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https://www.readbyqxmd.com/read/28811948/the-dorsoulnar-artery-perforator-adipofascial-flap-in-the-treatment-of-distal-radioulnar-synostosis
#1
Alessia Pagnotta, Giorgio Antonietti, Iakov Molayem
Posttraumatic radioulnar synostosis (RUS) is a rare event following forearm fractures. Consequences are disabling for patients who suffer from functional limitation in forearm pronosupination. Distal RUS are even more rare and more difficult to treat because of high recurrence rates. The patient we describe in this paper came to our attention with a double distal RUS recurrence and a Darrach procedure already performed. We performed a radical excision of RUS and interposition with a vascularized dorsoulnar artery (DUA) adipofascial perforator flap...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28805950/management-of-osteonecrosis-of-the-femoral-head-with-pedicled-iliac-bone-flap-transfer-a-multicenter-study-of-2190-patients
#2
Dewei Zhao, Hui Xie, Yongqing Xu, Yisheng Wang, Aixi Yu, Youwen Liu, Aimin Wang, Wei He, Xiuli Wang, Zirong Li, Wei Sun, Simiao Tian, Benjie Wang, Baoyi Liu
BACKGROUND: Osteonecrosis of the femoral head (ONFH) often affects young active adults and leads to destruction of the hip joint and disabling arthritis. Several procedures have been developed to arrest the progress of osteonecrosis and postpone the procedure of total hip replacement especially in young patients. The aim of this multicenter study was to analyze the results of the use of the vascularized iliac bone flap transfer for management of ONFH. METHODS: From January 1985 to December 2012, a total of 2190 patients (2690 hips) with the mean age of 43...
August 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/28802984/free-grafts-and-microvascular-anastomoses
#3
REVIEW
Valery F Scharf
Skin grafts and free skin flaps are useful options for closure of wounds in which primary closure or use of traditional skin flaps is not feasible. Grafts are classified by their morphology and host-donor relationship. Free skin flaps with microvascular anastomoses are developed from previously described axial pattern flaps and have the added advantage of reestablishing robust vascular supply to the flap, but require specialized equipment and a high degree of technical expertise. Despite intensive perioperative care and the risk of graft or flap failure, skin grafts and free skin flaps can serve as rewarding methods of closing difficult wounds...
August 9, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28802886/-lumbar-artery-perforator-flap-for-breast-reconstruction
#4
J-F Honart, N Leymarie, B Sarfati, H Alknashnam, K Rem, F Rimareix, F Kolb
Even though DIEP-SIEA flaps or latissimus dorsi musculocutaneous flap are the most frequently used, a wide variety of flaps have been described for autologous breast reconstruction. Concerning the choice of donor-site, the aim is to prevent and to limit the morbidity. That is why the donor-site should be carefully chosen, according to the morphology of the patient. Lumbar artery perforator flap (LAP) is an option for breast reconstruction, but it is not well known and its use is limited. This study summarizes the authors' early experience with free LAP flap for breast reconstruction...
August 9, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28801079/re-raising-muscle-flaps-a-randomised-controlled-animal-study
#5
K Bradshaw, M Wagels
BACKGROUND: In the experience of our centre, 33% of reconstructed compound lower limb injuries will need an orthopaedic revision.(1) A flap may be re-raised through numerous methods, and historically, the approach of choice has been based on the principle of protecting the vascular pedicle rather than the inset. Our aim was to determine whether a marginal versus a split approach to re-raising inferred a higher risk of flap necrosis and whether more attention should be paid to protecting the inset of the flap, particularly at the distal portion...
