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Deep inferior epigastric

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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