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microvascular free flap

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https://www.readbyqxmd.com/read/27908574/reconstruction-of-a-post-traumatic-maxillary-ridge-using-a-radial-forearm-free-flap-and-immediate-tissue-engineering-bone-morphogenetic-protein-bone-marrow-aspirate-concentrate-and-cortical-cancellous-bone-case-report
#1
James C Melville, Ramzey Tursun, J Marshall Green, Robert E Marx
The purpose of this article is to describe reconstruction of the maxillary alveolar ridge by use of a microvascular free flap combined with an immediate tissue-engineered bone graft. This novel surgical technique involved the use of a radial forearm free flap and immediate allogeneic avascular bone graft augmented with bone morphogenetic protein and bone marrow aspirate concentrate. A poly-d,l-lactic acid mesh was used a containment unit for the bone graft. The patient was successfully treated with a viable radial forearm free flap for soft tissue and regeneration of bone with adequate height and width, which allowed the placement of 3 dental implants with excellent arch coordination...
November 9, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27898199/microsurgical-reconstruction-in-patients-greater-than-80-years-old
#2
Paul I Heidekrueger, Albrecht Heine-Geldern, Milomir Ninkovic, Frank Herter, Daniel Schmauss, Thiha Aung, P Niclas Broer
BACKGROUND: Demographic change implies that the human population is getting older and the elderly are living longer. Consequently, achieving good functional and aesthetic outcomes in microvascular procedures, especially in very old patients with higher incidence of atherosclerosis and vessel calcifications, constitutes a microsurgical challenge. This study evaluates the feasibility of microsurgical procedures in a very old patient cohort. PATIENTS AND METHODS: Between 2009 and 2015, 754 patients underwent 838 free flap reconstructions...
November 29, 2016: Microsurgery
https://www.readbyqxmd.com/read/27898195/cost-effectiveness-of-microsurgical-reconstruction-for-head-and-neck-defects-after-oncologic-resection
#3
Lin Lin Gao, Marten Basta, Suhail K Kanchwala, Joseph M Serletti, David W Low, Liza C Wu
BACKGROUND: Microvascular free tissue transfer has become the main technique used for head and neck reconstruction. We assessed the cost-effectiveness of free flap reconstruction for head and neck defects after oncologic resection for squamous cell carcinoma (SCC). METHODS: We developed a Markov model of the cost, quality of life, survival, and incremental cost-effectiveness of reconstruction with free tissue transfer compared with locoregional flaps. Health state probabilities and quality of life scores were determined from literature...
November 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/27883877/surgical-management-of-progressive-hemifacial-atrophy-with-de-epithelialized-profunda-artery-perforator-flap-a-case-report
#4
Zoltán Lóderer, Ágnes Janovszky, Péter Lázár, József Piffkó
Progressive hemifacial atrophy (PHA) is a rare disorder characterized by slow, unilateral atrophy of the soft tissues and bones of the craniofacial region. The defect becomes more pronounced with age, leading to esthetic and functional deficits. However, the proper timing and method of surgical reconstruction are still debated. The correction of this defect markedly influencing the quality of life of the patient can be achieved with less invasive to more invasive surgical approaches. A 21-year-old female patient with hemifacial atrophy and extensive alopecia presented to our clinic...
October 29, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27879584/stacked-thoracodorsal-artery-perforator-flaps-for-unilateral-breast-reconstruction
#5
Claudio Angrigiani, Alberto Rancati, Guillermo Artero, Roger K Khouri, Frances M Walocko
The thoracodorsal artery perforator flap is reliable and safe for breast reconstruction, but stacking bilateral thoracodorsal artery perforator flaps for unilateral reconstruction to achieve greater volumes has not been reported. To create a stacked thoracodorsal artery perforator flap, the ipsilateral flap is transferred as an island, and the contralateral flap is transferred as a microvascular free flap. In this article, the authors present their 8-year 14- patient experience with stacked thoracodorsal artery perforator flaps for unilateral breast reconstruction...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27876545/submental-island-flap-reconstruction-in-oral-cavity-cancer-patients-with-level-i-lymph-node-metastasis
#6
P Sittitrai, C Srivanitchapoom, D Reunmakkaew, K Yata
The submental island flap is useful as an alternative to microvascular free tissue transfer for the reconstruction of defects after resection of oral cancer because it is simple to harvest, reliable, and is associated with good oral function and low morbidity. However, because cancer of the oral cavity carries a risk of level I nodal metastases, the oncological safety of the flap remains controversial. Between April 2012 and September 2016, we studied patients with squamous cell carcinoma of the oral cavity who underwent surgical resection with submental island flap reconstruction for viability of the flap, signs of recurrence, and complications...
