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https://www.readbyqxmd.com/read/29344982/experience-with-pharmacologic-leeching-with-bivalirudin-for-adjunct-treatment-of-venous-congestion-of-head-and-neck-reconstructive-flaps
#1
Aisha Harun, Rachel M Kruer, Andrew Lee, Kofi Boahene, Patrick J Byrne, Jeremy D Richmon
OBJECTIVES: The goal of this study was to review the feasibility of local bivalirudin injection for adjunct treatment of venous congestion of head and neck reconstructive flaps. METHODS: A retrospective chart review of patients who underwent bivalirudin treatment for venous congestion of head and neck reconstructive flaps in a single institution from September 1, 2012 to September 1, 2015 was undertaken. Individuals were treated with variable number of intradermal injections directly into the flap followed by a small skin incision to allow extended passive bleeding...
January 18, 2018: Microsurgery
https://www.readbyqxmd.com/read/29343893/assessment-of-perfusion-of-free-flaps-used-in-head-and-neck-reconstruction-using-pulsatility-index
#2
Akshay Kapoor, Malay Karmakar, Collin Roy, Kaushal Priya Anand
Objective: To detect venous or arterial obstruction in the pedicle of a free flap we can monitor resistance in the flap bed which is reflected in Pulsatility Index (PI) Therefore if we detect change in the values of the PI in these flaps then we can detect complications in flap due to vascular insufficiency early. Materials and Methods: Seven patients of Free Fibular Flap Reconstruction and ten patients of Free Radial Forearm Flap reconstruction were evaluated over a period of 18 months...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29335032/-sit-and-tilt-preparation-for-subscapular-system-free-flaps
#3
J Mark, H Patwa, M S Costello, Y Patil
BACKGROUND: The ablation of advanced head and neck cancer often results in large three-dimensional defects that require free tissue transfer to optimally address functional and cosmetic issues. The subscapular system is a highly versatile donor site for flaps used for head and neck reconstruction. Traditional methods of harvesting subscapular flaps require repositioning and re-preparing, which significantly increases the operative time and prevents simultaneous harvesting of the flap...
January 16, 2018: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29331076/submental-artery-island-flap-with-simultaneous-level-i-neck-dissection
#4
Antoine Eskander, Daniel Strigenz, Nolan Seim, Enver Ozer
BACKGROUND: The purpose of this study was to illustrate the submental island flap elevation technique with simultaneous level I neck dissection followed by the inset and reconstruction of an oropharyngeal defect. METHODS: A 63-year-old patient with a T2N1M0 human papillomavirus-positive squamous cell carcinoma of the tonsil was treated with concurrent chemoradiotherapy (cisplatin + 66 Gy). A local recurrence 2.5 years after treatment was treated surgically and reconstructed with a submental island flap...
January 13, 2018: Head & Neck
https://www.readbyqxmd.com/read/29328540/case-of-late-onset-relapsing-surgical-site-infection-related-to-a-venous-coupler-placed-during-free-flap-reconstruction-for-major-head-and-neck-cancer
#5
Yin Ren, Daniel G Deschler, Dipti Sajed, Marlene L Durand
BACKGROUND: Venous coupling devices are widely used during reconstructive surgery involving microvascular anastomosis but have not served as foreign bodies in head and neck surgical site infections. METHODS: We conducted a case report. RESULTS: A patient underwent resection and free flap reconstruction for recurrent tongue squamous cell carcinoma. She developed a neck abscess due to Streptococcus intermedius 7 weeks postoperatively, days after starting chemoradiotherapy...
January 12, 2018: Head & Neck
https://www.readbyqxmd.com/read/29290568/outcome-predictors-in-elderly-head-and-neck-free-flap-reconstruction-a-retrospective-study-and-systematic-review-of-the-current-evidence
#6
Cindy Siaw-Lin Goh, Yee-Onn Kok, Cheryl Pei-Chyi Yong, Esther Wan-Xian Tan, Lee-Gan Goh, Khong-Yik Chew, Constance Ee-Hoon Teo, Terence Lin-Hon Goh
Free flap tissue transfer has become the gold standard for reconstruction of composite head and neck defects. We sought to investigate the efficacy and morbidity of these procedures in the elderly. We retrospectively reviewed 245 head and neck free flap procedures (234 patients). Patients were stratified by age group (≥ or <65 years). Univariate and multivariate analyses were used to evaluate the following primary outcomes - free flap survival, postoperative medical and surgical complications and 30-day mortality...
December 12, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29288289/anterolateral-thigh-flap-combined-with-reconstruction-plate-versus-double-free-flaps-for-composite-mandibular-reconstruction-a-propensity-score-matched-study
#7
Anaeze C Offodile, Jennifer An-Jou Lin, Kai-Ping Chang, Mohamed Abdelrahman, Hao-Wei Kou, Charles Yuen Yung Loh, Mario A Aycart, Huang-Kai Kao
OBJECTIVE: This study was designed to examine the comparative effectiveness of oromandibular defect reconstruction via anterolateral thigh flap and bridging plate (ALT only) versus simultaneous soft tissue and vascularized bone flap (DFF), with regards to long-term plate exposure and complications. METHODS: A propensity score-matched analysis of patients with an oncologic head and neck defect who underwent microvascular reconstruction was performed. Two surgical groups, i...
