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Vascularized flap

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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/29165016/the-use-of-osteochondral-flaps-in-the-treatment-of-carpal-disorders
#2
James P Higgins, Heinz K Bürger
Vascularized osteochondral flaps have been described for use in reconstruction of the wrist, providing the benefits of osteochondral grafts in addition to the benefit of osseous and subchondral perfusion via the microvascular pedicle. Various harvest sites have been described including the medial and lateral femoral trochlea and the proximal third metatarsal. The reconstructed surfaces described include the cartilage surfaces of the scaphoid, lunate, capitate and radius. The ability to transfer analogous osteochondral surfaces poses the possibility for new motion-preserving alternatives for difficult articular problems previously treated with salvage procedures...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29153422/a-flap-based-on-the-plantar-digital-artery-arch-branch-to-improve-appearance-of-reconstructed-fingers-anatomical-and-clinical-application
#3
Lin-Feng Tang, Ji-Hui Ju, Yue-Fei Liu, Bo Lan, Rui-Xing Hou
AIM: To investigate blood supply features of the flap based on the plantar digital artery arch and arch branch artery, and the treatment of outcomes of reconstructed fingers by the plantar digital artery arch branch island flap. METHODS: Eight fresh foot specimens were employed with red emulsion infusion and microdissection. The vascular organization was observed in the second toe, such as initiation site, the course, and the number of the plantar digital artery arch branch...
November 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29152539/early-mobilizing-and-dangling-of-the-lower-leg-after-one-stage-reconstruction-of-achilles-tendon-and-overlying-tissue-defect-using-an-anterolateral-thigh-flap-with-vascularized-fascia-lata
#4
Masayuki Okochi, Masanori Momiyama, Hiromi Okochi, Kazuki Ueda
We have treated two patients who had an Achilles tendon and overlying tissue defect using an anterolateral thigh flap with fascia lata. Postoperatively, skeletal suspension of the affected leg and intra-arterial heparin infusion were performed for seven days. Six weeks postoperatively, the patients could walk again.
2017: Case Reports in Plastic Surgery & Hand Surgery
https://www.readbyqxmd.com/read/29147150/localized-aortic-root-dissection-with-a-superior-mesenteric-artery-aneurysm
#5
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
#6
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/29135896/vertical-skin-paddle-orientation-for-the-latissimus-dorsi-flap-in-breast-reconstruction-a-modification-to-simultaneously-correct-inferior-pole-constriction-and-improve-projection
#7
Megan Fracol, Michelle Grim, Steven Lanier, Neil A Fine
The latissimus dorsi myocutaneous flap (LDMF) is a reliable and frequently used option to bring vascularized skin and soft tissue to improve the stability and aesthetic result in breast reconstruction. Standard techniques with skin paddle inset in a horizontal or oblique fashion preferentially improve anterior projection (when inset at the mastectomy scar) or lower pole and infra-mammary fold (IMF) constriction (when inset into the IMF). Here, we describe a modification for inset of the LDMF that improves both anterior projection and lower pole/IMF constriction, while also allowing the latissimus muscle to fan out and provide complete implant coverage...
November 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29135409/double-inlay-plus-ventral-onlay-buccal-mucosa-graft-for-simultaneous-penile-and-bulbar-urethral-stricture
#8
Luciano A Favorito, Paulo P Conte, Ulisses G Sobrinho, Rodrigo G Martins, Tomas Accioly
OBJECTIVES: Buccal mucosa grafts and fascio-cutaneous flaps are frequently used in long anterior urethral strictures (1). The inlay and onlay buccal mucosa grafts are easier to perform, do not need urethral mobilization and generally have good long-term results (2-4). In the present video, we present a case where we used a double buccal mucosa graft technique in a simultaneous penile and bulbar urethral stricture. MATERIALS AND METHODS: A 54 year-old male patient was submitted to appendectomy where a urethral catheter was used for two days in May 2015...
November 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29132254/reverse-flow-intrinsic-fasciocutaneous-island-flaps-in-foot-reconstruction
#9
Sujin Bahk, GyeongHyeon Doh, Ki Yong Hong, SooA Lim, SuRak Eo
Reconstruction of soft tissue defects in the foot remains a challenge due to its specialized tissue for weightbearing and ambulation. Considering the principle of replacing "like with like," adjacent soft tissues would be a best option for a donor site. Although several kinds of reverse-flow island flaps for the lower leg have been well described, intrinsic foot reverse flow flaps have been rarely reported. We describe 3 kinds of reverse-flow intrinsic fasciocutaneous flaps (RIFFs) for foot reconstruction. From September 2012 to August 2015, a retrospective study was done on case notes of all patients who had a RIFF for coverage of soft tissue defects within the foot following trauma or tumor ablation...
