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https://www.readbyqxmd.com/read/28938389/shortening-and-angulation-strategies-to-address-composite-bone-and-soft-tissue-defects
#1
Sarah N Pierrie, Joseph R Hsu
Gustilo-Anderson IIIB tibial fractures and infected tibial nonunions represent particular challenges for the orthopaedic trauma surgeon. Debridement of dysvascular bone and soft tissues can create composite bone and soft tissue defects. Restoring the soft tissue envelope is a critical step in preventing or treating ongoing infection and in restoring local blood supply. Shortening and angulation techniques, including the gradual expansion muscle flap, rely on distraction histogenesis to address composite bone and soft tissue loss...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938268/surgical-and-survival-outcomes-following-pelvic-exenteration-for-locally-advanced-primary-rectal-cancer-results-from-an-international-collaboration
#2
(no author information available yet)
OBJECTIVE: The aim of the study was to analyze data from an international collaboration, and ascertain prognostic indicators that inform clinical decision-making and practices regarding the role of pelvic exenteration for locally advanced primary rectal cancer (LARC). BACKGROUND: With improved national screening programs fewer patients present with LARC. Despite this, select cohorts of patients require pelvic exenteration. To date, the majority of outcome data are from single-center series...
September 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28937444/methylene-blue-for-bronchopleural-fistula-localization
#3
Kenneth K Sakata, Faria Nasim, Dante N Schiavo, Darlene R Nelson, Ryan M Kern, John J Mullon
A bronchopleural fistula (BPF) is a communication between the pleural space and the bronchial tree. BPFs are challenging to diagnose and are associated with a high morbidity and mortality. Sequential balloon occlusion is commonly used for localization of a BPF. We describe our experience with 4 cases of successful localization of the BPF by instillation of methylene blue into the pleural space through a pigtail catheter, with simultaneous bronchoscopic visualization of dye in the tracheobronchial tree. Two patients were treated with endobronchial valves and 3 had a surgical thoracic muscle flap placed...
September 20, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28930925/conical-modification-of-forearm-free-flaps-for-single-stage-reconstruction-after-total-orbital-exenteration
#4
Chad A Purnell, Elbert E Vaca, Marco F Ellis
BACKGROUND: Orbital exenteration is a significant reconstructive challenge for plastic surgeons. Options described for these defects range from healing by secondary intention to free tissue transfer. The authors present our preferred reconstruction of orbital defects with free forearm-based flaps, which provides quality soft tissue and orbital contouring in 1 stage to consistently allow placement of bone-anchored implants for eventual orbital prosthesis. METHODS: This conical shape of the orbit is deconstructed into a "Pac-Man" type shaped flap that leaves adequate depth for a prosthesis...
September 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28926875/-effects-of-perforator-flaps-combined-with-muscle-flaps-for-repairing-grade-%C3%A2-pressure-ulcers-in-ischial-tuberosity-of-elderly-patients
#5
W G Su, D P Li, P P Xing, L G Xu, F C Shi, B Wen, X H Niu
Objective: To explore effects of perforator flaps combined with muscle flaps for repairing grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients. Methods: Nine elderly patients with grade Ⅳ pressure ulcers in ischial tuberosity were hospitalized in our burn ward from April 2014 to April 2017. Size of wounds ranged from 5 cm×3 cm to 12 cm×7 cm, and depth of sinus ranged from 6 to 22 cm. After admission, emergency debridement or debridement in selective time was performed. After debridement, the wounds were treated with continuous vacuum assisted closure therapy...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28918934/reconstructive-microsurgical-approach-for-the-treatment-of-pyoderma-gangrenosum
#6
Karl Schwaiger, Elisabeth Russe, Hassan Kholosy, Michaela Hladik, Klemens Heinrich, Laurenz Weitgasser, Thomas Schoeller, Gottfried Wechselberger
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare type of autoimmune disease that results in progressive ulcers with or without previous trauma. However, PG is not well understood to date, and its treatment therefore remains a challenge. Because of the disease's systemic characteristic and the unpredictability of the clinical course, no gold standard treatment is available, especially concerning the surgical procedures to treat pyodermic lesions. Often, PG is not recognized during routine clinical practice, and standard ulcer treatment (conservative wound care, debridement, skin grafting, and local flap coverage) is initiated; this induces an autoinflammatory response, resulting in disastrous ulcers, thereby making free flap coverage necessary...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28916504/going-skin-deep-a-direct-comparison-of-penetration-potential-of-lipid-based-nanovesicles-on-the-isolated-perfused-human-skin-flap-model
#7
Selenia Ternullo, Louis de Weerd, Ann Mari Holsæter, Gøril Eide Flaten, Nataša Škalko-Basnet
Phospholipid-based nanocarriers are attractive drug carriers for improved local skin therapy. In the present study, the recently developed isolated perfused human skin flap (IPHSF) model was used to directly compare the skin penetration enhancing potential of the three commonly used nanocarriers, namely conventional liposomes (CLs), deformable liposomes (DLs) and solid lipid nanoparticles (SLNs). Two fluorescent markers, calcein (hydrophilic) or rhodamine (lipophilic), were incorporated individually in the three nanosystems...
