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https://www.readbyqxmd.com/read/28938363/reconstruction-of-the-heel-middle-foot-sole-and-plantar-forefoot-with-the-medial-plantar-artery-perforator-mpap-flap-clinical-experience-with-28-cases
#1
Mario F Scaglioni, Daniel Rittirsch, Pietro Giovanoli
INTRODUCTION: Defects in the weight-bearing region of the foot sole can represent a substantial restriction in quality of life and pose a challenge for reconstructive plastic surgery.The purpose of this article is to report our experience with the use of medial plantar artery perforator (MPAP) flap for reconstruction of defects of the foot sole in 3 different regions: heel, middle foot sole and plantar forefoot. PATIENTS AND METHODS: From January 2003 to May 2016, 28 patients (13 males and 15 females) with an average age of 54 years (range 12 to 84 y...
September 15, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28938362/muscle-versus-fasciocutaneous-free-flaps-in-lower-extremity-traumatic-reconstruction-a-multicenter-outcomes-analysis
#2
Eugenia H Cho, Ronnie L Shammas, Martin J Carney, Jason M Weissler, Andrew R Bauder, Adam D Glener, Stephen J Kovach, Scott T Hollenbeck, L Scott Levin
PURPOSE: Clinical indications are expanding for the use of fasciocutaneous free flaps in lower extremity traumatic reconstruction. We assessed the impact of muscle versus fasciocutaneous free flap coverage on reconstructive and functional outcomes. METHODS: A multicenter retrospective review was conducted on all lower extremity traumatic free flaps performed at Duke University (1997-2013) and the University of Pennsylvania (2002-2013). Muscle and fasciocutaneous flaps were compared in two subgroups (acute trauma and chronic traumatic sequelae), according to limb salvage, return to ambulation, flap outcomes, and secondary flap procedures...
September 15, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28938361/columellar-reconstruction-following-nasal-cpap-injury
#3
Catherine S Chang, Jordan W Swanson, Anthony Wilson, David W Low, Scott P Bartlett
Nasal continuous positive airway pressure (nCPAP) is utilized increasingly to treat pulmonary immaturity in premature neonates. Nasal injury is common with nCPAP use, with full thickness tissue loss at the columella among the most devastating complications.Columellar necrosis often imparts a full thickness injury to the overlying columellar skin, the medial crura of the lower lateral nasal cartilages, as well as the anteromedial inner nasal mucosal lining, and potentially the anterior septal cartilage. Consequently, the columella can become scarred and shortened...
September 15, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28937438/cutaneous-cytomegalovirus-infection-in-an-immunocompetent-patient-innocent-bystander-or-culprit
#4
Solomiya Grushchak, Kelli A Hutchens, Cossette Joy, Anthony Peterson, Jodi Speiser, Kumaran Mudaliar
We present a rare case of cutaneous cytomegalovirus (CMV) infection in a nonimmunocompromised patient. A 74-year-old woman with a history of diabetes presented with an ulcer on the right lateral tibia that occurred at the site of a nerve core biopsy. Subsequent biopsy of the ulcer edge showed granulation tissue with neutrophilic inflammation. The patient underwent extensive antibiotic treatment for possible infection with weekly wound care. However, the ulceration persisted and enlarged. A repeat biopsy 1 year later showed superficial and deep mixed inflammation with an associated vasculitis...
September 11, 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28937406/tolerance-in-xenotransplantation
#5
Kazuhiko Yamada, Megan Sykes, David H Sachs
PURPOSE OF REVIEW: This review describes recent progress in tolerance-inducing strategies across xenogeneic immunological barriers as well as the potential benefit of a tolerance strategy for islets and kidney xenotransplantation. RECENT FINDINGS: Using advanced gene editing technologies, xenotransplantation from multitransgenic alpha-1,3-galactosyltransferase knockout pigs has demonstrated marked prolongation of renal xenograft survival, ranging from days to greater than several months for life-supporting kidneys, and more than 2 years in a heterotopic nonlife-supporting cardiac xenograft model...
September 20, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28937303/palliative-coverage-of-cranial-defect-following-failed-cranial-flap-for-advanced-squamous-cell-carcinoma-case-report
#6
Vyacheslav Makler, Jeffrey S Litt, N Scott Litofsky
INTRODUCTION: With advanced-stage head and neck cancers, patients may develop large and/or complex wounds despite multiple reconstruction attempts. Wound coverage may require novel approaches to palliate the patient. METHOD: We present the case of a 56-year-old female with advanced squamous cell carcinoma of the scalp and skull who required multiple surgical interventions. Despite our best reconstructive efforts, the patient subsequently developed scalp infection and sepsis, necessitating further debridement for source control...
