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Flap necrosis

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https://www.readbyqxmd.com/read/28210555/breast-reconstruction-with-absorbable-mesh-sling-dynamic-infrared-thermography-of-skin-envelope
#1
Yoko Hashimoto, Naoki Watanabe, Takeshi Yuasa, Yoshinori Suzuki, Hiroshi Saisho
BACKGROUND: To immediate reconstruct ptosis breasts, we used polyglactin (Vicryl; Ethicon Inc., Somerville, NJ, USA) mesh as an inferolateral sling. However, Vicryl mesh is absorbable and losing function as a supporting structure. We doubt about the stability of the blood supply to the inferior part of the flap when it is in direct contact with inner implant. In this study, we examine the complications and the safety of the skin flap of this absorbable mesh sling (AMS) procedure. METHODS: The outcomes of 80 cases were examined, and the 1-year safety record of 40 cases was assessed...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28204937/a-new-approach-to-upper-eyelid-reconstruction
#2
A Bulla, C Vielà, L Fiorot, A Bolletta, E Pancrazi, G V Campus
BACKGROUND: Reconstruction of large defects of the upper eyelid is challenging because of its complex anatomy and specialized function. The aim of this work is to develop a single-stage reconstruction procedure based on a new approach. The technique consists of the advancement of an orbicularis oculi myocutaneous flap designed within the blepharoplasty skin excision pattern. METHODS: After the tumor's excision is completed with clear margins, the borders of the flap are incised down to the submuscular plane inside the classical pattern of upper eyelid blepharoplasty...
February 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28204936/impact-of-acellular-dermal-matrix-adm-use-under-mastectomy-flap-necrosis-on-perioperative-outcomes-of-prosthetic-breast-reconstruction
#3
So Young Kim, Sa Ik Bang
BACKGROUND: There is conflicting data on the potential necrotic complications of acellular dermal matrix (ADM) use in breast reconstruction, and most studies focus on mastectomy flap necrosis as an outcome measure associated with ADM use. The aim of this study was to examine cases with necrotic complications with and without the use of ADM and to investigate whether ADM affected perioperative outcomes in cases with necrotic complications. METHODS: Patients who experienced mastectomy flap necrosis following mastectomy with tissue expander placement between January 2009 and March 2015 were retrospectively reviewed...
February 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28203496/management-of-bronchopleural-fistula-complicated-by-skin-wound-necrosis-after-thoracomyoplasty
#4
Duilio Divisi, Mirko Barone, Gino Zaccagna, William Di Francescantonio, Roberto Crisci
Skin necrosis is a rare complication after thoracomyoplasty and usually needs conservative treatment. We described positive findings with surgical approach. A 54-year-old man showed bronchopleural fistula after undergoing right pneumonectomy for lung cancer, treated with thoracomyoplasty. On the 20th postoperative day, a skin wound lesion was noted, whose deterioration required a skin flap transposition. Patient was discharged from hospital on the 7th postoperative day and did not show relapse at the 7th year follow-up...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28196171/er-yag-laser-for-surgical-crown-lengthening-a-6-month-clinical-study
#5
Chang-Kai Chen, Yung-Tsan Wu, Nai-Jen Chang, Wan-Hong Lan, Jyuhn-Hurng Ke, Earl Fu, Da-Yo Yuh
This study evaluated use of a solid-state laser to avoid the flap technique and suturing. An Er:YAG laser was used in 26 consecutive patients referred for osseous crown lengthening in 32 posterior teeth. The distance from the planned restoration margin to the alveolar crest (B) satisfied a 3-mm dentogingival complex. No tissue necrosis and no significant change in the distance from the gingival margin to B or probing depth were detected at 3 and 6 months. Minimally invasive Er:YAG laser surgery decreases the time needed to establish the gingival margin necessary for definitive restoration...
