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https://www.readbyqxmd.com/read/29166313/the-perineal-turnover-perforator-flap-a-new-and-simple-technique-for-perineal-reconstruction-after-extralevator-abdominoperineal-excision
#1
Maria Chasapi, Mohamed Maher, Peter Mitchell, Milind Dalal
BACKGROUND: Extralevator abdominoperineal excision (ELAPE) is increasingly used to treat locally advanced low rectal cancer as it has been related to superior oncological outcomes than traditional abdominoperineal excision.However, ELAPE also has been associated with high perineal wound morbidity rates as it creates a larger perineal cavity than standard abdominoperineal excision. This greater defect, along with the effects of preoperative chemoradiation on wound healing, makes uneventful perineal reconstruction post-ELAPE a real challenge for the plastic surgeon...
November 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29163697/reoperation-following-the-use-of-non-standardized-procedures-for-malignant-parotid-tumors
#2
Xiangmin Zhang, Xiangfu Zeng, Xiaolin Lan, Jing Huang, Keqing Luo, Keqiang Tian, Xiuhong Wu, Fufu Xiao, Shaojin Li
Non-standardized or conservative procedures are employed when parotid tumors involving the facial nerve or parotid carcinoma are misdiagnosed as benign parotid tumors prior to or during surgery. Remedial measures are usually required when the pathological diagnosis of a malignant parotid tumor is confirmed following surgery. The aim of the present study was to systematically evaluate reoperation subsequent to treatment with non-standardized procedures for malignant parotid tumors, and to explore the preoperative diagnoses, the primary procedure selection and the necessity of reoperation following non-standardized procedures in malignant parotid tumors...
December 2017: Oncology Letters
https://www.readbyqxmd.com/read/29151373/nasoseptal-flap-for-palatal-reconstruction-after-hemi-maxillectomy-case-report
#3
M K Alwashahi, P Battaglia, M Turri-Zanoni, P Castelnuovo
OBJECTIVE: Palatal reconstruction following maxillectomy is a surgical challenge, and a nasoseptal flap is a feasible approach. This paper reports the first known successful clinical case of a nasoseptal pedicle flap applied for the reconstruction of maxillary bone following hemi-maxillectomy. CASE REPORT: This report describes hemi-maxillectomy in a 60-year-old Italian male diagnosed with stage IV squamous cell carcinoma of the left maxilla. Endoscopic transnasal extended medial maxillectomy was performed, followed by a transoral modified midfacial degloving technique for removal of the maxillary bone...
November 20, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29147150/localized-aortic-root-dissection-with-a-superior-mesenteric-artery-aneurysm
#4
Akihiko Ikeda, Tomomi Nakajima, Yuji Hiramatsu, Tomoaki Jikuya
In this study, the case of a 46-year-old female patient with localized aortic root dissection and a superior mesenteric artery (SMA) aneurysm is described. Computed tomographic angiography could not clearly delineate an intimal flap in the aortic root, but it detected SMA aneurysm, which implied the presence of a vulnerability of the aortic wall. Finally, transesophageal echocardiography (TEE) evidently showed the intimal flap localized in the aortic root. The present case suggests that TEE is of paramount importance for detecting localized aortic root dissection...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29137568/first-dorsal-metatarsal-artery-perforator-flap-to-cover-great-toe-defect
#5
Roongsak Limthongthang, Perajit Eamsobhana
BACKGROUND: There were very few options available for distal foot and toe defects that required a vascularized flap for coverage. As such, the use of a free flap was often justified in this region of the foot. The use of perforator flaps has created a new subset of local tissue transfer alternatives that increases the potential that the difficulties associated with microvascular tissue transfers could be avoided. The first dorsal metatarsal artery (FDMA) perforator flap was one variant of this new type of tissue transfer...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29130235/-a-meta-analysis-on-risk-factors-of-postoperative-perineal-wound-complications-after-abdominoperineal-resection-for-rectal-cancer
#6
Senqi Lu, Xiaofeng Chang, Xiaodong Yang, Decai Yu, Qigen Huang, Feng Wang
OBJECTIVE: To investigate the risk factors of postoperative perineal wound complications after abdominoperineal resection for rectal cancer. METHODS: The databases of Medline, Embase, Web of Science, Ovid, Cochrane Library, CBM, CNKI, VIP and WANFANG were searched for the studies of abdominoperineal resection up to October 2016. The quality of the included studies was assessed by using "Cochrane collaboration's tool for assessing risk of bias" and "the Newcastle-Ottawa Scale"...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29124855/reconstructive-options-for-large-back-free-flap-donor-sites
#7
Arshia Azizeddin, Peter F M Choong, Damien Grinsell
BACKGROUND: Reconstruction of posterior thoracic and trunk defects can prove challenging even to the most seasoned surgeons. Many commonly used techniques for closing back defects include primary closure and split skin grafts. Often times, however, other techniques are needed in order to give the patient the best aesthetic and functional outcome. In this study, we focus on and evaluate donor site closure techniques for defects in the back created by harvesting scapular and parascapular flaps...
