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https://www.readbyqxmd.com/read/28925512/suprafascial-dissection-of-the-pedicled-groin-flap-a-safe-and-practical-approach-to-flap-harvest
#1
Mohamed Abdelrahman, Jonathan Zelken, Ren-Wen Huang, Chung-Chen Hsu, Chih-Hung Lin, Yu-Te Lin, Cheng-Hung Lin
BACKGROUND: The groin flap has been relied upon for more than 4 decades and is well suited for reconstruction of the mutilated hand. Classic groin flap harvest is subfascial and includes the superficial circumflex iliac artery (SCIA). SCIA perforator flaps have shown that one perforator is sufficient to supply a large flap without breaching fascia. Accordingly, we routinely preserve the fascia and rely wholly on the superficial branch of the SCIA, sparing the deep branch. We aim to investigate the safety of suprafascial flap elevation and encourage a paradigm shift in reconstruction with groin flap transfer...
September 19, 2017: Microsurgery
https://www.readbyqxmd.com/read/28925493/repair-and-sensory-reconstruction-of-the-children-s-finger-pulp-defects-with-perforator-pedicled-propeller-flap-in-proper-digital-artery
#2
S-M Feng, A-G Wang, Z-Y Zhang, Q-Q Sun, Y-L Tao, M-M Zhou, Y-J Hao
OBJECTIVE: This study was designed to investigate the clinical effects of adopting perforator pedicled propeller flap in the proper digital artery for treatment and sensory reconstruction of finger pulp defects in children. PATIENTS AND METHODS: Perforator pedicled propeller flap of proper digital arteries in thirty-one fingers from twenty-three children patients were selected for repairing the pulp defects on the 2nd to the 5th fingers. All cases were treated from September 2012 to December 2013...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28892973/large-eccrine-acrospiroma-of-the-hand
#3
Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj, Narayanamurthy Sundaramurthy, Vimal Chander Rajamanohar, Prabu Shankar Sivagnanam
Eccrine acrospiroma are benign skin tumours of sweat duct origin. They usually present as small solid or cystic lesions which are confused clinically with other solid or cystic lesions. These are generally benign lesions with few reports of malignant transformation. Here, we report a case of a middle aged female presenting with a swelling of the dorsum of left first web space which was histopathologically diagnosed as an eccrine acrospiroma, which was managed with surgical excision and covered with a regional flap...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28891897/simultaneous-reconstruction-of-both-facial-paralysis-and-temporomandibular-joint-ankylosis-with-a-composite-flap-from-dorsum-of-foot
#4
Osman Akdag, Seyda Guray Evin, Mehtap Karamese, Zekeriya Tosun
Free extensor digitorum brevis muscle flap in facial paralysis, and the second metatarsophalangeal joint flap is used at the temporomandibular joint reconstruction for a long time. Anatomically, these flaps can be harvested through even the same pedicle flap even on the same regions. Literature is available of their usage along with the use of hand and upper extremity reconstruction. Unlike this example, the authors have used these flaps in maxillofacial region where facial paralysis and temporomandibular joint reconstruction will be performed together...
September 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28873495/-defect-coverage-of-the-hand-using-a-rare-siamese-combined-flap
#5
Itai Pasternak, Urs Hug, Eva Meia Rüegg, Elmar Fritsche
We report 2 cases of extensive soft tissue defects simultaneously affecting the palm and dorsum of the hand. The defect was covered with a Siamese flap combination consisting of a free, distally extended lateral upper arm flap with microvascular anastomosis, and a posterior interosseous artery flap. We discuss possible indications, the operative technique and advantages versus disadvantages of this rarely applied flap combination.
September 5, 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28869456/perfusion-control-of-a-partial-revascularized-hand-via-application-of-indocyanine-green-icg-and-near-infrared-fluorescence-imaging
#6
C Strauss, E Brix, A Anker, L Prantl, V Brébant, T Aung
BACKGROUND: Intra- and postoperative assessment of perfusion with near-infrared fluorescence imaging is commonly used among plastic surgeons to evaluate the quality of a microsurgical anastomosis in free flaps. OBJECTIVE: As microsurgical anastomosis can be monitored with near-infrared fluorescence imaging there is potential concerning revascularized fingers and hands with soft tissue depths not exceeding 7 mm above anastomosis. In a case of a severe crush injury of the hand more information about the perfusion was necessary as clinical assessment suspected loss of perfusion...
