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https://www.readbyqxmd.com/read/28746932/morbidity-and-functional-outcomes-following-free-jejunal-flap-reconstruction-for-head-and-neck-cancer
#1
Song Ni, Yiming Zhu, Dong Qu, Jian Wang, Dezhi Li, Bin Zhang, Zhengang Xu, Shaoyan Liu
AIM: To evaluate the morbidity and fundamental functional outcomes (swallow and speech) after free jejunal flap (FJF) reconstruction following total pharyngolaryngo-esophagectomy (PLE) in China. METHODS: 18 patients with FJF reconstruction after total PLE were retrospectively reviewed. Scheduled barium swallow test was performed 7-10 days postoperatively. Rehabilitation of swallowing and speech for patients was assessed by the Performance Status Scale for Head and Neck Cancer Patients...
July 27, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28740778/takotsubo-cardiomyopathy-after-head-and-neck-reconstructive-surgery
#2
Masanori Mori, Hayato Nagashima, Satoshi Akazawa, Noriko Saegusa, Yuichi Ichikawa, Kei Iida, Kotaro Yoshimura, Masahiro Nakagawa
Takotsubo cardiomyopathy (TCM) is a form of transient heart failure that clinically mimics acute coronary syndrome and is characterized by left ventricular wall motion abnormalities. The pathophysiology of TCM is not well established. TCM is often preceded by emotional or physical stress and may occur after surgery. We present 3 cases of TCM occurring after head and neck reconstructive surgery. Echocardiography plays a central role in the diagnosis of TCM. Left ventricular wall motion abnormalities extend beyond the territory of a single coronary artery...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740770/versatility-of-the-latissimus-dorsi-free-flap-during-the-treatment-of-complex-postcraniotomy-surgical-site-infections
#3
Nobutaka Yoshioka
BACKGROUND: Some intractable cases of postcraniotomy infection, which can involve compromised skin, an open frontal air sinus, and residual epidural dead space, have been reported. In such cases, reconstructing the scalp and skull is challenging. METHODS: Between 2009 and 2016, the author treated 12 patients with recalcitrant postcraniotomy surgical site infections with latissimus dorsi (LD) free flaps. The patients' ages ranged from 37 to 79 years (mean, 63.5 years), and their underlying diseases included subarachnoid hemorrhaging (n = 5), brain tumors (n = 4), and cerebral arteriovenous malformations (n = 3)...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28739545/an-optimized-non-destructive-protocol-for-testing-mechanical-properties-in-decellularized-rabbit-trachea
#4
M Den Hondt, B M Vanaudenaerde, E F Maughan, C R Butler, C Crowley, E K Verbeken, S E Verleden, J J Vranckx
Successful tissue-engineered tracheal transplantation relies on the use of non-immunogenic constructs, which can vascularize rapidly, support epithelial growth, and retain mechanical properties to that of native trachea. Current strategies to assess mechanical properties fail to evaluate the trachea to its physiological limits, and lead to irreversible destruction of the construct. Our aim was to develop and evaluate a novel non-destructive method for biomechanical testing of tracheae in a rabbit decellularization model...
July 21, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28734752/long-term-effect-of-oncoplastic-breast-conserving-surgery-using-latissimus-dorsi-miniflaps-on-mammographic-surveillance-and-the-detection-of-local-recurrence
#5
S Mele, D Wright, N Paramanathan, S Laws, L Peiris, R Rainsbury
INTRODUCTION: Latissimus dorsi miniflap is a breast-conserving volume replacement technique for the reconstruction of large breast defects. While mammographic features of miniflap reconstruction have been described, little is known about the incidence, mode of presentation and size of local recurrence after this procedure. This study aimed to investigate the impact of latissimus dorsi miniflap reconstruction on the frequency, presentation and detection of local recurrence. METHODS: Clinical, radiological and pathological data were reviewed in 261 patients...
