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Reconstructive Surgery

S Chauhan, K Manoj, S Rastogi, S A Khan, A Prasad
Extra Corporeal irradiation and Reimplantation Therapy (ECRT) is an established biological reconstruction technique of limb salvage surgery for malignant bone tumor. Several studies have focused on clinical outcome of the procedure, but biomechanical changes post ECRT procedure are not well established. The present study investigates changes in strength, deformation, and composition of cortical bone obtained post en block resection from five patients suffering from ECRT, and the results are verified against age-match control specimen from cadaver...
October 4, 2016: Journal of the Mechanical Behavior of Biomedical Materials
Xiucun Li, Jianli Cui, Suraj Maharjan, Ziping Jiang, Laijin Lu, Xu Gong
OBJECTIVE: The posterior thigh region has been neglected as a donor site for free perforator flaps, likely due to difficulties in positioning the patient during surgery. This study describes the clinical application of the posterior thigh perforator flap based on the third perforating artery of the profunda femoris artery (PFA). METHODS: The free posterior thigh perforator flap based on the third perforating artery of the PFA was used for reconstruction of soft tissue defects in nine patients between February 2010 and May 2014...
October 19, 2016: Annals of Plastic Surgery
Y D Pacheco, C Lorca-García, B Berenguer, E De Tomás
INTRODUCTION: Preaxial polydactyly is one of the most common congenital malformations of the hand. The treatment is surgical and should be done early, between 6 and 12 months old. The purpose of this paper is to review our experience in terms of casuistry, treatment and functional and aesthetic results of duplicity of thumb, since 2000 until today. MATERIAL AND METHODS: A retrospective study of patients with diagnosis of preaxial polydactyly from 2000 to january 2016 was performed...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
P Deltell Colomer, N Albertos Mira-Marcelí, N Gallego Mellado, M E Kuan Argüello, M F Bordallo Vázquez, J Mira Navarro, J Gonzálvez Piñera
INTRODUCTION: In more than 50% of the necrotizing enterocolitis that underwent surgery will require an ileostomy. The optimal time to reestablish intestinal transit still is a controversial subject. Many times ileostomies cause medical issues that require early intestinal reconstruction. Our objective is to compare the early closure against late close, being the shift point 35 days according to other published research. MATERIAL AND METHODS: Retrospective study off all patients that in the last 10 years have had an episode of necrotizing enterocolitis which required an intestinal derivation like ileostomy...
January 15, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Jung-Won Cho, Jung-Hyun Park, Jin-Woo Kim, Sun-Jong Kim
BACKGROUND: Temporomandibular joint (TMJ) ankylosis in children often leads to facial deformity, functional deficit, and negative influence of the psychosocial development, which worsens with growth. The treatment of TMJ ankylosis in the pediatric patient is much more challenging than in adults because of a high incidence of recurrence and unfavorable growth of the mandible. CASE REPORT: This is a case report describing sequential management of the left TMJ ankylosis resulted from trauma in early childhood...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
Young-Wook Park
BACKGROUND: The dimensions and shape of the forehead determine the esthetics of the upper third of the face. Korean young people consider a broad and smooth, rounded forehead more attractive. As a result, frontal augmentation becomes more popular in patients with dentofacial deformities. Various surgical procedures and materials have been used in frontal augmentation surgery, with associated advantages and disadvantages. Silicone is a good candidate for frontal augmentation. The author presents two cases of esthetic frontal augmentation with a prefabricated silicone implant in female patients with dentofacial deformities...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
Marco Castagnetti, Vincenzo Bagnara, Waifro Rigamonti, Marcello Cimador, Ciro Esposito
OBJECTIVE: In principle, the prepuce can be reconstructed during hypospadias repair, but the procedure has not gained wide acceptance and preputial reconstruction (PR) is surrounded by several controversies. MATERIAL AND METHODS: A review is provided of the technique for PR, how PR combines with the other steps of hypospadias repair, the risks of complications related to the urethroplasty and specific to PR, and the results of PR with particular regard to the relevance for the patient and his family...
