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Flap necrosis

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https://www.readbyqxmd.com/read/29026816/aesthetic-refinements-in-forehead-flap-reconstruction-of-the-asian-nose
#1
Yen-Chang Hsiao, Chun-Shin Chang, Jonathan Zelken
BACKGROUND: Traditional paramedian forehead flap reconstruction exploits the aesthetic subunit principle. Refinements and outcomes of forehead flap nasal reconstruction largely reflect Western experience. Differences in ethnic Asian anatomy and wound healing may foster suboptimal outcomes. We modified methods to address Asian features by extending subunit and flap boundaries, minimizing flap thinning, and overbuilding the nasal framework to combat contraction and suboptimal scarring. METHODS: Between November 2010 and September 2015, 40 Asians were treated for nasal reconstruction with a modified forehead flap technique...
May 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29026671/bilateral-caudate-nucleus-infarcts-a-case-report-of-a-rare-complication-following-endoscopic-resection-of-a-tuberculum-sellae-meningioma
#2
Joel Bierer, Amparo Wolf, Donald H Lee, Brian W Rotenberg, Neil Duggal
BACKGROUND: We present a rare complication of bilateral caudate infarcts and necrosed nasoseptal flaps after endoscopic transsphenoidal resection of tuberculum sellae meningioma. This case highlights the importance of early and accurate diagnosis and treatment of a postoperative cerebrospinal fluid (CSF) leak and associated bacterial meningitis, and reviews any existing guidelines regarding its management. CASE DESCRIPTION: A 54-year-old otherwise healthy man presented with progressive bitemporal hemianopsia...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29025616/the-peroneus-brevis-flap-in-the-treatment-of-bone-infections-of-the-lower-limb
#3
Andrea Antonini, Carlo Rossello, Carlo Salomone, Giovanni Riccio, Lamberto Felli, Giorgio Burastero
The Peroneus Brevis Flap is a described option for the soft tissue coverage and for small bone gap reconstruction in the lower third of the lower leg, where few other local flaps are available and reliable. We analysed retrospectively a case series of 11 consecutive patients whose age ranged from 31 to 87 years (mean 56), who underwent a reconstruction with a PB flap in the treatment of post-traumatic bone infections from October 2010 to February 2012. In our series, only one patient at a 3 year minimum follow-up showed recurrence of the bone infection and required further surgical treatment...
October 2017: Injury
https://www.readbyqxmd.com/read/29025216/assisted-salvage-of-ischemic-fasciocutaneous-flap-using-adipose-derived-mesenchymal-stem-cells-in-situ-revascularization
#4
Michael H Carstens, Mauricio Mendieta, Cecilia Pérez, Esperanza Villareal, Rodolfo Garcia
Adipose-derived mesenchymal stem cells (ASCs) have been shown to produce vascular endothelial growth factor (VEGF) and can increase perfusion in patients with critical limb ischemia. We will show that this concept can be applied to augment blood flow in zones of flap ischemia. We presented a case study of a 26-year-old man with a complex hand injury covered by a reverse radial perforator fasciocutaneous flap, which developed ischemic necrosis and was treated by debridement, transplantation of ASCs to enhance vascular support, and saline dressings...
July 1, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29019574/effects-of-dimethylsulfoxide-and-pentoxifylline-in-the-vitality-of-cutaneous-flaps-in-rats
#5
Stephanie Luzia da Costa Pedretti, Cícero de Lima Rena, Maria Christina Marques Nogueira Castãnon, Ana Paula do Nascimento Duque, Fernando Henrique Pereira, Tarcizo Afonso Nunes
OBJECTIVES: to verify the influence of dimethylsulfoxide and pentoxifylline on the vitality of cutaneous flaps in rats and the tissue repair process. METHODS: were studied 30 Wistar rats, submitting them to a 2cm wide by 8cm long dorsal cutaneous flap, of caudal base. We distributed the animals in three groups: Control Group (n=10) with application gauze moistened with 0.9% Saline in the flap bed for 30 seconds; Dimethylsulfoxide group (n=10), with administration of 1ml of 5% dimethylsulfoxide divided into five injections of 0...
