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Microvascular reconstruction

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https://www.readbyqxmd.com/read/28216818/limb-salvage-with-microvascular-free-fibula-following-primary-bone-sarcoma-resection
#1
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
https://www.readbyqxmd.com/read/28216817/turned-in-fasciocutaneous-island-flap-from-face-and-neck-based-on-subdermal-microcirculation-for-reconstruction-of-the-oral-cavity-following-cancer-surgery
#2
Kalpesh Jayantkumar Gajiwala
BACKGROUND: The skin and soft tissues of the face and neck have a rich plexus of dermal-subdermal vessels, which creates the possibility of raising a fasciocutaneous flap based on this vascular supply. A turned in fasciocutaneous island flap (TIFCIF) from an adjacent area of the defect can provide a simple substitute to many complex reconstructive procedures. MATERIALS AND METHODS: Fifteen patients underwent wide excision for oral cancer and upper neck dissection, maintaining bone framework, between August 2010 and June 2014...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28198595/free-microvascular-rotationplasty-with-nerve-repair-for-rhabdomyosarcoma-in-a-18-month-old-patient
#3
Alberto Pérez-García, Marta Salom, María Eloísa Villaverde-Doménech, Francisco Baixauli, Eduardo Simón-Sanz
Rotationplasty is a limb-sparing surgical option in lower limb malignancies. Sciatic or tibial nerve encasement has been considered an absolute contraindication to this procedure. We report a case of an 18-month-old girl with a rhabdomyosarcoma that affected the leg and popliteal fossa, with neurovascular involvement. Knee and proximal leg intercalary resection was performed followed by reconstruction with free microvascular rotationplasty and neurorraphy from tibial division of sciatic nerve to sural and tibial nerves, and from saphenous nerve to superficial peroneal nerve...
February 15, 2017: Microsurgery
https://www.readbyqxmd.com/read/28196858/the-2016-walter-b-cannon-lecture-deconstructing-metabolic-inflammation-using-cellular-systems
#4
Kenny L Chan, Parastoo Boroumand, Marciane Milanski, Nicolas J Pillon, Philip J Bilan, Amira Klip
Over the past years we have embarked in a systematic analysis of the effect of obesity or fatty acids on circulating monocytes, microvascular endothelial cells, macrophages and skeletal muscle cells. Using cell culture strategies, we have deconstructed complex physiological systems, then reconstructed 'partial equations' to better understand cell-to-cell communication. Through these approaches we identified that in high saturated fat environments, cell-autonomous pro-inflammatory pathways are activated in monocytes and endothelial cells, promoting monocyte adhesion and transmigration...
February 14, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28195555/blood-brain-barrier-supported-neurogenesis-in-healthy-and-diseased-brain
#5
Elena A Pozhilenkova, Olga L Lopatina, Yulia K Komleva, Vladimir V Salmin, Alla B Salmina
Adult neurogenesis is one of the most important mechanisms contributing to brain development, learning, and memory. Alterations in neurogenesis underlie a wide spectrum of brain diseases. Neurogenesis takes place in highly specialized neurogenic niches. The concept of neurogenic niches is becoming widely accepted due to growing evidence of the important role of the microenvironment established in the close vicinity to stem cells in order to provide adequate control of cell proliferation, differentiation, and apoptosis...
February 14, 2017: Reviews in the Neurosciences
https://www.readbyqxmd.com/read/28185144/complications-and-thromboembolic-events-associated-with-tamoxifen-therapy-in-patients-with-breast-cancer-undergoing-microvascular-breast-reconstruction-a-systematic-review-and-meta-analysis
#6
REVIEW
Rajiv P Parikh, Elizabeth B Odom, Liyang Yu, Graham A Colditz, Terence M Myckatyn
PURPOSE: Tamoxifen therapy is integral in the treatment of patients with hormone receptor-positive breast cancer. However, there is an association between tamoxifen and thromboembolic events. Flap and systemic thromboembolic events have devastating consequences in microvascular breast reconstruction. Currently, there are conflicting data on the association between tamoxifen therapy and thromboembolic complications for patients undergoing microvascular breast reconstruction. The objective of this study is to determine if perioperative tamoxifen therapy modifies the risk of complications and thromboembolic events for patients with breast cancer undergoing microvascular breast reconstruction...
February 9, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28177337/free-flap-loss-caused-by-heparin-induced-thrombocytopenia-and-thrombosis-hitt-a-case-report-and-literature-review
#7
E Segna, A R Bolzoni, C Baserga, A Baj
Heparin-induced thrombocytopenia and thrombosis (HITT) represents a dramatic condition that is difficult to diagnose because of nuanced clinical presentation. Therefore, in every case of microvascular thrombosis during heparin-therapy prompt suspicion about HITT is necessary to avoid flap necrosis. We present a case of HITT which, as the 8 other articles reviewed, clearly shows that HITT is difficult to diagnose and complex to manage. Microvascular reconstruction is the first choice in head and neck reconstruction; unfortunately, dramatic outcomes in free flap surgery due to unpredictable thrombotic events are still reported in the English literature...
