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Microvascular reconstruction

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https://www.readbyqxmd.com/read/27919597/axiographic-results-of-cad-cam-assisted-microvascular-fibular-free-flap-reconstruction-of-the-mandible-a-prospective-study-of-21-consecutive-cases
#1
Lucas M Ritschl, Thomas Mücke, Andreas M Fichter, Maximilian Roth, Clemens Kaltenhauser, Jean Marc Pho Duc, Marco R Kesting, Klaus-Dietrich Wolff, Denys J Loeffelbein
Virtual planning and guided reconstruction of the mandible following ablative surgery have become standard procedures in reconstructive surgery. Many advantages regarding operation time, morphology, bony fit, and consolidation have been described, but analyses of the functional outcome of virtually planned mandibular reconstructions are lacking. We prospectively analyzed 21 consecutive cases of mandibular reconstructions using CAD/CAM-assisted microvascular, fibular free flaps in operations between July 2014 and January 2016 at a single center...
November 12, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27919113/analysis-of-flap-weight-and-postoperative-complications-based-on-flap-weight-in-patients-undergoing-microsurgical-breast-reconstruction
#2
Gretl Lam, Katie E Weichman, Patrick L Reavey, Stelios C Wilson, Jamie P Levine, Pierre B Saadeh, Robert J Allen, Mihye Choi, Nolan S Karp, Vishal D Thanik
Background Higher body mass index (BMI) has been shown to increase postoperative complications in autologous breast reconstruction. However, the correlation with flap weight is unknown. Here, we explore the relationship of flap weights and complication rates in patients undergoing microvascular breast reconstruction. Methods Retrospective chart review identified all patients undergoing microvascular breast reconstruction with abdominally based flaps at a single institution between November 2007 and April 2013...
December 5, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27908574/reconstruction-of-a-post-traumatic-maxillary-ridge-using-a-radial-forearm-free-flap-and-immediate-tissue-engineering-bone-morphogenetic-protein-bone-marrow-aspirate-concentrate-and-cortical-cancellous-bone-case-report
#3
James C Melville, Ramzey Tursun, J Marshall Green, Robert E Marx
The purpose of this article is to describe reconstruction of the maxillary alveolar ridge by use of a microvascular free flap combined with an immediate tissue-engineered bone graft. This novel surgical technique involved the use of a radial forearm free flap and immediate allogeneic avascular bone graft augmented with bone morphogenetic protein and bone marrow aspirate concentrate. A poly-d,l-lactic acid mesh was used a containment unit for the bone graft. The patient was successfully treated with a viable radial forearm free flap for soft tissue and regeneration of bone with adequate height and width, which allowed the placement of 3 dental implants with excellent arch coordination...
November 9, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27898199/microsurgical-reconstruction-in-patients-greater-than-80-years-old
#4
Paul I Heidekrueger, Albrecht Heine-Geldern, Milomir Ninkovic, Frank Herter, Daniel Schmauss, Thiha Aung, P Niclas Broer
BACKGROUND: Demographic change implies that the human population is getting older and the elderly are living longer. Consequently, achieving good functional and aesthetic outcomes in microvascular procedures, especially in very old patients with higher incidence of atherosclerosis and vessel calcifications, constitutes a microsurgical challenge. This study evaluates the feasibility of microsurgical procedures in a very old patient cohort. PATIENTS AND METHODS: Between 2009 and 2015, 754 patients underwent 838 free flap reconstructions...
November 29, 2016: Microsurgery
https://www.readbyqxmd.com/read/27898195/cost-effectiveness-of-microsurgical-reconstruction-for-head-and-neck-defects-after-oncologic-resection
#5
Lin Lin Gao, Marten Basta, Suhail K Kanchwala, Joseph M Serletti, David W Low, Liza C Wu
BACKGROUND: Microvascular free tissue transfer has become the main technique used for head and neck reconstruction. We assessed the cost-effectiveness of free flap reconstruction for head and neck defects after oncologic resection for squamous cell carcinoma (SCC). METHODS: We developed a Markov model of the cost, quality of life, survival, and incremental cost-effectiveness of reconstruction with free tissue transfer compared with locoregional flaps. Health state probabilities and quality of life scores were determined from literature...
