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Flap reconstruction

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https://www.readbyqxmd.com/read/28528074/skin-perforator-flap-pedicled-by-intercostal-muscle-for-repair-of-a-tracheobronchoesophageal-fistula
#1
Nicolas Bertheuil, Caterina Cusumano, Cécile Meal, Yann Harnoy, Eric Watier, Bernard Meunier
A tracheobronchial fistula (TBF) is a rare complication when an operation is performed to treat esophageal carcinoma; no consensus treatment strategy has emerged. We describe a surgical interposition strategy, using a new flap, to repair a TBF that arose when esophageal squamous cell carcinoma was treated with neoadjuvant chemoradiation and minimally invasive esophagectomy (the 3-stage McKeown procedure). We performed a skin perforator flap pedicled by the intercostal muscle. It is a valuable option that may be the optimal first-line treatment, especially in the context of neoadjuvant radiation therapy...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527396/breast-oedema-following-free-flap-breast-reconstruction
#2
Jennifer Greenhowe, Christopher Stephen, Liusaidh McClymont, D Alex Munnoch
OBJECTIVES: Breast oedema causes significant morbidity and is historically difficult to quantify. The aim of this study was to identify changes in breast tissue water content from pre-operative levels in the native breast to post-operative levels in mastectomy skin flaps and free flaps in the reconstructed breast. MATERIALS AND METHODS: One hundred patients undergoing unilateral mastectomy and immediate free flap breast reconstruction were examined pre-operatively and at three post-operative appointments...
May 17, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28526903/compartmental-tongue-resection-with-submental-island-flap-reconstruction-for-large-carcinoma-of-the-oral-tongue
#3
Sameh Roshdy, Mohamed Elbadrawy, Ashraf Khater, Tamer Fady, Hend A El-Hadaad, Nazem Shams, Hany M Elbarbary
BACKGROUND: Tongue resection is a surgical challenge because of its adverse effects on language articulation, swallowing, respiration, the eventual quality of life, and poor prognosis of advanced disease. To date, the currently accepted standard treatment has been based on excision of the primary lesion with a 1.5-2-cm circumferential macroscopic margin. Compartmental tongue surgery (CTS) is a surgical technique that removes an anatomo-functional compartment containing the primary tumor...
May 19, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28525414/the-muscle-sparing-latissimus-dorsi-flap-for-breast-reconstruction-a-retrospective-review-of-126-consecutive-flaps
#4
Jonathan Cook, Jessica Waughtel, Christopher Brooks, Dawn Hardin, Yin Kan Hwee, Yoav Barnavon
Our experience in the use of muscle-sparing latissimus dorsi (MSLD) flaps for breast reconstruction is presented. The procedure was performed on 83 patients by the senior author over an 8-year period. Of the 83 patients reviewed, a total of 126 MSLD flaps were done for immediate (26) or delayed (100) breast reconstructions. Preoperative and postoperative photographs were taken of all patients, and complications as well as ancillary procedures were recorded. The MSLD flap is shown to be a versatile option for breast reconstruction in a variety of clinical settings, with minimal complications and satisfactory aesthetic results...
June 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28523088/treatment-of-a-large-traumatic-encephalocele-with-titanium-mesh
#5
Alan Motta do Canto, Manuela Monteiro Pinotti, Fernando Alves Maciel, Alexandre Bossi Todeschini, Guilherme Brasileiro Aguiar, Ronaldo Rodrigues de Freitas
Encephalocele is defined as protrusion of cranial contents beyond the normal confines of the skull. Although most encephalocele cases have a congenital etiology, fractures of the skull base can cause traumatic encephalocele. In most encephalocele cases, the bone defect presents reduced dimensions and the endoscopic treatment is generally performed to reconstruct the area using mucosal and/or fat grafts. This article sought to report on a rare case of traumatic encephalocele associated with an extensive defect of the anterior skull base...
June 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28522300/primary-reconstructive-method-for-tracheal-defect-from-invasion-by-differentiated-thyroid-carcinoma
#6
Atsumori Hamahata, Takeshi Beppu, Takashi Yamaki, Hiroyuki Sakurai
Differentiated thyroid carcinoma is not highly malignant, and thus surgical resection is the most common treatment even if the carcinoma has invaded the trachea. Although some cases exist in which the carcinoma invades the trachea, using the tracheal window resection method allows complete resection of the carcinoma. Yet these patients must often control a large tracheocutaneous wound until reconstructive surgery is performed because such surgery occurs secondarily. Our hospital admitted three patients for which tracheally invasive, differentiated thyroid carcinoma was surgically resected...