November 19, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/27875515/reconstruction-of-congenital-mandibular-hypoplasia-with-microvascular-free-fibula-flaps-in-the-pediatric-population-a-paradigm-shift
#7
Emily C Cleveland, Jamie Zampell, Tomer Avraham, Z-Hye Lee, David Hirsch, Jamie P Levine
BACKGROUND: The microvascular free fibula flap has become the gold standard for reconstruction of complex mandibular defects since its description by Hidalgo in 1989. Prior studies have demonstrated its safety and efficacy in the pediatric population. However, this reconstructive method is often used only as a last resort for correction of congenital mandibular hypoplasia, after failure of bone grafting and distraction osteogenesis. The authors describe our experience using this technique, facilitated by virtual planning and prefabricated cutting jigs, for children with severe congenital mandibular hypoplasia...
November 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27858701/contrast-enhanced-ultrasonography-as-a-new-method-for-assessing-autonomization-of-pedicle-and-microvascular-free-flaps-in-head-and-neck-reconstructive-surgery
#8
Steffen Mueller, Christina M Wendl, Tobias Ettl, Christoph Klingelhöffer, Sebastian Geis, Lukas Prantl, Torsten E Reichert, Ernst Michael Jung
OBJECTIVE: Evaluating vascular autonomization of pedicle and microvascular free flaps for soft tissue reconstruction in the head and neck area by means of postoperative quantitative measurement of dynamic contrast values obtained with contrast-enhanced ultrasound. METHODS: 8/18 patients underwent lip reconstruction with a pedicle flap, 10 patients reconstruction of other parts of the head with a microvascular free transplant. Ultrasound examinations were within the 1st postoperative week and 4 weeks after surgery...
November 18, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27847734/surgical-implications-of-anatomical-variation-in-anterolateral-thigh-flaps-for-the-reconstruction-of-oral-and-maxillofacial-soft-tissue-defects-focus-on-perforators-and-pedicles
#9
Ji-Wan Kim, Dong-Young Kim, Kang-Min Ahn, Jee-Ho Lee
OBJECTIVES: To gain information on anatomical variation in anterolateral thigh (ALT) flaps in a series of clinical cases, with special focus on perforators and pedicles, for potential use in reconstruction of oral and maxillofacial soft tissue defects. MATERIALS AND METHODS: Eight patients who underwent microvascular reconstructive surgery with ALT free flaps after ablative surgery for oral cancer were included. The number of perforators included in cutaneous flaps, location of perforators (septocutaneous or musculocutaneous), and the course of vascular pedicles were intraoperatively investigated...
October 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/27833281/one-plus-one-two-free-flaps-from-same-donor-thigh-for-simultaneous-coverage-of-two-different-defects
#10
Susmitha Bandi, Rayidi Venkata Koteswara Rao, Damalacheruvu Mukunda Reddy
INTRODUCTION: Primary microvascular reconstruction of multiple defects is challenging particularly if it has to be simultaneous. In trauma cases, harvesting two independent free flaps from different sites is very time-consuming and adds to morbidity. To eliminate these disadvantages, we sought to find out a reliable alternative method of harvesting two independent free flaps based on the descending branch of circumflex femoral artery, i.e., one anterolateral thigh (ALT) flap and one rectus femoris muscle flap...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27826458/factors-influencing-the-incidence-of-severe-complications-in-head-and-neck-free-flap-reconstructions
#11
Martin Broome, Naline Juilland, Yann Litzistorf, Yan Monnier, Kishore Sandu, Philippe Pasche, Peter K Plinkert, Philippe A Federspil, Christian Simon
BACKGROUND: Complications after head and neck free-flap reconstructions are detrimental and prolong hospital stay. In an effort to identify related variables in a tertiary regional head and neck unit, the microvascular reconstruction activity over the last 5 years was captured in a database along with patient-, provider-, and volume-outcome-related parameters. METHODS: Retrospective cohort study (level of evidence 3), a modified Clavien-Dindo classification, was used to assess severe complications...
