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Journal of Reconstructive Microsurgery

Jennifer An-Jou Lin, Angela Ting-Wei Hsu, Jung-Ju Huang, Bassem W Daniel, Che-Hsiung Lee, Soo-Ha Kwon, Evelyn Ting-Hsuan Tang, Cheng-Feng Chu, Cheng-An Tony Chien, David Chwei-Chin Chuang, Johnny Chuieng-Yi Lu, Isao Koshima, Zeng-Tao Wang, Liwen Hao, Chao Chen, Tommy Nai-Jen Chang
BACKGROUND:  Medical conferences are forums for research, continuing medical education, and networking. Social media is increasingly used for communication and networking due to its low cost and ability to overcome large distances. This study investigates the impact that social media brings to the current conference system. METHODS:  There are three parts of this study: (1) comparing two similar brachial plexus injuries (BPIs) courses without (2009) and with (2017) social media support, and the participants' feedback; (2) sharing our experiences in the management of the 2018 International Course on SuperMicrosurgery (ICSM) conference; and (3) evaluating the studies from the social media platform International Microsurgery Club (IMC), for the consensus pertaining to social media and conference system...
February 13, 2019: Journal of Reconstructive Microsurgery
George N Kamel, David Nash, Joshua Jacobson, Robin Berk, Karan Mehta, Teresa Benacquista, Lawrence B Draper, Evan S Garfein, Katie E Weichman
BACKGROUND:  Delayed immediate (DI) autologous breast reconstruction consists of immediate postmastectomy tissue expander placement, radiation therapy, and subsequent autologous reconstruction. The decision between timing of reconstructive methods is challenging and remains to be elucidated. We aim to compare patient reported outcomes and quality of life between delayed and DI reconstruction. METHODS:  A retrospective review of all patients, who underwent autologous breast reconstruction at Montefiore Medical Center from January 2009 to December 2016, was conducted...
February 4, 2019: Journal of Reconstructive Microsurgery
Ulrike Maria Hamscha, Wolfgang Josef Weninger, Christian Freystätter, Chieh-Han Tzou, Christine Radtke
BACKGROUND:  Functional restoration in reconstructive surgery can require complex and adaptable approaches. In this anatomical study, the combined angiosome of the septofasciomyocutaneous vessels originating from the fibular artery was defined as basis for a chimeric flap of the lateral lower leg. METHODS:  Methylene blue injection into the fibular artery was performed in 10 legs of fresh cadavers for visualization of the angiosome on the skin, fibula, and adjacent muscles as the lateral hemisoleus (HS) muscle...
January 31, 2019: Journal of Reconstructive Microsurgery
Noor Alolabi, Lisa Dickson, Christopher James Coroneos, Forough Farrokhyar, Carolyn Levis
BACKGROUND:  The necessity for routine preoperative imaging for free fibula harvest is controversial. The primary objective of this meta-analysis is to determine if lower extremity angiography is necessary to detect abnormalities that may alter flap selection. The secondary objective is to determine if physical examination alone is sufficient to predict these abnormalities. METHODS:  A literature search was performed using Cochrane, CENTRAL, MEDLINE, CINAHL, and EMBASE...
January 29, 2019: Journal of Reconstructive Microsurgery
Amir Inbal, Zachary Jonathan Collier, Chien-Liang Ho, Lawrence Jay Gottlieb
BACKGROUND:  In 1949, a French vascular surgeon, Jean Kunlin, first described a venous end-to-side anastomotic technique to address large vessel size mismatches. It was later modified by Dr. Robert Linton for end-to-end (ETE) anastomoses on the "macrovascular" scale. While multiple procedures exist for addressing moderate caliber discrepancies, few safely and reliably compensate for marked diameter differences at the microvascular level. In this study, we present the first large series adapting a modified geometric Kunlin's technique for arterial and venous ETE anastomoses in reconstructive microsurgery...
January 25, 2019: Journal of Reconstructive Microsurgery
Shinsuke Akita, Yoshihisa Yamaji, Motone Kuriyama, Hideki Tokumoto, Tatsuya Ishigaki, Takafumi Tezuka, Hideyuki Ogata, Yoshitaka Kubota, Nobuyuki Mitsukawa
BACKGROUND:  Although the usefulness of efferent lymphaticovenular anastomosis (ELVA) in lymphatic microsurgery has been reported, the optimal method to distinguish efferent from afferent lymphatics is not yet established. We propose a novel technique to detect efferent lymphatics appropriate for anastomosis. METHODS:  In total, 62 groin lymph nodes (LNs) of 46 limbs were divided into four groups based on the findings of indocyanine green lymphography: n  = 15 in normal, 15 in dermal backflow stage 0, 18 in stage I, and 14 in stage II groups...
