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Flap reconstruction

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https://www.readbyqxmd.com/read/29341294/topical-nitroglycerin-for-the-treatment-of-intraoperative-microsurgical-vasospasm
#1
Joseph A Ricci, Dhruv Singhal, Eugene Y Fukudome, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: Papaverine remains a popular agent to treat intraoperative microsurgical vasospasm. However, the recent shortage has forced surgeons to trial antispasmodic agents unproven in microsurgery, but commonly used in other areas. During this shortage we have trialed topical nitroglycerin to break intraoperative vasospasm. This study aims to analyze the outcomes of this medication on flap complications compared with papaverine. METHODS: All consecutive free flaps performed for breast reconstruction at a single institution were reviewed...
January 17, 2018: Microsurgery
https://www.readbyqxmd.com/read/29341249/reconstruction-of-an-upper-posterior-thigh-extensive-defect-with-a-free-split-anterolateral-thigh-s-alt-flap-by-perforator-to-perforator-anastomosis-a-case-report
#2
Mario F Scaglioni, Andrè A Barth, Pietro Giovanoli
The anterolateral thigh (ALT) flap is one of the most commonly used flap worldwide in reconstructive surgery, as both free flap and pedicled local flap. Here, we report the use of a free split anterolateral thigh (s-ALT) flap for reconstruction of a 14 cm × 16 cm soft tissue defect of the left upper posterior thigh region due to sarcoma resection in a patient. The ALT flap was harvested based on two musculocutaneous perforators from the right thigh and anastomosed to the contralateral descending branch of the lateral circumflex femoral artery (LCFA) in perforator-to-perforator manner, in order to gain more pedicle length and being able to cover the posterior thigh defect...
January 17, 2018: Microsurgery
https://www.readbyqxmd.com/read/29341038/-the-use-of-deep-inferior-epigastric-vessels-to-revascularise-free-flaps-for-reconstruction-of-complex-oncosurgical-defects-of-the-thigh-and-the-abdomen
#3
F Simunovic, U Wittel, B Passlick, S Wiesemann, M Czerny, M Südkamp, G B Stark, H Bannasch
BACKGROUND: The resection of large soft-tissue sarcoma requires reconstruction with free flaps. The choice of recipient vessels is crucial for the success of surgery. PATIENTS: We report four cases with large soft-tissue sarcomas with complex anatomical relationships: two tumors of the thigh surrounding the femoral neurovascular structures and two tumors of the abdomen with infiltration of the thorax and the abdomen. All cases received multimodal interdisciplinary treatment...
January 16, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29339717/complex-reconstruction-with-flaps-after-abdominoperineal-resection-and-groin-dissection-for-anal-squamous-cell-carcinoma-a-difficult-case-involving-many-specialities
#4
Claudia Reali, Richard Guy, Christopher R Darby, Lucy Cogswell, Roel Hompes
BACKGROUND Anal squamous cell carcinoma accounts for about 2-4% of all lower gastrointestinal malignancies, with a distant disease reported in less than 5%. Although surgical treatment is rarely necessary, this often involve large dissections and difficult reconstructive procedures. CASE REPORT We present a complex but successful case of double-flap reconstruction after abdominoperineal resection and groin dissection for anal squamous cell carcinoma (cT3N3M0) with metastatic right inguinal lymph nodes and ipsilateral threatening of femoral vessels...
January 17, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29336816/traumatic-thoracic-rib-cage-hernias-operative-management-and-proposal-for-a-new-anatomic-based-grading-system
#5
John Kuckelman, Riyad Karmy-Jones, Elizabeth Windell, Seth Izenberg, Jean-Stephane David, William Long, Matthew J Martin
BACKGROUND: Traumatic Rib Cage Hernias (TRCH) requiring operative repair are rare and there is currently no literature to guiding surgical management. METHODS: Perioperative review of TRCH over 32 years. Five operative grades were developed based on extent of tissue/bone damage, size, and location. RESULTS: Twenty-four patients (20 blunt, 4 penetrating) underwent operative repair. Lung was the herniated organ in 88% with a median of 4 rib fractures and average size of 60...
January 5, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29336293/using-the-nasoseptal-flap-for-reconstruction-after-endoscopic-debridement-of-radionecrosis-in-nasopharyngeal-carcinoma
#6
Gwanghui Ryu, Yoon Kyoung So, Min Young Seo, Woori Park, Hyo Yeol Kim, Hun-Jong Dhong, Seung-Kyu Chung, Sang Duk Hong
BACKGROUND: Radionecrosis is a complication of nasopharyngeal carcinoma (NPC) that is difficult to treat. Endoscopic debridement is the first-line treatment for radionecrosis. After debridement, however, either bone or the internal carotid artery is exposed and requires mucosal coverage. OBJECTIVES: This study sought to demonstrate the effectiveness of a nasoseptal flap (NSF) after endoscopic debridement of radionecrosis in the reconstruction of nasopharyngeal or skull base defects...
