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https://www.readbyqxmd.com/read/29788686/augmented-reality-and-dynamic-infrared-thermography-for-perforator-mapping-in-the-anterolateral-thigh
#1
Ignacio Javier Cifuentes, Bruno Leonardo Dagnino, María Carolina Salisbury, María Eliana Perez, Claudia Ortega, Daniela Maldonado
Dynamic infrared thermography (DIRT) has been used for the preoperative mapping of cutaneous perforators. This technique has shown a positive correlation with intraoperative findings. Our aim was to evaluate the accuracy of perforator mapping with DIRT and augmented reality using a portable projector. For this purpose, three volunteers had both of their anterolateral thighs assessed for the presence and location of cutaneous perforators using DIRT. The obtained image of these "hotspots" was projected back onto the thigh and the presence of Doppler signals within a 10-cm diameter from the midpoint between the lateral patella and the anterior superior iliac spine was assessed using a handheld Doppler device...
May 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29788685/the-lateral-intercostal-artery-perforator-as-an-alternative-donor-vessel-for-free-vascularized-lymph-node-transplantation
#2
Min-Seok Daniel Kwak, Hans-Guenther Machens
Chronic lymphedema is caused by an impairment of the lymphatic system due to primary or secondary causes. Vascularized lymph node transplantation (VLNT) is currently the most promising and frequently used technique besides lymphaticovenous anastomosis. However, the vessel anatomy in the lateral thoracic region is sometimes quite variable. Based on our experiences with vascular anatomical inconstancy in the lateral thoracic region, we planned a lateral intercostal artery perforator flap for VLNT in a female patient with chronic stage II lymphedema of both legs after cervical cancer treatment...
May 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29781856/neoumbilicoplasty-with-a-pedicled-deep-inferior-epigastric-perforator-island-flap
#3
Matthew A DelMauro, Louis-Joseph Auguste, Peter T Korn
Management of the umbilicus is a common dilemma at the time of abdominoplasty and abdominal wall reconstruction. It is not uncommon for underlying pathologies, such as hernias and surgical scars, to result in a disfigured or obliterated native umbilicus or make the blood supply to the umbilical stalk unreliable. In these scenarios, the umbilicus is often sacrificed. Staged neoumbilical reconstruction may be offered and typically utilizes a small skin flap and full-thickness skin graft (Ann Plast Surg 2009;63:358-360)...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781853/the-use-of-pedicled-perforator-flaps-in-chest-reconstruction-a-systematic-review-of-outcomes-and-reliability
#4
Anne-Sophie Florczak, Benoit Chaput, Christian Herlin, Pascal Rousseau, Eric Watier, Nicolas Bertheuil
BACKGROUND: In recent years, pedicled perforator flaps have revolutionized plastic surgery by reducing donor site morbidity and ensuring larger and deeper reconstructions with local pedicled cutaneous flaps. The aim of the study was to make a systematic review of perforator pedicled propeller flaps (PPPFs) in chest reconstruction. METHODS: Pubmed and Cochrane databases were searched from 1989 to October 2016 for articles describing the use of PPPFs in chest reconstruction...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781208/a-useful-alternative-surgical-technique-to-reconstructing-large-defects-following-excision-of-recurrent-pilonidal-sinus-disease-in-the-intergluteal-region-an-operative-approach-for-the-transverse-lumbar-artery-perforator-flap
#5
Alethea My Tan, Zeeshan Ahmad, Charles Yy Loh, Sonya Gardiner, Bhagwat Mathur
The reconstruction of defects in the intergluteal region following pilonidal sinus excision is challenging due to its anatomical location, close proximity to the anus, and being a high-tension area prone to wound-healing problems. Excision and primary closure is known to carry a higher risk of recurrence and subsequent complications compared with using nearby local healthy tissue, such as a flap, to reconstruct defect. Extra due diligence should be given to patient selection and flap choice when deciding the reconstruction of a defect...
