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perforator flap

Andreas M Fichter, Lucas M Ritschl, Luisa K Robitzky, Stefan Wagenpfeil, David A Mitchell, Klaus-Dietrich Wolff, Thomas Mücke
The effects of antithrombotic drugs on random and free flap survival have been investigated in the past, but the experimental and clinical results are not in agreement. A perforator-based critical ischaemia model was used to evaluate the effects of different perioperatively administered pharmaceutical agents on tissue ischaemia and to assess the potential additional haemorheological or vasodilative effects of antithrombotics on flap microcirculation. Combined laser Doppler flowmetry and remission spectroscopy revealed an increase in certain microcirculation parameters in most groups in comparison with saline controls, and these changes correlated with flap survival...
October 21, 2016: Scientific Reports
Michele Antonio De Riggi, Nicola Rocco, Giulio Gherardini, Emanuela Esposito, Massimiliano D'Aiuto
INTRODUCTION: One-stage implant-based breast reconstruction using titanium-coated polypropylene mesh is a novel approach widely used in Europe. Complication rates in breast reconstruction with the use of titanium-coated meshes seem to be comparable to those in patients with implant-based breast reconstruction alone. However, the use of synthetic meshes in implant-based breast reconstructive surgery leads to new clinical scenarios with the need for the breast surgeon to face new complications...
October 20, 2016: Aesthetic Plastic Surgery
Kun Hwang
The aim of this paper was to review the origins and history of deltopectoral flaps and the pectoralis major myocutaneous flap.The first published paper on the deltopectoral flap was written by Aymard in 1917. He described raising a medially based fasciocutaneous flap from the shoulder skin, which was then tubed and used for staged nasal reconstruction. Conley introduced the laterally based deltopectoral flap, which was supplied by the lateral thoracic and thoracocranial branches. Bakamjian used a medially based deltopectoral flap for pharyngoesophageal reconstruction; this was an axial flap based medially on the intercostal perforating vessels of the internal mammary artery...
October 2016: Journal of Craniofacial Surgery
Rei Ogawa, Shimpei Ono, Satoshi Akaishi, Teruyuki Dohi, Takeshi Iimura, Junichi Nakao
: It is difficult to completely resect huge anterior chest wall keloids and then close the wound directly. We report here our retrospective analysis of our case series of patients with such keloids who underwent reconstruction with internal mammary artery perforator (IMAP) pedicled propeller flaps and then received postoperative high-dose-rate superficial brachytherapy. METHODS: All consecutive patients with large/severe keloids on the anterior chest wall who underwent keloid resection followed by reconstruction with IMAP-pedicled propeller flaps and then high-dose-rate superficial brachytherapy in our academic hospital were identified...
September 2016: Plastic and Reconstructive Surgery. Global Open
Nidal Farhan Al Deek, Donald H Lalonde
Fu-Chan Wei is a world-renowned plastic and reconstructive surgeon. He is clearly one of the most influential and innovative surgeons in the history of plastic surgery. The Taiwanese legend is the innovator of the osteoseptocutaneous fibula flap, which revolutionized the reconstruction of composite bone and soft tissue defects in the jaw and extremities. He has pioneered several perforator flaps, including the free style variety. He has taken toe-to-hand microsurgical transplantation to a whole new level. He is not only recognized for his surgical skills and clinical innovations, but also for his vision, leadership, and teaching...
September 2016: Plastic and Reconstructive Surgery. Global Open
Chairat Burusapat, Tirapat Nanasilp, Paiboon Kunaphensaeng, Anuchit Ruamthanthong
: The anterolateral thigh (ALT) flap has been widely used for reconstructions. Nevertheless, the atherosclerotic risk factors that affect the lateral circumflex femoral artery (LCFA) are still inconclusive. The aim was to study the effect of atherosclerosis on the LCFA and descending branch (dLCFA) visualized by computer tomographic angiography (CTA) between nonatherosclerosis and atherosclerosis. METHODS: Retrospective studies of CTA of lower extremity were reviewed...