November 9, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29119078/treatment-of-cavitary-bone-defects-in-chronic-osteomyelitis-biogactive-glass-s53p4-vs-calcium-sulphate-antibiotic-beads
#8
Albert Ferrando, Joan Part, Jose Baeza
Aim: To evaluate the efficacy of bioglass (BAG-S53P4) in the treatment of patients with chronic osteomyelitis and compare the results with calcium sulphate antibiotic beads in one medical centre. Methods: Retrospective analysis of 25 cases. INCLUSION CRITERIA: patients diagnosed clinically and radiographically of osteomyelitis and treated surgically (Group 1: cavitary bone defects treated with bioglass and Group 2: cavitary bone defects treated with calcium sulphate antibiotic beads) during the period of 2014 and 2015 in one medical centre...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/29115655/delayed-bipedicled-flap-an-alternative-and-new-method-for-reconstruction-of-distal-leg-defect-after-gunshot-trauma-a-case-report-and-review-of-the-literature
#9
Ali Rıza Yıldırım, Murat İğde, Mehmet Onur Öztürk, Hasan Murat Ergani, Ramazan Erkin Ünlü
Shotgun injury is a trauma that leads to soft tissue defects, in which important structures such as the tendon and bone are exposed with fractures in the distal lower extremity. Because this region has insufficient soft tissue support, local flap options are highly limited. Although the most suitable options are free or perforator flaps for contemporarily reconstructing that region; owing to such highenergy traumas, the available local flaps are becoming more suitable. Besides having various advantages, bipedicled flaps are commonly used for reconstructing small- and medium-sized lower extremity defects...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29113672/vulvo-vaginal-reconstruction-after-radical-excision-for-treatment-of-vulvar-cancer-evaluation-of-feasibility-and-morbidity-of-different-surgical-techniques
#10
REVIEW
Violante Di Donato, Carlotta Bracchi, Emanuele Cigna, Lavinia Domenici, Angela Musella, Andrea Giannini, Francesca Lecce, Claudia Marchetti, Pierluigi Benedetti Panici
BACKGROUND: Vulvar cancer is a rare disease accounting for approximately 5% of female genital tract tumors worldwide. Currently surgery represents the mainstay alone or sometimes, in combination with chemo-radiotherapy, for locally advanced tumors and recurrent disease. However, significant physical and sexual impairment mostly due to anatomical distortion of external genitalia are a consequence of radical surgical treatment. Postoperative reconstruction after demolitive surgeries improves aesthetic and functional results, guarantees an adequate coverage of large tumors and assures safe surgical margin...
December 2017: Surgical Oncology
https://www.readbyqxmd.com/read/29113647/super-radical-hysterectomy-for-recurrent-cervical-cancer
#11
Hee Seung Kim, Ranah Kim, Maria Lee
BACKGROUND: Recurrent cervical cancer with the pelvic side wall invasion has a deleterious effect on prognosis if there is no alternative method to achieve local tumor control [1, 2]. For the surgical treatment, super-radical hysterectomy has been introduced by Ryukichi Mibayashi in 1941 [3, 4]. However, its feasibility and safety is still on debate because of a lack of reproducibility and high level of surgical techniques. Thus, we showed the surgical procedure of super-radical hysterectomy for recurrent cervical cancer...
December 2017: Surgical Oncology
https://www.readbyqxmd.com/read/29109842/submental-perforator-flap-for-soft-tissue-reconstruction-in-bisphosphonate-related-osteonecrosis-of-the-jaws
#12
Jose-Antonio García-de Marcos, Juan Rey-Biel
Bisphosphonate-related osteonecrosis of the jaws (BRONJ) has emerged as an important and increasingly common comorbidity, especially in patients undergoing long-term treatment with high doses of bisphosphonates. The management of BRONJ remains controversial. Surgical treatment is necessary in severe cases. Treatment of the bone requires sequestrectomy or resection. Given the lack of sufficient mucosa to perform the operation and fragility of margins in many patients, local flaps are crucial. We report two cases of stage-3 BRONJ presenting secondary infection with Actinomyces , receiving treatment consisting of marginal resection of the necrotic bone, reinforcement with a reconstruction plate, and reconstruction of soft tissues using a submental perforator artery flap ipsilateral to the lesion...
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29105820/the-radial-forearm-free-flap-as-a-vascular-bridge-for-secondary-microsurgical-head-and-neck-reconstruction-in-a-vessel-depleted-neck
#13
Pedro Ciudad, Mouchammed Agko, Shivprasad Date, Wei-Ling Chang, Oscar J Manrique, Tony C T Huang, Federico Lo Torto, Emilio Triganano, Hung-Chi Chen
BACKGROUND: In a vessel-depleted neck, distant recipient sites may be the only option for secondary free flap reconstruction. While interposition vein grafts and arteriovenous loops can bridge the gap between the recipient and donor pedicle, they are not without risks. In these scenarios, we examinate the reliablity of a radial forearm free flap (RFFF) as an alternative vascular conduit. PATIENTS AND METHODS: A retrospective review of cases between March 2005 and May 2016 was performed...
