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https://www.readbyqxmd.com/read/27922966/local-coverage-for-acute-severely-herniated-brain-using-scalp-and-forehead-flaps-in-a-pediatric-patient-with-head-trauma
#1
Matthew Brown, Navid Pourtaheri, Kristopher Katira, Sunil Manjila, Ali S Totonchi
A 4-year-old-boy required emergent craniectomy and drainage of a large right-sided acute subdural hematoma after head trauma, during which massive sinus hemorrhage with brain swelling occurred. Acute intraoperative management entailed dural cover using synthetic dural membrane substitute and scalp coverage over the herniated brain using acellular dermal matrix. After intensive monitoring and control of raised intracranial pressure over the next few days, the exposed brain was then covered by scalp and forehead flaps with cadaveric skin grafting to the donor site...
December 5, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27920067/injectable-diphenhydramine-used-as-anaesthetic-for-wide-local-excision-with-flap-closure
#2
Laura E Pickett, Jillian Macdonald
BACKGROUND: Lidocaine-allergic patients pose a challenge for cutaneous surgical procedures. We present a case of a successful wide local excision with flap closures on the face using topical tetracaine followed by infiltration with 1% diphenhydramine. CASE SUMMARY: An 84-year-old woman, with a lidocaine intolerance, presented to the Mohs surgery clinic for wide local excision of a nodular basal cell carcinoma on her right medial cheek. Successful anaesthesia was achieved using topical 4% tetracaine followed by intradermal and subcutaneous injection of 1% diphenhydramine...
December 5, 2016: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/27919596/chimeric-anterolateral-thigh-free-flap-for-reconstruction-of-complex-cranio-orbito-facial-defects-after-skull-base-cancers-resection
#3
Mario Cherubino, Mario Turri-Zanoni, Paolo Battaglia, Marco Giudice, Igor Pellegatta, Federico Tamborini, Francesca Maggiulli, Luca Guzzetti, Danilo Di Giovanna, Maurizio Bignami, Carolina Calati, Paolo Castelnuovo, Luigi Valdatta
Complex cranio-orbito-facial defects after skull base cancers resection entail a functional and esthetic reconstruction. The introduction of endoscopic assisted techniques for excision surgery with the advances in reconstructive surgery and anesthesiology allowed to improve the management of such critical patients. We report a series of chimeric anterolateral thigh (ALT) flaps used to reconstruct complex cranio-orbital-facial defects after skull base surgery. A retrospective review of patients that underwent cranio-orbito-facial reconstruction using a chimeric ALT flap from March 2013 to October 2015 at a single tertiary care referral Institute was performed...
November 2, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27919594/clinical-audit-and-national-survey-on-the-assessment-of-collateral-circulation-before-radial-forearm-free-flap-harvest
#4
Anwer Abdullakutty, Mandeep S Bajwa, Sonum Patel, Jacob D'Souza
Controversy exists regarding the use of Duplex Ultrasound (DUS) in addition to the Modified Allen's Test (MAT) for the assessment of collateral circulation prior to elevation of the Radial Forearm Free Flap (RFFF). A survey amongst members of BAOMS Head & Neck Oncology Subspecialty Interest Group and a completed local audit was undertaken to assess the need for DUS. Data for the initial audit was collected retrospectively between 2010 and 2013. Both MAT and DUS was performed routinely during this period. The results of the survey and initial audit led to a change in practice and DUS was no longer requested...
November 2, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27916282/repair-of-complex-pharyngocutaneous-fistula-using-a-staged-temporoparietal-fascial-flap
#5
Nicholas B Abt, Priya Srikanth, Sidharth V Puram, Daniel G Deschler
INTRODUCTION: PCF is the most common major complication after salvage total laryngectomy (TL), especially for previously irradiated patients with laryngeal or hypopharyngeal cancer. METHODS/RESULTS: A 65-year-old woman presented with recurrent bilateral supraglottic SCC requiring salvage TL 5.5years after initial T1N0M0 epiglottic SCC resection. Her post-operative course was complicated by PCF development one month post-operatively and surgical fistula closure was delayed for adjuvant chemoradiotherapy...
