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Microvascular reconstruction

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https://www.readbyqxmd.com/read/28322117/effect-of-overlapping-operations-on-outcomes-in-microvascular-reconstructions-of-the-head-and-neck
#1
Larissa Sweeny, Eben L Rosenthal, Tyler Light, Jessica Grayson, Daniel Petrisor, Scott H Troob, Benjamin J Greene, William R Carroll, Mark K Wax
Objective To compare outcomes after microvascular reconstructions of head and neck defects between overlapping and nonoverlapping operations. Study Design Retrospective cohort study. Setting Tertiary care center. Subjects and Methods Patients undergoing microvascular free tissue transfer operations between January 2010 and February 2015 at 2 tertiary care institutions were included (n = 1315). Patients were divided into 2 cohorts by whether the senior authors performed a single or consecutive microvascular reconstruction (nonoverlapping; n = 773, 59%) vs performing overlapping microvascular reconstructions (overlapping; n = 542, 41%)...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28293511/de-novo-reconstruction-of-a-hybrid-patella-by-staged-fabrication-of-a-microvascular-bone-transplant-with-an-osteointegrated-prosthetic-socket
#2
Goetz A Giessler, Christian Hendrich
Total patellectomy is sometimes unavoidable but usually results in severely impaired function, pain, and instability in the affected knee. Any patellar prosthetic solutions rely on a certain amount of remaining bone and therefore are not applicable after total patellectomy. Traditionally, reconstruction of a neopatella by avascular or allogeneic bone grafts is hampered by mechanical failure, resorption, or infection. We developed a new, 3-stage approach to reconstruct a hybrid patella composed of a revascularized scapula tip transplant fabricated with a prosthetic socket...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293504/an-appraisal-of-internal-mammary-artery-perforators-as-recipient-vessels-in-microvascular-breast-reconstruction-an-analysis-of-515-consecutive-cases
#3
Felix H Vollbach, Christoph D Heitmann, Hisham Fansa
BACKGROUND: The usage of internal mammary artery perforators (IMAPs) has been described in autologous breast reconstruction although IMAPS are not yet considered standard recipient vessels. It remains unclear if these vessels can be safely used in large flaps after radiation therapy or in delayed breast reconstruction. METHODS: Over a 2-year period, 515 free flaps for autologous breast reconstruction were performed on 419 patients by 2 surgeons (S1 and S2). In a retrospective analysis, time of reconstruction, ischemia time, flap weight, diameter of couplers, and complications were analyzed...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28285013/use-of-revascularized-artery-as-a-recipient-in-microvascular-reconstruction-of-the-lower-leg-an-analysis-of-62-consecutive-free-flap-transfers
#4
Hyung Min Hahn, Yeon Seong Jeong, You Sun Hong, Je Hwan Won, Sang Hyun Lim, Jinoo Kim, Myong Chul Park, Dong Ha Park, Il Jae Lee
BACKGROUND: This study aimed to demonstrate the safety and reliability of combined preoperative angioplasty and free flap transfer in patients with peripheral arterial occlusive disease (PAOD) by analyzing the surgical outcomes. METHODS: Between October 2011 and October 2015, patients who had undergone lower extremity angiography and subsequent free flap transfer were retrospectively reviewed. Data collected included demographics, perioperative data, and postoperative outcomes...
February 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28280670/a-comprehensive-approach-to-lower-extremity-free-tissue-transfer
#5
Lee L Q Pu
BACKGROUND: The purpose of this study was to introduce a comprehensive approach to lower extremity free-tissue transfer and report the clinical outcome that has been achieved with this approach. METHODS: The comprehensive approach developed by the author includes patient selection, flap selection, selection of the recipient vessels, flap dissection, flap preparation, microvascular anastomosis, flap inset, immediate postoperative care, intermediate postoperative care, and further follow-up care...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28280668/zygomatico-maxillary-reconstruction-with-computer-aided-manufacturing-of-a-free-dcia-osseous-flap-and-intraoral-anastomoses
#6
Andrée-Anne Roy, Johnny I Efanov, Geneviève Mercier-Couture, André Chollet, Daniel E Borsuk
Craniomaxillofacial reconstruction using virtual surgical planning, computer-aided manufacturing, and new microsurgical techniques optimizes patient-specific and defect-directed reconstruction. A 3D customized free deep circumflex iliac artery (DCIA) flap with intraoral anastomoses was performed on a 23-year-old man with a posttraumatic right zygomatico-maxillary defect with failure of alloplastic implant reconstruction. An osseous iliac crest flap was sculpted based on a customized 3D model of the mirror image of the patient's unaffected side to allow for perfect fit to the zygomatico-maxillary defect...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28280662/avoiding-facial-incisions-with-midface-free-tissue-transfer
#7
Mark W Stalder, Michael Sosin, Leo J Urbinelli, James L Mayo, Amir H Dorafshar, Hugo St Hilaire, Daniel E Borsuk, Eduardo D Rodriguez
BACKGROUND: We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions. METHODS: Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intraoral, transmucosal approach, obviating the need for visible skin incisions...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28279397/-reconstruction-of-the-ear-in-the-burns-patient
#8
Jorge Raúl Carrillo-Córdova, Yusef Jiménez Murat, Armando Apellaniz-Campo, Hazel Bracho-Olvera, Raúl Carrillo Esper
Face burns are a singular pathology with great functional and psychological impact in the patients suffering them. The ears play a fundamental role in personal interactions and damage to this organ results in physical and emotional distress. The reconstructive treatment of the burned ear is a challenge. Multiple procedures have been described to achieve success in the reconstruction of the burned ear; immediate reconstruction with autologous rib cartilage, secondary reconstruction, alloplastic material reconstruction, tissue expansion, skin grafts and also microvascular flaps are some of the most common procedures used in this patients...
