Search results for " flaps"
showing 10 items of 187 documents
Evaluation of cut quality using the Amadeus microkeratome with different settings.
2004
Abstract Purpose: To evaluate the quality of keratectomy specimens created with the Amadeus® microkeratome (AMO) using scanning electron microscopy (SEM). Setting: Johannes Gutenberg-University Hospital, Department of Ophthalmology, Mainz, and the Department of Anatomy, Justus Liebig-University, Giessen, Germany. Methods: Corneal cuts were performed in freshly enucleated pig eyes using the Amadeus microkeratome with 9 combinations of oscillation rate and head-advance speed. For the cutting trials, oscillation rates of 8000, 13000, and 18000 rpm and head-advance speeds of 1.0, 2.5, and 4.0 mm/s were chosen. Fifty-four eyes were included, resulting in 9 groups of 6 eyes for each configuration…
Reconstruction of the face with skin-grafted muscle flaps: Optimizing the aesthetic outcome
2011
BACKGROUND: Reconstruction of large defects in the temporal region can be performed with skin grafts or pedicled or free flaps. Results are often not optimal because of the patch of a skin graft, lack of availability of local flaps, and distant skin from free flaps. A technique for reconstruction of these defects with local tissue is presented in this article that uses superficial musculoaponeurotic system (SMAS) plication to allow wide advancement of a cervicofacial flap. METHODS: Once the defect is outlined, a face-lift-like skin incision is used to raise the flap. The SMAS is plicated with two purse-string sutures that relieve tension on the flap and allow maximal advancement. Thirteen f…
The foot fillet flap for ischial pressure sore reconstruction: A new indication
2018
Abstract Introduction The main cause of ischial pressure sores in paraplegic patients is prolonged sitting without pressure relief. These wounds are subject to recurrence and may need repeated reconstruction with local flaps. When all options are exhausted, the total thigh flap is the last resort. Disarticulation of the hip joint impairs stability even when sitting and causes subsequently very high discomfort. In this manuscript, we describe an alternative to the total thigh flap to avoid hip disarticulation: the foot fillet flap. Materials & Methods This study was performed on four patients at the department of Plastic & Reconstructive Surgery of the Ghent University Hospital, Belgium. Inc…
The effects of optimizing blood inflow in the pedicle on perforator flap survival: A pilot study in a rat model
2020
Background Perforator flaps have led to a revolution in reconstructive surgery by reducing donor site morbidity. However, many surgeons have witnessed partial flap necrosis. Experimental methods to increase inflow have relied on adding a separate pedicle to the flap. The aim of our study was to experimentally determine whether increasing blood flow in the perforator pedicle itself could benefit flap survival. Methods In 30 male Lewis rats, an extended posterior thigh perforator flap was elevated and the pedicle was dissected to its origin from the femoral vessels. The rats were assigned to three groups: control (group I), acute inflow (group II) and arterial preconditioning (group III) dep…
Lentiviral transduction of face and limb flaps: implications for immunomodulation of vascularized composite allografts.
2012
Background Ex vivo introduction of an immunomodulatory transgene into a face or hand allograft may improve the risk-to-benefit ratio of vascularized composite allografts. Abrogation of the immunogenicity of the skin component of a face or hand allograft may decrease alloreactivity and permit the induction of immunologic tolerance. Proof-of-principle demonstrations of transduction of composite tissue have been established using adenoviral vectors, producing transient gene expression. The authors hypothesized that transduction, integration, and long-term expression of transgenes in a vascularized composite allograft could be achieved using lentiviral vectors. Methods Ex vivo transduction of h…
Meta-analytic study on the frequency and treatment of oral antral communications
2010
Objective: To determine the optimum surgical treatment for oral antral communications (OAC) and to understand the main post-operative complications.Study Design: Meta-analytical, observational and retrospective study of 1,072 cases of OAC obtained from a literature review of 15 articles. Results: OAC occur slightly more often in men and during the fourth decade of life. Its primary etiological factor is dental extraction, most often affecting the third molar. The most common treatment has been the use of Bichat's fat pad grafts, whereas the technique with the highest percentage of complications has been the use of the palatal rotation flap. The most frequent complication has been the fistul…
Botulinum toxin in preparation of oral cavity for microsurgical reconstruction.
2010
CONCLUSIONS: Infiltration of botulinum toxin in the major salivary glands allows a temporary reduction of salivation that begins 8 days afterwards and returns to normal within 2 months. The inhibition of salivary secretion, carried out before the oral cavity reconstructive surgery, could allow a reduction of the incidence of oro-cutaneous fistulas and local complications. OBJECTIVES: Saliva stagnation is a risk factor for patients who have to undergo reconstructive microsurgery of the oral cavity, because of fistula formation and local complications in the oral cavity. The authors suggest infiltration of botulinum toxin in the major salivary glands to reduce salivation temporarily during th…
Noninvasive Flap Preconditioning by Foam-Mediated External Suction Improves the Survival of Fasciocutaneous Axial-Pattern Flaps in a Type 2 Diabetic …
2018
Background Advances in reconstructive surgery are leading to an increased number of flaps at risk for ischemic necrosis, because of either intrinsic (e.g., larger flap size) or extrinsic (e.g., diabetes) factors. Methods to preoperatively improve flap vascularity and limit postoperative ischemia are lacking. Noninvasive suction, using either a macrodeformational silicone cup interface (external volume expansion) or a microdeformational polyurethane foam interface (foam-mediated external volume expansion), has been shown to induce angiogenesis in tissues. The authors investigated whether the preoperative use of external volume expansion/foam-mediated external volume expansion improves flap s…
Pedicled Flaps for Anterior Chest Wall Reconstruction
2020
Pedicled local or regional flaps are the main reconstructive tool for chest wall defects. Muscle or musculocutaneous flaps are most commonly used, with the latissimus dorsi and the pectoralis major being the workhorse flaps. However, perforator flaps have recently affirmed even for reconstruction of complex defects. A thorough knowledge of the vascular anatomy of the thorax and of the patient’s medical history is essential for selecting the best reconstructive option. The defect location, size, and depth as well as previous surgeries in the same area are the main issues affecting the reconstructive choices.