July 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28799442/the-use-of-innervated-radial-artery-superficial-palmar-branch-perforator-free-flap-for-complex-digital-injuries-reconstruction
#6
Zhenglin Chi, Georgios Pafitanis, Luis Eduardo Parra Pont, Roshan Vijayan, Stefano Marcelli, Weiyang Gao, Zan Li, Xiao Zhou, Dajiang Song, Peng Yang
Loco-regional flaps have been widely used for the reconstruction of digital injuries without requiring microvascular anastomosis, however, they result in scarring and compromised functional outcomes. This study demonstrates our experience utilizing the innervated radial artery superficial palmar branch (RASPB) perforator free flap for complex digital injury reconstruction. From May 2007 to March 2014, the innervated RASPB perforator free flap was used to reconstruct 79 distal complex hand and digital soft tissue defects of which 14 were used to re-vascularise the distal digit in a flow-through fashion...
August 11, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28796101/use-of-the-ipsilateral-anteromedial-thigh-flap-for-immediate-rescue-of-nonviable-anterolateral-thigh-flaps-in-head-and-neck-cancer-reconstruction
#7
Hsu-Tang Cheng, Jin-Yi Tian, Yung-Chang Hsu, Hsin-Han Chen, Sophia Chia-Ning Chang
BACKGROUND: It is not always possible to use the anatomically variable free anterolateral thigh (ALT) flap for reconstructive surgery. An anteromedial thigh (AMT) flap serves as a good alternative, and shares the same vascular pedicle as the ALT flap. METHODS: Of 698 reconstructions performed in 2006 to 2013 following head and neck tumor ablation surgery, ALT flaps were used in 653 patients. Eighteen free AMT flaps were harvested to replace variant nonviable ALT flaps...
August 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28796099/radiotherapy-and-smoking-history-are-significant-independent-predictors-for-osteosynthesis-associated-late-complications-in-vascular-free-fibula-reconstruction-of-mandible
#8
YiMing Chen, JiaLing Wu, Sandhya Gokavarapu, Qingcheng Shen, Tong Ji
BACKGROUND: The vascular fibula flap is an ideal choice for function and appearance reconstruction of mandible. Despite the high success rate, "late complications" such as Ti plate exposure and local infection related to osteosynthesis are not uncommon. PATIENTS AND METHOD: A retrospective cohort of patients who received vascular fibula reconstruction for mandible from January 2011 to December 2013 from the Department of Oral and Maxillofacial Oncology in a tertiary hospital were charted: clinical, pathological, and therapeutic factors were analyzed for late complications in univariate and multivariate analyses...
August 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28782246/the-surgical-anatomy-of-the-vascularized-lateral-thoracic-artery-lymph-node-flap-a-cadaver-study
#9
Ines E Tinhofer, Stefan Meng, Johannes Steinbacher, Julia Roka-Palkovits, Eva Györi, Lukas F Reissig, Ming-Huei Cheng, Wolfgang J Weninger, Chieh-Han J Tzou
BACKGROUND: One promising surgical treatment of lymphedema is the VLNT. Lymph nodes can be harvested from different locations; inguinal, axillary, and supraclavicular ones are used most often. The aim of our study was to assess the surgical anatomy of the lateral thoracic artery lymph node flap. MATERIALS AND METHODS: In total, 16 lymph node flaps from nine cadavers were dissected. Flap markings were made between the anterior and posterior axillary line in dimensions of 10 × 5 cm...
August 7, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28776087/efficacy-of-in-vivo-electroporation-mediated-il-10-gene-delivery-on-survival-of-skin-flaps
#10
S Morteza Seyed Jafari, Maziar Shafighi, Helmut Beltraminelli, Benedikt Weber, Ralph A Schmid, Thomas Geiser, Amiq Gazdhar, Robert E Hunger
Despite advances in understanding the underlying mechanisms of flap necrosis and improvement in surgical techniques, skin flap necrosis after reconstructive surgery remains a crucial issue. We investigated the efficacy of electroporation-mediated IL-10 gene transfer to random skin flap with an aim to accelerate wound healing and improve skin flap survival. Nine male Wistar rats (300-330 g) were divided in two groups (a) control group (n = 5), only surgery no gene transfer, and (b) experimental group, received electroporation-mediated IL-10 gene transfer 24 h before the surgery as prophylaxis (n = 4)...