September 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28933697/enhanced-skin-regeneration-using-a-novel-amniotic-derived-tissue-graft
#7
Katie C Mowry, Paul P Bonvallet, Susan L Bellis
BACKGROUND: Chronic and recalcitrant wounds present a significant therapeutic challenge. Amniotic tissues contain many regenerative cytokines, growth factors, and extracellular matrix molecules including proteoglycans, hyaluronic acid, and collagens I, III, and IV. Dehydrated amnion/chorion grafts are currently used to treat a variety of wounds such as diabetic foot ulcers and burns. OBJECTIVE: The investigators hypothesized that processing methodologies, dehydration, and hypothermic processing and storage of amniotic tissues would affect overall quality of wound healing; they compared dehydrated amnion/chorion (dHACM) grafts to a novel hypothermically stored amniotic membrane (HSAM) graft in a full-thickness rat wound model...
September 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28930780/splinting-after-ear-reconstruction-a-stepwise-and-inexpensive-workflow-protocol
#8
Herman Vercruysse, James I J Green, Gaynor Osman, Brigitte Harrison, Kana Miyagi, Neil W Bulstrode
BACKGROUND: Long-term postoperative splinting plays a role in the prevention of contracture of the grafted skin after a second-stage ear reconstruction. The scar retraction could lead to an unfavorable aesthetic outcome. Splinting could play a role to overcome or prevent the loss of projection and the obliteration of the sulcus. MATERIAL AND METHODS: We have defined the characteristics of an ideal long-term splint and present a stepwise clinical protocol for the fabrication of an ethylene-vinyl acetate splint...
September 19, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28929069/our-experience-of-treating-wide-spectrum-of-external-ear-canal-atresia-of-different-etiologies-in-pediatric-patients
#9
Kranti Bhavana
External auditory canal atresia (EACA) is a common otologic condition. Etiology can vary from congenital to acquired causes. It causes considerable difficulty to the patient. Bilateral ear canal atresia in children can lead to speech delays due to hearing impairment caused by this condition. Though easily diagnosed it is one of the most difficult conditions to treat. Acquired conditions can affect any age group. Restenosis following treatment is very common. This article focuses on the treatment of EACA due to different etiologies and emphasizes on special points of surgical treatment and follow up...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28926877/-clinical-effects-of-repair-of-wounds-in-fingers-after-electrical-burn-with-wrist-perforator-free-flaps
#10
H P Di, C D Xia, P P Xing, Q Li, D W Han, J D Xue, D Y Cao
Objective: To explore the clinical effects of repair of wounds in the fingers after electrical burn with wrist perforator free flaps. Methods: Twelve patients (13 fingers) with electrical burn were hospitalized in our burn ward from January 2016 to January 2017. After radical debridement, the size of wounds ranged from 5.0 cm×2.0 cm to 10.0 cm×7.0 cm. Wounds with size below or equal to 6.0 cm ×2.5 cm were repaired with free flaps based on the superficial palmar branch of radial artery, with flap area ranging from 2...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28926875/-effects-of-perforator-flaps-combined-with-muscle-flaps-for-repairing-grade-%C3%A2-pressure-ulcers-in-ischial-tuberosity-of-elderly-patients
#11
W G Su, D P Li, P P Xing, L G Xu, F C Shi, B Wen, X H Niu
Objective: To explore effects of perforator flaps combined with muscle flaps for repairing grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients. Methods: Nine elderly patients with grade Ⅳ pressure ulcers in ischial tuberosity were hospitalized in our burn ward from April 2014 to April 2017. Size of wounds ranged from 5 cm×3 cm to 12 cm×7 cm, and depth of sinus ranged from 6 to 22 cm. After admission, emergency debridement or debridement in selective time was performed. After debridement, the wounds were treated with continuous vacuum assisted closure therapy...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28926874/-multicenter-epidemiological-investigation-of-hospitalized-elderly-young-and-middle-aged-patients-with-severe-burn
#12
Y Tang, L X Wang, W G Xie, Z A Shen, G H Guo, J J Chen, C M Han, L C Ren, Z G Chu, M F Yin, Y Wang, D X Zhang, Y S Huang, J P Zhang
Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28925493/repair-and-sensory-reconstruction-of-the-children-s-finger-pulp-defects-with-perforator-pedicled-propeller-flap-in-proper-digital-artery
#13
S-M Feng, A-G Wang, Z-Y Zhang, Q-Q Sun, Y-L Tao, M-M Zhou, Y-J Hao
OBJECTIVE: This study was designed to investigate the clinical effects of adopting perforator pedicled propeller flap in the proper digital artery for treatment and sensory reconstruction of finger pulp defects in children. PATIENTS AND METHODS: Perforator pedicled propeller flap of proper digital arteries in thirty-one fingers from twenty-three children patients were selected for repairing the pulp defects on the 2nd to the 5th fingers. All cases were treated from September 2012 to December 2013...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28922518/accelerated-epithelialization-and-improved-wound-healing-metrics-in-porcine-full-thickness-wounds-transplanted-with-full-thickness-skin-micrografts
#14
Christina L Rettinger, John L Fletcher, Anders H Carlsson, Rodney K Chan
Split-thickness skin grafting (STSG) is the current gold standard for treatment of extensive burn and traumatic skin injuries. However, STSG is limited by donor-site morbidity and availability, and often leads to scarring and wound contracture. Furthermore, these thin grafts lack dermal elements such as nerves and adnexa which are important in recapitulating normal skin function. Methods of fractional skin replacement either as minced STSGs or microscopic skin tissue columns (MSTCs) have been proposed, though these techniques have not been fully-characterized and lack evidence of regenerated adnexal structures...