September 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29017862/emergency-repair-of-upper-extremity-large-soft-tissue-and-vascular-injuries-with-flow-through-anterolateral-thigh-free-flaps
#6
Yi Zhan, Guo Fu, Xiang Zhou, Bo He, Li-Wei Yan, Qing-Tang Zhu, Li-Qiang Gu, Xiao-Lin Liu, Jian Qi
BACKGROUND: /Objectives: Complex extremity trauma commonly involves both soft tissue and vascular injuries. Traditional two-stage surgical repair may delay rehabilitation and functional recovery, as well as increase the risk of infections. We report a single-stage reconstructive surgical method that repairs soft tissue defects and vascular injuries with flow-through free flaps to improve functional outcomes. METHODS: Between March 2010 and December 2016 in our hospital, 5 patients with severe upper extremity trauma received single-stage reconstructive surgery, in which a flow-through anterolateral thigh free flap was applied to repair soft tissue defects and vascular injuries simultaneously...
October 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28990255/role-of-surgery-in-the-treatment-of-osteoradionecrosis-and-its-complications-after-radiotherapy-for-nasopharyngeal-carcinoma
#7
Wen Bo Huang, Stanley Thian Sze Wong, Jimmy Yu Wai Chan
BACKGROUND: The purpose of this study was to review the efficacy of surgery for patients with osteoradionecrosis (ORN) after radiotherapy for nasopharyngeal carcinoma (NPC). METHODS: Between 2000 and 2016, we identified 162 patients with skull base ORN, among which 58 patients required surgery. A retrospective medical chart review was performed and the indications and results of surgical interventions were recorded. RESULTS: All surgeries were performed for the treatment of secondary complications of ORN, including central nervous system (CNS) infection (48...
October 9, 2017: Head & Neck
https://www.readbyqxmd.com/read/28985927/association-between-targeted-her-2-therapy-and-breast-reconstruction-outcomes-a%C3%A2-propensity-score-matched-analysis
#8
Ronnie L Shammas, Eugenia H Cho, Adam D Glener, Luke P Poveromo, Lily R Mundy, Rachel A Greenup, Kimberly L Blackwell, Scott T Hollenbeck
BACKGROUND: Current treatment for HER-2+ breast cancer includes chemotherapy and targeted HER-2 therapy with trastuzumab and/or pertuzumab. Evidence is lacking on the safety of breast reconstructive operations in these patients. We hypothesized that targeted HER-2 therapy was not associated with post-mastectomy reconstructive outcomes. STUDY DESIGN: Women receiving chemotherapy and post-mastectomy reconstruction at Duke University Medical Center from 2006 to 2016 were retrospectively identified...
September 26, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28984661/surgeon-controlled-comparison-of-direct-to-implant-and-2-stage-tissue-expander-implant-immediate-breast-reconstruction-outcomes
#9
Vitali Azouz, Stephen Lopez, Douglas S Wagner
BACKGROUND: Current literature comparing outcomes of immediate breast reconstruction using direct-to-implant (DTI) single-stage and 2-stage tissue expanders (TEs) is conflicting. This study compared overall outcomes and determined predictive patient factors associated with higher complication rates. METHODS: After institutional review board approval, a retrospective cohort study of consecutive patients who underwent immediate breast reconstruction from 2010 to 2014 at a single hospital was performed...