August 3, 2017: Journal of Membrane Biology
https://www.readbyqxmd.com/read/28774250/vascularized-spare-parts-reconstruction-of-hand-gunshot-injury
#11
Nathan Patrick, Alexander Payatakes
Reconstruction of extensive traumatic bone and soft tissue deficits in the hand often presents a significant challenge. We present a case of a gunshot wound managed with a resourceful "vascularized spare parts" reconstruction in which a single compromised digit provided two separate vascularized tissue transfers. A rarely reported pedicled phalanx restored osseous stability, a digital fillet flap achieved soft tissue coverage, and the flexor tendons reanimated the hand. An excellent functional and cosmetic result was obtained and the patient was able to return to manual labor within six months of injury...
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28767568/three-dimensional-virtual-planning-in-precise-chimeric-fibula-free-flap-for-metacarpal-defects-a-case-report
#12
Hui Shen, Xiang-Qian Shen, Ying Lv, Hui Lu, Jing-Hong Xu, Shou-Cheng Wu
RATIONALE: Metacarpal and phalanx defects with soft tissue loss were suggested to be reconstructed by vascularized bone flap. The fibular osteocutaneous flap is a preferred method. Three-dimensional virtual planning has successfully applied in mandibular reconstruction with fibular free flap. We applied three-dimensional virtual planning in precise fibula flap harvest to maintain the continuity of the fibula and to achieve accurate metacarpal and phalanx reconstruction. PATIENT CONCERNS: A 35-year-old male presented with extensive soft tissue defects and first metacarpal defect involving the first metacarpophalangeal joint...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28767176/sequential-chimeric-medial-femoral-condyle-and-anterolateral-thigh-flow-through-flaps-for-one-stage-reconstructions-of-composite-bone-and-soft-tissue-defects-report-of-three-cases
#13
Dominic Henn, Mohamed H Abouarab, Christoph Hirche, Jochen F Hernekamp, Volker J Schmidt, Ulrich Kneser, Thomas Kremer
Small recalcitrant non-unions with poor perfusion require reconstruction with vascularized bone flaps. Cases with concomitant large soft tissue defects are especially challenging, since vascularized soft tissue transfer is often indicated and distant microvascular anastomoses may be required. We introduce a sequential chimeric free flap composed of a medial femoral condyle corticoperiosteal flap anastomosed to an anterolateral thigh flow-through flap (MFC-ALT flap) and report its use for reconstruction of small non-unions with concomitant large soft tissue defects in three exemplary patients...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28767166/radiological-anatomy-of-the-perforators-of-the-gluteal-region-the-radiosome-based-anatomy
#14
Enrico Vigato, Eleonora De Antoni, Cesare Tiengo, Andrea Porzionato, Cinzia Tortorella, Maurizio Governa, Veronica Macchi, Raffaele De Caro
BACKGROUND: The superior (SGA) and the inferior gluteal artery (IGA) perforator flaps are widely used in pressure-sore repair and in breast reconstruction. The aim was to exhaustively depict the topographical anatomy of the whole system of perforators in the buttock. METHODS: Eighty lower-extremity computed tomographic angiography (CTA) of patients (20 males/20 females, mean age 61-years old, range 38-81) were considered. The source artery, location, type, and caliber of gluteal perforators were analyzed...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28765065/reconstructive-outcome-of-intraoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-surgery-for-tumors-involving-skull-base
#15
Chi-Man Jeon, Sang Duk Hong, Ho Jun Seol, Jung-Il Lee, Do-Hyun Nam, Yoon Jung Hwang, Doo-Sik Kong
Endoscopic transnasal surgery for tumors located at the base of the skull has a high incidence of postoperative cerebrospinal fluid (CSF) leaks. Here, we assessed the repair outcomes for high-flow CSF leaks based upon the tumor location, and analyzed the reasons for repair failure after transnasal endoscopic surgery solely for tumors involving the base of the skull. From Feb. 2009 to Dec. 2014 we performed endoscopic endonasal surgery for a variety of skull base lesions in 788 patients at our institution. Among them, 95 patients with intradural skull base tumors underwent endoscopic transnasal surgery...
