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Flap necrosis

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https://www.readbyqxmd.com/read/28346687/itade-flap-after-mastectomy-for-locally-advanced-breast-cancer-a-good-choice-for-mid-sized-defects-of-the-chest-wall-based-on-a-systematic-review-of-thoracoabdominal-flaps
#1
René Aloisio da Costa Vieira, Katia Mathias Teixeira da Silva, Idam de Oliveira-Junior, Marcos Alves de Lima
BACKGROUND: Locally advanced breast cancer (LABC) is still a common problem in developing countries. Extensive resections are aimed at local control and improving quality of life. Dermofat flaps are an option for medium-sized defects. OBJECTIVES: Evaluate the results of a new thoracoabdominal flap (TAF). METHODS: We describe and evaluate an ipsilateral, thoracoabdominal horizontal, dermofat (ITADE) flap performed in patients submitted to mastectomy and immediate reconstruction...
March 27, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28340662/vascularized-small-bone-transfers-for-fracture-nonunion-and-bony-defects
#2
REVIEW
Ai Dong Deng, Marco Innocenti, Rohit Arora, Markus Gabl, Jin Bo Tang
Vascularized small-bone grafting is an efficient and often necessary surgical approach for nonunion or necrosis of several bones in particular sites of the body, including scaphoid, lunate, distal ulna, and clavicle. The medial femoral condyle is an excellent graft source that can be used in treating scaphoid, ulna, clavicle, or lower-extremity bone defects, including nonunion. Vascularized bone grafting to the small bones, particularly involving reconstruction of damaged cartilage surfaces, should enhance subchondral vascular supply and help prevent cartilage regeneration...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340661/medial-femoral-trochlea-osteochondral-flap-applications-for-scaphoid-and-lunate-reconstruction
#3
REVIEW
James P Higgins, Heinz K Bürger
Vascularized osteochondral flaps are a new technique described for the reconstruction of challenging articular defects of the carpus. The medial femoral trochlea osteochondral flap is supplied by the descending geniculate artery. This osteochondral flap has shown promise in the treatment of recalcitrant scaphoid proximal pole nonunions and advanced avascular necrosis of the lunate. The anatomy, surgical technique, and results are discussed, with clinical cases provided.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28338587/medial-row-perforators-are-associated-with-higher-rates-of-fat-necrosis-in-bilateral-diep-flap-breast-reconstruction
#4
Parisa Kamali, Michelle Lee, Babette E Becherer, Winona Wu, Daniel Curiel, Bao Ngoc N Tran, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: The purpose of this study is to evaluate perfusion related complications in bilateral deep inferior epigastric perforator (DIEP) flap breast reconstruction based on perforator selection. METHODS: A retrospective review of a prospectively maintained database was performed on all patients undergoing bilateral DIEP flap reconstruction at a single institution between 2004-2014. The hemiflaps were separated into three cohorts based on perforator location: lateral row only, medial row only, and medial plus lateral row...
March 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28338372/the-modified-temporalis-muscle-flap-in-reconstruction-of-palate-and-temporal-deformity
#5
Wei Liu, Xiaohong Chen, Xin Ni
PURPOSE: The purpose of this article was to introduce a modified temporalis muscle flap (TMF) which was used to reconstruct palate and temporal deformity. PATIENT AND METHODS: This was a retrospective review of the use of the modified TMF in reconstruction of palate and temporal deformity. We evaluated the result which included operative time, bleeding, necrosis, infection, facial nerve deficit, and cosmetic deformity. RESULTS: All the 16 patients accepted the modified TMF surgery successfully...
March 24, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28333309/positive-margin-re-excision-following-immediate-autologous-breast-reconstruction-morbidity-cosmetic-outcome-and-oncologic-significance
#6
Oscar Ochoa, Constantine Theoharis, Steven Pisano, Minas Chrysopoulo, Peter Ledoux, Gary Arishita, Chet Nastala
Background: Acquisition of negative resection margins is paramount in the surgical management of operable breast cancer. Management of positive margins following mastectomy and immediate breast reconstruction is presently poorly defined. Objectives: The present study aims at defining morbidity and cosmetic sequela of re-excision procedures aimed at clearing involved mastectomy margins in the setting of immediate autologous breast reconstruction. Oncologic outcomes are recorded...
