Search results for "flap"
showing 10 items of 263 documents
Pharmacological thrombolysis: one more weapon for free-flap salvage.
2005
Despite the high success rate of free-tissue transfer, thrombosis still complicates 5-30% of cases. Meticoulous technique, careful vessel selection, and pharmacological prophylaxis are not always enough to avoid thrombosis. Early diagnosis and reintervention provide the only way to salvage a thrombosed free flap, in case of either arterial or venous thrombosis. When kinking, torsion, or external compression of the pedicle are ruled out, and thrombectomy and redo of the anastomosis are unsuccessful, the last resort to save the flap is thrombolytic therapy. The authors present their experience with the salvage of two otherwise lost flaps by means of urokinase thrombolysis through direct intra…
Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction
2017
Background The use of vascular grafts is indicated in case of insufficient pedicle length or for complex defects involving both soft tissues and vessels. Venous grafts (for both venous and arterial reconstructions) and arterial grafts (arterial reconstruction) can be used. This study retrospectively evaluated the needs for vascular reconstruction and its results in a clinical series of lower limb reconstructions with microsurgical free flaps. Materials and Methods From 2010 to 2015, a total of 16 vascular grafts or flow-through flaps were used in 12 patients out of a total of 150 patients undergoing microsurgical reconstruction (8%). Arterial reconstruction was performed in seven cases (si…
Three-year (2014-2016) activity report of the Replantation Service for hand amputations in Poland
2018
W pracy przedstawiono podsumowanie 32 miesięcy działalności Serwisu Replantacyjnego dla amputacji rąk w Polsce od stycznia 2014 roku do sierpnia 2016 roku. W analizowanym czasie zgłoszono łącznie 568 przypadków – amputacji, częściowych amputacji i innych rozległych urazów kończyn górnych, z czego zaakceptowano 354 przypadki (62%), a odrzucono 214 (38%). Wśród 354 wszystkich zaakceptowanych przypadków znalazło się 167 całkowitych amputacji (47%), 142 amputacji niecałkowitych (40%) i 45 (13%) innych ciężkich urazów, które zagrażały utratą kończyny. W większości ofiarami byli mężczyźni o średniej wieku 39 lat. Najwięcej pacjentów przeszło amputacje kilku palców i kciuków – łącznie 229 (65%) os…
Vertical distraction osteogenesis of a free vascularized fibula flap in a reconstructed hemimandible for mandibular reconstruction and optimization o…
2009
Free vascularized fibular flap is considered the treatment of choice in mandibular reconstruction for extensive bone defects (over 6 centimeters) resulting from trauma, infections or tumor resections. But, when the reconstruction involves a dentate mandible, the fibula has the limit as it does not offer sufficient bone height to restore the alveolar arch up to the occlusal plane. Therefore, the deficiency in bone height makes implant placement impractical. We report a case of vertical distraction osteogenesis of a free vascularized fibula flap used to reconstruct a hemimandible after resection of an odontogenic myxoma, for optimization of the implant prosthetic rehabilitation. The distracti…
Effect of lingual-based flap design on postoperative pain of impacted mandibular third molar surgery : split-mouth randomized clinical trial
2020
Background The extraction of third molars is one of the most common procedures in oral and maxillofacial surgery clinic. Surgical extraction involves the manipulation of both soft and hard tissues, so the patient usually experiences pain, swelling, and trismus in the immediate post-operative period. Several studies have been conducted using different types of surgical flaps to provide access with the least possible damage of soft tissues. Designing and implementing an optimum flap, which provides easier technique, better visibility, minimal post-operative complications, and best healing, is an aspired goal of every oral surgeon. This study aimed to compare lingual-based four-cornered flap w…
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…
Efficacy of a bioactive alloplast, in the treatment of human periodontal osseous defects-a clinical study.
2010
Presently, bone replacement grafts are one of the modalities of therapy for which there is histologic evidence of regeneration coronal to the base of the previous osseous defect. Bioactive glasses are used extensively in medicine and dentistry. This study evaluated the additional efficacy of a bioactive alloplast, PerioGlas, in comparison with open flap debridement only. 8 systemically healthy volunteers were chosen, each having 2 collateral sites with ?6 mm clinical probing depth and radiographic evidence of an intrabony defect. Randomly, one defect was treated with open flap debridement plus bioactive glass (test) and the other with open flap debridement alone (control). At baseline, 3, 6…
Superior pedicle retroauricular island flap for ear and temporal region reconstruction: anatomic investigation and 52 cases series.
2008
Superior pedicle retroauricular island flap for ear and temporal region reconstruction: anatomic investigation and 52 cases series. Cordova A, Pirrello R, D'Arpa S, Moschella F. Source Cattedra di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Università degli Studi di Palermo, Palermo, Italy. adriana.cordova@excite.com Abstract BACKGROUND: On the basis of a previously published anatomic study on the superior auricular artery (SAA) and on a series of 52 consecutive cases, the authors propose a new superior pedicle retroauricular island flap (SP-RIF) for defects of the upper half of the ear and for temporal region or superficial helical defects. ME…