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Deep inferior epigastric

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https://www.readbyqxmd.com/read/27906762/complications-in-postmastectomy-breast-reconstruction-one-year-outcomes-of-the-mastectomy-reconstruction-outcomes-consortium-mroc-study
#1
Edwin G Wilkins, Jennifer B Hamill, Hyungjin M Kim, John Y Kim, Richard J Greco, Ji Qi, Andrea L Pusic
OBJECTIVE: In postmastectomy reconstruction, procedure choice is heavily influenced by the relative risks of the various options. This study sought to evaluate complications in a large, multicenter patient population. SUMMARY OF BACKGROUND DATA: Previous studies have reported widely varying complication rates, but have been limited by their single center designs and inadequate controlling for confounders in their analyses. METHODS: Eleven sites enrolled women undergoing first time, immediate, or delayed reconstruction following mastectomy for cancer treatment or prophylaxis...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27894571/pre-expanded-deep-inferior-epigastric-perforator-flap
#2
REVIEW
Sharon E Monsivais, Nicholas D Webster, Stacy Wong, Michel H Saint-Cyr
The deep inferior epigastric perforator (DIEP) flap can be used to cover large defects of the proximal lower extremity, abdominal wall, perineum, vulva, and buttock. Pre-expanding DIEP flaps cause a possible delay phenomenon improving vascularity, decrease donor site morbidity, and increase the area that can be covered. Pre-expansion requires staged procedures, has risk of extrusion and infection, causes temporary contour deformity during the expansion process, and requires a longer course. Pre-expanded DIEP flaps can be a useful flap with proper patient selection and planning...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894155/increased-lower-extremity-venous-stasis-may-contribute-to-deep-venous-thrombosis-formation-after-microsurgical-breast-reconstruction-an-ultrasonographic-study
#3
Arash Momeni, Michael G Tecce, Michael A Lanni, Shagun Aggarwal, Christopher Pannucci, Stephen J Kovach, Suhail K Kanchwala, Liza C Wu, Joseph M Serletti
Background Despite guideline-compliant prophylaxis, an increased rate of deep venous thrombosis (DVT) formation has been reported following autologous versus implant-based breast reconstruction. We hypothesized that tight abdominal fascia closure might decrease lower extremity venous return and promote venous stasis. Methods An observational crossover study of patients who underwent autologous breast reconstruction using transverse rectus abdominis musculocutaneous/deep inferior epigastric artery perforator flaps was conducted...
November 28, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27887016/inferior-vena-caval-filter-strut-perforation-causing-intramural-duodenal-haematoma
#4
Zoheb Berry Williams, Nicole M Organ, Stephen Deane
We present a case of intramural duodenal haematoma caused by inferior vena caval (IVC) filter strut perforation requiring innovative open and endovascular retrieval. A 32-year-old woman presents in shock with dull epigastric pain and non-bilious vomiting. She had previously had an IVC filter for deep venous thrombosis and pulmonary embolism. Computed tomography demonstrated strut perforation into the second part of the duodenum, causing intramural haematoma and duodenal obstruction. Laparotomy facilitated evacuation of the duodenal haematoma, while the IVC filter was retrieved by endovascular means...
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27885675/intratissue-lymphovenous-communications-in-the-mechanism-of-action-of-vascularized-lymph-node-transfer
#5
María Miranda Garcés, Gemma Pons, Rosa Mirapeix, Jaume Masià
BACKGROUND AND OBJECTIVES: Vascularized lymph node transfer (VLNT) as a surgical treatment for cancer-related lymphedema has shown beneficial effects. The mechanism of action of this procedure involves lymphangiogenesis and lymphovenous communications (LVC) within the lymph nodes. We propose intratissue LVC as an additional element responsible for drainage of lymph to blood in the flap and examine this hypothesis in the current study. METHODS: This prospective study determined the passage of lymph to the venous system via intratissue LVC in 26 free flaps used for breast reconstruction...
November 25, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27798424/considering-the-optimal-timing-of-breast-reconstruction-with-abdominal-flaps-with-adjuvant-irradiation-in-370-consecutive-pedicled-transverse-rectus-abdominis-myocutaneous-flap-and-free-deep-inferior-epigastric-perforator-flap-performed-in-a-chinese-oncology
#6
Shanshan He, Jian Yin, Geoffrey L Robb, Jingyan Sun, Xuehui Zhang, Haixin Li, Jing Liu, Chunyong Han
PURPOSE: There is an ongoing debate on the optimal sequence of radiation and breast reconstruction. The purpose of this article was to (a) assess the impact of radiation on autologous breast reconstruction and (b) analyze the best timing for autologous breast reconstruction in the setting of radiation in a Chinese population. METHODS: A retrospective review of patients undergoing breast reconstruction with autologous lower abdominal flaps between 2001 and 2014 in the Tianjin Medical University and Cancer Hospital was performed...
