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Vascularized flap

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https://www.readbyqxmd.com/read/28543381/ileocecal-vascularized-lymph-node-transfer-for-the-treatment-of-extremity-lymphedema-a-case-report
#1
Pedro Ciudad, Oscar J Manrique, Mouchammed Agko, En-Wei Liu, Wei-Ling Chang, Matthew Sze-Wei Yeo, Tony Chieh-Ting Huang, Ram M Chilgar, Hung-Chi Chen
Vascularized lymph node (VLN) transfer has been of high interest in the past decade for the treatment of lymphedema, since it has been shown to be effective in reducing limb volumes, decreasing infectious episodes and improving quality of life. Multiple donor sites have been described in the quest for the optimal one. Herein, we describe a novel lymph node flap option based on the ileocolic artery and vein. The ileocecal vascularized lymph node (IC-VLN) flap was used in the management of a 33-year-old male patient with lower extremity lymphedema secondary to left inguinal trauma...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28543027/the-vascularized-groin-lymph-node-flap-vgln-anatomical-study-and-flap-planning-using-multi-detector-ct-scanner-the-golden-triangle-for-flap-harvesting
#2
Assaf A Zeltzer, Alexander Anzarut, Delphine Braeckmans, Katrin Seidenstuecker, Benoit Hendrickx, Eddy Van Hedent, Moustapha Hamdi
INTRODUCTION: A growing number of surgeons perform lymph node transfers for the treatment of lymphedema. When harvesting a vascularized lymph node groin flap (VGLNF) one of the major concerns is the potential risk of iatrogenic lymphedema of the donor-site. This article helps understanding of the lymph node distribution of the groin in order to minimize this risk. MATERIALS AND METHODS: Fifty consecutive patients undergoing abdominal mapping by multi-detector CT scanner were included and 100 groins analyzed...
May 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28542070/collagen-elastin-and-collagen-glycosaminoglycan-scaffolds-promote-distinct-patterns-of-matrix-maturation-and-axial-vascularization-in-arteriovenous-loop-based-soft-tissue-flaps
#3
Volker J Schmidt, Johanna O Wietbrock, Nico Leibig, Torsten Gloe, Dominic Henn, J Frederik Hernekamp, Leila Harhaus, Ulrich Kneser
INTRODUCTION: Autologous free flaps are the criterion standard for reconstructions of complex soft tissue defects; however, they are limited by donor-site morbidities. The arteriovenous (AV) loop model enables the generation of soft tissue constructs based on acellular dermal matrices with a functional microvasculature and minimal donor site morbidity. The ideal scaffold for AV loop-based tissue engineering has not been determined. METHODS: AV loops were placed into subcutaneous isolation chambers filled with either a collagen-elastin scaffold or a collagen-glycosaminoglycan scaffold in the thighs of rats...
May 25, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28538802/the-effect-of-intradermal-administration-of-inactive-platelet-rich-plasma-on-flap-viability-in-rats
#4
Erkan Orhan, Ahmet Çağrı Uysal, Engin Başer, Dürdane Keskin, Çiğdem Demiroğlu-Yakut
Purpose: To evaluate the effect of inactive form of platelet rich plasma (PRP) on the flap viability. Methods: Thirty six rats were used. Rats were divided into six groups then 9x3 cm random pattern skin flaps were elevated from dorsum of all rats. For precluding vascularization from the base, a silicone layer was placed under the flap in groups 2(only flap+silicone), 4(saline+silicone) and 6(PRP+silicone). In groups 1(only flap), 2(only flap+silicone) nothing was done except flap surgery...