October 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27810548/immediate-transoral-allogeneic-bone-grafting-for-large-mandibular-defects-less-morbidity-more-bone-a-paradigm-in-benign-tumor-mandibular-reconstruction
#12
James C Melville, Nader N Nassari, Issa A Hanna, Jonathan W Shum, Mark E Wong, Simon Young
PURPOSE: Reconstruction of hard tissue continuity defects caused by ablative tumor surgery has been traditionally reconstructed with autogenous bone grafts or microvascular free flaps. Although results have been predictable from these 2 methods of reconstruction, the morbidity associated with bone harvest is quite serious for the patient. Predictable results have been obtained with using a combination of 100% cadaver bone, bone marrow aspirate concentrate (BMAC), and recombinant human bone morphogenic protein in immediate reconstruction for benign tumor extirpations through the extraoral approach...
October 6, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27810163/surgical-site-infection-in-clean-contaminated-wounds-after-multimodal-treatment-of-advanced-oral-squamous-cell-carcinoma
#13
Christina Eder-Czembirek, Cornelia Czembirek, Pamela Braun, Christos Perisanidis, Rudolf Seemann
OBJECTIVES: The aim of this study was to assess the incidence rate for surgical site infections (SSI), patient- and therapy-related risk factors in UICC stage III and IV oral squamous cell carcinoma patients treated with preoperative radiochemotherapy, ablative surgery and immediate microvascular free flap reconstruction. MATERIAL AND METHODS: This retrospective analysis included 85 patients with oral squamous cell carcinoma treated by neoadjuvant radiochemotherapy, tumor surgery and immediate free flap reconstruction...
September 29, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27789210/a-pilot-study-demonstrating-the-feasibility-of-supermicrosurgical-end-to-side-anastomosis-onto-large-recipient-vessels-in-head-and-neck-reconstruction
#14
Takuya Iida, Hidehiko Yoshimatsu, Takumi Yamamoto, Isao Koshima
In head and neck reconstruction using free flaps, microvascular anastomosis is commonly performed in an end-to-end fashion to relatively sizable arteries including the superficial temporal, facial, and superior thyroid arteries. With the recent developments of less invasive perforator flaps such as the superficial circumflex iliac artery perforator flap, anastomosis of smaller vessels of less than 0.8 mm diameter has become necessary; however, appropriate recipient arteries for end-to-end anastomosis are often absent...
September 28, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27782984/determining-the-cost-of-incidental-findings-for-patients-undergoing-preoperative-planning-for-abdominally-based-perforator-free-flap-breast-reconstruction-with-computed-tomographic-angiography
#15
Shailesh Agarwal, Jordan Talia, Peter S Liu, Adeyiza O Momoh, Jeffrey H Kozlow
BACKGROUND: Computed tomographic angiography is increasingly used during surgical planning for abdominally based microvascular breast reconstruction. Cost-analysis studies have demonstrated a benefit to the use of computed tomographic angiography, although the secondary costs of incidental findings have not been previously reported. This study investigates the cost of computed tomographic angiography, taking into account the cost of incidental findings found during imaging. METHODS: Patients undergoing preoperative computed tomographic angiography in preparation for autologous abdominally based breast reconstruction from July of 2010 through May of 2014 were included in this study...