September 12, 2017: European Journal of Pharmaceutics and Biopharmaceutics
https://www.readbyqxmd.com/read/28915833/deltopectoral-flap-revisited-for-reconstruction-surgery-in-patients-with-advanced-thyroid-cancer-a-case-report
#8
Taro Mikami, Shintaro Kagimoto, Yuichiro Yabuki, Kazunori Yasumura, Toshinori Iwai, Jiro Maegawa, Nobuyasu Suganuma, Shohei Hirakawa, Katsuhiko Masudo
BACKGROUND: We present the cases of 2 patients with invasive thyroid cancer, who underwent reconstructive surgery using a deltopectoral flap. Although the overall rate of extrathyroidal extension in patients with thyroid cancer is quite low, skin invasion is the most common pattern observed. Reconstructive surgery, involving local skin flaps, is required in these patients. The deltopectoral flap relies on the blood supply from intercostal perforators of the internal thoracic artery and usually requires skin grafting to the donor site...
September 15, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28913317/reconstruction-of-a-complex-scalp-defect-after-the-failure-of-free-flaps-changing-plans-and-strategy
#9
Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha Kim
The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neurosurgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft...
June 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28906302/chemotherapy-extravasation-management-21-year-experience
#10
Maria Giuseppina Onesti, Sara Carella, Paolo Fioramonti, Nicolò Scuderi
Chemotherapy extravasation may result in serious damage to patients, with irreversible local injures and disability. Evidence-based standardization on extravasation management is lacking and many institutions do not practice adequate procedures to prevent the severer damages. Our aim was to explore the prevention and treatment of extravasation injuries, proposing a standard therapeutic protocol together with a review of the literature. From January 1994 to December 2015, 545 cases were reviewed (age range, 5-87 years; 282 men and 263 women)...
September 12, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28906298/a-simple-flap-design-for-the-salvage-of-immediate-implant-based-breast-reconstruction
#11
Sukru Yazar, Altug Altinkaya, Emine Cigdem Karadag, Halil Kara, Cihan Uras
BACKGROUND: Breast reconstruction with implants is a real challenge in patients with large breast volume. Skin-reducing inverted-T mastectomy is the best solution for these patients. Delayed wound healing or necrosis at the T-junction area can be seen in this procedure, although it may also lead to severe conditions such as the exposure and loss of implant. In this article, the use of local pedicled flap for the management of these situations was discussed. METHODS: Between April 2010 and July 2015, 54 patients underwent breast reconstruction by inverted-T skin-reducing mastectomy and immediate implant-based breast reconstruction at our clinic...
September 12, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28894709/prognosis-and-risk-factors-influencing-recurrence-in-surgery-treated-patients-with-primary-sacral-tumors
#12
Xiliang Dang, Liping Lian, Dongsheng Wu
BACKGROUND: We aimed to explore the prognosis and risk factors influencing tumor recurrence in surgery-treated patients with primary sacral tumors. METHODS: Fifty-six patients between February 2011 and December 2016 in Yishui Central Hospital with primary sacral tumors were selected and treated with radical surgeries. The perioperative outcomes and postoperative neurological functions were observed. After postoperative follow-up, the overall survival time (OS), disease-free survival time (DFS), and recurrence were recorded to analyze the potential risk factors influencing tumor recurrence...
August 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28894652/double-pedicled-free-deep-inferior-epigastric-perforator-flap-for-the-coverage-of-thigh-soft-tissue-defect
#13
Olimpiu Bota, Nick Spindler, Jeannine Sauber, Emrah Aydogan, Stefan Langer
Soft-tissue defects caused by radiation injury are a challenging task for the reconstructive surgeon, due to the extent of the soft-tissue damage and the associated injuries of the local blood vessels and bone tissue. We present the application of the versatile deep inferior epigastric perforator (DIEP) flap for the coverage of an extended lateral thigh soft-tissue defect after the surgical resection of an undifferentiated pleomorphic high-grade sarcoma, neoadjuvant chemotherapy, and adjuvant chemo- and radiotherapy...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28893718/alternatives-to-connective-tissue-graft-in-the-treatment-of-localized-gingival-recessions-a-systematic-review
#14
Khadija Amine, Yasser El Amrani, Siham Chemlali, Jamila Kissa
AIM: The aim of this Systematic Review (SR) was to assess the clinical efficacy of alternatives procedures; Acellular Dermal Matrix (ADM), Xenogeneic Collagen Matrix (XCM), Enamel Matrix Derivative (EMD) and Platelet Rich Fibrin (PRF), compared to conventional procedures in the treatment of localized gingival recessions. MATERIAL AND METHODS: Electronic searches were performed to identify randomized clinical trials (RCTs) on treatment of single gingival recession with at least 6 months of follow-up...
