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Flap reconstruction

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https://www.readbyqxmd.com/read/28350682/vasculature-of-a-medial-femoral-condyle-free-flap-in-intact-and-osteotomized-flaps
#1
Maciej Rysz, Wojciech Grabczan, Maciej Jan Mazurek, Romuald Krajewski, Dariusz Grzelecki, Bogdan Ciszek
BACKGROUND: A small size and difficulties with shaping a medial femoral condyle corticocancellous bone flap are factors limiting its use. The goal of this study was to evaluate range of vascular supply to a medial femoral condyle corticocancellous bone flap to determine whether harvesting of larger flaps and performing a flap osteotomy would compromise the vasculature of a flap's bone. METHODS: Twenty-four limbs were dissected and medial femoral condyle corticocancellous bone flaps were harvested with skin paddles...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350674/a-new-microtia-reconstruction-method-using-delayed-postauricular-skin-flap
#2
Gaofeng Li, Fan Zhang, Wei Ding, Zihan Wu, Yigao Hu, Tao Luo, Bo Zhang, Xia Jiang
BACKGROUND: This article presents a new microtia reconstruction method using a delayed postauricular skin flap. METHODS: The surgery is scheduled in three stages, the first of which delays the postauricular skin flap and deals with the remnant auricle. Three weeks later, the second stage is carried out. An erect, three-dimensional ear framework fabricated from autogenous rib cartilage is inserted between two flaps. The anterior auricular surface of the framework is draped with the delayed skin flap, and the postauricular surface is draped with postauricular fascia and overlying grafted skin...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350654/a-prospective-randomized-trial-of-the-efficacy-of-fibrin-glue-triamcinolone-acetonide-and-quilting-sutures-in-seroma-prevention-after-latissimus-dorsi-breast-reconstruction
#3
Alexandra M Hart, Clarie Duggal, Ximena Pinell-White, Albert Losken
BACKGROUND: Donor-site seroma is the most common complication following latissimus dorsi flap breast reconstruction. Various agents and techniques have attempted to minimize seroma formation. The purpose of this study was to compare the efficacy of different products and quilting sutures at seroma prevention. METHODS: This is a single-center, double-blinded, randomized, controlled trial of a consecutive series of breast cancer patients (n = 96) undergoing latissimus dorsi flap reconstruction performed by a single surgeon...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28346687/itade-flap-after-mastectomy-for-locally-advanced-breast-cancer-a-good-choice-for-mid-sized-defects-of-the-chest-wall-based-on-a-systematic-review-of-thoracoabdominal-flaps
#4
René Aloisio da Costa Vieira, Katia Mathias Teixeira da Silva, Idam de Oliveira-Junior, Marcos Alves de Lima
BACKGROUND: Locally advanced breast cancer (LABC) is still a common problem in developing countries. Extensive resections are aimed at local control and improving quality of life. Dermofat flaps are an option for medium-sized defects. OBJECTIVES: Evaluate the results of a new thoracoabdominal flap (TAF). METHODS: We describe and evaluate an ipsilateral, thoracoabdominal horizontal, dermofat (ITADE) flap performed in patients submitted to mastectomy and immediate reconstruction...
March 27, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28346508/most-women-recover-from-psychological-distress-after-postoperative-complications-following-implant-or-diep-flap-breast-reconstruction-a-prospective-long-term-follow-up-study
#5
Reinier Timman, Jessica P Gopie, J Nick Brinkman, Annelies Kleijne, Caroline Seynaeve, Marian B E Menke-Pluymers, Moniek M Ter Kuile, Aad Tibben, Marc A M Mureau
BACKGROUND: Substantial complication rates after postmastectomy breast reconstruction (BR) in breast cancer patients have been reported. Few studies have reported on the resulting psychological distress (PD) and satisfaction with the aesthetic result in relation to postoperative complications after completion of implant or DIEP flap BR. The present study investigated whether women were able to recover from complication related distress in the long term. METHODS: PD was prospectively measured using questionnaires regarding anxiety, depression and cancer distress...
2017: PloS One
https://www.readbyqxmd.com/read/28346311/latissimus-dorsi-flap-breast-reconstruction-a-nationwide-inpatient-sample-review
#6
Michael R DeLong, Vickram J Tandon, George H Rudkin, Andrew L Da Lio
INTRODUCTION: The latissimus dorsi (LD) myocutaneous flap has been a long term standard for breast reconstruction. The variable indications for the LD flap have not been statistically examined because of the relative infrequency of its use by any single surgeon or institution. METHODS: The Nationwide Inpatient Sample data set was queried for all patient encounters involving a LD myocutaneous flap procedure. The study population was further restricted to female patients with a history of breast cancer or previous mastectomy...