November 25, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27914865/nasolabial-and-forehead-flap-reconstruction-of-contiguous-alar-upper-lip-defects
#6
Jonathan A Zelken, Sashank K Reddy, Chun-Shin Chang, Shiow-Shuh Chuang, Cheng-Jen Chang, Hung-Chang Chen, Yen-Chang Hsiao
BACKGROUND: Defects of the nasal ala and upper lip aesthetic subunits can be challenging to reconstruct when they occur in isolation. When defects incorporate both the subunits, the challenge is compounded as subunit boundaries also require reconstruction, and local soft tissue reservoirs alone may provide inadequate coverage. In such cases, we used nasolabial flaps for upper lip reconstruction and a forehead flap for alar reconstruction. METHODS: Three men and three women aged 21-79 years (average, 55 years) were treated for defects of the nasal ala and upper lip that resulted from cancer (n = 4) and trauma (n = 2)...
November 11, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27906851/silk-ligation-delay-for-the-random-pattern-flap
#7
Lei Liu, Chen Zhang, Haizhou Tong, Tao Song, Ningbei Yin, Haidong Li, Zhenmin Zhao
OBJECTIVE: The purpose of this study is to explore a silk ligation delay for the expanded and unexpanded random flaps to improve the vascularization and survival length of the flap. METHODS: Marked incision points 2 to 3 cm at every interval along the design line with methylene blue, each incision was about 3 mm long. A subepidermal tunnel was formed on the superfacial layer of dermis between every adjacent incision; another gap was done on the surface of the expander...
November 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27904649/fasciocutaneous-flap-reinforcement-of-ventral-onlay-buccal-mucosa-grafts-enables-neophallus-revision-urethroplasty
#8
Stelios C Wilson, John T Stranix, Kiranpreet Khurana, Shane D Morrison, Jamie P Levine, Lee C Zhao
BACKGROUND: Urethral strictures or fistulas are common complications after phalloplasty. Neourethral defects pose a difficult reconstructive challenge using standard techniques as there is generally insufficient ventral tissue to support a graft urethroplasty. We report our experience with local fasciocutaneous flaps for support of ventrally-placed buccal mucosal grafts (BMGs) in phalloplasty. METHODS: A retrospective review of patients who underwent phalloplasty and subsequently required revision urethroplasty using BMGs between 2011 and 2015 was completed...
December 2016: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/27901645/fenestrated-adipofascial-reverse-flap-a-modified-technique-for-the-reconstruction-of-fingertip-amputations
#9
Francesco Idone, Andrea Sisti, Juri Tassinari, Giuseppe Nisi
AIMS OF THE STUDY: Fingertip injuries can be treated in different ways, including shortening with primary closure, skin graft, and local or distant flaps. Several local flaps for the reconstruction of the amputated fingertip were described. We present our experience with a new concept of homodigital adipofascial reverse flap that avoids the second surgical stage and allows a complete and anatomically perfect reconstruction of nail bed, with preservation of the nail lamina. MATERIALS AND METHODS: Between March 2014 and February 2015, five patients with digital amputations (distally to the nail matrix) were treated using the Fenestrated Adipofascial Reverse (F...
