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Vascularized flap

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https://www.readbyqxmd.com/read/28734534/elbow-vascularized-composite-allotransplantation-surgical-anatomy-and-technique
#1
Zvi Steinberger, Heng Xu, Nikolas H Kazmers, Stephanie Thibaudeau, Russel G Huffman, L Scott Levin
BACKGROUND: Elbow reconstruction with vascularized composite allotransplantation (VCA) may hold promise in treating end-stage arthritis as no current treatment is both functional and durable. We describe the vascular and gross anatomy of the elbow in the context of VCA procurement and propose a step-by-step surgical technique for human elbow VCA. METHODS: We injected latex in the arterial tree of 16 fresh adult cadaveric upper extremities. We identified and measured arteries and nerves and their branch points relative to the medial epicondyle...
August 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28731395/nasoseptal-flap-necrosis-a-rare-complication-of-endoscopic-endonasal-surgery
#2
Joseph D Chabot, Chirag R Patel, Marion A Hughes, Eric W Wang, Carl H Snyderman, Paul A Gardner, Juan C Fernandez-Miranda
OBJECTIVE The vascularized nasoseptal flap (NSF) has become the workhorse for skull base reconstruction during endoscopic endonasal surgery (EES) of the ventral skull base. Although infrequently reported, as with any vascularized flap the NSF may undergo ischemic necrosis and become a nidus for infection. The University of Pittsburgh Medical Center's experience with NSF was reviewed to determine the incidence of necrotic NSF in patients following EES and describe the clinical presentation, imaging characteristics, and risk factors associated with this complication...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28719734/tissue-engineering-of-a-composite-trachea-construct-using-autologous-rabbit-chondrocytes
#3
James E Dennis, Kristina G Bernardi, Thomas J Kean, Nelson E Liou, Tanya K Meyer
The repair of large tracheal segmental defects remains an unsolved problem. The goal of this study is to apply tissue engineering principles for the fabrication of large segmental trachea replacements. Engineered tracheal replacements composed of autologous cells ("neotracheas") were tested in a New Zealand White rabbit model. Neotracheas were formed in the rabbit neck by wrapping a silicone tube with consecutive layers of skin epithelium, platysma muscle and an engineered cartilage sheet, and allowing the construct to mature for 8-12 weeks...
July 18, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28717295/animal-inflicted-maxillofacial-injuries-treatment-modalities-and-our-experience
#4
Anjani Kumar Yadav, Mehul Rajesh Jaisani, Leeza Pradhan, Ashok Dongol, Arpita Singh, Pradeep Acharya, Alok Sagtani
INTRODUCTION: Animal inflicted injuries to the face and neck are becoming much more common as people lavish affection on pets. Injuries caused by animal attacks to the face can cause complex injuries to soft and hard tissues, presented as perforations, lacerations, crushes, avulsion or fractures. An uncountable number of bacteria and virus can be found in such injuries, with a potential pathological effect to humans, regarding infections. Although the infection rate is low due to excellent blood supply to face, the injuries have disfiguring effect with possible psychological repercussion to the patients...
September 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28712882/perfusion-of-muscle-flaps-independent-of-the-anatomical-vascular-pedicle-pedicle-autonomy
#5
K Bradshaw, M Wagels
INTRODUCTION: Free muscle flaps are being used more commonly for complex lower limb reconstruction. Up to 33% of flaps used to reconstruct lower limb trauma will require an orthopaedic procedure after reconstruction. To date there have been only case reports detailing the variable survival of muscle flaps after actual or simulated pedicle injury and the process and timeframe of neovascularisation remains undefined. We aim to show that perfusion of a muscle flap is possible after injury to its anatomical vascular pedicle...
June 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28709536/margin-analysis-has-free-tissue-transfer-improved-oncologic-outcomes-for-oral-squamous-cell-carcinoma
#6
REVIEW
Sean P Edwards
Microvascular reconstruction of ablative defects has become a mainstay of contemporary management of head and neck cancer patients. These techniques offer myriad tissue options that vary in character, volume, and components and have vastly improved the esthetic and functional outcomes achieved in this patient population. Although consensus exists regarding the reliability and functional and esthetic benefits of free tissue transfer, the same cannot be said for oncologic outcomes. The increase in resources required for the routine use of free tissue transfer has led to asking this question-Do vascularized free flaps allow for increased surgical margins and improvements in oncologic outcomes?...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28708772/successful-laparoscopic-harvesting-of-omental-pedicle-flap-for-salvage-cerebral-revascularization-in-2-adults-with-moyamoya-disease-technique-and-lessons-learned
#7
Max Schumm, Kathleen Simon, Rapheal Sacho, Jon C Gould
Moyamoya is an idiopathic and progressive disease that leads to occlusion of intracranial arteries. When other methods of revascularization fail, omentum can be used as an indirect bypass to improve cerebral perfusion. Laparoscopic mobilization of a pedicled omental flap with subcutaneous tunneling to the brain has been described in small case series in children. We report our techniques and outcomes in 2 adults with Moyamoya to undergo such a procedure. An omental flap based on the right gastroepiploic artery was created and intraoperative fluorescence imaging using indocyanine green was used to assess the viability of the flap and to guide lengthening of the pedicle...
