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microvascular free flap

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https://www.readbyqxmd.com/read/29218804/impact-of-diabetes-on-free-flap-surgery-of-the-head-and-neck-a-nsqip-analysis
#1
Jacob S Brady, Aparna Govindan, Meghan M Crippen, Andrey Filimonov, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVE: Diabetes is associated with microvascular pathology and may predispose patients undergoing microvascular surgery to complications. This study assesses diabetes as a risk factor for complications following free flap surgery of the head and neck. PATIENTS AND METHODS: In this retrospective cohort study, data on free flap surgeries of the head and neck between 2005 and 2014 was collected from the National Surgical Quality Improvement Program (NSQIP) database...
December 8, 2017: Microsurgery
https://www.readbyqxmd.com/read/29218284/how-much-can-we-do-by-reverse-superficial-sural-artery-flap-to-potentiate-its-effects-introducing-spout-sural-flap-as-a-new-modification
#2
Jalaluddin Khoshnevis, Terifeh Dashti, Eznollah Azargashb, Mohamad Reza Kalantar Motamedi
BACKGROUND: Due to shortage of local donor tissue and unreliable blood supply, free flaps were the mainstay of treatment for tissue defects in the lower leg and foot region, but it requires a qualified microvascular surgeon. Recently, attention has been paid to reverse superficial sural artery flap (RSSAF) and its modifications as a good alternative to pave the way to simple and friendly techniques. METHODS: Excluding each patient with septic and severely ischemic foot, every patient with tissue defect in distal leg and proximal foot region were studied...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29192315/clinical-factors-associated-with-reoperation-and-prolonged-length-of-stay-in-free-tissue-transfer-to-oncologic-head-and-neck-defects
#3
William W Thomas, Jason Brant, Jinbo Chen, Orly Coblens, John P Fischer, Jason G Newman, Ara A Chalian, Rabie M Shanti, Steven B Cannady
Importance: Prolonged hospitalization and reoperation after free tissue transfer may be associated with certain clinical factors. Objective: To determine patient and surgical factors associated with length of stay (LOS) and reoperation following surgical procedures for malignant neoplasm of the head and neck involving microvascular free tissue transfer reconstruction. Design, Setting, and Participants: This was a retrospective review of American College of Surgeons National Surgical Quality Improvement Program data from 2012 to 2014 using International Classification of Diseases, Ninth Revision (ICD-9), codes for malignant neoplasms of the head and neck...
November 30, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29189524/magnitude-of-soft-tissue-defect-as-a-predictor-of-free-flap-failures-does-size-matter
#4
Mark Shasti, Julio J Jauregui, Awais Malik, Gerard Slobogean, Walter Andrew Eglseder, Raymond A Pensy
OBJECTIVES: To examine the relationship between the magnitude of soft-tissue defect and the risk of free-flap and limb-salvage complications/failures. DESIGN: Retrospective cohort. SETTING: Level I Trauma Center. PATIENTS: One hundred twelve patients with free tissue transfers between January 2009 and June 2015. INTERVENTION: A standardized approach using a consistent team of 2 orthopaedic microvascular surgeons was used for each free-flap reconstruction...
December 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29187756/pilot-study-on-microvascular-anastomosis-performance-and-future-educational-prospects
#5
G Berretti, G Colletti, G Parrinello, A Iavarone, P Vannucchi, A Deganello
The introduction of microvascular free flaps has revolutionised modern reconstructive surgery. Unfortunately, access to training opportunities at standardised training courses is limited and expensive. We designed a pilot study on microvascular anastomoses with the aim of verifying if a short course, easily reproducible, could transmit microvascular skills to participants; if the chosen pre-test was predictive of final performance; and if age could influence the outcome. A total of 30 participants (10 students, 10 residents and 10 surgeons) without any previous microvascular experience were instructed and tested during a single 3 to 5 hour course...
November 30, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29186749/-microvascular-reconstruction-of-the-larynx-following-total-laryngectomy
#6
Stephan Hackenberg, Norbert Kleinsasser, Agmal Scherzad, Fabian Kraus, Rudolf Hagen
Total laryngectomy still is a standard procedure for the treatment of advanced laryngeal or hypopharyngeal carcinoma. The unavoidable loss of voice may lead to serious impairments in quality of life. The most common technique of voice restoration is the tracheal-esophageal puncture combined with the application of a voice prosthesis. Laryngeal reconstruction with a radial forearm flap represents a possible surgical method of voice restoration. This study is a mono-center retrospective analysis of patients receiving a so-called laryngoplasty after total laryngectomy between 2006 and 2015, focusing on long-term functional outcome and complications...
November 29, 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29153254/facial-reanimation-surgery-in-m%C3%A3-bius-syndrome-experience-from-76-cases-from-a-tertiary-referral-hospital-in-latin-america
#7
A Cardenas-Mejia, D Palafox
INTRODUCTION: Möbius syndrome is defined as a combined congenital bilateral facial and abducens nerve palsies. The main goal of treatment is to provide facial reanimation by means of a dynamic surgical procedure. The microneurovascular transfer of a free muscle transplant is the procedure of choice for facial animation in a child with facial paralysis. OBSERVATION: Between January 2008 and January 2017, 124 patients with the syndrome have been approached at our institution...
