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Deep inferior epigastric

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
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
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
Michael W Chu, Julia A Cook, Alexes Hazen
No abstract text is available yet for this article.
September 2016: Archives of Plastic Surgery
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
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
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
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
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
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
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
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...
July 12, 2016: Journal of Gynecologic Oncology
Claudia Claroni, Giulia Torregiani, Marco Covotta, Maria Sofra, Alessandra Scotto Di Uccio, Maria E Marcelli, Alessia Naccarato, Ester Forastiere
BACKGROUND: In many clinical conditions that involve free flaps and tissue transplantations the possibility of minimizing ischemia-reperfusion injury can be a determinant factor for the success of the surgery itself. We hypothesize that preconditioning with sevoflurane is a protective factor against ischemia-reperfusion injury. METHODS: In this randomized controlled trial, patients ASA I-II undergoing breast reconstruction with deep inferior epigastric perforator flaps were allocated into two groups and analyzed: group BAL included patients who received balanced anesthesia with sevoflurane for 30 min before removal of the flap and throughout the surgery...
2016: BMC Anesthesiology
Ryckie G Wade, Francesco Marongiu, Elaine M Sassoon, Richard M Haywood, Rozina S Ali, Andrea Figus
INTRODUCTION: Women undergoing unilateral deep inferior epigastric artery perforator (DIEP) flap breast reconstruction may be offered a contralateral symmetrisation either at the time of reconstruction (simultaneous/immediate) or at a later stage (delayed). Simultaneous contralateral breast symmetrisation may be more beneficial to patients and healthcare institutions by avoiding staged surgery, although there is limited evidence on which to base practice. This deficit formed the rationale for our study...
October 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Moustapha Hamdi, Barbara Craggs, Carola Brussaard, Katrin Seidenstueker, Benoit Hendrickx, Assaf Zeltzer
BACKGROUND: Breast reconstruction with the lumbar artery perforator flap is indicated in patients with unfavorable abdominal donor site. In addition to their clinical experience with lumbar artery perforator free flap breast reconstruction, the authors present an anatomical study of the origin and course of the perforators. METHODS: Images of multidetector computerized tomography scans were used to visualize the location of the dominant lumbar artery perforator in 20 patients...
August 2016: Plastic and Reconstructive Surgery
Daniel M Balkin, Quan-Yang Duh, Gabriel M Kind, David S Chang, Mary H McGrath
No abstract text is available yet for this article.
2016: BMC Surgery
Hirokazu Uda, Yoko Katsuragi Tomioka, Syunji Sarukawa, Ataru Sunaga, Hideaki Kamochi, Yasusih Sugawara, Kotaro Yoshimura
BACKGROUND AND AIM: The reduced incidence of donor site morbidity after deep inferior epigastric perforator (DIEP) flap is because the rectus muscle and its fascia are preserved. However, no study has proved that trunk flexion recovers not by the compensatory effect of the contralateral rectus muscle but by reinnervation of the ipsilateral rectus muscle. We hypothesized that if sufficient reinnervation occurs, patients who undergo single-pedicled DIEP (S-DIEP) flap or double-pedicled DIEP (D-DIEP) flap breast reconstruction would have similar levels of preoperative trunk flexion...
September 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Omer Ekin, Ozan Bitik, Dicle Aksoyler, Ali Aliyev, Samir Abdullazade, Ali Emre Aksu
Background Reconstruction of complex pharyngoesophageal defects presents a major challenge, particularly in soft tissue deficient and previously scarred surgical sites. In recent years, the free jejunum flap method has emerged as a reliable means of esophageal reconstruction. However, it may require cutaneous coverage with an additional flap in extensively scarred, secondary reconstructions. Prefabrication of an intestinal/cutaneous composite flap can potentially solve this problem. Materials and Methods Total 28 Sprague Dawley rats were used in the study protocol...
October 2016: Journal of Reconstructive Microsurgery
Christian T Bonde, Lisa Toft Jensen, Tina Tos, Birgitte Jul Kiil, Gete Ester Toft, Søren Erik Larsen, Peter Birkeland, Jens Ahm Sørensen
The most common indication for free flap surgery is breast reconstruction. Deep inferior epigastric perforator flaps are safe, quick and provide excellent cosmetic results. The reconstruction in head and neck cancer patients is more complex. The aims are preservation of function and appearance. Free flaps are important in traumatology and the timing of intervention can make the difference between amputation and extremity conserving treatment. Due to the improvement in surgical technique failure rates as low as 2% can be seen...
June 6, 2016: Ugeskrift for Laeger
Priya Tiwari, Bien Keem Tan
No abstract text is available yet for this article.
January 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
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