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Perineal reconstruction

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https://www.readbyqxmd.com/read/28801729/-plastic-reconstruction-of-external-genitalia-after-fournier-s-gangrene
#1
REVIEW
E Comploj, A Pycha
Fournier's gangrene is a rapidly progressing necrotizing fasciitis restricted to the perineal and genital regions. Although rare, it is an acute life-threatening disease, requiring rapid radical surgical debridement and antibiotic treatment, resulting in large soft tissue defects. Various reconstructive methods for defect coverage are applied to satisfactorily reconstitute functionality and esthetics.
August 11, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28796733/outcomes-of-immediate-internal-pudendal-artery-perforator-flap-reconstruction-for-irradiated-abdominoperineal-resection-defects
#2
Pedro S Coltro, Fábio F Busnardo, Franklin C Mônaco Filho, Marcelo V Olivan, Lincoln S Millan, Victor A Grillo, Carlos F Marques, Caio S Nahas, Sérgio C Nahas, Ulysses Ribeiro, Rolf Gemperli
BACKGROUND: There are many previous reports for using the internal pudendal artery perforator flap in vulvovaginal reconstruction; however, reports of this flap for perineal reconstruction after abdominoperineal excision of the rectum are scarce. OBJECTIVE: The purpose of this study was to evaluate the outcomes of immediate internal pudendal artery perforator flap reconstruction for irradiated abdominoperineal resection defects. DESIGN: This was a prospective case series...
September 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28792191/comparison-of-vacuum-assisted-closure-therapy-and-debridement-with-primer-surgical-closure-for-fournier-s-gangrene-treatment-10-years-experience-of-a-single-centre
#3
Mustafa Ozan Horsanali, Utku Eser, Burcu O Horsanali, Omer Altas, Huseyin Eren
OBJECTIVE: Fournier's gangrene is a type of necrotizing soft tissue infection of the perineal, genital and perianal region that has a rapidly progressive and potentially fatal course. In the present study, our goal was to compare the patients submitted to surgical debridement for Fournier Gangrene with Vacuum-asisted Closure (VAC) and without VAC therapy after debridement. MATERIALS AND METHODS: We retrospectively analyzed 313 patients underwent surgical debridement for FG in our hospital...
August 8, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28755966/characteristics-of-idiopathic-urethral-strictures-a-link-to-remote-perineal-trauma
#4
Boyd R Viers, Travis J Pagliara, Charles A Rew, Lauren Folgosa Cooley, Christine Y Shiang, Jeremy M Scott, Allen F Morey
OBJECTIVE: To characterize the physical features and reconstructive outcomes of a series of idiopathic urethral stricture (IUS) cases in an effort to elucidate the nature of this common, yet poorly understood entity. METHODS: We retrospectively reviewed our urethroplasty database to identify men undergoing initial urethral reconstruction from 2007-2014 at one of three hospitals (N=514). Patients were stratified by stricture etiology including IUS, acute trauma, iatrogenic, hypospadias, balanitis xerotica obliterans, and radiation...
July 26, 2017: Urology
https://www.readbyqxmd.com/read/28755440/the-effectiveness-of-surgical-interventions-for-women-with-fgm-c-a-systematic-review
#5
Rigmor C Berg, Sølvi Taraldsen, Maryan A Said, Ingvil Krarup Sørbye, Siri Vangen
BACKGROUND: Female genital mutilation/cutting (FGM/C) changes normal genital functionality and can cause complications. There is an increasing demand for treatment of FGM/C-related complications. OBJECTIVES: We conducted a systematic review of empirical quantitative research on the outcomes of interventions for women with FGM/C-related complications. SEARCH STRATEGY: A search specialist searched 16 electronic databases. SELECTION CRITERIA: Selection was independent by two researchers...