November 1, 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29127470/rectus-abdominis-muscle-innervation-an-anatomical-study-with-surgical-implications-in-diep-flap-harvesting
#10
Carla Stecco, Gian Paolo Azzena, Veronica Macchi, Andrea Porzionato, Astrid Behr, Anna Rambaldo, Cesare Tiengo, Raffaele De Caro
PURPOSE: To improve the current knowledge of rectus abdominis innervation, so as to identify a safe area where the vascular pedicle should be dissected to reduce the risk of nerve damage during deep inferior epigastric perforator (DIEP) flap harvesting. METHODS: Ten abdominal wall dissections were performed. Perforating arteries were identified and classified into nerve-related perforators and non-nerve-related perforators depending on the presence of nerve branches crossing vessels...
November 10, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29126769/cardiovascular-complications-in-head-neck-microvascular-flap-reconstruction-a-retrospective-risk-stratification-and-outcomes-assessment
#11
Naseem Ghazali, Steven Caldroney, Donita Dyalram, Joshua E Lubek
BACKGROUND: To determine the incidence and predictors of cardiac complications (CC) in head & neck microvascular flap reconstruction. METHODS: A series of 216 microvascular flaps performed between 2012 and 2015 were analyzed using the Revised Cardiac Risk Index (CRCI) and the Charlson Comorbidity Index (CCI). Multivariate regression analysis was undertaken for predictive factors of outcomes. RESULTS: Twenty patients developed CC (9.7%) with transient cardiac arrhythmia (6...
October 12, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29126421/peroneal-artery-perforator-flap-for-the-treatment-of-chronic-lower-extremity-wounds
#12
Liang Cheng, Xiaqing Yang, Tingxiang Chen, Zhijie Li
BACKGROUND: Reconstruction of chronic lower extremity wounds remains challenging. These wounds are mainly associated with diabetes mellitus, infections, and osteomyelitis. Although several reconstructive techniques are available, the peroneal artery perforator flap has unique advantages. METHODS: In this study, we discuss our experiences with peroneal artery perforator flaps in 55 patients who had suffered from chronic lower limb wounds. The size of the defect, comorbidities, etiology, flap size, and complications were recorded and analyzed based on a retrospective chart review...
November 10, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29125707/vascularized-humeral-periosteal-flap-to-treat-lateral-humeral-condyle-nonunion-an-anatomical-study-and-report-of-two-successfully-treated-pediatric-cases
#13
S Sergi Barrera-Ochoa, Francisco Soldado, Alfonso Rodriguez-Baeza, Paula Diaz-Gallardo, Felipe Hodgson, Pablo S Corona, Jorge Knörr
PURPOSE: Nonunion is a common complication of lateral condyle humeral (LCH) fractures in children. In situ fixation with a screw and bone grafting is the classically-recommended method of treatment. The purpose of this study is to analyze the feasibility of obtaining a vascularized periosteal flap obtained from the lateral humerus and based on the posterior collateral radial vessels (PCRV). Second, to report the results after the application in two pediatric cases. METHODS: Periosteal branches of PCRV were studied in ten upper limbs from fresh human cadavers...
November 10, 2017: Microsurgery
https://www.readbyqxmd.com/read/29123881/unexpected-complications-immediately-after-cranioplasty
#14
Akihito Kato, Hiroyuki Morishima, Goro Nagashima
Case: An 84-year-old man with subarachnoid hemorrhage underwent craniotomy and clipping with external decompression. Perfusion magnetic resonance imaging showed subclinical sinking skin flap syndrome, and he underwent cranioplasty on postoperative day 58. No problems occurred during the operation, but cerebral edema and hemorrhage were recognized on immediate postoperative computed tomography. Edema continued to progress, but edema and bleeding eventually improved without additional surgery...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29121845/improving-outcomes-for-lower-extremity-amputations-using-intraoperative-fluorescent-angiography-to-predict-flap-viability
#15
Andrew E Yang, Charles A Hartranft, Alisha Reiss, Charles R Holden
OBJECTIVES: Nearly 25% of vascular surgery patients operated on for peripheral vascular disease are readmitted within 30 days. Development of adjuncts to minimize wound complications remains an area of great interest. Here, we present our experience with intraoperative fluorescent angiography (IFA) as a tool to predict skin flap viability following lower extremity amputations (LEAs). METHODS: Experience with IFA using indocyanine green (ICG) dye was reviewed retrospectively at a single institution...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29118537/choosing-an-ideal-vascular-cover-for-snodgrass-repair
#16
Mamatha Basavaraju, Dhiraj K Balaji
Aim: The aim of this study is to compare tunica vaginalis (TV), dorsal dartos, and ventral dartos flap as a second layer vascular cover during Snodgrass repair. Materials and Methods: Data of 83 patients who underwent primary hypospadias repair with Snodgrass technique (age range: 1.6-12 years) were retrospectively collected and compared. They were divided into three groups. Group A (26 patients) included cases using TV flap, Group B (36 patients) included those where dorsal dartos from prepuce was used as second cover, and Group C (21 patients) included those with ventral dartos as cover...
