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Perforator flap imaging

Hemin Oathman Sheriff, Kawa Abdullah Mahmood, Nzar Hamawandi, Aram Jamal Mirza, Jawad Hawas, Esther Granell Moreno, Juan Antonio Clavero, Christopher L Hankins, Jaume Masia
No abstract text is available yet for this article.
September 2018: Journal of Reconstructive Microsurgery
Anita T Mohan, Lin Zhu, Mohamed Morsy, Yoo Joon Sur, Gregory J Michalak, Nirusha Lachman, Samir Mardini, Michel Saint-Cyr
BACKGROUND: The superficial femoral artery and medial thigh region has been an underused donor site for perforator flaps. This study evaluated perforasomes of the superficial femoral artery and its principal branches to review the clinical applications for locoregional reconstruction. METHODS: Twenty-six fresh cadaveric lower extremities were dissected. Perforator size and anatomical course from the superficial femoral artery, descending genicular artery, and saphenous artery branch were documented...
March 2019: Plastic and Reconstructive Surgery
Jieke Wang, Encheng Ji, Chen Lin, Long Wang, Li Dai, Weiyang Gao
BACKGROUND: Bradykinin, a vasoactive peptide, has many biological functions. For example, it accelerates angiogenesis. Thus, we studied the effects of bradykinin on the survival of perforator flaps. METHODS: Averagely, 50 male Sprague-Dawley rats were divided into control and bradykinin groups and underwent procedures to the multiterritory perforator flap. Areas of flap survival were tested 7 days later. Flap perfusion was evaluated by laser Doppler imaging. We assessed the extent of autophagy by determining LC3-II/I, Beclin 1, and p62...
February 27, 2019: World Journal of Surgical Oncology
Jesse Hu, Giulio Cuffolo, Vaishali Parulekar, Victoria Chan, Alexandra Tenovici, Pankaj G Roy
INTRODUCTION: Partial breast reconstruction (PBR) using chest wall perforator flaps (CWPF) allows for excision of tumors in the outer quadrant of the breast in women with small to moderate non-ptotic breasts resulting in a good aesthetic outcome. There are limited data available in the literature regarding long-term follow-up and the effect of CWPF on subsequent surveillance mammographic interpretation and recall rates. A retrospective audit with qualitative analysis of initial mammograms was performed to assess this...
January 31, 2019: Clinical Breast Cancer
Yu Guo, Zairong Wei, Kewei Zeng, Fengling Zhang, Chengliang Deng, Wenduo Zhang, Dali Wang
Objective: To investigate the application of high frequency color Doppler ultrasound (HFCDU) combined with wide-field imaging in the preoperative navigation of anterolateral thigh perforator flap graft. Methods: Between January 2017 and March 2018, 28 patients with skin and soft tissue defects were treated, including 22 males and 6 females, with an average age of 33.5 years (range, 17-66 years). The causes of injury included 2 cases of scald scar, 7 cases of heavy object crushing injury, 12 cases of traffic accident injury, 4 cases of fall injury, 2 cases of machine injury, and 1 case of infection ulcer...
February 1, 2019: Chinese Journal of Reparative and Reconstructive Surgery
Johan Zötterman, Erik Tesselaar, Simon Farnebo
BACKGROUND: We evaluated the use of laser speckle contrast imaging (LSCI) in the perioperative planning in reconstructive flap surgery. The aim of the study was to investigate whether LSCI can predict regions with a high risk of developing postoperative necrosis. Our hypothesis was that, perioperatively, such regions have perfusion values below a threshold value and show a negative perfusion trend. METHODS: A porcine flap model based on the cranial gluteal artery perforator was used...
January 3, 2019: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ledibabari M Ngaage, Raed Hamed, Georgette Oni, Bruno Di Pace, Dina T Ghorra, Brendan C Koo BMedSci, Charles M Malata
BACKGROUND: Abdominal scars can affect the patency of deep inferior epigastric artery (DIEA) perforators and are a concern when planning free flap breast reconstruction (FFBR). Computed tomography angiography (CTA) is routinely used for preoperative DIEA flap imaging. We investigated CTA utility in predicting the most clinically useful DIEA perforators in scarred abdomens. METHODS: A single surgeon's CTA FFBR patients were studied. All were imaged by one radiologist...
