Evolution of Local Perforator Flaps in Lower Extremity Reconstruction
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Optimizing Breast Reconstruction After Mastectomy University of Antwerp Faculty of Medicine and Health Sciences
Optimizing breast reconstruction after mastectomy mastectomy after reconstruction Optimizing breast Filip Thiessen University of Antwerp Faculty of Medicine and Health Sciences Optimizing breast reconstruction after mastectomy The use of dynamic infrared thermography Filip THIESSEN 2020 Antwerp, 2020 Thesis submitted in fulfilment of Promoters: Prof. dr. Wiebren Tjalma the requirements for the degree of Prof. dr. Gunther Steenackers Doctor in Medical Sciences at the Prof. dr. Guy Hubens University of Antwerp Co-promoter: Prof. dr. Veronique Verhoeven University of Antwerp Faculty of Medicine and Health Sciences Optimizing breast reconstruction after mastectomy: The use of dynamic infrared thermography Optimaliseren van borstreconstructies na mastectomie: Het gebruik van dynamic infrared thermography Thesis submitted in fulfilment of the requirements for the degree of Doctor in Medical Sciences at the University of Antwerp to be defended by Filip THIESSEN Proefschrift voorgelegd tot het behalen van de graad van doctor in de Medische Wetenschappen aan de Universiteit Antwerpen te verdedigen door Antwerpen, 2020 Promotoren: Prof. dr. Wiebren Tjalma Prof. dr. Gunther Steenackers Prof. dr. Guy Hubens Begeleider: Prof. dr. Veronique Verhoeven Promotoren Prof. dr. Wiebren Tjalma Prof. dr. Gunther Steenackers Prof. dr. Guy Hubens Begeleider Prof. dr. Veronique Verhoeven Members of the jury Internal Prof. dr. Jeroen Hendriks Prof. dr. Manon Huizing Prof. dr. Wiebren Tjalma Prof. dr. Gunther Steenackers Prof. dr. Guy Hubens External Prof. dr. Emiel Rutgers Prof. dr. Assaf Zeltzer © Filip Thiessen Optimizing breast reconstruction after mastectomy: The use of dynamic infrared thermography / Filip Thiessen Faculteit Geneeskunde, Universiteit Antwerpen, Antwerpen 2020 Thesis Universiteit Antwerpen – with summary in Dutch Lay-out and cover : Dirk De Weerdt (www.ddwdesign.be) Cover figure: Cold challenge to bilateral DIEP in skin sparing mastectomy (top), rapid and overall rewarming of the skin islands of the DIEP flap (bottom). -
Thin Anterolateral Thigh Perforator Flaps: Minimizing the Partial Necrosis Rate
Extremity/Lymphedema Original Article The perforator-centralizing technique for super- thin anterolateral thigh perforator flaps: Minimizing the partial necrosis rate Young Chul Suh, Na Rim Kim, Dai Won Jun, Jung Ho Lee, Young Jin Kim Department of Plastic and Reconstructive Surgery, Bucheon St. Mary Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea Background Despite the wide demand for thin flaps for various types of extremity recon- Correspondence: Young Chul Suh struction, the thin elevation technique for anterolateral thigh (ALT) flaps is not very popular Department of Plastic and Reconstructive Surgery, Bucheon St. because of its technical difficulty and safety concerns. This study proposes a novel perforator- Mary Hospital, College of Medicine, centralizing technique for super-thin ALT flaps and analyzes its effects in comparison with a The Catholic University of Korea, 327 skewed-perforator group. Sosa-ro, Wonmi-gu, Bucheon 14647, Methods From June 2018 to January 2020, 41 patients who required coverage of various Korea Tel: +82-32-340-2095 types of defects with a single perforator-based super-thin ALT free flap were enrolled. The in- Fax: +82-32-340-7227 cidence of partial necrosis and proportion of the necrotic area were analyzed on postopera- E-mail: [email protected] tive day 20 according to the location of superficial penetrating perforators along the flap. The centralized-perforator group was defined as having a perforator anchored to the middle third of the x- and y-axes of the flap, while the skewed-perforator group was defined as having a perforator anchored outside of the middle third of the x- and y-axes of the flap. -
Burn Contracture Surgery
