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https://www.readbyqxmd.com/read/28799442/the-use-of-innervated-radial-artery-superficial-palmar-branch-perforator-free-flap-for-complex-digital-injuries-reconstruction
#1
Zhenglin Chi, Georgios Pafitanis, Luis Eduardo Parra Pont, Roshan Vijayan, Stefano Marcelli, Weiyang Gao, Zan Li, Xiao Zhou, Dajiang Song, Peng Yang
Loco-regional flaps have been widely used for the reconstruction of digital injuries without requiring microvascular anastomosis, however, they result in scarring and compromised functional outcomes. This study demonstrates our experience utilizing the innervated radial artery superficial palmar branch (RASPB) perforator free flap for complex digital injury reconstruction. From May 2007 to March 2014, the innervated RASPB perforator free flap was used to reconstruct 79 distal complex hand and digital soft tissue defects of which 14 were used to re-vascularise the distal digit in a flow-through fashion...
August 11, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28791454/-midcarpal-partial-arthrodesis-with-locking-plate-osteosynthesis
#2
REVIEW
J-F Hernekamp, U Kneser, T Kremer, B Bickert
OBJECTIVE: Preservation of residual mobility and pain reduction in the wrist in advanced carpal collapse (scapholunate advanced collapse, SLAC or scaphoid nonunion advanced collapse, SNAC). INDICATIONS: Advanced osteoarthritis of the radiocarpal and intercarpal articulations, SLAC/SNAC stages 2-3. CONTRAINDICATIONS: Arthrotic alterations to the proximal joint surface of the lunate bone or the corresponding joint surface of the radius (lunate fossa)...
August 8, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28774250/vascularized-spare-parts-reconstruction-of-hand-gunshot-injury
#3
Nathan Patrick, Alexander Payatakes
Reconstruction of extensive traumatic bone and soft tissue deficits in the hand often presents a significant challenge. We present a case of a gunshot wound managed with a resourceful "vascularized spare parts" reconstruction in which a single compromised digit provided two separate vascularized tissue transfers. A rarely reported pedicled phalanx restored osseous stability, a digital fillet flap achieved soft tissue coverage, and the flexor tendons reanimated the hand. An excellent functional and cosmetic result was obtained and the patient was able to return to manual labor within six months of injury...
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28767568/three-dimensional-virtual-planning-in-precise-chimeric-fibula-free-flap-for-metacarpal-defects-a-case-report
#4
Hui Shen, Xiang-Qian Shen, Ying Lv, Hui Lu, Jing-Hong Xu, Shou-Cheng Wu
RATIONALE: Metacarpal and phalanx defects with soft tissue loss were suggested to be reconstructed by vascularized bone flap. The fibular osteocutaneous flap is a preferred method. Three-dimensional virtual planning has successfully applied in mandibular reconstruction with fibular free flap. We applied three-dimensional virtual planning in precise fibula flap harvest to maintain the continuity of the fibula and to achieve accurate metacarpal and phalanx reconstruction. PATIENT CONCERNS: A 35-year-old male presented with extensive soft tissue defects and first metacarpal defect involving the first metacarpophalangeal joint...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28763908/-effects-of-flow-through-descending-branch-of-lateral-circumflex-femoral-artery-flap-on-repairing-high-voltage-electrical-burn-wounds-of-wrist-of-patients
#5
Y M Shen, X Chen, C Zhang, C Wang, F J Qin, C X Ma, X H Hu
Objective: To investigate the effects of flow-through descending branch of lateral circumflex femoral artery flap on repairing high-voltage electrical burn wounds of wrist of patients. Methods: From January 2014 to June 2016, 5 patients with high-voltage electrical burn of unilateral wrist were hospitalized in our burn ward, with extensive necrosis of skin soft tissue of burn wrist. Five patients were transferred to our burn ward 6 to 12 days post injury after undergoing emergency dermotomy of wrist to reduce tension in other hospitals...
July 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28754750/postoperative-gluteal-compartment-syndrome-following-microsurgical-free-flap-hand-reconstruction-the-importance-of-early-recognition-and-treatment
#6
Umran Sarwar, Jason Ting
Compartment syndrome, a surgical emergency, is caused by an increase in pressure within a closed osseofascial space, often due to trauma. This causes a decrease in tissue perfusion and ultimately tissue necrosis and multiorgan failure if not treated in a timely fashion. Gluteal compartment syndrome is a rare variant and often caused by a period of immobilisation secondary to intoxication with alcohol or drugs or during long operations, typically in the supine position. We report on a case of gluteal compartment syndrome developing in a patient postoperatively following a long microsurgical procedure to a hand, which has not been documented before...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28753228/use-of-arterialized-saphenous-vein-venous-flow-through-flaps-as-a-temporizing-measure-for-hand-salvage-in-contaminated-wounds-presenting-with-limb-ischemia-a-case-series
#7
Julian Diaz-Abele, Bauback Safa, Rudolf F Buntic, Avinash Islur
BACKGROUND: Vascular injuries resulting in limb ischemia are traditionally treated acutely with autologous or prosthetic bypass grafts. Traumatic contaminated injuries with soft tissue and vascular segmental loss are challenging as prosthetic bypasses are at risk of erosion, infection, and occlusion; and autologous bypasses are at risk of desiccation, blow-out, infection, and clotting. We propose a novel approach to these injuries by using arterialized saphenous vein venous flow-through free flaps (S-VFTF) as an autologous bypass, and present the results of its application in a series of cases...
