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Flap necrosis

Tarsila Pagnan Silva Dos Santos, Marcelo Tavares de Oliveira, Luiz Carlos Angelini
Objective: To assess the homodigital flap surgical procedure, as well as the function of the finger, pain, sensation, esthetics, and patient satisfaction. Method: Retrospective analysis of records and questionnaires of patients who underwent this surgical technique between the months of May 2013 and October 2016. Eight were included in the study, with an average follow-up period of 23 months. Patients with digital pulp lesions of the thumbs and those who did not perform rehabilitation were excluded...
March 2018: Revista Brasileira de Ortopedia
Michael Benson, Moneer K Hanna
INTRODUCTION AND OBJECTIVES: The desire to preserve the prepuce is often based on cultural norms. Recently, the concept of "genital autonomy" has been invoked to delay circumcision (or any genital altering procedure) until the individual reaches maturity and can make his or her own decision. However, some uncircumcised boys develop one or more episodes of balanitis resulting in scarring of the prepuce and pathologic phimosis which is difficult to treat. Herein we report on the management of severe phimosis and preputial scarring using preputial Z-plasties...
June 8, 2018: Journal of Pediatric Urology
Denise S Coelho da Mota, Fernando L Sicuro, Angela C Resende, Roberto S De Moura, Daniel A Bottino, Eliete Bouskela
BACKGROUND: Tissue necrosis caused by insufficient perfusion is a major complication in flap transfer. This study evaluated whether treatment with cilostazol or hydroalcoholic extract of seeds of Euterpe oleracea Mart. (açaí) protects the transverse rectus abdominis myocutaneous (TRAM) flap against ischemic damage in hamsters. MATERIALS AND METHODS: Fifty-four hamsters were divided into three oral treatment groups: placebo, açaí, or cilostazol. Caudally based, unipedicled TRAM flaps were raised, sutured back, classified into four vascular zones (I-IV), and evaluated for tissue viability, capillary blood flow (CBF), perfused vessel density (PVD), and microvascular flow index (MFI) by orthogonal polarization spectral imaging at three time points: immediately postoperatively (IPO), 24 h postoperatively (24hPO), and 7 d postoperatively (7POD)...
August 2018: Journal of Surgical Research
Nicholas A Calotta, Rachel Pedreira, E Gene Deune
BACKGROUND: Traditionally, the gracilis free flap is used for coverage of small- to medium-sized wounds (<50 cm) or as a functional muscle transfer. The purpose of this study is to examine the use of the gracilis free flap in the reconstruction of large extremity wounds (>100 cm). METHODS: We retrospectively reviewed records of 34 patients who underwent extremity soft-tissue reconstruction using gracilis free flaps for wounds larger than 100 cm from 1998 to 2016...
June 13, 2018: Annals of Plastic Surgery
Arumugom Archana, Sathasivam Sureshkumar, Chellappa Vijayakumar, Chinnakali Palanivel
Introduction Only a few studies compare the efficacy of the harmonic scalpel and electrocautery in performing mastectomies, and these have mainly compared their intraoperative parameters. But the main concern with electrocautery is the incidence of flap necrosis and seroma formation. Therefore, this study was done to determine if the harmonic scalpel has any advantages over electrocautery in reducing postoperative flap necrosis and seroma formation in patients undergoing a modified radical mastectomy (MRM)...
April 13, 2018: Curēus
Kaya Turan, Mesut Tahta, Tuğrul Bulut, Ulaş Akgün, Muhittin Sener
Objective: This study presents the results of 25 consecutive patients and evaluates the success of reverse sural fasciocuteneous flap (RSFF) on coverage of the foot and ankle region. Methods: A total of 25 patients with soft tissue defects in the lower leg, foot, or ankle were treated with RSFF, from January 2010 to January 2017. In the evaluation of patients, the form prepared by the clinic was used and the following data were collected: age, follow-up, gender, etiology, defect size, complications, and patient satisfaction rates...
