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Flap necrosis

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https://www.readbyqxmd.com/read/28448311/surgical-techniques-for-closure-of-a-scalp-defect-after-resection-of-skin-malignancy
#1
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
#2
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
https://www.readbyqxmd.com/read/28445273/staged-management-of-open-lisfranc-injury-experience-from-14-patients
#3
Wenqi Gu, Zhongmin Shi
There are still controversies on the management and outcome of open Lisfranc injury in available studies. This study evaluates the staged management of Lisfranc injury and its complications.Patients who received a staged strategy for open Lisfranc injury were reviewed.One patient with degloving injury suffered from partial skin and hallux necrosis which was treated by debridement, hallux amputation, definitive internal fixation, and local flap transfer on the 12th day after first stage management. A definitive internal fixation and simultaneous skin graft or flap coverage were performed in another 3 patients with soft tissue defects...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28444764/prospective-unbiased-experience-with-three-acellular-dermal-matrices-in-breast-reconstruction
#4
Edward I Chang, Jun Liu
BACKGROUND: The use of acellular dermal matrix (ADM) has become the standard of care in breast reconstruction. However, the majority of current studies are biased or combine large databases introducing inherent flaws. Here, we present a prospective single surgeon experience comparing three ADM. METHODS: All expander based breast reconstructions between 2014 and 2015 using ADM were included. RESULTS: Eighteen patients (32 breasts) underwent reconstruction using Flex Pliable, 15 patients (22 breasts) used Alloderm, and 14 patients (20 breasts) had Dermacell...
April 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28441303/surgical-techniques-for-closure-of-a-scalp-defect-after-resection-of-skin-malignancy
#5
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...
May 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28438396/the-versatile-use-of-revisited-de-epithelialization-concept-in-superficial-circumflex-iliac-and-anterolateral-thigh-perforator-free-flap-for-head-and-neck-reconstructions
#6
Jong Woo Choi, Young Chul Kim, Tae Suk Oh, Kyung S Koh, Woo Shik Jeong
BACKGROUND: Although the perforator free flap is now a standard choice for head and neck reconstruction, problems such as microvascular complications, insufficient volume support for the defect, and fistula formation occur. We revisited a de-epithelialized concept for superficial circumflex iliac artery and anterolateral thigh perforator free flap to overcome these problems. METHODS: We applied the de-epithelized perforator free flaps in 35 cases among 761 microsurgical head and neck reconstructions and investigated flap characteristics (length gain of pedicle, flap size, and volumetric analysis) and outcomes (flap failure, partial flap necrosis, hematoma, infection, and fistula)...
February 20, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28427136/-effects-and-related-mechanism-of-bivalirudin-on-the-survival-of-random-skin-flap-on-the-back-of-rat
#7
L Y Cai, T Wang, D S Lin, D Lu
Objective: To investigate the effects and related mechanism of bivalirudin on the survival of random skin flap on the back of rat. Methods: Thirty SD rats were divided into bivalirudin group and normal saline group according to the random number table, with 15 rats in each group. The random flap model with size of 9 cm×3 cm was reproduced on the back of rats in two groups. Immediately post injury, rats in bivalirudin group were intraperitoneally injected with 5 mg/mL bivalirudin (0.8 mL/kg), while rats in normal saline group were intraperitoneally injected with normal saline (0...
April 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28425594/trilobed-pedicled-superior-gluteal-artery-perforator-flap-for-lumbosacral-defect-coverage
#8
Ji Min Kim, Jun Ho Lee, Deuk Young Oh, Suk-Ho Moon
BACKGROUND: There are many available options for the coverage of lumbosacral area defects. Surgeons usually use the superior gluteal artery perforator flap (SGAP) by rotational fashion, which risks complications, such as wound dehiscence or skin necrosis at the Y-point on the donor site due to the tension. In this report, the authors present the experience of using trilobed pedicled SGAP flaps in coverage of the lumbosacral area defects. METHODS: From 2011 to 2015, 16 trilobed pedicled SGAP flaps were performed for the coverage of sacral defects in our facility...
