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Deep inferior epigastric

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https://www.readbyqxmd.com/read/29781856/neoumbilicoplasty-with-a-pedicled-deep-inferior-epigastric-perforator-island-flap
#1
Matthew A DelMauro, Louis-Joseph Auguste, Peter T Korn
Management of the umbilicus is a common dilemma at the time of abdominoplasty and abdominal wall reconstruction. It is not uncommon for underlying pathologies, such as hernias and surgical scars, to result in a disfigured or obliterated native umbilicus or make the blood supply to the umbilical stalk unreliable. In these scenarios, the umbilicus is often sacrificed. Staged neoumbilical reconstruction may be offered and typically utilizes a small skin flap and full-thickness skin graft (Ann Plast Surg 2009;63:358-360)...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762436/preoperative-analysis-of-venous-anatomy-before-deep-inferior-epigastric-perforator-free-flap-breast-reconstruction-using-ferumoxytol-enhanced-magnetic-resonance-angiography
#2
John Dortch, Antonio J Forte, Candice Bolan, Pujan Kandel, Galen Perdikis
BACKGROUND: Venous congestion after deep inferior epigastric artery perforator (DIEP) flap breast reconstruction is a complication that may be partially attributable to variations in venous abdominal wall anatomy. In previous work, we have shown that ferumoxytol may be used as a bloodpool contrast agent to perform high-resolution venous imaging. Our current aim was to use this technology to perform a detailed analysis of the venous anatomy among patients undergoing DIEP flap breast reconstruction...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29750760/prospective-randomized-controlled-comparison-of-local-anesthetic-infusion-pump-versus-depofoam-bupivacaine-for-pain-management-after-unilateral-delayed-deep-inferior-epigastric-perforator-free-flap-reconstruction
#3
James Gatherwright, Rebecca Knackstedt, Amir Ghaznavi, Steven Bernard, Graham Schwarz, Andrea Moreira, Raffi Gurunluoglu, Risal Djohan
BACKGROUND: Effective postsurgical analgesia is a critical aspect of patient recovery. The goal of this prospective, randomized, controlled, blinded study was to examine the effect that liposomal bupivacaine delivered via a transversus abdominis plane (TAP) block has on pain control in women undergoing unilateral deep inferior epigastic perforator reconstruction. METHODS: IRB approval was granted for this prospective study. Patients were eligible if they were undergoing unilateral, delayed DIEP reconstruction...
March 15, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29734445/a-multicenter-analysis-examining-patients-undergoing-conversion-of-implant-based-breast-reconstruction-to-abdominally-based-free-tissue-transfer
#4
Ruya Zhao, Bao Ngoc N Tran, Andres F Doval, Gloria Broadwater, Kate J Buretta, Jonah P Orr, Bernard T Lee, Scott T Hollenbeck
BACKGROUND:  Breast implant placement is the most common method for postmastectomy reconstruction. For patients who develop complications associated with implant-based reconstruction, additional surgeries may be challenging. This study examined implant-based reconstruction failure in patients undergoing salvage with abdominal free tissue transfer. METHODS:  We conducted an Institutional Review Board approved, multicenter retrospective study of patients with implant-based primary breast reconstruction followed by implant removal and subsequent abdominal free tissue transfer between 2006 and 2016...
May 7, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29723579/perineal-closure-after-abdominoperineal-resection-using-a-pedicled-deep-inferior-epigastric-perforator-flap-a-safe-alternative-to-rectus-abdominis-myocutaneous-flap
#5
Zaher Lakkis, Maxime Laydi, Brice Paquette, Célia Turco, Nicolas Bouviez, Simone Manfredelli, Alexandre Doussot, Julien Pauchot
No abstract text is available yet for this article.
April 30, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29698414/ct-of-the-paraumbilical-and-ensiform-veins-in-patients-with-superior-vena-cava-or-left-brachiocephalic-vein-obstruction
#6
Joseph Casullo, Han Zeng, Geneviève Belley, Giovanni Artho
The purpose of this study was to elaborate on the anastomoses between the paraumbilical and systemic veins, particularly the ensiform veins. The connections with the ensiform veins have received little attention in the anatomical and radiological literature, and remain incompletely described. Too small to be reliably traced in normal CT scans, the paraumbilical veins can dilate in response to increased blood flow from systemic veins in superior vena cava obstruction (SVCO), allowing a study of their arrangement and connections...
2018: PloS One
https://www.readbyqxmd.com/read/29697626/preoperative-and-postoperative-assessment-of-rectus-abdominis-muscle-size-and-function-following-diep-flap-surgery
#7
Shane K F Seal, Mark K Hewitt, Michael L Martin, Penelope M A Brasher, Sheina A Macadam
BACKGROUND: Prospective evaluation of rectus abdominis muscle function after deep inferior epigastric artery perforator (DIEP) flap breast reconstruction is limited. Elimination of muscle harvest with this procedure is theoretically associated with preservation of rectus abdominis function and minimization of abdominal wall morbidity. In this study, the authors evaluate the change in rectus abdominis muscle size and function after DIEP flap surgery. METHODS: Patients undergoing unilateral DIEP flap surgery were recruited prospectively...