November 30, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27900013/surgical-treatment-of-rare-giant-malignant-tumors-of-the-scalp-a-report-of-3-cases-with-different-tumor-types
#10
Xiaoliang Liu, Wenzhong Li, Hepei Yuan, Weihong Gu, Dawei Chen
The scalp is the most frequent site of occurrence of malignant tumors. As an area that is generally neglected by the patient and not closely monitored during physical examinations, scalp tumors can go unnoticed until they become malignant. The present study reports 3 cases of rare giant malignant tumors of the scalp, namely a peripheral nerve sheath tumor, a fibrous tumor and a malignant proliferating trichilemmal tumor, that were treated at The First Bethune Hospital of Jilin University (Changchun, China)...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27896441/pterygium-surgery-using-the-principle-of-contact-inhibition-results-of-13-years-experience
#11
Tsutomu Hara, Takako Hashimoto, Takeshi Hara
PURPOSE: To report a technique to prevent pterygium recurrence using the principle of contact inhibition. METHODS: Two hundred and fifteen patients (232 eyes; average age, 64.1 years) with primary pterygia who underwent pterygium surgery at the Hara Eye Hospital between 1999 and 2012. We retrospectively evaluated the patients who underwent the following procedure to prevent pterygium recurrence. The surface conjunctiva on the pterygium body was not removed. After removing the pterygium body, by placing a narrow pedicle autoconjunctival flap along the corneal limbus and tying it tightly to the front area of the residual conjunctiva, there is no room for the active residual tissue to proliferate, thus preventing a recurrence by contact inhibition...
November 28, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/27896193/multidisciplinary-approach-to-an-extended-pressure-sore-at-the-lumbosacral-area
#12
Sehoon Yoon, Euicheol Jeong, Hudson Alex Lázaro
A pressure sore wound is often extensive or complicated by local infection involving adjacent soft tissue and bone. In this case, a regional flap after simple debridement is not adequate. Here, we present a case of an extensive pressure sore in the sacral area with deep tissue infection. A 43-year-old female patient with a complicated sore with deep tissue infection had a presacral abscess, an iliopsoas abscess, and an epidural abscess in the lumbar spine. After a multidisciplinary approach performed in stages, the infection had subsided and removal of the devitalized tissue was possible...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27895685/pediatric-peri-operative-fractionated-high-dose-rate-brachytherapy-for-recurrent-wilms-tumor-using-a%C3%A2-reconstructed-freiburg-flap
#13
Emily Flower, Kathy Ngoc Tran, Salman Zanjani, Wayne Smith, Jonathan Karpelowsky, Katie Summerhayes, Edgar Estoesta, Jennifer Chard
PURPOSE: To report peri-operative fractionated high-dose-rate (HDR) brachytherapy with a 3D customized Freiburg flap applicator to treat locally recurrent Wilms' tumor, followed by immediate hyperthermic intraperitoneal chemotherapy for a 16-year-old with a second recurrence of nephroblastoma (Wilms' tumor). MATERIAL AND METHODS: The tumor was excised and surgical bed was treated with fractionated HDR brachytherapy using a Freiburg flap applicator. Hyperthermic intraperitoneal chemotherapy was performed immediately after the removal of brachytherapy applicator...
October 2016: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/27895538/syndactyly-release
#14
REVIEW
Tara L Braun, Jeffrey G Trost, William C Pederson
Syndactyly is one of the most common congenital hand anomalies treated by pediatric plastic surgeons. Established principles of syndactyly separation dictate the timing and order of syndactyly release, with the goals of surgery being the creation of an anatomically normal webspace, tension-free closure of soft tissue, and return of function to the fingers. Numerous surgical methods have been described, many of which involve the use of local flaps to reconstruct the commissure and full-thickness skin grafts for coverage of raw areas...
