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https://www.readbyqxmd.com/read/28223854/mohs-surgical-reconstruction-educational-activity-a-resident-education-tool
#1
Julie A Croley, C Helen Malone, Brandon P Goodwin, Linda G Phillips, Eric L Cole, Richard F Wagner
BACKGROUND: Surgical reconstructive planning following Mohs surgery can be a difficult subject for dermatology residents to master. Prior research demonstrates that active learning is preferred and more effective compared to passive learning models and that dermatology residents desire greater complexity and volume in surgical training. We present a novel, active, problem-based learning tool for the education of Mohs reconstruction with the goal of improving residents' ability to plan surgical reconstructions...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28203497/refinement-of-nasal-reconstruction-with-a-v-y-alar-perforator-flap
#2
Dominik L Feinendegen, Martin F Langer, J Camilo Roldán
BACKGROUND: The ala of the nose is vascularized by a dense net of perforators originating from the lateral nasal artery or the angular artery. These vessels reach the ala in a cascade fashion from the alar groove/lateral nasal wall. Based on these vessels, a V/Y flap can be dissected with a wide range of mobility. MATERIALS AND METHODS: Nineteen patients underwent reconstruction of the nose by means of a V/Y-alar-perforator flap alone or in combination with a myocutaneous rotation flap from the lateral nasal wall and/or from the nasal dorsum for reconstruction of defects at the nasal tip, ala of the nose, and/or lateral nasal wall...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28194323/usage-of-a-rotational-flap-for-coverage-of-a-large-central-forehead-defect
#3
Ahmed Hassan El-Sabbagh
Background: The forehead is a donor site for facial reconstruction but has no generous donor site for its coverage. All options of the reconstructive ladder can be used. A large rotation flap was used to reconstruct a big central forehead defect following failed previous repair in an elderly diabetic patient after a motor car accident. Case presentation: A 64-year-old diabetic man presented with an extensive central forehead defect after failed previous repair following a motor car accident. Coverage of the defect was performed using a flap based around the ear on one side in a rotation movement...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/28160055/earlobe-reduction-with-minimally-visible-scars-the-sub-antitragal-groove-technique
#4
Lennert Van Putte, Steven D M Colpaert
BACKGROUND: Ptosis of the earlobe is a common consequence of ageing, defined as an unappealingly large free caudal segment of over 5 mm. It is therefore important to consider reduction as a complement to rhytidectomy in selected patients. Moreover, facelifting operations can result in disproportionate or poorly positioned earlobes. Current earlobe-reducing techniques can leave a scar on the free lateral edge causing notching or involve complex pattern excisions with limited resection capability and the risk of deformities...
February 3, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28131500/resurfacing-the-penis-of-complex-hypospadias-repair-hypospadias-cripples
#5
Mina M Fam, Moneer K Hanna
PURPOSE: After the creation of a neourethra in a "hypospadias cripple," resurfacing the penis with healthy skin is a significant challenge because local tissue is often scarred and unusable. We reviewed our experience with various strategies to resurface the penis of hypospadias cripples. MATERIALS AND METHODS: We retrospectively reviewed the records of 215 patients referred after multiple unsuccessful hypospadias repairs from 1981 to 2014. In 130 of 215 patients we performed resurfacing using local penile flaps using various techniques, including Byars flaps, Z-plasty or double Z-plasty, or a dorsal relaxing incision...
January 25, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28130562/becker-expander-based-breast-reconstruction-following-wise-pattern-skin-reducing-mastectomy-complication-rates-and-risk-factors
#6
E Demiri, D Dionyssiou, S Sapountzis, L Pavlidis, I Natsiopoulos, S Miliaras
Our aim is to analyze the results of immediate breast reconstruction in women with macromastia after skin-reducing mastectomy (SRM), with an emphasis on complications and risk factors. Between 2008 and 2013, fifty women with hypertrophic breasts, aged 21-74 years, underwent immediate expander-based breast reconstruction after Wise pattern SRM. An inferiorly based de-epithelialized skin flap was sutured to the inferolateral border of the pectoralis major muscle and covered the expander. Thirty-five women had a unilateral and fifteen a bilateral procedure (total 65 breasts)...
