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https://www.readbyqxmd.com/read/27914123/extending-the-indications-for-autologous-breast-reconstruction-using-a-two-stage-modified-goldilocks-procedure-a-case-report
#1
Jean-Claude D Schwartz, Piotr P Skowronksi
Post-mastectomy reconstruction is performed using implant-based or autologous techniques. Many women refuse or are poor candidates for implant-based reconstruction. We previously described a single-stage autologous technique that was most applicable in obese women with significant ptosis that made use of the mastectomy skin flap and subcutaneous tissue to reconstruct a breast mound. Here, we extend this technique to smaller breasted women by incorporating a second stage of skin tailoring and fat grafting. This technique does not require donor site surgery nor extended operative and recovery times...
December 3, 2016: Breast Journal
https://www.readbyqxmd.com/read/27909467/invasive-squamous-cell-carcinoma-of-the-scalp-and-calvarium-a-multidisciplinary-approach
#2
Jennifer Stark, Silvio Podda, Karen Szymanski
Objective: The correlation between immunosuppression-associated skin cancer and lymphoma has been well established. This includes squamous cell carcinoma and chronic lymphocytic leukemia. When a lesion requires excision, reconstruction can be challenging based on the depth and size of the tumor. We present a patient with chronic lymphocytic leukemia and invasive squamous cell carcinoma of the scalp that extended through the calvarium to the dura mater. His tumors were badly neglected for a long period of time and presented at an advanced stage...
2016: Eplasty
https://www.readbyqxmd.com/read/27908370/graft-use-in-bulbar-urethroplasty
#3
REVIEW
Mya E Levy, Sean P Elliott
The gold standard for bulbar urethroplasty has been excision and primary anastomosis. Application of this approach is generally limited to strictures that are 2 cm or less in the bulbar urethra due to penile shortening. Strictures greater than 2 cm are successfully treated with augmentation urethroplasty wherein the narrowed segment is not excised but widened with the use of a skin flap or a tissue graft. Buccal mucosa is the most prevalent tissue for bulbar urethral stricture repair for strictures greater than 2 cm...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908367/use-of-alternative-techniques-and-grafts-in-urethroplasty
#4
REVIEW
Brendan Michael Browne, Alex J Vanni
The current management for complex urethral strictures commonly uses open reconstruction with buccal mucosa urethroplasty. However, there are multiple situations whereby buccal mucosa is inadequate (eg, pan-urethral stricture or prior buccal harvest) or inappropriate for utilization (eg, heavy tobacco use or oral radiation). Multiple options exist for use as alternatives or adjuncts to buccal mucosa in complex urethral strictures. This article reviews the current state of alternate techniques for urethral stricture treatment besides buccal mucosa, including injectable antifibrotic agents, augmentation urethroplasty with skin flaps, lingual mucosa, colonic mucosa, and new developments in tissue engineering for urethral graft material...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908364/management-of-urethral-strictures-after-hypospadias-repair
#5
REVIEW
Warren T Snodgrass, Nicol C Bush
Strictures of the neourethra after hypospadias surgery are more common after skin flap repairs than urethral plate or neo-plate tubularizations. The diagnosis of stricture after hypospadias repair is suspected based on symptoms of stranguria, urinary retention, and/or urinary tract infection. It is confirmed by urethroscopy during anticipated repair, without preoperative urethrography. The most common repairs for neourethra stricture after hypospadias surgery are single-stage dorsal inlay graft and 2-stage labial mucosa replacement urethroplasty...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27904753/skin-flap-complications-after-decompressive-craniectomy-and-cranioplasty-proposal-of-classification-and-treatment-options
#6
Alessandro Di Rienzo, Pier Paol Pangrazi, Michele Riccio, Roberto Colasanti, Ilaria Ghetti, Maurizio Iacoangeli
BACKGROUND: The list of complications reported after decompressive craniectomy (DC) and cranioplasty is progressively increasing. Nonetheless, the exact incidence of these events is still ill-defined. Problems affecting skin flaps after DC and cranioplasty have never been accurately analyzed in papers and their impact on patients' prognosis is largely underestimated. METHODS: In a 10-year time, we treated by DC 450 patients, 344 of whom underwent cranioplasty, either with autologous bone or artificial implants (hydroxyapatite, polyetheretherketone, titanium, polymethylmethacrylate)...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27901645/fenestrated-adipofascial-reverse-flap-a-modified-technique-for-the-reconstruction-of-fingertip-amputations
#7
Francesco Idone, Andrea Sisti, Juri Tassinari, Giuseppe Nisi
AIMS OF THE STUDY: Fingertip injuries can be treated in different ways, including shortening with primary closure, skin graft, and local or distant flaps. Several local flaps for the reconstruction of the amputated fingertip were described. We present our experience with a new concept of homodigital adipofascial reverse flap that avoids the second surgical stage and allows a complete and anatomically perfect reconstruction of nail bed, with preservation of the nail lamina. MATERIALS AND METHODS: Between March 2014 and February 2015, five patients with digital amputations (distally to the nail matrix) were treated using the Fenestrated Adipofascial Reverse (F...