July 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28746417/immunological-and-inflammatory-mapping-of-vascularized-composite-allograft-rejection-processes-in-a-rat-model
#8
Or Friedman, Narin Carmel, Meirav Sela, Ameen Abu Jabal, Amir Inbal, Moshe Ben Hamou, Yakov Krelin, Eyal Gur, Nir Shani
BACKGROUND: Hand and face vascularized composite allotransplantation (VCA) is an evolving and challenging field with great opportunities. During VCA, massive surgical damage is inflicted on both donor and recipient tissues, which may contribute to the high VCA rejection rates. To segregate between the damage-induced and rejection phase of post-VCA responses, we compared responses occurring up to 5 days following syngeneic versus allogeneic vascularized groin flap transplantations, culminating in transplant acceptance or rejection, respectively...
2017: PloS One
https://www.readbyqxmd.com/read/28745437/vascularized-ulnar-periosteal-pedicled-flap-for-forearm-reconstruction-anatomical-study-and-a-case-report
#9
Barrera-Ochoa Sergi, Velez Roberto, Rodriguez-Baeza Alfonso, De Bergua-Domingo Josep Maria, Knörr Jorge, Soldado Francisco
PURPOSE: Through an anatomical review, the aim of this study is to define the ulnar periosteal branches of the posterior interosseous vessels (PIV). In addition, we report the clinical utility of a vascularized ulnar periosteal pedicled flap (VUPPF), supplied by the investigated PIV, in a complex case of radial nonunion. METHODS: Ten upper limbs latex colored from fresh human cadavers were used. Branches of the PIV were dissected under 2.5× loupe magnification, noting the periosteal, muscular, and cutaneous branches arising distal to the interosseous recurrent artery...
July 26, 2017: Microsurgery
https://www.readbyqxmd.com/read/28720057/use-of-integra-in-the-management-of-complex-hand-wounds-from-cancer-resection-and-nonburn-trauma
#10
Michael Reynolds, David A Kelly, Nicholas J Walker, Clayton Crantford, Anthony J Defranzo
BACKGROUND: Despite extensive use of Integra in burn reconstruction, little has been published regarding its utility in complex hand wounds from nonburn trauma or cancer resection. This study aimed to review outcomes following Integra use for hand reconstruction following cancer resection or nonburn trauma with exposed bone, joints, and/or tendons. METHODS: Retrospective review was performed of patients undergoing hand reconstruction with Integra for exposed bones, joints, or tendons over a 6-year period at a single institution...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28713704/the-anterior-interosseus-artery-perforator-flap-anatomical-dissections-and-clinical-study
#11
Nikhil S Panse, Sheetal B Joshi, Parag B Sahasrabudhe, B Bahetee, Pradnya Gurude, Ajay Chandanwale
BACKGROUND: Reconstruction of upper extremity deformities continues to be a challenge to the reconstructive surgeon. Various loco regional, distant and free flaps are available for reconstruction. However, each has its own set of advantages and disadvantages. Of the commonly performed local flaps, radial artery forearm flap, and the posterior interosseus artery flap stand out prominently. Recently, perforator propeller flaps have been used for resurfacing the upper extremity. The anterior interosseus artery perforator flap is an uncommonly used and described flap...
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28693649/morphological-and-molecular-characterization-of-tarantobelus-arachnicida-gen-n-sp-n-nematoda-rhabditida-brevibuccidae-a-parasitic-nematode-of-tarantulas
#12
J Abolafia, R Peña-Santiago
A new genus and new species, Tarantobelus arachnicida, was found in the oral opening of tarantula spiders bred in captivity in Poland. The new species is characterized by having a small body (0.77-0.95 mm long in females and 0.66-0.84 mm in males), cuticle poorly annulated by transverse incisures, lateral field inconspicuous, lips separated with small cuticular flaps topping each lip, stoma panagrolaimoid with gymnostom well developed with robust and refringent rhabdia, pharynx panagrolaimoid with isthmus slightly longer than the basal bulb, intestine with cardiac (anterior) and rectal (posterior) areas with narrower walls...
July 11, 2017: Journal of Helminthology
https://www.readbyqxmd.com/read/28688798/place-of-the-reposition-flap-in-the-treatment-of-distal-amputations-of-the-fingers
#13
Mohamed Ali Sbai, Mayssa El M'chirgui, Riadh Maalla, Adel Khorbi
PURPOSE: Distal finger amputations pose a therapeutic problem with the distal fragment quality. Reimplantation remains the reference treatment for functional and aesthetic recovery of the hand. The interest of this study is to propose the reposition flap as an alternative to different hedging techniques in the proximal stump, in many situations where revascularization is impossible. It consists in osteosynthesis of the bone fragment and its coverage by a pedicled local flap. METHODS: The technique of reposition flap was evaluated retrospectively between 2003 and 2016 through a study of 13 patients compiled in Nabeul orthopedic department...