Burn Contracture Surgery Stuart Watson Canniesburn Unit Glasgow Royal Infirmary Glasgow United Kingdom [email protected] 1 Table of Contents Prevention of Contractures ................................................................................................. 4 Contracture Definitions ....................................................................................................... 4 Timing of Contracture Surgery: Indications ....................................................................... 5 Urgent ............................................................................................................................. 5 Early ................................................................................................................................ 5 Late ................................................................................................................................. 5 General Principles and Technical Tips ............................................................................... 6 Approach to Contracture Surgery ....................................................................................... 8 Split Skin Grafts .................................................................................................................. 8 Full Thickness Grafts .......................................................................................................... 9 Dermal Substitutes ............................................................................................................. -
The Use of the Thoracodorsal Artery Perforator Flap in Both Autologous and Implant Based Breast Reconstruction Salvage Surgery
Research Article Clinics in Surgery Published: 28 Nov, 2020 The Use of the Thoracodorsal Artery Perforator Flap in Both Autologous and Implant Based Breast Reconstruction Salvage Surgery Nizamoglu M1*, Hardwick S1, Coulson S1 and Malata CM1,2,3 1Department of Plastic and Reconstructive Surgery, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, UK 2Cambridge Breast Unit, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, UK 3Anglia Ruskin University School of Medicine, UK Abstract Introduction: Since its introduction by Angrigiani the Thoracodorsal Artery Perforator (TDAP) flap has become a popular choice in partial breast reconstruction for volume replacement. Although mainly used to provide volume, it has also been reported as an adjunct to implant-based breast reconstruction. Methods: Patients undergoing salvage breast reconstruction surgery with the TDAP flap in the last 20 years were identified from the senior author’s logbook and their clinical data collected from EpicTM, the hospital electronic medical records system. Results: Two such patients, aged 44 and 52 years, were identified. The first had “impending failure” of a subpectoral implant reconstruction following severe cutaneous radiation reaction and poor quality soft tissues overlying the implant, coupled with recurrent seromas. The second had partial SIEA abdominal free flap fat necrosis, leading to volume loss, severe cutaneous scarring and significant deformity. The flap dimensions were 10 ×cm 25 cm and 8 cm × 25 cm, respectively. They OPEN ACCESS were each based on a single vascular perforator– one arising from the horizontal and the other from the vertical branch of the thoracodorsal vessels. Both flap transfers were successful and resulted in *Correspondence: viable reconstructions despite the challenging indications. -
Liposuction Contouring After Head and Neck Free Flap Reconstruction