March 24, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28345420/peroneal-perforator-pedicle-propeller-flap-for-lower-leg-soft-tissue-defect-reconstruction-clinical-applications-and-treatment-of-venous-congestion
#7
Lifeng Shen, Yiyang Liu, Chun Zhang, Qiaofeng Guo, Wenhua Huang, Kelvin Kian Loong Wong, Shimin Chang
Objective To describe the characteristics of the perforator vessel in the peroneal artery of the lower leg and to explore the use of perforator pedicle propeller flaps to repair soft tissue defects in the lower leg, heel and foot. Methods This retrospective study enrolled patients with soft tissue defects of the distal lower leg, heel and foot who underwent surgery using peroneal perforator-based propeller flaps. The peroneal artery perforators were identified preoperatively by colour duplex Doppler ultrasound...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28345267/color-duplex-ultrasonography-versus-handheld-doppler-to-plan-anterior-lateral-thigh-flaps
#8
Bernd Lethaus, Christina Loberg, Anita Kloss-Brandstätter, Alexander K Bartella, Timm Steiner, Ali Modabber, Frank Hölzle, Jan Teichmann
BACKGROUND: The anterior lateral thigh flap (ALT) has become increasingly important in reconstructive surgery in the head and neck region. To cope with the problem of anatomical variability in the supplying blood vessels, preoperative evaluation is desirable. Purpose of the study is to compare the most commonly used Doppler devices Handheld Doppler (HD) and Color Doppler Ultrasonography (CDU) for their clinical reliability. METHODS: Forty five consecutive head and neck cancer patients (mean age 66...
March 27, 2017: Microsurgery
https://www.readbyqxmd.com/read/28344538/surgical-excision-of-mycosis-fungoides-using-thumb-sparing-reconstruction
#9
Giancarlo McEvenue, Ashley Kim, Paul Binhammer
Background: The differential for soft tissue tumors of the hand and upper limb is broad. Hematologic malignancy remains quite low on the differential for soft tissue tumors involving the hand, and there is little in the literature describing surgical management of such cutaneous manifestations. When the tumor is large or involves the thumb, careful consideration of reconstructive options is required. Methods: We present a rare case of an aggressively enlarging mycosis fungoides, a cutaneous T-cell lymphoma tumor, involving the thumb...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28344527/reverse-radial-forearm-flap-to-provide-arterial-inflow-to-a-toe-transfer
#10
Joohak Kim, Alfred P Yoon, Neil F Jones
Background: Toe-to-thumb transfer has become the gold standard for thumb reconstruction, but in badly mutilated hands, additional soft tissue coverage may be required or a suitable recipient artery may not be available. There are only 3 case reports describing the successful use of a reverse radial forearm flap for coverage of a soft tissue defect around the thumb as well as providing arterial inflow for a toe transfer, performed either simultaneously or secondarily. Methods: A single surgeon's experience of all toe-to-hand transfers performed in conjunction with a reverse radial forearm flap between 1995 and 2014 was reviewed, including patient demographics, type of toe transfer and vascular pedicle, whether immediate or secondary, follow-up, and complications...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28342884/oral-cancer-reconstruction-using-the-supraclavicular-artery-island-flap-comparison-to-free-radial-forearm-flap
#11
Christian Welz, Martin Canis, Sabina Schwenk-Zieger, Jennifer L Spiegel, Bernhard G Weiß, Yiannis Pilavakis
PURPOSE: To evaluate whether the pedicled supraclavicular artery island flap (SCAIF) is a sufficient alternative to the fasciocutaneous radial forearm free flap (RFFF) for oral reconstruction in cancer surgery. PATIENTS AND METHODS: The authors designed and implemented a retrospective cohort study composed of all consecutive patients who underwent head and neck reconstruction after cancer surgery at their tertiary university hospital from 2013 to 2016. Demographics and peri- and postoperative information were recorded and statistically analyzed...
March 2, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28341956/improvement-on-the-neo-umbilicoplasty-technique-and-review-of-the-literature
#12
Valderi Vieira da Silva Júnior, Francis Régis Soares de Sousa
INTRODUCTION: The umbilicus is an important component of body esthetics, and its absence or dysmorphia may give rise to psychological discomfort, making it a common concern in surgical planning. Many techniques of umbilicus reconstruction have been proposed, each with its own limitations in terms of esthetics, risk of stenosis or final positioning. Reconstruction techniques may involve skin grafting, cartilage, purse-string suture and flaps. One of the most promising approaches is scarless neo-umbilicoplasty...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28341070/severe-hand-injuries-from-fireworks-injury-patterns-%C3%A2-outcomes-and-fireworks-types
#13
Brinkley K Sandvall, Kari A Keys, Jeffrey B Friedrich
PURPOSE: The purpose of this study was to characterize injury patterns and outcomes of fireworks-related hand injuries and determine if there was an association with certain fireworks types. METHODS: A retrospective cohort study was conducted on patients treated at a trauma center between 2005 and 2015. A total of 105 patients sustaining operative hand injuries due to fireworks were identified. Medical records were reviewed to identify injury patterns, treatment outcomes, and fireworks types...
