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https://www.readbyqxmd.com/read/28544074/single-stage-aesthetic-and-functional-reconstruction-of-composite-facial-gunshot-wound-with-a-chimeric-functioning-muscle-and-fibular-osseous-flap-case-report-and-review-of-the-literature
#1
Andreas Gravvanis, Konstantinos Apostolou, Dimitrios Anterriotis, Dimosthenis Tsoutsos
The current concepts in the aesthetic and functional reconstruction of complex oromandibular defects are presented with a case of a patient with self-inflicted gunshot wound to the face. The patient presented with a 6 cm composite mandibular defect; the buccomandibular and suborbital aesthetic zones of the cheek along with the mucosa lining, and the ipsilateral facial musculature were missing. A rapid prototyping model of the facial skeleton was used to assist in preoperative planning. A single stage reconstruction with two free flaps was planned; a free fibula osseous flap to reconstruct the mandibular defect, and a free chimeric ALT/functioning vastus lateralis muscle...
May 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28528049/an-old-solution-for-a-new-problem-eloesser-flap-management-of-infected-defibrillator-patches
#2
Heidi B Schubmehl, Huan Huan Sun, Jessica S Donington, Deane E Smith, Eugene A Grossi
Cardiac surgery patients with infected implantable cardioverter defibrillator hardware face high morbidity with both surgical and nonoperative management options. We present a case of infected epicardial patch defibrillator leads in a patient with prohibitively high risk of death with open surgical removal. As a less morbid alternative, an Eloesser flap was used to convert his presenting mediastinal empyema necessitans into a chronic, manageable wound.
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28507858/reconstructing-discontinuous-facial-defects-with-simultaneous-ulnar-perforator-free-flaps
#3
Carissa M Thomas, Mofiyinfolu Sokoya, Frederic W-B Deleyiannis
Multiple, simultaneous skin cancers of the face are common. This is the first description of reconstructing discontinuous facial defects (i.e., separate sites of the face) with simultaneous ulnar perforator flaps. The distinct innovations of this multiple flap design are the ability to restrict the harvest site to one extremity, to obtain vein and arterial grafts from the same extremity, and to create multiple flaps with minimal hirsutism and bulk. We present a case of a 57-year-old male with multiple basal cell carcinomas who underwent wide local excisions of the right upper lip and cheek and of the left lower eyelid and infraorbital cheek...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28493355/consideration-of-difficulties-and-exit-strategies-in-a-case-of-face-allotransplantation-resulting-in-failure
#4
Özlenen Özkan, Ömer Özkan, Umuttan Doğan, Vural Taner Yılmaz, Hilmi Uysal, Levent Ündar, Ebru Apaydın Doğan, Ozan Salim, Anı Çinpolat, Atilla Ramazanoglu
We describe the first rescue procedure in a case of total face allotransplantation. The recipient was a 54-year-old man with severe disfigurement of the entire face following an accidental gunshot injury 5 years previously. The large defect included the maxilla, mandible, and mid-face. Full face procurement was performed from a multiorgan cadaveric donor and was allotransplanted to the recipient. The post-transplant induction immunosuppressive regimen included ATG combined with tacrolimus, mycophenolate mofetil, and prednisone, while maintenance was provided by the last three of these...
May 11, 2017: Microsurgery
https://www.readbyqxmd.com/read/28482626/ten-minutes-of-ischemia-is-superior-to-shorter-intervals-for-the-remote-ischemic-conditioning-of-human-microcirculation
#5
J Kolbenschlag, A Sogorski, C Timmermann, K Harati, A Daigeler, T Hirsch, O Goertz, M Lehnhardt
BACKGROUND: Surgical flaps have become reliable tools in the microsurgical armamentarium, but are still faced with tissue loss due to impaired perfusion which can lead to complete flap failure. Remote Ischemic Conditioning (RIC) has been demonstrated to be an effective way to improve microcirculation in surgical flaps in humans. However, little is known about the optimal amount and length of RIC cycles. OBJECTIVE: Determination of a superior protocol for RIC of cutaneous microcirculation in humans...
May 5, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28481422/dual-chimeric-innervated-vastus-lateralis-free-flap-for-single-stage-blink-and-midface-reanimation
#6
Lauren S H Chong, Richard Tjahjono, Timothy J Eviston, Jonathan R Clark
BACKGROUND: The immediate reconstruction of the face in the setting of radical parotidectomy for malignancy represents a particular challenge. We present a novel technique using 2 sections of the vastus lateralis muscle as a chimeric flap in combination with the anterolateral thigh (ALT) fasciocutaneous flap to achieve midface reanimation and eye closure after radical parotidectomy. METHODS: The harvest technique in view of variations in chimeric muscle components, vascular pedicles, and neural coaptations is described herein...