May 15, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28522026/-breast-reconstruction-in-elderly-patients-studies-of-the-practices-at-institut-bergoni%C3%A3-during-2005-2015
#7
Guillaume Babin, Julie Commeny, Marion Fournier, Aurélien Rousvoal, Youssef Kabbani, Marc Debled, Anne Jaffre, Christine Tunon de Lara
INTRODUCTION: The objective of our study is to describe the practices of breast reconstruction in patients aged 70 years and over undergoing a radical mastectomy at institut Bergonié. MATERIAL AND METHODS: We performed a detailed single-site retrospective study from January 2005 to December 2015. Through a computerized review, we have identified and analyzed all patients aged 70 years and over who underwent a breast reconstruction. RESULTS: Five hundred and ninety patients underwent a radical mastectomy during the period...
May 15, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28520896/laser-assisted-indocyanine-green-dye-angiography-for-postoperative-fistulas-after-salvage-laryngectomy
#8
Erin J Partington, Lindsay S Moore, Russel Kahmke, Jason M Warram, William Carroll, Eben L Rosenthal, Benjamin J Greene
Importance: Pharyngocutaneous fistula formation is an unfortunate complication after salvage laryngectomy for head and neck cancer that is difficult to anticipate and related to a variety of factors, including the viability of native pharyngeal mucosa. Objective: To examine whether noninvasive angiography with indocyanine green (ICG) dye can be used to evaluate native pharyngeal vascularity to anticipate pharyngocutaneous fistula development. Design, Setting, and Participants: This cohort study included 37 patients enrolled from June 1, 2013, to June 1, 2016, and follow-up was for at least 1 month postoperatively...
May 18, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28516962/design-of-a-customised-bridging-mandibular-prosthesis-for-complex-reconstruction-a-pilot-study
#9
A Tarsitano, S Battaglia, A Sandi, C Marchetti
The gold standard for mandibular reconstruction is universally recognised and consists of the replacement of the bony part of the mandible with a bony microvascular free flap supported by a reconstructive plate. Although this procedure is feasible and reproducible in most patients, at times poor oncological prognosis or poor performance status force surgeons to consider other reconstructive solutions. In these cases, the main alternative in reconstructing a mandibular defect is represented by bridging plates combined with soft tissue flaps...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28514343/-effect-of-dexmedetomidine-on-perfusion-of-free-flaps-transferred-to-head-and-neck
#10
A S Dobrodeev, S A Rabinovich, I F Malykhina
The paper presents the impact of perioperative care on feasibility of free fibula flap transfer for facial reconstruction. Flaps vitality was measured by means of somatic oximetry in 85 patients aged 20-74 years receiving reconstruction procedures in midfacial and lower facial areas. The patients were divided in three groups according to sedation agent used postoperatively. It has been demonstrated that dexmedetomidine postoperative sedation significantly improved free fibula flaps perfusion compared to propofol sedation...
2017: Stomatologii︠a︡
https://www.readbyqxmd.com/read/28514018/salvage-of-postcranioplasty-implant-exposure-using-free-tissue-transfer
#11
Pang-Yun Chou, Cheng-Hung Lin, Chung-Chen Hsu, Wei-Hsun Yang, Alex A Kane, Chih-Hung Lin
BACKGROUND: Refractory implant exposure is frustrating after cranioplasty. The purpose of this study was for the authors to present their experience with free tissue transfer for salvage of postcranioplasty implant exposure. METHODS: A retrospective medical chart review was conducted on all free tissue transfers performed for exposed implant coverage after cranioplasty between January 2004 and February 2016. RESULTS: Twelve free flaps were performed in 11 patients who underwent postcranioplasty with implant exposure, and whose attempted implant coverage using locoregional flaps had failed...
May 17, 2017: Head & Neck
https://www.readbyqxmd.com/read/28513834/the-association-between-complications-and-quality-of-life-after-mastectomy-and-breast-reconstruction-for-breast-cancer
#12
John P Browne, Ranjeet Jeevan, Carmel Gulliver-Clarke, Jerome Pereira, Christopher M Caddy, Jan H P van der Meulen
BACKGROUND: Medical treatment for breast cancer is associated with substantial toxicity and patient burden. There is less known about the impact of surgical complications. Understanding this impact could provide important information for patients when they are considering surgical options. METHODS: Between 2008 and 2009, the UK National Mastectomy and Breast Reconstruction Audit recorded surgical complications for a prospective cohort of 17,844 women treated for breast cancer at 270 hospitals; 6405 of these women were surveyed about their quality of life 18 months after surgery...
May 17, 2017: Cancer
https://www.readbyqxmd.com/read/28513219/a-temporofrontal-fascia-flap-that-penetrated-temporal-muscle-for-the-reconstruction-of-an-anterior-skull-base-bone-and-dura-a-technical-case-report
#13
Makoto Katsuno, Koichi Uchida, Akira Matsuno
During skull base surgery, reconstruction of the dura is a very important procedure. Here, the use of a temporofrontal pedicled fascia flap tunnelled between temporal muscle fibres is described. This technique is easily performed and has a low postoperative morbidity, including skin and temporal muscle complications.