October 2017: Urology Annals
https://www.readbyqxmd.com/read/29113902/evaluation-of-the-use-of-calcium-phosphate-cement-for-aesthetic-neurosurgical-cranial-reconstruction
#17
Toshiaki Kodera, Hiroyuki Tada, Ayumi Akazawa, Norichika Hashimoto, Hidetaka Arishima, Shinsuke Yamada, Hiroshi Arai, Yoshifumi Higashino, Ryuhei Kitai, Hiroaki Takeuchi, Ken-Ichiro Kikuta
OBJECTIVE: The authors evaluated whether newly developed calcium phosphate cement (CPC), mounted around the titanium plates, is useful for aesthetic cranial reconstruction by using two methods. METHODS: The morphological changes of CPC were observed in the videos of six patients who had undergone cranial reconstruction with CPC during the first surgery and required second surgery. The facial aesthetic outcomes of 74 consecutive patients, more than 12 months after frontotemporal (FT) or bifrontal (BF) craniotomy and reconstruction with or without CPC, were evaluated...
November 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29113176/stereolithographic-model-assisted-reconstruction-of-the-mandibular-condyle-with-a-vascularized-fibular-flap-following-hemimandibulectomy-evaluation-of-morphological-and-functional-outcomes
#18
Hitoshi Yoshimura, Shinpei Matsuda, Seigo Ohba, Yoshiki Minegishi, Kunihiro Nakai, Shigeharu Fujieda, Kazuo Sano
The vascularized fibular flap is one of the standard treatment choices for the reconstruction of the mandible; however, the consequences of condylar restoration have not previously been reported. The use of three-dimensional models allows for a more predictable reconstruction. The purpose of the present study was to assess the outcome of stereolithographic model-assisted reconstruction of the mandibular condyle with a vascularized fibular flap. A total of 5 patients underwent mandibular resection including the condyle and immediate reconstruction with a vascularized fibular flap...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29111474/the-middle-temporal-artery-surgical-anatomy-and-exposure-for-cerebral-revascularization
#19
Roberto Rodriguez Rubio, Michael T Lawton, Olivia Kola, Halima Tabani, Sonia Yousef, Ali Tayebi Meybodi, Jan-Karl Burkhardt, Ivan El-Sayed, Arnau Benet
BACKGROUND: The middle temporal artery (MTA) is the proximal medial branch of the superficial temporal artery (STA), supplying the temporalis muscle along with deep temporal arteries. Its use in vascularized flaps for reconstructive and otologic procedures has been described, yet its potential use in neurosurgery is not studied. We report a novel technique for exposing the MTA and evaluated its characteristics for extracranial-intracranial (EC-IC) cerebrovascular bypass. METHODS: After a curvilinear frontotemporal incision in 10 cadaveric specimens, the STA was dissected from distal to proximal...
October 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29108083/-pedicled-omentum-flaps-in-the-management-of-deep-sternal-wound-infections
#20
Nick Spindler, Christian Etz, Martin Misfeld, Christoph Josten, Michael Borger, Friedrich Wilhelm Mohr, Stefan Langer
Aim Coverage of a deep sternal wound infection with a greater omentum flap. Due to a persistent infection caused by an infected aortic prosthesis, the primarily performed reconstruction with a latissimus dorsi flap had to be revised, and an alternative solution had to be found. Indication A deep sternal wound infection is a rare but devastating complication following median sternotomy. If the commonly used muscle flap is not sufficient and artificial material is still present in the wound, for instant drivelines or a vascular prosthesis, the greater omentum flap is a useful option due to its immunologic capacity...
November 6, 2017: Zentralblatt Für Chirurgie
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