April 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28538578/total-abdominal-wall-transplantation-an-anatomical-study-and-classification-system
#5
David Light, Neilendu Kundu, Risal Djohan, Cristiano Quintini, Namita Gandhi, Brian R Gastman, Richard Drake, Maria Siemionow, James E Zins
BACKGROUND: Candidates for multivisceral transplantation present with complex defects often beyond traditional reconstructive options. In this study, the authors describe a dissection technique for a total abdominal wall vascularized composite flap. In addition, the authors suggest a classification system for complex abdominal wall defects. METHODS: Forty fresh, cadaveric hemiabdomens were dissected, with care taken to preserve the iliofemoral, deep circumflex iliac, superficial circumflex iliac, deep inferior epigastric, and superficial inferior epigastric arteries and corresponding veins...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28538567/hyperspectral-imaging-provides-early-prediction-of-random-axial-flap-necrosis-in-a-preclinical-model
#6
Michael S Chin, Ava G Chappell, Giorgio Giatsidis, Dylan J Perry, Jorge Lujan-Hernandez, Anthony Haddad, Hajime Matsumine, Dennis P Orgill, Janice F Lalikos
BACKGROUND: Necrosis remains a significant complication in cutaneous flap procedures. Monitoring, and ideally prediction, of vascular compromise in the early postoperative period may allow surgeons to limit the impact of complications by prompt intervention. Hyperspectral imaging could be a reliable, effective, and noninvasive method for predicting flap survival postoperatively. In this preclinical study, the authors demonstrate that hyperspectral imaging is able to correlate early skin perfusion changes and ultimate flap survival in a preclinical model...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28538566/predicting-thrombosis-formation-in-1-mm-diameter-arterial-anastomoses-with-transit-time-ultrasound-technology
#7
Gabrielle Shaughness, Collin Blackburn, Alberto Ballestín, Yelena Akelina, Jeffrey A Ascherman
BACKGROUND: Thrombosis is a common source of failure in anastomoses, flaps, and vascular grafts. Ensuring vessel patency is critical to the success of microvascular procedures. Any tool that can accurately predict the patency of an anastomosis intraoperatively would enable the surgeon to detect and correct flow restrictions while the patient is still in the operating room. METHODS: The authors used transit-time ultrasound technology in this pilot study to investigate whether a minimal cutoff value for quantitative postoperative blood flow (in milliliters per minute) could be established that would reliably predict sustained vessel patency at 24 hours postoperatively...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28538066/radial-forearm-osteocutaneous-free-flap-for-reconstruction-of-hard-palate-with-alveolar-defect
#8
Euicheol C Jeong, Sehoon Yoon, Young Ho Jung
The radial forearm free flap is beneficial for reconstruction of large palatal defect with oronasal fistula.A 51-year-old male patient who had anterior palate defect including alveolus after the radiation therapy of malignant cancer on the nasopharyngeal area undertook the radial forearm osteocutaneous free flap to close the oronasal fisula and restore the alveolar arch. The small radial bone segment was fixed in the alveolar defect and vascular anastomoses were performed with facial vessels in neck. The donor site was closed with split thickness skin graft...
May 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28536869/the-technique-and-benefits-of-angiographic-embolization-of-inferior-epigastric-arteries-prior-to-pedicled-tram-flap-breast-reconstruction-results-from-a-single-center
#9
Alysse J Sever, Chirag Patel, Yahya Albeer, Vigen B Darian
PURPOSE: To report a single center's experience with selective arterial embolization of the deep inferior epigastric arteries (DIEA) prior to pedicled TRAM flap breast reconstruction including techniques and outcomes. MATERIALS AND METHODS: Retrospective chart review was performed for 15 patients who underwent pedicled TRAM flap breast reconstruction after selective embolization of bilateral DIEA. Data were analyzed to display the spectrum of postoperative outcomes following the TRAM flap procedure status post-selective angiographic embolization of the bilateral DIEA to improve vascularity of the TRAM flaps by rendering the tissue partially ischemic to undergo neovascularization...
May 23, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28532969/lip-reconstruction-using-a-functioning-serratus-anterior-free-flap-preliminary-study
#10
A O Gundeslioglu, E C Karadag, I Inan, L Jasharllari, M N Selimoglu, F Guney, B Yuruten, M Bekerecioglu
Reconstructive surgery to the lips requires the replacement of defective tissues with similarly functioning tissues. While non-dynamic free tissue transfers provide adequate lower lip reconstruction, improved benefits may be obtained with innervated free muscle flaps. This study reports the use of innervated serratus anterior muscle free flaps for lip reconstruction in five patients. All patients had squamous cell carcinoma of either the upper or lower lip. After resection of the tumours, the resultant defects comprised two-thirds of the lips...
