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Breast flap

Samuel Golpanian, David J Gerth, Jun Tashiro, Seth R Thaller
INTRODUCTION: Conventionally, free transverse rectus abdominis myocutaneous (fTRAM) flap breast reconstruction has been associated with decreased donor site morbidity and improved flap inset. However, clinical success depends upon more sophisticated technical expertise and facilities. This study aims to characterize postoperative outcomes undergoing free versus pedicled TRAM (pTRAM) flap breast reconstruction. METHODS: Nationwide inpatient sample database (2008-2011) was reviewed for cases of fTRAM (ICD-9-CM 85...
October 14, 2016: Aesthetic Plastic Surgery
Kristen S Higgins, Joshua Gillis, Jason G Williams, Martin LeBlanc, Michael Bezuhly, Jill M Chorney
Clinical experience suggests that flap failure after autologous breast reconstruction can be a devastating experience for women. Previous research has examined women's experiences with autologous breast reconstruction with and without complications, and patients' experiences with suboptimal outcomes from other medical procedures. The authors aimed to examine the psychosocial experience of flap failure from the patient's perspective. Seven women who had experienced unilateral flap failure after deep inferior epigastric perforator flap surgery in the past 12 years completed semistructured interviews about their breast cancer treatments, their experiences with flap failure, the impact of flap failure on their lives, and the coping strategies they used...
October 6, 2016: Annals of Plastic Surgery
Alvin C Kwok, Jayant P Agarwal
PURPOSE: We sought to use the NSQIP database to determine the national rate and predictors of free flap failure based upon flap sites and flap types. METHODS: Free flaps were identified using the 2005-2010 NSQIP database. We examined overall flap failure rates as well as failure rates based upon flap sites (head and neck, extremities, trunk, and breast) and flap types (muscle, fascial, skin, bone, and bowel flaps). Univariate and multivariate analyses were used to determine predictors of flap failure...
October 7, 2016: Microsurgery
Benedetto Longo, Rosaria Laporta, Michail Sorotos, Matteo Atzeni, Fabio Santanelli di Pompeo
We report a case of complete DIEP flap survival, following venous congestion due to the excision of a local recurrence with main pedicle, 4 years after its transfer for breast reconstruction.
2016: Case Reports in Plastic Surgery & Hand Surgery
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
Ki Yong Hong, Lan Sook Chang, Hak Chang, Kyung Won Minn, Ung Sik Jin
BACKGROUND: Breast reconstruction with microvascular free tissue transfer has become a widely used method. Despite a high rate of success, a compromised flap necessitating re-exploration can occur. Here, we introduce direct thrombectomy as a flap salvage technique, and compared the results with conventional thrombectomy. METHODS: A total of 488 patients who underwent breast reconstruction using a free transverse rectus abdominis myocutaneous flap between March 2009 and February 2014 were retrospectively analyzed...
October 5, 2016: Microsurgery
Gül Alço, Sefik Igdem, Sait Okkan, Maktav Dincer, Dauren Sarsenov, Ahmet Serkan Ilgun, Filiz Agacayak, Filiz Elbüken, Tulay Ercan, Derya Selamoglu, Vahit Ozmen
The aim of the present study was to evaluate the geographic variability of the tumor bed following oncoplastic breast-conserving surgery (OP-BCS), and to assess its relevance for radiotherapy planning. In this prospective study, pre- and postoperative computerized tomography (CT) scans of 22 patients with early-stage breast cancer were fused. The preoperative gross tumor volume or excisional biopsy cavity were contoured under the guidance of preoperative radiological images. Postoperative lumpectomy cavities were contoured under the guidance of surgical clips...
October 2016: Molecular and Clinical Oncology
Maryam Rezaei, Mohammad Hashemi, Sara Sanaei, Mohammad Ali Mashhadi, Seyed Mehdi Hashemi, Gholamreza Bahari, Mohsen Taheri
Flap endonuclease 1 (FEN1), a DNA repair protein, is important in preventing carcinogenesis. Two functional germ line variants -69G>A (rs174538) and +4150G>T (rs4246215) in the FEN1 gene have been associated with risk of various types of cancer. The aim of the present study was to evaluate the possible impact of FEN1 polymorphisms on risk of breast cancer (BC) in a sample of Iranian subjects. The FEN1 -69G>A and +4150G>T polymorphisms were analyzed in a case-control study that included 266 BC patients and 225 healthy females...
October 2016: Biomedical Reports
Funda Tamer, Esra Adışen, Serhan Tuncer, Mehmet A Gurer
Pyoderma gangrenosum is a chronic inflammatory disease characterized by painful cutaneous ulcers. The etiology remains unknown; however, pyoderma gangrenousm can be triggered by surgery. Here we report the case of a 34-year-old Caucasian female that developed pyoderma gangrenosum following deep inferior epigastric perforator flap breast reconstruction. The patient was successfully treated with systemic immunosuppressive therapy and primary closure.
September 2016: Acta Dermatovenerologica Alpina, Panonica, et Adriatica
Michael W Chu, Julia A Cook, Alexes Hazen
No abstract text is available yet for this article.