March 17, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28331365/mastectomy-skin-flap-necrosis-challenges-and-solutions
#7
REVIEW
Stuart A Robertson, Johann A Jeevaratnam, Avi Agrawal, Ramsey I Cutress
INTRODUCTION: Mastectomy skin flap necrosis (MSFN) has a reported incidence of 5%-30% in the literature. It is often a significant and underappreciated problem. The aim of this article was to review the associated challenges and possible solutions. METHODS: A MEDLINE search was performed using the search term "mastectomy skin flap necrosis". Titles and abstracts from peer-reviewed publications were screened for relevance. RESULTS: MSFN is a common complication and may present as partial- or full-thickness necrosis...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28329664/prospective-evaluation-of-complications-in-dermatologic-surgery-associated-with-hypertension-conroy
#8
Conroy Chow, Matthew J Simpson, Niko Pascua, Harjot Maan, Jacqueline G Berlier, Siegrid Yu, Isaac Neuhaus, Roy Grekin, Sarah T Arron
BackgroundPoorly controlled hypertension is a known risk factor for surgical complications. OBJECTIVE: This study examines the incidence of complications in participants undergoing Mohsmicrographic surgery (MMS) based on preoperative blood pressure (BP) measurement and investigates the role of potential confounders in the relationship between preoperative BP and postoperative complications.MethodsThis 10-month prospective cohort study at the University of California, San Francisco (UCSF) Dermatologic Surgery Center approached all patients undergoing MMS for participation and assessed for the diagnosis of hypertension, anti-hypertensive medication use, use of tobacco or blood thinners, immunosuppression, concomitant diabetes, or previous treatment with radiation therapy at the surgical site...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28319433/breast-reconstruction-following-nipple-sparing-mastectomy-clinical-outcomes-and-risk-factors-related-complications
#9
Rosaria Laporta, Benedetto Longo, Michail Sorotos, Alessio Farcomeni, Caterina Patti, Maria Rosaria Mastrangeli, Corrado Rubino, Fabio Santanelli di Pompeo
BACKGROUND: The aim of this study was to investigate clinical outcomes and risk factors related complications in patients who had undergone nipple-sparing mastectomy (NSM) followed by implant-based or autologous reconstruction. METHODS: Between 2004-2014 a single-institution retrospective review was collected on NSMs reconstruction. Patient demographics, comorbidities, breast morphological factors, type and timing of radiotherapy, type of incision, reconstruction type and timing, implant volume and complications were collected...
March 20, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28314066/comparison-of-propeller-perforator-flap-and-venous-supercharged-propeller-perforator-flap-in-reconstruction-of-lower-limb-soft-tissue-defect-a-prospective-study
#10
Benoit Chaput, Nicolas Bertheuil, Jean-Louis Grolleau, Farid Bekara, Raphael Carloni, Jerome Laloze, Christian Herlin
INTRODUCTION: In lower limbs, reliability of propeller perforator flaps (PPF) remains uncertain. The main complication is venous congestion, which can lead to distal necrosis. We aim to highlight if venous supercharging of PPF could substantially limit complications in lower limb coverage. METHODS: Between 2011 and 2016, we developed a standardized procedure of venous supercharging in the lower limb reconstruction with PPF using saphenous veins anastomosis. Then, we prospectively compared a consecutive series of 30 PPF to cover lower limbs defect, with a consecutive series of 30 venous-supercharged PPF (vsPPF)...
March 17, 2017: Microsurgery
https://www.readbyqxmd.com/read/28306199/surgical-management-of-extensive-osteoradionecrosis-in-nasopharyngeal-carcinoma-patients-with-the-maxillary-swing-approach-and-free-muscular-flaps
#11
N Y Choi, H J Kim, Chung-Hwan Baek
Radiation therapy has been a standard treatment for nasopharyngeal carcinoma. However, it can cause extensive osteoradionecrosis which is associated with catastrophic complications including carotid artery rupture, cerebral infection, brain necrosis and cachexia.(1,2,3,4) Most of the cases of limited osteoradionecrosis of the nasopharynx have been treated by endoscopic debridement with a favorable success rate.(3.) This article is protected by copyright. All rights reserved.
March 17, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28296984/implant-stability-and-bone-characteristics-in-free-fibula-flaps-used-for-jaw-reconstruction-a-prospective-cohort-study
#12
Vinay V Kumar, Ullash Kumar, Vijay Pillai, Vinotha Ponnusamy, Bilal Al-Nawas, Moni A Kuriakose
PURPOSE: The primary objective of this prospective cohort study was to evaluate primary and secondary implant stability values of implants placed into healed free fibula-reconstructed mandibles. The secondary objective was to investigate whether a correlation existed between primary implant stability and the quantity of cortical bone-implant contact and of cortical fibular bone in contact with the implants. MATERIALS AND METHODS: The study participants are patients enrolled in a registered trial (No...
March 17, 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/28295126/gluteus-maximus-advancement-flap-procedure-for-reconstruction-of-posterior-soft-tissue-deficiency-in-revision-total-hip-arthroplasty
#13
Benjamin F Ricciardi, Peter W Henderson, Alexander S McLawhorn, Geoffrey H Westrich, Mathias P Bostrom, Lloyd B Gayle
The current study describes the surgical technique and early outcomes of a gluteus maximus advancement flap procedure for the treatment of posterior soft tissue insufficiency among patients with complex revision total hip arthroplasty. This retrospective case series was conducted with a prospective, single-institution arthroplasty registry. Patients who underwent a gluteus maximus advancement flap procedure in the setting of revision total hip arthroplasty between January 2012 and January 2016 were eligible for inclusion (N=7)...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28293746/long-standing-crohn-s-disease-and-its-implication-on-anal-squamous-cell-cancer-management
#14
Amy L Lightner, Sara B Moncrief, Thomas C Smyrk, John H Pemberton, Michael G Haddock, David W Larson, Eric J Dozois, Kellie L Mathis
BACKGROUND: Anal squamous cell carcinoma (ASCC) is rare, accounting for only 1% of gastrointestinal malignancies. We sought to better understand management strategies for ASCC in the setting of Crohn's disease (CD). METHODS: A retrospective chart review from 2001 to 2016 was conducted using ICD-9/10 codes for CD (555.9/K50) and ASCC (154.3/C44.520). Adult patients with a diagnosis of CD at the time of ASCC diagnosis were included. RESULTS: Seven patients (five female) were included with a median age of 50 years...
