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Microvascular reconstruction

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https://www.readbyqxmd.com/read/28063278/combined-anterolateral-thigh-and-tensor-fasciae-latae-flaps-an-option-for-reconstruction-of-large-head-and-neck-defects
#1
Ramzey Tursun, Hisham Marwan, J Marshall Green, Fawaz Alotaibi, Andre LeDoux
PURPOSE: The advent of microvascular free tissue transfer has provided the reconstructive surgeon with an enormous array of treatment options for reconstruction of large head and neck defects. However, when indicated by defect size, the need for more than 1 flap not only increases surgical complexity but also patient morbidity. The combination of the anterolateral thigh (ALT) flap and the tensor fascia latae (TFL) flap can be used to reconstruct such complex head and neck defects, thereby minimizing any additional morbidity that would be imposed by an additional flap harvest site...
December 26, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28062176/characteristics-and-surgical-management-of-flap-compromise-caused-by-thrombosis-of-the-internal-jugular-vein
#2
Bin Yang, Yi Qu, Ming Su, Jinzhong Li, Hua Li, Rudong Xing, Zhengxue Han
BACKGROUND: A principal reason for flap compromise in oral and maxillofacial head and neck surgery, and failure of a free flap transfer, is thrombosis of a drainage vein such as the internal jugular vein. This study characterized flap compromise caused by internal jugular vein thrombosis after a free flap transfer, and its management. PATIENTS AND METHODS: A retrospective clinical study was conducted of 306 consecutive microvascular free flaps performed for 305 patients with head and neck cancer from March 2003 to March 2013 at the Department of Oral and Maxillofacial Surgery at Beijing Stomatological Hospital, Capital Medical University...
December 18, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28059901/conservative-surgery-for-laryngeal-chondrosarcoma-a-review-of-the-most-recently-proposed-approaches
#3
Cesare Piazza, Alberto Paderno, Piero Nicolai
PURPOSE OF REVIEW: The aim of this study was to describe the most recent technical nuances for resection and reconstruction of Grade 1 and 2 laryngeal chondrosarcomas, with a special emphasis on those located at the level of the cricoid plate, which is the site of origin of the vast majority of these rare tumours. RECENT FINDINGS: Even though inherently based on retrospective small clinical series or anecdotal case reports, a number of studies have been recently published focusing on conservative transoral and open-neck surgical procedures aimed at an oncologically sound removal of the tumour together with organ and function preservation...
January 3, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28056483/complex-orofacial-reconstruction-with-the-intrinsic-chimeric-flap
#4
Andrés A Maldonado, Amanda K Silva, Laura S Humphries, Lawrence J Gottlieb
Background Ablation of locally advanced or recurrent head and neck cancer often results in large composite orofacial defects with limited recipient vessels. These complex defects lend well to intrinsic chimeric flap reconstruction, which allows greater ability to inset various flap component tissue types than composite flaps and requires only one set of microvascular anastomoses. Methods A retrospective chart review was performed on all patients who underwent orofacial reconstruction with an intrinsic chimeric free flap from 2002 to 2015...
January 5, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28052811/short-term-outcomes-of-mandibular-reconstruction-in-oncological-patients-using-a-cad-cam-prosthesis-including-a-condyle-supporting-a-fibular-free-flap
#5
Achille Tarsitano, Salvatore Battaglia, Valerio Ramieri, Piero Cascone, Leonardo Ciocca, Roberto Scotti, Claudio Marchetti
PURPOSE: Condylar reconstruction and replacement using alloplastic materials currently attracts much surgical interest. The major challenge is to functionally reconstruct the anatomical region; this is crucial in terms of correct mandibular function. The goal of the present study was to evaluate the clinical outcomes of and complications experienced by a series of oncological patients who underwent computer-aided design/computer-aided manufacturing (CAD/CAM) condylar reconstruction following resection-disarticulation of the mandible...
