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Vascularized flap

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https://www.readbyqxmd.com/read/29788685/the-lateral-intercostal-artery-perforator-as-an-alternative-donor-vessel-for-free-vascularized-lymph-node-transplantation
#1
Min-Seok Daniel Kwak, Hans-Guenther Machens
Chronic lymphedema is caused by an impairment of the lymphatic system due to primary or secondary causes. Vascularized lymph node transplantation (VLNT) is currently the most promising and frequently used technique besides lymphaticovenous anastomosis. However, the vessel anatomy in the lateral thoracic region is sometimes quite variable. Based on our experiences with vascular anatomical inconstancy in the lateral thoracic region, we planned a lateral intercostal artery perforator flap for VLNT in a female patient with chronic stage II lymphedema of both legs after cervical cancer treatment...
May 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29788679/delayed-bipedicled-nasolabial-flap-in-facial-reconstruction
#2
Cindy Siaw-Lin Goh, Joshua Guy Perrett, Manzhi Wong, Bien-Keem Tan
BACKGROUND: The nasolabial flap is ideal for reconstruction of the nasal alar subunit due to its proximity, color and contour match, and well-placed donor scar. When raised as a random-pattern flap, there is a risk of vascular compromise to the tip with increased flap length and aggressive flap thinning. Surgical delay can greatly improve the chances of tip survival, allowing the harvest of longer flaps with greater reach. METHODS: We describe our technique of lengthening the nasolabial flap through multiple delay procedures...
May 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29781768/guided-bone-regeneration-and-implant-placement-in-association-with-a-coronally-positioned-palatal-sliding-flap-a-17-year-follow-up-case-report
#3
Carlo Maiorana, Pier Paolo Poli, Mario Beretta
The aim of the present case report was to show the 17-year hard and soft tissues stability of guided bone regeneration procedure associated with dental implants insertion. A 52-year-old male patient presented with a partial edentulism in the upper right maxilla. A graft consisting of deproteinized bovine bone mineral and autogenous bone stabilized by a non-resorbable expanded polytetrafluoroethylene membrane was used to reconstruct the missing bone applying the biological principles of guided bone regeneration...
May 21, 2018: Journal of Oral Implantology
https://www.readbyqxmd.com/read/29777577/autologous-bone-marrow-mesenchymal-stem-cells-improve-the-quality-and-stability-of-vascularized-flap-surgery-of-irradiated-skin-in-pigs
#4
Christine Linard, Michel Brachet, Carine Strup-Perrot, Bruno L'homme, Elodie Busson, Claire Squiban, Valerie Holler, Michel Bonneau, Jean-Jacques Lataillade, Eric Bey, Marc Benderitter
Cutaneous radiation syndrome has severe long-term health consequences. Because it causes an unpredictable course of inflammatory waves, conventional surgical treatment is ineffective and often leads to a fibronecrotic process. Data about the long-term stability of healed wounds, with neither inflammation nor resumption of fibrosis, are lacking. In this study, we investigated the effect of injections of local autologous bone marrow-derived mesenchymal stromal cells (BM-MSCs), combined with plastic surgery for skin necrosis, in a large-animal model...
May 18, 2018: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29775982/the-supraclavicular-artery-perforator-flap-a-comparative-study-of-imaging-techniques-used-in-preoperative-mapping
#5
Hemin Oathman Sheriff, Kawa Abdullah Mahmood, Nzar Hamawandi, Aram Jamal Mirza, Jawad Hawas, Esther Granell Moreno, Juan Antonio Clavero, Christopher Hankins, Jaume Masia
BACKGROUND:  The supraclavicular artery flap is an excellent flap for head and neck reconstruction. The aim of this study is to assess imaging techniques to define the precise vascular boundaries of this flap. METHODS:  Six imaging techniques were used for supraclavicular artery mapping in 65 cases; handheld Doppler, triplex ultrasound, computed tomography angiography, magnetic resonance angiography, digital subtraction angiography, and indocyanine green angiography...