September 8, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28888700/surgical-repair-of-rectovaginal-fistula-using-the-modified-martius-procedure-a-step-by-step-guide
#15
Dan Wang, Juan Chen, Lan Zhu, Mingchen Sang, Fan Yu, Qing Zhou
STUDY OBJECTIVE: to demonstrate the surgical repair of rectovaginal fistula by the modified Martius procedure. DESIGN: step by step presentation of the procedure using video. SETTING: Rectovaginal fistula (RVF) is abnormal epithelialized connections between the vagina and rectum. Causes of rectovaginal fistula include obstetrical trauma, Crohn disease, pelvic irradiation and postsurgical complications. Many surgical interventions have been developed, from laparoscopic technique to muscle transposition and even rectal resection...
September 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28888309/head-and-neck-reconstruction
#16
REVIEW
Shannon Wong, Alyson Melin, Debra Reilly
Management of head and neck burns involves acute and intermediate phases. Acutely, the goals are establish a secure airway and treat life-threatening injuries. Then, optimize nutrition, assess extent of the burn, perform local wound care, and provide eye protection. Management depends on the degree of the head and neck burn. Postinjury splinting and rehabilitation are vital to healing. After the acute inflammation has resolved and the scars have matured, reconstruction begins with the goals of restoring both function and aesthetics...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28886357/a-retrospective-volume-matched-analysis-of-the-submental-artery-island-pedicled-flap-as-compared-to-the-forearm-free-flap-is-it-a-good-alternative-choice-for-the-reconstruction-of-defects-of-the-oral-cavity-and-oropharynx
#17
Nawaf Aslam-Pervez, Steven J Caldroney, Amal Isaiah, Joshua E Lubek
PURPOSE: The submental artery island pedicled flap (SMIF) is an underused alternative for reconstruction of head and neck defects after tumor ablation. The purpose of this study was to perform a comparative evaluation of reconstructive outcomes based on surgical site and ablative defect volume in patients who underwent reconstruction with the SMIF versus the forearm free flap (FFF). MATERIALS AND METHODS: A retrospective cohort study of all patients with oral cavity and oropharyngeal defects reconstructed with the SMIF and a cohort of patients with similar volume defects reconstructed with the FFF were compared for oncologic safety and viability of equivalent reconstructive outcomes...
August 12, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28884028/spontaneous-coronary-artery-dissection-a-rare-manifestation-of-alport-syndrome
#18
Amornpol Anuwatworn, Prince Sethi, Kelly Steffen, Orvar Jonsson, Marian Petrasko
Alport syndrome (AS) is a genetic disorder due to inheritance of genetic mutations which lead to production of abnormal type IV collagen. AS has been associated with renal, auditory, and ocular diseases due to the presence of abnormal alpha chains of type IV collagen in the glomerulus, cochlea, cornea, lens, and retina. The resulting disorder includes hereditary nephritis, corneal opacities, anterior lenticonus, fleck retinopathy, temporal retinal thinning, and sensorineural deafness. Aortic and aortic valve pathologies have been described as extrarenal manifestations of AS in multiple case reports...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28878968/the-leading-edge-vortex-of-swift-wing-shaped-delta-wings
#19
Rowan Eveline Muir, Abel Arredondo-Galeana, Ignazio Maria Viola
Recent investigations on the aerodynamics of natural fliers have illuminated the significance of the leading-edge vortex (LEV) for lift generation in a variety of flight conditions. A well-documented example of an LEV is that generated by aircraft with highly swept, delta-shaped wings. While the wing aerodynamics of a manoeuvring aircraft, a bird gliding and a bird in flapping flight vary significantly, it is believed that this existing knowledge can serve to add understanding to the complex aerodynamics of natural fliers...
August 2017: Royal Society Open Science
https://www.readbyqxmd.com/read/28877804/use-of-antibiotic-impregnated-absorbable-beads-and-tissue-coverage-of-complex-wounds
#20
MULTICENTER STUDY
Terris L White, Alfred T Culliford, Martin Zomaya, Gary Freed, Christopher P Demas
The treatment of complex wounds is commonplace for plastic surgeons. Standard management is debridement of infected and devitalized tissue and systemic antibiotic therapy. In cases where vital structures are exposed within the wound, coverage is obtained with the use of vascularized tissue using both muscle and fasciocutaneous flaps. The use of nondissolving polymethylmethacrylate and absorbable antibiotic-impregnated beads has been shown to deliver high concentrations of antibiotics with low systemic levels of the same antibiotic...
November 1, 2016: American Surgeon
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