March 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28340670/keystone-and-pedicle-perforator-flaps-in-reconstructive-surgery-new-modifications-and-applications
#14
REVIEW
Jasson T Abraham, Michel Saint-Cyr
Pedicle perforator flaps and keystone perforator island flaps are additional tools for reconstructive surgeons. Advances in understanding of vascular anatomy, the dynamic nature of perforator perfusion, inter-perforator flow and the hot-spot principle have led to reconstructive techniques that allow innovative autologous tissue transfer while limiting donor site morbidity. Further modifications of the pedicle perforator flap have led to a multitude of freestyle pedicle perforator flap options, as well as freestyle free flaps for soft tissue reconstruction...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340669/maximizing-the-utility-of-the-pedicled-anterolateral-thigh-flap-for-locoregional-reconstruction-technical-pearls-and-pitfalls
#15
REVIEW
Aparna Vijayasekaran, Waleed Gibreel, Brian T Carlsen, Steven L Moran, Michel Saint-Cyr, Karim Bakri, Basel Sharaf
The pedicled anterolateral thigh (PALT) flap is an underutilized flap for locoregional reconstruction largely because methods to maximize its reach are neither universally implemented nor fully understood. In addition, most of the available literature has focused on the utility of the free anterolateral thigh flap with less emphasis on the PALT flap. Moreover, flap design concepts to maximize its utility and reach and optimize outcomes have not been comprehensively described. In an effort to address this knowledge gap, the authors sought to review their institution's experience with the PALT flap for locoregional reconstruction...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340667/microsurgical-tissue-transfer-in-breast-reconstruction
#16
REVIEW
Nakul Gamanlal Patel, Venkat Ramakrishnan
Autologous breast reconstructions have grown in popularity because of their durability, aesthetic outcomes, symmetry, increase in external beam radiotherapy use, and potential aesthetic enhancement at the donor site. Increasing patient expectations for predictable high aesthetic outcomes with minimal complications or need for further procedures has been met by refinement in the use of flaps. The authors' microsurgical breast reconstruction center aims to provide this while delivering efficient service. The deep inferior epigastric flaps form 85% and transverse upper gracilis and profunda artery perforator flaps account for 10%; lumbar artery perforator flaps are a new addition to the authors' armamentarium...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340665/pediatric-microsurgery-a-global-overview
#17
REVIEW
Ali Izadpanah, Steven L Moran
As microsurgical expertise has improved, allowing for the safe transfer of smaller and more refined flaps, free tissue transfer has continued to gain popularity for the management of pediatric soft tissue and bony defects. For the past 2 decades pediatric microsurgery has been shown to be technically feasible and reliable. The major advantage of free tissue transfer in children is the ability to reconstruct defects in a single stage, avoiding the historic treatments of skin grafting, tissue expansion, and pedicled flaps...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340663/compound-or-specially-designed-flaps-in-the-lower-extremities
#18
REVIEW
Bruno Battiston, Davide Ciclamini, Jin Bo Tang
Novel and combined tissue transfers from the lower extremity provide new tools to combat soft tissue defects of the hand, foot, and ankle, or fracture nonunion. Flaps can be designed for special purposes, such as providing a gliding bed for a grafted or repaired tendon or for thumb or finger reconstruction. Propeller flaps can cover soft tissue defects of the leg and foot. In repairing severe bone and soft tissue defects of the lower extremity, combined approaches, including external fixators, one-stage vascularized bone grafting, and skin or muscle flap coverage of the traumatized leg and foot, have become popular...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340662/vascularized-small-bone-transfers-for-fracture-nonunion-and-bony-defects
#19
REVIEW
Ai Dong Deng, Marco Innocenti, Rohit Arora, Markus Gabl, Jin Bo Tang
Vascularized small-bone grafting is an efficient and often necessary surgical approach for nonunion or necrosis of several bones in particular sites of the body, including scaphoid, lunate, distal ulna, and clavicle. The medial femoral condyle is an excellent graft source that can be used in treating scaphoid, ulna, clavicle, or lower-extremity bone defects, including nonunion. Vascularized bone grafting to the small bones, particularly involving reconstruction of damaged cartilage surfaces, should enhance subchondral vascular supply and help prevent cartilage regeneration...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340661/medial-femoral-trochlea-osteochondral-flap-applications-for-scaphoid-and-lunate-reconstruction
#20
REVIEW
James P Higgins, Heinz K Bürger
Vascularized osteochondral flaps are a new technique described for the reconstruction of challenging articular defects of the carpus. The medial femoral trochlea osteochondral flap is supplied by the descending geniculate artery. This osteochondral flap has shown promise in the treatment of recalcitrant scaphoid proximal pole nonunions and advanced avascular necrosis of the lunate. The anatomy, surgical technique, and results are discussed, with clinical cases provided.
April 2017: Clinics in Plastic Surgery
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