November 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/27890228/tissue-engineered-prevascularized-bone-and-soft-tissue-flaps
#6
REVIEW
F Kurtis Kasper, James Melville, Jonathan Shum, Mark Wong, Simon Young
The complex shapes of skeletal components of the craniofacial region combined with the prominence of the face and paucity of overlying soft tissue create significant challenges for the reconstructive surgeon. The in vivo bioreactor strategy is a promising alternative to microvascular surgical techniques that combines tissue engineering principles with microvascular reconstructive techniques to create patient-specific, prevascularized bone flaps for reconstruction of complex maxillofacial defects. This article discusses the use of traditional vascularized bone flaps; preclinical studies using the in vivo bioreactor approach; case reports that have attempted this novel technique; and future challenges and considerations in the development of patient-specific, prevascularized bone flaps for maxillofacial reconstruction...
February 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27890226/tissue-engineering-for-vertical-ridge-reconstruction
#7
REVIEW
Neel Patel, Beomjune Kim, Waleed Zaid, Daniel Spagnoli
This article provides an overview of basic tissue engineering principles as they are applied to vertical ridge defects and reconstructive techniques for these types of deficiencies. Presented are multiple clinical cases ranging from office-based dentoalveolar procedures to the more complex reconstruction of postresection mandibular defects. Several different types of regenerative tissue constructs are presented; either used alone or in combination with traditional reconstructive techniques and procedures, such as maxillary sinus augmentation, Le Fort I osteotomy, and microvascular free tissue transfer...
February 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27883877/surgical-management-of-progressive-hemifacial-atrophy-with-de-epithelialized-profunda-artery-perforator-flap-a-case-report
#8
Zoltán Lóderer, Ágnes Janovszky, Péter Lázár, József Piffkó
Progressive hemifacial atrophy (PHA) is a rare disorder characterized by slow, unilateral atrophy of the soft tissues and bones of the craniofacial region. The defect becomes more pronounced with age, leading to esthetic and functional deficits. However, the proper timing and method of surgical reconstruction are still debated. The correction of this defect markedly influencing the quality of life of the patient can be achieved with less invasive to more invasive surgical approaches. A 21-year-old female patient with hemifacial atrophy and extensive alopecia presented to our clinic...
October 29, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27879584/stacked-thoracodorsal-artery-perforator-flaps-for-unilateral-breast-reconstruction
#9
Claudio Angrigiani, Alberto Rancati, Guillermo Artero, Roger K Khouri, Frances M Walocko
The thoracodorsal artery perforator flap is reliable and safe for breast reconstruction, but stacking bilateral thoracodorsal artery perforator flaps for unilateral reconstruction to achieve greater volumes has not been reported. To create a stacked thoracodorsal artery perforator flap, the ipsilateral flap is transferred as an island, and the contralateral flap is transferred as a microvascular free flap. In this article, the authors present their 8-year 14- patient experience with stacked thoracodorsal artery perforator flaps for unilateral breast reconstruction...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27876545/submental-island-flap-reconstruction-in-oral-cavity-cancer-patients-with-level-i-lymph-node-metastasis
#10
P Sittitrai, C Srivanitchapoom, D Reunmakkaew, K Yata
The submental island flap is useful as an alternative to microvascular free tissue transfer for the reconstruction of defects after resection of oral cancer because it is simple to harvest, reliable, and is associated with good oral function and low morbidity. However, because cancer of the oral cavity carries a risk of level I nodal metastases, the oncological safety of the flap remains controversial. Between April 2012 and September 2016, we studied patients with squamous cell carcinoma of the oral cavity who underwent surgical resection with submental island flap reconstruction for viability of the flap, signs of recurrence, and complications...