August 28, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28865886/posterior-hypospadias-evaluation-of-a-paradigm-shift-from-single-to-staged-repair
#7
H Badawy, S Orabi, A Hanno, H Abdelhamid
INTRODUCTION: Repair of posterior hypospadias is a current dilemma. Single versus staged repair is the main question to answer. The answer is not easily reached due to lack of comparative studies. Hence such studies are not available, the reports of a change from one approach to the other one are important to point out the results of each procedure in the same hands and in the same center. Herein, we report our results of the repair of posterior hypospadias shifting from single stage to staged repair...
August 9, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28864313/toe-to-finger-combined-with-free-flap-transfer-for-primary-one-stage-post-traumatic-reconstruction-of-the-complex-fingerless-hand
#8
Hua Chen, Chaoyin Jiang, Yaozeng Xu, Yangbai Sun
Toe-to-finger transplantation is intimately related to the development of microsurgical free tissue transplantation, which is one of the most important advances in the history of reconstructive surgery. It is also generally acknowledged that a mangled hand with massive tissue loss and amputation of multiple digits presents a challenge for plastic and reconstructive surgeons. In this retrospective study we reviewed 11 cases of primary one-stage post-traumatic reconstruction of complex fingerless hands using a combination of toe-to-finger and free tissue transplantation performed in Shanghai Jiao Tong University affiliated Sixth People's Hospital and Shanghai Jiao Tong University School of Medicine affiliated Ninth People's Hospital from January 2001 to November 2014...
August 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28840677/microsurgical-reconstruction-in-limb-salvage-due-to-a-giant-cell-tumor-of-the-distal-radius-case-report
#9
L J Sánchez-Torres, M L de la Parra-Márquez, A M Cruz-Escalante, R Ramírez-Barroso, A Espinoza-Velazco
The giant cell tumor of bone is one of the most controversial neoplasms due to growth patterns that may present. The case reported shows a very aggressive tumor in a classic location, but key to hand function. Rather than treat with radical surgery, was planned and performed a wide resection with an ulnar-carpus arthrodesis and microsurgical reconstruction of the defect throught an anterolateral thigh flap. The multidisciplinary approach of bone neoplasms produce a positive impact on patients.
March 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28820839/smaller-diameter-anastomotic-coupling-devices-have-higher-rates-of-venous-thrombosis-in-microvascular-free-tissue-transfer
#10
Summer E Hanson, Matthew B Mitchell, Nihanth Palivela, S Andrew Peng, Lei Feng, Rene D Largo, Charles E Butler, Patrick B Garvey
BACKGROUND: Smaller anastomotic coupling devices may increase the risk of complications in free flap reconstructions; however, the relationship between coupler size and venous thrombosis rates has not been adequately evaluated. We hypothesized that smaller-diameter coupling devices are associated with higher rates of venous thrombosis than larger diameter devices in free tissue transfer. METHODS: We retrospectively reviewed data prospectively entered into a central departmental database for all patients who underwent microsurgical free tissue transfer at our institution in 2001-2013...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28820834/super-thin-scip-flap-for-reconstruction-of-subungual-melanoma-aesthetic-functional-surgery
#11
Kyeong-Tae Lee, Bo Young Park, Eun-Ji Kim, Jung-Han Kim, Kee-Taek Jang, Sang-Hee Choi, Dong-Youn Lee, Goo-Hyun Mun
BACKGROUND: This study aimed to use a super-thin, free superficial circumflex iliac artery perforator (SCIP) flap in the functional surgery for treating subungual melanoma and to evaluate its outcomes. METHODS: Forty-one patients with primary subungual melanoma of ≤ 2-mm thickness who were treated with functional surgery were prospectively enrolled. Following oncologic resection, a thin SCIP flap was harvested along the trans-superficial fat layer and transferred to the defect with further thinning by primary defatting...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28816489/the-path-to-an-autism-spectrum-disorders-diagnosis-in-ethiopia-parent-perspective
#12
Waganesh A Zeleke, Tammy Hughes, Morgan Chitiyo
This study explores the common characteristics of children with autism spectrum disorders (ASDs) and the available diagnostic and intervention currently practiced for children with ASDs in Ethiopia based on parents' experience. Data gathered from 100 parents in Ethiopia detail the difficulties families face when they suspect their child has an autism spectrum disorder (ASD). The data indicate Ethiopian parents pursued a diagnosis of ASD after noting common ASD behaviors such as hand flapping and unusual attachments to objects...
August 17, 2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28799442/the-use-of-innervated-radial-artery-superficial-palmar-branch-perforator-free-flap-for-complex-digital-injuries-reconstruction
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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