September 22, 2016: Journal of Pediatric Urology
N Y Choi, E H Kim, C H Baek, I Sohn, S Yeon, M K Chung
PURPOSE: To develop nomogram for prediction of postoperative delirium (POD) in patients undergoing ablative and reconstruction surgery for head and neck cancer. METHODS: Total 341 patients were retrospectively analyzed, and clinical variables in preoperative, intraoperative and postoperative periods were compared between delirium group (n = 89) and non-delirium group (n = 252). Multivariate logistic regression, receiver operating characteristics curve, and area under the curve (AUC) were used to generate and test a nomogram, which performance was evaluated by 10-fold cross validation (CV) procedure...
October 14, 2016: European Journal of Surgical Oncology
Paul I Heidekrueger, Denis Ehrl, Albrecht Heine-Geldern, Milomir Ninkovic, P Niclas Broer
INTRODUCTION: Free tissue transfers are a highly reliable procedure routinely performed for reconstruction of a wide range of defects. Main complication in free flap surgery is usually venous thrombosis. Many technical controversies exist regarding the technical details of the microvascular anastomosis in order to prevent occurrence of thrombosis and optimize outcomes. We therefore evaluated our results regarding the execution of one versus two venous anastomoses in a variety of free flaps (fasciocutaneous- or muscle free flap) utilized for lower limb reconstruction...
October 17, 2016: Injury
Hossein E Jazayeri, Mohammadreza Tahriri, Mehdi Razavi, Kimia Khoshroo, Farahnaz Fahimipour, Erfan Dashtimoghadam, Luis Almeida, Lobat Tayebi
Tissue regeneration is rapidly evolving to treat anomalies in the entire human body. The production of biodegradable, customizable scaffolds to achieve this clinical aim is dependent on the interdisciplinary collaboration among clinicians, bioengineers and materials scientists. While bone grafts and varying reconstructive procedures have been traditionally used for maxillofacial defects, the goal of this review is to provide insight on all materials involved in the progressing utilization of the tissue engineering approach to yield successful treatment outcomes for both hard and soft tissues...
January 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
Surbhi Wadhwa, Vandana Tomar
Radial artery is an important consistent vessel of the upper limb. It is a useful vascular access site for coronary procedures and its reliable anatomy has resulted in an elevation of radial forearm flaps for reconstructive surgeries of head and neck. Technical failures, in both the procedures, are mainly due to anatomical variations, such as radial loops, ectopic radial arteries or tortuosity in the vessel. We present a rare and a unique anomalous medial branch of the radial artery spiraling around the flexor carpi radialis muscle in the forearm with a high rising superficial palmar branch of radial artery...
2016: Acta Medica (Hradec Králové)
Manuel Guerrero-Hernandez, Carlos A Hinojosa, Javier E Anaya-Ayala, Erika Elenes, Aldo Torre
Portal vein (PV) thrombosis (PVT) in the absence of liver disease or thrombophilia is rare. We report a 57-year-old male with a history of stage 3 chronic kidney disease who presented at the emergency department 18 months after abdominal surgery with progressive abdominal pain and distention. Computed tomography revealed PVT with multiple collaterals and moderate ascites. He had undergone partial gastrectomy and gastrojejunal anastomosis at an outside facility for gastrointestinal stromal tumors that caused an iatrogenic stenotic lesion in the PV...
October 20, 2016: Vascular and Endovascular Surgery
Juho Suojanen, Junnu Leikola, Patricia Stoor
The use of virtual surgery, patient-specific saw and drill guides, and custom-made osteosynthesis plates is rapidly spreading from deformity surgery to orthognathic surgery. Most of the commercially available systems are using computer-aided design/computer-aided manufacture (CAD/CAM) wafers to produce patient-specific saw guides. However, most plate systems provided are still the conventional "in stock" mini plates that can be individually designed by pre-bending according to the stereolithographic model of the patient...
September 23, 2016: Journal of Cranio-maxillo-facial Surgery
Stephan Christian Möhlhenrich, Kristian Kniha, Dirk Elvers, Nassim Ayoub, Evgeny Goloborodko, Frank Hölzle, Ali Modabber
The aim of this study was to investigate the influence of two different microvascular reanastomized bone transplants on primary (PS) and secondary stability (SS) of dental implants. Totally 96 implants (Bone Level, Institut Straumann AG, Basel, Switzerland) were inserted in fibula (n = 50) and iliac crest (n = 46) in mean of 97.7 SD 75.6 weeks after performing reconstructive surgery. For measuring PS and SS the resonance frequency (RFA) analysis was used in mesiodistal and vestibulo-oral direction to quantify the implant stability quotient (ISQ)...
