate tissue expander reconstruction following total mastectomy for breast cancer, indocyanine green angiography (ICGA)-guided skin trimming is useful for the prevention of complications. However, instances of unclear ICGA contrast can occur with this method, which are difficult to judge as to whether preventive trimming is warranted. To further improve the mastectomy flap necrosis rate, more accurate objective parameters are necessary. METHODS: The degree of clinical improvement was compared between 81 patients trimmed according to the surgeon's judgment (non-ICGA group) and 100 patients with ICGA-guided trimming (ICGA group)...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507848/the-marriage-of-sartorius-and-tensor-fasciae-latae-in-treating-vascular-prosthetic-graft-infections
#6
Simone N Zoepke, Louis de Weerd
BACKGROUND: Vascular prosthetic graft infection in the groin is associated with high morbidity and mortality. This article presents a case series on the use of 2 flaps in the treatment of this condition. METHODS: Five patients, mean age 65 years (range, 49-74 years), with significant comorbidity were treated for an exposed and infected vascular prosthetic graft in the groin with a combination of sartorius muscle (SM) flap and tensor fascia lata (TFL) myocutaneous flap after debridement and start of microbiologic culture-guided antibiotic treatment...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507354/the-bilobed-flap-a-better-option-for-soft-tissue-release-in-the-management-of-radial-club-hand
#7
Uzair Ahmed Qazi, Ishtiaq Ur Rehman Orakzai, Mamoon Rashid
OBJECTIVE: To establish that the bilobed flap as soft tissue release component for the radial club hand is superior to the z-plasty technique in type III and IV radial club hands. METHODS: This study was conducted at the Shifa International Hospital, Islamabad, Pakistan, from 2009 to 2015, and comprised patients with radial club hands operated by a single consultant plastic surgeon. Soft tissue release was performed at 08 months. The extremity was then casted for 08 weeks and kept in a long-arm cast for 3 to 6 months...
May 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28506509/sub-fascial-flap-based-on-the-supraclavicular-artery-in-reconstruction-of-neck-burn-contractures
#8
Roberto Rudge Ramos, Lydia Masako Ferreira
This study presents 3 cases of women ages ranged from 25 to 52 years with anterior cervical contractures caused by burns that resulted in functional and aesthetic deficit. Contracture release in 3 patients and reconstruction was done using a sub-fascial flap whose main pedicle was the supraclavicular artery and the occipito-postero-cervical vessels that were preserved. The flap was designed differently from the classically described that uses the skin of the shoulder but which presents differences of color and texture with relation to the skin of the neck...
May 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28495572/a-tumor-ultrasound-guided-incision-tugi-approach-to-nipple-sparing-mastectomy-balancing-oncologic-safety-and-technical%C3%A2-outcomes
#9
Emil J Fernando, Benjamin R Eskenazi, Risal S Djohan, Stephen R Grobmyer
BACKGROUND: Nipple-sparing mastectomy (NSM) is a prevalent operation for patients with breast cancer. Indications have been limited to tumors accessible via radial, infra-mammary, or periareolar incisions out of concern for oncologic and technical safety. We study an alternative approach to NSM based on tumor ultrasound-guided incisions (TUGI) and report its oncologic and technical outcomes. MATERIALS AND METHODS: A retrospective chart review examined patients who underwent TUGI NSM between 2013 and 2016...
April 12, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28495027/medial-femoral-condyle-microvascular-bone-transfer-as-a-treatment-for-capitate-avascular-necrosis-surgical-technique-and-case-report
#10
Nikolas H Kazmers, Joshua C Rozell, Kevin M Rumball, Scott H Kozin, Dan A Zlotolow, L Scott Levin
Avascular necrosis (AVN) of the capitate is a rare clinical entity for which a variety of treatment options have been described, ranging from immobilization to microvascular bone transfer. Outcomes following medial femoral condyle corticocancellous free flap reconstruction have not been reported for this specific pathology. We present the case of a 16-year-old girl with posttraumatic capitate AVN who was treated with curettage and medial femoral condyle corticocancellous vascularized bone grafting. At 18 months after surgery, the patient remains pain-free and had resumed all activities including lifeguarding by 6 months after surgery...
