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Local flaps

Kerim Sariyilmaz, Ilker Eren, Okan Ozkunt, Mustafa Sungur, Onder I Kilicoglu, Fatih Dikici
BACKGROUND: Gout is a purine metabolism disease. Tophaceous gout may cause joint destruction and other systemic problems and sometimes may be complicated by infection. Infection and sinus with discharge associated with tophaceous gout are serious complications, and treatment is difficult. We present a patient with tophaceous gout complicated by infection and discharging sinus treated by bilateral amputation at the level of the first metatarsus. METHODS: A 43-year-old man previously diagnosed as having gout, and noncompliant with treatment, presented with tophaceous gout associated with discharging sinus and infection on his left first metatarsophalangeal joint...
January 2018: Journal of the American Podiatric Medical Association
Sheng Yan, Hangyan Shi, Da Chen, Jincai Guo, Yi Sun, Sufan Wu
The reconstruction of large full-thickness scalp defects remains a surgical challenge, especially when the skull is exposed completely without periosteum. Surgical technique options for wound coverage have included tissue expansion, skin grafting, local or regional flaps, and microvascular free tissue transfer. In recent years, some authors have reported to use biological material as an alternative for repairing complex wounds. The authors report the successful reconstruction of a large defect with bare skull in bilateral temporal regions of a 3-year-old child...
March 14, 2018: Journal of Craniofacial Surgery
Hemant K Mehta
The purpose is to present a new refined surgical technique for mild-to-severe acquired myogenic ptosis correction under local anaesthesia (LA) as day cases with resection of myotarsal (MT) flap and demonstrate the safety and efficacy of the technique. MT flap consists of 2 mm tarsal strip with attached levator complex - levator muscle, its aponeurosis, and Müller muscle. This is a retrospective personal series of 400+ patients, who underwent surgical correction with MT flap resection of 8-24 mm under LA mostly as day cases...
March 15, 2018: Orbit
Mark L Urken, Ansley M Roche, Kimberly J Kiplagat, Eliza H Dewey, Cathy Lazarus, Ilya Likhterov, Daniel Buchbinder, Devin J Okay
BACKGROUND: Palatomaxillary defects were historically restored with a prosthetic obturator; however, advances in local and free tissue transfer has provided a viable alternative for appropriately selected patients with palatomaxillary defects. METHODS: A retrospective chart review of patients who underwent palatomaxillary reconstruction by the lead author between 1998 and 2016 was conducted. Patients who were restored with a palatal obturator were excluded. RESULTS: One hundred forty patients were reconstructed with a total of 159 local, regional, and free flaps with a 96...
March 14, 2018: Head & Neck
Katharine M Hinchcliff, Jessica Crockett, Steven W Thorpe, Christopher O Bayne
Long ischemia times adversely affect free flap survival, and large muscle flaps are particularly vulnerable. Hypothermic machine perfusion (HMP) is a well-established method of organ preservation, and recent literature has detailed the use of HMP to extend free flap ischemia times, predominantly in the laboratory setting. One limitation in the study and adoption of free flap HMP has been the availability of standardized perfusion machinery, as thus far institutions have built their own devices. We present a case of a 75-year-old woman with dedifferentiated chondrosarcoma of her right proximal femur...
March 14, 2018: Microsurgery
M Sohn, M Dietrich, A Wirthmann, U M Rieger
BACKGROUND: Due to the rising incidence of penile cancer and increasing life expectancy in western nations, the current international guidelines recommend a less aggressive surgical approach with reduced safety margins and preferably with organ preservation. OBJECTIVES: The goal of this review is to review the current data on stage-dependent reconstructive surgical techniques and their oncological and functional results. MATERIALS AND METHODS: Five recently published reviews and several single studies and publications on the topic of organ-sparing surgical techniques and penile reconstruction were evaluated to draw conclusions for surgery in penile cancer...