October 3, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28979690/multifaceted-effects-of-astragaloside-iv-on-promotion-of-random-pattern-skin-flap-survival-in-rats
#10
Renjin Lin, Huanwen Chen, Daniel Callow, Shihen Li, Lei Wang, Shi Li, Long Chen, Jian Ding, Weiyang Gao, Huazi Xu, Jianzhong Kong, Kailiang Zhou
Random pattern skin flap transplantation is frequently applied in plastic and reconstructive surgery, but the distal part of skin flaps often suffers necrosis due to ischemia. Astragaloside IV (AS-IV), a natural saponin purified from Astragalus membranaceus, may have beneficial functions for flap survival. In this study, rats were divided into a control group and an AS-IV treatment group, and underwent surgery using a modified "McFarlane flap" model. After intragastric administration of vehicle control or AS-IV for their respective groups, flap survival area and water content were measured 7 days after surgery...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28978276/a-novel-rodent-excision-model-for-ischemia-impaired-wound-healing
#11
Anna Theresa Hofmann, Sabine Neumann, James Crawford Ferguson, Heinz Redl, Rainer Mittermayr
Delayed wound healing and the potentially resulting chronic wounds are a challenging clinical problem. Available therapeutic strategies are limited in both number and efficacy. For developing and establishing novel treatment approaches appropriate clinical relevant animal models are essential. The aim of the study was to establish a reliable and reproducible delayed wound healing model which simulates the clinical scenario of compromised vascular tissue perfusion (hypoxia/ischemia). Therefore a standard rodent ischemic flap model was modified by challenging the tissue with ascending degrees of ischemia using different surgical approaches (minimal, mild, moderate and severe ischemic invasive approach)...
October 5, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28966964/anterior-tibial-artery-perforator-plus-flaps-role-in-coverage-of-posttumor-excision-defects-around-the-knee-joint-and-upper-leg
#12
Harshvardhan Sahijwani, Vikas Warikoo, Abhijeet Ashok Salunke, Jaymin Shah, Preetish Bhavsar, Rahul Wagh, Subodh Pathak
OBJECTIVE: Posttumor excision defects can be very large, and many do require postoperative radiotherapy. It is therefore important to provide stable and durable wound coverage to provide ability to withstand radiotherapy as well as providing cover to vital structures. METHODS: Between July 2014 and June 2016, eight females and six male patients with defects around the knee were operated upon using a perforator plus flap from the anterior tibial artery perforator...
October 2017: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28964666/beneficial-effect-of-botulinum-toxin-a-on-secondary-ischaemic-injury-of-skin-flaps-in-rats
#13
L Huang
Botulinum toxin A (BTX-A) protects against primary ischaemia of skin flaps, but its effect on secondary ischaemia is unknown. We induced secondary arterial or venous ischaemia in skin flaps of 32 Wistar rats, and tested the effectiveness of BTX injected subcutaneously 12hours before the flap was raised. The animals were divided into two groups of 16 (arterial or venous). Eight animals in each group were then treated with saline 1ml (control), and eight with BTX-A 5 IU (treatment). Ischaemia and necrosis were assessed after five days...
September 27, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28964387/-resection-of-recurrent-neck-cancers-with-replacement-of-the-carotid-artery
#14
J-B Ricco, G Illuminati, R Belmonte
OBJECTIVES: The management of patients with recurrent neck cancer invading the carotid artery is controversial. The aim of this study was to evaluate the overall survival and healthy survival years (QALY) as well as the patency of carotid revascularization after enbloc tumor resection followed by complementary radiotherapy. METHODS: From 2000 to 2016, 42 consecutive patients with recurrent neck cancer invading the carotid artery underwent resection of the tumor associated with reconstruction of the carotid artery with a PTFE prosthesis (n=31) or with a saphenous vein graft (n=11)...
October 2017: J Med Vasc
https://www.readbyqxmd.com/read/28953725/the-functional-angiosome-clinical-implications-of-the-anatomical-concept
#15
G Ian Taylor, Russell J Corlett, Mark W Ashton
BACKGROUND: The angiosome is a three-dimensional block of tissue supplied by a source vessel with its boundary outlined either by an anastomotic perimeter of reduced-caliber choke vessels or by true anastomoses with no reduction of vessel caliber. This article focuses on the role of these anastomotic vessels in defining flap survival or the necrotic pattern seen in fulminating meningococcal septicemia. METHODS: Experiments in pigs, dogs, guinea pigs, and rabbits over the past 46 years were reviewed, focusing on the necrosis line of flaps, the effects of various toxins in vivo, and correlating these results in the clinical setting...