December 16, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28045814/recalcitrant-invasive-skin-cancer-of-the-scalp-combined-extirpation-and-microsurgical-reconstruction-without-cranioplasty
#6
Gerald J Cho, Frederick Wang, Steven M Garcia, Jennifer Viner, William Y Hoffman, Michael W McDermott, Jason H Pomerantz
BACKGROUND: Recurrent invasive skin cancer of the scalp and calvarium is a difficult problem for which universally accepted treatment protocols have not been established. The authors present their 10-year experience with treatment of this specific subset of scalp reconstruction patients and present a successful treatment algorithm that is well suited to this patient population. METHODS: The authors retrospectively reviewed all patients of microsurgical scalp reconstruction performed from 2005 to 2015 that involved invasive cutaneous malignancies of the scalp and calvarium...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28040453/erratum-to-predictors-and-consequences-of-intraoperative-microvascular-problems-in-autologous-breast-reconstruction-j-plast-reconstr-aesthet-surg-69-2016-1349-1355
#7
Anne C O'Neill, Siba Haykal, Shaghayegh Bagher, Toni Zhong, Stefan O P Hofer
No abstract text is available yet for this article.
December 28, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28039007/pedicle-orientation-in-free-flap-microvascular-maxillofacial-reconstruction
#8
Daniel M Cummins, Beomjune Kim, Arshad Kaleem, Waleed Zaid
Oncologic and traumatic defects of the maxilla can pose a challenge to patients, reconstructive surgeons, and maxillofacial prosthodontists in an attempt to provide satisfactory treatment. Oral-nasal and oral-antral fistulas are frequently treated with soft tissue flaps, osteocutaneous flaps, or a maxillofacial obturator. Often, surgical reconstruction is preferred for patient quality of life and definitive restoration. Surgical reconstruction also avoids the difficulties encountered with fabricating an obturator in an irradiated field with the often-resultant microstomia...
December 10, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28018904/3d-volumetric-modeling-and-microvascular-reconstruction-of-irradiated-lumbosacral-defects-after-oncologic-resection
#9
Emilio Garcia-Tutor, Marco Romeo, Michael P Chae, David J Hunter-Smith, Warren Matthew Rozen
BACKGROUND: Locoregional flaps are sufficient in most sacral reconstructions. However, large sacral defects due to malignancy necessitate a different reconstructive approach, with local flaps compromised by radiation and regional flaps inadequate for broad surface areas or substantial volume obliteration. In this report, we present our experience using free muscle transfer for volumetric reconstruction, in such cases, and demonstrate three-dimensional (3D) haptic models of the sacral defect to aid preoperative planning...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/28011124/islanded-facial-artery-musculomucosal-flap-for-tongue-reconstruction
#10
S T Joseph, B S Naveen, T M Mohan
Reconstruction of the tongue can be achieved by means of various local, regional, and microvascular free flaps. Local flaps commonly used for tongue reconstruction include the nasolabial flap, submental flap, infrahyoid flap, and pedicled facial artery musculomucosal (FAMM) flap. The purpose of this article is to propose a technical modification to the FAMM flap for the reconstruction of small to medium-sized tongue defects post tumour excision: islanding the flap and tunnelling it from the lingual aspect of the mandible in a single-stage procedure...
December 20, 2016: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28007392/donor-site-morbidity-and-quality-of-life-after-microvascular-head-and-neck-reconstruction-with-free-fibula-and-deep-circumflex-iliac-artery-flaps
#11
Christopher Schardt, Angela Schmid, Jens Bodem, Johannes Krisam, Jürgen Hoffmann, Christian Mertens
PURPOSE: Bone defects after resective tumor surgeries often require the use of microvascular reanastomized bone grafts for reconstruction. The decision as to which specific flap is most suitable for the particular patient is dependent on various factors. The aspects donor site morbidity and quality of life are rarely taken into account in this connection. The aim of this study was to analyze whether these factors, in the future, should influence the choice of donor site. MATERIAL AND METHODS: In this study, the donor sites of 46 patients with respect to deep-circumflex iliac artery (DCIA) and fibula flaps were analyzed using subjective and objective parameters...
