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Flap necrosis

Alessandro Innocenti, Sara Tanini, F Mori, D Melita, M Innocenti
INTRODUCTION: Genitalia are linked to self-esteem and male sexual identity, especially among young men, who sometimes require a surgical procedure to acquire more confidence. Among the surgical procedures requested for aesthetical purposes, circumcision is one of the most popular. Although it can be considered to be a simple surgical practice, it may cause severe complications such as penile skin necrosis. PRESENTATION OF CASE: We report a case of a catastrophic situation after a circumcision performed on a 27-year-old HIV positive man resulted in a drastic reduction in the length of the penile shaft due to extensive skin loss; this was subsequently restored using dartos-fascio-myo-cutaneous flaps...
October 15, 2016: International Journal of Surgery Case Reports
Minyan Zhang, Xiaochen Tian, Jun Shi, Huxian Liu, Ning Liu, Zhengjun Cui
OBJECTIVE: This study aims to observe the efficacies of microsurgical technique combined with the Zhuang's skin soft tissue expander in treating Hunter type III congenital microtia. METHODS: Fifty-eight patients (61 ears) were enrolled from 2003 to 2012; the skin tissue expander was embedded subepidermally in the first stage via the intrahairline longitudinal incision in the postauricular mastoid area, the diseased-side rib cartilage was then taken for preparing the ear bracket in the second stage, and the tragus was surgically reconstructed in the third stage...
October 17, 2016: Annals of Plastic Surgery
Joseph Château, Aram Gazarian, Fabien Boucher, Lionel Badet, Fabienne Braye, Michel Saint-Cyr, Ali Mojallal
We report a case of a young double-hand allotransplant patient who presented with a full-thickness skin necrosis of the dorsum of the left hand after vascular compromise of the allotransplantation. Considering the lack of viable dorsal tissue overlying the extensor tendons and the need for early hand rehabilitation, an ultrathin pedicled groin flap was used for the coverage. This procedure resulted in salvaging the allotransplantation, and the patient was able to successfully return to work after his surgery...
September 2016: Plastic and Reconstructive Surgery. Global Open
Ross M Clark, Brittany Coffman, Paul G McGuire, Thomas R Howdieshell
BACKGROUND: Murine models of diabetes and obesity have provided insight into the pathogenesis of impaired epithelialization of excisional skin wounds. However, knowledge of postischemic myocutaneous revascularization in these models is limited. MATERIALS AND METHODS: A myocutaneous flap was created on the dorsum of wild type (C57BL/6), genetically obese and diabetic (ob/ob, db/db), complementary heterozygous (ob(+)/ob(-), db(+)/db(-)), and diet-induced obese (DIO) mice (n=48 total; five operative mice per strain and three unoperated mice per strain as controls)...
2016: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
JiHui Ju, JianLong Wu, RuiXing Hou
Ischemia-reperfusion (I/R) injury often occurs during skin flap transplantation and results in tissue damage. Although estrogen treatment significantly alleviates this I/R injury-induced damage, the detailed molecular mechanism is not clear. In this study, a superficial epigastric artery flap I/R injury model was created in adult Wistar rats. Severe necrosis was observed in skin tissue after I/R injury. Histological examination of skin tissue revealed that I/R injury damages skin structure and results in neutrophil infiltration...
October 2016: Cell Biochemistry and Function
Chul Hyun Park, Oog Jin Shon, Gi Beom Kim
BACKGROUND: Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged treatment using negative pressure wound therapy (NPWT) for Gustilo Anderson grade IIIb open tibial fractures. MATERIALS AND METHODS: 15 patients with Gustilo Anderson grade IIIb open tibial fractures, treated using staged protocol by a single surgeon between January 2007 and December 2011 were reviewed in this retrospective study...
September 2016: Indian Journal of Orthopaedics
Marine Hitier, Jean-Luc Cracowski, Cynthia Hamou, Christian Righini, Georges Bettega
OBJECTIVE: We evaluated the feasibility and the tolerance of repeated fluorescent indocyanine green angiography in free flap monitoring, and determined the intraoperative predictive values of flap vitality. BACKGROUND: The free flap failure rate has been significantly reduced, but free flap loss still occurs and remains a costly disaster. Repeated clinical examinations are commonly used for flap monitoring, but they can be unreliable because of their subjectivity...