July 29, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28698756/treatment-of-decubitis-ulcer-stage-iv-in-the-patient-with-polytrauma-and-vertical-share-pelvic-fracture-diagnosed-entherocollitis-and-deep-wound-infection-with-clostridium-difficile-with-combined-negative-pressure-wound-therapy-npwt-and-faecal-management-system
#6
Slavcho Stojmenski, Igor Merdzanovski, Andrej Gavrilovski, Sofija Pejkova, Gjorge Dzokic, Smilja Tudzarova
AIM: The aim of this paper was to present a case with the successful treatment of decubitis ulcer stage IV in the patient with polytrauma and vertical share pelvic fracture and diagnosed entherocollitis combined with deep wound infection with Clostridium difficile treated with combined Negative Pressure Wound Therapy (NPWT) and faecal management system. CASE REPORT: Patient D.S.1967 treated on Traumatology Clinic after tentamen suicide on 9.2.2015 with diagnosis: brain contusion; contusion of thoracal space; vertical share pelvic fracture; open fracture type II of the right calcaneus; fracture of the left calcaneus; fracture on the typical place of the left radius; fracture of the right radius with dislocation...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28638794/biological-mesh-reconstruction-of-the-pelvic-floor-following-abdominoperineal-excision-for-cancer-a-review
#7
REVIEW
Boris Schiltz, Nicolas Christian Buchs, Marta Penna, Cosimo Riccardo Scarpa, Emilie Liot, Philippe Morel, Frederic Ris
Extralevator abdominoperineal excision and pelvic exenteration are mutilating operations that leave wide perineal wounds. Such large wounds are prone to infection and perineal herniation, and their closure is a major concern to most surgeons. Different approaches to the perineal repair exist, varying from primary or mesh closure to myocutaneous flaps. Each technique has its own associated advantages and potential complications and the ideal approach is still debated. In the present study, we reviewed the current literature and our own local data regarding the use of biological mesh for perineal wound closure...
June 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28625744/the-anterior-sagittal-transrectal-approach-astra-for-cases-associated-with-rectal-implantation-of-the-urethra-a-retrospective-review-of-six-cases
#8
A Macedo, M I S Silva, J A Pompermaier, S L Ottoni, R de Castro, M Leal da Cruz
INTRODUCTION: Severe genital abnormalities such as urogenital sinus and urethral duplication with ectopic urethra in the rectum represent a major challenge in reconstructive urology. OBJECTIVE: We aimed to review our cases presenting with functional ectopic urethra implanted in the rectum that were treated through an ASTRA approach. METHODS: We reviewed the medical records of all patients who had undergone an ASTRA approach from 2005-2016...
May 17, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28616723/post-operative-strictures-in-anorectal-malformation-trends-over-15%C3%A2-years
#9
Charlotte Holbrook, Devesh Misra, Indre Zaparackaite, Stewart Cleeve
AIM: For decades, paediatric surgeons have employed the standard posterior sagittal anorectoplasty (PSARP) approach to deal with patients with anorectal malformations (ARM). In recent years, we noted an apparent increase in the incidence of anal stricture after surgical repair of ARM following the introduction of laparoscopic pull-through and techniques aiming to preserve the internal sphincter-the internal sphincter sparing approach (ISSA). We decided to analyse our data to find out if these new trends had added to the problem of post-operative strictures...
August 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28607874/robotic-assisted-abdomino-perineal-vesicourethral-anastomotic-reconstruction-for-4-5-centimeter-post-prostatectomy-stricture
#10
Brian F Dinerman, Nicholas J Hauser, Jim C Hu, Rajveer S Purohit
We report surgical management of a disrupted radical prostatectomy vesicourethral anastomosis after bleeding from undiagnosed hemophilia that required re-exploration, pudendal artery embolization, and urinary diversion with nephrostomy and surgical drains. After referral, the 4.5 cm vesicourethral anastomotic defect was reconstructed with a robotic-assisted abdomino-perineal approach. Intra-abdominal robotic-assisted mobilization of the bladder and perineal mobilization of the urethra permitted a tension-free vesicourethral anastomosis while avoiding a pubectomy...
