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https://www.readbyqxmd.com/read/29777840/negative-pressure-wound-therapy-to-promote-fixation-and-remodeling-of-omental-flap-in-patients-with-revascularized-limbs-a-case-series
#1
Nicla Settembre, Mario D'oria, Charbel Saba, Zakariyae Bouziane, Sergueï Malikov
We present our experience with five patients with CLTI treated with distal revascularization and omental flap coverage. We decided to investigate the efficacy and safety of NPWT (negative-pressure wound therapy) in promoting the fixation and remodeling of the omental flap as there is some evidence in the literature about the optimization of results for skin graft and dermal substitutes. Surgical revascularization was always the first procedure attempted; wound coverage was realized 3-5 days after the primary procedure (omental free-flap in three patients and omental flow-through flap in two patients)...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772334/quality-of-life-and-mortality-after-endovascular-surgical-or-conservative-treatment-of-elderly-patients-suffering-from-critical-limb-ischemia
#2
Stijn L Steunenberg, Jolanda de Vries, Jelle W Raats, Willem J Thijsse, Nathalie Verbogt, Paul Lodder, Geert-Jan van Eijck, Eelco J Veen, Hans G W de Groot, Gwan H Ho, Lijckle van der Laan
INTRODUCTION: Revascularisation to relieve ischemic pain and prevent limb loss is the cornerstone of critical limb ischemia (CLI) treatment, however not all elderly patients are deemed fit for revascularisation. Patient related outcome measurements are important in these patients. Quality of Life (QoL) results regarding the effect of endovascular, surgical, and conservative treatment on the quality of life (QoL) in the elderly are scarce in current literature. Goal of this study is to explore the outcome of the different treatment modalities in elderly patients suffering from CLI, with a specific focus on QoL...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29770232/long-term-follow-up-of-adamantinoma-of-the-tibia-complicated-by-metastases-and-a-second-unrelated-primary-cancer-a-case-report-and-literature-review
#3
Brendan R Southam, Alvin H Crawford, David A Billmire, James Geller, Daniel Von Allmen, Adam P Schumaier, Sara Szabo
Adamantinoma is a rare, low-grade malignant tumor of the bone which grows slowly and typically occurs in the diaphysis of long bones, particularly in the tibia. Adamantinomas have the potential for local recurrence and may metastasize to the lungs, lymph nodes, or bone. We report a case of a 14-year-old female with a tibial adamantinoma who underwent wide resection with limb salvage and has subsequently been followed up for 18 years. The patient went on to have both a local soft tissue recurrence 5 years after the resection and metastases to both an inguinal lymph node and the right lower lobe of the lung 8 years after that recurrence, all of which have been treated successfully with marginal resections...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29768632/lower-extremity-limb-salvage-with-cross-leg-pedicle-flap-cross-leg-free-flap-and-cross-leg-vascular-cable-bridge-flap
#4
Oscar J Manrique, Sarah N Bishop, Pedro Ciudad, Kian Adabi, Jorys Martinez-Jorge, Steven L Moran, Tony Huang, Aparna Vijayasekaran, Shih-Heng Chen, Hung-Chi Chen
BACKGROUND:  Lower extremity salvage following significant soft tissue loss can be complicated by lack of recipient vessel for free tissue transfer. We describe our experience in lower limb salvage for patients with no recipient vessels with the use of pedicle, free and cable bridge flaps. METHODS:  A retrospective review from 1985 to 2017 of patients undergoing lower limb salvage using a contralateral pedicle cross leg (PCL) flaps, free cross leg (FCL) flaps, or free cable bridge (FCB) flaps was conducted...
May 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29761748/transfemoral-amputation-adductor-myodesis-using-fibertape-and-knotless-anchors
#5
Andrew R Hsu
Transfemoral amputation is considered the last treatment option for severe infection, vascular disease, trauma, and malignant tumors of the lower extremity that have failed limb salvage. Unopposed pull of the hip abductors causes a flexion-abduction thigh deformity that results in abnormal biomechanics and increased oxygen consumption during ambulation. Myodesis of the adductor tendons is a critical component of transfemoral amputation that creates dynamic muscle balance, enhances prosthetic fitting and function, and improves clinical outcomes...
