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perforator flap

Dorothee Boehm, Konstantin Bergmeister, Emre Gazyakan, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
AIMS: Reconstruction of breasts and chest wall deformities in female patients after severe burn injury is a challenge for reconstructive surgeons. In these patients, neither implant-based procedures nor standard free flaps are sometimes applicable because of limited skin quality and unavailability of donor sites at the abdomen, back, buttock, or medial thigh. METHODS: We present a case of a young female patient with a history of 80 % total body surface area burn after electric high-voltage injury...
March 13, 2018: Annals of Plastic Surgery
Saul N Rajak, Shyamala C Huilgol, Masahiro Murakami, Dinesh Selva
PURPOSE: Propeller flaps are island flaps that reach the recipient site through an axial rotation. The flap has a subcutaneous pedicle on which it pivots, thereby resembling a helicopter propeller. We present our series of propeller flaps for the reconstruction of large eyelid defects. METHODS: This is a retrospective review of the clinical case notes of eight patients that underwent tumour excision with reconstruction with a cutaneous propeller flap supplied by a non-perforator orbicularis pedicle between July and December 2016...
March 14, 2018: Eye
Hyun Ho Han, Yeon Ji Lee, Suk-Ho Moon
BACKGROUND: When a small, thin, and durable flap is required for coverage of the foot, the proximal peroneal artery perforator (PPAP) free flap may be a novel option. However, few clinical results and anatomical studies on the PPAP flap have been published. METHODS: A total of 24 PPAP flaps used in 22 patients from January 2013 to December 2016 were analyzed. All flaps were elevated in the subfascial plane based on a single perforator from the peroneal artery between the soleus and peroneus muscles...
February 22, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Epameinondas Kostopoulos, Christos Agiannidis, Petros Konofaos, Ioannis Kotsakis, Panagiota Hatzigianni, Gerasimos Georgopoulos, Zoe Papadatou, Chara Konstantinidou, Gregorios Champsas, Othon Papadopoulos, Vincent Casoli
INTRODUCTION: Medial canthus is a common area of skin cancer prevalence. Defects in this region represent a challenging reconstructive task. The nasal version of keystone perforator island flap (KPIF) has proven its versatility. The aim of the present study was to expand its utilization in the neighbor medial canthus area. A modified croissant-like KPIF (CKPIF) was used resolving inner convexity-related problems. The presence of procerus in the glabella area, bridging a surface from nasalis up to the frontalis, changed the traditional dissecting flap technique...
March 8, 2018: Journal of Craniofacial Surgery
Glenn Isaacson, Jonathan A Harounian
Objectives: To evaluate the success of pediatric endoscopic and endoscopically assisted transcanal cartilage inlay tympanoplasty. Methods: Retrospective review of single surgeon experience. Results: During a 3 year period, 30 children underwent 31 endoscopic or endoscopically assisted transcanal tympanoplasties by the senior surgeon using tragal cartilage/perichondrial inlay grafts. There were 22 boys and 8 girls, ranging in age from 3.5 to 17 years (median 6 years)...
September 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
Hozan Mufty, Athanasios Katsargyris, Sabrina Houthoofd, Inge Fourneau, Eric Verhoeven, Geert Maleux
INTRODUCTION: Fenestrated/branched thoracic endovascular aneurysm repair (F/Br-TEVAR) is a new minimal invasive treatment option for patients with post-dissection thoracoabdominal aortic aneurysms. This specific pathology is challenging to F/Br-TEVAR, especially when target vessels originate from the false lumen. Crossing from the true lumen into the false lumen to catheterize such target vessels may prove cumbersome in the usually thickened dissection flap. TECHNIQUE: We describe a bailout technique when standard catheterization techniques fail, by using a transjugular intrahepatic portosystemic shunt (TIPS)-needle to perforate the dissection flap...