June 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28728320/temple-and-postauricular-dissection-in-face-and-neck-lift-surgery
#6
Joo Heon Lee, Tae Suk Oh, Sung Wan Park, Jae Hoon Kim, Tanvaa Tansatit
Periauricular paresthesia may afflict patients for a significant amount of time after facelift surgery. When performing face and neck lift surgery, temple and posterior auricular flap dissection is undertaken directly over the auriculotemporal, great auricular, and lesser occipital nerve territory, leading to potential damage to the nerve. The auriculotemporal nerve remains under the thin outer superficial fascia just below the subfollicular level in the prehelical area. To prevent damage to the auriculotemporal nerve and to protect the temporal hair follicle, the dissection plane should be kept just above the thin fascia covering the auriculotemporal nerve...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28724133/a-nationwide-analysis-of-cost-variation-for-autologous-free-flap-breast-reconstruction
#7
Jessica I Billig, Yiwen Lu, Adeyiza O Momoh, Kevin C Chung
Importance: Cost variation among hospitals has been demonstrated for surgical procedures. Uncovering these differences has helped guide measures taken to reduce health care spending. To date, the fiscal consequence of hospital variation for autologous free flap breast reconstruction is unknown. Objective: To investigate factors that influence cost variation for autologous free flap breast reconstruction. Design, Setting, and Participants: A secondary cross-sectional analysis was performed using the Healthcare Cost and Utilization Project National Inpatient Sample database from 2008 to 2010...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28713713/reverse-peroneal-artery-flap-for-large-heel-and-sole-defects-a-reliable-coverage
#8
Yogesh C Bhatt, Sumer Singh, Piyush Doshi, Sanjay G Vaghani
BACKGROUND: Large soft tissue defects of ankle and foot always have been challenging to reconstruct. Reverse sural flaps, free flaps have been used for this problem with variable success. Reverse peroneal artery flap is an option to use with reliability without microvascular repair. Connections of peroneal artery around talus and ankle joint are deep and reliable with anterior tibial and posterior tibial artery. Arterial inflow and venous drainage improved with including short saphenous vein and reverse sural artery in the flap...
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28678328/oncoplastic-breast-surgery-comprehensive-review
#9
N Bertozzi, M Pesce, P L Santi, E Raposio
Breast cancer is the most common female cancer in Western populations, affecting 12.5% of women, with 1.38 million patients per year. Breast-conserving surgery followed by postoperative radiotherapy replaced the radical and modified-radical procedures of Halsted and Patey as the standard of care for early-stage breast cancer once the overall and disease-free survival rates of breast-conserving surgery were demonstrated to be equivalent to those of mastectomy. However, excision of >20% of breast tissue, low or centrally located cancer, and large-sized breasts with various grades of breast ptosis, result a in unacceptable cosmetic outcomes...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28675554/osteocutaneous-radial-forearm-free-flap-in-nonmandible-head-and-neck-reconstruction
#10
Faisal I Ahmad, Casey Means, Alex B Labby, Scott H Troob, Javier D Gonzalez, Michael M Kim, Ryan J Li, Mark K Wax
BACKGROUND: The osteocutaneous radial forearm free flap (RFFF) is a versatile flap primarily used to reconstruct composite defects involving the mandible. The purpose of this study was to describe our experience with this flap for nonmandible reconstruction. METHODS: All patients undergoing nonmandible osseous reconstruction with free-tissue transfer were reviewed. Patients with osteocutaneous RFFF reconstructions were evaluated. The retrospective review of all osteocutaneous RFFFs was performed from 1998 to 2014...
