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https://www.readbyqxmd.com/read/29166348/the-economics-of-prepectoral-breast-reconstruction
#1
Scot Bradley Glasberg
The world of breast reconstruction over the last several years has seen a dramatic shift in focus to discussion and the application of placing tissue expanders and implants back into the prepectoral space. Although this technique failed during the early advent of breast reconstruction, newer technologies such as advances in fat grafting, improved acellular dermal matrices, better methods of assessing breast flap viability, and enhanced implants appear to have set the stage for the resurgence and positive early results seen with this technique...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29166346/options-in-acellular-dermal-matrix-device-assembly
#2
Steven Sigalove
Prepectoral prosthetic breast reconstruction has become increasingly popular during the last several years. Original shortcomings and poor outcomes in the 1970s have been overcome with the use of the bioengineered breast concept-namely, use of improved form stable breast implants, autologous fat grafting, and acellular dermal matrices (ADMs). Careful use of these reconstructive tools combined with improved mastectomy skin flaps has lead to successful early outcomes. Prepectoral breast reconstruction mitigates the animation deformities and muscle tightness previously associated with dual-plane prosthetic breast reconstruction while at the same time producing reproducible and outstanding aesthetic outcomes...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29166345/prepectoral-immediate-direct-to-implant-breast-reconstruction-with-anterior-alloderm-coverage
#3
Glyn Jones, Aran Yoo, Victor King, Brian Jao, Huaping Wang, Charalambos Rammos, Eric Elwood
BACKGROUND: Staged subpectoral expander-implant breast reconstruction is widely performed. Disruption of the pectoralis major origin and the frequent occurrence of animation deformity and functional discomfort associated with subpectoral reconstruction remain ongoing concerns. Prepectoral single-stage direct-to-implant reconstruction resolves many of these issues. In this study, the authors explored the rationale for prepectoral single-stage implant-based breast reconstruction with anterior AlloDerm coverage as an alternative to the staged approach...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29166342/important-considerations-for-performing-prepectoral-breast-reconstruction
#4
Hani Sbitany
Prepectoral breast reconstruction has emerged as an excellent technique for postmastectomy reconstruction, as it allows for full preservation of a patient's pectoralis major muscle and chest wall function. This reduces pain, eliminates animation deformity, and results in high patient satisfaction. Safely performed prepectoral breast reconstruction requires a careful patient selection process before committing to the procedure, taking into account comorbidities, radiation status, and oncologic criteria such as tumor location and breast cancer stage...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29166313/the-perineal-turnover-perforator-flap-a-new-and-simple-technique-for-perineal-reconstruction-after-extralevator-abdominoperineal-excision
#5
Maria Chasapi, Mohamed Maher, Peter Mitchell, Milind Dalal
BACKGROUND: Extralevator abdominoperineal excision (ELAPE) is increasingly used to treat locally advanced low rectal cancer as it has been related to superior oncological outcomes than traditional abdominoperineal excision.However, ELAPE also has been associated with high perineal wound morbidity rates as it creates a larger perineal cavity than standard abdominoperineal excision. This greater defect, along with the effects of preoperative chemoradiation on wound healing, makes uneventful perineal reconstruction post-ELAPE a real challenge for the plastic surgeon...
November 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29165433/management-of-free-flap-failure-in-head-and-neck-surgery
#6
C Copelli, K Tewfik, L Cassano, N Pederneschi, S Catanzaro, A Manfuso, R Cocchi
Free flap surgery is overall considered the gold standard in head and neck reconstruction, with a success rate of 95%. The management of a total flap necrosis and which solution, between a pedicled or a second free flap, is safer for a salvage procedure is still controversial. Object of this study is to describe the authors' management of total free flap loss in head and neck reconstruction and compare the choices and results to those reported in the literature. From January 2012 to January 2016, 149 consecutive free flaps were performed at the Maxillo- Facial Operative Unit of the Hospital Casa Sollievo della Sofferenza in San Giovanni Rotondo (Italy) for reconstruction of head and neck defects...