May 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29697604/facebook-facts-breast-reconstruction-patient-reported-outcomes-using-social-media
#8
Sherry Y Q Tang, Jacqueline S Israel, Samuel O Poore, Ahmed M Afifi
BACKGROUND: Social media are used for information sharing among patients with similar health conditions, and analysis of social media activity could inform clinical decision-making. The aim of this study was to use Facebook to evaluate a cohort of individuals' perceptions of and satisfaction with breast reconstruction. METHODS: In this observational study, the authors collected and analyzed posts pertaining to autologous and implant-based breast reconstruction from active Facebook groups...
May 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29683203/risk-of-recurrence-and-death-in-patients-with-breast-cancer-after-delayed-deep-inferior-epigastric-perforator-flap-reconstruction
#9
H Adam, A C Docherty Skogh, Å Edsander Nord, I Schultz, J Gahm, P Hall, J Frisell, M Halle, J de Boniface
BACKGROUND: Postmastectomy reconstruction using a deep inferior epigastric perforator (DIEP) flap is increasingly being performed in patients with breast cancer. The procedure induces extensive tissue trauma, and it has been hypothesized that the release of growth factors, angiogenic agonists and immunomodulating factors may reactivate dormant micrometastasis. The aim of the present study was to estimate the risk of breast cancer recurrence in patients undergoing DIEP flap reconstruction compared with that in patients treated with mastectomy alone...
April 23, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29672777/diep-flap-breast-reconstruction-complication-rate-in-previously-irradiated-internal-mammary-nodes
#10
Shirley Shechter, Ehud Arad, Amir Inbal, Or Friedman, Eyal Gur, Yoav Barnea
BACKGROUND:  Postmastectomy radiation therapy (PMRT) is a widely accepted treatment for locally advanced breast cancer. Some patients require additional boost radiation to the internal mammary nodes as the part of regional nodal irradiation (RNI). Delayed breast reconstruction with an autologous free flap using the internal mammary vessels for microvascular flap anastomosis is a common practice for these patients. The aim of our study was to evaluate the effect of RNI on autologous microvascular breast reconstruction...
April 19, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29672776/postoperative-monitoring-of-free-diep-flap-in-breast-reconstruction-with-near-infrared-spectroscopy-variables-affecting-the-regional-oxygen-saturation
#11
Marzia Salgarello, Domenico Pagliara, Marco Rossi, Giuseppe Visconti, Liliana Barone-Adesi
BACKGROUND:  The timing of surgical reexploration in microanastomotic thrombosis is directly related to the salvage rate of free flap. Near-infrared spectroscopy (NIRS) is a noninvasive technique, which allows a continuous bedside monitoring of flap oxygenation. The current literature is lacking in the assessment of variables able to modify the NIRS monitoring. The aim of this study is to identify patient and flap-related variables that can affect regional oxygen saturation (rSO2 )...
April 19, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29668510/gauze-impregnated-with-quaternary-ammonium-salt-reduces-bacterial-colonization-of-surgical-drains-after-breast-reconstruction
#12
Amy L Strong, Emily T Wolfe, Nina Shank, Abigail E Chaffin, David A Jansen
Surgical site infection after breast reconstruction is associated with increased length of hospital stay, readmission rates, cost, morbidity, and mortality. Identifying methods to reduce surgical site infection without the use of antibiotics may be beneficial at reducing antimicrobial resistance, reserving the use of antibiotics for more severe cases. Quaternary ammonium salts have previously been shown to be a safe and effective antimicrobial agent in the setting of in vitro and in vivo animal experiments...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29668508/ultrasound-and-plastic-surgery-clinical-applications-of-the-newest-technology
#13
John P Miller, Martin J Carney, Soobin Lim, John T Lindsey
BACKGROUND: Color Doppler ultrasound (CDUS) has not been routinely used in plastic and reconstructive surgery. Barriers to use have included large, cumbersome equipment, low-definition images, cost, and availability. In addition, programs in plastic surgery have not included training with ultrasound (US); thus, many current-day practitioners are unfamiliar with and reluctant to use this technology. Nevertheless, recent studies have demonstrated the utility of US in surgical planning. With the miniaturization, clearer imaging, and decreased costs of the latest US technology, previous barriers to use have largely been eliminated...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29664829/nipple-sparing-mastectomy-and-immediate-breast-reconstruction-with-a-deep-inferior-epigastric-perforator-flap-a-study-of-patient-satisfaction
#14
Jerry Levy, Romain Bosc, Noel Warren, Sabban Rebecca, Thu Ha Dao, Barbara Hersant, Jean-Paul Meningaud
INTRODUCTION: The morphological result of nipple-areola complex (NAC) reconstruction may be disappointing for patients who undergo skin-sparing mastectomies and immediate breast reconstruction, followed by secondary reconstruction of the nipple-areola complex.The aim of this study was to analyze patient satisfaction after nipple-sparing mastectomy and immediate breast reconstruction with a deep inferior epigastric perforator flap. MATERIALS AND METHODS: Our retrospective study involved all patients who underwent an immediate breast reconstruction after unilateral mastectomy with conservation of the NAC...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29660924/vasopressor-support-vs-liberal-fluid-administration-in-deep-inferior-epigastric-perforator-diep-free-flap-breast-reconstruction-a-randomized-controlled-trial
#15
A M Anker, L Prantl, C Strauss, V Brébant, N Heine, P Lamby, S Geis, F Schenkhoff, M Pawlik, S M Klein
BACKGROUND: Perioperatively, patients' hemodynamics are modulated predominantly by intravenous fluid administration and vasoactive pharmacological support. Vasopressor agents are suspected to be detrimental on free flap survival by the cause of vasoconstriction of the pedicle with consecutive reduced overall flap perfusion and by aggravation of flap dissection. OBJECTIVE: A novel, standardized fluid restrictive perioperative hemodynamic management was assessed for its feasibility in clinical practice in free flap patients undergoing breast reconstruction...
