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Deep inferior epigastric

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https://www.readbyqxmd.com/read/29131393/flap-monitoring-with-continuous-oxygen-partial-tension-measurement-in-breast-reconstructive-surgery-a-preliminary-report
#1
Emilio Trignano, Nefer Fallico, Luca Fiorot, Alberto Bolletta, Matteo Maffei, Pedro Ciudad, Michele Maruccia, Hung-Chi Chen, Gian Vittorio Campus
BACKGROUND: The best method for the postoperative monitoring of flaps in reconstructive surgery is still a matter of debate. The aim of this study is to evaluate the usefulness of an oxygen partial tension monitoring system for the postoperative follow-up of a series of breast flaps, in addition to the traditional periodical clinical evaluations. PATIENTS AND METHODS: Twenty-one consecutive female patients (mean age: 61 years) who underwent free- or pedicled-flap reconstruction of the breast were included in the study...
November 13, 2017: Microsurgery
https://www.readbyqxmd.com/read/29127470/rectus-abdominis-muscle-innervation-an-anatomical-study-with-surgical-implications-in-diep-flap-harvesting
#2
Carla Stecco, Gian Paolo Azzena, Veronica Macchi, Andrea Porzionato, Astrid Behr, Anna Rambaldo, Cesare Tiengo, Raffaele De Caro
PURPOSE: To improve the current knowledge of rectus abdominis innervation, so as to identify a safe area where the vascular pedicle should be dissected to reduce the risk of nerve damage during deep inferior epigastric perforator (DIEP) flap harvesting. METHODS: Ten abdominal wall dissections were performed. Perforating arteries were identified and classified into nerve-related perforators and non-nerve-related perforators depending on the presence of nerve branches crossing vessels...
November 10, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29101984/acr-appropriateness-criteria-%C3%A2-imaging-of-deep-inferior-epigastric-arteries-for-surgical-planning-breast-reconstruction-surgery
#3
Isabel B Oliva, Kevin Day, Karin E Dill, Michael Hanley, Osmanuddin Ahmed, Shelby J Bennett, Benoit Desjardins, Kenneth L Gage, Michael Ginsburg, Adam H Hamawy, Michael L Steigner, Richard Strax, Nupur Verma, Frank J Rybicki
Breast cancer is the most common malignancy in women in the United States. Breast reconstruction surgery is a commonly used therapy for patients with breast cancer. The technique for the deep inferior epigastric perforator flap uses a preserved rectus muscle, which decreases donor site morbidity. Accurate identification and measurement of the perforator branches of the deep inferior epigastric artery is pivotal during pre-operative planning so that the surgeon can prioritize the best vessel to use and ultimately improve clinical outcome...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29080664/indications-and-controversies-for-nonabdominally-based-complete-autologous-tissue-breast-reconstruction
#4
REVIEW
Dries Opsomer, Koenraad van Landuyt
Autologous breast reconstruction can be challenging in mastectomy patients who are not eligible for a deep inferior epigastric artery perforator flap reconstruction. Depending on body habitus, alternative donor sites for free flap transfer can be found on the back, the thighs, and in the gluteal area. These alternative flaps can demand a higher level of expertise, which should be mastered by the modern day reconstructive microsurgeon. The flap choice should be tailored individually to each patient and should not be limited by the difficulty of the surgery...
