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Deep inferior epigastric

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https://www.readbyqxmd.com/read/28806290/-clinical-and-quantitative-isokinetic-comparison-of-abdominal-morbidity-and-dynamics-following-diep-versus-muscle-sparing-free-tram-flap-breast-reconstruction
#1
Hirokazu Uda, Hideaki Kamochi, Syunji Sarukawa, Ataru Sunaga, Yasusih Sugawara, Kotaro Yoshimura
BACKGROUND: The deep inferior epigastric perforator (DIEP) flap, which is a modification of the muscle-sparing free transverse rectus abdominis musculocutaneous (msTRAM) flap, is being more frequently used in an effort to reduce postoperative abdominal morbidity. However, there is no consensus as to which of these flaps is superior. We aimed to compare quantitative measurements of abdominal function obtained with an isokinetic dynamometer after DIEP and msTRAM flap elevation. METHODS: Patients who underwent unilateral single-pedicled DIEP (n = 42) or msTRAM flap (n = 36) breast reconstruction performed by a single surgeon were included in this study...
August 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28762169/successful-surgical-treatment-of-intractable-chylous-ascites-using-the-lymphatic-cable-flap-a-retrospective-review-study
#2
Shih-Heng Chen, Li-Fan Yeh, Pedro Ciudad, Hung-Chi Chen
OBJECTIVE: For evaluation of a novel surgical procedure for the treatment of chylous ascites. Chylous ascites is a debilitating condition associated with high morbidity and mortality rates. At least one-third of patients are refractory to medical therapy and may warrant further treatment. Traditional methods involving ligation of lymphatic fistulas or small bowel resection do not address the basic pathophysiologic mechanism of the underlying obstruction, and identification of chyloperitoneal fistulas may be challenging...
July 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28760638/the-impact-of-autologous-breast-reconstruction-using-diep-flap-on-the-oncologic-efficacy-of-radiation-therapy
#3
C Maalouf, J Bou-Merhi, E Karam, E Patocskai, A M Danino
INTRODUCTION: In the management of breast cancer radiation therapy plays a substantive role in decreasing local recurrence and increasing overall survival. Still, there exists controversy concerning compromised radiation delivery plans and suboptimal delivery after immediate autologous breast reconstruction. Our study aims to assess the oncologic safety of immediate breast reconstruction (IBR) with a Deep inferior epigastric perforator flap (DIEP), in the setting of adjuvant radiation therapy...
July 28, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28758229/time-dependent-factors-in-diep-flap-breast-reconstruction
#4
Rosaria Laporta, Benedetto Longo, Michail Sorotos, Alessio Farcomeni, Vittoria Amorosi, Fabio Santanelli di Pompeo
BACKGROUND: The process of harvesting and performing microsurgical anastomosis may lengthen deep inferior epigastric artery perforator (DIEP) flap breast reconstruction affecting results and patient safety. The aim of the study was to investigate the associations between predictors and operative time (OT). METHODS: Between 2004 and 2016, 336 immediate and 68 delayed unilateral reconstructions were performed in 404 patients. Age, weight, height, body mass index (BMI), nulliparity, or pluriparity condition were collected to determine the impact of patient characteristics on OT...
July 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28746268/101-consecutive-profunda-artery-perforator-flaps-in-breast-reconstruction-lessons-learned-with-our-early-experience
#5
Nicholas T Haddock, Andrew Gassman, Min-Jeong Cho, Sumeet S Teotia
BACKGROUND: Free and local flaps based on the profunda artery perforators were first used for reconstruction of pressure sores, burn contractures, and extremity wounds. Recently, a revised profunda artery perforator flap was introduced for breast reconstruction. However, despite increasing reports of the use of the flap, it remains a rarely used option. The authors present their early experience with the first 101 profunda artery perforator flaps used for breast reconstruction at their institution...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28740779/using-the-venous-pectoral-branch-from-the-thoracoacromial-system-as-a-lifeboat-in-autologous-breast-reconstruction
#6
Michael Tarakji, Matthew J Bartow, Charles Dupin, Oren Tessler
The most common recipient vessels for autologous free flap breast reconstruction are the internal mammary vessels. At times, there are problems with the exposed internal mammary vein (IMV) that require other options such as using the contralateral IMV, superior rib resection to access proximal IMV, retrograde IMV use, and thoracodorsal vein access with or without a vein graft. This case demonstrates using the pectoral branch of the thoracoacromial venous system without a vein graft as a lifeboat option when the IMV is not suitable for anastomosis...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740774/unilateral-internal-mammary-recipient-vessels-for-bilateral-diep-flap-breast-reconstruction
#7
Jeffrey H Lee, David E Varon, Eric G Halvorson
The deep inferior epigastric perforator flap has become increasingly popular for breast reconstruction with the most common recipient vessels being the internal mammary artery and vein. In certain cases, however, these recipient vessels are inadequate due to an absent or diminutive vein. Moreover, patients at high risk for future coronary artery disease may sacrifice the best conduit for coronary revascularization if the internal mammary recipients are used. Alternative recipient vessels, including the thoracodorsal, thoracoacromial, external jugular, and cephalic vessels have significant limitations...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740762/long-term-health-related-quality-of-life-after-breast-reconstruction-comparing-4-different-methods-of-reconstruction
#8
Andri Thorarinsson, Victoria Fröjd, Lars Kölby, Johan Ljungdal, Charles Taft, Hans Mark