March 2019: Journal of Surgical Research
Berit Kristine Skraastad, Cathrine Knudsen, Catherine Jackson, Tor Paaske Utheim, Are Hugo Pripp, Kim Alexander Tønseth
Autologous breast reconstruction (BR) aims to restore body image and improve health-related quality of life in women undergoing mastectomy due to breast cancer. We wanted to explore patient-reported cosmetic results and satisfaction 10 or more years post BR surgery, using deep inferior epigastric perforator flap (DIEP). This is a follow-up study based on the same patient population of 34 patients undergoing delayed DIEP-flap procedure during 2001-2004 at Oslo University Hospital investigated by our group and published in 2008; Four patients died during the 10 years' follow-up time and four patients with total or partial flap failure were excluded...
January 18, 2019: Journal of Plastic Surgery and Hand Surgery
Rui Chen, Zhi-Quan Huang, Wei-Liang Chen, Zhan-Peng Ou, Shi-Hao Li, Jian-Guang Wang
BACKGROUND: The aim of this study was to investigate the value of a smartphone-compatible thermal imaging camera in the mapping of the peroneal artery perforators. METHODS: Twelve consecutive patients scheduled for fibular flap reconstruction were enrolled. The lower limbs were first studied using smartphone-based dynamic infrared thermography (DIRT). During the rewarming, the hotspots were marked, small rubber markers were taped to the registered sites, and then the patients were sent for a CT scan...
January 12, 2019: Head & Neck
Nadine S Hillberg, Tom J M van Mulken, Marleen A J Meesters-Caberg, Andrzej Piatkowski, Xavier A H Keuter, Juliette Hommes, René R W van der Hulst
The deep inferior epigastric artery perforator (DIEP) flap is one of the most used free flaps for the reconstruction of the breast after a mastectomy. Despite careful selection of the patients and preoperative imaging, difficulties in vascularization of the flap can occur in some cases. Although multiple vascular connections (bipedicled, turbocharged, or stacked) can be made in selected cases, there can still be venous congestion before the flap is transferred.Between 2016 and 2018, 4 cases in our series of 281 patients experienced such problems...
January 9, 2019: Annals of Plastic Surgery
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
Nicolás Pereira, Matías Kufeke, Leonardo Parada, Ekaterina Troncoso, Jorge Bahamondes, Luis Sanchez, Ricardo Roa
INTRODUCTION: Perioperative microsurgical planning increases the likelihood of successful results. Augmented reality (AR) is the addition of artificial information to allow the user to perform tasks more efficiently. The aim of our study is to report the use of AR for microsurgical planning with a smartphone (ARM-PS) as a dissection route map. PATIENTS AND METHODS: AR was used for superficial circumflex iliac artery perforator (SCIP) flap planning. Three-dimensional (3D) reconstruction images of the inguinal and lower abdomen vascular anatomy were obtained by computed tomography angiography...
December 14, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Dincer Altinel, Burcu Biltekin, Merdan Serin, Ugur Sahin, Muzaffer Altindas
Background: In this study, we investigated the subdermal and perforator delay phenomena as a method to improve flap survival. Materials and Methods: In this experimental study, we used 24 rats in three groups. In the control group, the dorsal flaps were elevated and reinserted back to their place. In the experimental groups, we practiced the delay phenomena with two different techniques. In the first experimental group, cranial and lateral side incisions were performed; however, the flaps were not cut-off from the underlying fascia...
May 2018: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Long Wang, Hongqiang Wu, Chen Lin, Zihuai Huang, Renhao Jiang, Xianyao Tao, Jian Ding, Weiyang Gao
BACKGROUND: Necrosis of propeller flaps is a problem in clinical practice. This study was performed to investigate the effects of pedicle torsion on dynamic perforasome survival using a multiterritory perforator flap model in rats. METHODS: Intercostal artery perforator flaps (IC flaps) containing two adjacent dynamic perforasomes were applied to both sides of the dorsum in 15 rats. The IC vessels were dissected carefully under 10 × magnification. A 360° arc of pedicle torsion was applied to the right IC flaps, which comprised the rotary group...