March 6, 2018: Cardiovascular and Interventional Radiology
Il Hoon Sung, Dong Woo Jang, Se Wan Kim, Youn Hwan Kim, Sang Wha Kim
BACKGROUND: Reconstruction of complicated diabetic lower leg and foot defects involving multiple tissue components remains a challenge. The purpose of this report is to introduce thoracodorsal artery perforator (TDAP) chimeric flaps for reconstructing diabetic lower leg and foot soft tissue defects. PATIENTS AND METHODS: Between April 2010 and August 2016, 17 patients with multiple diabetic lower leg and foot defects underwent reconstruction with TDAP chimeric flaps...
March 5, 2018: Microsurgery
Casper E Sommeling, Edward J De Wolf, Ali Salim, Stan Monstrey, Dries Opsomer, Karel Claes, Salvatore D'Arpa
BACKGROUND: The coronaplasty is an important step of the phalloplasty procedure as it creates a prominent coronal ridge and a constricted coronal sulcus, resulting in the transformation of a regular skin flap into a flap resembling a circumcised penis. AIM: The aim of this article is to describe our new coronaplasty technique that exploits opposing contracting forces of 2 different skin grafts to hold the shape of a thick, distally based skin flap, resulting in a natural looking neo-phallus...
February 28, 2018: Journal of Sexual Medicine
N D Thimmappa, J V Vasile, C Y Ahn, J L Levine, M R Prince
Autologous breast reconstruction using muscle-sparing free flaps are becoming increasingly popular, although microvascular free flap reconstruction has been utilised for autologous breast reconstructions for >20 years. This innovative microsurgical technique involves meticulous dissection of artery-vein bundle (perforators) responsible for perfusion of the subcutaneous fat and skin of the flap; however, due to unpredictable anatomical variations, preoperative imaging of the donor site to select appropriate perforators has become routine...
February 27, 2018: Clinical Radiology
V Behrens, A Modabber, C Loberg, A Herrler, A Prescher, A Ghassemi
PURPOSE: Computed tomographic angiography (CTA) is reported to give insight into patient-specific anatomy of the flap pedicle preoperatively. We compared information available from standard CTA (s-CTA) with that gained by modifying the conventional CTA technique (modified CTA [m-CTA]). Dissected cadavers served as the control group. MATERIALS AND METHODS: We evaluated 16 s-CTA scans (32 deep circumflex iliac arteries [DCIAs]) and 12 m-CTA scans (17 DCIAs) using 3-dimensional software (Vesalius; ps-medtech, Amsterdam, The Netherlands)...
February 26, 2018: Journal of Oral and Maxillofacial Surgery
Assaf A Zeltzer, Randy A De Baerdemaeker, Benoit Hendrickx, Katrin Seidenstücker, Carola Brussaard, Moustapha Hamdi
Abdominal scars are no longer a contra-indication for abdominal perforator flap harvesting. Few research data exists about the regeneration potential of the abdominal wall's perforator system. Therefore, previous abdominoplasty with umbilical transposition is an absolute contra-indication for a DIEaP-flap (deep inferior epigastric artery perforator flap). A 50-year-old patient required a breast reconstruction of the right breast, 10 years after an abdominoplasty with undermining of the superior abdomen and umbilical transposition...
March 1, 2018: Acta Chirurgica Belgica
Zheng-Bing Zhou, Ding Pan, Pan-Feng Wu, Fang Yu, Xiao-Yang Pang, Yong-Bing Xiao, Lei Zeng, Bartlomiej Kachniarz, Ju-Yu Tang
BACKGROUND: This study investigates the feasibility and clinical impact of the microdissected thin perforator skin flap strategy on bulky and deformed skin flaps during second-stage revision surgery. METHODS: Seventeen patients were selected and underwent the microdissected thin perforator skin flap technique to treat bulky and deformed skin flaps after free flap reconstruction between October 2013 and October 2015. Perforator vessels were isolated and protected under a microscope...
