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Vascularized flap

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https://www.readbyqxmd.com/read/28099357/bilayered-negative-pressure-wound-therapy-preventing-leg-incision-morbidity-in-coronary-artery-bypass-graft-patients-a-randomized-controlled-trial
#1
Yongchao Yu, Zhigang Song, Zhiyun Xu, Xiaofei Ye, Chunyu Xue, Junhui Li, Hongda Bi
BACKGROUNDS: The harvesting of great saphenous veins for coronary artery bypass graft (CABG) patients may result in significant complications, including lymphorrhagia, lymphoedema, incision infection, wound dehiscence, and skin flap necrosis. We investigated the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) for reducing the above-mentioned complications using a clinical randomized controlled trial. METHODS: A single-center, pilot randomized controlled trial was conducted...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28099268/vascular-nature-and-existence-of-anastomoses-of-extrinsic-postauricular-fascia-application-for-staged-auricular-reconstruction
#2
Suphalerk Lohasammakul, Chairat Turbpaiboon, Supin Chompoopong, Rosarin Ratanalekha, Chongdee Aojanepong
A staged auricular reconstruction in microtia patients was developed by using superficial mastoid fascia (as part of extrinsic postauricular fascia) to cover the cartilagenous framework due to its highly vascularized nature. Three branches of external carotid artery (superficial temporal artery, posterior auricular artery and occipital artery) were found to supply this fascia, this study was therefore aimed to investigate the dimension of blood supply from each vessel and also to demonstrate the existence of anastomoses among these arteries...
January 18, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28093632/ureterocystoneostomy-in-complex-oncological-cases-with-an-uebelhoer-modified-boari-bladder-flap
#3
Jan P Radtke, Nina Korzeniewski, Johannes Huber, Celine D Alt, Sascha Pahernik, Boris A Hadaschik, Markus Hohenfellner, Dogu Teber
PURPOSE: The study aims to describe the technique and analyze the outcome of an arcuated bladder incision with building of a triangular flap, first described by Uebelhoer (UBBF), as a modification of the classical rectangular Boari bladder flap (BBF), that is often viable, but can present difficulties, such as reduced flap vascularization and mobility in pretreated patients. METHODS: Twelve consecutive patients with distal or mid ureteral leakage or stenosis, that underwent UBBF, were retrospectively analyzed...
January 16, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28092922/the-effectiveness-of-free-vascularized-fibular-flaps-in-osteonecrosis-of-the-femoral-head-and-neck-a-systematic-review
#4
Cassandra A Ligh, Jonas A Nelson, John P Fischer, Stephen J Kovach, L Scott Levin
Background Free vascularized fibular flaps (FVFFs) are accepted surgical options to treat osteonecrosis of the femoral head and neck (ONFHN) to prevent conversion to total hip replacement (THR), yet many studies are single institution cohorts, with little generalizability. Purpose The purpose of this study was to perform a systematic review examining the comparative effectiveness of FVFF to treat ONFHN, particularly preventing conversion to a THR and improving hip function/symptoms. Methods We searched PubMed and EMBASE databases using femoral head, free fibula, and femoral neck keywords...
January 16, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28092337/anatomical-basis-and-clinical-application-of-synovial-flaps-in-the-wrist-and-distal-forearm
#5
David L Colen, Jiun-Ting Yeh, Lawrence B Colen
Neuropathic symptoms after median nerve repair at the wrist or secondary to refractory carpal tunnel syndrome may become debilitating. These symptoms develop due to perineural adhesions, intraneural fibrosis and fixation of the nerve to the transverse carpal ligament after surgery and often require neurolysis. Interposition of vascularized soft tissue over the median nerve at the time of neurolysis prevents recurrence of such adhesions. The synovial flap, fashioned from the synovial lining of the flexor tendon sheath, is an ideal tissue for this purpose...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28090711/topical-application-of-nitrosonifedipine-a-novel-radical-scavenger-ameliorates-ischemic-skin-flap-necrosis-in-a-mouse-model
#6
Yutaka Fukunaga, Yuki Izawa-Ishizawa, Yuya Horinouchi, Eriko Sairyo, Yasumasa Ikeda, Keisuke Ishizawa, Koichiro Tsuchiya, Yoshiro Abe, Ichiro Hashimoto, Toshiaki Tamaki
Ischemic skin flap necrosis can occur in random pattern flaps. An excess amount of reactive oxygen species is generated and causes necrosis in the ischemic tissue. Nitrosonifedipine (NO-NIF) has been demonstrated to possess potent radical scavenging ability. However, there has been no study on the effects of NO-NIF on ischemic skin flap necrosis. Therefore, we evaluated the potential of NO-NIF in ameliorating ischemic skin flap necrosis in a mouse model. A random pattern skin flap (1.0 × 3.0 cm) was elevated on the dorsum of C57BL/6 mice...
January 16, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28089836/delayed-csf-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#7
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate to the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy, is exceedingly rare. METHODS: Retrospective chart review and review of the literature RESULTS: We present two cases of delayed CSF leak following GKRS to treat pituitary adenoma...