January 21, 2019: Journal of Reconstructive Microsurgery
Arif Chaudhry, Jeremie D Oliver, Krishna S Vyas, Nho V Tran, Jorys Martinez-Jorge, David Larson, Eric Dozois, Heidi Nelson, Oscar J Manrique
BACKGROUND:  The purpose of this study is to describe our experience and outcomes in oncoplastic pelvic reconstruction for patients who underwent either vertical rectus abdominis musculocutaneous (VRAM) or omental flap following abdominoperineal resection (APR) at a single tertiary care institution. METHODS:  All patients who underwent pelvic reconstruction following APR with either VRAM or omental flaps from January 1992 to January 2017 were retrospectively reviewed...
January 18, 2019: Journal of Reconstructive Microsurgery
Laurenz Weitgasser, Amro Amr, Michaela Hladik, Gottfried Wechselberger, Adrien Daigeler, Thomas Schoeller, Fabian Medved
BACKGROUND:  The need for plastic and reconstructive surgery on elderly patients has been on the rise due to an increase in life expectancy in the past decades. Therefore, a study was conducted on young and elderly patients following microsurgical extremity reconstructions with free gracilis muscle flaps with the primary aim to investigate the influence of age and the American Society of Anesthesiologists (ASA) score on the general outcome, as well as surgical and medical complications...
January 9, 2019: Journal of Reconstructive Microsurgery
Paul I Heidekrueger, Denis Ehrl, Lukas Prantl, Aung Thiha, Fabian Weinschenk, Antonio J Forte, Milomir Ninkovic, P Niclas Broer
BACKGROUND:  When faced with plantar defects, reconstruction of the weight-bearing areas presents unique surgical challenges. Several free flap modalities have been described in this respect, but there remains debate regarding the best-suited flap modality. Aim of this study was to compare free muscle and non-neurotized fasciocutaneous flaps for plantar reconstruction with respect to long-term functional outcomes. METHODS:  Overall, 89 patients received 100 free flaps (anterolateral thigh [ALT] n  = 46; gracilis n  = 54) for plantar reconstruction...
January 9, 2019: Journal of Reconstructive Microsurgery
C Jaloux, B Bertrand, A Mayoly, M Cegarra-Escolano, C Philandrianos
No abstract text is available yet for this article.
January 9, 2019: Journal of Reconstructive Microsurgery
Hani Sbitany, Rachel Lentz, Merisa Piper
BACKGROUND:  Deep inferior epigastric perforator (DIEP) flaps are routinely elevated on a single dominant perforator from the deep epigastric vascular system. However, the single perforator may not always perfuse an entire flap adequately, particularly suprascarpal tissue. We often perform "dual-plane" single perforator DIEP flaps by rerouting the superficial (SIEA/V) system directly into a branch of the deep (DIEA/V) vascular system pedicle, thus allowing both systems to contribute and enhance flap perfusion...
January 7, 2019: Journal of Reconstructive Microsurgery
Jonah Parker Orr, Ronnie Labib Shammas, Analise B Thomas, Tracy Truong, Eugenia H Cho, Maragatha Kuchibhatla, Scott Thomas Hollenbeck
BACKGROUND:  Despite limited oncologic benefit for women without an increased risk for breast cancer, the rates of contralateral prophylactic mastectomy (CPM) have increased. Patients undergoing CPM are more likely to undergo bilateral and immediate breast reconstruction. This study assessed the relationship between the timing and laterality of free flap-based breast reconstruction and the risk of postoperative bleeding complications. METHODS:  Women undergoing postmastectomy free-flap based breast reconstruction from 2010 to 2015 were identified using the National Surgical Quality Improvement Program (NSQIP) dataset...