September 18, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28922244/fibular-graft-effective-panorama-for-prosthetic-rehabilitation-of-resected-mandible
#15
Pankaj Kharade, Saidul Islam, Mahesh Verma, Swati Sharma, Ranjeet Bodh
Surgical management of extensive tumors in the mandibular region leads to massive disfigurement of the face. Also the prosthetic outcome of such patients rehabilitated with free soft tissue flaps is very poor. Reconstruction of extensive defects to overcome the disfigurement is a challenging procedure and can be achieved with free fibula flap. Free fibula graft provides sufficient length of bone for the reconstruction of the postsurgical defects. Excellent vascularity of fibula flap allows for easy uptake of the graft and osseointegration of the dental implants...
September 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28918934/reconstructive-microsurgical-approach-for-the-treatment-of-pyoderma-gangrenosum
#16
Karl Schwaiger, Elisabeth Russe, Hassan Kholosy, Michaela Hladik, Klemens Heinrich, Laurenz Weitgasser, Thomas Schoeller, Gottfried Wechselberger
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare type of autoimmune disease that results in progressive ulcers with or without previous trauma. However, PG is not well understood to date, and its treatment therefore remains a challenge. Because of the disease's systemic characteristic and the unpredictability of the clinical course, no gold standard treatment is available, especially concerning the surgical procedures to treat pyodermic lesions. Often, PG is not recognized during routine clinical practice, and standard ulcer treatment (conservative wound care, debridement, skin grafting, and local flap coverage) is initiated; this induces an autoinflammatory response, resulting in disastrous ulcers, thereby making free flap coverage necessary...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28917923/effect-of-carboxymethylation-on-rheological-and-drug-release-characteristics-of-terminalia-catappa-gum
#17
Radhika Sharma, Vikas Rana
The carboxymethylation of galactomannans, arabinogalactans, arbinoxylan, etc is known to modify solubility, swelling index, rheological behaviour, powder characteristics, etc. Therefore, an attempt had been made to study the effect of carboxymethylation on Terminalia catappa (TC) gum. For this, modified Williamson synthesis reaction was utilized employing Quality by Design (QbD) approach. Grafting of carboxymethyl group on Terminalia catappa was confirmed by ATR-FTIR, H(1)NMR and DSC analyses. The rheological attributes revealed that the carboxymethylation of TC lowers the viscosity, enhance thermal stability (high activation energy), disentanglement was near to re-entanglement, and weak gelling characteristic...
November 1, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/28915833/deltopectoral-flap-revisited-for-reconstruction-surgery-in-patients-with-advanced-thyroid-cancer-a-case-report
#18
Taro Mikami, Shintaro Kagimoto, Yuichiro Yabuki, Kazunori Yasumura, Toshinori Iwai, Jiro Maegawa, Nobuyasu Suganuma, Shohei Hirakawa, Katsuhiko Masudo
BACKGROUND: We present the cases of 2 patients with invasive thyroid cancer, who underwent reconstructive surgery using a deltopectoral flap. Although the overall rate of extrathyroidal extension in patients with thyroid cancer is quite low, skin invasion is the most common pattern observed. Reconstructive surgery, involving local skin flaps, is required in these patients. The deltopectoral flap relies on the blood supply from intercostal perforators of the internal thoracic artery and usually requires skin grafting to the donor site...
September 15, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28914704/rectoneovaginal-fistula-in-a-transgender-woman-successfully-repaired-using-a-buccal-mucosa-graft
#19
Molly Abbott Elmer-DeWitt, Hadley M Wood, Tracy Hull, Cecile A Unger
BACKGROUND: Rectoneovaginal fistulae (RnVFs) are abnormal connections between the rectum and a surgically created neovagina. Although very uncommon, they confer significant morbidity in patients and may require a multidisciplinary team approach to the repair. Risk factors for RnVF include rectal injury at the time of neovaginoplasty, malignancy in the neovagina, trauma (iatrogenic or otherwise), radiation, and neovaginal revision surgery. CASE DESCRIPTION: The patient is a 64-year-old transgender woman with recurrent RnVF following penile skin inversion neovaginoplasty, which was complicated by an intraoperative rectal injury...
September 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28913317/reconstruction-of-a-complex-scalp-defect-after-the-failure-of-free-flaps-changing-plans-and-strategy
#20
Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha Kim
The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neurosurgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft...
June 2017: Arch Craniofac Surg
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