September 10, 2016: Journal of Cranio-maxillo-facial Surgery
So-Eun Han, Eun-Ji Kim, Hyun Hwan Sung, Jai-Kyong Pyon
BACKGROUND: Reconstruction of extensive penoscrotal defects is a surgical challenge. Resurfacing defects in highly complex three-dimensional structures and restoring their function are an essential part of the reconstruction of penoscrotal regions. OBJECTIVE: We describe a technique using internal pudendal artery perforator (IPAP) pedicled propeller flaps created from the gluteal fold. This could be a reliable surgical option that maintains a natural looking scrotal pouch with minimal donor site morbidity and optimal sexual activity...
October 12, 2016: European Urology
Thomas Mücke, Christian R Krestan, David A Mitchell, Jan S Kirschke, Arno Wutzl
For patients with malignant disease taking bisphosphonates and denosumab, the incidence of medication-related osteonecrosis of the jaw (MRONJ) is up to 15% in contrast to 0.01% in patients with osteoporosis. Clinical presentation of MRONJ extends from asymptomatic exposure of bone in 94% of patients to severe cases of mandibular fractures in a minority of 4.5%. The strongest risk factors for MRONJ are invasive dental procedures and dental infections. Advances in imaging provide more preoperation information compared with panoramic radiograph...
July 2016: Seminars in Musculoskeletal Radiology
M T Letsch, M Kreulen, H A Rakhorst
Infections of the hand can result in significant limitation of the function of the hand, and may even require partial amputation of a digit. A felon is an abscess of the distal pulp of the fingertip, which can spread rapidly through the flexor tendon sheath when not treated appropriately. Knowledge of the anatomy and the correct method of physical examination are essential when assessing a patient suspected of having a felon or flexor tendon sheath infection. Here we present two patients with a complicated felon resulting in palmar necrosis of the distal phalanx of the thumb, in which a groin flap was used to reconstruct the thumb...
2016: Nederlands Tijdschrift Voor Geneeskunde
Erkan Orhan, Yağmur Reyyan Erol, Orgun Deren, Serdar Altun, Bülent Erdoğan
BACKGROUND: Flaps are often used in repairing tissue defects and partial or full flap loss is still an important morbidity cause. Several techniques have been tried to increase flap circulation but none of these could replace the delay technique. Our goal in this study is to show the efficacy of liposuction in delay of dorsal rat cutaneous flaps and improvement in flap survival. METHODS: Twenty-four Wistar rats were used. The rats in group 1 received 9 × 3-sized caudally-based random pattern skin flaps...
October 12, 2016: Aesthetic Plastic Surgery
François Simon, Charlotte Celerier, Erea-Noël Garabedian, Françoise Denoyelle
OBJECTIVE: Cryptotia is one of the most common malformations of the upper auricle with aesthetic and functional consequences, however there is no standard treatment. We present the surgical technique and results of a kite flap procedure which can be used in the different cryptotia subtypes. METHODS: We reviewed all patients treated in our department from 2010 to 2015, using a mastoid fascia kite flap technique. The incision of this local flap follows the retro-auricular sulcus along the rim of the helix superiorly and drawing a skin paddle inferiorly...
November 2016: International Journal of Pediatric Otorhinolaryngology
Ayfer Özdemir, Erkan Orhan, Serdar Altun, Emre İnözü
OBJECTIVE: Transverse Rectus Abdominis Myocutaneous (TRAM) flap is commonly used in breast reconstruction. The aim of this study is to demonstrate the effects of cilostazol on TRAM flap viability in a rat TRAM model. METHODS: Twenty-four Wistar rats were used. They were divided into four groups. Rats in Group 1 were applied TRAM flap. In Group 2, cilostazol 30 mg/kg was administered to rats via oral gavage 3 hours before the flap surgery. After the flap surgery, cilostazol 30 mg/kg was administered via oral gavage twice a day for 7 days...
October 6, 2016: Journal of Plastic Surgery and Hand Surgery
Zaher Jandali, Martin C Lam, Kiomars Aganloo, Benedikt Merwart, Jouke Buissink, Klaus Müller, Lucian P Jiga
BACKGROUND: The medial sural artery perforator (MSAP) flap shows advantages for reconstruction in the foot and ankle, where bulk is a liability. We evaluated the versatility of this flap and provide further evidence on its use for covering small-to-moderate size defects by comparing the outcome depending on the region of reconstruction. METHODS: Twenty-two patients with variable defects of 4 × 4 to 18 × 7 cm underwent MSAP flap reconstruction. Final outcomes of all patients were evaluated 12-months postoperatively using the AOFAS ankle-hindfoot, midfoot and hallux scale for clinical-functional evaluation, and the SF-36 health survey for quality-of-life measurement...