January 25, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29335394/landscape-of-oncoplastic-breast-surgery-across-poland
#7
Agnieszka Kolacinska, Diana Hodorowicz-Zaniewska, Artur Bocian, Dariusz Michalik, Rafal Matkowski, Andrzej Kurylcio, Pawel Pyka, Michal Charytonowicz, Maciej Berkan
Oncoplastic and reconstructive techniques are essential tools in the armamentarium of contemporary breast surgeons. The aim of the study was to identify oncoplastic reconstructive patterns in breast cancer centers across Poland. A questionnaire of 18 questions was sent by email to the members of the Polish Society of Surgical Oncology and the Polish Society of Plastic, Reconstructive and Esthetic Surgery via their dedicated websites. The numbers of breast cancer patients operated on in each center ranged from 120 to 904 per year...
December 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29335032/-sit-and-tilt-preparation-for-subscapular-system-free-flaps
#8
J Mark, H Patwa, M S Costello, Y Patil
BACKGROUND: The ablation of advanced head and neck cancer often results in large three-dimensional defects that require free tissue transfer to optimally address functional and cosmetic issues. The subscapular system is a highly versatile donor site for flaps used for head and neck reconstruction. Traditional methods of harvesting subscapular flaps require repositioning and re-preparing, which significantly increases the operative time and prevents simultaneous harvesting of the flap...
January 16, 2018: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29334788/latissimus-dorsi-flap-in-breast-reconstruction-recent-innovations-in-the-workhorse-flap
#9
Rachita Sood, Jeena M Easow, Geoffrey Konopka, Zubin J Panthaki
BACKGROUND: Surgeons employ the latissimus dorsi flap (LDF) for reconstruction of a large variety of breast cancer surgery defects, including quadrantectomy, lumpectomy, modified radical mastectomy, and others. The LDF may be used in delayed or immediate reconstruction, in combination with tissue expanders for a staged reconstruction, with implant-based immediate reconstruction, or alone as an autogenous flap. METHODS: The authors discuss the historical uses and more recent developments in the LDF...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/29333949/the-reading-man-flap-for-reconstruction-of-large-periorbital-defects
#10
Elizabeth A Insull, Varajini Joganathan, Jonathan H Norris
PURPOSE: The "reading man" flap (RMF), a double advancement transposition cutaneous flap named for its appearance, has been described in the reconstruction of various circular skin defects, particularly in the malar region. We describe two cases where this flap was used to reconstruct the lower eyelid/periorbital region. METHODS: Two oculoplastic patients with lower eyelid basal cell carcinomas underwent Mohs micrographic excision resulting in a large skin defects...
January 15, 2018: Orbit
https://www.readbyqxmd.com/read/29333919/reconstruction-of-extensive-medial-canthal-defects-using-a-single-v-y-island-pedicle-flap
#11
Christopher M Stewart, Jonathan H Norris
The medial canthus represents one of the most challenging regions of the face to reconstruct due to the anatomical structures present, the concavity of the area, and the differences in skin texture. We present a case series of 11 patients whose defects were reconstructed with a single V-Y island pedicle flap running along the nasofacial sulcus. Our single-stage flap which modified and simplified a previously described technique achieves similar cosmetic and postoperative outcomes along with a high level of patient satisfaction in an area which can be reconstructed in a variety of ways, often with suboptimal results...
January 15, 2018: Orbit
https://www.readbyqxmd.com/read/29333918/modified-second-stage-hughes-tarsoconjunctival-reconstruction-for-lower-eyelid-defects
#12
Shruti Aggarwal, Christopher T Shah, Maria Kirzhner
To describe a novel technique utilizing an amniotic membrane graft (AMT) to create the mucocutaneous portion of the lower eyelid margin in a modified Hughes eyelid reconstruction for secondary revision or prevention of a hyperemic, hypertrophic conjunctival margin with excessive discharge. This was a retrospective, non-comparative interventional study. Thirty consecutive patients who underwent a modified Hughes reconstruction were included. The first step of the reconstruction was performed in a standard fashion using a tarsoconjunctival flap from the ipsilateral upper eyelid...
January 15, 2018: Orbit
https://www.readbyqxmd.com/read/29333783/-application-of-preoperative-vascular-localization-techniques-for-perforator-flaps
#13
Wu Lianjun, Wang Huiming
With the development of microvascular technology, perforator flaps have gradually become a good alternative for reconstruction of tissue defects. However, the major limitations of perforator flaps include uncertainty in predicting anatomical location of perforators and high variability in perforator size and course, which require preoperative localization techniques. Recently, as one of the preoperative localization techniques, computed tomography angiography was used to determine the number, size, course, and exact emerging point of perforator flaps...
