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Flaps and grafts

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https://www.readbyqxmd.com/read/28915833/deltopectoral-flap-revisited-for-reconstruction-surgery-in-patients-with-advanced-thyroid-cancer-a-case-report
#1
Taro Mikami, Shintaro Kagimoto, Yuichiro Yabuki, Kazunori Yasumura, Toshinori Iwai, Jiro Maegawa, Nobuyasu Suganuma, Shohei Hirakawa, Katsuhiko Masudo
BACKGROUND: We present the cases of 2 patients with invasive thyroid cancer, who underwent reconstructive surgery using a deltopectoral flap. Although the overall rate of extrathyroidal extension in patients with thyroid cancer is quite low, skin invasion is the most common pattern observed. Reconstructive surgery, involving local skin flaps, is required in these patients. The deltopectoral flap relies on the blood supply from intercostal perforators of the internal thoracic artery and usually requires skin grafting to the donor site...
September 15, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28913317/reconstruction-of-a-complex-scalp-defect-after-the-failure-of-free-flaps-changing-plans-and-strategy
#2
Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha Kim
The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neurosurgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft...
June 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28913291/immediate-near-total-scalp-reconstruction-with-artificial-dermis-on-exposed-calvarium
#3
Sooyeon Park, Ki Taik Han, Min Cheol Kim, Jin Soo Lim
Scalp defect management is complicated secondary to reduced laxity in the scalp and forehead area. For reconstruction of larger defects with exposed bone and loss of the periosteal layer, free flap reconstruction is one option for single-stage surgery, although the procedure is lengthy and includes the possibility of flap loss. We successfully performed a single-stage reconstruction of a large scalp defect using a combination of artificial dermis, split-thickness skin graft, and full-thickness skin graft following wide excision of a cutaneous angiosarcoma, and present our method as one option for the treatment of large oncologic surgical defects in patients who are poor candidates for free flap surgery...
December 2016: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28913282/the-versatility-of-cheek-rotation-flaps
#4
Kyung Pil Kim, Ho Seup Sim, Jun Ho Choi, Sam Yong Lee, Do Hun Lee, Seong Hwan Kim, Hong Min Kim, Jae Ha Hwang, Kwang Seog Kim
BACKGROUND: The cheek rotation flap has sufficient blood flow and large flap size and it is also flexible and easy to manipulate. It has been used for reconstruction of defects on cheek, lower eyelid, or medial and lateral canthus. For the large defects on central nose, paramedian forehead flap has been used, but patients were reluctant despite the remaining same skin tone on damaged area because of remaining scars on forehead. However, the cheek flap is cosmetically superior as it uses the adjacent large flap...
December 2016: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28911959/histological-changes-in-the-periosteum-following-subperiosteal-expansion-in-rabbit-scalp
#5
Mohamad Taghi Kiani, Nasrin Takzare, Ahad Khoshzaban, Elahe Jalilianfar, Leila Aghajanpour, Reza Tabrizi
PURPOSE: In intraoral bone grafting, tension-free coverage of the recipient site with periosteal flap results in optimal wound closure. Tissue expansion could be a suitable modality to obtain soft tissue in the oral cavity. The aim of this study was to assess the histology of the periosteum after subperiosteal expansion in the rabbit scalp. MATERIALS AND METHODS: In this animal study, 6 rectangular tissue expanders were placed in the skulls of 6 male white New Zealand rabbits; in 6 control rabbits, an incision was made to the periosteum but no expansion was performed...
August 31, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28906587/vascularized-thumb-metacarpal-periosteal-pedicled-flap-for-scaphoid-nonunion-an-anatomical-study-and-pediatric-case-report
#6
Sergi Barrera-Ochoa, Gerardo Mendez-Sanchez, Alfonso Rodriguez-Baeza, Jorge Knörr, Jayme Augusto Bertelli, Francisco Soldado
PURPOSE: Through an anatomical review, the primary aim of this study was to delineate the dorsal thumb metacarpal (TM) periosteal branches of the radial artery (RA). In addition, we report here the clinical utility of a vascularized TM periosteal pedicled flap (VTMPF), supplied by the first dorsal metacarpal artery (FDMA), in a complex case of scaphoid nonunion. METHODS: Ten latex-colored upper limbs from fresh human cadavers were used. Branches of the RA were dissected under 3x loupe magnification, noting the periosteal branches arising from the FDMA...
