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https://www.readbyqxmd.com/read/29094390/reconstruction-of-a-long-defect-of-the-ulnar-artery-and-nerve-with-an-arterialized-neurovenous-free-flap-in-a-teenager-a-case-report-and-literature-review
#1
Diogo Casal, Diogo Pais, Eduarda Mota-Silva, Giovanni Pelliccia, Inês Iria, Paula A Videira, Maria Manuel Mendes, João Goyri-O'Neill, Maria Manuel Mouzinho
There is evidence that nerve flaps are superior to nerve grafts for bridging long nerve defects. Moreover, arterialized neurovenous flaps (ANVFs) have multiple potential advantages over traditional nerve flaps in this context. This paper describes a case of reconstruction of a long defect of the ulnar artery and nerve with an arterialized neurovenous free flap and presents a literature review on this subject. A 16-year-old boy sustained a stab wound injury to the medial aspect of the distal third of his right forearm...
November 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/29076683/outcome-of-distally-based-sural-artery-flap-for-distal-third-of-leg-and-foot-defects
#2
Kuldeep Singh, Rajesh Rohilla, Raj Singh, Sarita Singh, Bikramjit Singh, Milind Tanwar
BACKGROUND: Due to precarious blood supply, skin coverage for defects of leg, heel, dorsum of foot and the ankle has been a complicated task for plastic surgeons & orthopaedic surgeons. The present study aimed to prospectively evaluate the outcome of distally based sural flap for coverage of defects distal third of leg, ankle & foot. METHODS: In this study 15 patients with soft tissue defects on distal third of leg in (n=2), heel (n=4), medial malleolus (n=3), lateral malleolus (n=1), Achillis tendon (n=2), anterior ankle (n=2) and in dorsum of foot (n=1) were operated for coverage of defect by distally based sural flap...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28874067/sural-flap-use-for-the-treatment-of-wounds-with-underlying-osteomyelitis-graft-size-a-predictor-in-outcome-a-systematic-review
#3
Sham Persaud, Anthony Chesser, Ryan Pereira, Adrianne Ross
The sural flap procedure is a versatile technique that can be used to cover many types of defects about the lower extremity. The management of soft tissue defects of the lower extremity with underlying osteomyelitis is difficult. The goal for any of these patients is to create a biomechanically stable foot for weight-bearing purposes with no continued infection. Data were gathered using multiple databases from the years 2000 to 2016. Data were compiled looking at the number of subjects, age, comorbidities, number of complications, number of failures, and average flap size of complications/failures...
September 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28842095/functional-outcomes-after-heel-pad-reconstruction-a-review-of%C3%A2-7%C3%A2-cases
#4
Koh Khai Luen, Wan Azman Wan Sulaiman
Sensate, durable heel pad reconstruction is challenging. The present study assessed the functional outcomes after heel pad reconstruction using various flap techniques at our institution. From June 2011 to June 2016 (5-year period), 7 consecutive patients underwent heel pad reconstruction for various etiologies, with 3 microvascular free flaps (42.9%; 2 musculocutaneous flaps [66.7%] and 1 contralateral medial plantar flap [33.3%]) and 4 local pedicle flaps (57.1%; 3 instep medial plantar artery flaps [75.0%] and 1 distally based reverse sural flap [25...
September 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28792429/glabrous-flow-through-flaps-for-simultaneous-resurfacing-revascularization-and-reinnervation-of-digits
#5
Chao Chen, Liwen Hao, Wenhai Sun, Zengtao Wang, Zihai Ding, Shizhen Zhong
INTRODUCTION: Composite injuries of the volar surfaces of fingers are frequently associated with digital vessel and nerve damage. Flow-through glabrous flaps can provide esthetic tissue coverage as well as revascularization, and using a neurovascular flap, allows primary reconstruction of the digital nerve. METHODS: Between June 2010 and August 2014, we prospectively studied the use of Microsurgical flow-through glabrous flaps to achieve simultaneously digital revascularization and soft tissue coverage in 13 fingers of 12 patients who experienced volar injuries, comprising 6 great toe fibular flaps, 3 medial plantar flaps, 1 pedis medialis flap, and 3 hypothenar flaps...
November 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28753219/the-retrograde-transverse-cervical-artery-as-a-recipient-vessel-for-free-tissue-transfer-in-complex-head-and-neck-reconstruction-with-a-vessel-depleted-neck
#6
Pedro Ciudad, Mouchammed Agko, Oscar J Manrique, Shivprasad Date, Kidakorn Kiranantawat, Wei Ling Chang, Fabio Nicoli, Federico Lo Torto, Michele Maruccia, Georgios Orfaniotis, Hung-Chi Chen
BACKGROUND: Reconstruction in a vessel-depleted neck is challenging. The success rates can be markedly decreased because of unavailability of suitable recipient vessels. In order to obtain a reliable flow, recipient vessels away from the zone of fibrosis, radiation, or infection need to be explored. The aim of this report is to present our experience and clinical outcomes using the retrograde flow coming from the distal transverse cervical artery (TCA) as a source for arterial inflow for complex head and neck reconstruction in patients with a vessel-depleted neck...
