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Flaps and grafts

Danny Mangual, Luis A Bisbal-Matos, Ricardo Jiménez-Lee, Román Vélez, Miguel Noy
The case of a 27-year-old Hispanic female who presented with an occipito-parietal tumor after suffering trauma to the area. A physical examination revealed no tenderness to palpation and with evidence of healing ulcerations. The biopsy was consistent with a synovial sarcoma. A wide excision of the mass (15cm x 14cm x 6cm) followed by a pericranial flap was performed. A follow-up CT showed recurrence involving the parietal sagittal sinus. After a second biopsy the mass was determined to be a small-cell sarcoma, consistent with Ewing's sarcoma...
March 2018: Puerto Rico Health Sciences Journal
Stephen Honeybul, David Anthony Morrison, Kwok M Ho, Christopher R P Lind, Elizabeth Geelhoed
OBJECTIVE: To compare the long-term outcomes of patients who had been randomly allocated to receive primary titanium cranioplasty or autologous bone graft following decompressive craniectomy. METHODS: Sixty-four patients had been previously enrolled and randomised to receive either their own bone graft or a primary titanium cranioplasty. Functional and cosmetic outcomes had previously been assessed at 1-year following the cranioplasty procedure. Hospital records and the Picture Archiving communication system were reviewed to determine how many patients had cranioplasty failure or associated complications such as seizures beyond 1 year-with a minimum of 24-month follow-up...
March 15, 2018: Acta Neurochirurgica
Sheng Yan, Hangyan Shi, Da Chen, Jincai Guo, Yi Sun, Sufan Wu
The reconstruction of large full-thickness scalp defects remains a surgical challenge, especially when the skull is exposed completely without periosteum. Surgical technique options for wound coverage have included tissue expansion, skin grafting, local or regional flaps, and microvascular free tissue transfer. In recent years, some authors have reported to use biological material as an alternative for repairing complex wounds. The authors report the successful reconstruction of a large defect with bare skull in bilateral temporal regions of a 3-year-old child...
March 14, 2018: Journal of Craniofacial Surgery
Dorothee Boehm, Konstantin Bergmeister, Emre Gazyakan, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
AIMS: Reconstruction of breasts and chest wall deformities in female patients after severe burn injury is a challenge for reconstructive surgeons. In these patients, neither implant-based procedures nor standard free flaps are sometimes applicable because of limited skin quality and unavailability of donor sites at the abdomen, back, buttock, or medial thigh. METHODS: We present a case of a young female patient with a history of 80 % total body surface area burn after electric high-voltage injury...
March 13, 2018: Annals of Plastic Surgery
Leonardo Trombelli, Anna Simonelli, Luigi Minenna, Giulio Rasperini, Roberto Farina
BACKGROUND: In the attempt to limit the post-surgery increase in buccal gingival recession (bREC), effect of a connective tissue graft (CTG) when combined with a buccal single flap approach (SFA) in the regenerative treatment of intraosseous defects is evaluated. METHODS: Data related to 30 patients with an intraosseous defect treated with a buccal SFA with (SFA+CTG group; n = 15) or without (SFA group; n = 15) placement of a CTG and regenerative treatment were retrospectively derived at three clinical centers...
April 2017: Journal of Periodontology
Ahmed Y Gamal, Khaled A Abdel-Ghaffar, Mohamed G Zouair, Mohamed H Salama, Mahmoud T El Destawy
BACKGROUND: Since it is important to establish and maintain a firm blood clot to the surrounding tissues within the intrabony lesion; we have to investigate the potentials of different materials in resisting clot retraction that disrupt clot adhesion to the root surface. This study was designed to measure the gap distance created by clot retraction within the defect following intrabony defects grafting with and without root surface EDTA etching. METHODS: Eight mongrel dogs with surgically created acute-chronic bilateral mandibular interproximal intrabony defects in the premolar-molar areas were enrolled in this study (total 8 defects per dog)...