January 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28088938/clinical-analysis-of-54-cases-of-large-area-soft-tissue-avulsion-in-the-lower-limb
#8
Yu Chen, Lei Liu
OBJECTIVE: To assess the clinical curative effect of different treatment methods for large area avulsion injury in the lower limb. METHODS: Between January 2010 and December 2013, 54 patients with large area avulsion injury in the lower limb were treated in the trauma center of our hospital, including 34 males and 20 females with a mean age of 35.7 years (range, 16-65 years). The injury mechanism was traffic accident in 44 cases, hitting by heavy objects in 8 cases, and fall from height in 2 cases, involving 31 thighs, 19 legs and 4 feet involved...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28079700/the-chimera-flap-a-quarter-century-odyssey
#9
Geoffrey G Hallock
Incredibly complicated multidimensional defects have always strained the ingenuity of the reconstructive surgeon. Secondary perhaps to vascularized composite allotransplantation as a solution to this dilemma, the compound flap has been developed to be a more useful and available alternative. Their greatest versatility has been proven by its subtype, the chimera flap. The chimera flap itself consists of multiple flaps, the latter possibly composed of bone, skin, muscle, and so on, where each part has an independent vascular supply, and each part is independent of any physical interconnection whatsoever with the other components, except where joined ultimately only to a common vascular pedicle...
February 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28063782/acceptable-clinical-outcomes-and-recommended-reconstructive-strategies-for-secondary-maxillary-reconstruction-with-vascularized-fibula-osteomyocutaneous-flap-a-retrospective-analysis
#10
Yi Shen, Jun Li, Andrew Ow, Liang Wang, Ming-Ming Lv, Jian Sun
BACKGROUND: We conducted a retrospective analysis of the clinical outcomes and evaluated the reconstructive strategies in patients who underwent secondary maxillary reconstruction with a vascularized fibula osteomyocutaneous flap (VFOF). METHODS: From May of 2001 to June of 2014, 34 patients who underwent secondary maxillary reconstruction with VFOF, with or without titanium mesh, were reviewed. The patients were divided into two groups of maxillary reconstruction, according to different planning and treatment strategies...
December 14, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28063278/combined-anterolateral-thigh-and-tensor-fasciae-latae-flaps-an-option-for-reconstruction-of-large-head-and-neck-defects
#11
Ramzey Tursun, Hisham Marwan, J Marshall Green, Fawaz Alotaibi, Andre LeDoux
PURPOSE: The advent of microvascular free tissue transfer has provided the reconstructive surgeon with an enormous array of treatment options for reconstruction of large head and neck defects. However, when indicated by defect size, the need for more than 1 flap not only increases surgical complexity but also patient morbidity. The combination of the anterolateral thigh (ALT) flap and the tensor fascia latae (TFL) flap can be used to reconstruct such complex head and neck defects, thereby minimizing any additional morbidity that would be imposed by an additional flap harvest site...
December 26, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28063277/straightforward-method-for-coverage-of-major-vessels-after-modified-radical-neck-dissection
#12
Raúl González-García, Carlos Moreno-García, Manuel Moreno-Sánchez, Leticia Román-Romero
A new method for covering the internal jugular vein and carotid artery after exposure of the cervical vascular axis subsequent to neck dissection is presented. To cover the most caudal part of the vascular axis, a platysma coli muscle flap is harvested from its most medial and inferior part of the neck in a caudally based fashion and is slightly rotated posteriorly up to 45°. In addition, a superiorly based sternocleidomastoid muscle flap involving the posterior half of the muscle after detachment of the clavicle head is harvested and rotated 45° anteriorly to cover the upper two thirds of the vascular axis...
December 15, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28062176/characteristics-and-surgical-management-of-flap-compromise-caused-by-thrombosis-of-the-internal-jugular-vein
#13
Bin Yang, Yi Qu, Ming Su, Jinzhong Li, Hua Li, Rudong Xing, Zhengxue Han
BACKGROUND: A principal reason for flap compromise in oral and maxillofacial head and neck surgery, and failure of a free flap transfer, is thrombosis of a drainage vein such as the internal jugular vein. This study characterized flap compromise caused by internal jugular vein thrombosis after a free flap transfer, and its management. PATIENTS AND METHODS: A retrospective clinical study was conducted of 306 consecutive microvascular free flaps performed for 305 patients with head and neck cancer from March 2003 to March 2013 at the Department of Oral and Maxillofacial Surgery at Beijing Stomatological Hospital, Capital Medical University...
December 18, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28061548/suprafascial-harvest-of-the-radial-forearm-free-flap-decreases-the-risk-of-postoperative-tendon-exposure
#14
David C Shonka, Nikita V Kohli, Benjamin M Milam, Mark J Jameson
OBJECTIVE: To determine if suprafascial harvest of the radial forearm free flap improves postoperative donor site outcomes compared to subfascial harvest. METHODS: Retrospective chart review. RESULTS: Forty-six patients underwent reconstruction of a head and neck defect with a radial forearm free flap (RFFF). Subfascial harvest of the RFFF was performed in 25 (53%) patients and suprafascial harvest performed in 22 (47%) patients. All donor sites were covered with a split thickness skin graft and a bolster that remained in place for 6 days...
