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https://www.readbyqxmd.com/read/27914123/extending-the-indications-for-autologous-breast-reconstruction-using-a-two-stage-modified-goldilocks-procedure-a-case-report
#1
Jean-Claude D Schwartz, Piotr P Skowronksi
Post-mastectomy reconstruction is performed using implant-based or autologous techniques. Many women refuse or are poor candidates for implant-based reconstruction. We previously described a single-stage autologous technique that was most applicable in obese women with significant ptosis that made use of the mastectomy skin flap and subcutaneous tissue to reconstruct a breast mound. Here, we extend this technique to smaller breasted women by incorporating a second stage of skin tailoring and fat grafting. This technique does not require donor site surgery nor extended operative and recovery times...
December 3, 2016: Breast Journal
https://www.readbyqxmd.com/read/27913755/applications-of-three-dimensional-printing-in-surgery
#2
REVIEW
Chi Li, Tsz Fung Cheung, Vei Chen Fan, Kin Man Sin, Chrisity Wai Yan Wong, Gilberto Ka Kit Leung
Three-dimensional (3D) printing is a rapidly advancing technology in the field of surgery. This article reviews its contemporary applications in 3 aspects of surgery, namely, surgical planning, implants and prostheses, and education and training. Three-dimensional printing technology can contribute to surgical planning by depicting precise personalized anatomy and thus a potential improvement in surgical outcome. For implants and prosthesis, the technology might overcome the limitations of conventional methods such as visual discrepancy from the recipient's body and unmatching anatomy...
December 2, 2016: Surgical Innovation
https://www.readbyqxmd.com/read/27913719/surgical-site-infections-in-major-head-and-neck-surgeries-involving-pedicled-flap-reconstruction
#3
Neerav Goyal, Bharat B Yarlagadda, Daniel G Deschler, Kevin S Emerick, Derrick T Lin, Debbie L Rich, James W Rocco, Marlene L Durand
OBJECTIVE: To evaluate surgical site infections (SSI) after pedicled reconstruction in head and neck surgery. METHODS: Records of patients with pedicled flap reconstructions between 2009 and 2014 at Massachusetts Eye and Ear were reviewed. Onset of SSI or fistula ≤30 days postoperatively was noted. A free flap cohort was reviewed for comparison. RESULTS: Two hundred and eight pedicled reconstructions were performed for cancer (83%), osteoradionecrosis (7%), and other reasons (10%)...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27913340/efficient-3d-reconstruction-in-ultrasound-elastography-via-a-sparse-iteration-based-on-markov-random-fields
#4
Atul Ingle, Tomy Varghese, William Sethares
Percutaneous needle-based liver ablation procedures are becoming increasingly common for treatment of small isolated tumors in hepatocellular carcinoma patients who are not candidates for surgery. Rapid three dimensional visualization of liver ablations has potential clinical value because it can enable interventional radiologists to plan and execute needle-based ablation procedures with real time feedback. Ensuring the right volume of tissue is ablated is desirable to avoid recurrence of tumors from residual untreated cancerous cells...
November 29, 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/27913089/a-combined-one-stage-surgical-approach-of-orbital-tumor-debulking-lid-reconstruction-and-ptosis-repair-in-children-with-orbitotemporal-neurofibromatosis
#5
Shay Keren, Gad Dotan, Ran Ben-Cnaan, Leah Leibovitch, Igal Leibovitch
BACKGROUND AND AIM: To describe a series of children with neurofibromatosis type 1 (NF1) and a plexiform neurofibroma of the orbit with ptosis who underwent a combined one-stage surgery for tumor debulking, lid reconstruction, and ptosis repair. METHODS: A retrospective review of 6 cases of combined one-step surgeries for orbital plexiform neurofibroma with ptosis. RESULTS: The study included 6 children (4 boys, mean age 3.4 years). Follow-up time was at least 9 months...
November 11, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27912972/fate-of-males-with-urethral-y-duplication-40-year-long-follow-up-in-8-patients
#6
Mario Lima, Francesca Destro, Neil Di Salvo, Tommaso Gargano, Giovanni Ruggeri
PURPOSE: The spectrum of male urethral duplication is heterogeneous and it includes the Y-duplication. The malformation is rare and there is only a few case series reported in the literature. The management of Y-forms remains challenging for the surgeon and the long-term follow-up is still scarcely investigated. We report our 40-year experience in the management of patients with Y-duplication. MATERIALS AND METHODS: We conducted a restrospective analysis collecting information of patients with urethral Y-duplication treated at our department from April 1975 to April 2015...
November 17, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27912929/survival-failure-modes-and-function-of-combined-distal-femur-and-proximal-tibia-reconstruction-following-tumor-resection
#7
F Sevelda, W Waldstein, J Panotopoulos, C Stihsen, A Kaider, P T Funovics, R Windhager
BACKGROUND: Tumor spread to the knee joint or skip metastasis to the adjacent bones of the knee require reconstruction with combined distal femur and proximal tibia replacements. The literature on implant survival and failure modes with this type of reconstruction is sparse. The goals of this study were to determine the implant survival, the different failure modes and the functional outcome of this megaendoprosthetic reconstruction. PATIENTS AND METHODS: Thirty-nine patients with combined distal femur and proximal tibia reconstruction were retrospectively reviewed...
