keyword
https://read.qxmd.com/read/38313578/exploring-the-supremacy-of-microvascular-coupling-devices-for-arterial-anastomosis-in-terms-of-added-expeditiousness-safety-concerns-a-systematic-review
#21
REVIEW
Ajit Kumar Vishwakarma, Naresh Kumar Sharma, Neeraj Kumar Dhiman, Shankar Singh, Chandresh Jaiswara, Sadhana Swaraj
BACKGROUND: Arterial anastomoses are still most commonly performed using orthodox hand sewing technique. Various rationale such as non-pliable, atherosclerotic, thick-walled or irradiated vessels limit the competency of coupler devices for arterial micro-anastomosis. Microvascular coupling devices (MCD) are well known for venous anastomoses but arterial MCD have relatively been less navigated in reported literatures. This review outlines the current applications, troubleshooting, safety and efficiency of arterial MCD in free flaps...
2024: Journal of Oral Biology and Craniofacial Research
https://read.qxmd.com/read/38288031/multidisciplinary-management-of-total-anterior-skull-base-osteoradionecrosis
#22
Aatin K Dhanda, Sean P McKee, David Z Allen, Omar G Ahmed, Kurt A Yaeger, Laura Minhui Kim, Joshua J Kain
Cases of delayed osteoradionecrosis (ORN) of the anterior skull base have unique management considerations. A 59-year-old woman with a history of basaloid squamous cell carcinoma of the sinonasal cavity with intracranial extension through the anterior skull base developed delayed radiation sequelae of anterior skull base ORN. She underwent an initial endoscopic resection in 2011 with persistent disease that required an anterior craniofacial resection with left medial maxillectomy in 2012. She had a radiologic gross total resection with microscopic residual disease at the histologic margins prompting adjuvant chemoradiotherapy to target volume doses of 66 to 70 Gy with concurrent cisplatin chemotherapy...
January 2024: Journal of Neurological Surgery Reports
https://read.qxmd.com/read/38278774/perforator-based-chimeric-ulnar-forearm-microvascular-free-tissue-transfer-reconstruction-of-post-radiated-tracheoesophageal-puncture-fistulae
#23
JOURNAL ARTICLE
Ray Wang, Victoria Manon, Andrew T Huang
Tracheoesophageal puncture (TEP) performed during total laryngectomy in the primary treatment of laryngeal cancer is the standard method for voice restoration. Following adjuvant radiotherapy, the TEP site can experience complications resulting in a tracheoesophageal fistula (TEF) with chronic leakage making oral alimentation unsafe due to aspiration. Here, we describe a technique using chimeric ulnar artery perforator forearm free flaps (UAPFF) in the reconstruction of these complex deformities. Four patients underwent chimeric UAPFF reconstruction of TEP site TEFs following primary TL with TEP and adjuvant radiotherapy...
January 26, 2024: Head & Neck
https://read.qxmd.com/read/38267722/mid-term-clinical-outcome-of-microvascular-gracilis-muscle-flaps-for-defects-of-the-hand
#24
JOURNAL ARTICLE
Tatjana Pastor, Rahel Meier, Dominique Merky, Luzian Haug, Torsten Pastor, Cédric Zubler, Esther Vögelin
PURPOSE: Gracilis muscle flaps are useful to cover defects of the hand. However, there are currently no studies describing outcome measurements after covering soft tissue defects using free flaps in the hand. AIM: To analyze mid-term results of gracilis muscle flap coverage for defects on the hand, with regard to functional and esthetic integrity. METHODS: 16 patients aged 44.3 (range 20-70) years were re-examined after a mean follow-up of 23...
January 24, 2024: Archives of Orthopaedic and Trauma Surgery
https://read.qxmd.com/read/38212165/comparison-of-the-microvascular-anastomotic-coupler%C3%A2-system-with-hand-sewn-suture-for-end-to-end-veno-venous-anastomosis-for-head-and-neck-reconstruction-with-free-flap-transfer-medico-economic-retrospective-case-control-study
#25
JOURNAL ARTICLE
Charline Mourgues, David Balayssac, Aurélien Mulliez, Claire-Marie Planeix, Gabrielle Feydel, Adrien Biard, Véra Alaux-Boïko, Charles Irthum, Nicolas Saroul, Nathalie Pham Dang
The aim of this study was to assess the medico-economic impact of the MACD Coupler™ system in comparison with HSA for end to end veno-venous anastomosis during free flap transfer. A retrospective case-control study was performed in an academic institution, from March 2019 through July 2021, to analyze medical and economic outcomes of patients managed for head and neck reconstruction with free flap transfer. 43 patients per group were analyzed. Rates of initial success, re-intervention, complications and flap transfer failure were not different between groups...