September 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/28906302/chemotherapy-extravasation-management-21-year-experience
#7
Maria Giuseppina Onesti, Sara Carella, Paolo Fioramonti, Nicolò Scuderi
Chemotherapy extravasation may result in serious damage to patients, with irreversible local injures and disability. Evidence-based standardization on extravasation management is lacking and many institutions do not practice adequate procedures to prevent the severer damages. Our aim was to explore the prevention and treatment of extravasation injuries, proposing a standard therapeutic protocol together with a review of the literature. From January 1994 to December 2015, 545 cases were reviewed (age range, 5-87 years; 282 men and 263 women)...
September 12, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28904904/scrotal-reconstruction-and-testicular-prosthetics
#8
REVIEW
Jacob W Lucas, Kyle M Lester, Andrew Chen, Jay Simhan
Scrotal surgery encompasses a wide-variety of surgical techniques for an even wider variety of indications. In this manuscript, we review our indications, techniques, and pit-falls for various reconstructive scrotal surgeries as-well-as surgical tips for placement of testicular prostheses. Penoscrotal webbing (PSW) is an abnormal, often-problematic distal insertion of scrotal skin onto the ventral penile shaft. There are several effective and straightforward techniques used to revise this condition, which include simple scrotoplasty, single- or double-Z-plasty, or the VY-flap scrotoplasty...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28894666/optimizing-aesthetic-outcomes-in-delayed-breast-reconstruction
#9
Wojciech Dec
BACKGROUND: The need to restore both the missing breast volume and breast surface area makes achieving excellent aesthetic outcomes in delayed breast reconstruction especially challenging. Autologous breast reconstruction can be used to achieve both goals. The aim of this study was to identify surgical maneuvers that can optimize aesthetic outcomes in delayed breast reconstruction. METHODS: This is a retrospective review of operative and clinical records of all patients who underwent unilateral or bilateral delayed breast reconstruction with autologous tissue between April 2014 and January 2017...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28894664/aesthetic-female-to-male-chest-transformation-power-of-combining-modified-mastectomy-with-a-pectoral-implant
#10
Turkia Abbed, David A Shifrin
Gender reassignment surgery has gained in popularity with increased media exposure and society's recognition of gender dysphoria. Female-to-male gender reassignment often begins with the "top" or chest surgery. Mastectomy with free nipple grafting is the most frequently described technique in the literature. This technique is reliable yet lacks the ability to provide a true male chest shape. We discuss our technique for female-to-male "top" surgery combining traditional mastectomy techniques with a lower pole pedicle vascularized areola and a pectoral implant...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28894659/prevention-of-mandible-reconstruction-plate-exposure-by-costal-cartilage-wrapping
#11
Motonao Iwasawa, Yoshito Mishima, Miho Ohtsubo
After mandibulectomy in cancer surgery, reconstruction is often performed with a reconstruction plate covered with a soft-tissue free flap in patients in poor condition. However, the rate of complications for mandibular reconstruction is higher with a reconstruction plate than with vascularized bone grafts. We have developed a costal cartilage wrapping method to prevent exposure of the mandible reconstruction plate. The eighth costal cartilage was removed and split into 2 pieces to wrap around the reconstruction plate...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28893718/alternatives-to-connective-tissue-graft-in-the-treatment-of-localized-gingival-recessions-a-systematic-review
#12
Khadija Amine, Yasser El Amrani, Siham Chemlali, Jamila Kissa
AIM: The aim of this Systematic Review (SR) was to assess the clinical efficacy of alternatives procedures; Acellular Dermal Matrix (ADM), Xenogeneic Collagen Matrix (XCM), Enamel Matrix Derivative (EMD) and Platelet Rich Fibrin (PRF), compared to conventional procedures in the treatment of localized gingival recessions. MATERIAL AND METHODS: Electronic searches were performed to identify randomized clinical trials (RCTs) on treatment of single gingival recession with at least 6 months of follow-up...
September 8, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28893706/hypertension-acute-stent-thrombosis-and-paraplegia-6-months-after-tevar-for-blunt-thoracic-aortic-injury-in-a-22-year-old-patient
#13
O Martinelli, F Faccenna, A Malaj, J Jabbour, S Venosi, R Gattuso, B Gossetti, L Irace
TEVAR is a less invasive option for managing traumatic injuries of the descending aorta in polytraumatized patients. Concerns arise when treating young patients with TEVAR. A 22-year old male was admitted to the Emergency Department following a high-impact road traffic collision. Whole body CT scan documented multiple injuries, including rupture of descending thoracic aorta just below the isthmus. There was no evidence of paraplegia or stroke. We decided to treat him in an endovascular fashion with a Zenith Cook (Cook Incorporated, Bloomington, IN) endograft...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28893226/effect-of-periodontitis-on-the-development-of-osteoporosis-results-from-a-nationwide-population-based-cohort-study-2003-2013
#14
Jung-Kyu Choi, Young-Taek Kim, Hye-In Kweon, Eun-Cheol Park, Seong-Ho Choi, Jae-Hong Lee
BACKGROUND: The prevalence of osteoporosis associated with the aging process is anticipated to increase along with the rising aging population. Periodontitis that the most common chronic infections of humankind is considered the risk factor for osteoporosis. The aim of this study was to identify the association between osteoporosis and periodontitis using a population-based cohort. METHODS: The case group was defined as patients diagnosed with periodontitis and treated with subgingival curettage, root conditioning, periodontal flap operation, bone grafting for alveolar bone defects, and guided tissue regeneration...