plastol na og A y Ibrahim AE, et al., Anaplastology 2015, 4:2 Anaplastology DOI: 10.4172/2161-1173.1000145 ISSN: 2161-1173 Review Article Open Access Liposuction Contouring After Head and Neck Free Flap Reconstruction Amir E Ibrahim*, Hamed Janom, Mohamad Raad Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Lebanon *Corresponding author: Amir E Ibrahim, Faculty Member, Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Lebanon, Tel: +9613720594; E-mail: [email protected] Received date: May 28, 2014, Accepted date: April 22, 2015, Published date: April 27, 2015 Copyright: © 2015 Ibrahim AE et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Resection of bulky head and neck tumors is typically followed by microvascular free flap reconstruction. The latter has shown an acceptable success rate but often requires a secondary revision with a free tissue transfer reconstruction to improve outcome; both cosmetic and functional. Direct surgical revision via electrocautery/scalpel poses a high risk of flap perfusion compromise. Suction assisted lipectomy on the other hand is a feasible and safe technique that offers favorable contouring with comparable restoration cosmetic and functional outcomes. In this article, we review the indications and advantages of this technique and provide an outlook on its safety and pitfalls. Keywords: Liposuction; Free Flap; Reconstruction theoretically minimal since fibrous structures containing blood vessels remains unharmed as the fat is removed with liposuction [8]. -
A Study of Popliteal Artery and Its Variations with Clinical Applications
Dissertation on A STUDY OF POPLITEAL ARTERY AND ITS VARIATIONS WITH CLINICAL APPLICATIONS. Submitted in partial fulfillment for M.D. DEGREE EXAMINATION BRANCH- XXIII, ANATOMY Upgraded Institute of Anatomy Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai - 600 003 THE TAMILNADU Dr.M.G.R. MEDICAL UNIVERSITY CHENNAI – 600 032 TAMILNADU MAY-2018 CERTIFICATE This is to certify that this dissertation entitled “A STUDY OF POPLITEAL ARTERY AND ITS VARIATIONS WITH CLINICAL APPLICATIONS” is a bonafide record of the research work done by Dr.N.BAMA, Post graduate student in the Institute of Anatomy, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai- 03, in partial fulfillment of the regulations laid down by The Tamil Nadu Dr.M.G.R. Medical University for the award of M.D. Degree Branch XXIII- Anatomy, under my guidance and supervision during the academic year from 2015-2018. Dr. Sudha Seshayyan,M.B.B.S., M.S., Dr. B. Chezhian, M.B.B.S., M.S., Director & Professor, Associate Professor, Institute of Anatomy, Institute of Anatomy, Madras Medical College, Madras Medical College, Chennai– 600 003. Chennai– 600 003. The Dean, Madras Medical College & Rajiv Gandhi Govt. General Hospital, Chennai Chennai – 600003. ACKNOWLEDGEMENT I wish to express exquisite thankfulness and gratitude to my most respected teachers, guides Dr. B. Chezhian, Associate Professor Dr.Sudha Seshayyan, Director and Professor, Institute ofAnatomy, Madras Medical College, Chennai – 3, for their invaluable guidance, persistent support and quest for perfection which has made this dissertation take its present shape. I am thankful to Dr. R. Narayana Babu, M.D., DCH, Dean, Madras Medical College, Chennai – 3 for permitting me to avail the facilities in this college for performing this study. -
Clinical Anatomy of the Lower Extremity
Государственное бюджетное образовательное учреждение высшего профессионального образования «Иркутский государственный медицинский университет» Министерства здравоохранения Российской Федерации Department of Operative Surgery and Topographic Anatomy Clinical anatomy of the lower extremity Teaching aid Иркутск ИГМУ 2016 УДК [617.58 + 611.728](075.8) ББК 54.578.4я73. К 49 Recommended by faculty methodological council of medical department of SBEI HE ISMU The Ministry of Health of The Russian Federation as a training manual for independent work of foreign students from medical faculty, faculty of pediatrics, faculty of dentistry, protocol № 01.02.2016. Authors: G.I. Songolov - associate professor, Head of Department of Operative Surgery and Topographic Anatomy, PhD, MD SBEI HE ISMU The Ministry of Health of The Russian Federation. O. P.Galeeva - associate professor of Department of Operative Surgery and Topographic Anatomy, MD, PhD SBEI HE ISMU The Ministry of Health of The Russian Federation. A.A. Yudin - assistant of department of Operative Surgery and Topographic Anatomy SBEI HE ISMU The Ministry of Health of The Russian