December 2016: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28177328/head-and-neck-reconstruction-with-pedicled-flaps-in-the-free-flap-era
#8
R Mahieu, G Colletti, P Bonomo, G Parrinello, A Iavarone, G Dolivet, L Livi, A Deganello
Nowadays, the transposition of microvascular free flaps is the most popular method for management of head and neck defects. However, not all patients are suitable candidates for free flap reconstruction. In addition, not every defect requires a free flap transfer to achieve good functional results. The aim of this study was to assess whether pedicled flap reconstruction of head and neck defects is inferior to microvascular free flap reconstruction in terms of complications, functionality and prognosis. The records of consecutive patients who underwent free flap or pedicled flap reconstruction after head and neck cancer ablation from 2006 to 2015, from a single surgeon, in the AOUC Hospital, Florence Italy were analysed...
December 2016: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28174322/4d-microvascular-analysis-reveals-that-regenerative-angiogenesis-in-ischemic-muscle-produces-a-flawed-microcirculation
#9
John-Michael Arpino, Zengxuan Nong, Fuyan Li, Hao Yin, Nour W Ghonaim, Stephanie Milkovich, Brittany Balint, Caroline O'Neil, Graham M Fraser, Daniel Goldman, Christopher G Ellis, J G Pickering
RATIONALE: Angiogenesis occurs following ischemic injury to skeletal muscle and enhancing this response has been a therapeutic goal. However, to appropriately deliver oxygen, a precisely organized and exquisitely responsive microcirculation must form. Whether these network attributes exist in a regenerated microcirculation is unknown and methodologies for answering this have been lacking. OBJECTIVE: To develop 4D methodologies for elucidating microarchitecture and function of the reconstructed microcirculation in skeletal muscle...
February 7, 2017: Circulation Research
https://www.readbyqxmd.com/read/28170119/lateral-arm-free-tissue-transfer-for-parotid-reconstruction-a-pictorial-essay
#10
Stephen Y Kang, Matthew O Old, Theodoros N Teknos
BACKGROUND: The goals of parotid reconstruction are to provide accurate volume reconstruction of the defect while minimizing ptosis, optimize color match to surrounding facial skin, maintain anatomic position of the auricle, and to perform facial nerve rehabilitation in cases in which the facial nerve is removed. METHODS AND RESULTS: For many complex parotid defects, the lateral arm free tissue transfer achieves these reconstructive goals and is the ideal donor site for microvascular reconstruction...
February 7, 2017: Head & Neck
https://www.readbyqxmd.com/read/28151027/end-to-end-versus-end-to-side-anastomoses-in-free-flap-reconstruction-single-centre-experiences
#11
Paul I Heidekrueger, Milomir Ninkovic, Albrecht Heine-Geldern, Frank Herter, P Niclas Broer
BACKGROUND: The choice of microsurgical anastomotic technique, end-to-end (ETE) or end-to-side (ETS), is a relevant point in free tissue transfer. The decision-making process of choosing ETE or ETS technique depends on several clinical and perioperative factors. This study evaluates the outcomes of microvascular procedures in a large single centre patient series, focusing on ETE vs ETS arterial anastomoses. MATERIALS AND METHODS: Between January 2009 and June 2015, 838 patients underwent free flap surgery for reconstruction after trauma, infection, or malignancies...
February 2, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28142350/giant-cell-tumor-of-distal-radius-treated-with-ulnar-translocation-and-wrist-arthrodesis
#12
Abhijeet Ashok Salunke, Jaymin Shah, Vikas Warikoo, Amit Chakraborty, Harshwardhan Pokharkar, Yongsheng Chen, Manish Pruthi, Jyotindra Pandit
INTRODUCTION: The aim is to analyze the functional outcomes of patients of giant cell tumor (GCT) of distal radius treated with ulnar translocation and wrist arthrodesis. METHODS: Study included 25 patients of aggressive GCT of distal radius, resected and reconstructed using ulnar translocation and wrist arthrodesis. The ulna-carpal radius fixation was performed with plate and screws. The patients were followed to bony union and minimum follow-up was 1 year. RESULT: Twenty-two patients were of Campanacci grade 3 and three patients were of Campanacci grade2...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28139320/extended-use-of-perioperative-antibiotics-in-head-and-neck-microvascular-reconstruction
#13
Stefanie Saunders, Stephen Reese, Jimmy Lam, Jacqueline Wulu, Scharkuh Jalisi, Waleed Ezzat
PURPOSE: Many head and neck surgical procedures are considered clean-contaminated wounds and antibiotic prophylaxis is recommended. Despite prophylaxis, the incidence of surgical site infections remains significant - especially in the setting of free tissue transfer. The antibiotic course is often of a longer duration after free tissue transfer than the recommended 24hour post-operatively. Currently, there is no consensus on appropriate antibiotic regimen or duration at this time. This study investigates the outcomes of a 7-day perioperative antibiotic regimen after microvascular reconstruction of the head and neck at our institution...