September 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28542071/vertical-rectus-abdominis-myocutaneous-versus-alternative-flaps-for-perineal-repair-after-abdominoperineal-excision-of-the-rectum-in-the-era-of-laparoscopic-surgery
#11
Mark Scott Johnstone
AIMS: Plastic surgical reconstruction of the perineum is often required after abdominoperineal excision of the rectum. Options for this reconstruction include a vertical rectus abdominis myocutaneous (VRAM) flap, gluteal fasciocutaneous flap, and gracilis myocutaneous flap. Although the VRAM flap is well established at most centers, less experience exists with the gluteal and gracilis flaps. In the era of laparoscopic colorectal resection, plastic surgeons are being forced to use gluteal and gracilis flaps because the VRAM flap must be tunnelled intra-abdominally requiring laparotomy...
July 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28508281/perineal-hernia-repair-after-abdominoperineal-excision-or-extralevator-abdominoperineal-excision-a-systematic-review-of-the-literature
#12
REVIEW
A Balla, G Batista Rodríguez, N Buonomo, C Martinez, P Hernández, J Bollo, E M Targarona
BACKGROUND: The incidence of perineal hernia after abdominoperineal excision and extralevator abdominoperineal excision ranges from 1 to 26%. In this systematic review, we compared surgical options and postoperative outcomes of perineal hernia repair in this setting from 2012 to 2016 with findings in a review of publications 1944-2011. METHODS: We searched the PubMed database using the keywords "hernia" AND "perineum" identified 392 papers published from 1946 to 2016...
May 15, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28499524/one-stage-gender-confirmation-surgery-as-a-viable-surgical-procedure-for-female-to-male-transsexuals
#13
Borko Stojanovic, Marta Bizic, Marko Bencic, Vladimir Kojovic, Marko Majstorovic, Milos Jeftovic, Dusan Stanojevic, Miroslav L Djordjevic
BACKGROUND: Female-to-male gender-confirmation surgery (GCS) includes removal of breasts and female genitalia and complete genital and urethral reconstruction. With a multidisciplinary approach, these procedures can be performed in one stage, avoiding multistage operations. AIM: To present our results of one-stage sex-reassignment surgery in female-to-male transsexuals and to emphasize the advantages of single-stage over multistage surgery. METHODS: During a period of 9 years (2007-2016), 473 patients (mean age = 31...
May 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28436214/a-comparison-of-the-cost-of-primary-closure-or-rectus-abdominis-myocutaneous-flap-closure-of-the-perineum-after-abdominoperineal-excision
#14
John Woodfield, Michael Hulme-Moir, Jasen Ly
AIM: Perineal wound complications following abdominoperineal resection continue to be a major challenge.. The aim of this study was to compare the clinical outcomes and cost of primary closure (PC) and rectus abdominis myocutaneous flap reconstruction (RAM). METHOD: Retrospective case review of consecutive patients by one surgeon over 11 years. Patient demographics, risk factors, operative details and complications were identified. Inpatient and outpatient costs were calculated...
April 24, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28422365/successful-vaginal-delivery-at-term-after-vaginal-reconstruction-with-labium-minus-flaps-in-a-patient-with-vaginal-atresia-a-rare-case-report
#15
Yu Liu, Yi-Feng Wang
We report a case of successful vaginal delivery after vaginal reconstruction with labium minus flaps in a 23-year-old patient with congenital vaginal atresia. The patient primarily presented with amenorrhea and cyclic abdominal pain; transabdominal ultrasonography revealed an enlarged uterus due to hematometra and absence of the lower segment of the vagina. Eight years ago, she had undergone an unsuccessful attempt at canalization at a local hospital. Upon referral to our hospital, she underwent vaginal reconstruction with labium minus flaps...