BACKGROUND: Studies have confirmed that breast reconstruction is beneficial to improve health-related quality of life (HR-QoL) in breast cancer patients. Our aim was to compare 4 different methods of breast reconstruction on patient satisfaction and HR-QoL using both general and specific patient-reported outcome instruments. METHODS: Retrospectively, 459 patients who underwent breast reconstruction with a deep inferior epigastric artery perforator (DIEP) flap, latissimus dorsi flap, lateral thoracodorsal flap, or expander with secondary implant and who had responded to the questionnaires were enrolled...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28716501/high-incidence-of-recess-formation-at-myopectineal-orifice-during-laparoscopic-surgery
#9
Yuka Mine, Fumihiko Fujita, Hiroko Kinoe, Yousuke Inoue, Kosyo Yamanouchi, Kengo Kanetaka, Kazuma Kobayashi, Mitsuhisa Takatsuki, Susumu Eguchi
BACKGROUND: Groin hernias are frequently seen in clinical practice. The purpose of this study was to determine the rate of patients who might have latent groin hernia. METHODS: During laparoscopic abdominal surgery, we observed the area around the groin lesion and attempted to evaluate the degree of recess at myopectineal orifice. The classification defining the recess was as follows: Grade 0: no recess, Grade I: slight recess with a visible bottom, Grade II: deep recess with an invisible bottom, Grade III: other organ invaginated into the recess, and Grade IV: confirmed bulging on the body surface...
July 14, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28713703/comparative-perfusion-analysis-of-free-muscle-sparing-versus-pedicle-transverse-rectus-abdominis-myocutaneous-tram-flaps-in-vivo-in-the-peri-operative-and-late-post-operative-periods
#10
Richard McNally, Jonathan Rimler, Vincent Laurence, Keyianoosh Z Paydar, Garrett A Wirth
BACKGROUND: Current teaching suggests increased perfusion in free transverse rectus abdominis myocutaneous (TRAM) flaps over pedicled TRAM flaps, broadening indications for its use in high risk patients. This study compared perfusion analysis of free muscle-sparing versus pedicle TRAM flaps in vivo in the peri-operative and late post-operative periods. METHODS: The SPY-Elite system using indocyanine green dye was used to analyze flap perfusion intra-operatively and at 1 week and 3 months post-operatively...
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28703885/use-of-a-72-cm-long-extended-bilateral-deep-inferior-epigastric-artery-perforator-free-flap-for-reconstruction-of-a-lower-leg-with-no-suitable-recipient-vessel-around-the-injury-zone-a-case-report
#11
Hidehiko Yoshimatsu, Takumi Yamamoto, Akitatsu Hayashi, Takuya Iida
In free-flap reconstruction of the lower extremity, due either to trauma or pre-existing vascular disease, healthy vessels may not be readily available in the proximity of the defect. A variety of options including a cross-leg free flap, vein grafts, arteriovenous loops, and "bridging" flaps have been used to address the issue. The purpose of this report is to present a case in which a 72-cm long extended bilateral deep inferior epigastric artery perforator (DIEP) free flap was used for coverage of a 20 × 25 cm soft tissue defect of the lower leg following a Gustilo grade IIIC fracture in a 29-year-old man...
July 13, 2017: Microsurgery
https://www.readbyqxmd.com/read/28688657/umbilical-necrosis-rates-after-abdominal-based-microsurgical-breast-reconstruction
#12
Joseph A Ricci, Parisa Kamali, Babette E Becherer, Daniel Curiel, Winona Wu, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: Umbilical stalk necrosis represents a rare, yet important complication after abdominal-based microsurgical breast reconstruction, which is both underrecognized and understudied in the literature. Once identified, umbilical reconstruction can be an extremely challenging problem. METHODS: All consecutive breast free flaps at a single institution from February 2004 to February 2016 were reviewed, excluding non-abdominal-based flaps. Patients were divided based on the development of umbilical necrosis postoperatively...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28654605/selective-intraoperative-vasopressor-use-is-not-associated-with-increased-risk-of-diep-flap-complications
#13
Ashley Szabo Eltorai, Chuan-Chin Huang, Jeffrey T Lu, Asako Ogura, Stephanie A Caterson, Dennis P Orgill
BACKGROUND: During deep inferior epigastric perforator (DIEP) flap cases, anesthesiologists commonly avoid intravenous vasopressor administration because of the theoretical concern of inducing vasospasm, thrombosis, or congestion in the vessels of the anastomosis, potentially resulting in poor flap perfusion and ischemia and necessitating revision. In the setting of hypotension, however, vasopressor administration may actually improve outcomes by augmenting flap perfusion by means of increased mean arterial pressure...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28654582/predictors-classification-and-management-of-umbilical-complications-in-diep-flap-breast-reconstruction
#14
Min-Jeong Cho, Sumeet S Teotia, Nicholas T Haddock
BACKGROUND: In recent years, the deep inferior epigastric perforator (DIEP) flap has become the workhorse flap for autologous breast reconstruction. Despite increased reports on DIEP flaps, umbilical complications have not been previously studied. The aesthetics of the umbilicus dictates the beauty of the abdomen, and it is critical for plastic surgeons to minimize the scarring of the umbilicus. In this study, we retrospectively reviewed patients who underwent DIEP flaps to determine the predictors of umbilical complications, and created a classification system of these wounds...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28615810/computed-tomography-angiographic-study-of-internal-mammary-perforators-and-their-use-as-recipient-vessels-for-free-tissue-transfer-in-breast-reconstruction
#15
Aditya V Kanoi, Karnav B Panchal, Saugata Sen, Gautam Biswas
CONTEXT: The internal mammary artery perforator vessels (IMPV) as a recipient in free flap breast reconstruction offer advantages over the more commonly used thoracodorsal vessels and the internal mammary vessels (IMV). AIMS: This study was designed to assess the anatomical consistency of the IMPV and the suitability of these vessels for use as recipients in free flap breast reconstruction. PATIENTS AND METHODS: Data from ten randomly selected female patients who did not have any chest wall or breast pathology but had undergone a computed tomography angiography (CTA) for unrelated diagnostic reasons from April 2013 to October 2013 were analysed...