May 2018: Revista Brasileira de Ortopedia
K O Opara, I C Nwagbara
Background: : The management of soft-tissue defects following surgery for chronic osteomyelitis of the tibia is challenging. It often requires complex reconstructive procedures, especially when the distal third of the tibia is involved. We present a relatively simple method of addressing these defects. Aim: : This study aims to report our experience with the use of the sural Island musculo fasciocutaneous flap in the management of osteomyelitis of the tibia. Materials and Methods: : Consecutive patients with osteomyelitis of the tibia requiring soft-tissue cover were managed using the sural Island musculo fasciocutaneous flap, and the outcome was analyzed...
June 2018: Nigerian Journal of Clinical Practice
Michael Benson, Moneer K Hanna
INTRODUCTION: Congenital scrotal agenesis (CSA) is an extremely rare condition with fewer than 10 cases reported in the literature. These patients are often further complicated by undescended testicles as well as systemic developmental disorders. Herein, we report our experience and an innovative surgical technique for creation of a neo-scrotum in three children. MATERIALS AND METHODS: We evaluated the records of three children in our database who were labeled as having an absent (1 patient) or severely underdeveloped scrotum (2 patients)...
May 5, 2018: Journal of Pediatric Urology
Edward A Luce
No abstract text is available yet for this article.
June 2, 2018: Plastic and Reconstructive Surgery
Sergey Y Turin, Daniel D Li, Elbert E Vaca, Neil Fine
BACKGROUND: Mastectomy flap necrosis (MFN) remains a challenging complication in immediate tissue expander breast reconstruction (ITEBR). Nitroglycerin ointment has been shown to reduce the incidence of MFN in a randomized controlled study, using 45g per breast and treating one side only in bilateral cases. This study was conducted to determine the efficacy of 15g of nitroglycerin ointment per breast - therefore permitting application to both breasts in cases of bilateral mastectomy. METHODS: A retrospective cohort study of patients undergoing ITEBR by a single reconstructive surgeon was conducted...
June 2, 2018: Plastic and Reconstructive Surgery
Austin Hembd, Sumeet Teotia, Hong Zhu, Nicholas Haddock
INTRODUCTION: This study aims to elucidate the important predicting factors for fat necrosis and abdominal morbidity in the patient undergoing DIEP flap reconstruction. METHODS: Retrospective review of 866 free-flap breast reconstructions performed at one institution from 2010-2016. 28 potential predictors were included in multivariable analyses to control for possible confounding interactions. RESULTS: 409 total DIEA perforator flaps were included in our statistical analysis...
June 2, 2018: Plastic and Reconstructive Surgery
Alfredo Hoyos, Mauricio E Perez, David E Guarin, Alvaro Montenegro
BACKGROUND: Several innovations and modifications to abdominal lipectomy procedure have been performed through the years. Despite the recent improvements, the lack of natural results, including high scars, navel deformities and "tense" abdomen are still challenging. The objective is to present an alternative technique of combined 360-degree truncal liposuction with abdominal definition, abdominoplasty and neoumbilicoplasty. METHODS: From January 2005 to June 2017, 736 VASER assisted lipoabdominoplasties were performed...
June 5, 2018: Plastic and Reconstructive Surgery
Sarah M Elswick, Christin A Harless, Sarah N Bishop, Cathy D Schleck, Jay Mandrekar, Ryan D Reusche, Robert W Mutter, Judy C Boughey, Steven R Jacobson, Valerie Lemaine
BACKGROUND: Two-stage subpectoral implant-based breast reconstruction (IBBR) is the most common method for breast reconstruction. Recent advances in surgical techniques and technology have made prepectoral IBBR feasible. There is limited data on outcomes after prepectoral IBBR and post-mastectomy radiation therapy (PMRT). METHODS: A retrospective review of consecutive patients undergoing immediate two-stage prepectoral IBBR with PMRT was performed. Outcomes of radiated breasts were compared with non-radiated breasts in bilateral cases...
March 26, 2018: Plastic and Reconstructive Surgery
Baichuan Wang, Qiang Wu, Zhicai Zhang, Jianxiang Liu, Zengwu Shao
BACKGROUND: Surgical reconstruction after total scapulectomy presents a great challenge. Currently, the constrained scapular prosthesis reconstruction is considered as the most effective and promising method. However, the mid- to long-term functional outcomes and complications of this procedure are unclear. METHODS: We retrospectively analyzed eight patients with scapular malignant tumors treated by total scapulectomy and constrained scapular prosthesis reconstruction between 2011 and 2013...
