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https://www.readbyqxmd.com/read/28538567/hyperspectral-imaging-provides-early-prediction-of-random-axial-flap-necrosis-in-a-preclinical-model
#1
Michael S Chin, Ava G Chappell, Giorgio Giatsidis, Dylan J Perry, Jorge Lujan-Hernandez, Anthony Haddad, Hajime Matsumine, Dennis P Orgill, Janice F Lalikos
BACKGROUND: Necrosis remains a significant complication in cutaneous flap procedures. Monitoring, and ideally prediction, of vascular compromise in the early postoperative period may allow surgeons to limit the impact of complications by prompt intervention. Hyperspectral imaging could be a reliable, effective, and noninvasive method for predicting flap survival postoperatively. In this preclinical study, the authors demonstrate that hyperspectral imaging is able to correlate early skin perfusion changes and ultimate flap survival in a preclinical model...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28502080/the-contemporary-role-of-ureterolysis-in-retroperitoneal-fibrosis-rpf-treatment-of-last-resort-or-first-intent-an-analysis-of-50-cases
#2
Tim O'Brien, Archie Fernando
OBJECTIVE: To determine the outcomes of open ureterolysis in a contemporary cohort of patients presenting with ureteric obstruction secondary to retroperitoneal fibrosis (RPF). PATIENTS AND METHODS: Prospective analysis of 50 patients undergoing open ureterolysis and omental wrap between January 2012 and January 2016 in a single centre managed by a multi-disciplinary RPF team. Minimum follow up of 1 year. Indications were: nephrostomy-dependent drainage (n=5); stent failure as evidenced by persistent hydronephrosis (n=20); severe stent symptoms (n=22); and patient choice/pre-emptive (n=3)...
May 14, 2017: BJU International
https://www.readbyqxmd.com/read/28489683/intraoperative-use-of-vasopressors-does-not-increase-the-risk-of-free-flap-compromise-and-failure-in-cancer-patients
#3
Lin Fang, Jun Liu, Cuicui Yu, Matthew M Hanasono, Gang Zheng, Peirong Yu
OBJECTIVE: To examine the effects of vasopressors on free flap outcomes. BACKGROUND: Most micro-surgeons avoid the use of vasopressors during free flap surgery due to concerns of vasoconstriction, which could potentially lead to vascular thrombosis and flap failure. Previous studies lack the statistical power to draw meaningful conclusions. METHODS: All free flaps between 2004 and 2014 from a single institution were reviewed retrospectively...
May 9, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28472203/anatomy-and-surgical-approaches-to-the-rabbit-nasal-septum
#4
Karam W Badran, John C Chang, Edward C Kuan, Brian J F Wong
Importance: The rabbit is the primary animal model used to investigate aspects of nasal surgery. Although several studies have used this model, none has provided a comprehensive analysis of the surgical anatomy and techniques used to gain access to the rabbit nasal fossae and septum. Objective: To describe and optimize the surgical anatomy and approach to the rabbit nasal vault and septal cartilage. Design, Setting, and Participants: In an ex vivo animal study conducted at an academic medical center, preliminary cadaveric dissections were performed on rabbit head specimens to establish familiarity with relevant anatomy and rehearse various approaches...
May 4, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28467662/impact-of-venous-outflow-tract-on-survival-of-osteocutaneous-free-fibula-flaps-for-mandibular-reconstruction-a-14-year-review
#5
Eric I Chang
BACKGROUND: The principle reconstructive modality for segmental mandibulectomy defects is the osteocutaneous free fibula flap. Preoperative CT angiography has been recommended to assess the quality of arterial inflow to the flap and donor limb. However, the impact of the venous system on flap viability has not been explored. METHODS: A retrospective review of all patients undergoing free fibula flap mandible reconstruction was performed at a single tertiary cancer center from 2002 to 2015...