October 5, 2016: Microsurgery
Vinay V Kumar, Supriya Ebenezer, Peer W Kämmerer, P C Jacob, Moni A Kuriakose, Naveen Hedne, Wilfried Wagner, Bilal Al-Nawas
OBJECTIVES: The objective of this study was to assess the difference in success rates of implants when using two or four implant-supported-overdentures following segmental mandibular reconstruction with fibula free flap. METHODS AND DESIGNS: This prospective, parallel designed, randomized clinical study was conducted with 1:1 ratio. At baseline, all participants already had segmental reconstruction of mandible with free fibula flap. The participants were randomized into two groups: Group-I received implant-supported-overdentures on two tissue-level implants and Group-II received implant-supported-overdentures on four tissue-level implants...
September 9, 2016: Journal of Cranio-maxillo-facial Surgery
K J Lee, S H Lee, M B Kim, Y H Lee
PURPOSE: We report the clinical outcome after coverage for soft-tissue defect on the medial foot and ankle with an adipofascial fold-down flap based on the posterior tibial artery perforator branch proximal to the defect. MATERIALS: Nine patients (five males and four females) with soft-tissue defects on the medial foot and ankle area underwent the procedure from March 2009 to May 2014. The average age of the patients was 54 years (range, 8-82). The pivot point of transposition of this flap is the posterior tibial artery perforator proximal to the defect...
September 8, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ki Wook Sung, Won Jai Lee, In Sik Yun, Dong Won Lee
BACKGROUND: Perineal defects are commonly encountered during the treatment of conditions such as malignancy, infectious disease, and trauma. Covering large defects in the perineal area is challenging due to its complicated anatomy and the need for functional preservation. METHODS: Fourteen patients who underwent reconstructive surgery with multiple perforator flaps for defects >100 cm(2) in the perineal area were included in this retrospective cohort study. Characteristics of the perforator flap operation and postoperative outcomes were reviewed...
September 2016: Archives of Plastic Surgery
Gui-Yong Park, Eul-Sik Yoon, Hee-Eun Cho, Byung-Il Lee, Seung-Ha Park
BACKGROUND: The objective of this paper was to describe a novel technique for improving the maintenance of nipple projection in primary nipple reconstruction by using acellular dermal matrix as a strut in one of three different configurations, according to the method of prior breast reconstruction. The struts were designed to best fill the different types of dead spaces in nipple reconstruction depending on the breast reconstruction method. METHODS: A total of 50 primary nipple reconstructions were performed between May 2012 and May 2015...
September 2016: Archives of Plastic Surgery
Chandrashekhar Bande, Pawan Dawane, M K Gupta, Mayur Gawande, Vijay Rode
PURPOSE: Oral submucous fibrosis is a disease of an Indian subcontinent with obscure aetiology and poorly treated with varying signs and symptoms. OSMF occurs at any age but is most commonly seen in teenagers and adults in the age ranging between 16 and 35 years. A number of surgical treatments have been used for the treatment of oral submucous fibrosis with unpredictable results. PATIENTS AND METHOD: In this study, 220 patients were randomly divided into two groups with mouth opening less than 16 mm and evaluated with immediate and delayed aggressive physiotherapy with buccal fat pad interposition after fibrotomy...
September 28, 2016: Oral and Maxillofacial Surgery
José Francisco Sales Chagas, Maria Beatriz Nogueira Pascoal, José Luís Braga Aquino, Luís Antônio Brandi, Evandro Von Zuben Previtale, Ana Sofia Pontes Trillo, Otávio Alberto Curioni, Abrão Rapoport, Rogério Aparecido Dedivitis
OBJECTIVE: to assess the efficacy of the single transverse extended cervical incision in radical neck dissection. METHOD: we conducted a prospective study, from January 2008 to January 2009, with 18 patients undergoing surgical treatment of malignant tumors of the upper aero-digestive tract. The primary lesion was located in the oral cavity in eight cases, in the oropharynx in three, in the hypopharynx in three, in the larynx in two, in the maxillary sinus, and in one case, the primary injury was hidden...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
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