March 14, 2018: Journal of Periodontology
H W Guo, W S Kong, Y Q Lai, F Kuang, J W Zhuang, Z G Shan
Objective: To explore the diagnosis, therapy and prevention method of chronic sternal osteomyelitis with sinus tract after cardiovascular surgery. Methods: A total of 53 patients with chronic sternal sinus tract after cardiovascular surgery between January 2000 and January 2016. After definite diagnosis by contrast fistulography and CT scanning, all the patients received combined modality therapy including debridement, musculocutaneous flap transplantation and intermediate thickness free skin graft transplantation if necessary...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Anne-Sophie Poinsard, Iona Mathieson, Olivier Balland
OBJECTIVE: The aim of our work was to study the potential of tarsomarginal grafting technique, in canine. ANIMAL STUDIED: All dogs included in this study had tumors of the upper or lower eyelid. Furthermore, resection of the tumor necessitated excision of the eyelid margin comprising 1/4 and 2/3. PROCEDURE: Harvesting of the graft with the length of half the length of the tumor, including its free margins was performed via a full-thickness incision on the ipsilateral healthy eyelid...
March 13, 2018: Veterinary Ophthalmology
A Llobet, N Nieto, A Damecourt, S Galmiche, M de Boutray
INTRODUCTION: The omental free flap is an effective tool for craniofacial reconstruction. However it is generally under-utilised by a large number of practitioners. This paper's goal is to increase awareness of this free flap's accessibility and to demonstrate that it can be an attractive option for reconstructive surgery. CLINICAL REPORT: This article outlines the details of a 57-year-old patient who required coverage of a fronto-parietal wound with dura mater exposure...
March 9, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
T Vimont, Arnaud, A Rouffet, J-P Giot, A S Florczak, P Rousseau
BACKGROUND: Preserving the integrity of the eyelid margin in eyelid reconstruction remains a challenge for plastic surgeons. In 1976, Hübner described a technique to repair full-thickness eyelid defects using a tarsomarginal graft covered with a local flap. This simple technique addresses both functional and aesthetic requirements of eyelid reconstruction by using tissue from the contralateral eyelid. The aim of this study was to determine the appropriate role of this uncommon technique in eyelid reconstruction...
March 9, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Burak Özkan, Abbas Albayati, Atilla Adnan Eyüboğlu, Ahmet Çağrı Uysal, Nilgun Markal Ertaş, Mehmet Haberal
OBJECTIVES: Transplant patients, like the nontransplant population, can have surgical interventions for body shape disorders. Studies on aesthetic surgeries in transplant patients are scarce. Our aim was to share our experiences with various aesthetic procedures in solid-organ transplant recipients. MATERIALS AND METHODS: Six (5 female, 1 male) transplant patients who received surgical corrections of the aging face, ptosis and lipodystrophy of the breast, and abdomen at the Baskent University Plastic Reconstructive and Aesthetic Surgery Department between 2010 and 2017 were included...
March 2018: Experimental and Clinical Transplantation
Hyun Ho Han, Yeon Ji Lee, Suk-Ho Moon
BACKGROUND: When a small, thin, and durable flap is required for coverage of the foot, the proximal peroneal artery perforator (PPAP) free flap may be a novel option. However, few clinical results and anatomical studies on the PPAP flap have been published. METHODS: A total of 24 PPAP flaps used in 22 patients from January 2013 to December 2016 were analyzed. All flaps were elevated in the subfascial plane based on a single perforator from the peroneal artery between the soleus and peroneus muscles...
February 22, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Kohei Okuyama, Masashi Yamashiro, Atsushi Kaida, Aya Kawamata, Miho Mizutani, Yasuyuki Michi, Narikazu Uzawa, Tomoyuki Yano, Rei Tohyama, Satoshi Yamaguchi
For young growing children before the end of skeletal maturity, the growth activity of the grafted bone after hemimandibulectomy is not well-known. After an adolescence, such a patient may have facial deformity because the anterior growth point of the mandible is in the condylar neck. A 13-year-old boy was performed hemimandibulectomy with immediate mandibular reconstruction by fibula free flap (FFF) because of a huge ameloblastic fibroma. The authors evaluated the length of FFF on the images of computed tomography (CT) at 5 and 60 months after the operation and compared them by calculating growth rates...