May 21, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29775982/the-supraclavicular-artery-perforator-flap-a-comparative-study-of-imaging-techniques-used-in-preoperative-mapping
#6
Hemin Oathman Sheriff, Kawa Abdullah Mahmood, Nzar Hamawandi, Aram Jamal Mirza, Jawad Hawas, Esther Granell Moreno, Juan Antonio Clavero, Christopher Hankins, Jaume Masia
BACKGROUND:  The supraclavicular artery flap is an excellent flap for head and neck reconstruction. The aim of this study is to assess imaging techniques to define the precise vascular boundaries of this flap. METHODS:  Six imaging techniques were used for supraclavicular artery mapping in 65 cases; handheld Doppler, triplex ultrasound, computed tomography angiography, magnetic resonance angiography, digital subtraction angiography, and indocyanine green angiography...
May 18, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29764018/-clinical-application-of-modified-bilobed-chimeric-thoracoacromial-artery-perforator-flap-for-reconstruction-of-hypopharyngeal-defect-with-anterior-neck-skin-loss
#7
D J Song, Z Li, X Zhou, Y X Zhang, X W Peng, B Zhou, C L Lyu, P Wu, Y Y Tang, W Peng, H X Mao, Z Y Liu
Objective: To evaluate the efficacy of modified bilobed chimeric thoracoacromial artery perforator (TAAP) flap for the reconstruction of hypopharyngeal defect with anterior neck skin loss. Methods: Between May 2013 and September 2015, modified bilobed chimeric TAAP flap was used to reconstruct complex oncologic hypopharyngeal defects in 7 patients, including 6 males and 1 female. Patients' age ranged from 28 to 65 years old (mean age 50±3.4 years old). The size of hypopharyngeal defect ranged from 5.5 cm×3...
May 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29763940/simultaneous-septal-perforation-repair-with-septorhinoplasty-a-31-year-experience
#8
Russell W H Kridel, Sean William Delaney
Septal perforation repair and septorhinoplasty (SRP) each present unique surgical challenges. However, in many instances, these procedures may be performed together successfully. In this study, the authors aim to determine the safety and effectiveness of combining primary or revision SRP and septal perforation repair via an open approach. A retrospective review was carried out of all consecutive patients who had SRP and septal perforation repair via an open approach between 1986 and 2017 in the senior author's practice...
May 15, 2018: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/29762447/gastrocnemius-myocutaneous-flaps-for-knee-joint-coverage
#9
Alice Mayoly, Jean-Camille Mattei, Pierre Moullot, Charlotte Jaloux, Alexandre Rochwerger, Dominique Casanova, Baptiste Bertrand, Cécile Philandrianos
INTRODUCTION: The gastrocnemius muscular flap has already proven its efficiency for soft tissue coverage in cases of knee joint exposure. However, it may be too small to cover large defects and has not the same aesthetic and mechanical properties as normal skin. Perforator fasciocutaneous flaps have recently been described in knee joint coverage with good results as they replace skin by skin, but they can be hard to harvest. Gastrocnemius flaps can be easily harvested with a planned skin paddle designed over the chosen muscle...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762442/postburn-neck-reconstruction-with-preexpanded-upper-back-perforator-flaps-free-style-design-and-an-update-of-treatment-strategies
#10
Haizhou Li, Zi Wang, Bin Gu, Yashan Gao, Feng Xie, Hainan Zhu, Qingfeng Li, Tao Zan
BACKGROUND: For extensive postburn neck deformities, the preexpanded flaps in the upper back region were used and gained a uniform skin appearance and esthetic contours. Free-style perforator-based free-tissue transfer that represents the most recent advance in reconstructive surgery may provide more versatility of these flaps. METHODS: We retrospectively reviewed 31 patients treated at our institution for postburn neck contracture from March 2010 to May 2016. Various upper back flaps were designed according to the dominant perforators and the shape of the defect after fully releasing the neck contracture...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762438/venous-anastomoses-in-anterolateral-thigh-flaps-for-the-lower-extremity-vessel-selection-in-lieu-of-obligatory-number
