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Vascularized flap

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https://www.readbyqxmd.com/read/29352303/perfusion-decellularization-of-a-human-limb-a-novel-platform-for-composite-tissue-engineering-and-reconstructive-surgery
#1
Mattia Francesco Maria Gerli, Jacques Paul Guyette, Daniele Evangelista-Leite, Brian Burns Ghoshhajra, Harald Christian Ott
Muscle and fasciocutaneous flaps taken from autologous donor sites are currently the most utilized approach for trauma repair, accounting annually for 4.5 million procedures in the US alone. However, the donor tissue size is limited and the complications related to these surgical techniques lead to morbidities, often involving the donor sites. Alternatively, recent reports indicated that extracellular matrix (ECM) scaffolds boost the regenerative potential of the injured site, as shown in a small cohort of volumetric muscle loss patients...
2018: PloS One
https://www.readbyqxmd.com/read/29351682/radial-artery-fascial-flow-through-free-flap-for-combined-revascularization-in-moyamoya-disease
#2
Jonathan Russin, Joseph Carey
BACKGROUND: Free flaps are commonly used by other surgical subspecialties for soft tissue reconstruction and revascularization. Cranial applications of these flaps have been limited to only a single case report. OBJECTIVE: To present a new technique for combined revascularization in moyamoya disease using a flow-through free flap. METHODS: Data were obtained from an Institutional Review Board-approved, prospectively maintained database with informed consent from the patient...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29349048/versatility-of-modified-nasolabial-flap-in-oral-and-maxillofacial-surgery
#3
Geeti Vajdi Mitra, Sarwpriya Sharma Bajaj, Sushmitha Rajmohan, Tejas Motiwale
Background: To evaluate the versatility and reach of modified nasolabial flap used in reconstruction of defects created in and around the oral cavity. Methods: A total number of 20 cases were selected. Out of which 13 were males and 7 females. The age of these patients ranged from 24-63 years. 29 modified nasolabial flaps were raised in twenty patients. Based on clinical and histopathological examination, out of 20 patients, 14 patients were diagnosed with oral submucous fibrosis, 3 with verrucous carcinoma, 1 with squamous papilloma, 1 with oro-antral fistula and 1 with traumatic loss of lower lip...
December 2017: Archives of Craniofacial Surgery
https://www.readbyqxmd.com/read/29346567/epithelial-grafting-of-a-decellularized-whole-tracheal-segment-an-in-vivo-experimental-model
#4
Margot Den Hondt, Bart M Vanaudenaerde, Eric K Verbeken, Jan J Vranckx
OBJECTIVES: Prerequisites for successful trachea transplantation include the use of a biocompatible construct, submucosal vascularization and an epithelial covering. Implantation of non-epithelialized tracheal scaffolds may lead to stenosis. However, epithelial grafting or seeding can only be attempted onto a well-vascularized submucosal bed. Our aim was to investigate a method to prevent stenosis during prelamination of non-epithelialized, gently decellularized rabbit tracheae and to evaluate whether grafting of revascularized constructs with buccal mucosa is feasible...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29343893/assessment-of-perfusion-of-free-flaps-used-in-head-and-neck-reconstruction-using-pulsatility-index
#5
Akshay Kapoor, Malay Karmakar, Collin Roy, Kaushal Priya Anand
Objective: To detect venous or arterial obstruction in the pedicle of a free flap we can monitor resistance in the flap bed which is reflected in Pulsatility Index (PI) Therefore if we detect change in the values of the PI in these flaps then we can detect complications in flap due to vascular insufficiency early. Materials and Methods: Seven patients of Free Fibular Flap Reconstruction and ten patients of Free Radial Forearm Flap reconstruction were evaluated over a period of 18 months...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29339717/complex-reconstruction-with-flaps-after-abdominoperineal-resection-and-groin-dissection-for-anal-squamous-cell-carcinoma-a-difficult-case-involving-many-specialities
#6
Claudia Reali, Richard Guy, Christopher R Darby, Lucy Cogswell, Roel Hompes
BACKGROUND Anal squamous cell carcinoma accounts for about 2-4% of all lower gastrointestinal malignancies, with a distant disease reported in less than 5%. Although surgical treatment is rarely necessary, this often involve large dissections and difficult reconstructive procedures. CASE REPORT We present a complex but successful case of double-flap reconstruction after abdominoperineal resection and groin dissection for anal squamous cell carcinoma (cT3N3M0) with metastatic right inguinal lymph nodes and ipsilateral threatening of femoral vessels...