May 3, 2017: Head & Neck
https://www.readbyqxmd.com/read/28452623/advantages-of-autologous-platelet-rich-fibrin-membrane-on-gingival-crevicular-fluid-growth-factor-levels-and-periodontal-healing-a-randomized-split-mouth-clinical-study
#6
Taner Arabaci, Oguz Kose, Mevlut Albayrak, Yasin Cicek, Alper Kizildag
AIM: To evaluate the contributions of platelet rich fibrin (PRF) combined with conventional flap surgery on the growth factor levels in gingival crevicular fluid (GCF) and periodontal healing. MATERIALS AND METHOD: 26 patients (52 sites) with chronic periodontitis were treated either with autologous PRF with open flap debridement (OFD+PRF) or open flap debridement (OFD) alone. Growth factor levels in GCF at baseline and 2, 4 and 6 weeks postoperatively were analyzed, and clinical parameters such as probing depth (PD), relative attachment level (RAL) and gingival margin level (GML) at baseline and 9 months after surgery were compromised...
April 28, 2017: Journal of Periodontology
https://www.readbyqxmd.com/read/28445200/the-nasal-tip-rotation-flap-for-reconstruction-of-the-lateral-nasal-tip-anterior-ala-and-soft-triangle-the-authors-experience-with-55-patients
#7
Anastasia Benoit, S Tyler Hollmig, Brian C Leach
BACKGROUND: Defects of the lateral nasal tip, anterior ala, and soft triangle subunits lack reconstructive options that are consistently satisfactory. For such defects, the novel anterior-based nasal tip rotation flap provides functional and aesthetic results in a single operative session. OBJECTIVE: To describe the authors' experience with the nasal tip rotation flap, including patient selection and design modifications to enhance aesthetic success. METHODS: An IRB-approved retrospective database review of nasal tip rotation flap repairs was performed at the Medical University of South Carolina and Stanford University Medical Center...
April 24, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28444768/implantable-doppler-monitoring-of-buried-free-flaps-during-vascularized-lymph-node-transfer
#8
Chad M Teven, Adrian S H Ooi, Amir Inbal, David W Chang
BACKGROUND AND OBJECTIVES: Reliable flap monitoring is crucial to the success of free tissue transfer, including vascularized lymph node transfer (VLNT). However, no large-scale study has examined implantable Doppler monitoring in VLNT. We aimed to determine whether an implantable Doppler system can reliably monitor flap perfusion during VLNT and also to calculate the sensitivity and specificity of this system for detecting compromise in the monitored vessel. METHODS: An analysis of prospectively collected data of patients who underwent buried VLNT with implantable Doppler monitoring between 2014 and 2015 was performed...
April 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28403069/using-a-pedicle-pectoralis-major-musculocutaneous-flap-in-head-and-neck-reconstruction-after-modified-radical-mastectomy-a-case-report
#9
Jen-Wu Huang, Nai-Yuan Wu, Yi-Ying Lin
RATIONALE: A pedicle pectoralis major musculocutaneous (PMMC) flap is one of the strategies for head and neck reconstruction. Seldom studies reported the case in which the skin area of previous modified radical mastectomy (MRM) had been used as a PMMC flap in head and neck reconstruction. PATIENT CONCERNS: An 84-year-old female who had suffered from left breast cancer and undergone a left modified radical mastectomy (MRM) more than 20 years earlier. DIAGNOSES: She had squamous cell carcinoma of the tongue and had undergone partial glossection and left modified radial neck dissection...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28399607/surgeon-reported-needs-for-improved-training-in-identifying-and-managing-free-flap-compromise
#10
Catherine McMillan, Veerle D'Hondt, Alexandra H Marshall, Paul Binhammer, Joan Lipa, Laura Snell
Background This study examined the need for improved training in the identification and management of free flap (FF) compromise and assessed a potential role for simulated scenario training. Methods Online needs assessment surveys were completed by plastic surgeons and a subsample with expertise in microsurgery education participated in focus groups. Data were analyzed using descriptive statistics and mixed qualitative methods. Results In this study, 77 surgeons completed surveys and 11 experts participated in one of two focus groups...