May 18, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29772322/free-omental-flap-for-tissue-defect-coverage-after-resection-of-complicated-venous-malformation-in-the-area-of-the-knee
#6
Nicla Settembre, Mario D'Oria, Lucie DekerlE, Charbel Saba, Zakariyae Bouziane, Serguei Malikov
Venous malformations are the most common slow-flow vascular malformations; they are not prone to volume decrease over time and invasive treatment is usually required. There are two main techniques to address the definitive therapy of these lesions: sclerotherapy and surgical excision, each with its own advantages and disadvantages. We report the case of a 56 year-old man who came to our attention with persistent pain after multiple unsuccessful attempts to treat a large venous malformation located in the area of the right knee...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29768632/lower-extremity-limb-salvage-with-cross-leg-pedicle-flap-cross-leg-free-flap-and-cross-leg-vascular-cable-bridge-flap
#7
Oscar J Manrique, Sarah N Bishop, Pedro Ciudad, Kian Adabi, Jorys Martinez-Jorge, Steven L Moran, Tony Huang, Aparna Vijayasekaran, Shih-Heng Chen, Hung-Chi Chen
BACKGROUND:  Lower extremity salvage following significant soft tissue loss can be complicated by lack of recipient vessel for free tissue transfer. We describe our experience in lower limb salvage for patients with no recipient vessels with the use of pedicle, free and cable bridge flaps. METHODS:  A retrospective review from 1985 to 2017 of patients undergoing lower limb salvage using a contralateral pedicle cross leg (PCL) flaps, free cross leg (FCL) flaps, or free cable bridge (FCB) flaps was conducted...
May 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29761514/mandibular-reconstruction-in-elderly-patients
#8
Shimpei Miyamoto, Takuya Higashino, Minoru Sakuraba
BACKGROUND AND OBJECTIVES: The choice of reconstructive technique for a segmental mandibular defect in elderly patients is controversial. The aim of this study was to establish an algorithm for selecting a method of mandibular reconstruction in elderly patients. METHODS: We retrospectively evaluated 121 patients aged ≥65 years who underwent immediate microvascular mandibular reconstruction after oncologic resection. Patients were divided into three groups based on method of reconstruction: vascularized bone graft (n = 49), mandibular reconstruction plate and soft tissue flap (n = 22), and soft-tissue flap (n = 50)...
May 14, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29756364/free-jejunal-flap-transfer-with-multiple-vascular-pedicles-for-safe-and-reliable-pharyngoesophageal-reconstruction
#9
Tomoyuki Kurita, Tateki Kubo, Hiroki Tashima, Takashi Fujii
BACKGROUND: In pharyngoesophageal reconstruction, we transferred a long jejunum flap containing multiple pedicles to achieve a 100% flap survival rate, and used the redundant mesentery to cover important tissues and fill in the dead space to reduce common postoperative complications, such as surgical site infections and fistula formation. METHODS: A total of 243 jejunal flap transfers with multiple vascular anastomoses were reviewed to examine flap survival and rates of early postoperative complications, such as surgical site infections and fistula formation, perioperative mortality, and donor site morbidity...
May 13, 2018: Head & Neck
https://www.readbyqxmd.com/read/29754975/endoscopic-endonasal-double-flap-technique-for-reconstruction-of-large-anterior-skull-base-defects-technical-note
#10
Ricardo Landini Lutaif Dolci, Alexandre Bossi Todeschini, Américo Rubens Leite Dos Santos, Paulo Roberto Lazarini
INTRODUCTION: One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base. OBJECTIVE: Describe the technique of performing endoscopic double flap multi-layered reconstruction of the anterior skull base without craniotomy...