November 30, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28005769/aberrant-lower-extremity-arterial-anatomy-in-microvascular-free-fibula-flap-candidates-management-algorithm-and-case-presentations
#12
Alyssa R Golas, Jamie P Levine, Justin Ream, Eduardo D Rodriguez
An accurate and comprehensive understanding of lower extremity arterial anatomy is essential for the successful harvest and transfer of a free fibula osteoseptocutaneous flap (FFF). Minimum preoperative evaluation includes detailed history and physical including lower extremity pulse examination. Controversy exists regarding whether preoperative angiographic imaging should be performed for all patients. Elevation of an FFF necessitates division of the peroneal artery in the proximal lower leg and eradicates its downstream flow...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005734/risk-factors-leading-to-free-flap-failure-analysis-from-the-national-surgical-quality-improvement-program-database
#13
Paymon Sanati-Mehrizy, Benjamin B Massenburg, John M Rozehnal, Michael J Ingargiola, Jonatan Hernandez Rosa, Peter J Taub
BACKGROUND: The objective of this study was to identify risk factors for free flap failure among various anatomically based free flap subgroups. METHODS: The 2005 to 2012 American College of Surgeons National Surgical Quality Improvement Program database was queried for patients undergoing microvascular free tissue transfer based on current procedural terminology codes. Univariate analysis was performed to identify any association between flap failure and the following factors: age, gender, race, body mass index (BMI), diabetes, smoking, alcohol use, hypertension, intraoperative transfusion, functional health status, American Society of Anesthesiologists class, operative time, and flap location...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27995558/is-there-benefit-to-free-over-pedicled-vascularized-grafts-in-augmenting-tibial-intercalary-allograft-constructs
#14
Marco Manfrini, Srimanth Bindiganavile, Ferhat Say, Marco Colangeli, Laura Campanacci, Massimiliano Depaolis, Massimo Ceruso, Davide Donati
BACKGROUND: Intercalary reconstruction of tibial sarcomas with vascularized fibula autografts and massive bone allografts is reliable with predictable long-term results. However, inadequate data exist comparing free and pedicled vascularized fibula autografts in combination with a massive bone allograft in patients undergoing intercalary tibia reconstructions. QUESTIONS/PURPOSES: Among patients undergoing large-segment intercalary allografting, we sought to compare supplemental free vascularized fibular autografts with supplemental pedicled vascularized fibular autografts, in terms of (1) oncologic results, (2) complications associated with surgery, (3) Musculoskeletal Tumor Society (MSTS) scores, and (4) surgical time...
December 19, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27983899/-the-use-of-microvascular-free-flaps-in-head-and-neck-reconstruction-performed-by-the-otorhinolaryngologists-a-series-of-65-flaps
#15
Bora Başaran, Selin Ünsaler, İsmet Aslan
OBJECTIVES: This study aims to assess the success rate of surgery and postoperative morbidity in patients who underwent major head and neck surgery with reconstruction by microvascular free flaps performed by otolaryngologists. PATIENTS AND METHODS: We retrospectively analyzed the medical records of 63 patients (31 males, 32 females; mean age 47.9±12.5 years; range 20-71 years) operated in our clinic between September 2012 - August 2016. The indications of reconstruction by free flap, success rates, need for revision and re-exploration, reasons of flap failure, morbidity and mortality were evaluated...