July 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28708658/condyle-head-reimplantation-combined-with-vascularized-free-flap-for-mandibular-reconstruction
#8
Jun-Yi Zhu, Hai-Xiao Zou, Hui-Min Li, Wei Wang, Jun Jia
Due to the anatomic and functional complexity, reconstruction of the condylar process after mandibular tumor extirpation remains a surgical challenge. The aim of this study was to present the results and experience of condyle head reimplantation combined with vascularized free flap for mandibular reconstruction in our institution. In the current study, the authors evaluated the clinical features of condyle head reimplantation combined with vascularized free flap for mandibular reconstruction in 5 patients with benign mandibular intraosseous lesions from December 2013 to March 2015 in our institution...
July 13, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28705843/headache-tia-and-subarachnoid-haemorrhage-dissecting-an-unusual-cause-for-stroke-like-symptoms
#9
Elliot T Dawson, Desmond A Brown, Alejandro A Rabinstein
We present a case of supraclinoid internal carotid artery dissection. Eleven months prior, the patient developed isolated periorbital pain and was diagnosed with giant-cell arteritis with iritis. The patient experienced recurrent spells concerning for transient ischaemic attacks and was transferred to our institution for endovascular intervention after head CT revealed an embolic infarct with a 'dense middle cerebral artery sign.' Digital subtraction angiography was negative for occlusion, instead demonstrating luminal stenosis and poststenotic dilatation...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28703885/use-of-a-72-cm-long-extended-bilateral-deep-inferior-epigastric-artery-perforator-free-flap-for-reconstruction-of-a-lower-leg-with-no-suitable-recipient-vessel-around-the-injury-zone-a-case-report
#10
Hidehiko Yoshimatsu, Takumi Yamamoto, Akitatsu Hayashi, Takuya Iida
In free-flap reconstruction of the lower extremity, due either to trauma or pre-existing vascular disease, healthy vessels may not be readily available in the proximity of the defect. A variety of options including a cross-leg free flap, vein grafts, arteriovenous loops, and "bridging" flaps have been used to address the issue. The purpose of this report is to present a case in which a 72-cm long extended bilateral deep inferior epigastric artery perforator (DIEP) free flap was used for coverage of a 20 × 25 cm soft tissue defect of the lower leg following a Gustilo grade IIIC fracture in a 29-year-old man...
July 13, 2017: Microsurgery
https://www.readbyqxmd.com/read/28701801/adipose-tissue-formation-utilizing-fat-flap-distraction-technique
#11
Myung Chul Lee, Won Jai Lee, Byung Il Lee, Kee Yang Chung, Jae Woo Kim, Eun Hye Kang, Yong Oock Kim
Co-regulation between adipocytes and supporting vasculature is considered an important process in adipose tissue generation. The objective of this study was to evaluate the mechanical and biological effects of a distraction technique on adipose tissue formation and maintenance. Based on the hypothesis that fat flaps gradually receding from each other can develop an adipose tissue construct, perforated polycarbonate syringe-shaped chambers were implanted in a rabbit model. Latency (1 week) and distraction (3 weeks) periods were followed by a consolidation period in the experimental groups (4, 8, and 12 weeks)...
July 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28699660/binding-of-indocyanine-green-in-polycaprolactone-fibers-using-blend-electrospinning-for-in-vivo-laser-assisted-vascular-anastomosis
#12
Annemarie Schönfeld, Zacharia Mbäıdjol Kabra, Mihai Constantinescu, Dieter Bosshardt, Michael H Stoffel, Kirsten Peters, Martin Frenz
BACKGROUND AND OBJECTIVE: The clinical application of laser-assisted vascular anastomosis is afflicted by unreliable and low bonding strengths as well as tedious handling during microvascular surgery. The challenge to be met arises from the flow-off of the chromophore during soldering that changes the absorption and stains the surrounding tissue, leading to an uncontrollable thermal damage zone. In this study, we investigated the feasibility to produce an indocyanine green (ICG)-loaded patch by electrospinning and tested its applicability to both in vitro and in vivo microvascular laser soldering...
July 12, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28695707/comparison-of-long-term-clinical-outcomes-among-different-vascularized-lymph-node-transfers-6-year-experience-of-a-single-center-s-approach-to-the-treatment-of-lymphedema
#13
Pedro Ciudad, Mouchammed Agko, John Jaime Perez Coca, Oscar J Manrique, Wei-Ling Chang, Fabio Nicoli, Shih-Heng Chen, Hung-Chi Chen
BACKGROUND: This study evaluated the long-term clinical outcomes among different vascularized lymph node transfers (VLNT) used at our institution. METHODS: Between July 2010 and July 2016, all patients with International Society of Lymphology (ISL) stages II-III who underwent VLNT were evaluated. Demographic and clinical data (limb circumference, infectious episodes, lymphoscintigraphic studies) were recorded pre-operatively. Clinical outcomes, complications, and additional excisional procedures were analyzed post-operatively...