May 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29753451/single-stage-reconstruction-of-post-traumatic-and-post-excisional-composite-perigenual-defects-using-chimeric-pedicled-propelled-osteomyocutaneous-fibula-flap
#6
T M Balakrishnan, Sruthi Sridhar, J Jaganmohan, Hemantha Kumar Govinda Rajan, Singaravadivelu Vaidyanathan
INTRODUCTION: Composite perigenual defects (CPGDs) are exacting the expertise of the reconstructive surgeons. Segmental skeletal defects continue to be a challenge for both orthopedic and plastic surgeons. There are many techniques available for the reconstruction of segmental skeletal defects in the perigenual region. This study explores the outcomes of pedicled chimeric propelled osteomyocutaneous fibula flap reconstruction of post traumatic and post excisional composite perigenual defects (CPGDs) MATERIALS AND METHODS: It was a retrospective study conducted from 2011 to 2016 including 16 patients (5 post excisional defects and 11 post traumatic defects)...
April 27, 2018: Injury
https://www.readbyqxmd.com/read/29752218/elevated-international-normalized-ratio-is-not-associated-with-increased-perioperative-morbidity-in-podiatric-limb-salvage-surgery-a-retrospective-analysis
#7
Nalini Vadivelu, Alice M Kai, Feng Dai, Hosni Mikhael, Rima Aouad, Peter Blume
The risk of hemorrhage always exists in anticoagulated patients with an elevated international normalized ratio (INR), a risk that must be measured against the necessity for surgical procedures. The objective of the present retrospective medical record study was to assess the safety with which limb salvage procedures can be conducted in patients with an INR >1.4. The medical records of 231 patients who had undergone limb salvage procedures by 1 surgeon at the Yale New Haven Health System from November 2008 through July 2014 were reviewed...
May 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29746275/the-role-of-reconstructive-surgery-after-skeletal-and-soft-tissue-sarcoma-resection
#8
Visakha Suresh, Junheng Gao, Sin-Ho Jung, Brian Brigman, William Eward, Detlev Erdmann
BACKGROUND: Skeletal and soft tissue reconstruction after sarcoma resection remains challenging. The use of advanced reconstructive techniques has been shown to improve function and increase rates of limb salvage. This study aims to analyze the utilization of plastic surgery within a multidisciplinary team approach after sarcoma resection at Duke University Medical Center from 2001 to 2014. METHODS: Medical records were reviewed to determine procedure type, postoperative complications, and tumor recurrence...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29745256/salvage-of-cervical-motor-radiculopathy-using-peripheral-nerve-transfer-reconstruction
#9
Fardad T Afshari, Taushaba Hossain, Caroline Miller, Dominic M Power
PURPOSE: Motor nerve transfer surgery involves re-innervation of important distal muscles using either an expendable motor branch or a fascicle from an adjacent functioning nerve. This technique is established as part of the reconstructive algorithm for traumatic brachial plexus injuries. The reproducible outcomes of motor nerve transfer surgery have resulted in exploration of the application of this technique to other paralysing conditions. The objective of this study is to report feasibility and increase awareness about nerve transfer as a method of improving upper limb function in patients with cervical motor radiculopathy of different aetiology...
May 10, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29737002/lower-limb-reconstruction-with-chimeric-flaps-the-quad-flap
#10
Solomon M Azouz, Nikki A Castel, Aparna Vijayasekaran, Alanna M Rebecca, Salvatore C Lettieri
Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. We describe 2 cases of lower-extremity crush injuries salvaged with the quad flap. This novel flap consists of parascapular, scapular, serratus, and latissimus dorsi free flaps in combination on one pedicle...