April 7, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29659449/evolution-in-monitoring-of-free-flap-autologous-breast-reconstruction-after-nipple-sparing-mastectomy-is-there-a-best-way
#16
Jordan D Frey, John T Stranix, Michael V Chiodo, Michael Alperovich, Christina Y Ahn, Robert J Allen, Mihye Choi, Nolan S Karp, Jamie P Levine
BACKGROUND: Free flap monitoring in autologous reconstruction after nipple-sparing mastectomy remains controversial. The authors therefore examined outcomes in nipple-sparing mastectomy with buried free flap reconstruction versus free flap reconstruction incorporating a monitoring skin paddle. METHODS: Autologous free flap reconstructions with nipple-sparing mastectomy performed from 2006 to 2015 were identified. Demographics and operative results were analyzed and compared between buried flaps and those with a skin paddle for monitoring...
May 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29655664/a-retrospective-investigation-of-abdominal-visceral-fat-body-mass-index-bmi-and-active-smoking-as-risk-factors-for-donor-site-wound-healing-complications-after-free-diep-flap-breast-reconstructions
#17
Floyd W Timmermans, Pèdrou B Westland, Stefan Hummelink, Joep Schreurs, Marijn Hameeteman, Dietmar J O Ulrich, Nicholas J Slater
BACKGROUND: The deep inferior epigastric artery perforator (DIEP) flap is one of the most common techniques for breast reconstruction. Body mass index (BMI) is considered as an important predictor of donor site healing complications such as wound dehiscence. The use of computed tomography (CT) proved to be a precise and objective method to assess visceral adipose tissue. It remains unclear whether quantification of visceral fat provides more accurate predictions of abdominal wound healing complications than BMI...
March 28, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29653454/how-does-autologous-breast-reconstruction-impact-downtime
#18
Giovanni Zoccali, Daniel Simon Rais, Jian Farhadi
BACKGROUND:  Although autologous breast reconstruction is technically quite demanding, it offers the best outcomes in terms of durable results, patient perceptions, and postoperative pain. Many studies have focused on clinical outcomes and technical aspects of such procedures, but few have addressed the impact of various flaps on patient recovery times. This particular investigation entailed an assessment of commonly used flaps, examining the periods of time required to resume daily activities...
April 13, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29620551/practical-applications-of-delayed-immediate-autologous-breast-reconstruction-a-flexible-and-safe-operative-strategy
#19
Gloria R Sue, Arhana Chattopadhyay, Chao Long, Eva A Huis in 't Veld, Gordon K Lee
BACKGROUND: Timing is an important consideration in patients undergoing mastectomy for breast cancer. While immediate reconstruction results in superior aesthetic outcomes, the need for postmastectomy radiation can often only be ascertained after review of surgical pathology. Delayed-immediate autologous reconstruction (DIAR) is a reconstructive approach that consists of mastectomy with tissue expander placement in the first stage and flap-based breast reconstruction in the second stage...
May 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29616172/pork-belly-a-simulation-training-model-for-intramuscular-perforator-dissection
#20
Georgios Pafitanis, Damjan Veljanoski, Ali M Ghanem, Simon Myers
Background: Free tissue transfer has evolved from muscle flaps to fasciocutaneous flaps. Dissection of the intramuscular course of feeding vessels is technically challenging. Simulation-based microsurgery skills acquisition is moving toward nonliving training models. Living porcine model or human cadavers are currently cost-ineffective methods for the early learning curve in teaching intramuscular dissection. The aim of this study was to validate an inexpensive ex vivo porcine model simulating harvest of the deep inferior epigastric artery perforator (DIEAP) flap, specifically including perforator intramuscular dissection...
February 2018: Plastic and Reconstructive Surgery. Global Open
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