October 28, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27782983/techniques-and-perforator-selection-in-single-dominant-diep-flap-breast-reconstruction-algorithmic-approach-to-maximize-efficiency-and-safety
#7
Anita T Mohan, Lin Zhu, Zhen Wang, Aparna Vijayasekaran, Michel Saint-Cyr
BACKGROUND: Perforator selection is critical to deep inferior epigastric perforator (DIEP) flap harvest. Commitment to a single perforator has the potential benefit of a simpler dissection, but may increase fat necrosis or perfusion-related complications compared with multiple perforator harvest. METHODS: A 3-year retrospective study was carried out of all patients who underwent DIEP flap breast reconstruction performed by the senior author (M.S.-C). Data were collected on patient demographics and surgical outcomes...
November 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27780514/a-totally-laparoscopic-peritoneal-free-flap-for-reconstruction-of-hand
#8
En-Qi Guo, Qing-Ping Xie
Management of defects on the hand and foot with exposed tendons remains a major challenge for plastic surgeons. Here, we present a case of hand reconstruction with a totally laparoscopic peritoneal flap. The anterior rectus sheath was preserved in situ. The peritoneal free flap supplied by peritoneal branches of the deep inferior epigastric artery was retrieved by laparoscopy to cover the soft tissue defect of the hand. The defect of the dorsal hand was 17 cm ×12 cm. The peritoneal flap measuring 22 cm × 15 cm survived completely without any complications...
October 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27770240/does-the-internal-inguinal-ring-need-closure-during-laparoscopic-orchiopexy-with-prentiss-manoeuvre
#9
Sarath Kumar Narayanan, Jagadeesh N Puthenvariath, Prathap Somnath, Arun Mohanan
BACKGROUND: Undescended testis is a common problem, which is prevalent in 3 % of male infants. This study aimed to determine the effect of leaving the deep inguinal ring (DIR) without closure during laparoscopic orchiopexy (LO), with regard to post-operative hernia formation and other outcomes. METHODS: From 2012 to 2014, 63 testicular units were managed with laparoscopy for non-palpable testis (NPT). Diagnostic laparoscopy was performed for all NPTs, and when they were intra-abdominal (42 testicular units), the DIR was left open after mobilization of the testis into the scrotum medial to the inferior epigastric vessels (Prentiss manoeuvre)...
October 21, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27740955/women-s-experiences-with-flap-failure-after-autologous-breast-reconstruction-a-qualitative-analysis
#10
Kristen S Higgins, Joshua Gillis, Jason G Williams, Martin LeBlanc, Michael Bezuhly, Jill M Chorney
Clinical experience suggests that flap failure after autologous breast reconstruction can be a devastating experience for women. Previous research has examined women's experiences with autologous breast reconstruction with and without complications, and patients' experiences with suboptimal outcomes from other medical procedures. The authors aimed to examine the psychosocial experience of flap failure from the patient's perspective. Seven women who had experienced unilateral flap failure after deep inferior epigastric perforator flap surgery in the past 12 years completed semistructured interviews about their breast cancer treatments, their experiences with flap failure, the impact of flap failure on their lives, and the coping strategies they used...
October 6, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27695868/surgical-treatment-of-pyoderma-gangrenosum-following-deep-inferior-epigastric-perforator-flap-breast-reconstruction
#11
Funda Tamer, Esra Adışen, Serhan Tuncer, Mehmet A Gurer
Pyoderma gangrenosum is a chronic inflammatory disease characterized by painful cutaneous ulcers. The etiology remains unknown; however, pyoderma gangrenousm can be triggered by surgery. Here we report the case of a 34-year-old Caucasian female that developed pyoderma gangrenosum following deep inferior epigastric perforator flap breast reconstruction. The patient was successfully treated with systemic immunosuppressive therapy and primary closure.
September 2016: Acta Dermatovenerologica Alpina, Panonica, et Adriatica
https://www.readbyqxmd.com/read/27689060/acute-febrile-neutrophilic-dermatosis-after-deep-inferior-epigastric-perforator-flap-breast-reconstruction
#12
Michael W Chu, Julia A Cook, Alexes Hazen
No abstract text is available yet for this article.
September 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27651974/successful-deep-inferior-epigastric-perforator-flap-harvest-despite-preoperative-therapeutic-subcutaneous-heparin-administration-into-the-abdominal-pannus
#13
Joseph W Duncumb, Kana Miyagi, Parto Forouhi, Charles M Malata
Abdominal free flaps for microsurgical breast reconstruction are most commonly harvested based on the deep inferior epigastric vessels that supply skin and fat via perforators through the rectus muscle and sheath. Intact perforator anatomy and connections are vital for subsequent optimal flap perfusion and avoidance of necrosis, be it partial or total. The intraflap vessels are delicate and easily damaged and it is generally advised that patients should avoid heparin injection into the abdominal pannus preoperatively as this may compromise the vascular perforators through direct needle laceration, pressure from bruising, haematoma formation, or perforator thrombosis secondary to external compression...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27622090/predictors-of-reoperations-in-deep-inferior-epigastric-perforator-flap-breast-reconstruction
#14
Dmytro Unukovych, Camilo Hernandez Gallego, Helena Aineskog, Andres Rodriguez-Lorenzo, Maria Mani
BACKGROUND: The deep inferior epigastric perforator (DIEP) procedure is regarded a safe option for autologous breast reconstruction. Reoperations, however, may occur, and there is no consensus in the literature regarding the risk factors. The aim of this study was to identify factors associated with reoperations in DIEP procedure. PATIENTS AND METHODS: A retrospective study of consecutive patients undergoing DIEP breast reconstruction 2007 to 2014 was performed and included a review of 433 medical charts...