April 19, 2018: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29752152/vascularized-dermal-autograft-for-the-treatment-of-irreparable-rotator-cuff-tears
#11
Michael A Stone, Antoine Carre, Nicholas Trasolini, Michael Minneti, Reza Omid
BACKGROUND: Irreparable rotator cuff tears (IRCTs) are a challenging problem with diverse treatment modalities. We propose a technique for the treatment of IRCTs in which a vascularized dermal autograft is transferred to the posterosuperior region of the rotator cuff using the supraclavicular artery (SCA) island flap. MATERIALS AND METHODS: Dissection of 11 fresh cadavers (19 shoulders) was performed, and the SCA island flap was harvested in all specimens. A full-thickness posterosuperior rotator cuff defect was created, and the flap was tunneled under the acromion and secured into position over the defect using multiple suture anchors...
May 8, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29747901/use-of-a-microvascular-coupler-device-for-end-to-side-venous-anastomosis-in-oral-and-maxillofacial-reconstruction
#12
W-M Wang, L Huang, X Gao, Y-X Yuan, X-Q Chen, X-C Jian
The aim of this study was to compare the use of a microvascular coupler device (MCD) for end-to-side venous anastomosis (ETS group) and phleboplasties combined with MCD for end-to-end venous anastomosis (ETE group) in free tissue transfer for oral and maxillofacial reconstruction, with regard to the anastomosis time and occurrence of postoperative vascular crisis. The ETS group included 22 patients and the ETE group included 40 patients. Patient demographic data, anastomotic time, coupler size, microvascular complications, and flap survival rates were collected and analyzed...
May 7, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29746278/computed-tomographic-angiography-used-for-localization-of-the-cutaneous-perforators-and-selection-of-anterolateral-thigh-flap-bail-out-branches
#13
Anna K Steve, Colin P White, Ali Alkhawaji, Thomas E J Hayakawa, Edward W Buchel, Steven F Morris
BACKGROUND: The purpose of this study was to evaluate the territory supplied by the lateral circumflex femoral artery for the consistency of a proximal perforator that could be used as an alternative pedicle for the anterolateral thigh flap if a tedious intramuscular course is encountered during elevation of the perforator used to develop the initial surgical plan. It is hypothesized that a consistent "bail-out" perforator supplying the proximal thigh would facilitate a simpler anterolateral thigh flap harvest, with minimal modification to flap design...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29746277/skin-paddles-improve-muscle-flap-salvage-rates-after-microvascular-compromise-in-lower-extremity-reconstruction
#14
John T Stranix, Adam Jacoby, Z-Hye Lee, Lavinia Anzai, Pierre B Saadeh, Vishal Thanik, Jamie P Levine
PURPOSE: Free tissue transfer after lower extremity trauma is associated with notoriously high complication rates. Theoretically, the inclusion of a cutaneous paddle on muscle free flaps may improve clinical flap monitoring. The effect of skin paddle presence on muscle free flap salvage outcomes after take-back was examined. METHODS: Retrospective query of our institutional free-flap registry (1979-2016) identified 362 muscle-based flaps performed for soft tissue coverage after below-knee trauma...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29742652/the-use-of-a-honeycomb-technique-combined-with-ultrasonic-aspirators-and-indocyanine-green-fluorescence-angiography-for-a-superthin-anterolateral-thigh-flap-a-pilot-study
#15
Song Fan, Han-Qing Zhang, Qun-Xing Li, Tian Tian, Wei-Xiong Chen, Guo-Kai Pan, Michael Ho-Young Ahn, Sheng Sun, Bing-Hao Wu, Jin-Song Li
BACKGROUND: Harvesting an optimally thinned anterolateral thigh flaps (ALTFs) is a challenge in overweight individuals and in the Western population. Here, we describe a novel honeycomb technique to achieve a superthin ALTF in overweight patients. METHODS: Forty patients with a body mass index(BMI) >25 kg/m who required a thinned ALTF for reconstruction were randomly assigned to a honeycomb technique (HCT) group or a microdissection technique (MDT) group. Patients in the HCT group received cavitron ultrasonic surgical aspiration (CUSA) to thin the flaps, and flap thinning was performed with a conventional MDT in the MDT group...