January 2018: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/29068921/evidence-based-clinical-practice-guideline-autologous-breast-reconstruction-with-diep-or-pedicled-tram-abdominal-flaps
#5
COMPARATIVE STUDY
Bernard T Lee, Jayant P Agarwal, Jeffrey A Ascherman, Stephanie A Caterson, Diedra D Gray, Scott T Hollenbeck, Seema A Khan, Lauren D Loeding, Raman C Mahabir, Archibald S Miller, Galen Perdikis, Jaime S Schwartz, Beth A Sieling, Achilles Thoma, Judith A Wolfman, Jean L Wright
The American Society of Plastic Surgeons commissioned a multistakeholder Work Group to develop recommendations for autologous breast reconstruction with abdominal flaps. A systematic literature review was performed and a stringent appraisal process was used to rate the quality of relevant scientific research. The Work Group assigned to draft this guideline was unable to find evidence of superiority of one technique over the other (deep inferior epigastric perforator versus pedicled transverse rectus abdominis musculocutaneous flap) in autologous tissue reconstruction of the breast after mastectomy...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29050873/comparing-the-sensation-of-common-donor-site-regions-for-autologous-breast-reconstruction-to-that-of-a-healthy-breast
#6
Anouk J M Cornelissen, Jop Beugels, Arno Lataster, Esther M Heuts, Shai M Rozen, Aldona J Spiegel, René R W J van der Hulst, Stefania M H Tuinder
INTRODUCTION: Autologous breast reconstruction has become the standard care for breast cancer patients. Although excellent cosmetic results can be achieved, most reconstructed breasts fail to regain normal sensation. Nerve coaptation of the flap has been suggested to improve sensation; the effect of the donor flap native sensory threshold on the degree of sensory restoration is yet to be determined. The aim of this study is to evaluate the differences in sensation between various potential donor site regions in comparison to the sensation of the healthy breast...
September 25, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29019862/complications-and-patient-reported-outcomes-after-abdominal-based-breast-reconstruction-results-of-the-mastectomy-reconstruction-outcomes-consortium-mroc-study
#7
Jessica Erdmann-Sager, Edwin G Wilkins, Andrea L Pusic, Ji Qi, Jennifer B Hamill, Hyungjin Myra Kim, Gretchen E Guldbrandsen, Yoon S Chun
BACKGROUND: Abdominal flap reconstruction is the most popular form of autologous breast reconstruction. The current study compared complications and patient-reported outcomes (PROs) after pedicled transverse rectus abdominis myocutaneous (PTRAM), free TRAM (FTRAM), deep inferior epigastric perforator (DIEP), and superficial inferior epigastric artery (SIEA) flaps. METHODS: Patients having abdominal-based breast reconstruction at 11 centers were prospectively evaluated for abdominal donor-site and breast complications...
October 10, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28972286/foot-and-ankle-reconstruction-with-vertically-designed-deep-inferior-epigastric-perforator-flap
#8
Osman Akdag, Mehtap Karamese, Gokce Unal Yıldıran, Mustafa Sutcu, Zekeriya Tosun
INTRODUCTION: The deep inferior epigastric perforator (DIEP) flap is one of the most commonly utilized flaps of reconstructive surgery. Although the horizontal flap design is the most commonly used, this flap can be vertically designed to avoid drawbacks such as excessive tissue dissection, relatively reduced flap perfusion, and scarification of the contralateral flap opportunity. The aim of this report is to present our case series for foot and ankle reconstruction with vertical designed DIEP flap...
October 3, 2017: Microsurgery
https://www.readbyqxmd.com/read/28958568/effect-of-distal-venous-drainage-on-the-survival-of-four-territory-flaps-with-no-pedicle-vein-results-from-a-rat-model
#9
Seong Oh Park, Jeongmok Cho, Nobuaki Imanishi, Hak Chang
BACKGROUND: Venous super-drainage can improve flap survival not only because it prevents congestion, but also because it affects the dominant circulation in multi-territory thin skin flaps. We aimed to evaluate the survival of various flap areas and detect vascular changes in artery-based, four-territory skin flaps after different distal venous drainage procedures. METHODS: 4 x 12 cm sized flaps were elevated based only on the deep circumflex iliac artery. Fifty rats were divided into five groups, as follows: group 1, flaps drained with the deep circumflex iliac vein; group 2, flaps drained with the ipsilateral superficial inferior epigastric vein; group 3, flaps drained with the contralateral superficial inferior epigastric vein; group 4, flaps drained with the contralateral deep circumflex iliac vein; and group 5, flaps super-drained with the contralateral deep circumflex iliac vein...
September 13, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28929035/porcine-urinary-bladder-matrix-for-management-of-infected-radiation-mastectomy-wound
#10
Yana Puckett, Theophilus Pham, Shirley McReynolds, Catherine A Ronaghan
We present a case report on the successful healing of a Pseudomonas infection wound in a 52-year-old female with morbid obesity, noninsulin dependent diabetes mellitus and a history of tobacco use, who presented with Stage IIIA (T3, N2, Mo) infiltrating ductal carcinoma. The patient received neoadjuvant chemotherapy prior to her bilateral skin-sparing total mastectomies with right axillary sentinel lymphadenectomy. She also had staged reconstruction with temporary breast implants and plans for deep inferior epigastric perforator flaps...