February 2019: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ignazio G Vetrano, Francesco Prada, Alessandro Perin, Cecilia Casali, Francesco DiMeco, Marco Saini
OBJECTIVE: Piezoelectric surgery represents an innovative technique to perform safe and effective osteotomies, alternative to traditional bony tissue management using rotating or perforating instruments. We evaluated safety and feasibility of craniotomies using an ultrasonic device that allows the selective cut of mineralized structures, avoiding damages to the vascular, dural and parenchymal structures. METHODS: We analyzed a series of 300 patients (range 1-81 years, SD±15...
November 17, 2018: World Neurosurgery
Mahmoud Sabbah, Takeshi Tada, Kazushige Kadota, Shunsuke Kubo, Suguru Otsuru, Daiji Hasegawa, Seiji Habara, Hiroyuki Tanaka, Yasushi Fuku, Tsuyoshi Goto
OBJECTIVES: The clinical implications of subintimal stenting (SS) of the recanalized chronic total occlusion (CTO) segment have not been characterized. We evaluated the in-hospital and the long-term clinical and angiographic outcomes of drug-eluting stents (DESs) deployed in true vs. false lumen of successfully recanalized CTO. METHODS AND RESULTS: Two independent reviewers analyzed the intravascular ultrasound (IVUS) images of 173 successfully recanalized CTO lesions (157 patients), between August 2011 and October 2012...
October 22, 2018: Catheterization and Cardiovascular Interventions
Christoffer Aam Ingvaldsen, Tyge Tind Tindholdt, Kim Alexander Tønseth
Background: The dermolipectomy of the deep inferior epigastric artery perforator (DIEAP) flap procedure is designed to give an end result as seen with abdominoplasty (AP). Several steps of an AP are, however, not routinely performed. This study compared the patient-reported outcomes between these 2 procedures with an emphasis on the abdomen. Methods: Thirty-four patients reconstructed with a DIEAP flap (DIEAP group), and 30 patients with an AP (AP group) were asked to complete 2 study-specific questionnaires...
August 2018: Plastic and Reconstructive Surgery. Global Open
Zhongjie Wang, Xiaoping Yi, Jiqiang He, Liming Qing, Zhengbing Zhou, Youming Zhang, Zhiming Zhu, Chunhui Zhou, Hui Xie, Xuejun Li, Chishing Zee, Bihong T Chen
BACKGROUND:  During reconstructive surgery, anterolateral thigh (ALT) flap harvest is challenging due to variation and uncertainty in perforator distribution. We performed a pilot study to identify the predictive value of catheter-based computed tomography angiography (C-CTA) and traditional CTA (T-CTA) in ALT perforator mapping for patients whose ALT perforators were difficult to identify. METHODS:  Thirty-four consecutive T-CTA/C-CTA-mapped ALT flaps were evaluated for extremity reconstruction...
October 2, 2018: Journal of Reconstructive Microsurgery
M Barone, A Cogliandro, E Tsangaris, R Salzillo, M Morelli Coppola, S Ciarrocchi, B Brunetti, S Tenna, V Tambone, P Persichetti
INTRODUCTION: The objectives of this study are: (1) comparison of long-term outcomes after correction of severe gynecomastia using different techniques; (2) apply the Italian version of the BODY-Q; (3) present the role of intercostal perforator flap (ICAP) after massive weight loss for correction of severe gynecomastia. MATERIALS AND METHODS: Between January 2008 and March 2016, we performed surgical correction of bilateral severe gynecomastia in 80 men (160 breasts) following massive weight loss...
September 26, 2018: Aesthetic Plastic Surgery
Li-Ying Liao, Tzong-Shiun Li, Hung Chi Chen
In the past decades, numerous surgical techniques and conservative treatments for pilonidal sinus disease (PSD) had been discussed and published. There is still no consensus yet of the best techniques because of high recurrence rates and prolonged wound healing. In the case of complicated discharging sinus or recurrent PSD resistant to treatment with antibiotics, we recommend radical excision followed by a regional flap, which can obliterate the dead space with well-vascularised tissue. In this article, we presented the technique of snug suture fixation between the dermis and periosteum using a superior gluteal artery perforator (SGAP) flap...
September 21, 2018: International Wound Journal
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