June 19, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28678689/a-clinical-approach-to-animal-bites-with-an-avulsion-flap-a-case-report
#14
Andrew Williamson, Cyril Thomas
INTRODUCTION: Animal bites are a common reason for visits to the Emergency Department in the US and worldwide. There are many different approaches to managing these wounds. CASE PRESENTATION: We present a case of a 90-year-old white woman who sustained a large dog bite to her hand, over the dorsal aspect of the first metacarpal. We used the avulsion flap as a biologic dressing and employed a perforating technique to successfully treat the wound and allow for optimal wound healing...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28673621/technical-points-of-5-free-vascularized-flaps-for-the-hand-repairs
#15
REVIEW
Jing Chen, Reena Bhatt, Jin Bo Tang
In this article, we present the experiences from Chinese microsurgeons on 5 less commonly used free vascularized flaps in hand reconstruction. In many units in China, these flaps have become the mainstays of treatment; they are routinely used for fingertip and thumb reconstruction. Their combined experience has demonstrated the reliability and versatility of these flaps for hand reconstruction, as well as their cosmetic value.
August 2017: Hand Clinics
https://www.readbyqxmd.com/read/28673620/microsurgical-flaps-in%C3%A2-repair-and-reconstruction-of-the-hand
#16
REVIEW
Shimpei Ono, Sandeep J Sebastin, Hiroyuki Ohi, Kevin C Chung
The authors' strategy for soft-tissue coverage of the hand is presented. The concept of replacing like with like and reconstruction with similar adjacent tissue enhances functional and aesthetic outcomes. In this viewpoint, the pedicle perforator flap is an ideal flap. A decision-making algorithm to select an ideal flap for a particular hand defect is challenging, requiring experiential consideration of functional outcome, appearance, donor-site morbidity, and patient satisfaction. To assist surgeons in determining the most appropriate flap with more evidence, studies are necessary to compare the outcomes of each flap by evaluating hand function, aesthetics, donor site morbidity, and patient satisfaction...
August 2017: Hand Clinics
https://www.readbyqxmd.com/read/28658139/computer-designed-surgical-guide-template-compared-with-free-hand-operation-for-mesiodens-extraction-in-premaxilla-using-trapdoor-method
#17
COMPARATIVE STUDY
Ying Kai Hu, Qian Yang Xie, Chi Yang, Guang Zhou Xu
The aim of this study was to introduce a novel method of mesiodens extraction using a vascularized pedicled bone flap by piezosurgery and to compare the differences between a computer-aided design surgical guide template and free-hand operation.A total of 8 patients with mesiodens, 4 with a surgical guide (group I), and 4 without it (group II) were included in the study. The surgical design was to construct a trapdoor pedicle on the superior mucoperiosteal attachment with application of piezosurgery. The bone lid was repositioned after mesiodens extraction...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28624042/wound-management-and-outcome-of-595-electrical-burns-in-a-major-burn-center
#18
Haisheng Li, Jianglin Tan, Junyi Zhou, Zhiqiang Yuan, Jiaping Zhang, Yizhi Peng, Jun Wu, Gaoxing Luo
BACKGROUND: Electrical burns are important causes of trauma worldwide. This study aims to analyze the clinical characteristics, wound management, and outcome of electric burns. METHODS: This retrospective study was performed at the Institute of Burn Research of the Third Military Medical University during 2013-2015. Data including the demographics, injury patterns, wound treatment, and outcomes were collected and analyzed. RESULTS: A total of 595 electrical burn patients (93...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28615807/soft-embalming-of-cadavers-for-training-purposes-optimising-for-long-term-use-in-tropical-weather
#19
Raghuveer Reddy, Subramania Iyer, Minnie Pillay, Krishnakumar Thankappan, Janarthanan Ramu
BACKGROUND: Surgical and anatomical training has been found to be most optimally simulated in a cadaver than any other available methods. Soft embalming methods have made the bodies more 'lifelike' and better suited for training. The widely accepted soft embalming techniques, including Thiel embalming, are designed for temperate climates. Their use in tropical locations has been found to be associated with poor short-term and long-term preservation of the bodies. In fact, adequate reports from tropical countries on effective methods for soft embalming are lacking...
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28607872/vascularized-fibula-based-physis-transfer-a-follow-up-study-of-longitudinal-bone-growth-and-complications
#20
Ronnie L Shammas, Yash J Avashia, Alfredo E Farjat, Anthony A Catanzano, L Scott Levin, William C Eward, Brian E Brigman, Detlev Erdmann
BACKGROUND: The vascularized free fibula epiphyseal transfer provides an option for the preservation of limb lengthening after resection of the proximal humerus in pediatric sarcoma patients. The purpose of this study was to provide a long-term follow-up of longitudinal growth patterns and outcomes after free fibula epiphyseal transfer in upper extremity reconstruction. METHODS: A retrospective review of 4 patients who underwent free fibula epiphyseal transfer after oncologic resection of the proximal humerus for osteosarcoma was performed...
May 2017: Plastic and Reconstructive Surgery. Global Open
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