May 7, 2018: Microsurgery
https://www.readbyqxmd.com/read/29733065/impacto-de-la-revascularizaci%C3%A3-n-y-factores-asociados-en-el-salvamento-de-la-extremidad-en-pacientes-con-pie-diab%C3%A3-tico
#11
Carlos A Hinojosa, Estefanía Boyer-Duck, Javier E Anaya-Ayala, Ana E Núñez-Salgado, Hugo Laparra-Escareno, René Lizola
Introducción: El pie diabético es causa frecuente de hospitalización. Objetivo: Examinar el impacto de la revascularización en la preservación de los miembros inferiores. Método: Estudio retrospectivo de pacientes diabéticos con úlceras en el pie. Se evaluó extensión del tejido perdido conforme las clasificaciones PEDIS y de Wagner, así como indicaciones y técnicas de revascularización. Los factores involucrados en la amputación mayor y el salvamento de la extremidad fueron evaluados por pruebas Fisher y chi cuadrado...
2018: Gaceta Médica de México
https://www.readbyqxmd.com/read/29717398/successful-limb-salvage-through-staged-bypass-combined-with-free-gracilis-muscle-transfer-for-critical-limb-ischemia-with-osteomyelitis-after-failed-endovascular-therapy
#12
Keisuke Miyake, Shinsuke Kikuchi, Hiroko Okuda, Atsuhiro Koya, Satomi Abe, Yoshiki Sawa, Tetsuo Ota, Nobuyoshi Azuma
BACKGROUND: Critical limb ischemia with osteomyelitis is so difficult to treat that even appropriate revascularization and wound therapy cannot achieve limb salvage because of uncontrollable infection. It is still difficult to judge the possibility of limb salvage before revascularization. CASE PRESENTATION: A 73-year-old male complained of a small ulcer on his left toe, which was treated with multiple endovascular therapy. After failed endovascular therapy, he suffered extensive tissue loss with tibial osteomyelitis...
May 2, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29709112/a-five-year-study-of-the-efficacy-of-purified-cd34-cell-therapy-for-angiitis-induced-no-option-critical-limb-ischemia
#13
Yuan Fang, Zheng Wei, Bin Chen, Tianyue Pan, Shiyang Gu, Peng Liu, Daqiao Guo, Xin Xu, Junhao Jiang, Jue Yang, Zhenyu Shi, Ting Zhu, Yun Shi, Yifan Liu, Zhihui Dong, Weiguo Fu
Angiitis-induced critical limb ischemia (AICLI) patients constitute a remarkable proportion of no-option critical limb ischemia (CLI) patients. Stem cell therapy has become an innovative and promising option for no-option CLI patients. As one of these promising stem cell therapies, purified CD34+ cell transplantation (PuCeT) has shown favorable short-term results. However, the long-term efficacy of PuCeT has yet to be reported. This study evaluates the long-term efficacy of PuCeT in AICLI patients. Twenty-seven AICLI patients were enrolled from May 2009 to December 2011...
April 30, 2018: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29706734/thoracoumbilical-flap-anatomy-technique-and-clinical-applications-in-upper-limb-reconstruction-in-the-era-of-microvascular-surgery
#14
Ravikiran Naalla, Moumita De, Rakesh Dawar, Shashank Chauhan, Maneesh Singhal
Purpose: Microvascular reconstruction is the standard of care for salvage of soft tissue defects in complex upper extremity due to their distinct advantages over the pedicled flaps. However, in the era of microsurgery, pedicled flaps have an acceptable significant role for reconstruction of complex soft tissue defects. The authors aim to demonstrate the versatility of pedicled thoracoumbilical flap (TUF) in selected clinical scenarios. Patients and Methods: Retrospective analysis of patients who underwent TUF for upper limb posttraumatic reconstruction was performed between January 2016 and October 2017...
April 2018: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/29706552/flap-choice-does-not-affect-complication-rates-or-functional-outcomes-following-extremity-soft-tissue-sarcoma-reconstruction
#15
Jelena Slump, Stefan O P Hofer, Peter C Ferguson, Jay S Wunder, Anthony M Griffin, Harald J Hoekstra, Esther Bastiaannet, Anne C O'Neill
BACKGROUND: Flap reconstruction plays an essential role in facilitating limb preservation in patients with extremity soft tissue sarcoma (ESTS). However, the effect of flap choice on the rates of postoperative complications and functional outcomes has not been clearly established. This study directly compares the outcomes of free and pedicled flap reconstructions in patients with ESTS. METHODS: Two hundred sixty-six patients who underwent flap reconstruction following ESTS resection were included...