August 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27595188/reducing-postoperative-abdominal-bulge-following-deep-inferior-epigastric-perforator-flap-breast-reconstruction-with-onlay-monofilament-poly-4-hydroxybutyrate-biosynthetic-mesh
#15
Blair A Wormer, Nicholas W Clavin, Jean-Francois Lefaivre, Jason M Korn, Edward Teng, Anthony S Aukskalnis, J Michael Robinson
Background The purpose of this study was to evaluate the use of a biosynthetic mesh onlay on reducing postoperative abdominal bulge following deep inferior epigastric perforator (DIEP) flap breast reconstruction. Methods All patients undergoing DIEP reconstructions from January, 2010 to January, 2014 at a tertiary center were reviewed. Patients were divided into two groups for comparison based on whether a biosynthetic mesh onlay (Phasix [monofilament poly-4-hydroxybutyrate], Bard Inc., Warwick, RI) was used for reinforcement of the anterior rectus fascia...
September 5, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27579248/diep-flap-for-breast-reconstruction-using-epidural-anesthesia-with-the-patient-awake
#16
Miguel de la Parra, Marco Camacho, Jonatan de la Garza
BACKGROUND: Many articles have been published about breast reconstruction using the deep inferior epigastric perforator (DIEP) flap; however, few articles have been published in plastic/reconstructive surgery journals describing the difference between anesthetic techniques and recovery in microsurgical patients. METHODS: We analyzed 16 patients who underwent DIEP flap for breast reconstruction. Patients were divided into 2 groups: group 1: general anesthesia (n = 9); group 2: epidural block with the patient awake (n = 7)...
May 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27577517/utility-of-dual-energy-spectral-ct-and-low-iodine-contrast-medium-in-diep-angiography
#17
Zhipeng Gao, Donghua Meng, Hong Lu, Bingyu Yao, Ning Huang, Zhaoxiang Ye
OBJECTIVE: To evaluate the utility of dual-energy spectral computed tomography (CT) and low-iodine intake in CT angiography (CTA) of deep inferior epigastric perforator (DIEP) flaps. METHODS: In this prospective study, 40 patients with a BMI <28.0 kg/m(2) underwent CTA examination for breast reconstruction and were randomly assigned into two groups (n=20 for each group) as follows: Group A was submitted to dual-energy spectral CT and iodixanol (270 mg I/mL) and Group B was submitted to conventional high iodine contrast agent iohexol (350 mg I/mL)...
September 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/27556615/computed-tomographic-angiography-based-planning-of-bipedicled-diep-flaps-with-intraflap-crossover-anastomosis-an-anatomical-and-clinical-study
#18
So Young Kim, Kyeong-Tae Lee, Goo-Hyun Mun
BACKGROUND: When using deep inferior epigastric artery perforator (DIEP) flaps in breast reconstruction, harvesting bipedicled flaps can be a valuable option in cases requiring the transfer of a large portion of harvested flaps. Connecting the bilateral deep inferior epigastric arteries (DIEAs) by intraflap crossover anastomosis is one of the most popular methods of constructing bipedicled DIEP flaps. Planning the primary and secondary pedicle configurations for reliable intraflap crossover anastomosis is crucial...
September 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27556613/the-telemark-breast-score-a-reliable-method-for-the-evaluation-of-results-after-breast-surgery
#19
Anadi Begic, Birgit Stark
BACKGROUND: Validated instruments for assessing results after breast surgery are sparse. The authors present here a method used for the past 10 years at their institution for evaluation of outcome after breast-conserving surgery and microsurgical breast reconstruction. METHODS: The Telemark Breast Score is a method based on standard two-dimensional photographs assessing the outcome after breast surgery in terms of volume, shape, and symmetry. Three panels comprising two plastic surgeons, two breast surgeons, and two nurses tested the Telemark Breast Score on 346 patients who underwent breast-conserving surgery for cancer and 31 other patients who underwent deep inferior epigastric perforator flap reconstruction...
September 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27550406/surgical-therapy-of-vulvar-cancer-how-to-choose-the-correct-reconstruction
#20
Stefano Gentileschi, Maria Servillo, Giorgia Garganese, Simona Fragomeni, Francesca De Bonis, Giovanni Scambia, Marzia Salgarello
OBJECTIVE: To create a comprehensive algorithmic approach to reconstruction after vulvar cancer ablative surgery, which includes both traditional and perforator flaps, evaluating anatomical subunits and shape of the defect. METHODS: We retrospectively reviewed 80 cases of reconstruction after vulvar cancer ablative surgery, performed between June 2006 and January 2016, transferring 101 flaps. We registered the possibility to achieve the complete wound closure, even in presence of very complex defects, and the postoperative complications...
November 2016: Journal of Gynecologic Oncology
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