March 14, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28293502/microvascular-fragment-transplantation-improves-rat-dorsal-skin-flap-survival
#15
Randolph Stone, Christopher R Rathbone
BACKGROUND: The development of flap necrosis distally remains a concern during microsurgical flap transfers because, at least in part, of decreased perfusion. Microvascular fragments (MVFs) are microvessels isolated from adipose tissue that are capable of improving tissue perfusion in a variety of tissue defects. The aim of this study was to determine whether the transplantation of MVFs in a dorsal rat skin flap model can improve flap survival. METHODS: A 10 × 3 cm flap was raised in a cranial to caudal fashion on the dorsal side of 16 Lewis rats, with the caudal side remaining intact...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293496/closure-of-a-large-thoracolumbar-myelomeningocele-using-a-modified-bilateral-keystone-flap
#16
Hytham Jamjoom, Hatem Alnoman, Yasser Almadani
The keystone flap, an emerging reconstructive option that can be used in many parts of the body, is gaining popularity among reconstructive surgeons. These reliable and versatile flaps can be used for large myelomeningocele closure. A modified bilateral keystone flap was used to achieve tension-free closure of a large thoracolumbar myelomeningocele associated with severe kyphosis in a newborn girl. The flap was modified by undermining in the subfascial plane in the medial aspect of the middle third. This undermining was performed to facilitate flap movement while preserving random musculocutaneous perforators captured within the island of tissues...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28289617/perforator-flaps-for-reconstruction-of-lower-limb-defects
#17
Mir Yasir, Adil Hafeez Wani, Haroon Rashid Zargar
BACKGROUND: Reconstruction of soft tissue defects in the lower third of the leg remains challenging. Anatomical constraints limit the local options available for complex defects especially lower third of leg. Local flaps based on perforator vessels are raising interest in reconstructive surgery of the limbs. We present our experience with perforator flaps for reconstruction of soft tissue defects in the lower limb. METHODS: The study was carried prospectively and 23 patients with lower limb defects treated with various perforator flaps (both elective as well as emergency) were included in the study...
January 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28286743/the-use-of-the-buccal-fat-pad-flap-for-oral-reconstruction
#18
REVIEW
Min-Keun Kim, Wonil Han, Seong-Gon Kim
Many congenital and acquired defects occur in the maxillofacial area. The buccal fat pad flap (BFP) is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various intraoral defects. In this article, we have reviewed BFP and the associated anatomical background, surgical techniques, and clinical applications. The surgical procedure is simple and has shown a high success rate in various clinical applications (approximately 90%), including the closure of oroantral fistula, correction of congenital defect, treatment of jaw bone necrosis, and reconstruction of tumor defects...
December 2017: Maxillofacial Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28285314/the-staged-urethroplasty-with-vascularised-scrotal-flap-and-buccal-mucosa-graft-after-failed-hypospadias-surgery-a-reliable-technique-with-a-novel-tool
#19
Abhishek Pandey, Anna-Maria Barta-Kelemen, Michael Borisenkov, Hansjörg Keller
Background/Aims/Objectives: To report the outcome of staged urethroplasty with buccal mucosa and vascularised scrotal flap after failed hypospadias surgery. METHODS: n = 35. INCLUSION CRITERIA: destroyed urethral plate, deficient local skin, fistula and penile deviation. Five out of 35 patients also had a secondary proximal stricture. Stage 1: excision of scarred tissue and fistulae, correction of the penile deviation through dorsal plication and the ventral placement and quilting of buccal graft...
March 11, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28282676/peroneal-flap-for-tongue-reconstruction
#20
Ying-Sheng Lin, Wen-Chung Liu, Yaoh-Shiang Lin, Lee-Wei Chen, Kuo-Chung Yang
Background For large tongue defects, reconstructive surgeons have devised a variety of feasible options, such as radial forearm free flap and anterolateral thigh (ALT) flap. In our institution, peroneal flap has been the workhorse flap for the soft tissue defect in head and neck reconstruction. We present our experience using peroneal flap in tongue reconstruction. Patients and Methods The study included 47 patients who had undergone tongue reconstructions with peroneal flaps after tumor resection. The size and location of the defect after tumor resection determined whether the peroneal flaps could be harvested as pure septocutaneous flaps to solely reconstruct the neotongue or to carry an additional muscle bulk to fill the adjacent defect...
March 10, 2017: Journal of Reconstructive Microsurgery
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