April 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28422830/management-of-the-extensive-thoracic-defects-after-deep-sternal-wound-infection-with-the-rectus-abdominis-myocutaneous-flap-a-retrospective-case-series
#9
Yue-Hua Li, Zhao Zheng, Jiaomei Yang, Lin-Lin Su, Yang Liu, Fu Han, Jia-Qi Liu, Da-Hai Hu
Deep sternal wound infection is a severe complication after open heart surgery. According to the different severity and dimensions of the deep sternal wound infection, the treatment method is different. In this study, we aimed to describe our experience with the rectus abdominis myocutaneous flap for large sternal wound management, especially when 1 or 2 internal mammary arteries were absent.Between October 2010 and January 2016, a retrospective review of 9 patients who suffered from the extensive thoracic defects after deep sternal wound infection was conducted...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28417653/modified-dufourmentel-flap-with-superior-pedicle-a-useful-technique-for-sacrococcygeal-pilonidal-sinus
#10
Naohiro Ishii, Yusuke Shimizu, Tomito Oji, Kazuo Kishi
PURPOSE: In order to prevent postoperative infection and recurrence of sacrococcygeal pilonidal sinus, the authors developed a modified Dufourmentel flap, involving the superior pedicles, and designed a descriptive prospective study to evaluate its efficiency. METHODS: Between July 2007 and March 2014, 16 patients with sacrococcygeal pilonidal sinus were treated with an irregular quadrilateral excision and reconstruction by a modified Dufourmentel flap with superior pedicle...
April 18, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28410984/a-systematic-review-of-complications-associated-with-direct-implants-vs-tissue-expanders-following-wise-pattern-skin-sparing-mastectomy
#11
REVIEW
Jason Corban, Hani Shash, Tyler Safran, Nicolas Sheppard-Jones, Omar Fouda-Neel
INTRODUCTION: With proven oncological safety and improved aesthetic outcomes, the Type IV or "Wise pattern" skin-sparing mastectomy (SSM) is a procedure that is being performed with increasing frequency. Unfortunately, it is also associated with an increased risk of complications. The purpose of this investigation was to determine the complications associated with direct-to-implant and two-step tissue-expander breast reconstruction following Wise pattern SSM. METHODS: Systematic electronic searches were performed using PubMed, MEDLINE, and Embase databases...
March 14, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28403069/using-a-pedicle-pectoralis-major-musculocutaneous-flap-in-head-and-neck-reconstruction-after-modified-radical-mastectomy-a-case-report
#12
Jen-Wu Huang, Nai-Yuan Wu, Yi-Ying Lin
RATIONALE: A pedicle pectoralis major musculocutaneous (PMMC) flap is one of the strategies for head and neck reconstruction. Seldom studies reported the case in which the skin area of previous modified radical mastectomy (MRM) had been used as a PMMC flap in head and neck reconstruction. PATIENT CONCERNS: An 84-year-old female who had suffered from left breast cancer and undergone a left modified radical mastectomy (MRM) more than 20 years earlier. DIAGNOSES: She had squamous cell carcinoma of the tongue and had undergone partial glossection and left modified radial neck dissection...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28400133/perioperative-serum-levels-of-procalcitonin-c-reactive-protein-and-leukocytes-in-head-and-neck-free-flaps
#13
S Koerdt, N Rommel, N H Rohleder, S Sandig, G Frohwitter, T Steiner, K D Wolff, M R Kesting
Microvascular free flaps are considered to be the gold standard in reconstructive head and neck surgery. However, reduced postoperative transplant perfusion is one of the serious postoperative complications and calls for close and reliable monitoring. Procalcitonin, C-reactive protein, and leukocytes are closely associated with local and systemic inflammatory reactions and might have prognostic capacity concerning tissue necrosis. This study aimed to evaluate perioperative serum levels of these three biomarkers to assess their potential in postoperative flap monitoring...
April 8, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28383404/progressive-fingertip-necrosis-after-nail-avulsion-injury-in-a-patient-with-ulnar-artery-hypoplasia-a-case-report
#14
Yeon Jin Jeong, Seong Hyuk Park, Jun Yong Lee
RATIONALE: Slowly progressive hand ischemia is mostly associated with medical illness such as vasculitis, and in patients with smoking history, Buerger disease is often considered first. However, despite the very low incidence of vascular anatomical anomalies, they can lead to hand ischemia. And if there is no consideration for them, proper treatment cannot be selected. PATIENT CONCERNS: A 42-year-old male smoker presented with a slowly progressing 5th fingertip necrosis following blunt trauma...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28374295/windmill-flap-nipple-reduction-a-new-method-of-nipple-plasty
#15
Yijia Yu, Liyuan Wei, Yichen Shen, Wei Xiao, Jiaxin Huang, Jinghong Xu
BACKGROUND: Nipple hypertrophy is a common aesthetic issue for Asian women. Thus, methods to correct this problem are needed. Several nipple reduction procedures have been reported, but all have shortcomings. In this article, we propose a new method to reduce both the height and diameter of the nipple without affecting its function. METHODS: Sixteen female patients, between the ages of 24-41 years, underwent a new nipple reduction method in our department between May 17, 2010, and May 5, 2014...