July 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28746238/-sural-nerve-splitting-in-reverse-sural-artery-perforator-flap-anatomical-study-in-40-cadaver-legs
#7
Hyeonwoo Kim, Julong Hu, Hak Chang, Byung Jun Kim
BACKGROUND: The reverse sural artery perforator flap (RSAPF) has been widely used in reconstructions of the lower extremity. However, along with the high rate of flap necrosis, sural nerve (SN) injury is one of the most frequent complications. This cadaveric study investigated a simple SN preservation technique during RSAPF. METHODS: Anatomic dissection of the sural nerve was performed on 40 lower legs, from 20 cadavers, to investigate the pattern of SN distribution...
July 12, 2017: Plastic and Reconstructive 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/28698831/effectiveness-of-reverse-sural-artery-flap-in-the-management-of-wheel-spoke-injuries-of-the-heel
#9
Hafiz U Farooq, Rizwan Ishtiaq, Shabana Mehr, Sadia Ayub, Umer H Chaudhry, Anam Ashraf
OBJECTIVE: Soft tissue injuries at the level of lower extremities, plantar, and dorsal foot pose a surgical challenge for reconstructive surgeons. This kind of injury commonly occurs when lower limbs get stuck in between the spokes of the wheel. Reverse sural artery flap has been proven to be an effective option to cover such defects. The aim of this study is to analyze the demographic variables of affected individuals, technical aspects of reverse sural artery flap, quantify the effectiveness of reverse sural artery flap among various treatment options available, and to study the outcome of injury...
June 10, 2017: Curēus
https://www.readbyqxmd.com/read/28642191/new-aspects-in-free-flap-surgery-mini-perforator-flaps-and-extracorporeal-flap-perfusion
#10
K-D Wolff
BACKGROUND: The scope of microvascular tissue transfer in the Head and Neck reaches from coverage of simple soft tissue defects to complex 3-D reconstructions using multiple or chimeric flaps. This paper summarises the presentation given at the Congress of the French Society of Oral and Maxillofacial Surgery in Marseille 2017. It was the aim of our work to add further elements to this wide spectrum of reconstructive possibilities. METHODS: For patients with small intraoral soft tissue defects in whom the use of a radial forearm flap would not be justified because of its donor site morbidity, but who nevertheless would take a benefit from a small free flap, we used mini-perforator flaps from the lower leg...
September 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28616759/is-dual-semitendinosus-allograft-stronger-than-turndown-for-achilles-tendon-reconstruction-an-in-vitro-analysis
#11
Michael C Aynardi, Lara C Atwater, Roshan Melvani, Brent G Parks, Adrian G Paez, Stuart D Miller
BACKGROUND: Large Achilles tendon defects pose a treatment challenge. The standard treatment with a turndown flap requires a large extensile incision, puts the sural nerve at risk, and demands slow, careful rehabilitation. Dual allograft semitendinosus reconstruction is a new clinical alternative that has the theoretical advantages of a smaller incision, less dissection, and a stronger construct that may allow for faster rehabilitation. QUESTIONS/PURPOSES: In a cadaver biomechanical model, we compared the dual allograft semitendinosus reconstruction with the myofascial turndown in terms of (1) mechanical strength and resistance to deformation and (2) failure mechanisms in reconstruction of large segmental Achilles defects...
October 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28512866/medial-sural-artery-perforator-free-flap-for-the-reconstruction-of-leg-foot-and-ankle-defect-an-excellent-option
#12
Jyoshid R Balan
BACKGROUND: The defects over the leg, foot and ankle are best covered with a thin pliable flap. The use of muscle flap for the reconstruction of these defects leaves a grafted, aesthetically inferior result. The medial sural artery perforator (MSAP) free flap gives a thin pliable tissue for the reconstruction with better aesthesis. METHODS: The study design was retrospective case analysis over a period of 2 years. All the patients who underwent flap for leg, foot and ankle defect reconstruction in the form of MSAP free flap were included in the study...