April 19, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28413306/urogenital-management-in-cloaca-an-alternative-approach
#16
Harshjeet Singh Bal, Sudipta Sen, Cenita Sam, Jacob Chacko, John Mathai, S R Regunandan
INTRODUCTION: In the management of cloaca, there is concern that dissection of the urogenital sinus in early childhood with the aim of total anatomical correction is hazardous. Avoiding such mobilization and providing mitrofanoff channel, when needed, till peripubertal period reduces complications and is technically easier. MATERIALS AND METHODS: Forty-three cases of cloaca were managed in the period 2004-2016. Case records and radiology were reviewed retrospectively...
April 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28392008/long-term-follow-up-after-traditional-versus-modified-perineal-approach-in-the-management-of-female-epispadias
#17
F Alyami, N Fernandez, L Lee, P Metcalfe, A Lorenzo, J Pippi Salle
OBJECTIVE: Isolated female epispadias (IFE) is a rare congenital anomaly. The defect extends to the bladder neck, which is usually incompetent. The traditional surgical approach includes urethral and genital reconstruction in the first year, followed by bladder neck reconstruction (Young-Dees-Leadbetter cervicoplasty (YDL)) at the age of social continence. An alternative single-stage technique includes urethral, bladder neck and clitoris repair by a perineal approach. The aim of the present study was to describe long-term follow-up of patients who underwent the traditional vs alternative approach...
March 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28387059/pouch-excision-indications-and-outcomes
#18
Amy L Lightner, Sheev Dattani, Eric J Dozois, Sara B Moncrief, John H Pemberton, Kellie L Mathis
INTRODUCTION: Resotrative proctolectomy (RPC) with Ileal-pouch anal anastomosis (IPAA) is the procedure of choice for ulcerative colitis. Unfortunately, up to 10% of pouches will fail, requiring either reconstruction or excision. While several series have reported on the aetiology of pouch failure, no study to date has focused on the postoperative complications associated with pouch excision. METHODS: Patients who had excision of ileoanal reservoir with ileostomy (CPT code 45136) were included...
April 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28293441/free-gingival-graft-to-increase-keratinized-mucosa-after-placing-of-mandibular-fixed-implant-supported-prosthesis
#19
Danny Omar Mendoza Marin, Andressa Rosa Perin Leite, Lélis Gustavo Nícoli, Claudio Marcantonio, Marco Antonio Compagnoni, Elcio Marcantonio
Insufficiently keratinized tissue can be increased surgically by free gingival grafting. The presence or reconstruction of keratinized mucosa around the implant can facilitate restorative procedure and allow the maintenance of an oral hygiene routine without irritation or discomfort to the patient. The aim of this clinical case report is to describe an oral rehabilitation procedure of an edentulous patient with absence of keratinized mucosa in the interforaminal area, using a free gingival graft associated with a mandibular fixed implant-supported prosthesis...
2017: Case Reports in Dentistry
https://www.readbyqxmd.com/read/28279398/-perineal-reconstruction-salvage-surgery-with-2flaps-technique
#20
Marta Jiménez Gómez, Antonio Navarro-Sánchez, Jaime Lima Sánchez, Juan Ramón Hernández Hernández
BACKGROUND: The principles of perineal reconstructive surgery comprise adequate filling of the defect along with stable and durable skin coverage, with a low morbidity rate. Two-flap perineal reconstruction is a simple, fast and reliable technique that uses a single donor site. This improves scar position with low morbidity. It is based in the use of 2flaps; one flap fills the defect with a «turn over» technique and the other is a rotation - advancement flap for skin coverage. CLINICAL CASE: A 52-year-old male diagnosed with Lynch syndrome who underwent laparoscopic abdominoperineal amputation for adenocarcinoma of the lower rectum and developed recurrence 2years later over the perineal scar that required radical resection and perineal reconstruction...
March 6, 2017: Cirugia y Cirujanos
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