January 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28060087/analysis-of-postoperative-bleeding-after-posterior-pharyngeal-flap-pharyngoplasty
#15
Teng Wan, Guomin Wang, Yusheng Yang, Yang Chen, Yong Zhang, Yun Liang, Yilai Wu
The aim of this study was to analyze the location and cause of postoperative bleeding after posterior pharyngeal flap pharyngoplasty and to investigate the surgical techniques with the goal of treating the bleeding. The patients received posterior pharyngeal flap pharyngoplasty in the Cleft Lip and Palate Treatment and Research Center of Shanghai Jiaotong University School of Medicine from January 2003 to December 2014, and postoperative bleeding in the surgical area was retrospectively analyzed. According to the record of the exploration of hemostasis, the locations and causes of the bleeding were summarized...
January 5, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28058777/platysma-sparing-vascularized-submental-lymph-node-flap-transfer-for-extremity-lymphedema
#16
Igor Poccia, Chia-Yu Lin, Ming-Huei Cheng
BACKGROUND AND OBJECTIVES: Due to its consistent vascular and lymphatic anatomy, the vascularized submental lymph node flap is a reliable option for lymphedema treatment. Despite these advantages, flap harvest requires resection of platysma, which may cause a marginal mandibular nerve pseudo-paralysis. The aim of this study was to investigate the donor site morbidity of an innovative platysma-sparing vascularized submental lymph node flap transfer for treating extremity lymphedema. METHODS: Ten patients undergoing platysma sparing submental lymph-node flap harvest were prospectively enrolled in the study and compared with a control group of 10 patients who underwent standard submental lymph-node flap harvest...
January 6, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28045826/free-hand-perforator-concept-in-osteocutaneous-free-fibula-flap-through-posterior-approach
#17
Yigit Ozer Tiftikcioglu, Ersin Gur, Tahir Gurler
BACKGROUND: The fibula flap is a workhorse flap for bony reconstruction of oro-mandibular area and can be modified to include soft tissue for reconstruction of composite defects. However, the design of a reliable skin paddle that can be used for composite tissue reconstruction remains a challenge. The authors described the applicability of perforator concept for a more reliable free osteomusculocutaneous fibula flap. METHODS: Between 2013 and 2015, 29 patients underwent free fibula osteocutaneous flap reconstruction...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28042321/pre-vascularization-enhances-therapeutic-effects-of-human-mesenchymal-stem-cell-sheets-in-full-thickness-skin-wound-repair
#18
Lei Chen, Qi Xing, Qiyi Zhai, Mitchell Tahtinen, Fei Zhou, Lili Chen, Yingbin Xu, Shaohai Qi, Feng Zhao
Split thickness skin graft (STSG) implantation is one of the standard therapies for full thickness wound repair when full thickness autologous skin grafts (FTG) or skin flap transplants are inapplicable. Combined transplantation of STSG with dermal substitute could enhance its therapeutic effects but the results remain unsatisfactory due to insufficient blood supply at early stages, which causes graft necrosis and fibrosis. Human mesenchymal stem cell (hMSC) sheets are capable of accelerating the wound healing process...
2017: Theranostics
https://www.readbyqxmd.com/read/28039007/pedicle-orientation-in-free-flap-microvascular-maxillofacial-reconstruction
#19
Daniel M Cummins, Beomjune Kim, Arshad Kaleem, Waleed Zaid
Oncologic and traumatic defects of the maxilla can pose a challenge to patients, reconstructive surgeons, and maxillofacial prosthodontists in an attempt to provide satisfactory treatment. Oral-nasal and oral-antral fistulas are frequently treated with soft tissue flaps, osteocutaneous flaps, or a maxillofacial obturator. Often, surgical reconstruction is preferred for patient quality of life and definitive restoration. Surgical reconstruction also avoids the difficulties encountered with fabricating an obturator in an irradiated field with the often-resultant microstomia...
December 10, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28039005/reconstruction-of-through-and-through-oromandibular-defects-with-combined-fibula-flap-and-anterolateral-thigh-flap
#20
Zhao-Jian Gong, Shuai Zhang, Sheng Zhang, Jiang Liu, Yu-Ming Xu, Han-Jiang Wu
PURPOSE: The reconstruction of massive through-and-through oromandibular defects is still a challenge because no single adequate candidate for a donor site of vascularized bone and a large amount of soft tissue has yet been found. The aim of this study was to evaluate the feasibility and reconstructive efficacy of the combined fibula flap and anterolateral thigh (ALT) flap in tandem for the reconstruction of such defects. PATIENTS AND METHODS: We performed a retrospective case series of patients who had undergone reconstruction of through-and-through oromandibular defects with the combined fibula flap and ALT flap in tandem from January 2012 through December 2014 at the Second Xiangya Hospital...
December 13, 2016: Journal of Oral and Maxillofacial Surgery
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