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https://www.readbyqxmd.com/read/28528800/an-innovative-method-of-planning-and-displaying-flap-volume-in-diep-flap-breast-reconstructions
#1
S Hummelink, Arico C Verhulst, Thomas J J Maal, Yvonne L Hoogeveen, Leo J Schultze Kool, Dietmar J O Ulrich
BACKGROUND: Determining the ideal volume of the harvested flap to achieve symmetry in deep inferior epigastric artery perforator (DIEP) flap breast reconstructions is complex. With preoperative imaging techniques such as 3D stereophotogrammetry and computed tomography angiography (CTA) available nowadays, we can combine information to preoperatively plan the optimal flap volume to be harvested. In this proof-of-concept, we investigated whether projection of a virtual flap planning onto the patient's abdomen using a projection method could result in harvesting the correct flap volume...
April 23, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28527396/breast-oedema-following-free-flap-breast-reconstruction
#2
Jennifer Greenhowe, Christopher Stephen, Liusaidh McClymont, D Alex Munnoch
OBJECTIVES: Breast oedema causes significant morbidity and is historically difficult to quantify. The aim of this study was to identify changes in breast tissue water content from pre-operative levels in the native breast to post-operative levels in mastectomy skin flaps and free flaps in the reconstructed breast. MATERIALS AND METHODS: One hundred patients undergoing unilateral mastectomy and immediate free flap breast reconstruction were examined pre-operatively and at three post-operative appointments...
May 17, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28525414/the-muscle-sparing-latissimus-dorsi-flap-for-breast-reconstruction-a-retrospective-review-of-126-consecutive-flaps
#3
Jonathan Cook, Jessica Waughtel, Christopher Brooks, Dawn Hardin, Yin Kan Hwee, Yoav Barnavon
Our experience in the use of muscle-sparing latissimus dorsi (MSLD) flaps for breast reconstruction is presented. The procedure was performed on 83 patients by the senior author over an 8-year period. Of the 83 patients reviewed, a total of 126 MSLD flaps were done for immediate (26) or delayed (100) breast reconstructions. Preoperative and postoperative photographs were taken of all patients, and complications as well as ancillary procedures were recorded. The MSLD flap is shown to be a versatile option for breast reconstruction in a variety of clinical settings, with minimal complications and satisfactory aesthetic results...
June 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28522026/-breast-reconstruction-in-elderly-patients-studies-of-the-practices-at-institut-bergoni%C3%A3-during-2005-2015
#4
Guillaume Babin, Julie Commeny, Marion Fournier, Aurélien Rousvoal, Youssef Kabbani, Marc Debled, Anne Jaffre, Christine Tunon de Lara
INTRODUCTION: The objective of our study is to describe the practices of breast reconstruction in patients aged 70 years and over undergoing a radical mastectomy at institut Bergonié. MATERIAL AND METHODS: We performed a detailed single-site retrospective study from January 2005 to December 2015. Through a computerized review, we have identified and analyzed all patients aged 70 years and over who underwent a breast reconstruction. RESULTS: Five hundred and ninety patients underwent a radical mastectomy during the period...
May 15, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28513834/the-association-between-complications-and-quality-of-life-after-mastectomy-and-breast-reconstruction-for-breast-cancer
#5
John P Browne, Ranjeet Jeevan, Carmel Gulliver-Clarke, Jerome Pereira, Christopher M Caddy, Jan H P van der Meulen
BACKGROUND: Medical treatment for breast cancer is associated with substantial toxicity and patient burden. There is less known about the impact of surgical complications. Understanding this impact could provide important information for patients when they are considering surgical options. METHODS: Between 2008 and 2009, the UK National Mastectomy and Breast Reconstruction Audit recorded surgical complications for a prospective cohort of 17,844 women treated for breast cancer at 270 hospitals; 6405 of these women were surveyed about their quality of life 18 months after surgery...