January 1, 2024: Journal of Cranio-maxillo-facial Surgery
https://read.qxmd.com/read/38205684/microvascular-surgery-using-surgical-loupes-versus-operating-microscope-a-single-head-and-neck-reconstructive-surgeon-s-experience
#26
JOURNAL ARTICLE
Jeewanjot S Grewal, Amy M Williams, Uthman Alamoudi, Mohamed Shama, Tamer A Ghanem
BACKGROUND: This prospective randomized study evaluates surgical outcomes of head and neck free tissue transfer surgery performed by a single head and neck reconstructive surgeon comparing the use of surgical loupes and the operating microscope. METHODS: Cases using surgical loupes were performed under ×3.5 magnification, whereas cases using the microscope were done using the standard operating microscope. Patient demographics, comorbidities, operative details, surgical outcomes, and flap failure were assessed...
January 11, 2024: Head & Neck
https://read.qxmd.com/read/38194889/virtual-surgical-planning-for-mandibular-reconstruction-in-an-abbreviated-admission-pathway
#27
JOURNAL ARTICLE
Olivia E Speed, Kaersti Rickells, Soroush Farsi, Tyler Merrill, J Reed Gardner, Deanne King, Jumin Sunde, Emre Vural, Mauricio A Moreno
OBJECTIVES: Virtual Surgical Planning (VSP) creates individualized surgical plans for free flap reconstruction of mandibular defects. Prior studies indicate that VSP can offer cost benefits due to reduced operative time and length of stay (LOS). We assessed the impact of VSP in the context of a validated postoperative abbreviated LOS clinical pathway. METHODS: This study assessed patients undergoing VSP vs conventional fibular free flap reconstruction for mandibular defects (12/2015-10/2020) and their operative time, ischemia time, and LOS were evaluated...
December 6, 2023: American Journal of Otolaryngology
https://read.qxmd.com/read/38162533/postoperative-outcomes-of-aspirin-in-microvascular-free-tissue-transfer-surgery-a-systematic-review-and-meta-analysis
#28
REVIEW
Sahal A Khan, Ramah K Tayeb
Microvascular free tissue transfer surgery is a frequently used technique for head and neck reconstruction involving anticoagulants, and the present study aimed to analyse the postoperative outcomes of aspirin use in conjunction with this procedure. We searched databases for articles published between 2007 and 2022 on microvascular free tissue transfer surgery using aspirin and assessed them for primary and secondary outcomes. Odds ratios (ORs) and 95 % confidence intervals (CIs) were determined through analyses, followed by constructing a forest plot for complication rates...
March 2024: JPRAS Open
https://read.qxmd.com/read/38158599/pedicled-peroneus-brevis-muscle-flaps-as-an-alternative-to-fasciocutaneous-rotational-flaps-for-lower-extremity-soft-tissue-defects
#29
JOURNAL ARTICLE
Merlin Antúnez, Cormac Huyen, Rafael Neiman
OBJECTIVE: To report our experience using a peroneus brevis flap for soft tissue defects of the distal third of the tibia, ankle, and hindfoot in resource challenged environments. DESIGN: Retrospective review. SETTING: Rural outpatient surgical facility in Honduras. PATIENT SELECTION CRITERIA: Patients who sustained tibia, ankle, or hindfoot fractures or traumatic degloving, with critical sized soft tissue defects treated with either a proximally based or distally based pedicled peroneus brevis flap (PBF) to achieve coverage of the middle and distal third of the leg, ankle, and/or hindfoot...
December 26, 2023: Journal of Orthopaedic Trauma
https://read.qxmd.com/read/38156807/evaluate-the-microvascular-invasion-of-hepatocellular-carcinoma-%C3%A2-5%C3%A2-cm-and-recurrence-free-survival-with-gadoxetate-disodium-enhanced-mri-based-habitat-imaging
#30
JOURNAL ARTICLE
Yunfei Zhang, Chun Yang, Xianling Qian, Yongming Dai, Mengsu Zeng
BACKGROUND: Tumors are heterogenous and consist of subregions, also known as tumoral habitats, each exhibiting varied biological characteristics. Each habitat corresponds to a cluster of tissue sharing similar structural, metabolic, or functional characteristics. The habitat imaging technique facilitates both the visualization and quantification of these tumoral habitats. PURPOSE: To evaluate the microvascular invasion (MVI) in hepatocellular carcinoma (HCC) (≤5 cm) and assess the recurrence-free survival (RFS) using gadoxetate disodium-enhanced MRI-based habitat imaging...
