Search results for "perforator flap"
showing 10 items of 37 documents
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…
PEDICLED PERFORATOR FLAPS IN NASAL RECONSTRUCTION: A REVIEW
2014
The use of perforator flaps in face reconstruction is becoming increasingly common. They are particularly useful in nose reconstruction, where they can be tailored to match the complex three-dimensional structure of the nasal concave and convex subunits. In this paper, we present a review of the literature on the use of pedicled perforator flaps in nose reconstruction, discussing current indications and outcomes. Literature on this topic is still limited, with only 12 studies reporting data on 129 reconstructions. Reconstruction of nasal defects with pedicled perforator flaps is a novel and expanding field. It allows for the achievement of good aesthetic results, with a single operation and…
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;…
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.
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…
Periodontal health in a population with Parkinson's disease in Spain: a cross-sectional study.
2022
Background: The aim of this research is to evaluate the periodontal health of patients with Parkinson Disease (PD) in a Spanish cohort. Material and Methods: A cross-sectional study was performed on 104 patients with PD (mean age: 66.19+9.3 years) and 106 controls (mean age: 59.26+14.11 years). A pre-designed clinical protocol was implemented, which included a standardized epidemiological index for periodontal disease (CPITN), clinical attachment loss (CAL), tooth-loss, full mouth plaque index (FMPI), and oral hygienic habits. Univariate descriptions and comparative analysis were performed. Results: The majority of PD patients presented good oral hygienic habits. There were no significant d…
Anterolateral thigh perforator flap made by customized 3D-printing fabrication of fixed positioning guide for oromaxillofacial reconstruction:a preli…
2022
Oromaxillofacial carcinomas frequently result in serious tissue defect due to enlarged resection for treating their extensive invasion, which require challenging reconstruction. Three-dimensional (3D) printing is an advanced technology which has greatly promoted the progress of craniomaxillofacial reconstructive surgery. This present study aimed to investigate the advantages of anterolateral thigh (ALT) perforator flap manufactured by 3D printing fixed positioning guide template in curing oromaxillofacial defect. Twenty patients with oromaxillofacial defects resulted from severe primary malignant tumors were divided into experimental group assisted by digital technique (n=8) and controlled …
Novel fasciocutaneous flaps for the reconstruction of complicated lower extremity wounds
2009
Summary: Reconstruction of the leg is particularly challenging especially when the defect involves its lower third. The options for lower leg reconstruction are very few because of the lack of local soft tissue available for transfer. Novel fasciocutaneous flaps nourished by perforator vessels have been developed and are increasingly used as a valuable local alternative to the local flaps, with their high complication rates, and to the microsurgical flaps, with their more difficult and specialized technique. They provide local tissue, replacing like with like, but they harvest it from a distant, undamaged, region of the leg, which means healthy and well-vascularized tissue. They do not need…
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…
Complications and Solutions in Propeller Flap Surgery
2020
AbstractPropeller perforator flaps (PPFs) have long been proven as valid reconstructive tools for a wide range of soft tissue defects in different body regions. During the last decade, despite their numerous advantages, many authors have thoroughly analyzed outcomes of these flaps, sometimes discouraging their use mainly because of a high failure rate. Accurate patient selection, adequate preoperative planning, and an appropriate dissection technique seem to potentially improve outcomes. Our study provides a review of the relevant literature related to PPF complications and of our experience, describing reasons for failure, measures for preventing them, and approaches for a prompt evaluatio…