January 27, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28124539/one-staged-reconstruction-of-bladder-exstrophy-in-male-patients-long-term-follow-up-outcomes
#7
Amilcar Martins Giron, Marcos Figueiredo Mello, Paulo Afonso Carvalho, Paulo Renato Marcelo Moscardi, Roberto Iglesias Lopes, Miguel Srougi
INTRODUCTION: The surgical correction of bladder exstrophy remains challenging. In our institution, the repair has evolved from a staged repair to one-stage reconstruction. The one-stage reconstruction includes; bladder closure, Cantwell-Ransley neourethroplasty and abdominoplasty using groin flaps, without the need of pelvic ostheotomies. Repair of urinary continence (UC) and vesicoureteral reflux (VUR) is done after development of the infant. OBJECTIVE: To present our experience of our modified one-stage reconstruction of bladder exstrophy in male patients...
January 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28118939/endonasal-septal-perforation-repair-using-posterior-and-inferiorly-based-mucosal-rotation-flaps
#8
Steven Dayton, Nipun Chhabra, Steven Houser
IMPORTANCE: Repair of nasal septal perforations is challenging regardless of surgical technique due to their location and the health of surrounding tissue. There is currently no surgical procedure which is completely effective in the treatment of anteriorly located perforations. OBJECTIVE: To report a novel method of closing anterior septal perforations using an inferiorly based mucosal rotation flap and an acellular dermal interposition graft, as well as expand upon a previous series...
January 16, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28114211/removal-of-an-unusual-neglected-foreign-body-in-infratemporal-region-using-navigation
#9
Avani Jain, Gaurav Gupta, Mohnish Grover
A 19-year-old male presented with complaint of a bluish mass in the hard palate since 3 months. The patient had a history of trauma 8 years back in the left zygomatic area with a pen. It was lodged in the wound and removed at that time. Computed tomography scan was revealed a linear heterogenous dense structure extending from left infratemporal fossa to oral cavity, traversing through left maxillary sinus, with bone defect seen in lateral and medial wall of maxilla, and in the hard palate, most likely a neglected foreign body...
January 20, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28099270/a-prospective-assessment-of-surgical-risk-factors-in-114-gluteal-fold-flap-reconstructions-after-oncological-vulvoperineal-resection-to-establish-clinically-relevant-selection-criteria
#10
Maurits Lange, J Joris Hage, Marc van Beurden
BACKGROUND AND AIM: To date, clinically relevant selection criteria have not been established for the use of the gluteal fold flap after oncological vulvoperineal resection. We prospectively assessed the surgical risk factors of this reconstructive technique in a large series. METHODOLOGY: From April of 2000 through December of 2015, 114 gluteal fold flaps were used for vulvoperineal reconstruction after excision of (pre)malignant skin disorders in 75 women. The possible influence of 10 patient-related and 6 procedure-related risk factors on flap-related postoperative complications was statistically analyzed...
January 18, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28093318/massive-vulvar-linear-verrucous-epidermal-nevus-presenting-at%C3%A2-menarche
#11
Jaclyn E Morrison, Adrienne Bonham
BACKGROUND: Epidermal nevi are benign hamartomatous growths of the skin that present at birth and develop in early childhood often linearly along the "lines of Blaschko." Verrucous linear epidermal nevi are the most common epidermal nevi and often are located on the trunk or extremities. There is minimal evidence regarding vulvar involvement and subsequent management of the associated cosmetic deformity in this anatomic location. CASE: An 11-year-old menarchal girl who underwent full-thickness dermal excision of a 9...
January 16, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28092337/anatomical-basis-and-clinical-application-of-synovial-flaps-in-the-wrist-and-distal-forearm
#12
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/28077761/on-the-autorotation-of-animal-wings
#13
Victor Manuel Ortega-Jimenez, Antonio Martín-Alcántara, Ramon Fernandez-Feria, Robert Dudley
Botanical samaras spin about their centre of mass and create vertical aerodynamic forces which slow their rate of descent. Descending autorotation of animal wings, however, has never been documented. We report here that isolated wings from Anna's hummingbirds, and also from 10 species of insects, can stably autorotate and achieve descent speeds and aerodynamic performance comparable to those of samaras. A hummingbird wing loaded at its base with the equivalent of 50% of the bird's body mass descended only twice as fast as an unloaded wing, and rotated at frequencies similar to those of the wings in flapping flight...