December 29, 2023: Journal of Magnetic Resonance Imaging: JMRI
https://read.qxmd.com/read/38149718/trends-in-free-flap-reconstruction-of-the-head-and-neck-a-single-surgeon-series-of-1027-free-tissue-transfers
#31
JOURNAL ARTICLE
Michael J Papanikolas, Jonathan R Clark
BACKGROUND: Free tissue transfer has fundamentally changed head and neck surgery, enabling reliable reconstruction of large defects with better function and aesthetics. This study assesses two decades of trends in free flap reconstruction, and how disease incidence, survival, surgeon caseload, team approach, and technology have impacted practice. METHODS: Retrospective analysis of 1027 head and neck free flaps from 2006 to 2022. Outcomes examined include chronological changes in flap selection, indication, length of stay, incorporation of virtual surgical planning (VSP), annual caseload, survival, and their associations with the single versus multi-team approach...
December 27, 2023: ANZ Journal of Surgery
https://read.qxmd.com/read/38140922/radical-resection-of-mandibular-ameloblastoma-and-functional-reconstruction-with-a-fibula-free-flap-report-of-two-cases-and-review-of-the-literature
#32
JOURNAL ARTICLE
Rareș Călin Roman, Cosmin Ioan Faur, Emil Boțan, Ștefan Bidiga, Mădălina Anca Moldovan
INTRODUCTION: Ameloblastoma is a borderline bone tumor that origins from the residual epithelium of the teeth germs, the epithelium of the enamel organ or the epithelium of odontogenic cysts. Ameloblastoma management is challenging owing to the necessity of tumor radical excision and the functional and aesthetic reconstruction of the surgical defect. The fibula-free flap (FFF) provides a high-quality and predictable mandibular reconstruction due to the high-caliber vascular pedicle, the bone length that can reconstruct large defects, the possibility for implants-based prosthetic reconstruction, and the possibility of harvesting a composite flap that can replace the mucosa, hence protecting the underlying bone reconstruction...
December 20, 2023: Annali Italiani di Chirurgia
https://read.qxmd.com/read/38139436/the-potential-role-of-gossypetin-in-the-treatment-of-diabetes-mellitus-and-its-associated-complications-a-review
#33
REVIEW
Karishma Naidoo, Andile Khathi
Type 2 diabetes mellitus (T2DM) is a metabolic disorder caused by insulin resistance and dysfunctional beta (β)-cells in the pancreas. Hyperglycaemia is a characteristic of uncontrolled diabetes which eventually leads to fatal organ system damage. In T2DM, free radicals are continuously produced, causing extensive tissue damage and subsequent macro-and microvascular complications. The standard approach to managing T2DM is pharmacological treatment with anti-diabetic medications. However, patients' adherence to treatment is frequently decreased by the side effects and expense of medications, which has a detrimental impact on their health outcomes...
December 18, 2023: International Journal of Molecular Sciences
https://read.qxmd.com/read/38130246/prolonged-operative-time-predicts-postoperative-deep-venous-thrombosis-in-head-and-neck-cancer-patients-who-undergo-free-flap-reconstruction
#34
JOURNAL ARTICLE
Kevin C Lee, Nicholas A Waring, Victoria X Yu, Ogoegbunam Okolo, Salvatore M Caruana, Scott H Troob, Anuraag S Parikh
OBJECTIVE: This study sought to quantify the deep venous thrombosis (DVT) incidence in head and neck cancer (HNC) patients undergoing free tissue transfer and to identify independent predictors of postoperative DVT. MATERIALS AND METHODS: This is a cross-sectional study of the National Surgical Quality Improvement Program database from 2010 through 2020. The sample included all HNC surgical patients treated with free flap reconstruction. The study outcome was the presence of a DVT requiring treatment within 30 days of surgery...
December 2023: Laryngoscope Investigative Otolaryngology
https://read.qxmd.com/read/38110301/melatonin-supplementation-does-not-alter-vascular-function-or-oxidative-stress-in-healthy-normotensive-adults-on-a-high-sodium-diet
#35
RANDOMIZED CONTROLLED TRIAL
Macarena Ramos Gonzalez, Michael R Axler, Kathryn E Kaseman, Andrea J Lobene, William B Farquhar, Melissa A Witman, Danielle L Kirkman, Shannon L Lennon
High sodium diets (HSD) can cause vascular dysfunction, in part due to increases in reactive oxygen species (ROS). Melatonin reduces ROS in healthy and clinical populations and may improve vascular function. The purpose was to determine the effect of melatonin supplementation on vascular function and ROS during 10 days of a HSD. We hypothesized that melatonin supplementation during a HSD would improve vascular function and decrease ROS levels compared to HSD alone. Twenty-seven participants (13 M/14 W, 26...