May 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28507850/distally-based-sural-artery-peroneus-flap-dbspf-for-foot-and-ankle-reconstruction
#13
Ahmed Ali Ebrahiem, Raj Kumar Manas, Gustavo Vinagre
BACKGROUND: Reconstruction of soft-tissue defects in lower third of leg, ankle, and foot has been a challenge and reconstructive surgeons have been trying to innovate different flaps. To solve this issue, we propose a distally based sural artery peroneus flap (DBSPF) in which we include superficial portion of the peroneus brevis muscle and its blood supply with the peroneal artery distally. The aim of this study was to evaluate the functional outcome and its usefulness over conventional distal sural artery flap or other local options available...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28489206/lower-extremity-reconstruction-epidemiology-management-and-outcomes-of-patients-of-the-federal-district-north-wing-regional-hospital
#14
Jefferson Lessa Soares Macedo, Simone Corrêa Rosa, Daniel Lobo Botelho, Clendes Pereira Dos Santos, Murilo Neves DE Queiroz, Tabatha Gonçalves Andrade Castelo Branco Gomes
Objective: to evaluate the management of lower limbs complex traumatic injuries by analyzing their characteristics, types, conduct and evolution, with emphasis on surgical treatment. Methods: we conducted a prospective study of patients treated by Plastic Surgery at a regional hospital of the Federal District during a one-year period. We collected data through serial evaluations and telephone contact records. Results: we studied 40 patients, with a mean age of 25...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28403000/the-combined-use-of-a-neurocutaneous-flap-and-the-ilizarov-technique-for-reconstruction-of-large-soft-tissue-defects-and-bone-loss-in-the-tibia
#15
Jia Xu, Wan-Run Zhong, Liang Cheng, Chun-Yang Wang, Gen Wen, Pei Han, Yi-Min Chai
BACKGROUND: Management of posttraumatic large soft tissue defects and bone loss remains a therapeutic and surgical challenge for orthopedic surgeons. We assessed the use of a neurocutaneous flap and the Ilizarov technique in the reconstruction of severe composite defects in the tibia. METHODS: We retrospectively reviewed 18 consecutive patients with trauma-related soft tissue defects and bone loss. The size of the soft tissue defect ranges from 8 × 9 cm to 14 × 18 cm...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28350683/the-relationship-of-superficial-cutaneous-nerves-and-interperforator-connections-in-the-leg-a-cadaveric-anatomical-study
#16
Adam C Gascoigne, G Ian Taylor, Russell J Corlett, Chris Briggs, Mark W Ashton
BACKGROUND: The lower limb is a source of many flaps both for closure of local defects and for free transfer. Fasciocutaneous flap techniques have been progressively refined, although the vascular basis for their success needs clarification. METHODS: Archival studies of 48 lower limbs were reviewed and combined with 20 studies of lower limbs from fresh cadavers, making a total of 68 investigations. Lower limbs were injected with a dilute lead oxide solution; the integument was removed and radiographed; and the cutaneous nerves were dissected, tagged with wire, radiographed again, and their paths traced on the original images...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28277072/free-flap-reconstruction-for-diabetic-foot-limb-salvage
#17
Tomoya Sato, Yuichiro Yana, Shigeru Ichioka
BACKGROUND: Although free flap is gaining popularity for the reconstruction of diabetic foot ulcers, it is unclear whether free flap reconstruction increases the chances of postoperative independent ambulation. The aim of this study is to evaluate the relationship between free flap success and postoperative ambulation. METHODS: This study reviewed 23 cases of free flap reconstruction for diabetic foot ulcers between January 2007 and March 2014. Free rectus abdominis, latissimus dorsi, and anterolateral thigh flaps were used in ten, eight, and five patients, respectively...
February 13, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28272123/reconstruction-of-moderate-sized-hand-defects-using-a-superficial-lateral-sural-artery-perforator-flap
#18
Xiao-Qing He, Yue-Liang Zhu, Jia-Zhang Duan, Xi Yang, Fanzhe Feng, Yong-Qing Xu
BACKGROUND: The skin on the lower leg has abundant perforators and, thus, is an excellent donor site for transplant tissue flaps. However, due to vascular variations and body positions, tissue flaps at the posterolateral proximal portion of the lower leg are rarely used for transplantation. This study reports our experience with the use of superficial lateral sural artery perforator (SLSAP) flaps in the repair of moderate-sized hand wounds. METHODS: From March 2012 to April 2015, the hand wounds of 15 patients were planned for repair using a superficial sural artery perforator flap...
April 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28258949/foot-and-ankle-reconstruction-using-the-distally-based-sural-artery-flap-versus-the-medial-plantar-flap-a-comparative-study
#19
Wael Hussein Mahmoud
Soft tissue defects around the foot and ankle region often present an awkward problem for plastic surgeons. The medial plantar artery flap raised from the non-weightbearing instep of the plantar foot offers a thick, sensorial, durable, and glabrous skin. The reversed sural artery flap offers a reliable option for coverage with the advantages of a wide arc of rotation, adequate dimensions, and a reliable blood supply. The present study compared the outcomes of the medial plantar artery flap and the distally based sural artery flap in foot and ankle reconstruction...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28255387/reverse-sural-flap-for-ankle-and-heel-soft-tissues-reconstruction
#20
R N Ciofu, D G Zamfirescu, S A Popescu, I Lascar
Introduction: The potential of the medial calf integument, as donor site for a free flap based on musculocutaneous branches of the medial sural artery, was first identified by Taylor and Daniel, following cadaver investigation. In 1981, Pontén described the fasciocutaneous sural flap as a reconstructive option for soft tissue loss of the lower extremity, particularly around the knee. Two years later, Donski and Fogdestram presented the distally based fasciocutaneous flap from the sural region followed by Montegut and Allen who considered the sural artery perforator flap as a viable alternative for the gastrocnemius myocutaneous flap...
January 2017: Journal of Medicine and Life
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