July 4, 2017: Head & Neck
https://www.readbyqxmd.com/read/28654608/the-efficacy-of-perforator-flaps-in-the-treatment-of-chronic-osteomyelitis
#11
Joon Pio Jp Hong, Terence L H Goh, Dong Hoon Choi, Jung Jae Kim, Hyun Suk Suh
BACKGROUND: Treatment of chronic osteomyelitis involves aggressive d├ębridement followed by soft-tissue coverage. The dictum of muscle coverage being superior has been challenged by successful reports of coverage with skin flaps. The objective of this article is to evaluate the efficacy of perforator flaps for reconstruction of chronic osteomyelitis defects. METHODS: A retrospective review of 120 patients with chronic osteomyelitis who underwent d├ębridement and reconstruction using perforator flaps from April of 2000 to November of 2015 was conducted...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28654584/a-novel-noncontact-diffuse-correlation-spectroscopy-device-for-assessing-blood-flow-in-mastectomy-skin-flaps-a-prospective-study-in-patients-undergoing-prosthesis-based-reconstruction
#12
Nneamaka B Agochukwu, Chong Huang, Mingjun Zhao, Ahmed A Bahrani, Li Chen, Patrick McGrath, Guoqiang Yu, Lesley Wong
A new advanced technology, noncontact diffuse correlation spectroscopy, has been recently developed for the measurement of tissue blood flow through analyzing the motions of red blood cells in deep tissues. This technology is portable, inexpensive, and noninvasive, and can measure up to 1.5-cm tissue depth. In this prospective study, the authors aimed to explore the use of this novel device in the prediction of mastectomy skin flap necrosis. The noncontact diffuse correlation spectroscopy device was used to measure mastectomy skin flap flow in patients undergoing mastectomy and immediate implant-based breast reconstruction before and immediately after mastectomy, and after placement of the prosthesis...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28643223/the-effect-of-membrane-exposure-on-lateral-ridge-augmentation-a-case-controlled-study
#13
Mehmet A Eskan, Marie-Eve Girouard, Dean Morton, Henry Greenwell
BACKGROUND: The effect of membrane exposure on guided bone regeneration (GBR) for lateral ridge augmentation has been poorly addressed. This case-controlled study aimed to investigate potential effect of membrane exposure lateral ridge augmentation and subsequent implant placement. METHODS: A total of 14 patients that did receive lateral ridge augmentation procedure using allogeneic cancellous graft particulate in combination with an alloplastic bioresorbable matrix barrier were retrospectively selected for this study...
December 2017: International Journal of Implant Dentistry
https://www.readbyqxmd.com/read/28605949/venous-flaps-for-coverage-of-traumatic-soft-tissue-defects-of-the-hand-a-systematic-review
#14
R Wharton, H Creasy, C Bain, M James, A Fox
A PRISMA-guided systematic review was performed of all published cases that detail the use of venous flaps for soft tissue reconstruction of the hand following trauma. Outcome measures examined included flap survival rates, venous congestion, and return to theatre. Database searches were performed on Medline, Embase, AHMED, CINAHL. A total of 381 articles were identified. Data were extracted from 45 articles that met inclusion criteria. A total of 756 flaps were described and their data analysed. A total of 75% of flaps were arterialized and 25% were pure venous flaps...
June 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28582335/a-prospective-clinical-trial-comparing-visible-light-spectroscopy-to-handheld-doppler-for-postoperative-free-tissue-transfer-monitoring
#15
Alexander F Mericli, James Wren, Patrick B Garvey, Jun Liu, Charles E Butler, Jesse C Selber
BACKGROUND: Early detection of compromised free flap perfusion is critical. A common modality of thrombosis detection, physical exam augmented with hand-held Doppler, only provides intermittent data and is insensitive to venous compromise. Visible light spectroscopy (VLS) provides continuous, non-invasive evaluation of tissue perfusion. We hypothesized that VLS is a more sensitive and specific monitoring method for early detection of post-operative flap compromise than intermittent, hand-held Doppler and clinical exam...
June 1, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28570718/free-flap-reconstruction-monitoring-techniques-and-frequency-in-the-era-of-restricted-resident-work-hours
#16
Urjeet A Patel, David Hernandez, Yelizaveta Shnayder, Mark K Wax, Matthew M Hanasono, Joshua Hornig, Tamer A Ghanem, Matthew Old, Ryan S Jackson, Levi G Ledgerwood, Patrik Pipkorn, Lawrence Lin, Adrian Ong, Joshua B Greene, James Bekeny, Yin Yiu, Salem Noureldine, David X Li, Joel Fontanarosa, Evan Greenbaum, Jeremy M Richmon
Importance: Free flap reconstruction of the head and neck is routinely performed with success rates around 94% to 99% at most institutions. Despite experience and meticulous technique, there is a small but recognized risk of partial or total flap loss in the postoperative setting. Historically, most microvascular surgeons involve resident house staff in flap monitoring protocols, and programs relied heavily on in-house resident physicians to assure timely intervention for compromised flaps...
June 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28538567/hyperspectral-imaging-provides-early-prediction-of-random-axial-flap-necrosis-in-a-preclinical-model
#17
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
#18
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
#19
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
#20
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
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