January 17, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29336371/in-vitro-flow-perfusion-maintaining-long-term-viability-of-the-rat-groin-fat-flap-a-novel-model-for-research-on-large-scale-engineered-tissues
#7
Yang An, Fang-Fei Nie, Ze-Lian Qin, Hong-Yu Xue, Lu-Jia Chen, Bi Li, Dong Li
BACKGROUND: Large-scale muscle tissue engineering remains a major challenge. An axial vascular pedicle and perfusion bioreactor are necessary for the development and maintenance of large-scale engineered muscle to ensure circulation within the construct. We aimed to develop a novel experimental model of a large-scale engineered muscle flap from an existing rat groin fat flap. METHODS: A fat flap based on the superficial inferior epigastric vascular pedicle was excised from rats and placed into a perfusion bioreactor...
January 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29334788/latissimus-dorsi-flap-in-breast-reconstruction-recent-innovations-in-the-workhorse-flap
#8
Rachita Sood, Jeena M Easow, Geoffrey Konopka, Zubin J Panthaki
BACKGROUND: Surgeons employ the latissimus dorsi flap (LDF) for reconstruction of a large variety of breast cancer surgery defects, including quadrantectomy, lumpectomy, modified radical mastectomy, and others. The LDF may be used in delayed or immediate reconstruction, in combination with tissue expanders for a staged reconstruction, with implant-based immediate reconstruction, or alone as an autogenous flap. METHODS: The authors discuss the historical uses and more recent developments in the LDF...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/29333783/-application-of-preoperative-vascular-localization-techniques-for-perforator-flaps
#9
Wu Lianjun, Wang Huiming
With the development of microvascular technology, perforator flaps have gradually become a good alternative for reconstruction of tissue defects. However, the major limitations of perforator flaps include uncertainty in predicting anatomical location of perforators and high variability in perforator size and course, which require preoperative localization techniques. Recently, as one of the preoperative localization techniques, computed tomography angiography was used to determine the number, size, course, and exact emerging point of perforator flaps...
December 1, 2017: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
https://www.readbyqxmd.com/read/29323065/emerging-role-of-preputial-vascular-pattern-and-postoperative-microvessel-density-in-cases-of-proximal-hypospadias-a-pilot-study
#10
Vishrut Narang, Amita Sen, Minakshi Bhardwaj
INTRODUCTION: Understanding of anatomical vascular patterns and anatomy of prepuce is critical for a good outcome in hypospadias surgery. A well-vascularized neourethral and preputial flaps used for repair are exceptionally important for a successful outcome, especially in cases of proximal hypospadias undergoing one-stage procedures. OBJECTIVE: To evaluate the vascular anatomy of prepuce in cases of proximal hypospadias and to evaluate microvessel density (MVD) by immunohistochemistry and its correlation with postoperative complications...
October 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29322547/improvement-of-the-salvage-rate-of-flap-after-venous-thrombosis-with-intraparenchymatous-venous-pressure-monitoring
#11
Hajime Matsumine, Mariko Mogami, Osamu Fujiwara, Masahiro Hasegawa, Hiroshi Ito, Hiroyuki Sakurai
PURPOSE: Intraparenchymatous venous pressure (IVP) monitoring in flap can measure venous pressure with catheter placement. Among patients with IVP monitoring, this study reviewed postoperative microvascular complications for investigating the transplanted-tissue salvage-rate. PATIENTS AND METHODS: Two hundred and seventy-one patients (male, 132; female, 139; mean age, 52.3 years; age range, 9-82 years) underwent free flap transfer and postoperative continuous IVP monitoring, which performed as follows; a venous catheter was connected to a transducer, and venous pressure in the flap was recorded for three consecutive days postoperatively...