November 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/29095185/immediate-perineal-reconstruction-after-extralevatory-abdominoperineal-excision-buried-desepidermised-fasciocutaneous-v-y-advancement-flap
#14
Özay Özkaya, Ayça Ergan Şahin, İlker Üsçetin, Hakan Güven, Fazil Sağlam
BACKGROUND: According to National Cancer Institute, there are approximately 39,800 rectal cancer cases per year, 25% of which will need an abdominoperineal resection (APR). The key to avoid most of the complications related to pelvic defect that occurs after APR is choosing an appropriate reconstruction option for perineum. This study aims to introduce an easily applicable flap option for closure to address postoperative pelvic defect in low rectal cancer. METHODS: This is a retrospective evaluation of 9 patients who have undergone perineal reconstruction for pelvic defects after extralevatory abdominoperineal excision with rectal cancer between 2014 and 2016...
October 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29090197/surgical-management-of-localized-scleroderma
#15
Jae Hyun Lee, Soo Yeon Lim, Jang Hyun Lee, Hee Chang Ahn
BACKGROUND: Localized scleroderma is characterized by a thickening of the skin from excessive collagen deposits. It is not a fatal disease, but quality of life can be adversely affected due to changes in skin appearance, joint contractures, and, rarely, serious deformities of the face and extremities. We present six cases of localized scleroderma in face from our surgical practice. METHODS: We reviewed six localized scleroderma cases that were initially treated with medication and then received follow-up surgery between April 2003 and February 2015...
September 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/29089205/extension-of-flaps-associated-with-burn-scar-reconstruction-a-key-difference-between-island-and-skin-pedicled-flaps
#16
Yukiko Yoshino, Ken Kubomura, Hyakuzoh Ueda, Takuya Tsuge, Rei Ogawa
OBJECTIVE: The choice between local flap designs for burn reconstruction is largely shaped by aesthetic, vascularity, procedural complexity, and wound-closure considerations. However, another key consideration is how well specific local flap designs release post-burn scar contractures. This is because constant tension on wound edges can generate pathological scarring. However, the ability of specific local flap to release post-burn scar contractures is poorly understood. This question was addressed by this study of patients who underwent local flap surgery to release post-burn scar contractures...
October 28, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29082566/immediate-chest-wall-reconstruction-using-an-external-oblique-myocutaneous-flap-for-large-skin-defects-after-mastectomy-in-advanced-or-recurrent-breast-cancer-patients-a-single-center-experience
#17
Seokwon Lee, Younglae Jung, Youngtae Bae
BACKGROUND AND OBJECTIVES: We report 75 single-stage chest-wall reconstructions using ipsilateral external oblique myocutaneous flap (EOMCF) to cover the extensive skin defects following resection of advanced or recurrent breast tumours at the Pusan National University Hospital. METHODS: Between January 2007 and October 2015, 75 women with advanced or recurred breast cancer who underwent extensive mastectomy with immediate chest wall reconstruction using EOMCF were reviewed retrospectively...
October 29, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29078657/materials-and-techniques-in-chest-wall-reconstruction-a-review
#18
REVIEW
Stefano Sanna, Jury Brandolini, Alessandro Pardolesi, Desideria Argnani, Marta Mengozzi, Andrea Dell'Amore, Piergiorgio Solli
Extensive chest wall resection and reconstruction are a challenging procedure that requires a multidisciplinary approach, including input from thoracic surgeon, plastic surgeon and oncologist. In particular chest wall neoplastic pathology is associated with high surgical morbidity and can result in full thickness defects hard to reconstruct. The goals of a successful chest wall reconstruction are to restore the chest wall rigidity, preserve pulmonary mechanic and protect the intrathoracic organs minimizing the thoracic deformity...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29076324/innovation-in-the-planning-of-v-y-rotation-advancement-flaps-a-template-for-flap-design
#19
Utku C Dölen, Uğur Koçer
Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. We designed 2 templates to plan a V-Y rotation advancement flap. The template for a unilateral V-Y rotation advancement flap was used on the face (n=5), anterior tibia (n=1), posterior axilla (n=1), ischium (n=1), and trochanter (n=2). The template for a bilateral flap was used on the sacrum (n=8), arm (n=1), and anterior tibia (n=1)...
October 27, 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29076322/double-sided-folded-internal-pudendal-artery-perforator-flap-for-the-repair-of-a-recurrent-rectovaginal-fistula
#20
Sang Gun Lee, Yong Seok Lee, Seung Yong Song, Won Jae Lee, Dong Won Lee
Rectovaginal fistula (RVF) is not common, but represents a challenge to both patients and surgeons. Various surgical techniques have been introduced for repair of RVF, such as local flap rearrangement, muscle transposition, or the use of an artificial mesh. Despite these treatments, recurrence of RVF has been frequently reported. This report presents the case of a 53-year-old woman who suffered from a recurrent RVF that first developed 32 years ago, 2 years after a vaginal delivery with an episiotomy. A satisfactory good result was achieved following a method using a double-sided folded internal pudendal artery perforator flap...
October 27, 2017: Archives of Plastic Surgery
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