Search results for " perforator flap"
showing 10 items of 14 documents
Versatility of the Free Anterolateral Thigh Flap in the Reconstruction of Large Defects of the Weight-Bearing Foot: A Single-Center Experience with 2…
2016
Background Reconstruction of the weight-bearing surface of the foot represents a challenging task. With very little scope to borrow glabrous tissue from adjacent areas means that achieving a “like for like” reconstruction is rarely possible. In this setting, alternative approaches need to be considered. In this article we present our experience with various differing designs of the anterolateral thigh flap (ALT) in the reconstruction of 20 large defects of the weight-bearing sole. Methods Twenty patients with complex soft tissue defects of the weight-bearing sole underwent reconstruction over a 5-year period. Five cases were complicated by osteomyelitis resulting in significant calcaneal …
ALGORITHM OF PARTIAL BREAST RECONSTRUCTION WITH PEDICLED PERFORATOR FLAPS
2010
INTRODUCTION: The authors present an algorithm of partial breast reconstruction following quadrantectomy that allows to restore the breast volume defect with the use of pedicled perforator flaps. MATERIAL AND METHODS: Between March 2009 and May 2010, at the Plastic and Reconstructive Institute of University of Palermo, pedicled perforator flaps were used to integrate volume and/or breast skin in 12 patients after benign and malignant breast tumors. The flaps used were based on perforators of the thoraco-dorsal artery (TDAP) and of the intercostal arteries (ICAP). TDAP flaps were used to reconstruct defects in any breast quadrant, while ICAP perforator were used to reconstruct lateral and ce…
Propeller Flaps: A Review of Indications, Technique, and Results
2014
In the last years, propeller flaps have become an appealing option for coverage of a large range of defects. Besides having a more reliable vascular pedicle than traditional flap, propeller flaps allow for great freedom in design and for wide mobilization that extend the possibility of reconstructing difficult wounds with local tissues and minimal donor-site morbidity. They also allow one-stage reconstruction of defects that usually require multiple procedures. Harvesting of a propeller flap requires accurate patient selection, preoperative planning, and dissection technique. Complication rate can be kept low, provided that potential problems are prevented, promptly recognized, and adequate…
Porcine Model for Deep Superior Epigastric Artery Perforator Flap Harvesting: Anatomy and Technique
2018
BACKGROUND Microsurgical training on rats before starting with clinical practice is a well-established routine. Animal model training is less widespread for perforator flaps, although these flaps represent a technical challenge. Unlike other flaps, they require specific technical skills that need to be adequately trained on a living model 1 : a cadaver is not enough because no bleeding, vessel damage, or vasospasm can be simulated. 2 The purpose of this study was to assess the suitability of the porcine abdomen as a training model for the deep inferior epigastric artery perforator (DIEAP) flap, commonly used in human breast reconstruction. METHODS A female swine (Sus scrofa domesticus, ssp;…
A sequence of flaps and dissection exercises in the living model to improve the learning curve for perforator flap surgery.
2020
Abstract Introduction The training to learn how to perform perforator flaps requires practice on a living model to optimize dissection and to evaluate outcome. The purpose of this study was to describe a training model that optimizes the use of animals in order to perform the maximum number of exercises per animal. Material and methods The sequence has been planned and practiced by the first and last author, recorded perfected and implemented in a two-day surgical course. The sequence was then evaluated by the trainers and the trainees by means of a questionnaire. Results All students were able to complete the sequence of exercises before the end of the second day except two (8/10) who coul…
Vascular Anatomy of the Supraclavicular Area Revisited: Feasibility of the Free Supraclavicular Perforator Flap
2008
Vascular anatomy of the supraclavicular area revisited: feasibility of the free supraclavicular perforator flap. Cordova A, Pirrello R, D'Arpa S, Jeschke J, Brenner E, Moschella F. Source Cattedra di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Università degli Studi di Palermo, Palermo, Italy. adriana.cordova.unipa@gmail.com Abstract BACKGROUND: The supraclavicular skin has been studied extensively and used as a pedicled flap for face and neck reconstruction. Its use as a free flap has not paralleled its use as a pedicled flap. The authors performed an anatomical investigation to assess the possibility of harvesting a free supraclavicular flap …
Nipple-sparing mastectomy and breast reconstruction with a deep inferior epigastric perforator flap using thoracodorsal recipient vessels and a low l…
2018
Background Nipple-sparing mastectomy poses challenges in providing esthetically-pleasing immediate autologous breast reconstruction. This study was to investigate the outcomes of nipple-sparing mastectomy with breast reconstruction using free abdominal flaps between two different recipient sites. Methods Between 2010 and 2016, 79 patients who underwent nipple-sparing mastectomy with autologous breast reconstruction using thoracodorsal (TD) vessels in 30 cases or internal mammary (IM) vessels in 49 cases were investigated. Demographics, intraoperative findings, complications, and quality of life using Breast-Q questionnaire were compared between two groups. Results All flap survived. There w…
The Thin bilateral and bipedicled DIEAP flap for axillary reconstruction in hidradenitis suppurativa
2019
Reconstruction after resection of advanced stage hidradenitis suppurativa is currently performed with pedicled perforator flaps, that allow functional reconstruction and preservation of shoulder function. Skin availability is limited by the possibility of closing the donor site primarily. Bilateral cases need to be treated in two stages, since the operation is carried out in the lateral decubitus. In this manuscript the application of bilateral and bipedicled DIEAP flaps to bilateral and extensive cases is presented.Between October 2008 and October 2018, 39 patients were treated for axillary hidradenitis suppurativa. Of these, 11 patients had bilateral reconstruction with bilateral DIEAP fl…
Response to "The ulnar palmar perforator flap: Anatomical study and clinical application"
2014
Porcine Model for Gluteal Artery Perforator Flap: Anatomy and Technique
2018
Although flap anatomy is well studied on cadavers and microsurgical techniques are well practiced on rats, still there are few training models for learning the techniques of perforator flap harvesting. The cadaver has no bloodstream, so accuracy of dissection cannot be evaluated and flap viability cannot be verified. Training on humans carries a high risk of flap damage. A living model for perforator flap harvest is needed to learn the technique before starting with its clinical application.