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microvascular free flap

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https://www.readbyqxmd.com/read/28728324/the-chicken-thigh-adductor-profundus-free-muscle-flap-a-novel-validated-non-living-microsurgery-simulation-training-model
#1
Georgios Pafitanis, Yasmine Serrar, Maria Raveendran, Ali Ghanem, Simon Myers
BACKGROUND: Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28718319/medical-modeling-for-precision-ulna-reconstruction-using-a-microvascular-fibula-free-flap
#2
Michael Alperovich, Jonathan M Bekisz, Vishal D Thanik
BACKGROUND: Despite the growing use of medical modeling in other surgical specialties, its utilization in extremity reconstruction has remained limited. METHODS: We present the application of medical modeling for ulna reconstruction using a microvascular fibula free flap. RESULTS: Following a motor vehicle accident, the patient suffered segmental loss of the right radius and ulna with concomitant forearm soft tissue and muscle loss. Using medical modeling, imaging from the unaffected contralateral forearm and lower extremity was used to plan a reconstruction that restored the anatomic length and orientation of the ulna...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28716300/the-effect-of-training-level-on-complications-after-free-flap-surgery-of-the-head-and-neck
#3
Jacob S Brady, Meghan M Crippen, Andrey Filimonov, Neil V Nadpara, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES: Analyze postoperative complications after free flap surgery based on PGY training level. METHODS: Data on free flap surgeries of the head and neck performed from 2005 to 2013 was collected from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Cases identifying the status of resident participation in the surgery and the PGY level were included. RESULTS: There were 582 cases with primary surgeon data available...
June 2, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28713713/reverse-peroneal-artery-flap-for-large-heel-and-sole-defects-a-reliable-coverage
#4
Yogesh C Bhatt, Sumer Singh, Piyush Doshi, Sanjay G Vaghani
BACKGROUND: Large soft tissue defects of ankle and foot always have been challenging to reconstruct. Reverse sural flaps, free flaps have been used for this problem with variable success. Reverse peroneal artery flap is an option to use with reliability without microvascular repair. Connections of peroneal artery around talus and ankle joint are deep and reliable with anterior tibial and posterior tibial artery. Arterial inflow and venous drainage improved with including short saphenous vein and reverse sural artery in the flap...
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28709536/margin-analysis-has-free-tissue-transfer-improved-oncologic-outcomes-for-oral-squamous-cell-carcinoma
#5
REVIEW
Sean P Edwards
Microvascular reconstruction of ablative defects has become a mainstay of contemporary management of head and neck cancer patients. These techniques offer myriad tissue options that vary in character, volume, and components and have vastly improved the esthetic and functional outcomes achieved in this patient population. Although consensus exists regarding the reliability and functional and esthetic benefits of free tissue transfer, the same cannot be said for oncologic outcomes. The increase in resources required for the routine use of free tissue transfer has led to asking this question-Do vascularized free flaps allow for increased surgical margins and improvements in oncologic outcomes?...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28697350/extended-karapandzic-flap-technique-for-reconstruction-of-lower-lip-and-chin-defect
#6
Emil Dediol, Igor Čvrljević, Marijan Dobranić, Vedran Uglešić
PURPOSE: Near total defect of the lower lip adjacent to the chin remains a reconstructive challenge for surgeons in function and esthetics. The objective of this study was to present a modified extended Karapandzic technique for reconstruction of near total defects of the lower lip adjacent with the chin. MATERIALS AND METHODS: From 2000 to 2013, patients with lip cancer or oral cavity cancer who required subtotal lower lip and chin resection and subsequently underwent reconstruction with an extended Karapandzic flap were included in this retrospective study...
June 23, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28691469/nasal-reconstruction-our-experience
#7
A Baj, A Russillo, E Segna, M Romano, A Bolzoni, F J Silvestre, A B Giannì, G A Beltramini
The nose is a critically important aesthetic and functional portion of the face. We can explore nasal defects following trauma or tumor resections. Reconstructive techniques based on primary closure, skin graft, local flap, regional flap and microvascular free tissue transfer provides an algorithmic framework applicable to any reconstructive problem. From 2010 to 2016, 33 patients were treated with nasal reconstruction. Malignant tumor resection was the main cause of nasal defect. The most common tumor resected was BCC (basal cell carcinoma) followed by SCC (squamous cell carcinoma)...