November 23, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27912031/three-dimensional-reconstruction-of-preoperative-imaging-improves-surgical-success-in-laparoscopy
#8
Tobias Simpfendörfer, Ziyao Li, Claudia Gasch, Frederik Drosdzol, Markus Fangerau, Michael Müller, Lena Maier-Hein, Markus Hohenfellner, Dogu Teber
PURPOSE: To show the benefit of three-dimensional (3D) reconstructions of preoperative imaging for surgical performance. METHODS: A laparoscopic training environment with 15 hidden lymph nodes was designed. Three of them were marked with radiographic contrast agent and were only distinguishable from unmarked nodes via CT imaging. Thirty-six surgeons were divided into two groups. To group 1 the unprocessed CT data were shown. Group 2 was additionally shown a 3D reconstruction of the anatomy...
December 2, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27911904/dressing-wear-time-after-breast-reconstruction-a-randomized-clinical-trial
#9
Daniela Francescato Veiga, Carlos Américo Veiga Damasceno, Joel Veiga-Filho, Luiz Francisley Paiva, Fernando Elias Martins Fonseca, Isaías Vieira Cabral, Natália Lana Larcher Pinto, Yara Juliano, Lydia Masako Ferreira
BACKGROUND: The evidence to support dressing standards for breast surgery wounds is empiric and scarce. OBJECTIVE: This two-arm randomized clinical trial was designed to assess the effect of dressing wear time on surgical site infection (SSI) rates, skin colonization and patient perceptions. METHODS: A total of 200 breast cancer patients undergoing breast reconstruction were prospectively enrolled. Patients were randomly allocated to group I (dressing removed on the first postoperative day, n = 100) or group II (dressing removed on the sixth postoperative day, n = 100)...
2016: PloS One
https://www.readbyqxmd.com/read/27909972/can-we-estimate-short-and-intermediate-term-survival-in-patients-undergoing-surgery-for-metastatic-bone-disease
#10
Jonathan A Forsberg, Rikard Wedin, Patrick J Boland, John H Healey
BACKGROUND: Objective means of estimating survival can be used to guide surgical decision-making and to risk-stratify patients for clinical trials. Although a free, online tool ( www.pathfx.org ) can estimate 3- and 12-month survival, recent work, including a survey of the Musculoskeletal Tumor Society, indicated that estimates at 1 and 6 months after surgery also would be helpful. Longer estimates help justify the need for more durable and expensive reconstructive options, and very short estimates could help identify those who will not survive 1 month and should not undergo surgery...
December 1, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27909861/surgical-reconstruction-for-fibular-hemimelia
#11
REVIEW
Dror Paley
Fibular hemimelia presents with foot deformity and leg length discrepancy. Previous classifications have focused on the degree of fibular deficiency rather than the type of foot deformity. Published methods of surgical reconstruction have often failed due to residual or recurrent foot deformity. The purpose of this report is to introduce new classification and reconstruction methods. The Paley SHORDT procedure is used to stabilize the ankle when there is a hypoplastic distal fibula with a dynamic valgus deformity...
December 1, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909667/arthroscopic-capsular-reconstruction-of-the-hip-with-acellular-dermal-extracellular-matrix-surgical-technique
#12
Itay Perets, David E Hartigan, John P Walsh, Edwin Chaharbakhshi, Mary R Close, Benjamin G Domb
Atraumatic instability of the hip has become an increasingly studied occurrence in recent years. There are several established surgical techniques that help restore stability of the native hip joint. In some cases, these procedures are not an option. As the phenomenon has become recognized more frequently, a greater number of revision surgeries are warranted in patients with ligamentous laxity. A durable solution for irreparable microinstability needs to be formulated to address this vulnerable patient demographic...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27908374/effect-of-lichen-sclerosis-on-success-of-urethroplasty
#13
REVIEW
Michael A Granieri, Andrew C Peterson, Ramiro J Madden-Fuentes
Lichen sclerosis (LS) is a chronic, relapsing disease with a variable presentation. In men, genitourinary LS may affect the penile foreskin, glans, meatus, and urethra. Treatment is multifaceted, ranging from pharmacotherapy to surgery. Urethral reconstruction due to stricture disease from LS is frequently plagued by a high recurrence rate. At the authors' institution, the high recurrence rate has shifted their practice toward potent steroids and minimally invasive surgical techniques. Management of recurrence includes dilation, meatotomy/meatoplasty, 1-stage and 2-stage repairs...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908368/endoscopic-treatment-of-urethral-stenosis
#14
REVIEW
Brittney H Cotta, Jill C Buckley
Urethral stricture disease continues to be a common problem for patients and urologists alike. Endoscopic treatment offers a simple, potentially effective treatment of primary, short, urethral strictures. For patients who recur after endoscopic management, urethral or bladder neck reconstruction should be offered with an experienced urologic reconstructionist familiar with the complexity of the situation and subtleties of the surgery. With the advent of adjunctive antifibrotic agents the durability of endoscopic repair seems to improve, but their use requires continued research and longer follow-up to determine their efficacy...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27906082/secondary-correction-of-nasal-deformities-in-cleft-lip-and-palate-patients-surgical-technique-and-outcome-evaluation
#15
Gabor Vass, Gabor Mohos, Zsofia Bere, Laszlo Ivan, Janos Varga, Jozsef Piffko, Laszlo Rovo
BACKGROUND: Nasal deformity associated with cleft lip and palate is a highly challenging reconstructive problem in rhinoplasty. In the literature, several operative solutions and evaluation methods have been described, however these do not offer a standard procedure for the surgeon. Our aim was to standardize our surgical technique-as much as the uniqueness of each case allowed it-based on the most frequent deformities we had faced; and to evaluate our results via a postoperative patient satisfaction questionnaire...