July 10, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28691463/use-of-the-orbital-fat-pad-in-eyelid-reconstruction
#14
A Baj, O D Orto, M Romano, G A Beltramini, F J Silvestre, A B Giannì
Eyelid reconstruction, though challenging, can produce a functional, esthetically pleasing lid. This should preferably be accomplished with a one-stage procedure, using robust, well-vascularized tissues similar to those being replaced, with minimal associated donor morbidity. According to the experience with Bichat pedicled flap in oral reconstruction, the authors propose the use of pedicle infraorbital fat pad for repair of conjunctival defect. Seven patients underwent eyelid reconstruction of full-thickness oncological or post-traumatic defects...
April 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28689388/osteoblast-and-bacterial-culture-from-cryopreserved-skull-flap-after-craniectomy-laboratory-study
#15
Tack Geun Cho, Suk Hyung Kang, Yong Jun Cho, Hyuk Jai Choi, Jin Pyeong Jeon, Jin Seo Yang
OBJECTIVE: Cranioplasty using a cryopreserved skull flap is a wide spread practice. The most well-known complications of cranioplasty are postoperative surgical infections and bone flap resorption. In order to find biological evidence of cryopreserved cranioplasty, we investigated microorganism contamination of cryopreserved skulls and cultured osteoblasts from cryopreserved skulls. METHODS: Cryopreserved skull flaps of expired patients stored in a bone bank were used...
July 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28688540/management-of-the-condyle-following-the-resection-of-tumours-of-the-mandible
#16
L Wang, K Liu, Z Shao, Z-J Shang
The aim of this study was to assess the management of the condyle during the restoration of mandibular defects following tumour resection. A total of 41 patients who underwent simultaneous tumour resection and reconstruction with vascularized iliac myocutaneous flaps for mandibular defects, from September 2010 to October 2014, were included. These patients were divided into three groups: group 1, condyle preserved; group 2, condyle sacrificed; group 3, condyle frozen. Patients were followed up at 1, 3, 6, and 12 months for the evaluation of appearance, occlusion, and speech...
July 5, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28682018/vascular-displacement-in-idiopathic-macular-hole-after-single-layered-inverted-internal-limiting-membrane-flap-surgery
#17
Jae Jung Lee, In Ho Lee, Keun Heung Park, Kang Yeun Pak, Sung Who Park, Ik Soo Byon, Ji Eun Lee
PURPOSE: To compare vascular displacement in the macula after surgical closure of idiopathic macular hole (MH) after single-layered inverted internal limiting membrane (ILM) flap technique and conventional ILM removal. METHODS: This retrospective study included patients who underwent either vitrectomy and ILM removal only or vitrectomy with single-layered inverted ILM flap for idiopathic MH larger than 400 μm from 2012 to 2015. A customized program compared the positions of the retinal vessels in the macula between preoperative and postoperative photographs...
June 26, 2017: Korean Journal of Ophthalmology: KJO
https://www.readbyqxmd.com/read/28679373/a-comprehensive-overview-on-the-surgical-management-of-secondary-lymphedema-of-the-upper-and-lower-extremities-related-to-prior-oncologic-therapies
#18
REVIEW
Ramon Garza, Roman Skoracki, Karen Hock, Stephen P Povoski
Secondary lymphedema of the upper and lower extremities related to prior oncologic therapies, including cancer surgeries, radiation therapy, and chemotherapy, is a major cause of long-term morbidity in cancer patients. For the upper extremities, it is most commonly associated with prior oncologic therapies for breast cancer, while for the lower extremities, it is most commonly associated with oncologic therapies for gynecologic cancers, urologic cancers, melanoma, and lymphoma. Both non-surgical and surgical management strategies have been developed and utilized, with the primary goal of all management strategies being volume reduction of the affected extremity, improvement in patient symptomology, and the reduction/elimination of resultant extremity-related morbidities, including recurrent infections...
July 5, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28676158/the-physiology-and-biomechanics-of-skin-flaps
#19
REVIEW
James B Lucas
Facial skin defects created by Mohs micrographic surgery are commonly reconstructed using local cutaneous flaps from surrounding skin. To provide optimal survival and aesthetic outcomes, the cutaneous surgeon must command a thorough understanding of the complex vascular anatomy and physiology of the skin as well as the imperative physiologic and biomechanical considerations when elevating and transferring tissue via local skin flaps.
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28673621/technical-points-of-5-free-vascularized-flaps-for-the-hand-repairs
#20
REVIEW
Jing Chen, Reena Bhatt, Jin Bo Tang
In this article, we present the experiences from Chinese microsurgeons on 5 less commonly used free vascularized flaps in hand reconstruction. In many units in China, these flaps have become the mainstays of treatment; they are routinely used for fingertip and thumb reconstruction. Their combined experience has demonstrated the reliability and versatility of these flaps for hand reconstruction, as well as their cosmetic value.
August 2017: Hand Clinics
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