April 11, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28392650/transoral-cross-lip-abb%C3%A3-estlander-flap-as-a-viable-and-effective-reconstructive-option-in-middle-lower-lip-defect-reconstruction
#11
Hyung Jin Hahn, Hyun Jee Kim, Jin Young Choi, Soo Young Lee, Young Bok Lee, Jin Wou Kim, Dong Soo Yu
The Abbé-Estlander flap surgery is a cross-lip procedure that is valuable in repairing a defect on the lower lip using a full-thickness flap, consisting of the skin, muscle and mucosa, from the upper lip. As usefulness and practicality of the flap in reconstruction of lower lip surgical defects in Asian ethnicity have not been documented, the authors present a case of successful lower lip reconstruction with a staged, Abbé-Estlander lip switching flap with commissuroplasty as an illustrative example. A 71-year-old male has presented with an ulcerating lip nodule in the middle one third of the lower lip, measuring about 1...
April 2017: Annals of Dermatology
https://www.readbyqxmd.com/read/28359353/guitar-string-suture-to-facilitate-closure-of-a-finger-like-flap-for-reconstruction-of-the-nose
#12
E Querol-Cisneros, P Redondo
INTRODUCTION: The basic principle of a lobed or finger-like transposition flap is that, after covering the defect with the transposed tissue, the donor site is closed primarily. With large defects, a second lobe may be added to the flap if primary closure of the area left by the first lobe is not possible. The flap can often be made to adapt to the defect, but this maneuver, in combination with primary closure of the adjacent tissue, can sometimes produce excessive tension and compromise the blood supply...
March 27, 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/28356686/evaluating-the-use-of-octyl-2-cyanoacrylate-in-unilateral-cleft-lip-repair
#13
Vijaylaxmy Malhotra, J K Dayashankara Rao, Varun Arya, Shalender Sharma, Sushil Singh, Payal Luthra
BACKGROUND: Facial cosmetic results are one of the most concerning issues for the parents who get their children operated for cleft lip. Moreover, the postoperative care of the surgical site, the discomfort associated with the suture removal, and additional visit for suture removal are other reasons which encourages one to use any new technologies that may replace the need for suture placement. In this study, we used octyl-2-cyanoacrylate, a tissue adhesive which offers a viable alternative to traditional techniques without compromising optimal wound closure...
July 2016: National Journal of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28352601/systematic-review-and-comparative-meta-analysis-of-outcomes-following-pedicled-muscle-versus-fasciocutaneous-flap-coverage-for-complex-periprosthetic-wounds-in-patients-with-total-knee-arthroplasty
#14
James M Economides, Michael V DeFazio, Kayvon Golshani, Mark Cinque, Ersilia L Anghel, Christopher E Attinger, Karen Kim Evans
BACKGROUND: In cases of total knee arthroplasty (TKA) threatened by potential hardware exposure, flap-based reconstruction is indicated to provide durable coverage. Historically, muscle flaps were favored as they provide vascular tissue to an infected wound bed. However, data comparing the performance of muscle versus fasciocutaneous flaps are limited and reflect a lack of consensus regarding the optimal management of these wounds. The aim of this study was to compare the outcomes of muscle versus fasciocutaneous flaps following the salvage of compromised TKA...