March 6, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28272127/reply-perioperative-tamoxifen-use-and-risk-of-deep-vein-thrombosis-role-of-caprini-risk-assessment-model-should-not-be-discarded-is-it-necessary-to-stop-tamoxifen-therapy-in-microvascular-flap-reconstruction
#9
Ara A Salibian, Andrew V Bokarius, Jeffrey Gu, Yoon Lee, Garrett A Wirth, Keyianoosh Z Paydar, Mark R Kobayashi, Gregory R D Evans
No abstract text is available yet for this article.
April 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28272126/is-it-necessary-to-stop-tamoxifen-therapy-in-microvascular-flap-breast-reconstruction
#10
Teresa Pérez-de la Fuente
No abstract text is available yet for this article.
April 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28269609/knife-edge-scanning-microscopy-for-in-silico-study-of-cerebral-blood-flow-from-biological-imaging-data-to-flow-simulations
#11
Michael R Nowak, Alexander Lozovskiy, Dimitri Dobroskok, Yoonsuck Choe
Knife-edge scanning microscopy provides the capability to image whole-brain cerebral microvasculature of small organisms, such as mice, at sub-micron resolution, providing a feasible foundation for the reconstruction of circulatory pathways from the systemic to cellular scale. In this paper, we illustrate the feasibility of using this data to model cerebral blood flow using numerical simulations. Starting with a small vascular element in microcirculation of interest, we present its segmentation from the imaging-data volume, construction of its triangular surface mesh, assembly of its tetrahedral volumetric mesh from the surface, and then conclude with Stokes flow simulation of plasma through the microvascular vessel...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267121/current-techniques-for-postoperative-monitoring-of-microvascular-free-flaps
#12
Nasir Khatri, Shuhao Zhang, Santosh S Kale
Free tissue transfer (FTT) is used in patients with complicated reconstructive needs; it can provide stable wound coverage, improved aesthetic appearance, and restore functional deficits. Despite the high success rates of free flaps, vascular occlusion is a significant risk leading to flap failure. Many studies have demonstrated that the salvage rate for flaps is inversely related to the time between onset of a vascular problem and its surgical correction. As a result, ongoing postoperative monitoring of free flaps for adequate perfusion is imperative to allow timely and accurate diagnosis of vascular compromise...
March 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28259642/determining-the-best-recipient-vessel-site-for-autologous-microsurgical-breast-reconstruction-with-diep-flaps-an-anatomical-study
#13
Martin Lhuaire, Mikael Hivelin, Moustapha Dramé, Peter Abrahams, Reza Kianmanesh, Christian Fontaine, Laurent Lantieri
INTRODUCTION: The deep inferior epigastric perforator (DIEP) flap is a reliable and reproducible technique for autologous microsurgical breast reconstruction. Several recipient vessels sites for microvascular anastomosis have been described such as the internal thoracic vessels, the thoracodorsal vessels, and the circumflex scapular vessels. Nonetheless, the choice of the recipient site depends mainly on individual operator's experience and preferences, and currently the best recipient vessel site is under debate...
February 13, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28259113/surgeon-based-3d-printing-for-microvascular-bone-flaps
#14
Erin M Taylor, Matthew L Iorio
Background Three-dimensional (3D) printing has developed as a revolutionary technology with the capacity to design accurate physical models in preoperative planning. We present our experience in surgeon-based design of 3D models, using home 3D software and printing technology for use as an adjunct in vascularized bone transfer. Methods Home 3D printing techniques were used in the design and execution of vascularized bone flap transfers to the upper extremity. Open source imaging software was used to convert preoperative computed tomography scans and create 3D models...