May 8, 2017: Head & Neck
https://www.readbyqxmd.com/read/28448262/an-unusually-large-carbuncle-of-the-temporofacial-region-demonstrating-remarkable-post-debridement-wound-healing-process-a-case-report
#7
Humaid Ahmad, Sheeraz Shakoor Siddiqui
Skin carbuncles are debilitating skin infections commonly seen in elderly patients with diabetes. These infections develop when a cluster of adjacent furuncles coalesce to form one inflammatory mass. While they commonly occur on the nape of the neck and back, rarer sites involving the face and head have been noted. Management of these rare sites is urgent because of the potential intracranial complications and the surgical outcome is often unsatisfactory due to associated facial scarring. Intraoral drainage is advocated to avoid this; however, when the carbuncle involves a larger area, debridement from the exterior is necessary...
April 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28445373/auricular-reconstruction-in-hemifacial-microsomia-with-an-expanded-two-flap-method
#8
Jin Qian, Zhibin Li, Tun Liu, Xu Zhou, Qingguo Zhang
BACKGROUND: Reconstruction of external ear is important for the child/adult with craniofacial deformities to achieve balance and harmony of the face and head. The aim of this study was to investigate the clinical application of an expanded two-flap method for auricular reconstruction in hemifacial microsomia. METHODS: Between January of 2014 and November of 2015, 111 hemifacial microsomia patients with microtia underwent auricular reconstruction with an expanded two-flap method...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28410710/supracapsular-glued-intraocular-lens-in%C3%A2-progressive-subluxated-cataracts-technique-to-retain-an-intact-vitreous-face
#9
Soosan Jacob, Smita Narasimhan, Amar Agarwal, Cosimo Mazzotta, Miguel Rechichi, Athiya Agarwal
We describe a technique to prevent late intraocular lens (IOL) subluxation and dislocation that can be associated with progressive zonulopathy. Supracapsular glued IOL fixation is done to retain an intact anterior hyaloid face and avoid vitreous disturbance while providing stable long-term IOL fixation. Phacoemulsification is followed by glued IOL implantation above intact anterior and posterior capsules. Sclerotomies are created ab interno in a supracapsular plane under diametrically opposite lamellar scleral flaps without entering the vitreous cavity...
March 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28385570/-why-is-it-important-to-differentiate-trichoblastic-carcinomas-ct-from-basal-cell-carcinomas-cbc-about-21-cases
#10
M Thomas, C Bruant-Rodier, F Bodin, B Cribier, M Huther, C Dissaux
Trichoblastic carcinoma is a rare epithelial malignant epithelial tumor, its diagnosis is difficult and the therapeutic management is non-consensual. This retrospective study, carried out between 2009 and 2015, covered 21 cases and analyzed the diagnostic and therapeutic characteristics of trichoblastic carcinomas. Sex ratio is 2. Trichoblastic carcinoma predominated in the face (65% of cases), particularly in perinasal (30% of cases). Its clinical presentation is in 95% of cases as basal cell carcinoma, which is the first clinical diagnosis evoked...
April 3, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28328683/surgical-support-during-the-terrorist-attacks-in-paris-november-13-2015-experience-at-b%C3%A3-gin-military-teaching-hospital
#11
Olivier Barbier, Brice Malgras, Camille Choufani, Antoine Bouchard, Didier Ollat, Gilbert Versier
BACKGROUND: Recent conflicts have allowed the French Army Health Service to improve management quality for wartime-injured people during military operations. On November 13, 2015, it was in Paris that France was directly attacked and Bégin Military Teaching Hospital, like several hospitals in Paris, had to face a large number of gunshot victims. Thanks to our operational experience, injured people hospitalized in military hospitals benefited from a management based on triage and damage control (DC) principles...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28286390/early-postoperative-malignant-subcutaneous-emphysema-report-and-review
#12
N K Sahoo, Shivinder Singh, I D Roy, Amit Bhandari
BACKGROUND: Subcutaneous emphysema is defined as presence of air or gas in subcutaneous tissue layer. It may be localized or generalized due to various aetiological factors. Although SE and pneumomediastinum are self-limiting conditions, life-threatening complications may develop. Escape of air into both pleural cavity causing bilateral pneumothorax and tension pneumothorax can be termed as malignant emphysema. PURPOSE: To report a case of malignant generalized subcutaneous emphysema in early postoperative phase following palatoplasty...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28280662/avoiding-facial-incisions-with-midface-free-tissue-transfer
#13
Mark W Stalder, Michael Sosin, Leo J Urbinelli, James L Mayo, Amir H Dorafshar, Hugo St Hilaire, Daniel E Borsuk, Eduardo D Rodriguez
BACKGROUND: We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions. METHODS: Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intraoral, transmucosal approach, obviating the need for visible skin incisions...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28279397/-reconstruction-of-the-ear-in-the-burns-patient
#14
Jorge Raúl Carrillo-Córdova, Yusef Jiménez Murat, Armando Apellaniz-Campo, Hazel Bracho-Olvera, Raúl Carrillo Esper
Face burns are a singular pathology with great functional and psychological impact in the patients suffering them. The ears play a fundamental role in personal interactions and damage to this organ results in physical and emotional distress. The reconstructive treatment of the burned ear is a challenge. Multiple procedures have been described to achieve success in the reconstruction of the burned ear; immediate reconstruction with autologous rib cartilage, secondary reconstruction, alloplastic material reconstruction, tissue expansion, skin grafts and also microvascular flaps are some of the most common procedures used in this patients...