October 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29165016/the-use-of-osteochondral-flaps-in-the-treatment-of-carpal-disorders
#7
James P Higgins, Heinz K Bürger
Vascularized osteochondral flaps have been described for use in reconstruction of the wrist, providing the benefits of osteochondral grafts in addition to the benefit of osseous and subchondral perfusion via the microvascular pedicle. Various harvest sites have been described including the medial and lateral femoral trochlea and the proximal third metatarsal. The reconstructed surfaces described include the cartilage surfaces of the scaphoid, lunate, capitate and radius. The ability to transfer analogous osteochondral surfaces poses the possibility for new motion-preserving alternatives for difficult articular problems previously treated with salvage procedures...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29163697/reoperation-following-the-use-of-non-standardized-procedures-for-malignant-parotid-tumors
#8
Xiangmin Zhang, Xiangfu Zeng, Xiaolin Lan, Jing Huang, Keqing Luo, Keqiang Tian, Xiuhong Wu, Fufu Xiao, Shaojin Li
Non-standardized or conservative procedures are employed when parotid tumors involving the facial nerve or parotid carcinoma are misdiagnosed as benign parotid tumors prior to or during surgery. Remedial measures are usually required when the pathological diagnosis of a malignant parotid tumor is confirmed following surgery. The aim of the present study was to systematically evaluate reoperation subsequent to treatment with non-standardized procedures for malignant parotid tumors, and to explore the preoperative diagnoses, the primary procedure selection and the necessity of reoperation following non-standardized procedures in malignant parotid tumors...
December 2017: Oncology Letters
https://www.readbyqxmd.com/read/29162784/quantitative-analysis-of-chronological-changes-in-the-volume-of-flaps-used-for-reconstruction-of-oral-cavity-defects
#9
Masashi Kimura, Ken Takada, Kenichiro Ishibashi, Hiroyuki Ohto, Akio Shibata, Hiroki Yamada, Shusuke Nishiwaki, Yoshiyuki Naganawa, Masahiro Umemura
Reconstruction of oral defects using flaps following resection of oral cancer has become a standard approach for restoration of oral function. The purpose of this study was to investigate chronological changes in the volume of such flaps used for reconstruction and the factors affecting flap volume. We performed a retrospective analysis of 17 patients who had undergone oral cancer resection and reconstruction with flaps. Measurements were performed using data from computed tomography, and the flaps were selected semi-automatically using a computer-operated region-of-interest system...
November 22, 2017: Journal of Oral Science
https://www.readbyqxmd.com/read/29159747/correction-to-reply-to-complications-in-diep-flap-breast-reconstruction-after-mastectomy-for-breast-cancer-a-prospective-cohort-study-comparing-unilateral-versus-bilateral-reconstructions
#10
Ryckie G Wade, Sergio Razzano, Elaine M Sassoon, Richard M Haywood, Justin C R Wormald, Andrea Figus
In the original article Justin C. R. Wormald's middle initials were incorrect. They are correct as reflected in this erratum. The original article has also been corrected.
November 20, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29156232/use-of-negative-pressure-wound-therapy-after-infection-and-flap-dehiscence-in-radical-vulvectomy-a-case-report
#11
Antoni Llueca, Jose Luis Herraiz, Raquel Del Moral, Dolors Piquer, Yasmine Maazouzi, Blanca Segarra, Jordan Barres, Anna Serra
INTRODUCTION: Vulvar cancer has a lower incidence in high income countries, but is rising, in part, due to the high life expectancy in these societies. Radical vulvectomy is still the standard treatment in initial stages. Wound dehiscence contitututes one of the most common postoperative complications. PRESENTATION OF CASE: A 76year old patient with a squamous cell carcinoma of the vulva, FIGO staged, IIIb is presented. Radical vulvectomy and bilateral inguinal lymph node dissection with lotus petal flaps reconstruction are performed as the first treatment...
November 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29153902/robotic-buccal-mucosal-graft-ureteroplasty-for-complex-ureteral-stricture
#12
Sohrab Arora, Logan Campbell, Mouafak Tourojman, Daniel Pucheril, Lamont R Jones, Craig Rogers
OBJECTIVE: To demonstrate robot-assisted ureterolysis and buccal mucosal graft (BMG) ureteroplasty for the management of a complex, long recurrent ureteral stricture developing after ureterolysis, and also to demonstrate the use of near-infrared fluorescence (NIRF) imaging and intraoperative ureteroscopy during this procedure. METHODS: A 58-year-old man with a history of cabergoline treatment and a cardiac catheterization through the left groin presented with left flank pain and hydronephrosis...
December 2017: Urology
https://www.readbyqxmd.com/read/29153868/-transposition-of-the-cephalic-vein-in-free-flap-breast-reconstruction-technical-note
#13
T Silhol, T Suffee, M Hivelin, L Lantieri
Free flaps have become a reliable practice for breast reconstruction. However, the venous congestion is still the most frequent reason of flap failure. It is due to bad quality of the internal mammary veins, a preferential superficial venous outflow of the flap or due to venous thrombosis. The transposition of the cephalic vein could useful in some cases. We describe the surgical technique and suggest an intraoperative algorithm. Seventeen patients (15 DIEP and 2 PAP) were included. Twenty nine point four percent had an unusable internal mammary vein, 23...