May 17, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28512866/medial-sural-artery-perforator-free-flap-for-the-reconstruction-of-leg-foot-and-ankle-defect-an-excellent-option
#14
Jyoshid R Balan
BACKGROUND: The defects over the leg, foot and ankle are best covered with a thin pliable flap. The use of muscle flap for the reconstruction of these defects leaves a grafted, aesthetically inferior result. The medial sural artery perforator (MSAP) free flap gives a thin pliable tissue for the reconstruction with better aesthesis. METHODS: The study design was retrospective case analysis over a period of 2 years. All the patients who underwent flap for leg, foot and ankle defect reconstruction in the form of MSAP free flap were included in the study...
May 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28509698/a-meta-analysis-of-studies-comparing-outcomes-of-diverse-acellular-dermal-matrices-for-implant-based-breast-reconstruction
#15
Kyeong-Tae Lee, Goo-Hyun Mun
BACKGROUND: The current diversity of the available acellular dermal matrix (ADM) materials for implant-based breast reconstruction raises the issue of whether there are any differences in postoperative outcomes according to the kind of ADM used. The present meta-analysis aimed to investigate whether choice of ADM products can affect outcomes. METHODS: Studies that used multiple kinds of ADM products for implant-based breast reconstruction and compared outcomes between them were searched...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28509697/repair-of-oropharyngeal-stenosis-with-bilateral-buccal-myomucosal-flaps
#16
Robert J Mann, Andrew L O'Brien, Nicholas S Adams, John A Girotto, John W Polley
Oropharyngeal stenosis (OPS) is a rare postoperative complication of adenotonsillectomy that can be a source of considerable patient distress and morbidity. Circumferential scarring of the soft palate and tonsillar pillars leads to narrowing of the oropharyngeal aperture. This case report describes the novel use of bilateral buccal myomucosal flaps for the repair of postoperative OPS in a 20-year-old woman presenting with dysphagia, odynophagia, dyspnea, and intermittent hypernasal speech. Postoperatively, the patient noted immediate improvement of her symptoms...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28509695/a-novel-augmented-reality-based-navigation-system-in-perforator-flap-transplantation-a-feasibility-study
#17
Taoran Jiang, Ming Zhu, Tao Zan, Bin Gu, Qingfeng Li
BACKGROUND: In perforator flap transplantation, dissection of the perforator is an important but difficult procedure because of the high variability in vascular anatomy. Preoperative imaging techniques could provide substantial information about vascular anatomy; however, it cannot provide direct guidance for surgeons during the operation. In this study, a navigation system (NS) was established to overlie a vascular map on surgical sites to further provide a direct guide for perforator flap transplantation...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28509694/does-the-use-of-acellular-dermal-matrix-increase-postoperative-complications-of-the-first-stage-reconstruction-of-immediate-expander-implant-breast-reconstruction-a-matched-cohort-study
#18
Kyong-Je Woo, Jin-Woo Park, Goo-Hyun Mun, Jai-Kyong Pyon, Byung-Joon Jeon, Sa Ik Bang
PURPOSE: Controversy exists regarding complications associated with the use of acellular dermal matrix (ADM). This likely stems from the heterogeneous and unmatched patient characteristics in study groups. The purpose of this study was to analyze complications in a matched cohort to identify whether ADM use increased postoperative complications of the first-stage immediate expander-implant breast reconstructions. METHODS: A retrospective matched-cohort study was performed...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28509443/hemodynamically-stimulated-and-in-vivo-generated-axially-vascularized-soft-tissue-free-flaps-for-closure-of-complex-defects-evaluation-in-a-small-animal-model
#19
Volker J Schmidt, Johanna O Wietbrock, Nico Leibig, Jochen F Hernekamp, Dominic Henn, Christian A Radu, Ulrich Kneser
The arteriovenous (AV) loop model permits the creation of significant volumes of axially vascularized tissue that represents an alternative to conventional free flaps, circumventing their common limitations. However, such AV-loop-based flaps have never before been examined in standardized animal models with respect to their suitability for reconstruction of critical bone exposing defects. In the course of our preliminary studies, we implemented a novel defect model in rats that provides standardized and critical wound conditions and evaluated whether AV-loop-generated flaps are suitable for free microsurgical transfer and closure of composite defects...
May 16, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28509409/soft-tissue-reconstruction-and-salvage-of-infected-fixation-hardware-in-lower-extremity-trauma
#20
Hyuma A Leland, Alexis D Rounds, Karen E Burtt, Daniel J Gould, Geoffrey S Marecek, Ram K Alluri, Ketan M Patel, Joseph N Carey
BACKGROUND: Tibial fracture management may be complicated by infection of internal fixation hardware (iIFH) resulting in increased morbidity and amputation rate. When iIFH removal is not possible, salvage of the lower extremity is attempted through debridement, antibiotics, and vascularized soft tissue coverage. This study investigates lower extremity salvage with retention of iIFH. METHODS: Demographics, outcomes, and bacterial speciation in patients with tibial fractures at a level 1 trauma center from 2007 to 2014 were reviewed...
May 16, 2017: Microsurgery
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