September 2016: Plastic and Reconstructive Surgery. Global Open
Chad M Teven, Julie Mhlaba, Annemarie O'Connor, Lawrence J Gottlieb
The majority of surgical burn care involves the use of skin grafts. However, there are cases when flaps are required or provide superior outcomes both in the acute setting and for postburn reconstruction. Rarely discussed in the context of burn care, the perforator-based propeller flap is an important option to consider. We describe our experience with perforator-based propeller flaps in the acute and reconstructive phases of burn care. We reviewed demographics, indications, operative details, and outcomes for patients whose burn care included the use of a perforator-based propeller flap at our institution from May 2007 to April 2015...
October 7, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
So-Eun Han, Eun-Ji Kim, Hyun Hwan Sung, Jai-Kyong Pyon
BACKGROUND: Reconstruction of extensive penoscrotal defects is a surgical challenge. Resurfacing defects in highly complex three-dimensional structures and restoring their function are an essential part of the reconstruction of penoscrotal regions. OBJECTIVE: We describe a technique using internal pudendal artery perforator (IPAP) pedicled propeller flaps created from the gluteal fold. This could be a reliable surgical option that maintains a natural looking scrotal pouch with minimal donor site morbidity and optimal sexual activity...
October 12, 2016: European Urology
Kristen S Higgins, Joshua Gillis, Jason G Williams, Martin LeBlanc, Michael Bezuhly, Jill M Chorney
Clinical experience suggests that flap failure after autologous breast reconstruction can be a devastating experience for women. Previous research has examined women's experiences with autologous breast reconstruction with and without complications, and patients' experiences with suboptimal outcomes from other medical procedures. The authors aimed to examine the psychosocial experience of flap failure from the patient's perspective. Seven women who had experienced unilateral flap failure after deep inferior epigastric perforator flap surgery in the past 12 years completed semistructured interviews about their breast cancer treatments, their experiences with flap failure, the impact of flap failure on their lives, and the coping strategies they used...
October 6, 2016: Annals of Plastic Surgery
Arzu Ozcan Akcal, Kerim Ünal, Tahsin Gorgulu, Mehmet Akif Akcal, Zekiye Bigat
In this report we present two cases of gunshot injury related midfoot defects, reconstructed with a chimeric partial scapula and latissimus dorsi muscle flap and short perforator-based skin flap. The first case, a 14 years old male, had 10 × 8 cm medial plantar and 6 × 4 cm dorsal foot defects and the second case, a 55 years old female, had only 8 × 6 cm dorsal foot defect. In both cases the defects were associated with fractures, one with lateral cuneiform and cuboid with 90% bone loss and the other with navicular bone, respectively...
October 2016: Microsurgery
Isaac Zilinsky, Detlev Erdmann, Oren Weissman, Niels Hammer, Mircea-Constantin Sora, Thilo L Schenck, Sebastian Cotofana
The anatomical basis for auricular flaps used in multiple aesthetic and reconstructive procedures is currently based on a random distribution of the underlying arterial network. However, recent findings reveal a systematic pattern as opposed to the present concepts. Therefore, we designed this study to assess the arterial vascular pattern of the auricle in order to provide reliable data about the vascular map required for surgical interventions. Sixteen human auricles from eight body donors (five females/three males, 84...
October 11, 2016: Journal of Anatomy
Semih Baghaki, Murat Diyarbakirlioglu, Ugur Sahin, Muge Anil Kucuksucu, Akif Turna, Bilgi Baca, Yağmur Aydın
Besides conventional flaps, intercostal artery perforator flaps have been reported to cover trunk defects. In this report the use of anterior intercostal artery perforator (AICAP) flap, lateral intercostal artery perforator (LICAP) flap and dorsal intercostal artery perforator (DICAP) flap for thoracic, abdominal, cervical, lumbar and sacral defects with larger dimensions and extended indications beyond the reported literature were reevaluated. Thirty-nine patients underwent surgery between August 2012 and August 2014...