April 12, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29701348/in-the-current-era-of-endovascular-surgery-what-is-the-role-of-axillofemoral-bypass
#16
Ricardo Correia, Rita Ferreira, Ana Garcia, Frederico Gonçalves, Rodolfo Abreu, Nelson Camacho, Joana Catarino, Maria Emília Ferreira
INTRODUCTION: Nowadays, axillofemoral bypass is viewed as an end-of-line solution for lower limb revascularization, owing to its classically described poor long-term patency, and recent advances in endovascular options for patients with complex aortoiliac anatomy not suitable for open reconstruction. There is a marked difference in patient profiles in published series of axillofemoral bypass, reflecting changing procedures indications due to technical innovations. The objective of this study is to determine the contemporary profile of patients treated with axillofemoral bypass and their outcome...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701340/comparaison-between-endovascular-approach-and-aorto-bifemoral-bypass-for-tasc-d-aorto-iliac-disease-patients-treated-between-2011-2017
#17
Joel Sousa, João Neves, André Ferreira, José Vidoedo, José Teixeira
INTRODUCTION: In the last few years, endovascular approaches have been demonstrating remarkable results on the treatment of aortoiliac TASC D lesions. However, the results remain conflictuous and proper evidence regarding the best treatment option for this group of patients is still lacking. Through this work, we aim to compare patency, cost-effectiveness and quality of life in patients successfully treated by these two approaches. METHODS: Patients with TASC D aorto-iliac disease, from two independent Vascular Surgery Centers, treated either by open surgery and endovascular intervention between 2011- 2017, were retrospectively analyzed and consecutively included (n=59)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697440/three-dimensionally-printed-personalized-implant-design-and-reconstructive-surgery-for-a-bone-tumor-of-the-calcaneus-a-case-report
#18
Jong Woong Park, Hyun Guy Kang, Kwun Mook Lim, June Hyuk Kim, Han Soo Kim
CASE: A 23-year-old soldier was diagnosed with a calcaneal desmoplastic fibroma. Limb-salvage surgery using a 3-dimensionally (3D) printed personalized implant made from a titanium alloy was planned. The implant had a mesh-style surface for free tendon suture, and the joint surface was smooth to preserve the subtalar joint. The implant had 3 hollow posts in case of future transarticular immobilization. At the last follow-up, the implant was painless and stable, and the patient could walk normally without support...
April 25, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29692655/limb-salvage-surgery-of-soft-tissue-sarcoma-with-sciatic-nerve-involvement
#19
Hussein Sweiti, Noor Tamimi, Fabian Bormann, Markus Divo, Daniela Schulz-Ertner, Marit Ahrens, Ulrich Ronellenfitsch, Matthias Schwarzbach
Background: The surgical resection of soft tissue sarcomas (STS) with sciatic nerve involvement presents a significant surgical and oncological challenge. Current treatment strategies pursue a multimodal approach with the aim of limb preservation. We aim to evaluate the outcomes of limb-sparing surgery of STS in a patient cohort and to propose a classification for STS with sciatic nerve involvement. Methods: Patients receiving limb-preserving resections for STS with sciatic nerve involvement between 01/2010 and 01/2017 were included...
2018: Sarcoma
https://www.readbyqxmd.com/read/29690818/in-situ-popliteal-tibial-bypass-with-the-short-saphenous-vein-through-a-posterior-approach-for-limb-salvage
#20
Sosei Kuma, Kohichi Morisaki, Jin Okazaki, Shinsuke Mii
A 69-year-old female patient was admitted to our hospital with gangrene of her left first and second digits. Angiography showed a diffuse occlusive lesion from the external iliac artery to the crural arteries. Endovascular therapy to the external iliac artery, above-knee femoropopliteal bypass with a polytetrafluoroethylene graft, and popliteal-tibial bypass through a posterior approach with the short saphenous vein graft were performed in 3 stages because the length of the great saphenous vein that was suitable for grafting was insufficient...
January 1, 2018: Vascular and Endovascular Surgery
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