January 7, 2019: Journal of Reconstructive Microsurgery
Abeer Kalandar, Steven F Morris
BACKGROUND:  To harvest any flap on the lateral circumflex femoral artery (LCFA) including tensor fasciae latae (TFL) muscle, a precise description of the vascular anatomy is required. There have been conflicting reports of the vascular supply of TFL and its overlying skin. The objective of this study was to evaluate the anatomy of the TFL muscle according to the location, origin, type, caliber, and length of vessels that supply the muscle. METHODS:  This study was performed on human cadavers ( n  = 16 thighs) that were injected with a mixture of lead oxide and gelatin through the femoral artery...
January 7, 2019: Journal of Reconstructive Microsurgery
William J Rifkin, Rami S Kantar, David A Daar, Allyson R Alfonso, Michael J Cammarata, Stelios C Wilson, J Rodrigo Diaz-Siso, Jamie P Levine, John T Stranix, Daniel J Ceradini
BACKGROUND:  The prevalence of obesity in the United States continues to grow and is estimated to affect over a quarter of the working-age population. Some studies have identified obesity as a risk factor for flap failure and complications in free flap-based breast reconstruction, but its clinical significance is less clear in nonbreast reconstruction. The role of obesity as a risk factor for failure and complications following lower extremity reconstruction has not been well described, and the limited existing literature demonstrates conflicting results...
December 22, 2018: Journal of Reconstructive Microsurgery
Hidehiko Yoshimatsu, Keita Inoue, Kenta Tanakura, Ryo Karakawa, Akitatsu Hayashi
No abstract text is available yet for this article.
December 22, 2018: Journal of Reconstructive Microsurgery
Nima Khavanin, Hannah M Carl, Robin Yang, Amir H Dorafshar
BACKGROUND:  Surgical intervention has established a vital role in the management of chronic headaches. The lesser occipital nerve (LON) is a common target in patients suffering from occipital neuralgia and is often resected as a first-line option. We endeavored to define the relationships of the LON in the posterolateral neck to facilitate its safe and rapid intraoperative identification. METHODS:  Seven fresh cadavers (14 nerves) were dissected, and their relationships to the mastoid prominence and nearby spinal accessory nerve (SAN) and greater auricular nerve were noted...
December 18, 2018: Journal of Reconstructive Microsurgery
Hyunsuk Peter Suh, Hyung Hwa Jeong, Joon Pio Jp Hong
BACKGROUND:  Due to the concern of circulation compromise, many surgeons hesitate to dangle or challenge the flap in the early postoperative phase. In our experience, early compression may have advantages such as collapse of dead space, evacuation of hematoma, reduction of edema, and stabilization of flap when ambulating. In this study, the effect of early compression of flaps with regard to flap physiology and outcome is evaluated. METHODS:  From postoperative day 3 to 5, a custom-made compression garment was fitted aiming to compress with a pressure of 30 to 35 mmHg...
December 17, 2018: Journal of Reconstructive Microsurgery
Sumanas Wanant Jordan, Steven Andrew Schulz, Amanda Marie Carraher, David Shannon Cabiling
BACKGROUND:  Abdominal wall morbidity following microvascular breast reconstruction continues to be an area of interest due to both functional and aesthetic concerns. Donor-site closure technique has been shown to affect bulge and hernia rates and ranges from primary closure to various uses of mesh. Few studies to date have compared types of mesh. The present study compares BARD polypropylene to bioabsorbable GORE Bio-A (polyglycolic acid/trimethylene carbonate) mesh used as a fascial underlay with primary fascial closure...
December 17, 2018: Journal of Reconstructive Microsurgery
Manuel Fernandez-Garrido, Tiara R Lopez Penha, Shan Shan Qiu
BACKGROUND:  The use of flow-through flaps was popularized in the early 1990s by Costa, Soutar and Lamberty in cases where an arterial gap was present or a major artery of the limb was damaged. We hypothesized that flow-through flaps can be used in all extremity reconstruction cases, where there is an indication for a free-flap, irrespective of the existence of arterial defect due to its many advantages while not increasing the flap loss significantly. METHODS:  A retrospective study was performed by examining patient status and surgery reports of all patients who underwent extremity reconstruction with a flow-through flap from January 2011 to January 2016...
December 17, 2018: Journal of Reconstructive Microsurgery
Marzia Salgarello, Domenico Pagliara, Giuseppe Visconti, Liliana Barone-Adesi
No abstract text is available yet for this article.
December 17, 2018: Journal of Reconstructive Microsurgery
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