May 19, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28530258/enhanced-recovery-program-erp-in-major-laryngeal-surgery-building-a-protocol-and-testing-its-feasibility
#11
M Gemma, S Toma, F Lira Luce, L Beretta, M Braga, M Bussi
Enhanced recovery programs (ERP) represent a multimodal approach to perioperative patient care. The benefits of ERP are well demonstrated in colorectal surgery and Enhanced Recovery After Surgery (ERAS®) programs, that epitomise the ERP concept, have being introduced in different specialties, including vascular, gastric, pancreatic, urogynecologic and orthopaedic surgery. However, no ERP has been proposed for head and neck surgery. We developed an expert-opinion-based ERP for laryngeal surgery based on the key principles of colorectal surgery ERAS®...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28529663/the-modified-dunn-procedure-for-slipped-capital-femoral-epiphysis-the-bernese-experience
#12
M Tannast, L M Jost, T D Lerch, F Schmaranzer, K Ziebarth, K A Siebenrock
PURPOSE: Based on previous investigations on the vascular blood supply to the femoral head, a technique for anatomical reduction after slipped capital femoral epiphysis was developed. This technique is a modification of the original technique by Dunn using a retinacular soft-tissue flap. This allows the visual control of the epiphyseal vascular blood supply. We report the experience at the inventor's institution with a critical discussion of the available literature. METHODS: Using a trochanteric osteotomy for surgical dislocation of the hip, a retinacular soft tissue flap is created containing the deep branch of the medial femoral circumflex artery, the external rotators and the capsule...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529662/femoral-and-acetabular-re-alignment-in-slipped-capital-femoral-epiphysis
#13
M Leunig, H M Manner, L Turchetto, R Ganz
NEW PATHOPHYSIOLOGICAL INSIGHTS: Based on improved knowledge of the vascular supply of the proximal femur, a safe surgical dislocation of the hip joint was established allowing direct insights to the pathomorphological malfunctioning of the joint. One insight was that slipped capital femoral epiphysis (SCFE) impingement leads to substantial damage of the chondrolabral rim area, even in the presence of minor slips. A further surgical development was the extended retinacular flap allowing for correction of the deformity with calculable risk for iatrogenic necrosis...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529045/influence-of-preoperative-imaging-on-fibula-free-flap-harvesting
#14
R Gryseleyn, M Schlund, P Pigache, T Wojcik, G Raoul, J Ferri
INTRODUCTION: The fibula free flap (FFF) is the gold standard for the reconstruction of large maxillofacial defects. Magnetic resonance angiography (MRA) seems to supersede digital subtraction angiography (DSA) as the reference in preoperative evaluation, being non-invasive and having equivalent diagnostic results. The aim of this study was to assess the impact of preoperative MRA versus DSA on the viability of FFF and its success rate. MATERIAL AND METHODS: A total of 216 patients, who underwent mandibular or maxillary FFF reconstruction from January 1995 to January 2011, were retrospectively included in the study...
May 18, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28526905/effectiveness-of-acellular-dermal-matrix-on-autologous-split-thickness-skin-graft-in-treatment-of-deep-tissue-defect-esthetic-subjective-and-objective-evaluation
#15
Yoo Jung Lee, Myong Chul Park, Dong Ha Park, Hyung Min Hahn, Sue Min Kim, Il Jae Lee
BACKGROUND: A split-thickness skin graft (STSG) is performed to cover a large full-thickness skin defect. Esthetic and functional deficits can result, and many studies have sought to overcome them. This study compared the effectiveness of the acellular dermal matrix (ADM) graft and STSG concerning esthetic and functional effectiveness of ADM on scar quality. METHODS: Of the patients who underwent anterolateral thigh free flap from 2011 to 2015, patients who received skin graft only (n = 10) or skin graft with ADM (n = 20) for coverage of the donor site were enrolled...