March 6, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28273213/reconstruction-of-face-and-scalp-after-dog-bites-in-children
#15
Jefferson Lessa Soares Macedo, Simone Corrêa Rosa, Murilo Neves DE Queiroz, Tabatha Gonçalves Andrade Castelo Branco Gomes
OBJECTIVE: to evaluate the immediate reconstruction of face and scalp after canine bites in children. METHODS: we conducted a prospective series of cases treated at the Emergency Unit of the Asa Norte Regional Hospital, Brasília - DF, from January 1999 to December 2014. At the time of patient admission to the emergency, the primary wound closure of the face and scalp bite was performed, regardless of the time or day of the event. The primary treatment of the bites was by means of direct suture, flaps rotation or grafting, depending on the type of wound and surgeon's decision...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28272147/long-term-follow-up-of-flap-prefabrication-in-facial-reconstruction-13-years-experiences
#16
Weixin Wang, Muxin Zhao, Yong Tang, Wen Chen, Zhe Yang, Ning Ma, Lisi Xu, Jun Feng, Yangqun Li
BACKGROUND: Flap prefabrication is to turn a random flap into an axial flap by transferring a vascular pedicle. METHODS: In the past 13 years, we have prefabricated 20 flaps in 20 patients by the superficial temporal artery and its concomitant veins. Typically, a 50- to 800-mL tissue expander was implanted in the donor site. After flap maturation, the prefabricated flap was raised and transferred locally to cover the large defect on the face. All the cases were followed up regularly...
March 7, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28255152/follicular-thyroid-cancer-with-sternal-metastasis-challenges-and-outcomes
#17
M A Syazni, H S Gendeh, N R Kosai, A R Ramzisham, B S Gendeh, N H Basiron, F H Imran
Sternal metastasis from differentiated thyroid carcinoma (DTC) is rare and presents a conundrum for surgeons. We present a lady diagnosed with follicular thyroid carcinoma and sternal metastasis who underwent thyroidectomy, sternectomy and sternoplasty with titanium mesh and acrylic plate. She developed a surgical site infection, of which multiple conservative approaches were attempted. She eventually required removal of the implant. Closure of sternal defect was completed with bilateral pectoralis major advancement flaps...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28226369/interpolated-flaps
#18
Samkon Kaltho Gado, Kaveh Karimnejad, Ian A Maher, Paul J Gruber, Scott Walen
Nasal reconstruction has been articulated in the literature since 700 B.C. when the earliest iteration of the forehead flap was described in the Indian medical treatise, the Sushruta Samhita. Since then it has evolved into the interpolated flap which has served as a powerful tool for facial reconstruction. The interpolated flap is constructed from nonadjacent donor tissue that has an inherent blood supply. It requires a multistaged approach and is best suited for reconstruction of large or deep defects of the nose...
February 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28216817/turned-in-fasciocutaneous-island-flap-from-face-and-neck-based-on-subdermal-microcirculation-for-reconstruction-of-the-oral-cavity-following-cancer-surgery
#19
Kalpesh Jayantkumar Gajiwala
BACKGROUND: The skin and soft tissues of the face and neck have a rich plexus of dermal-subdermal vessels, which creates the possibility of raising a fasciocutaneous flap based on this vascular supply. A turned in fasciocutaneous island flap (TIFCIF) from an adjacent area of the defect can provide a simple substitute to many complex reconstructive procedures. MATERIALS AND METHODS: Fifteen patients underwent wide excision for oral cancer and upper neck dissection, maintaining bone framework, between August 2010 and June 2014...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28207466/the-subunit-principle-in-scar-face-revision
#20
Ahmed Elshahat, Riham Lashin
Facial scaring is considered one of the most difficult cosmetic problems for any plastic surgeon to solve. The condition is more difficult if the direction of the scar is not parallel to relaxed skin tension lines. Attempts to manage this difficult situation included revisions using geometric designs, Z plasties or W plasties to camouflage the straight line visible scaring. The use of long-lasting resorbable sutures was tried too. Recently, the use of botulinum toxin during revision improved the results. Fractional CO2 lasers, microfat grafts, and platelet-rich plasma were added to the armamentarium...
February 15, 2017: Journal of Craniofacial Surgery
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