#11
David Mattos, Shawn Diamond, Anmol S Chattha, Johanna N Riesel, Matthew L Iorio
BACKGROUND: Dual venous drainage for anterolateral thigh flaps has been proposed to protect against flap-related complications in head and neck applications. Here we report our experience with single vs dual venous anastomosis during lower extremity free-tissue transfer. METHODS: All free anterolateral thigh flaps for lower extremity reconstruction from 2011 to 2017 were retrospectively reviewed. An algorithm was used to determine the type and number of venous anastomoses, emphasizing patient anatomy, venous quality, and size match...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762436/preoperative-analysis-of-venous-anatomy-before-deep-inferior-epigastric-perforator-free-flap-breast-reconstruction-using-ferumoxytol-enhanced-magnetic-resonance-angiography
#12
John Dortch, Antonio J Forte, Candice Bolan, Pujan Kandel, Galen Perdikis
BACKGROUND: Venous congestion after deep inferior epigastric artery perforator (DIEP) flap breast reconstruction is a complication that may be partially attributable to variations in venous abdominal wall anatomy. In previous work, we have shown that ferumoxytol may be used as a bloodpool contrast agent to perform high-resolution venous imaging. Our current aim was to use this technology to perform a detailed analysis of the venous anatomy among patients undergoing DIEP flap breast reconstruction...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29754756/reverse-thenar-perforator-flap-for-large-palmar-and-digital-defects
#13
REVIEW
Mehmet Tapan, Murat İğde, Ali Rıza Yıldırım, Burak Yaşar, Hasan Murat Ergani, Çağdaş Duru
Reconstruction of large, full-thickness palmar and digital defects is challenging. The glabrous skin of the palm provides excellent color and texture match for palmar hand and digital defects. The reverse thenar perforator flap, which was previously infrequently used, provides a method for primary closure of large glabrous palmar skin defects. Because of the origin of the source vessels, the reverse thenar perforator flap is a good choice for larger radial-sided palmar and finger defects. This flap provides good aesthetic results for both the donor and the recipient...
May 11, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29753300/superficial-circumflex-iliac-artery-based-iliac-bone-flap-transfer-for-reconstruction-of-bony-defects
#14
Hidehiko Yoshimatsu, Takuya Iida, Takumi Yamamoto, Akitatsu Hayashi
BACKGROUND:  The superficial circumflex iliac artery (SCIA)-based iliac bone flap has yet to be widely used. The purpose of this article is to validate the feasibility of SCIA-based iliac bone flap transfers for reconstruction of small to moderate-sized bony defects. Retrospective outcome comparisons between SCIA-based iliac bone flaps and fibula flaps were made. METHODS:  Twenty-six patients with bony tissue defects underwent reconstructions using either free SCIA-based iliac bone flaps (13) or fibula flaps (13)...
May 12, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29752921/reconstruction-of-small-chest-wall-defects-caused-by-tubercular-abscesses-using-two-different-flaps
#15
Woo Ju Kim, Woo Seob Kim, Han Koo Kim, Tae Hui Bae
Tubercular infection of the chest wall is rare and typically progresses to abscess formation. The treatment of these abscesses combines medical therapy with surgical debridement, which can cause defects of various sizes. We have reconstructed relatively small chest wall defects caused by tubercular abscesses using 2 different flaps: a lateral intercostal artery perforator flap and a split pectoralis major muscle flap. The use of these flap techniques may provide a novel approach to cover small chest wall defects caused by tubercular abscesses...