May 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28489213/effects-of-heparin-and-hyperbaric-oxygenation-on-necrosis-reduction-in-an-animal-model-for-degloving-injuries
#11
Douglas Neumar Menon, Letícia Teixeira, Natalha Bristot Paurosi, Marcio Eduardo Barros
Objective: to evaluate the efficacy of the treatment with hyperbaric oxygen therapy or with topical and intralesional heparin in an animal model of degloving lesions. Methods: we conducted an experimental study with adult, male Wistar rats submitted to degloving of the left hind limb and divided into four groups according to the treatment: Group 1 (control) - without treatment; Group 2 (Heparin) - intralesional application at the time of surgery and topically, in the postoperative period, with heparin spray 10,000IU/mL; Group 3 (hyperbaric oxygenation) - daily sessions of 30 minutes in a hyperbaric chamber with 100% oxygen and 2 ATA pressure; Group 4 (positive control) - administration of a single dose of 45 mg/kg of intraperitoneal allopurinol...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28481465/risk-factors-for-pedicled-flap-necrosis-in-hand-soft-tissue-reconstruction-a-multivariate-logistic-regression-analysis
#12
Xu Gong, Jianli Cui, Ziping Jiang, Laijin Lu, Xiucun Li
BACKGROUND: Few clinical retrospective studies have reported the risk factors of pedicled flap necrosis in hand soft tissue reconstruction. The aim of this study was to identify non-technical risk factors associated with pedicled flap perioperative necrosis in hand soft tissue reconstruction via a multivariate logistic regression analysis. METHODS: For patients with hand soft tissue reconstruction, we carefully reviewed hospital records and identified 163 patients who met the inclusion criteria...
May 8, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28466362/treatment-of-implant-exposure-due-to-skin-necroses-after-skin-sparing-mastectomy-initial-experiences-using-a-not-selective-random-epigastric-flap
#13
Estíbaliz Echazarreta-Gallego, Guillermo Pola-Bandrés, María Dolores Arribas-Del Amo, Ismael Gil-Romea, Ramón Sousa-Domínguez, Antonio Güemes-Sánchez
Breast prostheses exposure is probably the most devastating complication after a skin sparing mastectomy (SSM) and implant-based, one-stage, breast reconstruction. This complication may occur in the immediate post-operative period or in the weeks and even months after the procedure. In most cases, the cause is poor skin coverage of the implant due to skin necrosis. PATIENTS AND METHODS: Eight consecutive cases of implant exposure (or risk of exposure) due to skin necrosis in SSM patients over a period of 5 years, all patients were treated using a random epigastric rotation flap, executed by the same medical team...
May 2, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28464581/-effects-of-vacuum-sealing-drainage-technique-in-acute-and-chronic-suppurative-tenosynovitis-of-hand
#14
H Wang, F Xia, D M Xing, D Ren, W Feng, Y Chen, Z H Xiao, Z M Zhao
Objective: To investigate the effects of vacuum sealing drainage technique in acute and chronic suppurative tenosynovitis of hand. Methods: A total of 9 cases acute and chronic suppurative tenosynovitis patients from January 2013 to April 2015 in Puai Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology were retrospectively reviewed. There were 6 males and 3 females, aging from 27 to 65 years, the average age was 55 years. There were 3 cases of index finger, 3 cases of middle finger, 2 cases of ring finger, 1 case include three fingers...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28458978/determining-the-trimming-layer-in-breast-reconstruction-with-a-free-tram-flap-using-intraoperative-video-angiography
#15
Sang Keon Lee, Dong Won Lee, Dae Hyun Lew, Seung Yong Song
In breast reconstruction using a free transverse rectus abdominis myocutaneous or deep inferior epigastric perforator flap, the trimming process for the flap area, which is usually the upper portion of the reconstructed breast, is critical to creating a natural-looking breast. In this study, we investigated which subcutaneous fat layer of the abdominal flap benefited most from a well-maintained blood supply during the trimming process using intraoperative fluorescent angiography system in a cross-sectional view of the elevated abdominal flap...