April 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28676319/impact-of-adjuvant-anti-estrogen-therapies-tamoxifen-and-aromatase-inhibitors-on-perioperative-outcomes-of-breast-reconstruction
#8
Raphaëlle Billon, Romain Bosc, Yazid Belkacemi, Elias Assaf, Mounia SidAhmed-Mezi, Barbara Hersant, Jean-Paul Meningaud
PURPOSE: Hormone (anti-estrogen) therapy (HT) plays a major role in hormone receptor-positive breast cancer management. The latest guidelines propose to extend the duration of adjuvant treatment from 5 to 10 years. The association between HT and thromboembolic or microvascular complications during breast reconstruction has been investigated. However, while estrogens play a crucial role in wound healing, no study has assessed the impact of tamoxifen or aromatase inhibitors on other postoperative complications, including wound healing complications...
June 3, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28668299/head-neck-reconstruction-predictors-of-readmission
#9
Evan M Graboyes, Joseph Zenga, Brian Nussenbaum
Unplanned hospital readmission following head and neck cancer surgery is common and associated with significant negative consequences. Because of the vital role that microvascular free tissue transfer plays in the management of head and neck oncologic defects, its relationship to unplanned hospital readmission requires attention. In this review, the incidence of, risk factors for, and reasons for unplanned readmission in patients undergoing free flap reconstruction for head and neck cancer are analyzed. The role of free flap reconstruction as a separate risk factor for unplanned readmission in patients with head and neck cancer is described...
June 28, 2017: Oral Oncology
https://www.readbyqxmd.com/read/28648580/flowmetry-evolution-in-microvascular-surgery-a-systematic-review
#10
REVIEW
Georgios Pafitanis, Maria Raveendran, Simon Myers, Ali M Ghanem
This review aims to provide a summary of the flowmeter devices used in microvascular surgery and assesses their contribution to improving the clinical outcomes of free tissue transfer. Flowmeters are widely accepted as the standard method of intraoperative assessment of the patency of coronary vascular anastomoses, providing thresholds that predict outcome. There is limited evidence regarding the use of flow measurements in plastic surgery microvascular anastomoses; however, flowmetry appears to have some role in postoperative free flap monitoring and prevention of complications...
May 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28642191/new-aspects-in-free-flap-surgery-mini-perforator-flaps-and-extracorporeal-flap-perfusion
#11
K-D Wolff
BACKGROUND: The scope of microvascular tissue transfer in the Head and Neck reaches from coverage of simple soft tissue defects to complex 3-D reconstructions using multiple or chimeric flaps. This paper summarises the presentation given at the Congress of the French Society of Oral and Maxillofacial Surgery in Marseille 2017. It was the aim of our work to add further elements to this wide spectrum of reconstructive possibilities. METHODS: For patients with small intraoral soft tissue defects in whom the use of a radial forearm flap would not be justified because of its donor site morbidity, but who nevertheless would take a benefit from a small free flap, we used mini-perforator flaps from the lower leg...
June 19, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28616153/a-multidisciplinary-approach-to-the-successful-management-of-gorlin-syndrome
#12
Ryan N Mello, Zaki Khan, Umar Choudry
Gorlin-Goltz syndrome (GGS) is a rare genetic syndrome with variable expressivity and autosomal dominant inheritance. The major features of GGS include numerous basal cell carcinomas (BCCs), keratocysts of the jaw, palmar/plantar pits and calcification of the falx cerebri. Authors report the case of a 51-year-old male with a 19-year history of GGS and multiple BCCs of the head and neck. He presented with a large ulcerating lesion on the right side of his face involving cutaneous, subcutaneous and muscular tissues of the temporal and orbital region...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28606440/mandible-reconstruction-with-free-fibula-flaps-outcome-of-a-cost-effective-individual-planning-concept-compared-with-virtual-surgical-planning
#13
Niklas Rommel, Marco Rainer Kesting, Nils Hagen Rohleder, Florian Martin Josef Bauer, Klaus-Dietrich Wolff, Jochen Weitz
PURPOSE: The free osteomyocutaneous fibular flap has become one of the primary options for mandibular reconstruction, because of the later introduction and development of virtual surgical planning (VSP). However, VSP is associated with high additional pre-operative effort and costs. Therefore, the purpose of the study was to develop a new individual cost-effective pre-operative planning concept for free fibula mandible reconstruction and to compare it with VSP regarding clinical parameters and post-operative outcome...
May 9, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28602040/the-impact-of-a-head-and-neck-microvascular-fellowship-program-on-otolaryngology-resident-training
#14
Chad A Zender, Kate Clancy, Sami Melki, Shawn Li, Nicole Fowler
OBJECTIVE: To assess the impact of a microvascular head and neck (H&N) fellowship on senior residents' surgical experience. STUDY DESIGN: Retrospective review of Accreditation Council for Graduate Medical Education-generated operative case log reports, retrospective chart review, and electronic survey. METHODS: A retrospective review of one institution's residents' H&N operative case logs and free flap operative reports was performed to determine changes in key indicator cases (KICs) after the addition of a H&N fellowship...