November 15, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29146958/third-repeat-microvascular-reconstruction-in-head-and-neck-cancer-patients-aged-65-years-and-older-a-longitudinal-and-sequential-analysis
#8
Jonas Löfstrand, Kai-Ping Chang, Jennifer An-Jou Lin, Charles Yuen Yung Loh, Hsuan-Yu Chou, Huang-Kai Kao
Performing a sequential third free flap for reconstruction of a head and neck defect after cancer resection can be challenging, and the problem is further compounded in elderly patients. The outcomes in this clinical scenario are currently unknown and this study aims to compare the results in elderly patients with younger patients in a high-volume microsurgical unit. A retrospective review of 126 consecutive patients who had undergone three sequential free flap reconstructions after head and neck cancer was performed...
November 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29137568/first-dorsal-metatarsal-artery-perforator-flap-to-cover-great-toe-defect
#9
Roongsak Limthongthang, Perajit Eamsobhana
BACKGROUND: There were very few options available for distal foot and toe defects that required a vascularized flap for coverage. As such, the use of a free flap was often justified in this region of the foot. The use of perforator flaps has created a new subset of local tissue transfer alternatives that increases the potential that the difficulties associated with microvascular tissue transfers could be avoided. The first dorsal metatarsal artery (FDMA) perforator flap was one variant of this new type of tissue transfer...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29130554/sensory-recovery-of-myomucosal-flap-oral-cavity-reconstructions
#10
Olindo Massarelli, Luigi Angelo Vaira, Andrea Biglio, Roberta Gobbi, Giovanni Dell'aversana Orabona, Giacomo De Riu
BACKGROUND: Sensory restoration of the oral cavity is a primary aim of reconstructive surgery in posttraumatic or postablative defects. Sensitivity plays a key role in oral function, whose impairment strongly affects the patient's quality of life. Cheek myomucosal flaps provide a reliable and tissue-like reconstruction of these regions but their sensitive recovery, which we still know little about, deserves thorough assessment. METHODS: In this retrospective study, the myomucosal cheek flaps were tested for different aspects of sensory recovery: touch; 2-point discrimination; pain; sharp/smooth discrimination; ability to feel hot/cold stimulus; stereognosis; and taste...
November 11, 2017: Head & Neck
https://www.readbyqxmd.com/read/29128255/patients-experience-of-the-monitoring-of-free-flaps-after-reconstruction-for-oral-cancer
#11
H Nazir, D Lowe, S N Rogers
Regular monitoring of free flaps is essential after microvascular free tissue transfer, but the frequency and duration of the observations vary between units and there is no consensus nationally. Best practice can be informed by the feedback of patients, but as we know of no such studies, we did a cross-sectional survey of a consecutive group of patients after free tissue transfer to find out what they thought about monitoring. We designed a study-specific questionnaire after consultation with the patient and carer forum, and sent it to 150 patients who had had free tissue transfer in the maxillofacial department at Aintree University Hospital during 2015 and 2016...
November 8, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29127507/influence-of-coupler-size-on-revision-rate-and-timing-of-revision-after-free-flap-tissue-transfer-in-the-head-and-neck
#12
Ulrich Kisser, Christine Adderson-Kisser, Philipp Baumeister, Maximilian Reiter
OBJECTIVE: Microvascular coupler devices have been proven an effective alternative to standard hand-sutured anastomoses in reconstructive surgery. Until now, the influence of the coupler size on the revision rate after free flap tissue transfer in head and neck surgery has not been investigated. Neither has its influence on the timing of venous revisions. MATERIALS AND METHODS: A retrospective mono-center cohort study was performed in order to analyze the influence of coupler size on timing and revision rate of microvascular procedures...
November 10, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29124365/change-in-reimbursement-and-costs-in-german-oncological-head-and-neck-surgery-over-the-last-decade-ablative-tongue-cancer-surgery-and-reconstruction-with-split-thickness-skin-graft-vs-microvascular-radial-forearm-flap
#13
Sebastian Hoefert, Oliver Lotter
OBJECTIVES: Defects after ablative tongue cancer surgery can be reconstructed by split-thickness skin grafts or free microvascular flaps. The different surgical options may influence costs, reimbursement, and therefore possible profits. Our goal was to analyze the development of these parameters for different procedures in head and neck reconstruction in Germany over the last decade. MATERIALS AND METHODS: After tumor resection and neck dissection of tongue cancer, three different scenarios were chosen to calculate costs, reimbursement, length of stay (LoS), and profits...