May 19, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28520896/laser-assisted-indocyanine-green-dye-angiography-for-postoperative-fistulas-after-salvage-laryngectomy
#16
Erin J Partington, Lindsay S Moore, Russel Kahmke, Jason M Warram, William Carroll, Eben L Rosenthal, Benjamin J Greene
Importance: Pharyngocutaneous fistula formation is an unfortunate complication after salvage laryngectomy for head and neck cancer that is difficult to anticipate and related to a variety of factors, including the viability of native pharyngeal mucosa. Objective: To examine whether noninvasive angiography with indocyanine green (ICG) dye can be used to evaluate native pharyngeal vascularity to anticipate pharyngocutaneous fistula development. Design, Setting, and Participants: This cohort study included 37 patients enrolled from June 1, 2013, to June 1, 2016, and follow-up was for at least 1 month postoperatively...
May 18, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28509695/a-novel-augmented-reality-based-navigation-system-in-perforator-flap-transplantation-a-feasibility-study
#17
Taoran Jiang, Ming Zhu, Tao Zan, Bin Gu, Qingfeng Li
BACKGROUND: In perforator flap transplantation, dissection of the perforator is an important but difficult procedure because of the high variability in vascular anatomy. Preoperative imaging techniques could provide substantial information about vascular anatomy; however, it cannot provide direct guidance for surgeons during the operation. In this study, a navigation system (NS) was established to overlie a vascular map on surgical sites to further provide a direct guide for perforator flap transplantation...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28509693/microcirculatory-effects-of-botulinum-toxin-a-in-the-rat-acute-and-chronic-vasodilation
#18
Roberto Giorgio Aru, Somjade Jay Songcharoen, Samantha R Seals, Peter B Arnold, Robert L Hester
BACKGROUND: Botulinum toxin-A (BTX) has numerous cosmetic and therapeutic applications. Our previous studies have found that BTX augments pedicled flap survival through both vasodilatory effects and attenuation of the inflammatory response to ischemia in the rat. This study examines the effect of chronic BTX on microcirculatory vascular tone and its response to acute topical vasodilators in muscle flaps. METHODS: The spinotrapezius muscle of Sprague-Dawley rats underwent a single 2-week pretreatment of 0...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28509443/hemodynamically-stimulated-and-in-vivo-generated-axially-vascularized-soft-tissue-free-flaps-for-closure-of-complex-defects-evaluation-in-a-small-animal-model
#19
Volker J Schmidt, Johanna O Wietbrock, Nico Leibig, Jochen F Hernekamp, Dominic Henn, Christian A Radu, Ulrich Kneser
The arteriovenous (AV) loop model permits the creation of significant volumes of axially vascularized tissue that represents an alternative to conventional free flaps, circumventing their common limitations. However, such AV-loop-based flaps have never before been examined in standardized animal models with respect to their suitability for reconstruction of critical bone exposing defects. In the course of our preliminary studies, we implemented a novel defect model in rats that provides standardized and critical wound conditions and evaluated whether AV-loop-generated flaps are suitable for free microsurgical transfer and closure of composite defects...
May 16, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28509409/soft-tissue-reconstruction-and-salvage-of-infected-fixation-hardware-in-lower-extremity-trauma
#20
Hyuma A Leland, Alexis D Rounds, Karen E Burtt, Daniel J Gould, Geoffrey S Marecek, Ram K Alluri, Ketan M Patel, Joseph N Carey
BACKGROUND: Tibial fracture management may be complicated by infection of internal fixation hardware (iIFH) resulting in increased morbidity and amputation rate. When iIFH removal is not possible, salvage of the lower extremity is attempted through debridement, antibiotics, and vascularized soft tissue coverage. This study investigates lower extremity salvage with retention of iIFH. METHODS: Demographics, outcomes, and bacterial speciation in patients with tibial fractures at a level 1 trauma center from 2007 to 2014 were reviewed...
May 16, 2017: Microsurgery
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