December 30, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29284163/geometric-three-dimensional-end-to-side-microvascular-anastomosis-a-simple-and-reproducible-technique
#8
Adrian S H Ooi, Daniel R Butz, Sean M Fisher, Zachary J Collier, Lawrence J Gottlieb
BACKGROUND:  End-to-side (ETS) anastomoses are useful when preservation of distal vascularity is critical. The ideal ETS microanastomosis should maintain a wide aperture and have a smooth take-off point to minimize turbulence, vessel spasm, and thrombogenicity of the suture line. We have developed a unique, dependable, and reproducible geometric technique for ETS anastomoses, and analyze its efficacy in our series of patients. METHODS:  The geometric ETS technique involves creating a three-dimensional (3D) diamond-shaped defect on the recipient vessel wall, followed by a slit incision of the donor vessel to create a "spatula" fitting this defect...
December 28, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29280859/outcome-analysis-of-free-flap-salvage-in-outpatients-presenting-with-microvascular-compromise
#9
Rene D Largo, Jesse C Selber, Patrick B Garvey, Edward I Chang, Matthew M Hanasono, Peirong Yu, Charles E Butler, Donald P Baumann
BACKGROUND: Extensive flap salvage attempts are routinely performed in patients with late-onset flap vascular crisis despite low flap survival rates. A knowledge gap exists in management of compromised free flaps in patients who present with perfusion-related complications after hospital discharge. METHODS: A retrospective review of 7443 free flaps used in 7128 cancer patients at a single institution from January of 2001 to March of 2015 was performed. RESULTS: Of 7443 free flap reconstructions, 856 patients (12 percent) were taken back to the operating room...
January 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29277855/bifurcation-of-brachial-artery-into-a-common-radial-interosseous-trunk-and-superficial-ulnar-artery-a-rare-variation
#10
Suresh Narayanan, Senthil Murugan
Variations in the branching pattern of brachial artery and abnormal course of its branches are not uncommon. The present article describes a case of bifurcation of the brachial artery into a common radial-interosseous trunk and superficial ulnar artery. The embryological basis behind the present case report could be, the radial artery establishing a connection with the axis artery just below the level of origin of ulnar artery, the posterior interosseous artery arising from the axis artery distal to the origin of the radial artery...
December 26, 2017: Anatomical Science International
https://www.readbyqxmd.com/read/29275613/-epidemiological-investigation-on-2-133-hospitalized-patients-with-electrical-burns
#11
M J Jiang, Z Li, W G Xie
Objective: To analyze the epidemiological characteristics of the hospitalized patients with electrical burns in Institute of Burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital (hereinafter referred to as Institute of Burns of Wuhan Third Hospital), so as to provide reference for the prevention and treatment of electrical burns. Methods: Medical records of all hospitalized burn patients in Institute of Burns of Wuhan Third Hospital from January 2004 to December 2016 were collected. Genders, ages, social categories, seasons of injury, total burn areas, depths of wounds, electrical voltages of injury, sites of wound, treatment methods, amputation rates, lengths of hospital stay, operation costs, hospitalization costs, and treatment outcomes of the electrical burn patients were collected...
December 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29249929/pigeons-c-livia-follow-their-head-during-turning-flight-head-stabilization-underlies-the-visual-control-of-flight
#12
Ivo G Ros, Andrew A Biewener
Similar flight control principles operate across insect and vertebrate fliers. These principles indicate that robust solutions have evolved to meet complex behavioral challenges. Following from studies of visual and cervical feedback control of flight in insects, we investigate the role of head stabilization in providing feedback cues for controlling turning flight in pigeons. Based on previous observations that the eyes of pigeons remain at relatively fixed orientations within the head during flight, we test potential sensory control inputs derived from head and body movements during 90° aerial turns...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29249632/perforator-flaps-from-the-lower-leg-for-intraoral-reconstruction-experience-of-131-flaps
#13
Klaus-Dietrich Wolff, Andrea Rau, Andreas Kolk
BACKGROUND: During the last decade, perforator flaps have become popular for defect cover in the head and neck because they increase the choice of reconstructive possibilities and can lead to minimal donor site morbidity. In particular, the lower leg is considered a suitable option, as it provides thin and pliable skin for intraoral lining. Having gained experience with 131 flaps raised from four different donor sites at the lower leg, the aim of this paper is to evaluate success rates and patient satisfaction, but also difficulties and pitfalls during flap transfer...