July 10, 2017: Curēus
https://www.readbyqxmd.com/read/28917935/trends-in-post-mastectomy-breast-reconstruction-types-at-a-breast-cancer-tertiary-referral-centre-before-and-after-introduction-of-acellular-dermal-matrices
#11
Hadyn K N Kankam, George J M Hourston, Laura J Fopp, John R Benson, Sarah L Benyon, Michael S Irwin, Amit Agrawal, Parto Forouhi, Charles M Malata
BACKGROUND: Reconstructive breast surgery has continued to evolve over the last decade with a key change being the adoption of acellular dermal matrices (ADMs) as an adjunct for implant-based procedures. This retrospective observational study assesses the effect of ADMs on post-mastectomy reconstructive practice performed in a single institution. METHODS: We conducted a review of all patients undergoing breast reconstruction at a University Teaching Hospital for an 18-month period before and after adopting ADMs...
August 31, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28915211/minimally-invasive-laparoscopic-dissected-deep-inferior-epigastric-artery-perforator-flap-mild-diep-an-anatomic-feasibility-study-and-a-first-clinical-case
#12
Mikael Hivelin, Antoine Soprani, Nathaniel Schaffer, Stéphane Hans, Laurent Lantieri
The deep inferior epigastric perforator (DIEP) flap is a workhorse of breast reconstruction. Risks of herniation derive from violation of the rectus abdominis muscle anterior rectus sheath (ARS) and might be reduced by Minimally Invasive Laparoscopic Dissection (MILD) of the deep inferior epigastric vessels. We performed a feasibility study on five anatomical subjects and performed a secondary right breast reconstruction on a 67 year-old woman. A 30° laparoscope was used with laparoscopy ports inset to preserve the flap...
September 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28895195/estimation-of-diep-flap-weight-for-breast-reconstruction-by-the-pinch-test
#13
Kyong-Je Woo, Goo-Hyun Mun
BACKGROUND: Various methods have been introduced for estimating deep inferior epigastric artery perforator (DIEP) flap volume based on computed tomography or magnetic resonance angiographic images. However, when radiologic images cannot be obtained, estimations are subjective. The purpose of this study was to develop a prediction model for estimating DIEP flap weight using the pinch test. METHODS: The pinch test was performed at three paraumbilical sites using a skin-fold caliper in 107 consecutive patients who underwent DIEP flap breast reconstruction...
September 12, 2017: Microsurgery
https://www.readbyqxmd.com/read/28894652/double-pedicled-free-deep-inferior-epigastric-perforator-flap-for-the-coverage-of-thigh-soft-tissue-defect
#14
Olimpiu Bota, Nick Spindler, Jeannine Sauber, Emrah Aydogan, Stefan Langer
Soft-tissue defects caused by radiation injury are a challenging task for the reconstructive surgeon, due to the extent of the soft-tissue damage and the associated injuries of the local blood vessels and bone tissue. We present the application of the versatile deep inferior epigastric perforator (DIEP) flap for the coverage of an extended lateral thigh soft-tissue defect after the surgical resection of an undifferentiated pleomorphic high-grade sarcoma, neoadjuvant chemotherapy, and adjuvant chemo- and radiotherapy...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28867912/deep-inferior-epigastric-perforator-free-flaps-for-use-in-complicated-groin-wound-repair-a-case-report-of-severe-groin-scar-contracture-and-review-of-pedicled-and-free-flaps-in-groin-wound-repair
#15
James D Kotick, Roger S Sandelin, Richard D Klein
The use of pedicled and free flaps for tissue transfer and coverage has become a common practice in modern plastic surgery. An area that presents considerable challenge for tissue coverage is the groin. Defects in this area are complicated by issues such as prior surgery; scar contracture; extension of the defect beyond the borders of the groin; radiation damage; high probability of infection; and involvement of vital underlying structures, the genitalia, and perineal and perianal area. Therefore, the choice of donor site and flap usage is often difficult...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28867904/versatility-of-free-cutaneous-flaps-for-upper-extremity-soft-tissue-reconstruction
#16
REVIEW
Howard D Wang, Jose C Alonso-Escalante, Brian H Cho, Ramon A DeJesus