November 30, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27900320/the-golden-spiral-flap-a-new-flap-design-that-allows-for-closure-of-larger-wounds-under-reduced-tension-how-studying-nature-s-own-design-led-to-the-development-of-a-new-surgical-technique
#8
Sharad P Paul
This paper details the study of biodynamic excisional skin tension lines on the scalp and the development of a new flap technique for closure of scalp wounds. Recently, a study by this author, on pigskin, replicated whorls by placing tissue under rapid stretch using saline tissue expanders, by recreating rapid dermo-epidermal shear of skin - thereby concluding that the golden spiral pattern is nature's own pattern for rapid expansion. Given the relationship between tissue expansion and stretch has been shown to cause deformation gradients that have both elastic and growth factors, the author set out to test the hypothesis that a golden spiral pattern therefore would be more efficient at closing wounds under less tension when compared with standard semicircular rotational flap patterns...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27900221/grafted-tubularised-incised-plate-urethroplasty-an-objective-assessment-of-outcome-with-lessons-learnt-from-surgical-experience-with-263-cases
#9
Vipul Gupta, Sunil Kumar Yadav, Talal Alanzi, Islam Amer, Mohmmad Salah, Mamdouh Ahmed
OBJECTIVE: Snodgrass urethroplasty remains the preferred technique in primary distal hypospadias but development of meatal stenosis often limits distal extension of the midline incision of the urethral plate (MIUP), which remains a limiting factor in reconstructing an apical neomeatus (NM). We here-in assess the cosmetic and functional outcome with distal extension of the MIUP in grafted tubularised incised-plate urethroplasty (G-TIP) repair. PATIENTS AND METHODS: This prospective study included the surgical experience of 263 cases of primary hypospadias operated upon between 2012 and 2015...
December 2016: Arab Journal of Urology
https://www.readbyqxmd.com/read/27900013/surgical-treatment-of-rare-giant-malignant-tumors-of-the-scalp-a-report-of-3-cases-with-different-tumor-types
#10
Xiaoliang Liu, Wenzhong Li, Hepei Yuan, Weihong Gu, Dawei Chen
The scalp is the most frequent site of occurrence of malignant tumors. As an area that is generally neglected by the patient and not closely monitored during physical examinations, scalp tumors can go unnoticed until they become malignant. The present study reports 3 cases of rare giant malignant tumors of the scalp, namely a peripheral nerve sheath tumor, a fibrous tumor and a malignant proliferating trichilemmal tumor, that were treated at The First Bethune Hospital of Jilin University (Changchun, China)...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27898348/spontaneous-endometriosis-associated-with-an-umbilical-hernia-a-case-report-and-review-of-the-literature
#11
Hishaam Ismael, Yury Ragoza, Angela Harden, Steven Cox
INTRODUCTION: Umbilical endometriosis occurring in the presence of an underlying hernia is extremely rare and presents a diagnostic challenge for the general surgeon. We present an interesting case and perform a comprehensive review of the literature. METHODS: Medline and PubMed were queried for all cases of spontaneous umbilical endometriosis associated with an umbilical hernia. Data was analyzed and is presented along with an interesting case. RESULTS: Only 7 cases have been reported in the literature...
November 15, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27896193/multidisciplinary-approach-to-an-extended-pressure-sore-at-the-lumbosacral-area
#12
Sehoon Yoon, Euicheol Jeong, Hudson Alex Lázaro
A pressure sore wound is often extensive or complicated by local infection involving adjacent soft tissue and bone. In this case, a regional flap after simple debridement is not adequate. Here, we present a case of an extensive pressure sore in the sacral area with deep tissue infection. A 43-year-old female patient with a complicated sore with deep tissue infection had a presacral abscess, an iliopsoas abscess, and an epidural abscess in the lumbar spine. After a multidisciplinary approach performed in stages, the infection had subsided and removal of the devitalized tissue was possible...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27896189/simple-correction-of-alar-retraction-by-conchal-cartilage-extension-grafts
#13
Yong Jun Jang, Sung Min Kim, Dae Hyun Lew, Seung Yong Song
BACKGROUND: Alar retraction is a challenging condition in rhinoplasty marked by exaggerated nostril exposure and awkwardness. Although various methods for correcting alar retraction have been introduced, none is without drawbacks. Herein, we report a simple procedure that is both effective and safe for correcting alar retraction using only conchal cartilage grafting. METHODS: Between August 2007 and August 2009, 18 patients underwent conchal cartilage extension grafting to correct alar retraction...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27896188/foot-syndactyly-a-clinical-and-demographic-analysis
#14
Jong Ho Kim, Byung Jun Kim, Sung Tack Kwon