December 1, 2016: Head & Face Medicine
https://www.readbyqxmd.com/read/27905181/effectiveness-of-collagen-oxidised-regenerated-cellulose-silver-containing-composite-wound-dressing-for-the-treatment-of-medium-depth-split-thickness-skin-graft-donor-site-wounds-in-multi-morbid-patients-a-prospective-non-comparative-single-centre-study
#16
Alexander Konstantinow, Tatjana V Fischer, Johannes Ring
Split-thickness skin grafting (STSG) is a widely used method in reconstructive surgery, but donor site wounds (DSWs) are often slow healing and painful. This prospective study evaluated the performance of a composite wound dressing containing collagen/oxidised regenerated cellulose in the treatment of medium-depth (0·4 mm) DSWs in 25 multi-morbid patients with chronic leg ulcers requiring STSG. The range of patients' ages was 44-84 years (mean 71·6 years) with DSW sizes ranging between 12 and 162 cm(2) (mean 78 cm(2) )...
December 1, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27904933/-metastatic-disease-in-long-bones-review-of-surgical-treatment-options
#17
Franz Liska, Philipp Schmitz, Norbert Harrasser, Peter Prodinger, Hans Rechl, Rüdiger von Eisenhart-Rothe
Surgery in metastatic bone disease is currently the most frequent type of surgery in orthopedic oncology. Improved survival rates and an increasing incidence of bone metastasis have led to an increase in complications caused by metastatic disease, such as pathological fractures or hardware failure after operative treatment. Although surgery of metastatic lesions remains a palliative therapy concept, because of sufficient therapy for the primary carcinomas, tumor-specific-oriented follow-up protocols and a variation in the prognosis for the individual entities, an individually adapted treatment strategy is necessary...
November 30, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27904843/cardiac-surgery-in-africa-a-thirty-five-year-experience-on-open-heart-surgery-in-cote-d-ivoire
#18
Koffi Herve Yangni-Angate, Christophe Meneas, Florent Diby, Manga Diomande, Anicet Adoubi, Yves Tanauh
BACKGROUND: Few centers for open heart surgery (OHS) are in Sub-Saharan Africa. Lack of OHS results is also noted. By reporting our African experience on OHS, the aim of this study was to fill the gap. METHODS: It is a retrospective study on 2,612 patients who were subject to an OHS between 1978 and 2013. Data were collected from demographical, clinical, investigative studies, surgical and outcomes parameters. RESULTS: There were 1,475 cases of rheumatic heart diseases (RHD), 126 endomyocardial fibrosis (EMF), 741 congenital heart diseases (CHDs) and 270 various affections...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27904730/intramedullary-nailing-for-pathological-fractures-of-the-proximal-humerus
#19
Eun-Seok Choi, Ilkyu Han, Hwan Seong Cho, In Woong Park, Jong Woong Park, Han-Soo Kim
BACKGROUND: Endoprosthetic reconstruction is widely applied for pathological fractures of the proximal humerus; however, functional impairment is usually unsatisfactory. The aims of the current study are to evaluate the reliability of interlocking intramedullary (IM) nailing with cement augmentation as a fixation method in proximal humeral lesions and to assess functional outcomes. METHODS: We reviewed 32 patients with pathological fractures of the proximal humerus who underwent interlocking IM nailing and cement augmentation...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27904728/reconstruction-of-postburn-contracture-of-the-forefoot-using-the-anterolateral-thigh-flap
#20
Sang Hyun Lee, Sung Jin An, Nu Ri Kim, Um Ji Kim, Jeung Il Kim
BACKGROUND: Severe forefoot deformities, particularly those involving the dorsum of the foot, cause inconvenience in daily activities of living including moderate pain on the dorsal aspect of the contracted foot while walking and difficulty in wearing nonsupportive shoes due to toe contractures. This paper presents clinical results of reconstruction of severe forefoot deformity using the anterolateral thigh (ALT) free flap. METHODS: Severe forefoot deformities were reconstructed using ALT flaps in 7 patients (8 cases) between March 2012 and December 2015...
December 2016: Clinics in Orthopedic Surgery
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