January 11, 2018: Microsurgery
https://www.readbyqxmd.com/read/29319575/duplex-ultrasonography-assisted-freestyle-pedicled-perforator-flaps-for-the-repair-of-myelomeningocele-defects
#12
Atsushi Imaizumi
BACKGROUND: Perforator flaps have unique advantages that may overcome the shortcomings of conventional approaches to myelomeningocele reconstruction. However, identifying and dissecting tiny perforators in neonates is arduous. We have overcome these obstacles with a freestyle flap approach that uses duplex ultrasonography to locate perforator vessels, allowing for limited superficial dissection. This report describes the duplex ultrasonography-assisted freestyle pedicled perforator flap technique for closure of myelomeningocele defects, with long-term clinical outcomes...
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29319572/vascularized-composite-allotransplantation-of-the-elbow-joint-a-cadaveric-study
#13
Mitchell A Pet, Angelo B Lipira, Yusha Liu, Dennis Kao, Jason H Ko
BACKGROUND: Surgical options for the unreconstructable elbow are limited to arthrodesis, total arthroplasty, or osteoarticular allograft reconstruction. Each of these options is limited by severe functional impairment and/or high complication rates. Vascularized allotransplantation of the elbow joint has the potential to mitigate these complications. In this study, we describe our technique for harvesting the elbow for vascularized joint transplantation and demonstrate the flap's vascularity using contrast angiography...
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29318464/early-vascular-responses-to-everolimus-eluting-cobalt-chromium-stent-in-the-culprit-lesions-of-st-elevation-myocardial-infarction-results-from-a-multicenter-prospective-optical-coherence-tomography-study-mechanism-ami-2-week-follow-up-study
#14
Yoshihiro Morino, Daisuke Terashita, Hiromasa Otake, Tatsuo Kikuchi, Tetsuya Fusazaki, Nehiro Kuriyama, Takahide Suzuki, Yoshiaki Ito, Kiyoshi Hibi, Hiroyuki Tanaka, Shozo Ishihara, Toru Kataoka, Takashi Morita, Yoritaka Otsuka, Takatoshi Hayashi, Kengo Tanabe, Toshiro Shinke
The use of cobalt-chromium everolimus-eluting stents (CoCr-EES) for ST-segment elevation myocardial infarction (STEMI) reduces the incidence of stent thrombosis compared with bare metal stents, and a substantial difference is apparent in the initial 2 weeks. However, vascular behavior during this early period remains unclear. This was a prospective study (MECHANISM-AMI-2W) to investigate early vascular responses in STEMI patients immediately after CoCr-EES implantation and at 2-week follow-up using frequency domain-optical coherence tomography (FD-OCT)...
January 9, 2018: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/29315799/preserving-a-patent-diep-pedicle-to-facilitate-salvage-breast-reconstruction-with-a-second-free-flap-a-case-report
#15
Dimitris Reissis, Daniel P Butler, Francis P Henry, Simon H Wood
Surgeons performing free flap breast reconstruction need to have a range of techniques in their armamentarium to successfully salvage cases of flap failure. We present a case of 47-year-old patient who suffered near-total right breast deep inferior epigastric perforator (DIEP) flap failure 3 days post-bilateral immediate breast reconstruction with DIEP flaps. At debridement, the DIEP pedicle was noted to be patent with preserved perfusion to a small segment of tissue around the origin of the pedicle. This tissue and the DIEP pedicle itself were therefore preserved to facilitate subsequent breast reconstruction using stacked transverse upper gracilis flaps anastomosed end-to-end to the original DIEP pedicle...