March 2017: International Journal of Periodontics & Restorative Dentistry
https://www.readbyqxmd.com/read/28195893/functional-outcomes-and-complications-of-robot-assisted-free-flap-oropharyngeal-reconstruction
#6
Yueh-Chi Tsai, Shih-An Liu, Chih-Sheng Lai, Yen-Wei Chen, Chen-Te Lu, Jung-Hsing Yen, I-Chen Chen
BACKGROUND: Robotic surgical systems provide a clear, magnified 3-dimensional visualization as well as precise, stable instrumental movement, thereby minimizing technical difficulties that may be encountered in the surgical treatment of oropharyngeal tumors. This study assessed the outcomes of robotic-assisted free flap oropharyngeal reconstruction compared with those of conventional free flap reconstruction. MATERIALS AND METHODS: A retrospective review of 47 patients who underwent reconstructive operations using a free radial forearm fasciocutaneous flap for oropharyngeal defects was conducted over a 20-month period (May 2013-December 2014)...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28195891/simple-skin-stretching-device-in-assisted-tension-free-wound-closure
#7
Li-Fu Cheng, Jiunn-Tat Lee, Honda Hsu, Meng-Si Wu
BACKGROUND: Numerous conventional wound reconstruction methods, such as wound undermining with direct suture, skin graft, and flap surgery, can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28194796/the-utility-of-the-musculocutaneous-anterolateral-thigh-flap-in-pharyngolaryngeal-reconstruction-in-the-high-risk-patient
#8
Adrian S H Ooi, Chad M Teven, Amir Inbal, David W Chang
BACKGROUND AND OBJECTIVES: Prior radiotherapy leads to increased wound complication rates for microsurgical reconstruction of pharyngolaryngeal (PL) defects. Incorporating vastus lateralis muscle together with anterolateral thigh flap (ALT) skin in defect reconstruction is useful in protecting vital structures and reinforcing irradiated neck skin and suture lines. This study shows the utility of the musculocutaneous ALT (MC ALT) in PL reconstruction in previously irradiated patients. METHODS: A single-surgeon, retrospective chart review of all patients with defects of the PL region where an MC ALT was used for reconstruction from February 2014 to May 2016...
February 14, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28194347/is-rectosigmoid-vaginoplasty-still-useful
#9
Seok-Kwun Kim, Ji-Woen Park, Kwang-Ryeol Lim, Keun-Cheol Lee
BACKGROUND: The ideal vaginoplasty must be successful functionally as well as have a natural appearance, and also must retain its functionality and appearance over the long term. Conventional vaginoplasty techniques have functional limitations and are associated with recurrent complications, but rectosigmoid vaginoplasty is known to have a high satisfaction rate due to its functional similarity with the vagina. We conducted the present study to assess the usability of rectosigmoid vaginoplasty over the course of long-term follow-up...
January 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28194322/sural-artery-perforator-flap-with-posterior-tibial-neurovascular-decompression-for-recurrent-foot-ulcer-in-leprosy-patients
#10
Hossam El-Din Ali Ismail, Mohamed Hassan El Fahar
Introduction: The sensory loss and alteration of the shape of the foot make the foot liable to trauma and pressure, and subsequently cause more callus formation, blisters, and ulcers. Foot ulcers usually are liable to secondary infection as cellulitis or osteomyelitis, and may result in amputations. Foot ulcers are a major problem and a major cause of handicaps in leprosy patients. The current study is to present our clinical experience and evaluate the use of sural flap with posterior tibial neurovascular decompression (PTND) in recurrent foot ulcers in leprosy patients...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/28192378/analysis-and-management-of-complications-in-a-cohort-of-1-065-minimally-invasive-cochlear-implantations
#11
Yi Jiang, Ping Gu, Beicheng Li, Xue Gao, Baochun Sun, Yueshuai Song, Guojian Wang, Yongyi Yuan, Cuicui Wang, Miao Liu, Dongyi Han, Pu Dai
OBJECTIVES: To analyze complications associated with minimally invasive cochlear implantation by comparing data from different centers, to discuss major reasons for complications, and to refine implantation techniques to decrease them. PATIENTS: Patients who underwent cochlear implantation at our center by the same surgeon (the corresponding author of this article) from March 2006 to March 2015 were enrolled. INTERVENTION: First, a retrospective analysis of the complications associated with minimally invasive cochlear implantation at our center was performed...