March 4, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28236793/complications-and-cost-analysis-of-intraoperative-arterial-complications-in-head-and-neck-free-flap-reconstruction
#15
Catherine S Chang, Michael W Chu, Jonas A Nelson, Marten Basta, Patrick Gerety, Suhail K Kanchwala, Liza C Wu
Background Microvascular anastomotic patency is fundamental to head and neck free flap reconstructive success. The aims of this study were to identify factors associated with intraoperative arterial anastomotic issues and analyze the impact on subsequent complications and cost in head and neck reconstruction. Methods A retrospective review was performed on all head and neck free flap reconstructions from 2005 to 2013. Patients with intraoperative, arterial anastomotic difficulties were compared with patients without...
February 25, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28231374/mechanical-venous-anastomosis-in-head-and-neck-microvascular-reconstruction-as-an-equivalent-to-the-gold-standard
#16
Eric Thorpe, Yash Patil
To define the most successful and efficient manner to perform venous microvascular anastomoses, the effectiveness of mechanical venous anastomosis in head and neck microvascular reconstruction is reviewed. Head and neck reconstruction with free flap techniques has become the norm and gold standard for large defects. This retrospective, multicenter case series of a single microvascular surgeon's experience with mechanical venous anastomoses specifically assessed the effectiveness of head and neck reconstruction and the complications associated with it...
February 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28230584/microsurgical-replantation-of-total-avulsed-scalp-extending-the-limits
#17
Yunbo Jin, Chen Hua, Xiaojie Hu, Hui Chen, Gang Ma, Yun Zou, Bin Chen, Dongze Lyu, Mathias Tremp, Xiaoxi Lin
BACKGROUND: Avulsion of the scalp is a rare but severe trauma and challenging to the reconstructive surgeon. It poses not only physical concussion but also significant persisting psychological distress to the patients. METHODS: Medical records from 5 patients who suffered scalp avulsion were reviewed retrospectively. The following data and methods were assessed: age, number of vessels repaired, method of replantation, vein grafts required, blood transfusion, ischemia time, total operating time, and percentage of scalp survival...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28227867/knife-edge-scanning-microscopy-for-in-silico-study-of-cerebral-blood-flow-from-biological-imaging-data-to-flow-simulations
#18
Michael R Nowak, Alexander Lozovskiy, Dimitri Dobroskok, Yoonsuck Choe, Michael R Nowak, Alexander Lozovskiy, Dimitri Dobroskok, Yoonsuck Choe, Dimitri Dobroskok, Michael R Nowak, Alexander Lozovskiy, Yoonsuck Choe
Knife-edge scanning microscopy provides the capability to image whole-brain cerebral microvasculature of small organisms, such as mice, at sub-micron resolution, providing a feasible foundation for the reconstruction of circulatory pathways from the systemic to cellular scale. In this paper, we illustrate the feasibility of using this data to model cerebral blood flow using numerical simulations. Starting with a small vascular element in microcirculation of interest, we present its segmentation from the imaging-data volume, construction of its triangular surface mesh, assembly of its tetrahedral volumetric mesh from the surface, and then conclude with Stokes flow simulation of plasma through the microvascular vessel...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226373/microvascular-flaps-in-nasal-reconstruction
#19
Irene A Kim, Kofi D O Boahene, Patrick J Byrne, Shaun C Desai
Nasal reconstruction for subtotal and total rhinectomy defects is a challenging endeavor, which requires technical finesse, a keen artistic eye, and the ability to anticipate long-term changes that accompany postoperative healing. While local and regional flaps have traditionally been utilized to reconstitute missing nasal elements, certain situations may not provide sufficient or acceptable tissue for optimal reconstruction. In these situations, the three major components of the nose-lining, structural support, and external skin-may require reconstruction with tissues harvested from distant sites through microvascular free tissue transfer...
February 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28216818/limb-salvage-with-microvascular-free-fibula-following-primary-bone-sarcoma-resection
#20
Sahasrabudhe Parag, Panchwagh Yogesh, Jesal Rathod, Panse Nikhil, Jadhav Amit
BACKGROUND: Extremity sarcomas are challenging to manage. Total eradication of tumour has to be balanced with restoration of limb function to prevent mortality and morbidity. Disease-free survival with maximum limb function is the ultimate goal in these patients. MATERIALS AND METHODS: We present a series of ten cases of extremity malignancies, where limb salvage was attempted with microvascular free fibula for limb reconstruction from the period of 2008 to 2015...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
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