May 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29750760/prospective-randomized-controlled-comparison-of-local-anesthetic-infusion-pump-versus-depofoam-bupivacaine-for-pain-management-after-unilateral-delayed-deep-inferior-epigastric-perforator-free-flap-reconstruction
#16
James Gatherwright, Rebecca Knackstedt, Amir Ghaznavi, Steven Bernard, Graham Schwarz, Andrea Moreira, Raffi Gurunluoglu, Risal Djohan
BACKGROUND: Effective postsurgical analgesia is a critical aspect of patient recovery. The goal of this prospective, randomized, controlled, blinded study was to examine the effect that liposomal bupivacaine delivered via a transversus abdominis plane (TAP) block has on pain control in women undergoing unilateral deep inferior epigastic perforator reconstruction. METHODS: IRB approval was granted for this prospective study. Patients were eligible if they were undergoing unilateral, delayed DIEP reconstruction...
March 15, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29746279/free-style-capillary-perforator-based-island-flaps-for-reconstruction-of-skin-cancer-defects-of-the-face-body-and-extremities
#17
Giuseppe Visconti, Marzia Salgarello
BACKGROUND: The perforator flap concept has revolutionized reconstructive surgery. Recently, the attention has moved toward flaps based on capillary perforators, which have been usually neglected in the past as reliable perforators. The aim of this article is to report a series of freestyle capillary perforator-based island flap (c-PBIF) for reconstruction of skin cancer defects of the face, body, and extremities. PATIENTS AND METHODS: Between September 2015 and July 2017, 20 consecutive patients underwent c-PBIF reconstruction of facial, body, and limb defects after melanoma and nonmelanoma skin cancer excision...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29746278/computed-tomographic-angiography-used-for-localization-of-the-cutaneous-perforators-and-selection-of-anterolateral-thigh-flap-bail-out-branches
#18
Anna K Steve, Colin P White, Ali Alkhawaji, Thomas E J Hayakawa, Edward W Buchel, Steven F Morris
BACKGROUND: The purpose of this study was to evaluate the territory supplied by the lateral circumflex femoral artery for the consistency of a proximal perforator that could be used as an alternative pedicle for the anterolateral thigh flap if a tedious intramuscular course is encountered during elevation of the perforator used to develop the initial surgical plan. It is hypothesized that a consistent "bail-out" perforator supplying the proximal thigh would facilitate a simpler anterolateral thigh flap harvest, with minimal modification to flap design...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29744524/-defect-coverage-using-gluteal-flaps
#19
REVIEW
T R Mett, M K Boyce, R Ipaktchi, P M Vogt
OBJECTIVE: Gluteal skin, fasciocutaneous and myocutaneous flaps can be used to cover decubitus ulcers in the sacral and ischiocrural area. INDICATIONS: Decubitus ulcers in the sacral or ischial area that do not heal after exhausted conservative therapy. CONTRAINDICATIONS: Moribund patients who are very likely to suffer a life-threatening complication. Non-cooperative patients who cannot follow the postoperative recommendations. The presence of extensive scars after previous operations in the donor area or irradiation of the donor area which may compromise the flap perfusion...
May 9, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29742652/the-use-of-a-honeycomb-technique-combined-with-ultrasonic-aspirators-and-indocyanine-green-fluorescence-angiography-for-a-superthin-anterolateral-thigh-flap-a-pilot-study
#20
Song Fan, Han-Qing Zhang, Qun-Xing Li, Tian Tian, Wei-Xiong Chen, Guo-Kai Pan, Michael Ho-Young Ahn, Sheng Sun, Bing-Hao Wu, Jin-Song Li
BACKGROUND: Harvesting an optimally thinned anterolateral thigh flaps (ALTFs) is a challenge in overweight individuals and in the Western population. Here, we describe a novel honeycomb technique to achieve a superthin ALTF in overweight patients. METHODS: Forty patients with a body mass index(BMI) >25 kg/m who required a thinned ALTF for reconstruction were randomly assigned to a honeycomb technique (HCT) group or a microdissection technique (MDT) group. Patients in the HCT group received cavitron ultrasonic surgical aspiration (CUSA) to thin the flaps, and flap thinning was performed with a conventional MDT in the MDT group...
May 2, 2018: Plastic and Reconstructive Surgery
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