March 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28350682/vasculature-of-a-medial-femoral-condyle-free-flap-in-intact-and-osteotomized-flaps
#15
Maciej Rysz, Wojciech Grabczan, Maciej Jan Mazurek, Romuald Krajewski, Dariusz Grzelecki, Bogdan Ciszek
BACKGROUND: A small size and difficulties with shaping a medial femoral condyle corticocancellous bone flap are factors limiting its use. The goal of this study was to evaluate range of vascular supply to a medial femoral condyle corticocancellous bone flap to determine whether harvesting of larger flaps and performing a flap osteotomy would compromise the vasculature of a flap's bone. METHODS: Twenty-four limbs were dissected and medial femoral condyle corticocancellous bone flaps were harvested with skin paddles...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28331365/mastectomy-skin-flap-necrosis-challenges-and-solutions
#16
REVIEW
Stuart A Robertson, Johann A Jeevaratnam, Avi Agrawal, Ramsey I Cutress
INTRODUCTION: Mastectomy skin flap necrosis (MSFN) has a reported incidence of 5%-30% in the literature. It is often a significant and underappreciated problem. The aim of this article was to review the associated challenges and possible solutions. METHODS: A MEDLINE search was performed using the search term "mastectomy skin flap necrosis". Titles and abstracts from peer-reviewed publications were screened for relevance. RESULTS: MSFN is a common complication and may present as partial- or full-thickness necrosis...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28296715/evaluating-the-use-of-tissue-oximetry-to-decrease-intensive-unit-monitoring-for-free-flap-breast-reconstruction
#17
Joseph A Ricci, Christina R Vargas, Olivia A Ho, Samuel J Lin, Adam M Tobias, Bernard T Lee
BACKGROUND: Postoperative free flap care has historically required intensive monitoring for 24 hours in an intensive care unit. Continuous monitoring with tissue oximetry has allowed earlier detection of vascular compromise, decreasing flap loss and improving salvage. This study aims to identify whether a fast-track postoperative paradigm can be safely used with tissue oximetry to decrease intensive monitoring and costs. MATERIALS AND METHODS: All consecutive microsurgical breast reconstructions performed at a single institution were reviewed (2008-2014) and cases requiring return to the operating room were identified...
March 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28274072/versatility-of-tongue-flaps-for-closure-of-palatal-defects-case-report
#18
Vishnu Mohan, Roopesh U Nair, Arjun Madhu Usha
Palatal defects following congenital anomalies, traumatic injuries, benign and malignant pathologies frequently require resection and reconstruction. Reconstruction of these defects is challenging and complex due to the amount of tissue left for primary closure after excision, compromised vasculature as on repaired cleft palate and limited pedicled flaps around the lesion. Tongue flap though doesn't fulfil all the ideal requirements of a flap, however because of its flexibility, good blood supply and position it can be considered as the best among other flaps for reconstruction of oral and palatal defects...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28272856/macromastia-and-gigantomastia-efficacy-of-the-superomedial-pedicle-pattern-for-breast-reduction-surgery
#19
V Chetty, E Ndobe
BACKGROUND: Reduction mammoplasty procedures in patients with macromastia and gigantomastia can prove a major challenge to the plastic surgeon. Although several techniques have been described to reduce very large breasts, they can often result in vascular compromise to the nipple-areola complex (NAC) and skin flaps, decrease in NAC sensation and inability to breast-feed. The superomedial pedicle (SMP) procedure is often used in patients with moderate to large breast reductions. For extremely large breast reductions, macromastia and gigantomastia breast amputation with a free nipple graft is often recommended...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28267121/current-techniques-for-postoperative-monitoring-of-microvascular-free-flaps
#20
Nasir Khatri, Shuhao Zhang, Santosh S Kale
Free tissue transfer (FTT) is used in patients with complicated reconstructive needs; it can provide stable wound coverage, improved aesthetic appearance, and restore functional deficits. Despite the high success rates of free flaps, vascular occlusion is a significant risk leading to flap failure. Many studies have demonstrated that the salvage rate for flaps is inversely related to the time between onset of a vascular problem and its surgical correction. As a result, ongoing postoperative monitoring of free flaps for adequate perfusion is imperative to allow timely and accurate diagnosis of vascular compromise...
March 2017: Journal of Wound, Ostomy, and Continence Nursing
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