Federation. S. N. Redkov – assistant of department of Operative Surgery and Topographic Anatomy SBEI HE ISMU THE Ministry of Health of The Russian Federation. Reviewers: E.V. Gvildis - head of department of foreign languages with the course of the Latin and Russian as foreign languages of SBEI HE ISMU The Ministry of Health of The Russian Federation, PhD, L.V. Sorokina - associate Professor of Department of Anesthesiology and Reanimation at ISMU, PhD, MD Songolov G.I K49 Clinical anatomy of lower extremity: teaching aid / Songolov G.I, Galeeva O.P, Redkov S.N, Yudin, A.A.; State budget educational institution of higher education of the Ministry of Health and Social Development of the Russian Federation; "Irkutsk State Medical University" of the Ministry of Health and Social Development of the Russian Federation Irkutsk ISMU, 2016, 45 p. -
Treatment of Ischemia-Reperfusion Injury of the Skin Flap Using Human
LAB/IN VITRO RESEARCH e-ISSN 1643-3750 © Med Sci Monit, 2017; 23: 2751-2764 DOI: 10.12659/MSM.905216 Received: 2017.05.08 Accepted: 2017.05.19 Treatment of Ischemia-Reperfusion Injury Published: 2017.06.06 of the Skin Flap Using Human Umbilical Cord Mesenchymal Stem Cells (hUC-MSCs) Transfected with “F-5” Gene Authors’ Contribution: G 1 Xiangfeng Leng* 1 Department of Plastic Surgery, Affiliated Hospital of Qingdao University, Qingdao, Study Design A ADE 1 Yongle Fan* Shandong, P.R. China Data Collection B 2 Department of Nephrology, Qingdao Municipal Hospital, Qingdao, Shandong, Statistical Analysis C E 1 Yating Wang P.R. China Data Interpretation D B 2 Jian Sun 3 Tianjin University, Tianjin, P.R. China Manuscript Preparation E D 1 Xia Cai 4 The Eighth People’s Hospital of Qingdao, Qingdao, Shandong, P.R. China Literature Search F Funds Collection G F 1 Chunnan Hu C 3 Xiaoying Ding B 4 Xiaoying Hu AG 1 Zhenyu Chen * These authors contributed equally to this work Corresponding Author: Zhenyu Chen, e-mail: [email protected] Source of support: Natural Science Foundation of Shandong Province, China (ZR2014HM113) Background: Recent studies have shown that skin flap transplantation technique plays an important role in surgical pro- cedures. However, there are many problems in the process of skin flap transplantation surgeries, especially ischemia-reperfusion injury, which directly affects the survival rate of the skin flap and patient prognosis after surgeries. Material/Methods: In this study, we used a new method of the “stem cells-gene” combination therapy. The “F-5” gene fragment of heat shock protein 90-a (Hsp90-a) was transfected into human umbilical cord mesenchymal stem cells (hUC- MSCs) by genetic engineering technique. -
Plastic Surgery Essentials for Students Handbook to All Third Year Medical Students Concerned with the Effect of the Outcome on the Entire Patient
AMERICAN SOCIETY OF PLASTIC SURGEONS YOUNG PLASTIC SURGEONS STEERING COMMITTEE Lynn Jeffers, MD, Chair C. Bob Basu, MD, Vice Chair Eighth Edition 2012 Essentials for Students Workgroup Lynn Jeffers, MD Adam Ravin, MD Sami Khan, MD Chad Tattini, MD Patrick Garvey, MD Hatem Abou-Sayed, MD Raman Mahabir, MD Alexander Spiess, MD Howard Wang, MD Robert Whitfield, MD Andrew Chen, MD Anureet Bajaj, MD Chris Zochowski, MD UNDERGRADUATE EDUCATION COMMITTEE OF THE PLASTIC SURGERY EDUCATIONAL FOUNDATION First Edition 1979 Ruedi P. Gingrass, MD, Chairman Martin C. Robson, MD Lewis W.Thompson, MD John E.Woods, MD Elvin G. Zook, MD Copyright © 2012 by the American Society of Plastic Surgeons 444 East Algonquin Road Arlington Heights, IL 60005 All rights reserved. Printed in the United States of America ISBN 978-0-9859672-0-8 i INTRODUCTION PREFACE This book has been written primarily for medical students, with constant attention to the thought, A CAREER IN PLASTIC SURGERY “Is this something a student should know when he or she finishes medical school?” It is not designed to be a comprehensive text, but rather an outline that can be read in the limited time Originally derived from the Greek “plastikos” meaning to mold and reshape, plastic surgery is a available in a burgeoning curriculum. It is designed to be read from beginning to end. Plastic specialty which adapts surgical principles and thought processes to the unique needs of each surgery had its beginning thousands of years ago, when clever surgeons in India reconstructed individual patient by remolding, reshaping and manipulating bone, cartilage and all soft tissues. -
