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Deep inferior epigastric

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https://www.readbyqxmd.com/read/29325422/outcomes-in-deep-inferior-epigastric-perforator-flap-and-implant-based-reconstruction-does-age-really-matter
#1
Lauren V Kuykendall, Angie Zhang, Bugra Tugertimur, Sara Bijan, Corin Agoris, Ambuj Kumar, Deniz Dayicioglu
Despite the growing elderly population, there is limited research specific to this demographic concerning breast reconstruction (BR). Lack of evidence-based BR recommendations in older populations may contribute to misconceptions and subsequent underutilization of BR, especially autologous BR. Patients who received either deep inferior epigastric perforator (DIEP) flap BR or tissue expander/implant (TE/I) BR by a single surgeon between July 2011 and July 2015 were surveyed postoperatively by using the psychometrically validated BREAST-Q questionnaire to determine patient satisfaction...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/29315799/preserving-a-patent-diep-pedicle-to-facilitate-salvage-breast-reconstruction-with-a-second-free-flap-a-case-report
#2
Dimitris Reissis, Daniel P Butler, Francis P Henry, Simon H Wood
Surgeons performing free flap breast reconstruction need to have a range of techniques in their armamentarium to successfully salvage cases of flap failure. We present a case of 47-year-old patient who suffered near-total right breast deep inferior epigastric perforator (DIEP) flap failure 3 days post-bilateral immediate breast reconstruction with DIEP flaps. At debridement, the DIEP pedicle was noted to be patent with preserved perfusion to a small segment of tissue around the origin of the pedicle. This tissue and the DIEP pedicle itself were therefore preserved to facilitate subsequent breast reconstruction using stacked transverse upper gracilis flaps anastomosed end-to-end to the original DIEP pedicle...
January 8, 2018: Microsurgery
https://www.readbyqxmd.com/read/29302499/erratum-to-comparative-study-of-software-techniques-for-3d-mapping-of-perforators-in-deep-inferior-epigastric-artery-perforator-flap-planning
#3
Michael P Chae, David J Hunter-Smith, Warren Matthew Rozen
[This corrects the article on p. 99 in vol. 5, PMID: 27047778.].
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29302489/enhancing-breast-projection-in-autologous-reconstruction-using-the-st-andrew-s-coning-technique-and-3d-volumetric-analysis
#4
Michael P Chae, Warren Matthew Rozen, Nakul Gamanlal Patel, David J Hunter-Smith, Venkat Ramakrishnan
Background: An increasing number of women undergo mastectomy for breast cancer and post-mastectomy autologous breast reconstruction has been shown to significantly improve the psychosexual wellbeing of the patients. A goal of treatment is to achieve symmetry and projection to match the native breast, and/or the contralateral breast in the case of a unilateral reconstruction. Autologous reconstruction, particularly with the deep inferior epigastric artery perforator (DIEP) flap, is particularly advantageous as it can be manipulated to mimic the shape and turgor of the native breast...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29302477/concordance-between-preoperative-computed-tomography-angiographic-mapping-and-intraoperative-perforator-selection-for-deep-inferior-epigastric-artery-perforator-flap-breast-reconstructions
#5
Vivian B Boer, Jan J van Wingerden, Carolien F Wever, Joost J Kardux, Michiel R Beets, Hester J van der Zaag-Loonen, Willem J Theuvenet
Background: Preoperative imaging for perforator identification prior to a deep inferior epigastric artery perforator (DIEP) flap elevation for breast reconstruction has many advantages. Currently, computed tomography (CT) angiography provides good visualization of the perforators and their course, and is thus the imaging technique of choice. The primary aim of this study was to determine the concordance between the perforators identified preoperatively and the perforators ultimately selected intraoperatively, with a standardized protocol, in a single institution...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29285789/intraoperative-objective-evaluation-of-venous-congestion-in-deep-epigastric-artery-perforator-flap-breast-reconstruction-a-pilot-study
#6
Shinsuke Akita, Yoshihisa Yamaji, Hideki Tokumoto, Yoshitaro Sasahara, Takafumi Tezuka, Yoshitaka Kubota, Motone Kuriyama, Nobuyuki Mitsukawa
BACKGROUND: In a deep epigastric artery perforator (DIEP) flap breast reconstruction, the necessity of additional anastomosis of the superficial inferior epigastric vein (SIEV) should be determined intraoperatively. The purpose of this pilot study is to propose a method to detect venous congestion intraoperatively using the blood glucose measurement index (BGMI). METHODS: In 70 DIEP flaps of 67 patients for breast reconstruction, the ratio of blood glucose content in the flap to systemic blood glucose (BGMI) was measured immediately after wound closure...