December 2023: Physiological Reports
https://read.qxmd.com/read/38103578/outcomes-of-head-and-neck-microvascular-free-tissue-transfer-for-advanced-cutaneous-squamous-cell-carcinoma-a-comparison-of-solid-organ-transplant-recipients-to-nontransplant-patients
#36
JOURNAL ARTICLE
Ray Y Wang, K Kelly Gallagher, David J Hernandez, Vlad C Sandulache, Erich M Sturgis, Andrew T Huang
BACKGROUND: Patients with solid organ transplant (SOT) are at increased risk of developing aggressive cutaneous malignancies due to their immunosuppression, particularly cutaneous squamous cell carcinoma (cSCC). PURPOSE: There is limited data regarding SOT patients with locally advanced cSCC requiring radical surgery and microvascular free tissue transfer (MVFTT). Our objectives were to characterize outcomes in SOT patients and compare them with a non-SOT cohort...
November 27, 2023: Journal of Oral and Maxillofacial Surgery
https://read.qxmd.com/read/38091685/observing-vessel-stumps-axially-a-novel-exoscope-for-end-to-end-microvascular-anastomosis
#37
JOURNAL ARTICLE
Masayuki Okochi, Kyoko Dogo, Michiko Fukuba, Sotatsu Fukuyama, Yuzo Komuro
Although many free tissue transfers have been performed, free flap loss can still occur because of vascular compromise. To facilitate microsurgery, we invented the axial-view microscope (aMS), a new type of microscope that can axially visualize vessel stumps. The aMS was combined with an optical microscope, the so-called bird's-eye-view microscope (bMS). Using our aMS, we observed the cross-sections of the following 12 arteries during vascular anastomosis: three deep inferior epigastric arteries, three suprathyroid arteries, two thoracodorsal arteries, two jejunal arteries, one lateral circumflex femoral artery, and one facial artery...
December 9, 2023: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://read.qxmd.com/read/38070674/postoperative-volume-maintenance-rate-of-microvascular-free-flap-in-oral-and-maxillofacial-region-systematic-review-and-meta-analysis
#38
JOURNAL ARTICLE
Lei-Ming Cao, Zheng-Ye Kuo, Yi-Fu Yu, Jun Jia, Bing Liu, Lin-Lin Bu
BACKGROUND AND OBJECTIVES: The resorption of flap's volume can be frequently observed in the transplantation of microvascular free flaps, which could significantly affect postoperative function. Therefore, it's essential to comprehend the postoperative flap volume and the mechanisms behind before making clinical decisions. METHODS: Literature search was conducted from database on PubMed, EMBASE, Cochrane Library, Chinese database and Google Scholar. A random effects model meta-analyses and descriptive systematic review were performed...
December 7, 2023: Journal of Stomatology, Oral and Maxillofacial Surgery
https://read.qxmd.com/read/38068529/intraoperative-blood-flow-analysis-of-free-flaps-with-arteriovenous-loops-for-autologous-microsurgical-reconstruction
#39
JOURNAL ARTICLE
Alexander Geierlehner, Raymund E Horch, Ingo Ludolph, Werner Lang, Ulrich Rother, Alexander Meyer, Andreas Arkudas
BACKGROUND: Arteriovenous (AV) loops help to overcome absent or poor-quality recipient vessels in highly complex microvascular free flap reconstruction cases. There are no studies on blood flow and perfusion patterns. The purpose of this study was to evaluate and compare intraoperative hemodynamic characteristics of AV loops followed by free tissue transfer for thoracic wall and lower extremity reconstruction. METHODS: this prospective clinical study combined Transit-Time Flowmetry and microvascular Indocyanine Green Angiography for the assessment of blood flow volume, arterial vascular resistance and intrinsic transit time at the time of AV loop construction and on the day of free flap transfer...
December 2, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/38061389/surface-to-perforator-index-assessing-the-importance-of-the-number-of-perforators-in-successful-harvesting-of-the-anterolateral-thigh-flap
#40
JOURNAL ARTICLE
Noah Saad, Michelle McGill, Georgios Karamitros, Douglas Cromack, Howard Wang, Samuel Fisher, Efstathios Karamanos
INTRODUCTION:  The use of perforator flaps has become more popular with improvement of surgical technique, technology, as well as understanding of microvascular anatomy. The selection of well-perfused angiosomes is critical to the successful outcome of patients undergoing free tissue transfer. The number of perforators that are needed is dependent upon the surface area of the flap being harvested; however, there have been no studies to assess the optimal surface area supplied by each perforator...
December 7, 2023: Journal of Reconstructive Microsurgery
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