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Advancement flap

Giovan Paolo Pini Prato, Cristina Magnani, Leandro Chambrone
BACKGROUND: Coronally advanced flap (CAF) has been considered as one of the most predictable and versatile root coverage procedures. Thus, the aims of this study are two-fold: 1) to evaluate the long-term outcomes following CAF in the treatment of gingival recession (GR); and 2) to explore the influence of several tooth/patient-related factors on the stability of gingival margin at 5, 10, and 20 years after surgery. METHODS: Ninety-four patients with 97 GR (73 Miller`s Class I and 24 Miller's Class III) were treated with CAF in a private practice between 1984 and 1996...
March 12, 2018: Journal of Periodontology
N D Thimmappa, J V Vasile, C Y Ahn, J L Levine, M R Prince
Autologous breast reconstruction using muscle-sparing free flaps are becoming increasingly popular, although microvascular free flap reconstruction has been utilised for autologous breast reconstructions for >20 years. This innovative microsurgical technique involves meticulous dissection of artery-vein bundle (perforators) responsible for perfusion of the subcutaneous fat and skin of the flap; however, due to unpredictable anatomical variations, preoperative imaging of the donor site to select appropriate perforators has become routine...
February 27, 2018: Clinical Radiology
Milan Spasojevic, Anthony B Mariathasan, Mariusz Goscinski, Ebbe B Thorgersen, Arne M Solbakken, Hans-Petter Gullestad, Truls Ryder, Kjersti Flatmark, Stein G Larsen
BACKGROUND: Radiotherapy (RT) and subsequent abdominoperineal resection (APR) for locally advanced rectal cancer (LARC) is associated with significant perineal wound morbidity. The aim of the present study was to investigate if vertical rectus abdominis musculocutaneous (VRAM) flap repair after APR in LARC patients improves perineal wound healing compared with direct perineal wound closure (non-VRAM). METHODS: LARC patients (n = 329) operated with APR between January 2006 and December 2015 after neoadjuvant RT of ≥ 25 Gy were identified, including 260 and 69 patients in the non-VRAM and VRAM groups, respectively...
March 1, 2018: Annals of Surgical Oncology
Otto Zuhr, Stephan F Rebele, Stefani L Cheung, Markus B Hürzeler
Diverse clinical advancements, together with some relevant technical innovations, have led to an increase in popularity of tunneling flap procedures in plastic periodontal and implant surgery in the recent past. This trend is further promoted by the fact that these techniques have lately been introduced to a considerably expanded range of indications. While originally described for the treatment of gingival recession-type defects, tunneling flap procedures may now be applied successfully in a variety of clinical situations in which augmentation of the soft tissues is indicated in the esthetic zone...
March 1, 2018: Periodontology 2000
Ilia Lozev, Sonya Ruseva, Ivan Pidakev, José Carlos Cardoso, Uwe Wollina, Torello Lotti, Georgi Konstantinov Maximov, Ivan Terziev, Georgi Tchernev
Neoplasms of the major and minor salivary glands are morphologically and a clinically diverse group of neoplasms which lead the clinician to diagnostic and management challenges. This article aims to report a case of mucoepidermoid carcinoma in 83 - year - old woman who presented in the dermatology clinic with a tumour mass in the left auricular area. The patient complained of pain and abnormal bleeding of the mass. The lesion was examined, and surgical treatment was performed. A tumour was extirpated, and partial resection of both the parotid gland and the sternocleidomastoid muscle was done...
January 25, 2018: Open Access Macedonian Journal of Medical Sciences
Alberto Goldman, Uwe Wollina, Katlein França, Torello Lotti, Georgi Tchernev
Squamous cell carcinoma is the most common malignancy of the lower lip. Environmental factors such as ultraviolet light exposure, arsenic and smoking are contributing factors to the increasing incidence. Mohs surgery is the treatment of choice ensuring the lowest recurrence rates. The closure of the surgical defects, however, can be a challenge. Multiple and versatile methods of reconstructing vermilion defects have been described. Among these options, Goldstein developed the adjacent ipsilateral vermilion flap based on an arterialized myocutaneous flap...