December 29, 2017: Microsurgery
https://www.readbyqxmd.com/read/29232006/reconstruction-of-a-large-full-thickness-abdominal-wall-defect-with-flow-through-based-alt-flaps-a-case-report
#7
Dong Yeon Kim, Junho Lee, Jeong Tae Kim, Hye Kyung Chang, Suk-Ho Moon
An extensive 35 × 20 cm sized full-thickness abdominal wall defect was created after resection of aggressive abdominal fibromatosis in a 19-year-old male patient. Immediate reconstruction was not possible due to prolonged operation time and resulting severe bowel edema. A silicone sheet with NPWT was applied over the exposed viscera. After 1 week, silicone sheet was substituted with a composite mesh. Then, abdominal wall reconstruction with bilateral free anterolateral thigh (ALT) flaps (30 × 12 cm and 25 × 12 cm sized) was performed...
December 12, 2017: Microsurgery
https://www.readbyqxmd.com/read/29227815/meta-analysis-of-flap-perfusion-and-donor-site-complications-for-breast-reconstruction-using-pedicled-versus-free-tram-and-diep-flaps
#8
REVIEW
Woonhyeok Jeong, Seongwon Lee, Junhyung Kim
OBJECTIVES: The transverse rectus abdominis musculocutaneous (TRAM) flap is an important option for breast reconstruction. Several studies have recently evaluated whether a greater number of complications result from the use of pedicled TRAM (pTRAM) flaps versus either free TRAM (fTRAM) flaps or deep inferior epigastric artery perforator (DIEP) flaps. To clarify the evidence regarding this issue, we performed an objective meta-analysis of published studies. MATERIALS AND METHODS: A literature search of articles published between January 1, 1990, to January 1, 2017 was performed using the PubMed, EMBASE, Scopus, and Cochrane databases...
December 8, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29221853/venous-thromboembolism-events-after-breast-reconstructions-with-diep-free-flaps-in-192-consecutive-case
#9
A Modarressi, A-V Schettini, E M Rüegg, B Pittet-Cuénod
BACKGROUND: Patient candidates for breast reconstruction with free deep inferior epigastric perforator flap (DIEP) may present several risk factors for venous thromboembolism (VTE). Risk identification is essential for appropriate VTE prophylaxis measures to be put in place. This study aims to investigate VTE incidence after DIEP flap breast reconstruction and to assess the accuracy of the Caprini Risk Assessment Model (RAM), which is the unique score validated to assess the VTE risk for plastic surgery procedures and identify patients at high VTE risk...
December 5, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29199268/a-rare-case-of-giant-basal-cell-carcinoma-of-the-abdominal-wall-excision-and-immediate-reconstruction-with-a-pedicled-deep-inferior-epigastric-artery-perforator-diep-flap
#10
Sara Di Lorenzo, Giovanni Zabbia, Bartolo Corradino, Massimiliano Tripoli, Roberto Pirrello, Adriana Cordova
BACKGROUND Basal cell carcinoma (BCC) greater than 5 cm in diameter is called giant basal cell carcinoma (GBCC), or super giant basal cell carcinoma if it has a diameter larger than 20 cm. Giant BCC only accounts for 0.5% of BCCs and super giant BCC is exceedingly rare. On account of their rarity, there are no established guidelines for GBCC treatment. CASE REPORT We describe a peculiar case of an 82-year-old woman with a GBCC carcinoma of the lower abdominal wall. The tumor was surgically removed with ipsilateral inguinal lymph nodes and the abdominal wall was reconstructed immediately with a pedicled deep inferior epigastric artery perforator (DIEP) flap...