September 11, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28891728/bioengineered-dermal-substitutes-for-the-management-of-traumatic-periocular-tissue-loss
#15
Tiffany A Chen, Juan A Ayala-Haedo, Nathan W Blessing, Katie Topping, Chrisfouad R Alabiad, Benjamin P Erickson
PURPOSE: Traumatic periocular injuries occasionally result in significant soft tissue loss, for which there are limited management options that provide satisfactory cosmetic and functional outcomes. The authors describe the use of a bioengineered dermal substitute (Integra® Dermal Regeneration Template [DRT], Integra LifeSciences, Plainsboro, NJ) as an alternative to immediate flap reconstruction or skin grafting. METHODS: Retrospective interventional case series of patients who underwent DRT placement for periocular tissue loss at the time of trauma...
September 11, 2017: Orbit
https://www.readbyqxmd.com/read/28890056/giant-chest-wall-arteriovenous-malformation-a-case-report-and-literature-review
#16
Cullen McCarthy, Subrato Deb, Suhair Maqusi, Joshua Gierman
INTRODUCTION: We present an interesting case of a 55 year-old male with a large left chest mass after significant cutaneous bleeding. CT angiogram of the chest revealed arteriovenous malformation with blood supply from subbranches of the left subclavian artery, left internal mammary artery and left external carotid artery. Measuring 5.0x14.0x10.8cm, the mass extended superior to the clavicle and inferior to the third rib with medial and lateral borders at the level of the clavicular head and coracoid, respectively...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28889142/dengue-shock-syndrome-with-retroperitoneal-haematoma-requiring-repeated-artery-angioembolization
#17
Y H Teh, Y P Tan, M M Zain
Eyelid reconstruction is complex and challenging since it is not only for structural and functional restoration, but also for an acceptable aesthetic result. In full thickness eyelid injuries, it will involve both anterior and posterior lamella. Therefore, when reconstructing the defect, it requires at least two layers; one will be a flap with blood supply, and the other can be a free graft. In this case, a rotational advancement cheek flap and composite graft were used to reconstruct the lower eyelid.
August 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28888309/head-and-neck-reconstruction
#18
REVIEW
Shannon Wong, Alyson Melin, Debra Reilly
Management of head and neck burns involves acute and intermediate phases. Acutely, the goals are establish a secure airway and treat life-threatening injuries. Then, optimize nutrition, assess extent of the burn, perform local wound care, and provide eye protection. Management depends on the degree of the head and neck burn. Postinjury splinting and rehabilitation are vital to healing. After the acute inflammation has resolved and the scars have matured, reconstruction begins with the goals of restoring both function and aesthetics...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888307/microsurgical-burn-reconstruction
#19
REVIEW
Akhil K Seth, Jonathan S Friedstat, Dennis P Orgill, Julian J Pribaz, Eric G Halvorson
The treatment of burn-related wounds requires consideration of several factors, including defect size, available donor sites, exposure of critical structures, and the ultimate functional and aesthetic result of reconstruction. Although skin grafts and locoregional flaps are workhorses in burn reconstruction, they have inherent limitations that can directly impact reconstructive outcomes. Microsurgical free tissue transfer represents a viable option for the reconstruction of burn-related wounds in certain patients...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28885383/application-of-a-modified-pedicled-adipofascial-lateral-arm-flap-in-the-prevention-and-treatment-of-radial-nerve-injuries
#20
Steven M Koehler, Andrew P Matson, Suhail K Mithani
The fasciocutaneous lateral arm flap is a workhorse flap in upper extremity reconstruction. However, its adipofascial variant is not widely used. The technique can be used in various clinical scenarios. The adipofascial flap can be transposed to circumferentially wrap the radial nerve with a pliable, vascularized fat and fascial envelope, mimicking the natural fatty environment of peripheral nerves. This technique has the advantage of providing a scar tissue barrier, a barrier to hardware irritation and a milieu for vascular regeneration of the nerve...
September 6, 2017: Techniques in Hand & Upper Extremity Surgery
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