Search results for "Surgery.plastic"
showing 10 items of 23 documents
The Medial Sural Artery Perforator Free Flap
2001
The medial sural artery supplies the medial gastrocnemius muscle and sends perforating branches to the skin. The possible use of these musculocutaneous perforators as the source of a perforator-based free flap was investigated in cadavers. Ten legs were dissected, and the topography of significant perforating musculocutaneous vessels on both the medial and the lateral gastrocnemius muscles was recorded. A mean of 2.2 perforators (range, 1 to 4) was noted over the medial gastrocnemius muscle, whereas in only 20 percent of the specimens was a perforator of moderate size noted over the lateral gastrocnemius muscle. The perforating vessels from the medial sural artery clustered about 9 to 18 cm…
Refinements in buccal mucosal graft urethroplasty for hypospadias repair
1998
We evaluated our experience with buccal mucosa in urethral reconstruction for complex hypospadias repair in a total of 62 children operated on at our institution since 1990 at a mean follow-up of 23 months. After the graft had been taken from the lower lip, with possible extension to the inner cheek, complete thinning of the graft was performed. The graft was then sutured in an onlay fashion to the urethral plate, and suprapubic urinary diversion was carried out for 3 weeks. The overall complication rate in this rather complex series of patients, including 26 "hypospadias cripples," was 13%; the complications involved 4 fistulas, 3 cases of graft necrosis, and only 1 meatal stenosis during …
Perioperative antibiotic prophylaxis in plastic surgery: A prospective study of 1100 adult patients.
2011
Summary Background Although guidelines for antibiotic prophylaxis to prevent surgical site infections (SSIs) exist, specific guidelines for plastic surgery are missing and there is a tendency towards excessive administration of antibiotics. A total of 1100 patients were prospectively studied according to an evidence-based protocol to investigate if limiting antibiotic prophylaxis to high-risk cases does increase the infection rate. Methods Between April 2009 and April 2010, 1100 consecutive patients undergoing elective reconstructive or cosmetic procedures were enrolled. Procedures were classified into four groups, and prophylactic antibiotics were only administered perioperatively in 23.4%…
Correction of Constricted Ear
1995
We present a case of moderate constricted ear corrected using a modified Tanzer's technique for the helical deformity and lengthening the lower third of the pinna with a cutaneous transposition flap from the retroauricular area. The operation begins with a rapid intraoperative expansion of the retroauricular skin. Then an incision is made on the posteromedial ear aspect and the ear is degloved using a subperichondral plane. The upper pole of the cartilage is expanded and rearranged by an anteriorly pedicled helical flap and a cartilaginous graft is taken from the constricted part of the concha. The lower third of the pinna is lengthened by a cutaneous transposition flap from the retroauricu…
The Buccal Mucosal Graft For Urethral Reconstruction: A Preliminary Report
1992
Autologous buccal mucosa as a substitute for urethral epithelium was studied in 2 dogs and used in 6 patients with difficult urethral reconstruction problems. The indications for an operation in these patients were failed hypospadias repairs with limited skin in 3, severe structure disease after hypospadias repair in 1, a short urethra in 1 and epispadias in 1. Three urethral fistulas and 1 meatal stenosis occurred in 3 patients. No urethral stricture or diverticulum was noted, and the final outcome was good functionally and cosmetically in all patients. This technique is useful for urethral reconstruction when local skin is not available.
Reconstructive surgery following resection of primary vulvar cancers.
2005
Objective. This study describes the surgical treatment and follow-up of 213 patients with primary vulvar cancer; particular attention is given to reconstructive surgical procedures. Methods. The clinical and pathological parameters of the patients were recorded according to standardized procedures, and the data concerning type of operation, surgical reconstruction and postoperative course of disease (recurrence-free and overall survival) were analyzed. Results. In about one-third of the cases, plastic surgery reconstruction involving skin-flaps was performed. In the present group of patients, plastic surgery procedures led to an elevated degree of operability as well as to more satisfactory…
Innervated Island Flaps in Morphofunctional Vulvar Reconstruction
2000
In this article, the authors present their own experience in vulvar reconstruction following vulvectomy using two different innervated island flaps according to the size and site of the defect. Island-flap mobilization is possible thanks to the rich blood supply of the perineal region. The methods described are a "V-Y amplified sliding flap from the pubis" and a "fasciocutaneous island flap" raised from one or both gluteal folds. The V-Y amplified sliding flap from the pubis is indicated when the defect is symmetric and located anteriorly. This flap is harvested from the pubis and vascularized by the deep arterial network of the pubis. Sensory innervation is provided by branches of the ileo…
Pro-Inflammatory Cytokines in Elective Flap Surgery
2006
Surgical trauma releases inflammatory mediators such as pro-inflammatory cytokines. In this prospective, controlled, randomized trial we investigated the release of pro-inflammatory cytokines and monocyte/macrophage activation in patients scheduled for breast reconstruction after mastectomy. Patients were allocated to one of three surgical procedures, differing in complexity and in the need for implants used for reconstruction.Thirty mastectomized women underwent delayed breast reconstruction with the lateral thoracodorsal flap (LTD), the latissimus dorsi flap (LD), or the pedicled transverse rectus abdominis muscle flap (TRAM). Blood samples for TNF, IL-6, IL-8, neopterin, C-reactive prote…
Surgical therapy of recurrent vulvar cancer.
2005
Objective The success of various surgical interventions in 201 cases with recurrent vulvar carcinoma was examined in the light of patients' pretreatment, surgical therapy, plastic reconstruction, and postoperative disease course. Study design A databank of standardized clinical data was analyzed using statistical procedures. Results Therapy was selected on an individual basis according to tumor status. Recurrence at a site distant from the primary tumor, particularly in the inguinal region, indicated a markedly unfavorable prognosis. In contrast, tumors recurring locally did not exhibit any significant differences. Plastic surgery reconstruction led to improvements with respect to operabili…
Reconstructive plastic surgery in the treatment of vulvar carcinomas
2005
Abstract Objective The results obtained using plastic surgery reconstruction in 207 patients with a primary or recurrent vulvar carcinoma were analyzed with regard to the surgical procedures applied, pre-treatment and post-operative findings, along with the long-term oncological disease course. Study design Standardized data concerning the surgical procedures applied and clinical factors were collected in a databank and statistically analyzed. Results The flaps employed were termed either ‘local' (cutaneous or fasciocutaneous; n =84) or ‘regional' (myocutaneous, n =123). For local flaps, the rate of secondary healing was 31%, dropping to 20% for regional flaps. Such healing disturbances oft…