November 9, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29122486/trapezius-flaps-for-reconstruction-of-head-and-neck-defects-following-oncological-resection-a-systematic-review
#14
Conor M Sugrue, Grainne Rooney, Ryan M Sugrue
OBJECTIVE: Head and neck (H&N) reconstruction after cancer resection is challenging. Myocutaneous trapezius flaps provide an alternative reconstruction for patients not suitable for microvascular free tissue transfer. METHODS: A systematic review was performed on studies involving trapezius flaps for H&N reconstruction post oncological resection between the years 1985-2015. Data extracted included patient numbers and demographics, operative technique and complications...
October 10, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29104029/nasolabial-flap-improves-healing-in-medication-related-osteonecrosis-of%C3%A2-the-jaw
#15
Juliana Lemound, Thomas Muecke, Alexander-Nicolai Zeller, Jürgen Lichtenstein, André Eckardt, Nils-Claudius Gellrich
PURPOSE: Medication-related osteonecrosis of the jaw (MRONJ) is an adverse side effect of antiresorptive and antiangiogenic therapeutic agents that is difficult to treat owing to its high relapse rate. The aim of the present study was to determine whether patients with MRONJ treated using decortication and a nasolabial flap compared with those who underwent decortication with mucoperiosteal flaps have better outcomes regarding stable wound closure. MATERIALS AND METHODS: Two groups of patients with MRONJ and intraoral exposed bone were evaluated in a cohort clinical study retrospectively...
October 13, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29095187/defining-the-role-of-free-flaps-for-transoral-robotic-surgery
#16
Kyle M Hatten, Robert M Brody, Gregory S Weinstein, Jason G Newman, Andres M Bur, Ara A Chalian, Bert W OʼMalley, Christopher H Rassekh, Steven B Cannady
BACKGROUND: Transoral surgical techniques for oropharyngeal tumors have been widely accepted, yet often results in a significant functional deficit. Current reports on the safety, feasibility, and swallowing performance after microvascular reconstruction are limited to small volume case series. MATERIALS AND METHODS: Retrospective review of 42 consecutive patients, between December 2013 and May 2016, who underwent transoral robotic surgery oropharyngectomy followed by microvascular reconstruction...
October 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29083525/antibiotic-prophylaxis-in-clean-contaminated-head-and-neck-cases-with-microvascular-free-flap-reconstruction-a-systematic-review-and-meta-analysis
#17
REVIEW
Yarah M Haidar, Prem B Tripathi, Tjoson Tjoa, Sartaaj Walia, Lishi Zhang, Yanjun Chen, Danh V Nguyen, Hossein Mahboubi, William B Armstrong, Julie A Goddard
BACKGROUND: Optimal antibiotic prophylaxis duration in head and neck clean-contaminated free-flap cases is unknown. METHODS: A systematic review/meta-analysis was conducted using PubMed/MEDLINE, Cochrane Library, Web-of-Science, and Scopus databases. RESULTS: Of the 3755 searched articles, 5 articles were included for a total of 861 patients. The recipient surgical site infection risk was significantly higher in patients receiving prophylactic antibiotics for ≤24 hours compared to >24 hours (relative risk [RR] 1...
October 30, 2017: Head & Neck
https://www.readbyqxmd.com/read/29080960/protocol-for-mandibular-reconstruction-with-zygomatic-implants-zygomatic-mandibular-implant
#18
Ruben Muñoz, Golaszewski Gajos, Jose Bladimir, Diaz Carvajal, Alvaro Luis, Grace Del Valle Speranza
INTRODUCTION: This study describes a modified protocol using transmandibular zygomatic implants with immediate occlusal loading for the comprehensive dental rehabilitation of previously reconstructed mandibular defects and reports preliminary results of this modified protocol. MATERIALS AND METHODS: Fifteen patients (6 female and 9 male), with a mean of age 40.26 years (range 12 to 68 years), had previously undergone immediate mandibular reconstruction using either autologous bone grafting, bone transport, or microvascular free-flap reconstruction for a variety of diagnoses...
October 28, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29075158/locoregional-and-microvascular-free-tissue-reconstruction-of-the-lateral-skull-base
#19
REVIEW
Demetri Arnaoutakis, Sameep Kadakia, Manoj Abraham, Thomas Lee, Yadranko Ducic
The goals of reconstruction following any oncologic extirpation are preservation of function, restoration of cosmesis, and avoidance of morbidity. Anatomically, the lateral skull base is complex and conceptually intricate due to its three-dimensional morphology. The temporal bone articulates with five other cranial bones and forms many sutures and foramina through which pass critical neural and vascular structures. Remnant defects following resection of lateral skull base tumors are often not amenable to primary closure...
November 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29069877/is-robot-assisted-surgery-really-scarless-surgery-immediate-reconstruction-with-a-jejunal-free-flap-for-esophageal-rupture-after-robot-assisted-thyroidectomy
#20
Seong Hoon Park, Joo Hyun Kim, Jun Won Lee, Hii Sun Jeong, Dong Jin Lee, Byung Chun Kim, In Suck Suh
Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury...
November 2017: Archives of Plastic Surgery
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