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28607844/perforator-flaps-covering-alloplastic-materials-in-full-thickness-chest-wall-defects-reconstruction-a-safe-option
#16
Cristina Aubá, Álvaro Cabello, Emilio García-Tutor, Antonio Vila, Shan Shan Qiu, Wenceslao Torre
Large full-thickness chest wall reconstruction requires an alloplastic material to ensure chest wall stability, as well as a flap that provides good soft-tissue coverage. The choice not to use perforator flaps over any mesh or inert material is often based on the concern that the vascularization would be inadequate. However, perforator flaps have shown good results in several reconstructive fields, minimizing donor-site morbidity and offering versatility when local tissues are unavailable or affected by radiotherapy...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28606621/studying-the-blood-pressures-of-antegrade-and-retrograde-internal-mammary-vessels-do-they-really-work-as-recipient-vessels
#17
Yoko Katsuragi Tomioka, Hirokazu Uda, Kotaro Yoshimura, Ataru Sunaga, Hideaki Kamochi, Yasushi Sugawara
BACKGROUND: The proximal ends of internal mammary (IM) vessels are now the most common recipient vessels for breast reconstruction. On the other hand, bilateral deep inferior epigastric artery perforator (DIEP) flaps are often needed according to the territory and the volume required for reconstruction. The usefulness of retrograde IM vessels as second recipients has recently been reported, but there are very few quantitative studies on the hydrodynamics of the retrograde IM vessels. Because the flow is dependent on the pressure differential, the blood pressures of the antegrade IM artery (AIMA), antegrade IM vein (AIMV), retrograde IM artery (RIMA), retrograde IM vein (RIMV), and recirculated intraflap vein (FV) were investigated to solve this question and to confirm the reliability and usefulness of the retrograde IM vessels...
May 22, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28604546/sweet-syndrome-after-bilateral-deep-inferior-epigastric-perforator-flap-breast-reconstruction-a-case-report
#18
Rami D Sherif, Marco A Harmaty, Philip J Torina
No abstract text is available yet for this article.
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28604380/microsurgical-scia-siea-flap-for-facial-contour-correction-in-patient-with-hemifacial-microsomia
#19
Andrea Battisti, Andrea Cassoni Cassoni, Davina Bartoli, Marco Della Monaca, Giorgio Barbera, Edoardo Cerbelli, Valentino Valentini
AIM: We propose our experience in soft tissue reconstruction in Hemifacial microsomia using a free fascioadiposal flap. MATERIAL OF STUDY: Hemifacial microsomia (HFM) is a congenital disorder characterized by craniofacial malformation of one or both sides of the lower face. A 18-year-old female presented with hemifacial microsomia involving the left side. A free SCIA/SIEA fascioadiposal flap was transferred to the left face for soft tissue augmentation. RESULTS: The immediate postoperative course of the patient was uneventful, with no complication and adequate augmentation in contour deformity was achieved...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28602265/diep-flap-for-breast-reconstruction-is%C3%A2-abdominal-fat-thickness-associated-with-post-operative-complications
#20
Ali Modarressi, Camillo Theo Müller, Xavier Montet, Eva Meia Rüegg, Brigitte Pittet-Cuénod
INTRODUCTION: Some surgeons consider a high body mass index (BMI) or important abdominal fat excess as contraindications for breast reconstruction with free deep inferior epigastric perforator (DIEP) flap. This study aimed to identify factors associated with post-operative complications by using this type of flap, with an emphasis on BMI and abdominal subcutaneous fat thickness. METHODS: A retrospective chart review of 105 consecutive patients who underwent DIEP flap breast reconstruction at our institution was performed to assess post-operative complications...
May 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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