March 13, 2018: Der Urologe. Ausg. A
Saul N Rajak, Shyamala C Huilgol, Masahiro Murakami, Dinesh Selva
PURPOSE: Propeller flaps are island flaps that reach the recipient site through an axial rotation. The flap has a subcutaneous pedicle on which it pivots, thereby resembling a helicopter propeller. We present our series of propeller flaps for the reconstruction of large eyelid defects. METHODS: This is a retrospective review of the clinical case notes of eight patients that underwent tumour excision with reconstruction with a cutaneous propeller flap supplied by a non-perforator orbicularis pedicle between July and December 2016...
March 14, 2018: Eye
T Vimont, Arnaud, A Rouffet, J-P Giot, A S Florczak, P Rousseau
BACKGROUND: Preserving the integrity of the eyelid margin in eyelid reconstruction remains a challenge for plastic surgeons. In 1976, Hübner described a technique to repair full-thickness eyelid defects using a tarsomarginal graft covered with a local flap. This simple technique addresses both functional and aesthetic requirements of eyelid reconstruction by using tissue from the contralateral eyelid. The aim of this study was to determine the appropriate role of this uncommon technique in eyelid reconstruction...
March 9, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Ömer Özkan, Özlenen Özkan, Anı Çinpolat, Nasuh Utku Doğan, Gamze Bektaş, Kemal Dolay, Alihan Gürkan, Cumhur Arıcı, Selen Doğan
Although vaginal reconstructions with intestinal segments require particularly complex surgical procedures, this technique has become popular with respect to fairly good functional and esthetic outcomes. This study describes cases of vaginal reconstruction performed using a modified rectosigmoid colon held in an ischemic state in order to reduce secretion and denervated in order to prevent defecation problems. Vaginal reconstructions with rectosigmoid colon were performed on 43 patients. In this retrospective study, 34 patients had Müllerian agenesis, while nine had undergone male to female sex reassignment surgery in which adequate vaginal depth had not been achieved...
March 8, 2018: Journal of Plastic Surgery and Hand Surgery
Olga Jurek-Matusiak, Piotr Wójtowicz, Tomasz Szafarowski, Antoni Krzeski
PURPOSE OF THE STUDY: The aim of the study was to present the treatment outcomes after vertical partial laryngectomy with or without pedunculated sternothyroid muscle flap reconstruction following the resection of neoplasm-infiltrated vocal fold. The procedure was used in a patient with glottic cancer. Oncological outcomes, morphology of neo-vocal fold and the act of swallowing were evaluated. MATERIAL AND METHODS: 45 patients with T1-T2 glottic cancer were subjected to vertical partial laryngectomy with 26 patients undergoing a procedure with pedunculated sternothyroid muscle flap reconstruction and the remaining 19 patients undergoing a procedure without such a reconstruction...
February 28, 2018: Otolaryngologia Polska
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
Marcelo Carlos Bortoluzzi, Luciana Dorochenko, Giovana Massuqueto, Rodrigo César da Silva, Rafael Manfro, Fábio André Santos
AIMS: To identify relevant variables that may predict pain after routine extraction of erupted teeth, to construct a Pain Prediction Index (PPI) based on these variables, and to verify how these variables are related by using valid structural equation modeling (ie, path analysis). METHODS: This study was designed as an observational prospective study for postoperative memory of pain after dental extraction of erupted teeth. Data from a total of 781 surgical procedures related to dental extractions were included...
February 28, 2018: Journal of Oral & Facial Pain and Headache
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
Christopher J Dy, Benjamin Aunins, David M Brogan
The physiological limitations of neural regeneration make peripheral nerve surgery challenging to both the surgeon and the patient. Presence of nerve gaps and local wound factors may all influence outcome, suggesting that barriers to reduce perineural scarring, minimize fibrosis, and avoid ischemia would be beneficial. To examine the evidence supporting their use, we reviewed the autologous and commercially-available options for barriers against scarring around a nerve. Numerous clinical case series demonstrated the effectiveness and safety of local/rotational flaps and autologous vein wrapping when used in the presence of recurrent compressive neuropathy...