October 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28951642/surgical-management-of-pelvic-bone-sarcoma-with-internal-hemipelvectomy-oncologic-and-functional-outcomes
#16
Abhijeet Ashok Salunke, Jaymin Shah, Vikas Warikoo, Amit Chakraborty, Harshwardhan Sahijwani, Mohit Sharma, Rohit Jha, Avdhoot Dhange, Subodh Pathak, Jyotindra Pandit, Manish Pruthi, Shashank Pandya, Abhishek Jain
INTRODUCTION: The management of pelvic sarcoma is challenging and goals of surgery are adequate oncologic local control, maintenance of optimum function with good quality of life. METHODS: We have evaluated the results of internal hemipelvecotmy including age, type of resection, reconstruction, radiotherapy or chemotherapy. From 2010 to 2016, 23 patients with pelvic bone tumors (13 with Ewing's sarcoma, 9 with Osteosarcoma, 1 with chondrosarcoma) were treated by surgical resection...
July 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28949034/comparing-the-thoracodorsal-and-internal-mammary-vessels-as-recipients-for-microsurgical-autologous-breast-reconstruction-a-systematic-review-and-meta-analysis
#17
REVIEW
Osama A Samargandi, Jessica Winter, Joseph P Corkum, Sarah Al Youha, Simon Frank, Jason Williams
BACKGROUND: Our aim was to determine whether the thoracodorsal (Td) vessels have comparable clinical outcomes to the internal mammary (IM) vessels as recipients for autologous free tissue transfer for breast reconstruction. METHODS: Systematic searches of MEDLINE, EMBASE, CENTRAL, and World of Science from inception to June 2016 were performed by two independent reviewers. Studies that included adult females undergoing autologous free tissue transfer for breast reconstruction were selected...
September 26, 2017: Microsurgery
https://www.readbyqxmd.com/read/28946730/the-rolling-earlobe-flap-for-dilated-ear-holes-following-ear-gauging-a-novel-approach-to-aesthetically-preserving-earlobe-soft-tissue-volume
#18
Wan-Sze Pek, Lin Hon Terence Goh, Chong Han Pek
Patients are increasingly seeking repair of their earlobes following ear gauging. Research has shown that current repair techniques either excessively reduce the lobular volume or leave an obvious scar along the free edge of the earlobe. In our case series, we describe the use of a novel technique for repairing earlobes following ear gauging using a rolling earlobe flap that preserves the lobular volume and avoids leaving a scar on the free edge of the lobule. The procedure was performed on 3 patients (6 earlobes) who had defects from ear gauging that ranged from 3...
September 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28944942/paramedian-forehead-flap-for-repair-of-refractory-high-flow-anterior-skull-base-csf-leak
#19
Jeremy Ciporen, Brandon Lucke-Wold, Haley Gillham, David Cua, Jason Kim, Paul Akins
AIM: The paramedian forehead flap (PMFF) has been well described for nasal reconstruction. However, it has never been reported for use in the repair of high flow anterior skull base cerebral spinal fluid (CSF) leaks. MATERIAL AND METHODS: The patient is a 55 yo African American male cocaine abuser who initially presented with a high flow anterior skull base CSF leak, extensive pneumocephalus, and intra-cerebral and intra-ventricular abscesses with an oro-nasal-cerebral fistula...
July 11, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28944479/temporal-horizontal-h-figure-sliding-skin-flap-for-central-eyelid-reconstructive-surgery-in-dogs-a-retrospective-study
#20
C Giordano, A Vercelli, G Barsotti
OBJECTIVE: To describe a modified H-figure sliding skin flap for treating eyelid central neoplasms and to evaluate the cosmetic and functional results of this reconstructive blepharoplasty. MATERIAL AND METHODS: Eight dogs affected by eyelid neoplasia involving more than one-third of the central part of the margin underwent an en bloc rectangular surgical removal of the neoplasia. Reconstructive surgery was performed using a temporal horizontal H-figure sliding skin flap...
September 25, 2017: Journal of Small Animal Practice
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