December 1, 2017: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
https://www.readbyqxmd.com/read/29332408/effect-of-induction-chemotherapy-on-the-quality-of-life-in-patients-with-advanced-stage-tongue-cancer-by-a-prospective-study
#14
Tao Huang, Hui Liu, Pei Zhang, Yanxia Zhao
Abstracts Objective To assess how induction chemotherapy affects the quality-of-life (QoL) in patients with advanced tongue cancer. Methods This prospective study included patients who were diagnosed with advanced tongue cancer. Each patient was asked to complete the University of Washington QoL (UW-QoL), version 4, questionnaire preoperatively and at 12 months after surgery. Patients were divided into two groups based on whether or not they received induction chemotherapy. Results Of the 192 patients included in the analysis, 145 patients had received induction chemotherapy...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29331408/long-term-craniofacial-morphology-in-young-adults-treated-for-a-non-syndromal-uclp-a-systematic-review
#15
REVIEW
Isabelle F P M Kappen, Whitney R Yoder, Aebele B Mink van der Molen, Corstiaan C Breugem
Minimizing mid-facial growth impairment is one of the treatment goals in cleft lip and palate surgery. As growth of the maxilla extends into young adulthood, long-term evaluation is essential to make a comprehensive assessment of a treatment protocol. There are numerous treatment approaches for cleft lip/palate surgery, and most have the characteristic distinction between either an early or a late cleft palate closure. PRISMA guidelines were applied to explore the quality of the current literature and to identify treatment factors influencing long-term cephalometric outcomes...
December 13, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29331076/submental-artery-island-flap-with-simultaneous-level-i-neck-dissection
#16
Antoine Eskander, Daniel Strigenz, Nolan Seim, Enver Ozer
BACKGROUND: The purpose of this study was to illustrate the submental island flap elevation technique with simultaneous level I neck dissection followed by the inset and reconstruction of an oropharyngeal defect. METHODS: A 63-year-old patient with a T2N1M0 human papillomavirus-positive squamous cell carcinoma of the tonsil was treated with concurrent chemoradiotherapy (cisplatin + 66 Gy). A local recurrence 2.5 years after treatment was treated surgically and reconstructed with a submental island flap...
January 13, 2018: Head & Neck
https://www.readbyqxmd.com/read/29330076/frontoethmoidal-schwannoma-with-exertional-cerebrospinal-fluid-rhinorrhea-a-case-report-and-review-of-the-literature
#17
Yuichiro Yoneoka, Katsuhiko Akiyama, Yasuhiro Seki, Go Hasegawa, Akiyoshi Kakita
BACKGROUND: Frontoethmoidal schwannomas are rare. No case manifesting exertional cerebrospinal fluid (CSF) rhinorrhea has ever been reported to the best of our knowledge. CASE DESCRIPTION: In this report, we describe an extremely rare case of frontoethmoidal schwannoma extending through the olfactory groove (OG) with exertional CSF rhinorrhea as the initial symptom. A 50-year-old woman was presented to our clinic for frequent nasal discharge on exertion. A postcontrast computed tomographic scan demonstrated heterogeneously enhanced tumor from the anterior cranial fossa to the anterior ethmoid sinus...
January 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29328804/replacement-of-the-nose
#18
Harold Ellis
Today's reconstructive surgeons may not be aware that replacement of the nose was carried out successfully as long ago as the 16th century by the surgeon Gaspar Taliacozzo of Bologna, Italy, who published a detailed and illustrated account of his operation in 1597. This procedure comprised raising a flap of skin from the upper arm to reconstruct the nose. The arm was kept in place, with the hand resting on the patient's head, using elaborate splinting until adherence had taken place; the flap was then detached from the donor arm...
May 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328540/case-of-late-onset-relapsing-surgical-site-infection-related-to-a-venous-coupler-placed-during-free-flap-reconstruction-for-major-head-and-neck-cancer
#19
Yin Ren, Daniel G Deschler, Dipti Sajed, Marlene L Durand
BACKGROUND: Venous coupling devices are widely used during reconstructive surgery involving microvascular anastomosis but have not served as foreign bodies in head and neck surgical site infections. METHODS: We conducted a case report. RESULTS: A patient underwent resection and free flap reconstruction for recurrent tongue squamous cell carcinoma. She developed a neck abscess due to Streptococcus intermedius 7 weeks postoperatively, days after starting chemoradiotherapy...
January 12, 2018: Head & Neck
https://www.readbyqxmd.com/read/29328534/split-thickness-skin-grafting-for-reconstruction-of-auricular-skin-defects-a-statistical-analysis
#20
Tobias Thuile, Lorenz Larcher, Barbara Gatscher, Karl Schwaiger, Jenny Deluca, Amgiad Fallaha, Lukas Tappeiner, Mario Puviani, Klaus Eisendle
BACKGROUND AND OBJECTIVES: Surgical reconstruction following the removal of large malignant auricular lesions is challenging. While many options for defect closure have been described, in the elderly population usually affected flap surgery, long anesthesia times, patient compliance, and anticoagulant therapy pose additional risks. An alternative quick, simple, and effective method of defect closure is therefore highly desirable. The objective of the present study was to assess the aesthetic outcome, healing process, complications, and recurrence rates associated with unmeshed split-thickness skin grafts (STSGs) used for covering large auricular skin defects following cartilage-sparing skin cancer removal...
January 12, 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
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