October 5, 2016: Microsurgery
Zaher Jandali, Martin C Lam, Kiomars Aganloo, Benedikt Merwart, Jouke Buissink, Klaus Müller, Lucian P Jiga
BACKGROUND: The medial sural artery perforator (MSAP) flap shows advantages for reconstruction in the foot and ankle, where bulk is a liability. We evaluated the versatility of this flap and provide further evidence on its use for covering small-to-moderate size defects by comparing the outcome depending on the region of reconstruction. METHODS: Twenty-two patients with variable defects of 4 × 4 to 18 × 7 cm underwent MSAP flap reconstruction. Final outcomes of all patients were evaluated 12-months postoperatively using the AOFAS ankle-hindfoot, midfoot and hallux scale for clinical-functional evaluation, and the SF-36 health survey for quality-of-life measurement...
October 5, 2016: Microsurgery
I-Han Chiang, Chia-Chun Wu, Shyi-Gen Chen, Chih-Hsin Wang
Soft tissue defects exposing the patellar tendon or bone are common in patients who have experienced trauma or implant infection. The purpose of this article is to present our experience of six patients who underwent reconstruction of soft tissue defects of the knee using a pedicled medial sural perforator flap. Between November 2013 and November 2015, six patients who presented with a soft tissue defect overlying the knee were admitted to our hospital. After adequate debridement or wide excision of the tumour, these patients underwent pedicled medial sural perforator flap placement to resurface the complex soft tissue defects and to provide a gliding surface for the exposed patellar tendon...
October 3, 2016: International Wound Journal
Funda Tamer, Esra Adışen, Serhan Tuncer, Mehmet A Gurer
Pyoderma gangrenosum is a chronic inflammatory disease characterized by painful cutaneous ulcers. The etiology remains unknown; however, pyoderma gangrenousm can be triggered by surgery. Here we report the case of a 34-year-old Caucasian female that developed pyoderma gangrenosum following deep inferior epigastric perforator flap breast reconstruction. The patient was successfully treated with systemic immunosuppressive therapy and primary closure.
September 2016: Acta Dermatovenerologica Alpina, Panonica, et Adriatica
K J Lee, S H Lee, M B Kim, Y H Lee
PURPOSE: We report the clinical outcome after coverage for soft-tissue defect on the medial foot and ankle with an adipofascial fold-down flap based on the posterior tibial artery perforator branch proximal to the defect. MATERIALS: Nine patients (five males and four females) with soft-tissue defects on the medial foot and ankle area underwent the procedure from March 2009 to May 2014. The average age of the patients was 54 years (range, 8-82). The pivot point of transposition of this flap is the posterior tibial artery perforator proximal to the defect...
September 8, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Michael W Chu, Julia A Cook, Alexes Hazen
No abstract text is available yet for this article.
September 2016: Archives of Plastic Surgery
Seung Woo Cho, Hak Chang, Sung Tack Kwon
Extramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial malignancy that mainly involves the genital region, including the vulva, penis, scrotum, perianal, and periurethral areas. Although several treatment options exist, wide local excision with a safe margin is considered the treatment of choice. After resection of the lesion, it is often challenging to reconstruct the defect because defects in the perineal region require adequate volume for protection and are susceptible to infections, which is a particularly significant risk for large defects...
September 2016: Archives of Plastic Surgery
Keith S Hansen, Luke G Gutwein, Brett C Hartman, Rajiv Sood, Juan Socas
Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments...
September 2016: Archives of Plastic Surgery
Ki Wook Sung, Won Jai Lee, In Sik Yun, Dong Won Lee
BACKGROUND: Perineal defects are commonly encountered during the treatment of conditions such as malignancy, infectious disease, and trauma. Covering large defects in the perineal area is challenging due to its complicated anatomy and the need for functional preservation. METHODS: Fourteen patients who underwent reconstructive surgery with multiple perforator flaps for defects >100 cm(2) in the perineal area were included in this retrospective cohort study. Characteristics of the perforator flap operation and postoperative outcomes were reviewed...
September 2016: Archives of Plastic Surgery
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