December 4, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29193255/evaluation-of-the-single-medial-circummuscular-perforator-diep-flap-outcomes-and-comparison-to-traditional-transmuscular-single-perforator-flap
#11
Jessica F Rose, Dmitry Zavlin, Amanda E Garrett, Vishwanath Chegireddy, Warren A Ellsworth
INTRODUCTION: Successful breast reconstruction using deep inferior epigastric perforator (DIEP) flaps depends on optimal perforator choice. Circummuscular wraparound medial perforators allow for no rectus dissection and minimal fascial incisions, often presenting as an ideal option. The aim of our study is to evaluate outcomes of the single medial wraparound perforator flap in comparison to more traditional transmuscular single-perforator DIEP flaps. PATIENTS AND METHODS: A retrospective chart review was conducted of all DIEP flaps performed by the senior author from 2011 to 2016, yielding 269 flaps on 157 patients...
November 29, 2017: Microsurgery
https://www.readbyqxmd.com/read/29184749/pedicle-to-perforator-bypass-using-supermicrosurgical-technique-for-deep-inferior-epigastric-artery-perforator-flap-salvage
#12
Michael V DeFazio, Olivia A Abbate, Chrisovalantis Lakhiani, David H Song
No abstract text is available yet for this article.
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29184728/diep-flap-breast-reconstruction-in-patients-with-breast-ptosis-2-stage-reconstruction-using-3-dimensional-surface-imaging-and-a-printed-mold
#13
Koichi Tomita, Kenji Yano, Mifue Taminato, Michiko Nomori, Ko Hosokawa
Background: Autologous breast reconstruction can be performed for breasts with ptosis to a certain extent, but if patients desire to correct ptosis, mastopexy of the contralateral breast is indicated. However, accurate prediction of post-mastopexy breast shape is difficult to make, and symmetrical breast reconstruction requires certain experience. We have previously reported the use of three-dimensional (3D) imaging and printing technologies in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29178203/the-anatomy-of-the-musculocutaneous-latissimus-dorsi-flap-for-neophalloplasty
#14
M Dennis, A Granger, A Ortiz, M Terrell, M Loukos, J Schober
INTRODUCTION: In transgender surgery, the ideal neophallus is one that: (a) is constructed using a reproducible procedure, (b) possesses tactile and erogenous sensation, (c) is large and rigid enough (naturally, or using a prosthesis) to permit penetrative intercourse, (d) leaves acceptable donor site morbidity, (e) results in esthetically satisfactory appearance, and (f) allows for voiding while standing. The musculocutaneous latissimus dorsi (MLD) flap has favorable results in the area of neophalloplasty...
November 27, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/29176414/prospective-double-blind-evaluation-of-umbilicoplasty-techniques-using-conventional-and-crowdsourcing-methods
#15
RANDOMIZED CONTROLLED TRIAL
Charlotte L van Veldhuisen, Parisa Kamali, Winona Wu, Babette E Becherer, Hani H Sinno, Azra A Ashraf, Ahmed M S Ibrahim, Adam Tobias, Bernard T Lee, Samuel J Lin
BACKGROUND: Umbilical reconstruction is an important component of deep inferior epigastric perforator (DIEP) flap breast reconstruction. This study evaluated the aesthetics of three different umbilical reconstruction techniques during DIEP flap breast reconstruction. METHODS: From January to April of 2013, a total of 29 consecutive patients undergoing DIEP flap breast reconstruction were randomized intraoperatively to receive one of three umbilicoplasty types: a diamond, an oval, or an inverted V incision...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29166926/protocol-for-a-systematic-review-and-meta-analysis-on-the-clinical-outcomes-and-cost-of-deep-inferior-epigastric-perforator-diep-flap-versus-implants-for-breast-reconstruction
#16
Ankur Khajuria, Oliver J Smith, Maxim Prokopenko, Maximillian Greenfield, Afshin Mosahebi
BACKGROUND: Mastectomy in the context of breast malignancy can have a profoundly negative impact on a woman's self-image, impairing personal, sexual and social relationships. The deep inferior epigastric perforator (DIEP) flap and implants are the two commonest reconstructive modalities that can potentially overcome this psychological trauma. The comparative data on clinical outcomes and costs of the two modalities is limited. We aim to synthesise the current evidence on DIEP versus implants to establish which is the superior technique for breast reconstruction, in terms of clinical outcomes and cost-effectiveness...
November 22, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29131393/flap-monitoring-with-continuous-oxygen-partial-tension-measurement-in-breast-reconstructive-surgery-a-preliminary-report
#17
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
#18
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
#19
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
#20
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
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