September 28, 2016: Journal of Cranio-maxillo-facial Surgery
Filip B J L Stillaert, Casper Sommeling, Salvatore D'Arpa, David Creytens, Koenraad Van Landuyt, Herman Depypere, Rudy Van den Broecke, Stan Monstrey, Phillip N Blondeel, Wayne A Morrison
BACKGROUND: Breast reconstruction involves the use of autologous tissues or implants. Occasionally, microsurgical reconstruction is not an option because of insufficient donor tissues. Fat grafting has become increasingly popular in breast surgery. The challenge with this technique is how to reconstruct a stable and living "scaffold" that resembles a breast. METHODS: Breast reconstruction (n = 7) was performed using intratissular expansion with serial deflation-lipofilling sessions...
September 27, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
A Kanashiro, J M Gaya, J Palou, L Gausa, H Villavicencio
OBJECTIVES: To review our experience in robot-assisted radical cystectomy, assessing the complications and oncological and functional results. MATERIALS AND METHODS: From 2007 to 2014, we performed 67 robot-assisted radical cystectomies combined with lymphadenectomy in 61 cases. The operations were performed on 37 patients due to muscle-invasive tumours and on 30 due to high-risk nonmuscle-invasive tumours. Urinary diversion was conducted extracorporeally, using a Studer neobladder in 47 cases...
October 18, 2016: Actas Urologicas Españolas
Ricardo J Bello, Melanie R Major, Damon S Cooney, Gedge D Rosson, Scott D Lifchez, Carisa M Cooney
BACKGROUND: In 2013, we developed the Operative Entrustability Assessment (OEA) to facilitate evaluation and documentation of resident operative skills. This web-based tool provides real-time, transparent feedback to residents on operative performance. This study evaluated the construct validity of the OEA, assessing its association with operative time. METHODS: We used simple and multiple linear regression to estimate associations between OEA scores and operative time in selected procedures performed...
October 8, 2016: American Journal of Surgery
Juan Luis Gómez-Amador, Luis Alberto Ortega-Porcayo, Isaac Jair Palacios-Ortíz, Alexander Perdomo-Pantoja, Felipe Eduardo Nares-López, Alfredo Vega-Alarcón
Brainstem cavernous malformations are challenging due to the critical anatomy and potential surgical risks. Anterolateral, lateral, and dorsal surgical approaches provide limited ventral exposure of the brainstem. The authors present a case of a midline ventral pontine cavernous malformation resected through an endoscopic endonasal transclival approach based on minimal brainstem transection, negligible cranial nerve manipulation, and a straightforward trajectory. Technical and reconstruction technique advances in endoscopic endonasal skull base surgery provide a direct, safe, and effective corridor to the brainstem...
October 21, 2016: Journal of Neurosurgery
Sean Lewis, Marisa Earley, Richard Rosenfeld, Joshua Silverman
OBJECTIVES/HYPOTHESIS: To determine if open surgical treatment options for adult and adolescent laryngotracheal stenosis are more successful than endoscopic procedures. STUDY DESIGN: Systematic review. METHODS: Embase and MEDLINE were searched for publications on adult and adolescent patients (>13 years old) with laryngotracheal stenosis. Cause of stenosis (intubation, idiopathic, or trauma) and treatments (open laryngotracheal resection with anastomosis, open laryngotracheal reconstruction with expansion grafting, or endoscopic procedures) were included...
October 21, 2016: Laryngoscope
Kouhei Tajima, Nobuyuki Uchida, Hajime Sasamoto, Toshiyuki Okada, Takayuki Kohri, Akira Mogi, Hiroyuki Kuwano
A 69-year-old woman visited our hospital complaining of right chest pain. Chest computed tomography showed a 55 × 45 mm tumor in the right upper lobe. Bronchoscopy revealed displaced anomalous B (1) and B (2)(+3) arising from the right main bronchus, and the patient was diagnosed with lung adenocarcinoma by transbronchial lung biopsy from the displaced B (2)(+3) . Three-dimensional computed tomography with multiplanar reconstruction revealed a displaced anomalous B (1) and B (2)(+3) branching directly from the right main bronchus, respectively, and abnormal distribution of the aberrant pulmonary vein (V (2) ) descended dorsally to the right main bronchus and emptied into the left atrium...
September 2016: Thoracic Cancer
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