March 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28188996/dual-delivery-of-growth-factors-with-coacervate-coated-poly-lactic-co-glycolic-acid-nanofiber-improves-neovascularization-in%C3%A2-a-mouse-skin-flap-model
#12
Min Suk Lee, Taufiq Ahmad, Jinkyu Lee, Hassan K Awada, Yadong Wang, Kyobum Kim, Heungsoo Shin, Hee Seok Yang
Random skin flaps are commonly used in plastic and reconstructive surgery for patients suffering from severe or large scale wounds or in facial reconstruction. However, skin flaps are sometimes susceptible to partial or complete necrosis at the distal parts of the flaps due to insufficient blood perfusion in the defected area. In order to improve neovascularization in skin flaps, we developed an exogenous growth factor (GF) delivery platform comprised of coacervate-coated poly(lactic-co-glycolic acid) (PLGA) nanofibers...
January 30, 2017: Biomaterials
https://www.readbyqxmd.com/read/28187214/what-s-the-remedy-for-the-distal-necrosis-of-diep-flap-better-venous-drain-or-more-arterial-supply
#13
Yi Zhang, Tingliang Wang, Jiao Wei, Jinguang He, Tao Wang, Ying Liu, Hua Xu, Jiasheng Dong
BACKGROUND: We developed a novel pedicled DIEP flap model in rat to explore the possible remedy for the distal necrosis of the flap. METHODS: A deep inferior epigastric perforator (DIEP) flap, based on the second right cranial perforator (P2) as the main pedicle, was elevated in 48 Sprague-Dawley rats. The rats were randomized into 4 groups: group I, the left P2 remaining intact as supercharging; group II, the left P2 artery alone kept as supercharging; group III, the left P2 vein alone kept as supercharging; group IV, no supercharging...
2017: PloS One
https://www.readbyqxmd.com/read/28187027/investigating-the-effect-of-korean-red-ginseng-on-the-viability-of-random-pattern-skin-flaps-in-rats
#14
Hakan Tekin, Gönül Tekin, Gülay Bulut, Mustafa Fevzi Sargon, Dağhan Işik
OBJECTIVE: This experimental study investigated the efficacy of Korean Red Ginseng (KRG) extract in reducing the partial losses of random flaps. METHOD: Forty Wistar Albino rats were randomly distributed into 4 groups as (A) control group, (B) stress group, (C) oral KRG group, and (D) intraperitoneal KRG group. The modified McFarlane flap of 9 × 3 cm with a caudal pedicle was harvested from the back of the rats in all the groups. Korean Red Ginseng was administered to groups C and D at standard doses for 10 days...
February 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28182595/treatment-of-advanced-kienb%C3%A3-ck-disease-with-a-vascularized-radial-bone-flap-wrapped-in-the-pronator-quadratus
#15
Sang Ki Lee, Kap Jung Kim, Hyuck Soo Shin, Won Sik Choy
PURPOSE: In the present study, we aimed to assess the radiologic and clinical outcomes after excision of the lunate, insertion of a vascularized radial bone flap wrapped in the pronator quadratus, and distraction with an external fixator of the joint, for the treatment of avascular necrosis of the lunate with carpal height collapse, fragmentation, and perilunar osteoarthritic changes. MATERIALS AND METHODS: From May 2006 to July 2014, a total of 25 patients (13 men and 12 women; mean age, 38...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28177337/free-flap-loss-caused-by-heparin-induced-thrombocytopenia-and-thrombosis-hitt-a-case-report-and-literature-review
#16
E Segna, A R Bolzoni, C Baserga, A Baj
Heparin-induced thrombocytopenia and thrombosis (HITT) represents a dramatic condition that is difficult to diagnose because of nuanced clinical presentation. Therefore, in every case of microvascular thrombosis during heparin-therapy prompt suspicion about HITT is necessary to avoid flap necrosis. We present a case of HITT which, as the 8 other articles reviewed, clearly shows that HITT is difficult to diagnose and complex to manage. Microvascular reconstruction is the first choice in head and neck reconstruction; unfortunately, dramatic outcomes in free flap surgery due to unpredictable thrombotic events are still reported in the English literature...