November 2016: Kulak Burun Boğaz Ihtisas Dergisi: KBB, Journal of Ear, Nose, and Throat
https://www.readbyqxmd.com/read/27977494/microsurgical-forehead-reconstruction
#16
Denis Ehrl, P Niclas Broer, Paul I Heidekrueger, Milomir Ninkovic
Reconstruction of the forehead remains challenging. Especially in cases of large or even complete forehead defects, local flaps and skin grafting may not be an option, necessitating free flap coverage. The aim of this retrospective case series was to develop an algorithmic surgical approach as well as to evaluate surgical and aesthetic outcomes of microvascular-based forehead reconstructions, using gracilis muscle or anterolateral thigh flaps in 15 cases. The mean size of the defects was 84.6 (range: 25-160, ±44...
December 13, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27976451/arteriogenesis-in-murine-adipose-tissue-is-contingent-on-cd68-cd206-macrophages
#17
Scott A Seaman, Yiqi Cao, Chris A Campbell, Shayn M Peirce
OBJECTIVE: The surgical transfer of skin, fat, and/or muscle from a donor site to a recipient site within the same patient, is a widely performed procedure in reconstructive surgeries. A surgical pre-treatment strategy that is intended to increase perfusion in the flap, termed "flap delay", is a commonly employed technique by plastic surgeons prior to flap transplantation. Here, we explored whether CD68(+) /CD206(+) macrophages are required for arteriogenesis within the flap by performing gain-of-function and loss-of-function studies in a previously published flap delay murine model...
December 15, 2016: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/27975041/insufficient-fibrinogen-response-following-free-flap-surgery-is-associated-with-bleeding-complications
#18
Jonas Kolbenschlag, Yannick Diehm, Adrien Daigeler, David Kampa, Sebastian Fischer, Nicolai Kapalschinski, Ole Goertz, Marcus Lehnhardt
Background: Microvascular tissue transfer has become a safe and reliable tool in the reconstructive armamentarium, yielding high success rates. However, little is known about the changes in coagulation after free tissue transfer and their potential impact on morbidity. Methods: Fibrinogen concentration and platelet count among other values were available and assessed in 139 undergoing free tissue transfer before, immediately after, and 1-3 as well as 8-11 days after surgery. In patients undergoing urgent revision for either bleeding or microvascular thrombosis, blood samples were drawn directly before re-exploration...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/27974173/multivariate-analysis-as-an-advantageous-approach-for-prediction-of-the-adverse-outcome-in-head-and-neck-microvascular-reconstructive-surgery
#19
Pawel Golusinski, Jakub Pazdrowski, Mateusz Szewczyk, Piotr Pieńkowski, Ewa Majchrzak, Augusto Schneider, Michal M Masternak, Wojciech Golusinski
BACKGROUND: The use of a free flap has become a mainstay of reconstruction following the ablative surgery in head and neck. The success rates are about 90%, however, several factors have been described to have an adverse effect on free flap survival. METHODS: We have performed a retrospective analysis of the treatment outcome of 93 microvascular flaps and evaluated the factors influencing the risk of flap loss including patients' age, body mass index, smoking, general medical history and previous oncological treatment...
December 9, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27973925/a-reduced-gastric-corpus-microvascular-blood-flow-during-ivor-lewis-esophagectomy-detected-by-laser-speckle-contrast-imaging-technique
#20
Rikard Ambrus, Lars B Svendsen, Niels H Secher, Kim Rünitz, Hans-Jørgen Frederiksen, Morten B S Svendsen, Mette Siemsen, Steen C Kofoed, Michael P Achiam
BACKGROUND: Reduced microvascular blood flow is related to anastomotic insufficiency following esophagectomy, emphasizing a need for intraoperative monitoring of the microcirculation. This study evaluated if laser speckle contrast imaging (LSCI) was able to detect intraoperative changes in gastric microcirculation. METHODS: Gastric microcirculation was assessed prior to and after reconstruction of gastric continuity in 25 consecutive patients operated for adenocarcinoma with open Ivor-Lewis esophagectomy while hemodynamic variables were recorded...
December 15, 2016: Scandinavian Journal of Gastroenterology
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