January 19, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28118198/microvascular-tissue-transfers-for-midfacial-and-anterior-cranial-base-reconstruction
#14
Ali Emre Aksu, Hakan Uzun, Ozan Bitik, Gökhan Tunçbilek, Tunç Şafak
Reconstruction of a midfacial defect can represent a difficult challenge for the plastic surgeon. Although many midfacial deformities have traumatic or congenital origins, the vast majority of head and neck defects occur after resection of malignant head and neck neoplasms. Autogenous reconstruction is now routinely performed for larger, complex defects resulting from surgical resection or trauma. In this study, the authors present 27 patients with midfacial defects reconstructed with free flaps. Twenty-two of the defects were created by surgical ablation of cancer (maxillectomy) and the others were traumatic...
January 23, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28112411/medial-sural-artery-as-a-salvage-recipient-vessel-for-complex-post-traumatic-microvascular-lower-limb-reconstruction
#15
Amresh Baliarsing, Shivprasad Date, Pedro Ciudad
BACKGROUND: Complex lower extremity trauma still poses a formidable challenge for micro vascular reconstruction. The extensive surrounding zone of trauma can make it difficult to find a suitable recipient pedicle for anastomosis. A need was felt for exploration of newer recipient vessels in lower extremity which could be harnessed for reliable and tension free micro anastomosis. The purpose of the present report is to highlight the possibility of using medial sural artery for safe micro vascular anastomosis in selected scenarios like vessel depleted extremity...
January 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28109467/dexamethasone-in-head-and-neck-cancer-patients-with-microvascular-reconstruction-no-benefit-more-complications
#16
S Kainulainen, J Törnwall, A M Koivusalo, A L Suominen, P Lassus
OBJECTIVES: Glucocorticoids are widely used in association with major surgery of the head and neck to improve postoperative rehabilitation, shorten intensive care unit and hospital stay, and reduce neck swelling. This study aimed to clarify whether peri- and postoperative use of dexamethasone in reconstructive head and neck cancer surgery is associated with any advantages or disadvantages. MATERIALS AND METHODS: This prospective double-blind randomized controlled trial comprised 93 patients...
February 2017: Oral Oncology
https://www.readbyqxmd.com/read/28099975/functional-outcome-of-cad-cam-assisted-versus-conventional-microvascular-fibular-free-flap-reconstruction-of-the-mandible-a-retrospective-study-of-30-cases
#17
Lucas M Ritschl, Thomas Mücke, Andreas Fichter, Florian D Güll, Christopher Schmid, Jean Marc Pho Duc, Marco R Kesting, Klaus-Dietrich Wolff, Denys J Loeffelbein
Background Different advantages of virtually planned and guided mandibular reconstructions have been described. Functional analyses and comparisons with conventionally reconstructed patients. Methods We retrospectively analyzed 30 cases of mandibular reconstructions that involved virtually planned or conventional microvascular, fibular free flaps that occurred between April 2011 and December 2014 at a single center. The results were also compared with a healthy cohort of 30 participants. Axiographic measurements were performed postoperatively, and uni- and multivariate regressions analyses were performed to determine the association between possible predictor variables on functional outcome...
January 18, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28089863/prevention-of-thrombosis-in-hypercoagulable-patients-undergoing-microsurgery-a-novel-anticoagulation-protocol
#18
Jonas A Nelson, Cyndi U Chung, Andrew R Bauder, Liza C Wu
BACKGROUND: Hypercoagulable conditions are often considered relative contraindications to free flap reconstruction. This paper presents and critically examines a novel anticoagulation regimen developed to address this disease state. METHODS: Hypercoagulable patients who underwent free tissue transfer between 2007 and 2015 were identified. From 2011, all such patients were subjected to a novel anticoagulation protocol involving an intravenous bolus of 2000 U of unfractionated heparin prior to microvascular pedicle anastomosis, followed by a heparin infusion at 500 U/h, which was postoperatively increased to therapeutic levels...
December 18, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28089170/iliolumbar-artery-a-useful-pedicle-for-the-iliac-crest-free-flap-in-maxillofacial-reconstruction
#19
T Singh, K Andi
The iliac crest free flap is commonly used in maxillofacial reconstruction, and is typically supplied by the deep circumflex iliac artery (DCIA). However, the iliolumbar artery is an alternative blood supply that can potentially be used in such reconstructions. We describe the anatomy of the iliolumbar artery and review publications about its clinical use. We raised four cadaveric iliac crest free flaps using both the DCIA and the iliolumbar artery to illustrate its use in reconstructing maxillofacial defects...
January 11, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28063278/combined-anterolateral-thigh-and-tensor-fasciae-latae-flaps-an-option-for-reconstruction-of-large-head-and-neck-defects
#20
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
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