May 17, 2017: Cancer
https://www.readbyqxmd.com/read/28509698/a-meta-analysis-of-studies-comparing-outcomes-of-diverse-acellular-dermal-matrices-for-implant-based-breast-reconstruction
#6
Kyeong-Tae Lee, Goo-Hyun Mun
BACKGROUND: The current diversity of the available acellular dermal matrix (ADM) materials for implant-based breast reconstruction raises the issue of whether there are any differences in postoperative outcomes according to the kind of ADM used. The present meta-analysis aimed to investigate whether choice of ADM products can affect outcomes. METHODS: Studies that used multiple kinds of ADM products for implant-based breast reconstruction and compared outcomes between them were searched...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28509694/does-the-use-of-acellular-dermal-matrix-increase-postoperative-complications-of-the-first-stage-reconstruction-of-immediate-expander-implant-breast-reconstruction-a-matched-cohort-study
#7
Kyong-Je Woo, Jin-Woo Park, Goo-Hyun Mun, Jai-Kyong Pyon, Byung-Joon Jeon, Sa Ik Bang
PURPOSE: Controversy exists regarding complications associated with the use of acellular dermal matrix (ADM). This likely stems from the heterogeneous and unmatched patient characteristics in study groups. The purpose of this study was to analyze complications in a matched cohort to identify whether ADM use increased postoperative complications of the first-stage immediate expander-implant breast reconstructions. METHODS: A retrospective matched-cohort study was performed...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28507876/prediction-of-skin-necrosis-after-mastectomy-for-breast-cancer-using-indocyanine-green-angiography-imaging
#8
Katsuya Gorai, Keita Inoue, Noriko Saegusa, Ryo Shimamoto, Meisei Takeishi, Mutsumi Okazaki, Masahiro Nakagawa
BACKGROUND: In immediate tissue expander reconstruction following total mastectomy for breast cancer, indocyanine green angiography (ICGA)-guided skin trimming is useful for the prevention of complications. However, instances of unclear ICGA contrast can occur with this method, which are difficult to judge as to whether preventive trimming is warranted. To further improve the mastectomy flap necrosis rate, more accurate objective parameters are necessary. METHODS: The degree of clinical improvement was compared between 81 patients trimmed according to the surgeon's judgment (non-ICGA group) and 100 patients with ICGA-guided trimming (ICGA group)...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507857/greater-omental-lymph-node-flap-for-upper-limb-lymphedema-with-lymph-nodes-depleted-patient
#9
Yu-Ying Chu, Robert J Allen, Ting-Jung Wu, Ming-Huei Cheng
BACKGROUND: The greater omentum is supplied by the right, middle, and left omental arteries, which arise from the right and left gastroepiploic arteries. All or part of the greater omentum can be harvested based on this blood supply for free tissue transfer. It has stimulated new interest in its use as the donor site in the treatment of lymphedema. For patients who have failed other management options or have limited peripheral lymph node donor sites, the greater omental lymph node flap may offer the best chance for lymphedema treatment...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507852/survival-differences-in-women-with-and-without-autologous-breast-reconstruction-after-mastectomy-for-breast-cancer
#10
John L Semple, Kelly Metcalfe, Farah Shoukat, Ping Sun, Steven Narod
BACKGROUND: Breast reconstruction (BR) is an option for women who are treated with mastectomy; however, there has been concern regarding the oncologic safety of BR. In this study, we evaluated recurrences and mortality in women treated with mastectomy and compared outcomes in those treated with mastectomy alone to those with mastectomy plus transverse rectus adbominis (TRAM) flap BR. METHODS: The prospective cohort study included women treated with mastectomy at Women's College Hospital from 1987 to 1997...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507843/a-new-local-flap-nipple-reconstruction-technique-using-dermal-bridge-and-preoperatively-designed-tattoo
#11
Takako Komiya, Yoshiko Iwahira
BACKGROUND: Nipple-areolar reconstruction is the final step in breast reconstruction. Reconstruction using local flaps and tattooing is useful in cases of bilateral reconstruction, a small nipple-areolar complex (NAC) as the donor site, and avoiding disturbance of the normal side and other body parts. However, this method can cause projection loss and color fading of the nipple. Moreover, the breast mound is reconstructed with an implant. METHODS: We performed nipple-areolar reconstruction of 90 nipples using clover-designed flaps oriented at 120 degrees and tattooing after breast silicone implantation in 64 women...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507842/pyoderma-gangrenosum-after-deep-inferior-epigastric-perforator-breast-reconstruction-systematic-review-and-case-report
#12
Justin T Zelones, John F Nigriny
BACKGROUND: Pyoderma gangrenosum (PG) is a rare skin disorder of the neutrophilic dermatoses spectrum that can mimic wound infections in surgical patients. PG after breast surgery has been reported but in limited amounts in autologous breast reconstruction patients. We present the first case of PG after a delayed bilateral deep inferior epigastric perforator flap breast reconstruction in the setting of systemic disease along with a systematic review. METHODS: PubMed, Ovid, and Web of Science were systematically searched to obtain cases of PG after autologous breast reconstruction...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28498546/the-use-of-inverted-l-posteromedial-thigh-l-pmt-flap-for-autologous-breast-reconstruction-a-case-report
#13
Mario F Scaglioni, Maximilian Eder, Pietro Giovanoli
The posteromedial thigh (PMT) flap has been described for breast reconstruction in vertical fashion (vPMT). However, it might not incorporate enough soft tissue for reconstruction of a medium size breast. Here, we present a case utilizing the free inverted-L posteromedial thigh (L-PMT) flap for autologous reconstruction of the breast. A 65-year-old woman with a body max index (BMI) of 24.5 kg/m(2) underwent nipple sparring mastectomy and received immediate unilateral breast reconstruction. The flap was raised based on the first medial perforator of the profunda femoris artery (PFA)...