June 7, 2018: Journal of Surgical Oncology
Keyianoosh Z Paydar, Garrett A Wirth, Donald S Mowlds
Fenestrated acellular dermal matrix (ADM) has improved patient outcomes in both direct-to-implant and 2-stage tissue expander/implant breast reconstruction. This technical alteration utilizes optimal fenestration overlap to enhance the breast reconstruction experience. We present a novel, surgeon-designed shaped fenestrated ADM, placed in the recently repopularized prepectoral pocket for anterior coverage of implants in direct-to-implant and 2-stage breast reconstruction. A retrospective review of 10 patients (18 breasts) who underwent direct-to-implant or 2-stage breast reconstruction utilizing fenestrated shaped ADM in the prepectoral plane at a major academic institution in 2016 was conducted...
April 2018: Plastic and Reconstructive Surgery. Global Open
Pierre Pescheloche, Benoit Parmentier, Thevy Hor, Olivier Chamond, Maud Chabaud, Sabine Irtan, Georges Audry
INTRODUCTION: Fistulas are a common complication of hypospadias surgery; they are more frequent after mid-shaft and posterior hypospadias repair. Surgical treatment of fistula still remains challenging with a significant failure rate. The basic principle is to add layers between skin and neourethra in order to decrease the incidence of recurrent urethrocutaneous fistula (UCF). We report our experience of UCF repair using a vascularized tunica vaginalis flap (TVF) after posterior and mid-shaft hypospadias surgery...
May 21, 2018: Journal of Pediatric Urology
Sung Jae Ahn, Tae Yong Woo, Dong Won Lee, Dae Hyun Lew, Seung Yong Song
INTRODUCTION: Nipple-sparing mastectomy (NSM), combined with immediate breast reconstruction, has become the preferred surgical option to achieve better patient satisfaction and aesthetic outcome. However, nipple-areolar complex (NAC) ischemia and necrosis are common complications following nipple-sparing technique. MATERIALS AND METHODS: We performed a retrospective analysis of 220 breasts that underwent NSM and immediate reconstruction from May 2010 to December 2016 at our institute...
May 18, 2018: European Journal of Surgical Oncology
Caleb M Steffen, Kristopher M Day, Aaron J Gilson, Evon Zoog, Mark A Brzezienski
PURPOSE: The skin paddle of the latissimus dorsi flap is typically inset horizontally (HILD) in breast reconstruction. We describe our experience with the vertical inset of the latissimus dorsi (VILD) and its aesthetic benefit. METHODS: We performed a case-control study comparing the most recent cases of both VILD and HILD. Scar, as seen on anterior-posterior photographs, was digitally measured and compared from 3 clinically relevant areas: (1) all visible scarring ("mirror view"), (2) scarring above the nipple ("self-view"), and (3) scarring above or medial to the nipple ("social view")...
June 2018: Annals of Plastic Surgery
Xi Yang, Yongqing Xu, Xiaoqing He, Teng Wang, Yunjiao Wang
Objective: To investigate the feasibility and application value of digital technology in establishing the micro-vessels model of cross-boundary perforator flap in rat. Methods: Twenty 8-week-old female Sprague Dawley rats, weighing 280-300 g, were used to established micro-vessels model. The cross-boundary perforator flaps of 10 cm×3 cm in size were prepared at the dorsum of 20 rats; then the flaps were sutured in situ . Ten rats were randomly picked up at 3 and 7 days after operation in order to observe the necrosis of flap and measure the percentage of flap necrosis area; the lead-oxide gelatin solution was used for vessels perfusion; flaps were harvested and three-dimensional reconstruction of micro-vessel was performed after micro-CT scanning...
December 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Qiqiang Dong, Guojun Gu, Lijun Wang, Keda Fu, Shuqiang Xie, Songjian Zhang, Huafeng Zhang, Zhaosen Wu
Objective: To investigate the application of modified adjustable skin stretching and secure wound-closure system in repairing of skin and soft tissue defect. Methods: Between March 2016 and April 2017, 21 cases of skin and soft tissue defects were repaired with the modified adjustable skin stretching and secure wound-closure system (the size of regulating pressure and the times of adjustment were determined according to the color, temperature, capillary response, and swelling degree of the skin edge)...
December 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
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