November 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27771262/outcome-after-urgent-microvascular-revision-of-free-diep-siea-and-sgap-flaps-for-autologous-breast-reconstruction
#16
A Vanschoonbeek, G Fabre, L Nanhekhan, M Vandevoort
INTRODUCTION: Microvascular complications after free flap breast reconstruction are devastating, and revision of a compromised breast reconstruction is very challenging. The aim of this study was to review the different characteristics of urgent microvascular revision in DIEP, SIEA and SGAP flaps and to evaluate the final outcome after revision. MATERIALS AND METHODS: A retrospective chart review was performed for all patients who underwent an autologous breast reconstruction with a DIEP, SIEA or SGAP flap at the University Hospitals of Leuven between August 1997 and December 2013...
September 28, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27771041/one-versus-two-venous-anastomoses-in-microvascular-lower-extremity-reconstruction-using-gracilis-muscle-or-anterolateral-thigh-flaps
#17
Paul I Heidekrueger, Denis Ehrl, Albrecht Heine-Geldern, Milomir Ninkovic, P Niclas Broer
INTRODUCTION: Free tissue transfers are a highly reliable procedure routinely performed for reconstruction of a wide range of defects. Main complication in free flap surgery is usually venous thrombosis. Many technical controversies exist regarding the technical details of the microvascular anastomosis in order to prevent occurrence of thrombosis and optimize outcomes. We therefore evaluated our results regarding the execution of one versus two venous anastomoses in a variety of free flaps (fasciocutaneous- or muscle free flap) utilized for lower limb reconstruction...
December 2016: Injury
https://www.readbyqxmd.com/read/27769721/intraosseous-stability-of-dental-implants-in-free-revascularized-fibula-and-iliac-crest-bone-flaps
#18
Stephan Christian Möhlhenrich, Kristian Kniha, Dirk Elvers, Nassim Ayoub, Evgeny Goloborodko, Frank Hölzle, Ali Modabber
The aim of this study was to investigate the influence of two different microvascular reanastomized bone transplants on primary (PS) and secondary stability (SS) of dental implants. Totally 96 implants (Bone Level, Institut Straumann AG, Basel, Switzerland) were inserted in fibula (n = 50) and iliac crest (n = 46) in mean of 97.7 SD 75.6 weeks after performing reconstructive surgery. For measuring PS and SS the resonance frequency (RFA) analysis was used in mesiodistal and vestibulo-oral direction to quantify the implant stability quotient (ISQ)...
September 28, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27765549/factors-influencing-postoperative-complications-in-reconstructive-microsurgery-for-head-and-neck-cancer
#19
Shih-Lun Lo, Yu-Hsiu Yen, Pi-Jung Lee, Charles Chih-Ho Liu, Chi-Ming Pu
PURPOSE: The present study aimed to analyze multiple variables and to determine the factors influencing postoperative complications in reconstructive microsurgeries for head and neck cancer. MATERIALS AND METHODS: This was a retrospective review of the medical records of patients with head and neck cancer who underwent free flap reconstruction after ablation surgery at the Cathay General Hospital (Taipei, Taiwan) from January 2010 to December 2014. Clinical and surgical procedure-related factors were retrieved from a database and analyzed...
September 23, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27756552/free-flap-rescue-using-an-extracorporeal-perfusion-device
#20
Andreas M Fichter, Lucas M Ritschl, Andrea Rau, Claudia Schwarzer, Achim von Bomhard, Stefan Wagenpfeil, Klaus-Dietrich Wolff, Thomas Mücke
The warm ischaemia time of microvascular free flaps is limited. Incalculable events, such as lack of adequate recipient vessels or intraoperative medical emergencies, can lead to prolonged ischaemia and potentially to flap loss. In this study, critically perfused ischaemic or congested flaps were temporarily perfused with an extracorporeal perfusion system until anastomosis could be commenced. Temporary extracorporeal perfusion was performed in 8 radial forearm flaps for 147 ± 52 (range 77-237) minutes. Flap perfusion was assessed using Indocyanine Green fluorescence angiography and combined laser Doppler flowmetry and remission spectroscopy...
September 23, 2016: Journal of Cranio-maxillo-facial Surgery
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