November 19, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/27875515/reconstruction-of-congenital-mandibular-hypoplasia-with-microvascular-free-fibula-flaps-in-the-pediatric-population-a-paradigm-shift
#11
Emily C Cleveland, Jamie Zampell, Tomer Avraham, Z-Hye Lee, David Hirsch, Jamie P Levine
BACKGROUND: The microvascular free fibula flap has become the gold standard for reconstruction of complex mandibular defects since its description by Hidalgo in 1989. Prior studies have demonstrated its safety and efficacy in the pediatric population. However, this reconstructive method is often used only as a last resort for correction of congenital mandibular hypoplasia, after failure of bone grafting and distraction osteogenesis. The authors describe our experience using this technique, facilitated by virtual planning and prefabricated cutting jigs, for children with severe congenital mandibular hypoplasia...
November 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27875397/autologous-microvascular-breast-reconstruction-postoperative-strategies-to-improve-outcomes
#12
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Nursing
https://www.readbyqxmd.com/read/27871294/newly-designed-retentive-posts-of-mandibular-reconstruction-plate-in-oral-cancer-patients-based-on-preliminary-fem-study
#13
Ik Jae Kwon, Mi Young Eo, Sung Jae Park, Soung Min Kim, Jong Ho Lee
BACKGROUND: The reconstruction of a large mandibular defect poses a challenging issue in oral cancer ablation surgery. One popular option for mandibular continuity reconstruction after tumor resection involves the use of a reconstruction plate (R-plate), which maintains space and contour without bone harvesting. An R-plate, however, cannot provide final functional loading rehabilitation with implants or dentures. METHODS: We suggest a new method of functional mandibular reconstruction using retentive posts and an upper prosthesis...
November 21, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27858701/contrast-enhanced-ultrasonography-as-a-new-method-for-assessing-autonomization-of-pedicle-and-microvascular-free-flaps-in-head-and-neck-reconstructive-surgery
#14
Steffen Mueller, Christina M Wendl, Tobias Ettl, Christoph Klingelhöffer, Sebastian Geis, Lukas Prantl, Torsten E Reichert, Ernst Michael Jung
OBJECTIVE: Evaluating vascular autonomization of pedicle and microvascular free flaps for soft tissue reconstruction in the head and neck area by means of postoperative quantitative measurement of dynamic contrast values obtained with contrast-enhanced ultrasound. METHODS: 8/18 patients underwent lip reconstruction with a pedicle flap, 10 patients reconstruction of other parts of the head with a microvascular free transplant. Ultrasound examinations were within the 1st postoperative week and 4 weeks after surgery...
November 18, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27852330/appearance-of-claudin-5-leukocytes-in-the-central-nervous-system-during-neuroinflammation-a-novel-role-for-endothelial-derived-extracellular-vesicles
#15
Debayon Paul, Valentina Baena, Shujun Ge, Xi Jiang, Evan R Jellison, Timothy Kiprono, Dritan Agalliu, Joel S Pachter
BACKGROUND: The mechanism of leukocyte transendothelial migration (TEM) across the highly restrictive blood-brain barrier (BBB) remains enigmatic, with paracellular TEM thought to require leukocytes to somehow navigate the obstructive endothelial tight junctions (TJs). Transient interactions between TJ proteins on the respective leukocyte and endothelial surfaces have been proposed as one mechanism for TEM. Given the expanding role of extracellular vesicles (EVs) in intercellular communication, we investigated whether EVs derived from brain microvascular endothelial cells (BMEC) of the BBB may play a role in transferring a major TJ protein, claudin-5 (CLN-5), to leukocytes as a possible basis for such a mechanism during neuroinflammation...