BACKGROUND: Syndactyly of the foot is the second most common congenital foot anomaly. In East Asia, however, no large case study has been reported regarding the clinical features of isolated foot syndactyly. In this study, we report a review of 118 patients during the last 25 years. METHODS: We conducted a chart review of patients who underwent surgical correction for foot syndactyly between January 1990 and December 2014. Operations were performed with a dorsal triangular flap and a full-thickness skin graft...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27896187/fascial-free-flap-for-reconstruction-of-the-dorsolateral-hand-and-digits-the-advantage-of-a-thin-contour
#15
Min Gue Lee, Jin Soo Kim, Dong Chul Lee, Si Young Roh, Kyung Jin Lee, Byeong Kyoo Choi
BACKGROUND: Fascial free flaps have been widely used for reconstruction of the hand because they are thin. However, studies reporting objective data regarding the advantages of this approach are lacking. Thus, we report our experience with such flaps. METHODS: Forty-five cases of fascial free flaps between November 2006 and March 2014 were reviewed. Nine cases involving reconstructed dorsal or lateral defects were included. Four anterolateral thigh fascial free flaps and 5 lateral arm fascial free flaps were examined...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27896183/the-trapezius-muscle-flap-a-viable-alternative-for-posterior-scalp-and-neck-reconstruction
#16
Hee Jun Yang, Dong Hun Lee, Yang Woo Kim, Sang Gu Lee, Young Woo Cheon
BACKGROUND: The trapezius muscle flap is not usually the first reconstructive option for skin and soft tissue defects in the posterior neck and scalp due to surgeons' unfamiliarity with the surgical anatomy and developments in free tissue transfer techniques. The goals of this study were to describe the clinical use of trapezius flaps in posterior neck and scalp reconstruction, and to investigate the vascular anatomy of trapezius flaps in Asians in order to obtain information facilitating the safe design and elevation of flaps in which most of the muscle is preserved...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27895538/syndactyly-release
#17
REVIEW
Tara L Braun, Jeffrey G Trost, William C Pederson
Syndactyly is one of the most common congenital hand anomalies treated by pediatric plastic surgeons. Established principles of syndactyly separation dictate the timing and order of syndactyly release, with the goals of surgery being the creation of an anatomically normal webspace, tension-free closure of soft tissue, and return of function to the fingers. Numerous surgical methods have been described, many of which involve the use of local flaps to reconstruct the commissure and full-thickness skin grafts for coverage of raw areas...
November 2016: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/27895450/dermatofibrosarcoma-protuberans-a-case-report-and-review-of-the-literature
#18
D Paramythiotis, G Stavrou, D Panagiotou, G Petrakis, A Michalopoulos
BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) represents less than 0.1% of all tumors, but it is considered the most common skin sarcoma. Wide local excision (=5 cm) has been largely replaced by Mohs micrographic surgery; however, recurrence is not rare. Description of the case: A 35-year-old man presented with a large tumor on the upper side of his back and underwent local excision with the possible preoperative diagnosis of lipoma. Upon histological examination, the diagnosis of DFSP was made, and the patient underwent wide local excision with skin flap reconstruction and was referred for adjuvant radiotherapy...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27894916/reliability-of-extended-dorsal-intercostal-artery-perforator-propeller-flaps-for-reconstruction-of-large-myelomeningocele-defects
#19
Goktekin Tenekeci, Yavuz Basterzi
Reconstruction of large myelomeningocele defects using extended (elongated beyond the lateral margin of the latissimus dorsi muscle) dorsal intercostal artery perforator (DICAP) propeller flaps is not recommended by previous studies. However, to provide tension-free and successful closure of a defect, the DICAP propeller flaps must sometimes be elongated beyond this margin. Our experience and results in this issue are discussed. In this article, reconstruction of 11 consecutive cases, with large myelomeningocele defects in which standard DICAP propeller flaps were incapable to close the defect, was achieved using extended DICAP propeller flaps between June 2013 and November 2015...
November 15, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27894610/-reconstruction-of-proximal-nasal-defect-after-deep-carcinological-resection-interest-to-combine-titane-mesh-with-fat-grafting
#20
R Aimard, C Lalloué, C Ho Quoc, D Girodet, P Zrounba, E Delay
INTRODUCTION: The mucosal cylindroma or adenoid cystic carcinoma is the second sinonasal non-epithelial malignant tumor frequency argument. Due to the achievement of the nasal mucosa and a late diagnosis reconstructions are often complex. We report the case of a mucous cylindroma recurrence of nasal septum requiring a wide and deep excision of the root of the nose with nasal reconstruction. CASE REPORT: A patient aged 66 years whose history resection two years ago with a mucous adenoid cystic carcinoma of the right side of the nasal septum, had a local recurrence T2NOM0 imposing a wide excision with amputation nasal septum own bones of nose, the anterior portion of the triangular cartilages...
November 25, 2016: Annales de Chirurgie Plastique et Esthétique
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