The goals of upper extremity soft tissue reconstruction should go well beyond providing coverage and restoring function. As the field of reconstructive microsurgery has evolved, free cutaneous flaps (FCFs) are gaining wider application. The advantages of FCF include minimizing donor-site morbidity by preserving the muscle and fascia, improving versatility of flap design, and superior aesthetic results. This review highlights the application of anterolateral thigh, superficial circumflex iliac artery, deep inferior epigastric perforator, superficial inferior epigastric artery, and flow-through flaps for reconstruction of upper extremity defects...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28861376/patient-determinants-as-independent-risk-factors-for-postoperative-complications-of-breast-reconstruction
#17
Andri Thorarinsson, Victoria Fröjd, Lars Kölby, Mattias Lidén, Anna Elander, Hans Mark
BACKGROUND: Breast reconstruction is an essential component in the treatment of breast cancer. Postoperative complications after breast reconstruction are common and affect patient satisfaction. Determining independent risk factors using patient characteristics could be advantageous for patient assessment and counseling. METHODS: We retrospectively enrolled 623 consecutive patients who underwent reconstruction with a deep inferior epigastric perforator flap (DIEP), latissimus dorsi flap (LD), lateral thoracodorsal flap (LTDF), or tissue expander with a secondary implant (EXP) in this study...
August 2017: Gland Surgery
https://www.readbyqxmd.com/read/28855683/tracheal-reconstruction-with-a-free-vascularized-myofascial-flap-preclinical-investigation-in-a-porcine-model-to-human-clinical-application
#18
Won Shik Kim, Jae Won Chang, Woo Soon Jang, Young Joon Seo, Mi-Lan Kang, Hak-Joon Sung, Da Hee Kim, Jung Min Kim, Jae Hong Park, Myung Jin Ban, Gina Na, Seung Ho Shin, Hyung Kwon Byeon, Yoon Woo Koh, Se-Heon Kim, Hong Koo Baik, Eun Chang Choi
Although there are various methods for tracheal reconstruction, such as a simple approximation with suturing and coverage with adjacent soft tissue or muscle, large defects >50% of the tracheal length still present a clinical challenge. Tissue engineering, a recent promising way to possibly resolve this problem, requires a long preparatory period for stem cell seeding on a scaffold and relatively invasive procedures for stem cell harvesting. As an alternative, we used a vascularized myofascial flap for tracheal reconstruction...
August 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28843036/breast-reconstruction-with-diep-and-siea-flaps-in-patients-with-prior-abdominal-liposuction
#19
Dmitry Zavlin, Kevin T Jubbal, Warren A Ellsworth, Aldona J Spiegel
INTRODUCTION: Suction-assisted lipectomy (SAL) has been considered a relative contraindication for autologous breast reconstruction due to reservations about size and integrity of perforator vessels. Such patients are often not considered ideal candidates for breast reconstruction utilizing deep inferior epigastric perforator (DIEP) and superficial inferior epigastric artery (SIEA) flaps. The aim of this article is to describe our experience with these flaps after SAL. METHODS: Retrospectively, patient charts from 2005 to 2015 were analyzed and 9 patients (13 flaps) were identified who received breast reconstruction after prior donor-site SAL...
August 26, 2017: Microsurgery
https://www.readbyqxmd.com/read/28831346/donor-site-morbidity-after-dieap-flap-breast-reconstruction-a-2-year-postoperative-computed-tomography-comparison
#20
Christoffer Aam Ingvaldsen, Gerhard Bosse, Georg Karl Mynarek, Thomas Berg, Tyge Tind Tindholdt, Kim Alexander Tønseth
The study was undertaken to provide a more complete picture of donor-site morbidity following the deep inferior epigastric artery perforator (DIEAP) flap harvest in breast reconstruction. Most studies evaluating this subject have been performed using ultrasonography. Computed tomography (CT) might provide valuable information. METHODS: In 14 patients who were reconstructed with a DIEAP flap, donor-site morbidity was assessed by comparing routine preoperative CT abdomen with CT abdomen performed 2 years postoperatively...
July 2017: Plastic and Reconstructive Surgery. Global Open
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