December 2016: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28177328/head-and-neck-reconstruction-with-pedicled-flaps-in-the-free-flap-era
#17
R Mahieu, G Colletti, P Bonomo, G Parrinello, A Iavarone, G Dolivet, L Livi, A Deganello
Nowadays, the transposition of microvascular free flaps is the most popular method for management of head and neck defects. However, not all patients are suitable candidates for free flap reconstruction. In addition, not every defect requires a free flap transfer to achieve good functional results. The aim of this study was to assess whether pedicled flap reconstruction of head and neck defects is inferior to microvascular free flap reconstruction in terms of complications, functionality and prognosis. The records of consecutive patients who underwent free flap or pedicled flap reconstruction after head and neck cancer ablation from 2006 to 2015, from a single surgeon, in the AOUC Hospital, Florence Italy were analysed...
December 2016: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28177171/increased-survivability-of-ischemic-skin-flap-tissue-in-flk-1-mice-by-pellino-1-intervention
#18
Chandra K Rednam, Rickesha L Wilson, Vaithinathan Selvaraju, Muhammad T Rishi, Mahesh Thirunavukkarasu, Vladimir Coca-Soliz, Rajesh Lakshmanan, J Alexander Palesty, David W McFadden, Nilanjana Maulik
OBJECTIVE: Reduced skin flap survival due to ischemia is a serious concern during reconstructive cosmetic surgery. The absence of vascular endothelial growth factor (VEGF) and its receptors during ischemia may lead to flap failure. We identified Pellino-1 (Peli1), a 46-kDa protein, as a proangiogenic molecule and is directly regulated by VEGF. Therefore, we hypothesized that Peli1 acts downstream of Flk-1/VEGFR2 and aids in skin flap survival during ischemia. METHODS: Scratch and matrigel assays were performed to observe cell proliferation, migration and tube formation in vitro...
February 8, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/28168747/double-paddle-peroneal-flap-for-extensive-lip-defect-reconstruction
#19
Ying-Sheng Lin, Wen-Chung Liu, Yaoh-Shiang Lin, Lee-Wei Chen, Jung-Hua Hsueh, Kuo-Chung Yang
INTRODUCTION: Today, reconstructive surgeons offer an array of options to reconstruct the lip defects. Herein we present our experience of using free double-paddle peroneal flaps for extensive lip defect reconstruction. PATIENTS AND METHODS: From 1996 to 2014, 16 patients with extensive lip defects after tumor ablation were included. Free double-paddle peroneal flaps were used for reconstructions. In terms of flap design, one skin paddle superiorly placed on the lateral lower leg was used to reconstruct intraoral defects, whereas the other was inferiorly located and was used to reconstruct extraoral defects...
February 7, 2017: Microsurgery
https://www.readbyqxmd.com/read/28165571/negative-pressure-wound-therapy-and-early-pedicle-flap-reconstruction-of-the-chest-wall-after-epirubicin-extravasation
#20
Marios Papadakis, Afshin Rahmanian-Schwarz, Marzena Bednarek, Mohamed Arafkas, Philipp Holschneider, Gunnar Hübner
PURPOSE: Accidental extravasation is a serious iatrogenic injury among patients receiving anthracycline-containing chemotherapy. The aim of this work is to present a combination therapy for chest wall reconstruction following epirubicin extravasation. METHODS: Herein, we report a 68-year-old woman with massive soft tissue necrosis of the anterolateral chest wall after epirubicin extravasation from a port implanted in the subclavicular area. RESULTS: The necrotic tissue was resected, the port was removed, and negative-pressure wound therapy was applied...
January 31, 2017: Journal of Vascular Access
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