November 16, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29153422/a-flap-based-on-the-plantar-digital-artery-arch-branch-to-improve-appearance-of-reconstructed-fingers-anatomical-and-clinical-application
#14
Lin-Feng Tang, Ji-Hui Ju, Yue-Fei Liu, Bo Lan, Rui-Xing Hou
AIM: To investigate blood supply features of the flap based on the plantar digital artery arch and arch branch artery, and the treatment of outcomes of reconstructed fingers by the plantar digital artery arch branch island flap. METHODS: Eight fresh foot specimens were employed with red emulsion infusion and microdissection. The vascular organization was observed in the second toe, such as initiation site, the course, and the number of the plantar digital artery arch branch...
November 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29153233/temporomandibular-joint-reconstruction-in-the-growing-child
#15
REVIEW
Cory M Resnick
Indications and considerations for reconstruction of the temporomandibular joint (TMJ) differ between growing and skeletally mature patients. Osteoarthritis, which is the most common cause of TMJ destruction in adults, is comparatively rare in children. The most common indications in young patients are congenital deformities, pathology, ankylosis and progressive resorptive processes. Options for reconstruction include distraction osteogenesis, autologous reconstruction (ie, costochondral graft, free fibula flap), and total alloplastic joint replacement...
February 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29152783/comparison-of-sub-versus-suprafascially-raised-anterolateral-thigh-free-flaps-with-regard-to-donor-site-morbidity-function-and-aesthetics
#16
Sebastian Fischer, Yannick Diehm, Christoph Hirche, Thomas Kremer, Adrien Daigeler, Ulrich Kneser, J Frederick Hernekamp
BACKGROUND: Although the anterolateral thigh flap (ALT) is one of the most frequently applied free flaps in plastic surgery, it remains controversial if the flap should be raised in a sub- or suprafascial plane. The purpose of this study was to compare both harvest techniques regarding donor-site morbidity and outcomes. METHODS: We included 40 pair-matched patients, of whom 20 received a fasciocutaneous and 20 an adipocutaneous ALT free flap for extremity reconstruction...
November 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/29152539/early-mobilizing-and-dangling-of-the-lower-leg-after-one-stage-reconstruction-of-achilles-tendon-and-overlying-tissue-defect-using-an-anterolateral-thigh-flap-with-vascularized-fascia-lata
#17
Masayuki Okochi, Masanori Momiyama, Hiromi Okochi, Kazuki Ueda
We have treated two patients who had an Achilles tendon and overlying tissue defect using an anterolateral thigh flap with fascia lata. Postoperatively, skeletal suspension of the affected leg and intra-arterial heparin infusion were performed for seven days. Six weeks postoperatively, the patients could walk again.
2017: Case Reports in Plastic Surgery & Hand Surgery
https://www.readbyqxmd.com/read/29151381/feasibility-of-a-septal-mucosal-flap-for-preventing-re-stenosis-following-the-draf-iii-procedure
#18
O Erdur, K Ozturk, K Erkan
BACKGROUND: Re-stenosis and a consequent need for revision surgery are the most common problems in the follow-up period following endoscopic modification of the Lothrop procedure. METHOD: This paper reports a new technique for reconstructing and resurfacing of the posterior frontal recess bone for prevention of re-stenosis. RESULTS: A 46-year-old man presented with a frontal sinus osteoma, and treatment featured an endoscopic modification of the Lothrop procedure...
November 20, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29151373/nasoseptal-flap-for-palatal-reconstruction-after-hemi-maxillectomy-case-report
#19
M K Alwashahi, P Battaglia, M Turri-Zanoni, P Castelnuovo
OBJECTIVE: Palatal reconstruction following maxillectomy is a surgical challenge, and a nasoseptal flap is a feasible approach. This paper reports the first known successful clinical case of a nasoseptal pedicle flap applied for the reconstruction of maxillary bone following hemi-maxillectomy. CASE REPORT: This report describes hemi-maxillectomy in a 60-year-old Italian male diagnosed with stage IV squamous cell carcinoma of the left maxilla. Endoscopic transnasal extended medial maxillectomy was performed, followed by a transoral modified midfacial degloving technique for removal of the maxillary bone...
November 20, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29148237/supraclavicular-flap-repair-in-the-free-flap-era
#20
REVIEW
Jodie Trautman, Sinclair Gore, Matthew Potter, Jonathan Clark, Dylan Hyam, Ngian C Tan, Quan Ngo, Bruce Ashford
BACKGROUND: Supraclavicular flap (SCF) repair is widely reported in head and neck surgery in select patients and defects. The authors' objective is to present our series of 30 patients who underwent SCF repair for varying defects and to review the scope and outcome of SCF repair in the literature. METHODS: The authors contributed primary evidence of 30 cases of SCF repair. Our outcomes are compared with those reported in the last 5 years' literature; 33 articles published between January 2012 and January 2017 that present original clinical experience of 528 SCFs...
November 17, 2017: ANZ Journal of Surgery
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