November 2016: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/27895450/dermatofibrosarcoma-protuberans-a-case-report-and-review-of-the-literature
#15
D Paramythiotis, G Stavrou, D Panagiotou, G Petrakis, A Michalopoulos
BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) represents less than 0.1% of all tumors, but it is considered the most common skin sarcoma. Wide local excision (=5 cm) has been largely replaced by Mohs micrographic surgery; however, recurrence is not rare. Description of the case: A 35-year-old man presented with a large tumor on the upper side of his back and underwent local excision with the possible preoperative diagnosis of lipoma. Upon histological examination, the diagnosis of DFSP was made, and the patient underwent wide local excision with skin flap reconstruction and was referred for adjuvant radiotherapy...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27894610/-reconstruction-of-proximal-nasal-defect-after-deep-carcinological-resection-interest-to-combine-titane-mesh-with-fat-grafting
#16
R Aimard, C Lalloué, C Ho Quoc, D Girodet, P Zrounba, E Delay
INTRODUCTION: The mucosal cylindroma or adenoid cystic carcinoma is the second sinonasal non-epithelial malignant tumor frequency argument. Due to the achievement of the nasal mucosa and a late diagnosis reconstructions are often complex. We report the case of a mucous cylindroma recurrence of nasal septum requiring a wide and deep excision of the root of the nose with nasal reconstruction. CASE REPORT: A patient aged 66 years whose history resection two years ago with a mucous adenoid cystic carcinoma of the right side of the nasal septum, had a local recurrence T2NOM0 imposing a wide excision with amputation nasal septum own bones of nose, the anterior portion of the triangular cartilages...
November 25, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/27894385/-effect-of-expanded-lateral-thoracic-abdominal-flap-transferred-with-pedicle-on-repairing-large-area-of-hypertrophic-scar-after-burn-of-the-upper-extremity
#17
C D Xia, J D Xue, H P Di, J L Niu, X L Li, D Y Cao, Q Li, X H Niu
Objective: To observe the effect of expanded lateral thoracic abdominal flap transferred with pedicle on repairing large area of hypertrophic scar after burn of the upper extremity. Methods: Twelve patients with large area of secondary hypertrophic scar 8 month to 3 years after healing of burn wound on the upper extremity were hospitalized in Zhengzhou First People's Hospital from October 2008 to October 2015, with scar area ranging from 11 cm×7 cm to 20 cm×10 cm. Five patients were with limited straightening and bending of elbow...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27893570/nonoperative-treatment-of-a-tracheocutaneous-fistula-in-a-burn-patient
#18
Katherine Marie Huber, Alicia Rose Billington, Loryn J Taylor, Kimberly Brown Maynell, C Wayne Cruse
Tracheocutaneous fistula (TCF) is a complication occurring after decannulation of a long-term tracheostomy and can lead to significant morbidity. We describe a case of a TCF in a burn patient treated without surgery. No previous cases have been described. A 65-year-old woman presented with symptomatic hypertrophic burn scar contractures of the anterior neck 6 months after undergoing excision and grafting of full-thickness burns to the neck and chest. She had a history of tracheostomy placement at the time of burn...
November 18, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27888894/treating-scars-of-the-chin-and-perioral-region
#19
REVIEW
Jessyka G Lighthall, Fred G Fedok
Lip and chin scarring occurs owing to reconstruction of congenital, cancer resection, or traumatic defects. Knowledge of lip anatomy and function is critical to optimize results. Realistic expectations should be established before intervention. Scar revision and reconstruction is ideally performed with a subunit approach, placing scars along aesthetic borders and performing subunit reconstruction to camouflage scars. Surgical techniques include direct excision, scar reorientation, local flap rearrangement, pedicled flaps, and regional or free flaps...
February 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/27882141/clinical-study-on-local-application-of-low-dose-insulin-for-promoting-wound-healing-after-operation-for-deep-burns
#20
Ming Zeng, Yan Zhi, Wenjun Liu, Wei Zhang, Jinxiong Xu
Transplanted free skin flaps are often needed to treat deep burns; their survival, however, is less than optimal. This study examined whether local low-dose insulin injections can promote flap survival and wound healing after surgery. A total of 165 patients who underwent free skin flap transplantation for simple deep burns were enrolled in the study and divided into 5 groups of 33 patients each: Blank control group (no local subcutaneous drug injections), saline control group (saline injections), low-dose insulin group (0...
November 2016: Experimental and Therapeutic Medicine
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