November 26, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29249263/reconstructive-methods-in-mohs-micrographic-surgery-in-uruguay-a-bidirectional-descriptive-cohort-analysis
#14
J Navarrete, J Magliano, M Martínez, C Bazzano
BACKGROUND AND OBJECTIVES: The primary goal of Mohs micrographic surgery (MMS) is to completely excise a cancerous lesion and a wide range of reconstructive techniques of varying complexity are used to close the resulting wound. In this study, we performed a descriptive analysis of patients who underwent MMS, with a focus on wound closure methods. MATERIAL AND METHODS: We conducted a bidirectional descriptive cohort analysis of all MMS procedures performed by a single surgeon between November 2013 and April 2016...
December 14, 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/29236278/head-and-neck-surgical-reconstruction-in-operation-iraqi-freedom-and-operation-enduring-freedom-afghanistan-a-systematic-review
#15
Samantha J Mikals, Joshua M Jabaut, Art A Ambrosio
Historically, head and neck injuries constituted 16 to 20% of all nonfatal combat injuries. However, advances in body and vehicle armor in the context of the use of ambushes and improvised explosive devices by enemy combatants have resulted in fewer fatalities from head and neck wounds, and thus the incidence of nonfatal head and neck injuries has risen to as high as 52%. Despite this increase, data regarding specific injury distributions, surgical cases, and approaches to repair are lacking in the current literature...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29233698/ex-corpore-linguae-a-cohort-analysis-after-a-unique-surgical-technique-in-oral-cancer-resection
#16
Jan-Falco Wilbrand, Daniel Schmermund, Michael Knitschke, Philipp Streckbein, Christopher Kähling, Heiko Kerkmann, Heidrun Schaaf, Hans-Peter Howaldt, Sebastian Böttger
OBJECTIVE: Resection of posteriorly located oral squamous cell carcinomas (OSCCs) remains challenging for head and neck surgeons. However, several surgical techniques, such as lip and mandibular splitting, as well as submental "visor drop-down" of intraoral soft tissues, have been proposed for this purpose. Merrick et al. suggested that a pedicled genial drop-down surgical approach should be used to resect dorsally located OSCCs. Our study investigated patient outcomes following this surgical procedure, as no previous study has analyzed long-term follow-up data...
November 21, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29229134/animal-models-in-plastic-and-reconstructive-surgery-simulation-a-review
#17
REVIEW
Charles Yuen Yung Loh, Aline Yen Ling Wang, Vincent Tze Yang Tiong, Thanassi Athanassopoulos, Meiling Loh, Philip Lim, Huang-Kai Kao
BACKGROUND: The use of live and cadaveric animal models in surgical training is well established as a means of teaching and improving surgical skill in a controlled setting. We aim to review, evaluate, and summarize the models published in the literature that are applicable to Plastic Surgery training. MATERIALS AND METHODS: A PubMed search for keywords relating to animal models in Plastic Surgery and the associated procedures was conducted. Animal models that had cross over between specialties such as microsurgery with Neurosurgery and pinnaplasty with ear, nose, and throat surgery were included as they were deemed to be relevant to our training curriculum...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29224825/head-and-neck-free-flap-reconstruction-what-is-the-appropriate-post-operative-level-of-care
#18
Varun V Varadarajan, Hassan Arshad, Peter T Dziegielewski
Patients undergoing head and neck reconstruction require complex, multidisciplinary postoperative care which may include wound care, flap monitoring, tracheostomy management, and management of comorbid conditions. Historically, patients undergoing major resection of a head and neck or aerodigestive tract malignancy with regional or free flap reconstruction were routinely admitted to the ICU. Although head and neck cancer patients may have multiple medical comorbidities that may require postoperative critical care, the current trend in many institutions is to transfer stable and less medically complex patients to non-intensive care-level units with specialty trained nursing staff...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29224822/head-and-neck-reconstruction-with-free-flaps-based-on-the-thoracodorsal-system
#19
John Edward O'Connell, Mandeep S Bajwa, Andrew G Schache, Richard J Shaw
The advent or micro-vascular free tissue transfer has facilitated the reconstruction of increasingly complex head and neck defects. There are multiple donor sites available, each with its' own advantages and disadvantages. However, the subscapular system, including the thoracodorsal system, provides the widest array of soft tissue and osseous flaps, as well as chimeric options. Its advantages include a long pedicle, independently mobile tissue components, relative sparing from atherosclerosis, and minimal donor site morbidity...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29218804/impact-of-diabetes-on-free-flap-surgery-of-the-head-and-neck-a-nsqip-analysis
#20
Jacob S Brady, Aparna Govindan, Meghan M Crippen, Andrey Filimonov, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVE: Diabetes is associated with microvascular pathology and may predispose patients undergoing microvascular surgery to complications. This study assesses diabetes as a risk factor for complications following free flap surgery of the head and neck. PATIENTS AND METHODS: In this retrospective cohort study, data on free flap surgeries of the head and neck between 2005 and 2014 was collected from the National Surgical Quality Improvement Program (NSQIP) database...
December 8, 2017: Microsurgery
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