June 11, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28594742/outcomes-of-lymphedema-microsurgery-for-breast-cancer-related-lymphedema-with-or-without-microvascular-breast-reconstruction
#15
Holger Engel, Chia-Yu Lin, Jung-Ju Huang, Ming-Huei Cheng
OBJECTIVE: This study investigated the outcome of lymphedema microsurgery with or without microsurgical breast reconstruction for breast cancer-related lymphedema (BCRL). BACKGROUND: Complete decongestive therapy, lymphovenous anastomosis, and vascularized lymph node flap transfer are the 3 major treatment modalities for BCRL. Releasing axillary contracture and transferring a free flap may potentially improve the BCRL. METHODS: Between 2004 and 2015, 124 patients with BCRL who underwent 3 treatment modalities without or with microsurgical breast reconstruction were included in this study as groups I and II, respectively...
June 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28583233/myxofibrosarcoma-of-the-maxillary-sinus
#16
Anni Wong, Richard Chan Woo Park, Neena M Mirani, Jean Anderson Eloy
BACKGROUND: Myxofibrosarcoma (MFS) is a common sarcoma in the extremities of older individuals but is extremely uncommon in the head and neck region. Diagnosis may be challenging but is critical to the management of the patient. We discuss the radiographic and histopathologic characteristics of this destructive tumor. The distinguishing features of MFS and its differential diagnosis are reviewed to familiarize the managing otolaryngologist with this rare entity. METHODS: A 61-year-old woman presents with a 6-week history of severe left facial pain and left eye pain...
June 1, 2017: Allergy & Rhinology
https://www.readbyqxmd.com/read/28571928/free-tissue-flaps-in-head-and-neck-reconstruction-clinical-application-and-analysis-of-93-patients-of-a-single-institution
#17
Jiwang Liang, Tao Yu, Xu Wang, Yuejiao Zhao, Fengqin Fang, Wei Zeng, Zhendong Li
INTRODUCTION: Reconstruction with a free flap is routine in head and neck surgery because of better functional outcomes, improved esthetics, and generally higher success rates. OBJECTIVE: To evaluate the clinical outcomes in patients undergoing different microvascular free flap reconstructions. METHODS: This was a retrospective study of 93 patients undergoing reconstructions with free flaps from 2007 to 2015. Four types of free flap were performed: Anterolateral Thigh (76...
May 13, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28570718/free-flap-reconstruction-monitoring-techniques-and-frequency-in-the-era-of-restricted-resident-work-hours
#18
Urjeet A Patel, David Hernandez, Yelizaveta Shnayder, Mark K Wax, Matthew M Hanasono, Joshua Hornig, Tamer A Ghanem, Matthew Old, Ryan S Jackson, Levi G Ledgerwood, Patrik Pipkorn, Lawrence Lin, Adrian Ong, Joshua B Greene, James Bekeny, Yin Yiu, Salem Noureldine, David X Li, Joel Fontanarosa, Evan Greenbaum, Jeremy M Richmon
Importance: Free flap reconstruction of the head and neck is routinely performed with success rates around 94% to 99% at most institutions. Despite experience and meticulous technique, there is a small but recognized risk of partial or total flap loss in the postoperative setting. Historically, most microvascular surgeons involve resident house staff in flap monitoring protocols, and programs relied heavily on in-house resident physicians to assure timely intervention for compromised flaps...
June 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28516962/design-of-a-customised-bridging-mandibular-prosthesis-for-complex-reconstruction-a-pilot-study
#19
A Tarsitano, S Battaglia, A Sandi, C Marchetti
The gold standard for mandibular reconstruction is universally recognised and consists of the replacement of the bony part of the mandible with a bony microvascular free flap supported by a reconstructive plate. Although this procedure is feasible and reproducible in most patients, at times poor oncological prognosis or poor performance status force surgeons to consider other reconstructive solutions. In these cases, the main alternative in reconstructing a mandibular defect is represented by bridging plates combined with soft tissue flaps...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28507873/inferior-limb-salvage-by-combined-free-tissue-transfer-and-the-crane-principle-revisited
#20
Alessandro Thione, Pedro C Cavadas
Aggressive treatment of ischemia of the lower extremities has decreased the number of amputations in both diabetic and nondiabetic patients; combined vascular reconstruction and microvascular free-flap transfer has been used to improve distal perfusion and cover large tissue defects caused by the critical limb ischemia during the past 30 years. We present our experience with a 71-year-old diabetic patient who underwent revascularization with a vascular bypass and a simultaneous microvascular flap reconstruction for limb salvage after domestic trauma...
April 2017: Plastic and Reconstructive Surgery. Global Open
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