January 8, 2018: Microsurgery
https://www.readbyqxmd.com/read/29296632/free-serratus-anterior-fascial-flap-combined-with-vascularized-scapular-bone-for-reconstruction-of-dorsal-hand-and-finger-defects
#16
Takeshi Kitazawa, Masato Shiba, Kazuhiro Tsunekawa
We present two cases of serratus anterior free fascial flap combined with vascularized scapular bone graft for reconstruction of traumatized dorsal hand and phalangeal bone defects. Composite flaps with single vascular pedicles allowed conservation of severely injured fingers and provided good functional and cosmetic outcomes.
2018: Case Reports in Plastic Surgery & Hand Surgery
https://www.readbyqxmd.com/read/29288289/anterolateral-thigh-flap-combined-with-reconstruction-plate-versus-double-free-flaps-for-composite-mandibular-reconstruction-a-propensity-score-matched-study
#17
Anaeze C Offodile, Jennifer An-Jou Lin, Kai-Ping Chang, Mohamed Abdelrahman, Hao-Wei Kou, Charles Yuen Yung Loh, Mario A Aycart, Huang-Kai Kao
OBJECTIVE: This study was designed to examine the comparative effectiveness of oromandibular defect reconstruction via anterolateral thigh flap and bridging plate (ALT only) versus simultaneous soft tissue and vascularized bone flap (DFF), with regards to long-term plate exposure and complications. METHODS: A propensity score-matched analysis of patients with an oncologic head and neck defect who underwent microvascular reconstruction was performed. Two surgical groups, i...
December 30, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29284902/elongated-miofascial-temporal-flap-in-comparison-with-standard-surgical-procedure-of-temporal-muscle-reconstruction
#18
Dino Dizdarevic, Tarik Masic, Edi Muslic
Introduction: Flap of the temporal muscle (m. temporalis) with its natural position, its mass and its length, compared with other bound and free microvascular flaps, is the method of choice for covering the middle part of the face after the removal of large tumor masses. Material: The study included a sample of 36 patients who were surgically treated due to malignant process at the middle face level with the performed partial, total or bilateral maxillectomy at the Clinic for Maxillofacial Surgery, University Clinical Center in Sarajevo...
October 2017: Medical Archives
https://www.readbyqxmd.com/read/29284163/geometric-three-dimensional-end-to-side-microvascular-anastomosis-a-simple-and-reproducible-technique
#19
Adrian S H Ooi, Daniel R Butz, Sean M Fisher, Zachary J Collier, Lawrence J Gottlieb
BACKGROUND:  End-to-side (ETS) anastomoses are useful when preservation of distal vascularity is critical. The ideal ETS microanastomosis should maintain a wide aperture and have a smooth take-off point to minimize turbulence, vessel spasm, and thrombogenicity of the suture line. We have developed a unique, dependable, and reproducible geometric technique for ETS anastomoses, and analyze its efficacy in our series of patients. METHODS:  The geometric ETS technique involves creating a three-dimensional (3D) diamond-shaped defect on the recipient vessel wall, followed by a slit incision of the donor vessel to create a "spatula" fitting this defect...
December 28, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29280882/the-best-of-abdominal-wall-reconstruction
#20
REVIEW
Nakul Gamanlal Patel, Imran Ratanshi, Edward W Buchel
LEARNING OBJECTIVES: After reviewing this article, the participant should be able to: 1. List major risk factors for hernia formation and for failure of primary repair. 2. Outline an algorithmic approach to anterior abdominal wall reconstruction based on the degree of contamination, components involved in the deficit, and width of the hernia defect. 3. Describe appropriate indications for synthetic and biological mesh products. 4. List common flaps used in anterior abdominal wall reconstruction, including functional restoration strategies...
January 2018: Plastic and Reconstructive Surgery
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