May 12, 2017: Microsurgery
https://www.readbyqxmd.com/read/28497019/anatomical-basis-of-pedicles-in-breast-reduction
#14
REVIEW
Marcelo Irigo, Leonardo Coscarelli, Alberto Rancati
The mammary gland is composed of multiple tubules acinar pockets in which the secretory layer, connective tissue stroma, and fatty tissue all respond to hormonal and systemic influences. These structures are irrigated by three vascular pedicle branches, from the axillary artery, internal mammary artery, and intercostal artery. This vascular anastomotic arrangement forms the anatomical basis of the flaps used in breast reduction techniques. The veins form a strong subdermal network, latticed with the arterial network...
April 2017: Gland Surgery
https://www.readbyqxmd.com/read/28497017/improving-aesthetic-outcomes-in-mastopexy-with-the-autoprosthesis-technique
#15
Maurizio Nava, Alberto Rancati, Nicola Rocco, Giuseppe Catanuto, Marcelo Irigo
BACKGROUND: Many techniques have been described for mastopexy, with several types of skin incisions and parenchymal rearrangements. We present a parenchymal rearrangement technique allowing better upper pole fullness and nipple-areola-complex (NAC) projection when performing a mastopexy, with a combination of a superior pedicle for the NAC and an inferiorly-based parenchymal flap, the so-called "autoprosthesis". METHODS: From January 2008 to June 2015, 184 patients underwent "autoprosthesis" mastopexy...
April 2017: Gland Surgery
https://www.readbyqxmd.com/read/28495572/a-tumor-ultrasound-guided-incision-tugi-approach-to-nipple-sparing-mastectomy-balancing-oncologic-safety-and-technical%C3%A2-outcomes
#16
Emil J Fernando, Benjamin R Eskenazi, Risal S Djohan, Stephen R Grobmyer
BACKGROUND: Nipple-sparing mastectomy (NSM) is a prevalent operation for patients with breast cancer. Indications have been limited to tumors accessible via radial, infra-mammary, or periareolar incisions out of concern for oncologic and technical safety. We study an alternative approach to NSM based on tumor ultrasound-guided incisions (TUGI) and report its oncologic and technical outcomes. MATERIALS AND METHODS: A retrospective chart review examined patients who underwent TUGI NSM between 2013 and 2016...
April 12, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28489683/intraoperative-use-of-vasopressors-does-not-increase-the-risk-of-free-flap-compromise-and-failure-in-cancer-patients
#17
Lin Fang, Jun Liu, Cuicui Yu, Matthew M Hanasono, Gang Zheng, Peirong Yu
OBJECTIVE: To examine the effects of vasopressors on free flap outcomes. BACKGROUND: Most micro-surgeons avoid the use of vasopressors during free flap surgery due to concerns of vasoconstriction, which could potentially lead to vascular thrombosis and flap failure. Previous studies lack the statistical power to draw meaningful conclusions. METHODS: All free flaps between 2004 and 2014 from a single institution were reviewed retrospectively...
May 9, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28481705/breast-reconstruction-with-postmastectomy-radiation-choices-and-tradeoffs
#18
Matthew M Poppe, Jayant P Agarwal
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
May 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28476284/pyoderma-gangrenosum-with-pathergy-a-potentially-significant-complication-following-breast-reconstruction
#19
D K Patel, M Locke, P Jarrett
The failure of postoperative surgical site infection to resolve after appropriate antibiotic therapy should alert the clinician to other diagnoses. Pyoderma gangrenosum (PG) is an inflammatory neutrophilic dermatosis that is typically characterized by necrotizing ulceration. PG can be exacerbated by minor trauma leading to exaggerated skin injury, a condition known as pathergy. We present a case series of PG arising after immediate reconstruction for breast oncological surgery from 1st January 2006 to 1st September 2014...
April 12, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28470029/diep-flap-breast-reconstruction-preserving-a-lumbar-peritoneal-shunt-tube
#20
Kentarou Ueki, Katsuhiro Yoshikawa, Tatsuki Enoshiri, Masahiro Tanji, Megumi Takeuchi, Shigehiko Suzuki
We herein report a case of immediate deep inferior epigastric perforator flap (DIEP flap) breast reconstruction surgery in a 50-year-old female patient with a lumbar peritoneal shunt tube. We performed DIEP flap reconstruction in the patient by withdrawing and subsequently reinserting the abdominal side of an implanted shunt tube.
2017: Case Reports in Plastic Surgery & Hand Surgery
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