March 8, 2018: Journal of Craniofacial Surgery
Sergey Y Turin, Jamie A Spitz, Karina Alexander, Marco F Ellis
BACKGROUND: The anterolateral thigh (ALT) flap is a workhorse flap for a variety of wounds. The primary disadvantage of ALT flaps is donor site morbidity associated with large skin paddle defects. We present a strategy of managing the donor site with the Keystone flap to avoid skin grafts in cases where primary closure is not possible. METHODS: A retrospective, multi-institutional review from December 2015 to March 2017 based on a single surgeon's experience was performed...
March 9, 2018: Microsurgery
Daniele Marchioni, Angelo Musumeci, Cristoforo Fabbris, Stefano De Rossi, Davide Soloperto
BACKGROUND: The clivus is a region characterized by complex anatomy, with vascular and neural structures that are located in close proximity. Different pathologies can affect this area, and traditional surgical approaches were open approaches. Recently, the endoscopic transnasal technique has been introduced, and currently represents a good alternative for the surgical management of these lesions. This is a preliminary report on patients treated endoscopically for clival lesions by the authors' Skull Base Team...
March 8, 2018: European Archives of Oto-rhino-laryngology
Cimara Fortes Ferreira, Edival Barreto de Magalhães Junior, Barbara Zini
Achieving excellence in anterior rehabilitations requires close cooperation between the periodontist and the prosthodontist. Many techniques can be used to restore the lost alveolar hard and soft tissues. The more severe the peri-implant defect, the higher the challenge and lower the predictability of the procedure. The present case consists of Seibert class III with mal-aligned implants in the esthetic zone resolved with a cost-modified treatment plan to re-establish esthetics in the anterior maxilla using rotated palatal flap...
March 8, 2018: Journal of Oral Implantology
Glenn Isaacson, Jonathan A Harounian
Objectives: To evaluate the success of pediatric endoscopic and endoscopically assisted transcanal cartilage inlay tympanoplasty. Methods: Retrospective review of single surgeon experience. Results: During a 3 year period, 30 children underwent 31 endoscopic or endoscopically assisted transcanal tympanoplasties by the senior surgeon using tragal cartilage/perichondrial inlay grafts. There were 22 boys and 8 girls, ranging in age from 3.5 to 17 years (median 6 years)...
September 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
Kensuke Yamauchi, Shinnosuke Nogami, Yoshihiro Kataoka, Shigeto Koyama, Bernd Lethaus, Tetsu Takahashi
The objective of this study was to present a novel procedure for cortical bone repositioning (CBR) that maintains a secure space under the periosteum by replacement of the lateral cortex via fixation, employing titanium screws. Seven systemically healthy patients presenting with horizontal alveolar bone defects in radiographs and CT images were enrolled for CBR technique for horizontal alveolar bone augmentation. A lateral cortical bone block was cut in the defects and freed from the original bony surface. A screw was inserted into the block, and the block was placed laterally to allow fixation...
March 7, 2018: International Journal of Periodontics & Restorative Dentistry
Saul N Rajak, Raman Malhotra, Dinesh Selva
PURPOSE: To describe the 'Over-the-Top' Modified Cutler Beard Procedure (OTTMCB) for complete upper eyelid defect reconstruction Methods: This is retrospective case note review of four patients that underwent the OTTMCB procedure. This two-stage procedure comprises the replacement of the posterior lamella with a free tarsal graft from the contralateral upper eyelid, and the anterior lamella with a lower lid skin flap over the lower eyelid margin which is divided 2-4 weeks later. RESULTS: The procedure was undertaken for four patients with 75-90% upper eyelid defects from tumour excision surgery...
March 7, 2018: Orbit
Hozan Mufty, Athanasios Katsargyris, Sabrina Houthoofd, Inge Fourneau, Eric Verhoeven, Geert Maleux
INTRODUCTION: Fenestrated/branched thoracic endovascular aneurysm repair (F/Br-TEVAR) is a new minimal invasive treatment option for patients with post-dissection thoracoabdominal aortic aneurysms. This specific pathology is challenging to F/Br-TEVAR, especially when target vessels originate from the false lumen. Crossing from the true lumen into the false lumen to catheterize such target vessels may prove cumbersome in the usually thickened dissection flap. TECHNIQUE: We describe a bailout technique when standard catheterization techniques fail, by using a transjugular intrahepatic portosystemic shunt (TIPS)-needle to perforate the dissection flap...
March 6, 2018: Cardiovascular and Interventional Radiology
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