March 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28458967/improved-head-and-neck-free-flap-outcome-effects-of-a-treatment-protocol-adjustment-from-pre-to-postoperative-radiotherapy
#16
Martin Halle, Bjorn O Eriksson, Ann-Charlott Docherty Skogh, Pehr Sommar, Lalle Hammarstedt, Caroline Gahm
BACKGROUND: The impact of preoperative radiotherapy on microvascular reconstructive surgery outcome has been a subject of debate. However, data are conflicting and often dependent on local treatment protocols. We have studied the effects of radiotherapy in a unique, single-center setting where a treatment protocol change was undertaken from pre- to postoperative radiotherapy administration for microsurgical head and neck reconstructions. METHODS: A cohort study was conducted for 200 consecutive head and neck free flap cases, where 100 were operated on before and 100 after the treatment protocol adjustment in 2006...
March 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28454780/a-comparison-of-rat-degloving-injury-models
#17
Serdar Altun, Hakan Orbay, Mehmet Ekinci, Ahmet Cetinbas, Ali Bal, Enver Arpaci, Mehmet İhsan Okur
OBJECTIVE: Two different rat models for degloving injury were described in the literature. Our aim in this study is to compare these rat models to determine which one is more reliable and reproducible. METHODS: We surgically induced degloving injury on tails and left hindlimbs of Wistar albino rats (n = 8), and sutured the avulsed tissues back in their original positions after a waiting period. We observed the changes in the avulsed flaps every other day for 10 days...
April 25, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28452244/efficacy-of-double-mirrored-omega-pattern-for-skin-sparing-mastectomy-to-reduce-ischemic-complications
#18
Fabio Santanelli di Pompeo, Michail Sorotos, Rosaria Laporta, Marco Pagnoni, Benedetto Longo
BACKGROUND: Excellent cosmetic results from skin-sparing mastectomy (SSM) are often impaired by skin flaps' necrosis (SFN), from 8%-25% or worse in smokers. This study prospectively investigated the efficacy of Double-Mirrored Omega Pattern (DMOP-SSM) compared to Wise Pattern SSM (WP-SSM) for immediate reconstruction in moderate/large-breasted smokers. METHODS: From 2008-2010, DMOP-SSM was performed in 51 consecutive immediate breast reconstructions on 41 smokers (mean age = 49...
April 28, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28448311/surgical-techniques-for-closure-of-a-scalp-defect-after-resection-of-skin-malignancy
#19
Maciej Rysz, Dariusz Grzelecki, Maciej Mazurek, Stanisław Starościak, Romuald Krajewski
BACKGROUND: Surgery for scalp malignancies is aimed at the complete resection and a good aesthetic outcome. The goal was to develop an algorithm for scalp reconstruction based on the authors' surgical experience. METHODS: This is a retrospective analysis of 123 procedures of scalp malignancies in 105 patients. Twenty eight procedures were for resection of squamous cell carcinoma, 54 for basal cell carcinoma, and 41 for suspected melanomas. RESULTS: Primary closure (27 procedures), local flap (LF; 19), split-thickness skin graft (SG; 64), rotated LF and SG (9), and free vascularized flaps (4) were used...
April 12, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28445365/improvement-of-flap-necrosis-in-a-rat-random-skin-flap-model-by-in-vivo-electroporation-mediated-hgf-gene-transfer
#20
S Morteza Seyed Jafari, Maziar Shafighi, Helmut Beltraminelli, Thomas Geiser, Robert E Hunger, Amiq Gazdhar
BACKGROUND: Despite great understanding of underlying mechanisms for flap necrosis and advances in surgical techniques, flap necrosis remains a critical issue. In the present study, the authors investigated the efficacy of electroporation-mediated hepatocyte growth factor (HGF) gene delivery to random dorsal skin flaps (McFarlane) to accelerate wound healing and reduce flap necrosis. METHODS: Fifteen male Wistar rats (290 to 320 g) were divided randomly into three groups...
May 2017: Plastic and Reconstructive Surgery
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