September 2016: Archives of Plastic Surgery
Young-Eun Kim, Ki Yong Hong, Kyung Won Minn, Ung Sik Jin
Nipple-areolar complex (NAC) reconstruction is the final step in the long journey of breast reconstruction for mastectomy patients. Successful NAC reconstruction depends on the use of appropriate surgical techniques that are simple and reliable. To date, numerous techniques have been used for nipple reconstruction, including contralateral nipple sharing and various local flaps. Recently, it has been common to utilize local flaps. However, the most common nipple reconstruction problem encountered with local flaps is the loss of nipple projection; there can be approximately 50% projection loss in reconstructed nipples over long-term follow-up...
September 2016: Archives of Plastic Surgery
Keith S Hansen, Luke G Gutwein, Brett C Hartman, Rajiv Sood, Juan Socas
Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments...
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
Olivera Kosovac, Nada Santrac, Ivan Markovic, Dusica Gavrilovic, Aleksandar Martinovic, Marko Jevric, Igor Spurnic, Radan Dzodic
PURPOSE: To evaluate the adverse outcomes after delayed breast reconstruction (DBR) by abdominal advancement flap (AAF) and permanent prosthesis in patients treated with mastectomy due to unilateral breast carcinoma, as well as to determine which factors are predictive for their occurrence. METHODS: The study included 155 patients operated at the Institute for Oncology and Radiology of Serbia from 1996 to 2010. All patients had total mastectomy and axillary lymph node dissection, followed by specific oncological treatment...
July 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Gianluca Franceschini, Alejandro Martin Sanchez, Giuseppe Visconti, Alba Di Leone, Sabatino D'Archi, Antonino Mulè, Angela Santoro, Marzia Salgarello, Riccardo Masetti
: Oncoplastic surgery of the breast has generated great excitement over the past years and has become an integrated component of the surgical treatment of breast cancer. Oncoplastic procedures (OPP) associate the best surgical oncologic principles to achieve wide tumor-free margins with the best principles of plastic surgery to optimize cosmetic outcomes. So, a number of conventional mammoplasty techniques have been adapted to allow reconstruction of resection defects with parenchymal flaps using a variety of different approaches...
2016: Annali Italiani di Chirurgia
Thiago B de Araujo, Mary Jue Xu, Srinivas M Susarla, Karen Shmelev, Wei Jiang, Julian J Pribaz, Charles Hergrueter, Matthew J Carty, Stephanie Caterson, Yoon S Chun
BACKGROUND: The purpose of this study was to evaluate the impact of prior unilateral chest wall radiotherapy on reconstructive outcomes among patients undergoing bilateral immediate breast reconstruction. METHODS: A retrospective evaluation of patients with a history of unilateral chest wall radiotherapy was performed. In each patient, the previously irradiated and reconstructed breast was compared to the contralateral nonirradiated side, which served as an internal control...
October 2016: Plastic and Reconstructive Surgery
Joseph W Duncumb, Kana Miyagi, Parto Forouhi, Charles M Malata
Abdominal free flaps for microsurgical breast reconstruction are most commonly harvested based on the deep inferior epigastric vessels that supply skin and fat via perforators through the rectus muscle and sheath. Intact perforator anatomy and connections are vital for subsequent optimal flap perfusion and avoidance of necrosis, be it partial or total. The intraflap vessels are delicate and easily damaged and it is generally advised that patients should avoid heparin injection into the abdominal pannus preoperatively as this may compromise the vascular perforators through direct needle laceration, pressure from bruising, haematoma formation, or perforator thrombosis secondary to external compression...
2016: Case Reports in Surgery
J Ellart, B Chaput, J-L Grolleau
Tuberous breast deformity is a congenital breast anomaly with different clinical signs. The most consistent sign is the constricting ring at the base of the breast. There is deficiency in the horizontal and/or vertical dimensions of the breast and often herniation of breast parenchyma toward the nipple-areola complex with areola enlargement. Breast asymmetry is frequently associated. This anomaly occurs only in females, during breast development at puberty. The incidence is unknown because of minor forms more difficult to diagnose...
October 2016: Annales de Chirurgie Plastique et Esthétique
Nicola R Dean, Tamara Crittenden
OBJECTIVE: To assess the clinical effectiveness of breast reconstruction and the utility of the BREAST-Q patient-reported outcomes measure for routine patient care. METHODS: The BREAST-Q was administered to all patients attending a breast reconstructive service (n = 343) at a University Hospital at each visit. RESULTS: The BREAST-Q was easy to administer in a clinic setting, with a high participation rate (64.2% completing the minimum dataset of three BREAST-Qs)...
September 6, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Sourav Sarkar, Neeti Kapur, Hareesh M Mukri, Amritanshu Saurabh, Naveen Kumar
INTRODUCTION: Primary extra osseous osteogenic sarcomas have been reported in many tissues of the body but their occurrence in the breast is extremely rare. It can arise as a result of osseous metaplasia in a pre-existing benign or malignant neoplasm of the breast. CASE PRESENTATION: A 24 year-old young lady was diagnosed to have mass in right breast.Tru cut biopsy showed it was malignant phyllodes tumour. There was no distant metastasis or any axillary lymph nodes palpable...
2016: International Journal of Surgery Case Reports
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