January 25, 2018: Open Access Macedonian Journal of Medical Sciences
Satoshi Usami, Kohei Inami, Yuichi Hirase
BACKGROUND: Reconstruction of the finger and thumb dorsum has been considered difficult because of the need for a thin and flexible flap, and the surrounding tissue is sometimes insufficient for a local flap. The purpose of this report is to describe our concept for finger and thumb dorsum reconstruction with free-style perforator flaps and our clinical experience with transfer of various perforator flaps. METHODS: Thirty-two finger dorsum defects in 32 patients were covered with pedicled free-style perforator flaps...
February 13, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Yun Zou, Li Hu, Mathias Tremp, Yunbo Jin, Hui Chen, Gang Ma, Xiaoxi Lin
PURPOSE: The aim of this study was to repair large periorbital cutaneous defects by an innovative technique called PEPSI (periorbital elevation and positioning with secret incisions) technique with functional and aesthetic outcomes. METHODS: In this retrospective study, unilateral periorbital cutaneous defects in 15 patients were repaired by the PEPSI technique. The ages of patients ranged from 3 to 46 years (average, 19 years). The outcome evaluations included scars (Vancouver Scar Scale and visual analog scale score), function and aesthetic appearance of eyelids, and patient satisfaction...
February 23, 2018: Annals of Plastic Surgery
Chi-Yu Wang, Chien-Ju Wu, Tzi-Shiang Chu, Chun-Yu Chen, Chang-Yi Chou, Hao-Yu Chiao, Chun-Kai Chang, Niann-Tzyy Dai
Many types of flaps are available if surgical reconstruction of a pressure ulcer is indicated, including a gluteus maximus flap, V-Y advancement flap, and superior gluteal artery perforator flap. Regional flap failure can complicate treatment, requiring additional flap surgery. An 80-year old woman with a 2-year history of being unconscious following a cerebrovascular accident presented with a Stage 4 sacral pressure ulcer of 2 months' duration with eschar and abscess formation. Because the wound measured 15 × 10 cm2, bilateral V-Y advancement flaps were used for surgical closure...
February 2018: Ostomy/wound Management
Ryan B Thorpe, Rajiv I Nijhawan, Divya Srivastava
BACKGROUND AND OBJECTIVE: The V-to-Y advancement flap, also known as the island pedicle flap, is a single-stage repair option that can be used for defects on the distal nose. We report our experience using this flap for nasal defects following Mohs micrographic surgery, as well as describe optimal patient selection and flap design. MATERIALS AND METHODS: A retrospective review was conducted of all patient charts and operative photographs of nasal V-to-Y advancement flaps performed over 6 years at the Universtiy of Texas Southwestern Medical Center...
February 1, 2018: Journal of Cutaneous Medicine and Surgery
Marie-Alix Fauroux, Marie De Boutray, Eve Malthiéry, Jacques-Henri Torres
INTRODUCTION: Companies selling dental implant guided systems mostly offer similar surgical guides. The purpose of this paper is to present an innovative guided surgery system which originality lies in its guidance device, and to report the author's experience in using this system for dental implant surgery. TECHNICAL PROTOCOL: Two parallel tubes on either side of the drilling axis guide the successive drills and the implant placement. As a result of the lateral guidance, there is no friction of the drills on the surgical guide which would damage it or contaminate the drilling hole with particles torn out from the guide...
February 19, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Max J H Witjes, Rutger H Schepers, Joep Kraeima
PURPOSE OF REVIEW: This review describes the advances in 3D virtual planning for mandibular and maxillary reconstruction surgical defects with full prosthetic rehabilitation. The primary purpose is to provide an overview of various techniques that apply 3D technology safely in primary and secondary reconstructive cases of patients suffering from head and neck cancer. RECENT FINDINGS: Methods have been developed to overcome the problem of control over the margin during surgery while the crucial decision with regard to resection margin and planning of osteotomies were predetermined by virtual planning...
February 20, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Michael P Chae, David J Hunter-Smith, Marie Rostek, Julian A Smith, Warren Matthew Rozen
Optimizing preoperative planning is widely sought in deep inferior epigastric artery perforator (DIEP) flap surgery. One reason for this is that rates of fat necrosis remain relatively high (up to 35%), and that adjusting flap design by an improved understanding of individual perforasomes and perfusion characteristics may be useful in reducing the risk of fat necrosis. Imaging techniques have substantially improved over the past decade, and with recent advances in 3D printing, an improved demonstration of imaged anatomy has become available...