February 28, 2018: Annals of Plastic Surgery
Erica Y Xue, Laurel K Chandler, Stephen L Viviano, Jonathan D Keith
OBJECTIVE: Forward-looking infrared (FLIR) thermography technology uses a handheld camera that measures skin infrared emissivity, captures photographs, and can be analyzed through specialized software. Forward-looking infrared images can be used to analyze and correlate burn wound temperature with burn depth, burn progression, and the number of days needed for healing. FLIR ONE is a miniature, smartphone-compatible thermal imaging camera that has been used to assess inflammation in diabetic foot ulcers, as well as locating perforators in flap surgery...
February 28, 2018: Annals of Plastic Surgery
Pascal Berna, Bénédicte Toublanc, Alex Fourdrain
Pneumonectomy is known to be associated with high morbidity and mortality, and may be contraindicated in patients with altered lung function. Sleeve lobectomy is a treatment option but may be technically impossible in cases of large bronchial involvement. Here, we describe a patient with impaired lung function and right upper lobe lung cancer involving the intermediate bronchial trunk. He was treated successfully with a right upper sleeve lobectomy and bronchial replacement using a thoracodorsal artery perforator flap and a temporary endostent...
February 24, 2018: Annals of Thoracic Surgery
Joon Pio Hong, Terence L H Goh, Dong Hoon Choi, Jung Jae Kim, Peter Hyunsuk Suh
No abstract text is available yet for this article.
March 2018: Plastic and Reconstructive Surgery
Nathalie Kerfant, Nicolas Bertheuil, Baptiste Bertrand, Weiguo Hu, Christian Herlin, Benoit Chaput
No abstract text is available yet for this article.
March 2018: Plastic and Reconstructive Surgery
Jiao Wei, Tanja Herrler, Bin Gu, Mei Yang, Qingfeng Li, Chuanchang Dai, Feng Xie
BACKGROUND: The repair of extensive upper limb skin lesions in pediatric patients is extremely challenging due to substantial limitations of flap size and donor-site morbidity. We aimed to create an oversize preexpanded flap based on intercostal artery perforators for large-scale resurfacing of the upper extremity in children. METHOD: Between March 2013 and August 2016, 11 patients underwent reconstructive treatment for extensive skin lesions in the upper extremity using a preexpanded intercostal artery perforator flap...
February 26, 2018: Journal of Craniofacial Surgery
Carolina Posso, David Delgado Anaya, Jeison Aguilar Henao, Juan M Velasquez Gaviria
PURPOSE: The previous cadaveric studies of facial artery perforators have frequently reported high variability, and those results remain to be validated in the Colombian population. Thus, we aimed to describe the vascular anatomy of the lateral nasal artery cutaneous branches and their clinical applications using Colombian cadavers. MATERIALS AND METHODS: Nine hemifaces from six fresh cadavers were included in the study. Terminal branches of the facial artery and cutaneous perforators of the lateral nasal artery were dissected...
February 26, 2018: Journal of Surgical Oncology
Satoshi Usami, Kohei Inami, Yuichi Hirase
BACKGROUND: Reconstruction of the finger and thumb dorsum has been considered difficult because of the need for a thin and flexible flap, and the surrounding tissue is sometimes insufficient for a local flap. The purpose of this report is to describe our concept for finger and thumb dorsum reconstruction with free-style perforator flaps and our clinical experience with transfer of various perforator flaps. METHODS: Thirty-two finger dorsum defects in 32 patients were covered with pedicled free-style perforator flaps...
February 13, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Angie Zhang, Deniz Dayicioglu
BACKGROUND: The deep inferior epigastric perforator (DIEP) flap has gradually become the superior choice for autologous breast reconstruction because it reduces donor site morbidity, abdominal wall complications, and postoperative recovery time when compared with other flap types. METHODS: The purposes of this study are to report on the experience and clinical outcomes of consecutive DIEP flap breast reconstructions performed by a single surgeon at a cancer center between April 2011 and May 2016 and to characterize the trends among these flaps...
February 23, 2018: Annals of Plastic Surgery
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