May 2, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29741975/introducing-anatomically-correct-ct-guided-laparoscopic-right-colectomy-with-d3-anterior-posterior-extended-mesenterectomy-initial-experience-and-technical-pitfalls
#16
Robin Gaupset, Jens Marius Nesgaard, Airazat M Kazaryan, Bojan V Stimec, Bjørn Edwin, Dejan Ignjatovic
BACKGROUND: Laparoscopic D3 anterior posterior extended mesenterectomy (D3APEM) in right colectomy has received increased attention. The aim of this study is to prove feasibility, systemize technical accomplishment, and provide short-term outcomes data. METHODS: From July 2013 to February 2017, 18 patients with adenocarcinoma in the right colon underwent right colectomy with laparoscopic D3APEM, including lymph nodes anterior and posterior to the superior mesenteric vessels...
May 9, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29736923/reconstruction-of-complex-tissue-defect-of-forearm-with-a-chimeric-flap-composed-of-a-sural-neurocutaneous-flap-and-a-vascularized-fibular-graft-a-case-report
#17
Chunyang Wang, Jia Xu, Gen Wen, Yimin Chai
One-stage reconstruction of composite bone and soft-tissue defects in the forearm remains a tough challenge. Here, we present a case of reconstruction of complex tissue defect at forearm with a chimeric flap consisting of a sural neurocutaneous flap and a fibular graft. A 61-year-old man suffered from a machine crush injury in his left forearm, resulting in a complex tissue defect including extensive dorsomedial soft-tissue, digit extensor muscles of 2-4 fingers, the muscle flexor carpi ulnaris, the ulna bone with 5...
May 7, 2018: Microsurgery
https://www.readbyqxmd.com/read/29735291/chimeric-medial-femoral-condyle-osteocutaneous-flap-for-reconstruction-of-multiple-metacarpal-defects
#18
REVIEW
Chung-Chen Hsu, James Tseng, Yu-Te Lin
When faced with reconstructing metacarpal defects, various options have been described. We describe a chimeric medial femoral condyle osteocutaneous flap as a new method for providing multiple bone grafts as well as soft tissue coverage in a single stage. The medial femoral condyle has become an area of increased interest given the versatility it allows in harvesting the bone. This osteocutaneous flap is useful when reconstructing small- to medium-sized adjacent metacarpal bone defects. The chimeric design of the flap lends flexibility at the time of inset that is absent for other options of vascularized bone grafts...
May 5, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29734909/the-observation-of-the-vein-distribution-of-a-partial-toe-transfer-flaps-with-a-short-vascular-pedicle
#19
Koichi Kobayashi, Katsuyasu Fukasawa, Naoko Masuyama
BACKGROUND: When performing partial toe-transfer flaps with a short vascular pedicle, as the flap becomes smaller, the likelihood of securing veins in the flap decreases. The purpose of this study was to clarify how frequently the partial toe-transfer flap with a short pedicle (free vascularized half-big toenail flap) contains veins and elucidate how frequently we can secure the veins with an artery via the first web space approach alone, using the Genial Viewer (a near-infrared light transmission imaging device)...
June 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29730061/computed-tomographic-angiographic-perforator-localization-for-virtual-surgical-planning-of-osteocutaneous-fibular-free-flaps-in-head-and-neck-reconstruction
#20
Kyle S Ettinger, Amy E Alexander, Kevin Arce
Virtual surgical planning (VSP), computer-aided design and computer-aided modeling, and 3-dimensional printing are 3 distinct technologies that have become increasingly used in head and neck oncology and microvascular reconstruction. Although each of these technologies has long been used for treatment planning in other surgical disciplines, such as craniofacial surgery, trauma surgery, temporomandibular joint surgery, and orthognathic surgery, its widespread use in head and neck reconstructive surgery remains a much more recent event...
April 10, 2018: Journal of Oral and Maxillofacial Surgery
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