February 24, 2018: Journal of Hand Surgery
Leela S Mundra, Husain T AlQattan, Meghan G Janette, Carissa Patete, Seth R Thaller
BACKGROUND: Cleft lip and palate are the most common craniofacial congenital malformations. Timing of the nasal repair remains somewhat controversial. Some authors perform a combined nasal and lip repair in infancy while others advocate for a staged repair with the nasal component occurring later in childhood. Frequently, secondary repair is needed to address residual nasal deformities in early adulthood. Conchal cartilage has become increasingly popular as a source of cartilage for secondary reconstruction...
February 23, 2018: Journal of Craniofacial Surgery
Alexander J Gougoutas, Hakim K Said, Grace Um, Anne Chapin, David W Mathes
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Understand how to determine nipple-areola complex positioning on the reconstructed breast. 2. Understand the multitude of local flap and distant graft options for nipple-areola complex reconstruction. 3. Draw at least three fundamental nipple-areola complex reconstruction patterns. 4. Understand the forces that are responsible for flattening of the reconstructed papule. 5. Understand the current techniques used in secondary nipple-areola complex reconstructions...
March 2018: Plastic and Reconstructive Surgery
Elisabetta A Matsumoto, Haiyi Liang, L Mahadevan
Reconstructive surgeries often use topological manipulation of tissue to minimize postoperative scarring. The most common version of this, Z-plasty, involves modifying a straight line cut into a Z shape, followed by a rotational transposition of the resulting triangular pedicle flaps, and a final restitching of the wound. This locally reorients the anisotropic stress field and reduces the potential for scarring. We analyze the planar geometry and mechanics of the Z-plasty to quantify the rotation of the overall stress field and the local forces on the restitched cut using theory, simulations, and simple physical Z-plasty experiments with foam sheets that corroborate each other...
February 9, 2018: Physical Review Letters
J Chauvel-Picard, A Pierrefeu, O Harou, P Breton, N Sigaux
INTRODUCTION: Malignant chondroid syringomas, also known as cutaneous malignant mixed tumors, are rare neoplasms that most frequently occur on the torso or extremities of women. Here we present an illustrated case of a facial malignant chondroid syringoma. MATERIALS AND METHODS: A 32-year-old female patient with no notable medical history presented with an approximately 1cm-wide, painless, palpably-mobile subcutaneous nodule, suggestive of a sebaceous cyst, just above the middle third of the right eyebrow...
February 22, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Giancarlo Sborgia, Nicola Recchimurzo, Luigi Sborgia, Alfredo Niro, Alessandra Sborgia, Marina Piepoli, Giovanni Alessio
PURPOSE: To analyze morphologic and functional changes after inverted internal limiting membrane-flap technique for optic disk pit maculopathy using optical coherence tomography, multifocal electroretinography, and microperimetry. METHODS: One case report. RESULTS: A 30-year-old woman presented us with decreased visual acuity (20/63) in the left eye because of retinoschisis and serous macular detachment associated with optic disk pit. Optical coherence tomography did not localize the source of intraretinal and subretinal fluid...
February 22, 2018: Retinal Cases & Brief Reports
Koichi Ogura, Michiro Susa, Hideo Morioka, Akihiko Matsumine, Takeshi Ishii, Kenichiro Hamada, Takafumi Ueda, Akira Kawai
BACKGROUND: We conducted a nationwide survey of prosthetic reconstruction using a constrained-type hip tumor prosthesis (C-THA) following resection of periacetabular tumors. METHODS: Eighty patients with periacetabular tumors underwent wide resection and prosthetic reconstruction using C-THA at JMOG-affiliated institutions (39 males and 41 females; mean age, 46.7 years; mean follow-up period, 65 months). Primary bone or soft tissue sarcoma accounted for 75% of the cases...
February 23, 2018: Journal of Surgical Oncology
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