July 29, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28764951/reconstruction-of-the-bony-chin-using-sagittal-split-osteotomies-of-the-remaining-mandible-a-new-technique-for-a-special-indication-case-report
#16
Berthold H Hell
There are several indications for resecting the bony chin, such as squamous cell carcinoma, sarcoma, or benign tumors of the jaw such as ameloblastoma. Several techniques for reconstruction of the bony chin, such as the use of metal plates and also revascularized free bone grafts of the iliac crest, fibula, or scapula, are common. In the case of poor vascular supply, however, alternative techniques may be necessary. In this report, a new technique is described using pedicled bone flaps from both sagittally split mandibular stumps following chin resection...
June 16, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28764208/assessing-the-viability-of-hadad-flap-by-postoperative-contrast-enhanced-magnetic-resonance-imaging
#17
Hegde Jyotirmay, Sunil Kumar Saxena, A S Ramesh, K Nagarajan, Shreshta Bhat
INTRODUCTION: The Expanded Endonasal Approaches (EEAs) have been widely used for various skull base lesions. The reconstruction of the skull base defects is of vital importance to prevent postoperative complications. The vascular pedicled-nasoseptal flap (Hadad-Bassagasteguy flap) is used as a workhorse in reconstruction of majority of the defects. AIM: The purpose of this study was: (a) To assess the postoperative MRI appearance of vascularised pedicled nasoseptal flap for its viability; (b) To determine the variations in MRI that may suggest potential flap failure...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28763811/-ribeiro-technique-in-gigantomastia-review-of-294-reduction-mammaplasties-in-8-years
#18
Andreas Wolter, Naja Pluto, Till Scholz, Jens Diedrichson, Andreas Arens-Landwehr, Jutta Liebau
Introduction Reduction mammaplasty in patients with gigantomastia is challenging even to very experienced plastic surgeons. Extremely elongated pedicles impair the vascular supply of the nipple-areola complex. Breast shaping and effective reduction are difficult due to the severely stretched skin envelope. The Ribeiro technique is the standard technique for reduction mammaplasty in our clinic. The aim of this study is to review our approach in patients with gigantomastia in comparison to the current literature...
August 1, 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28762169/successful-surgical-treatment-of-intractable-chylous-ascites-using-the-lymphatic-cable-flap-a-retrospective-review-study
#19
Shih-Heng Chen, Li-Fan Yeh, Pedro Ciudad, Hung-Chi Chen
OBJECTIVE: For evaluation of a novel surgical procedure for the treatment of chylous ascites. Chylous ascites is a debilitating condition associated with high morbidity and mortality rates. At least one-third of patients are refractory to medical therapy and may warrant further treatment. Traditional methods involving ligation of lymphatic fistulas or small bowel resection do not address the basic pathophysiologic mechanism of the underlying obstruction, and identification of chyloperitoneal fistulas may be challenging...
July 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28760508/effects-of-gamma-low-dose-irradiation-on-skin-flap-survival-in-rats
#20
Mojtaba Karimipour, Vahid Amanzade, Nasrollah Jabbari, Gholam Hossein Farjah
PURPOSE: Skin flap necrosis due to inadequate blood supply has remained a common postoperative problem in constructive surgery. As low-dose irradiation (LDI) has been shown to promote the wound-healing process, this study aims to investigate whether LDI could increase neovascularization and skin flap survival in rats. METHODS: McFarlane flaps were created in 21 male rats, which were divided into one control and two treatment groups (Ta and Tb). The treatment groups received a whole body single dose of 100cGy gamma ray irradiation before (Tb) and after (Ta) flap surgery...
July 28, 2017: Physica Medica: PM
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