January 2018: Plastic and Reconstructive Surgery. Global Open
Hua Shen, Xinyi Dai, Jun Chen, Jing Wang, Zhaofen Zhang, Zhengdong Cai
Reconstruction of scalp defects caused by tumor resection or trauma is very challenging. A majority of the surgeons prefer to use local flap rather than skin graft or free flap for scalp defects repair. The aim of this study is to investigate the technique of modified unilateral pedicled V-Y advancement flap for the reconstruction of scalp defect.A retrospective review was performed in a series of 18 patients who had a modified unilateral pedicled V-Y advancement flap to restore scalp defect from May 2013 to January 2017...
February 14, 2018: Journal of Craniofacial Surgery
Luca Francetti, Roberto Weinstein, Silvio Taschieri, Stefano Corbella
Gingival recession can cause an esthetic impairment or dentin hypersensitivity due to root surface exposure to the oral cavity. These conditions may require specific surgical interventions to achieve root coverage. This controlled clinical trial on 20 subjects compared coronally advanced flap (CAF) technique and CAF plus subepithelial connective tissue graft (CTG) for the treatment of single maxillary gingival recession. Recession height (REC) and complete root coverage (CRC) were considered as primary outcomes...
February 16, 2018: International Journal of Periodontics & Restorative Dentistry
Annika Senghaas, Thomas Kremer, Volker J Schmidt, Leila Harhaus, Christoph Hirche, Ulrich Kneser, Amir K Bigdeli
Despite considerable advances in reconstructive surgery, massive abdominal wall defects continue to pose a significant surgical challenge. We report the case of a 72-year-old morbidly obese female patient with Clostridium septicum-related gas gangrene of the abdominal wall. After multidisciplinary treatment and multiple extensive debridements, a massive full-thickness defect (40 cm × 35 cm) of the right abdominal wall was present. The abdominal contents were covered with a resorbable mesh to prevent evisceration...
February 16, 2018: Microsurgery
Sarah R Ottenhof, Andrew Leone, Rosa S Djajadiningrat, Mounsif Azizi, Kamran Zargar, Laura C Kidd, Gregory Diorio, Gerard Mosiello, Niels M Graafland, Philippe E Spiess, Simon Horenblas
BACKGROUND: Treatment of locoregionally advanced penile squamous cell carcinoma (LAPSCC) is challenging. The exact role (in terms of oncological benefit) of extensive surgery is not well established. Moreover, surgery invariably leads to large defects requiring reconstructive surgery. Rectus abdominis myocutaneous (RAM) and abdominal advancement flaps have an independent and constant blood supply, are easily harvested, and provide substantial skin coverage and soft tissue. OBJECTIVE: To determine the surgical and oncological outcomes in patients with LAPSCC undergoing surgical resection with RAM flaps...
February 9, 2018: European Urology Focus
Ahmed Hassan El-Sabbagh
Background: Fournier's gangrene is a necrotizing fasciitis caused by mixed aerobic and anaerobic bacteria and results in loss of skin and subcutaneous tissue in the perineal area. Coverage of testis varies from closure of the defect primarily, burying inside the thigh, using the remnants of the scrotum for tissue expansion and coverage by flaps. In this manuscript, scrotal advancement flaps and pudendal thigh flaps were used for coverage of the testis unilaterally or bilaterally according to the size of the defect following Fournier gangrene...
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Isao Matsumoto, Kenji Iino, Hirofumi Takemura
Cavernostomy and fenestration were performed in a patient who developed a lung abscess and empyema in the left lung, which was damaged after multimodality therapy for advanced thymoma. The hospitalized patient suddenly experienced cardiopulmonary arrest due to major bleeding from the left main pulmonary artery. We immediately performed the main pulmonary arterial embolization, and the patient was resuscitated. Subsequently, the patient underwent supercharged free omental flap plombage performed in the following manner: first, laparoscopic harvesting of the omentum was performed in the supine position...
February 2, 2018: Interactive Cardiovascular and Thoracic Surgery
Irit Duek, Alon Pener-Tessler, Ravit Yanko-Arzi, Arik Zaretski, Avraham Abergel, Ahmad Safadi, Dan M Fliss
Introduction  Pediatric skull base and craniofacial reconstruction presents a unique challenge since the potential benefits of therapy must be balanced against the cumulative impact of multimodality treatment on craniofacial growth, donor-site morbidity, and the potential for serious psychosocial issues. Objectives  To suggest an algorithm for skull base reconstruction in children and adolescents after tumor resection. Materials and Methods  Comprehensive literature review and summary of our experience...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
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