November 16, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27847734/surgical-implications-of-anatomical-variation-in-anterolateral-thigh-flaps-for-the-reconstruction-of-oral-and-maxillofacial-soft-tissue-defects-focus-on-perforators-and-pedicles
#16
Ji-Wan Kim, Dong-Young Kim, Kang-Min Ahn, Jee-Ho Lee
OBJECTIVES: To gain information on anatomical variation in anterolateral thigh (ALT) flaps in a series of clinical cases, with special focus on perforators and pedicles, for potential use in reconstruction of oral and maxillofacial soft tissue defects. MATERIALS AND METHODS: Eight patients who underwent microvascular reconstructive surgery with ALT free flaps after ablative surgery for oral cancer were included. The number of perforators included in cutaneous flaps, location of perforators (septocutaneous or musculocutaneous), and the course of vascular pedicles were intraoperatively investigated...
October 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/27833295/successful-penile-reconstruction-following-prior-arteriovenous-loop-thrombosis-due-to-undiagnosed-protein-s-deficiency-and-exogenous-testosterone
#17
Parameswaran Anoop, Vithal Malmande, M N Prakash Kumar, Naveen Rao
Flap failure from microvascular thrombotic occlusion is a rare but significant cause for unsuccessful reconstructive surgery. We encountered thrombosis of arteriovenous loop in a patient undergoing phallus reconstruction. Further investigations revealed underlying previously asymptomatic hypercoagulable state due to protein-S deficiency in addition to long-term exogenous testosterone administration. Role of thrombophilia testing, thrombogenic potential of testosterone and the need for therapeutic perioperative anti-coagulation in such situations are described here...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27833281/one-plus-one-two-free-flaps-from-same-donor-thigh-for-simultaneous-coverage-of-two-different-defects
#18
Susmitha Bandi, Rayidi Venkata Koteswara Rao, Damalacheruvu Mukunda Reddy
INTRODUCTION: Primary microvascular reconstruction of multiple defects is challenging particularly if it has to be simultaneous. In trauma cases, harvesting two independent free flaps from different sites is very time-consuming and adds to morbidity. To eliminate these disadvantages, we sought to find out a reliable alternative method of harvesting two independent free flaps based on the descending branch of circumflex femoral artery, i.e., one anterolateral thigh (ALT) flap and one rectus femoris muscle flap...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27827846/age-related-renal-microvascular-changes-evaluation-by-three-dimensional-digital-imaging-of-the-human-renal-microcirculation-using-virtual-microscopy
#19
Noriko Uesugi, Yoshihito Shimazu, Kazunori Kikuchi, Michio Nagata
The renal microvasculature is targeted during aging, sometimes producing chronic kidney disease (CKD). Overdiagnosis of CKD in older persons is concerning. To prevent it, a new concept of "healthy aging" is arising from a healthy renal donor study. We investigated the renal microcirculatory changes of three older persons and compared them with that of one patient with nephrosclerosis using a three-dimensional (3D) reconstruction technique that we previously developed. This method uses a virtual slide system and paraffin-embedded serial sections of surgical material that was double-immunostained by anti-CD34 and anti-α smooth muscle actin (SMA) antibodies for detecting endothelial cells and medial smooth muscle cells, respectively...
November 2, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27826458/factors-influencing-the-incidence-of-severe-complications-in-head-and-neck-free-flap-reconstructions
#20
Martin Broome, Naline Juilland, Yann Litzistorf, Yan Monnier, Kishore Sandu, Philippe Pasche, Peter K Plinkert, Philippe A Federspil, Christian Simon
BACKGROUND: Complications after head and neck free-flap reconstructions are detrimental and prolong hospital stay. In an effort to identify related variables in a tertiary regional head and neck unit, the microvascular reconstruction activity over the last 5 years was captured in a database along with patient-, provider-, and volume-outcome-related parameters. METHODS: Retrospective cohort study (level of evidence 3), a modified Clavien-Dindo classification, was used to assess severe complications...
October 2016: Plastic and Reconstructive Surgery. Global Open
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