January 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28063277/straightforward-method-for-coverage-of-major-vessels-after-modified-radical-neck-dissection
#14
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/28050439/rotation-flap-closure-of-moderate-size-scalp-defects-technique-and-outcome
#15
Philip Umman, Vinod G Pillai, Pradip M Abraham, Roshan G Varkey
Many patients present to general surgeons with scalp lesions which require wide local excision with margin, following which the defect is too large to be closed primarily. These lesions can be benign or malignant. Skin grafting of these defects gives poor cosmetic outcome. Knowledge of basic flaps will enable the general surgeon to close these defects to heal by primary intention. Also, the margin of excision will not be compromised because of anticipated difficulty in closing the wound. We present a series of three cases who underwent excision of scalp lesions resulting in moderate size scalp defects...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28041753/modified-reversed-superficial-peroneal-artery-flap-in-the-reconstruction-of-ankle-and-foot-defects-following-severe-burns-or-trauma
#16
Shi-Ji Li, Hao Cheng, Xu Fang, Jian-Yang Xu, Fei Wang, Sheng Liu, Xu-Lin Chen, Xiong-Wen Lv
OBJECTIVE: Challenges persist in the reconstruction of the ankle and the foot with exposed tendons, joints, and bones as a result of severe burns and trauma. In flap elevation involving the sensitive superficial nerve, the local nerve was always sacrificed to obtain an anesthetic donor site; however, such a procedure introduced the possibility of painful neuromas. In this study, we present a desired clinical application of a modified reversed superficial peroneal artery flap, in which the superficial peroneal nerve is preserved...
December 29, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28032165/an-alternative-posterosuperior-auricular-fascia-flap-for-ear-elevation-during-microtia-reconstruction
#17
Yiyuan Li, Ruhong Zhang, Qun Zhang, Zhicheng Xu, Feng Xu, Datao Li
BACKGROUND: Advances in staged total auricular reconstruction have resulted in improved anterior auricular appearance; however, satisfactory postreconstruction esthetics of the retroauricular fold remain challenging. The postauricular appearance of the reconstructed ear depends largely upon optimizing the covering material. When used as the covering soft tissue for ear elevation, a flap containing primarily the upper portion of the retroauricular fascia has potential advantages over the conventional book cover-type retroauricular fascia flap...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28008267/oncological-outcomes-and-complications-after-volume-replacement-oncoplastic-breast-conservations-the-glasgow-experience
#18
Weiguang Ho, Sheila Stallard, Julie Doughty, Elizabeth Mallon, Laszlo Romics
INTRODUCTION: Oncoplastic breast conservation surgery (OBCS) combines the principles of surgical oncology and plastic surgery. OBCS has now become a growing option for the treatment of breast cancer and forms a part of breast-conserving therapy (BCT). We sought to investigate and report our experience in two breast units in Glasgow (Victoria Infirmary and Western Infirmary) on volume replacement OBCS. MATERIALS AND METHODS: Details of patients treated with volume replacement OBCS were identified from a prospectively recorded database from November 2010 to October 2015...
2016: Breast Cancer: Basic and Clinical Research
https://www.readbyqxmd.com/read/28005812/microcystic-adnexal-carcinoma-of-the-nasal-tip-treated-with-surgical-excision-and-rotational-forehead-skin-flap
#19
Min Seok Kang, Eun Jung Lee, Ji Seop Kim, In Sik Yun, Hyung Kwon Byeon
Microcystic adnexal carcinoma (MAC) is a rare malignant cutaneous adenocarcinoma that typically occurs in the head and neck, particularly at the central face. There are only slightly more than 300 patients reported worldwide, and most patients occur in Caucasians. A 72-year-old man was referred to our hospital for definitive treatment of known MAC from previous biopsy. Wide excision of nasal tip and reconstruction of nasal defect with paramedian forehead flap and nasolabial flap transposition were performed rather than conventional Mohs surgery, due to grossly evident disease...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005774/a-simple-closure-technic-for-tracheoesophageal-puncture-failures
#20
Ahmet Mutlu, Sinem Dasli, Murat Ozturk, Murat Topdag
Tracheosephageal puncture is the one of the most favorable methods, and widely used by physicians for voice reconstruction after total laryngectomy. Intractable leakages from the tracheosephageal punctures are the most common complication, and management of these fistulas is still troublesome for the patients and physicians. Local surgical sutures, rotational flaps, injections are reported previously, but in this report the authors aimed to mention on a very simple method with silicone septal button. Insertion of a temporary silicone septal button may be well tolerated by patients and can help to manage this complication easily on exact indications...
November 2016: Journal of Craniofacial Surgery
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