April 3, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28370229/more-than-just-the-helix-a-series-of-free-flaps-from-the-ear
#16
Patrik Lassus, Annastiina Husso, Jyrki Vuola, Andrew J Lindford
AIM: We herein present our experience using free flaps harvested from the ear region in facial, nasal and intraoral reconstruction. PATIENTS AND METHODS: Between 2011 and 2016, 19 patients underwent reconstruction using 20 free flaps from the ear region based on the superficial temporal vessels. There were 10 males and 9 females with a mean age of 57 years. Defect aetiology consisted of post-tumour ablation (n = 15), trauma (n = 2) and burn scar (n = 2)...
April 1, 2017: Microsurgery
https://www.readbyqxmd.com/read/28369015/nipple-areola-complex-malposition-in-nipple-sparing-mastectomy-a-review-of-risk-factors-and-corrective-techniques-from-greater-than-1000-reconstructions
#17
Mihye Choi, Jordan D Frey, Ara A Salabian, Nolan S Karp
BACKGROUND: Nipple-areola complex (NAC) malposition after nipple-sparing mastectomy (NSM) can be a challenging issue to correct. The current literature is largely limited to smaller series and implant-based reconstructions. METHODS: A retrospective review of all NSMs from 2006 to 2016 at a single institution was performed. Incidence, risk factors and corrective techniques of NAC malposition were analyzed. RESULTS: 1037 cases of NSM were identified, of which 77 (7...
March 31, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28360090/testosterone-prevents-cutaneous-ischemia-and-necrosis-in-males-through-complementary-estrogenic-and-androgenic-actions
#18
Caroline Chenu, Marine Adlanmerini, Frederic Boudou, Elodie Chantalat, Anne-Laure Guihot, Céline Toutain, Isabelle Raymond-Letron, Patricia Vicendo, Alain-Pierre Gadeau, Daniel Henrion, Jean-François Arnal, Françoise Lenfant
OBJECTIVE: Chronic nonhealing wounds are a substantial medical concern and are associated with morbidity and mortality; thus, new treatment strategies are required. The first step toward personalized/precision medicine in this field is probably in taking sex differences into account. Impaired wound healing is augmented by ischemia, and we previously demonstrated that 17β-estradiol exerts a major preventive effect against ischemia-induced skin flap necrosis in female mice. However, the equivalent effects of testosterone in male mice have not yet been reported...
May 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28359353/guitar-string-suture-to-facilitate-closure-of-a-finger-like-flap-for-reconstruction-of-the-nose
#19
E Querol-Cisneros, P Redondo
INTRODUCTION: The basic principle of a lobed or finger-like transposition flap is that, after covering the defect with the transposed tissue, the donor site is closed primarily. With large defects, a second lobe may be added to the flap if primary closure of the area left by the first lobe is not possible. The flap can often be made to adapt to the defect, but this maneuver, in combination with primary closure of the adjacent tissue, can sometimes produce excessive tension and compromise the blood supply...
March 27, 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/28358759/salvage-of-a-necrotic-flap
#20
Joo Hyun Jung, Seon Tae Kim, Sang Hee An, Kwang Ha Moon, Hyoung Min Park, Il Gyu Kang
OBJECTIVE: To report the case of a 68-year-old woman with a skin basal cell carcinoma on the nasal dorsum. After excision, the soft tissue defect was reconstructed using a rectangular advancement flap. However, 2 days later skin necrosis was observed. This report was issued to advise how to avoid and manage skin necrosis after regional flap placement. METHODS: This is a retrospective study. RESULTS: Superficial skin necrosis recovered completely after proper medical management...
March 29, 2017: Journal of Craniofacial Surgery
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