Product Information
G30 Latin VASA CAPITIS et CERVICIS ORGANA INTERNA 1 V. frontalis 49 Pulmo sinister 2 V. temporalis superficialis 50 Atrium dextrum 3 A. temporalis superficialis 51 Atrium sinistrum 3 a A. maxillaris 52 Ventriculus dexter 4 A. occipitalis 53 Ventriculus sinister 5 A. supratrochlearis 54 Valva aortae 6 A. et V. angularis 55 Valva trunci pulmonalis 7 A. et V. facialis 56 Septum interventriculare 7 a A. lingualis 57 Diaphragma 9 V. retromandibularis 58 Hepar 10 V. jugularis interna 11 A. thyroidea superior VASA ORGANORUM INTERNORUM 12 A. vertebralis 59 Vv. hepaticae 13 Truncus thyrocervicalis 60 V. gastrica dextra et sinistra 14 Truncus costocervicalis 61 A. hepatica communis 15 A. suprascapularis 61 a Truncus coeliacus 16 A. et V. subclavia dextra 62 V. mesenterica superior 17 V. cava superior 63 V. cava inferior 18 A. carotis communis 64 A. et V. renalis 18 a A. carotis externa 65 A. mesenterica superior 19 Arcus aortae 66 A. et V. lienalis 20 Pars descendens aortae 67 A. gastrica sinistra 68 Pars abdominalis® aortae VASA MEMBRII SUPERIORIS 69 A. mesenterica inferior 21 A. et V. axillaris 22 V. cephalica VASA REGIONIS PELVINAE 22 a A. circumflexa humeri anterior 72 A. et V. iliaca communis 22 b A. circumflexa humeri posterior 73 A. et V. iliaca externa 23 A. thoracodorsalis 74 A. sacralis mediana 24 A. et V. brachialis 75 A. et V. iliaca interna 25 A. thoracoacromialis 26 A. subclavia sinistra VASA MEMBRI INFERIORIS 27 V. basilica 76 Ramus ascendens a. circumflexae femoris 28 A. collateralis ulnaris superior lateralis 29 A. ulnaris 77 Ramus descendens a. -
SŁOWNIK ANATOMICZNY (ANGIELSKO–Łacinsłownik Anatomiczny (Angielsko-Łacińsko-Polski)´ SKO–POLSKI)
ANATOMY WORDS (ENGLISH–LATIN–POLISH) SŁOWNIK ANATOMICZNY (ANGIELSKO–ŁACINSłownik anatomiczny (angielsko-łacińsko-polski)´ SKO–POLSKI) English – Je˛zyk angielski Latin – Łacina Polish – Je˛zyk polski Arteries – Te˛tnice accessory obturator artery arteria obturatoria accessoria tętnica zasłonowa dodatkowa acetabular branch ramus acetabularis gałąź panewkowa anterior basal segmental artery arteria segmentalis basalis anterior pulmonis tętnica segmentowa podstawna przednia (dextri et sinistri) płuca (prawego i lewego) anterior cecal artery arteria caecalis anterior tętnica kątnicza przednia anterior cerebral artery arteria cerebri anterior tętnica przednia mózgu anterior choroidal artery arteria choroidea anterior tętnica naczyniówkowa przednia anterior ciliary arteries arteriae ciliares anteriores tętnice rzęskowe przednie anterior circumflex humeral artery arteria circumflexa humeri anterior tętnica okalająca ramię przednia anterior communicating artery arteria communicans anterior tętnica łącząca przednia anterior conjunctival artery arteria conjunctivalis anterior tętnica spojówkowa przednia anterior ethmoidal artery arteria ethmoidalis anterior tętnica sitowa przednia anterior inferior cerebellar artery arteria anterior inferior cerebelli tętnica dolna przednia móżdżku anterior interosseous artery arteria interossea anterior tętnica międzykostna przednia anterior labial branches of deep external rami labiales anteriores arteriae pudendae gałęzie wargowe przednie tętnicy sromowej pudendal artery externae profundae zewnętrznej głębokiej -
Factors Affecting the Outcome of Lower Extremity Osteomyelitis Treated With
Thai et al. Journal of Orthopaedic Surgery and Research (2021) 16:535 https://doi.org/10.1186/s13018-021-02686-x RESEARCH ARTICLE Open Access Factors affecting the outcome of lower extremity osteomyelitis treated with microvascular free flaps: an analysis of 65 patients Duy Quang Thai1,2, Yeon Kyo Jung1, Hyung Min Hahn1 and Il Jae Lee1* Abstract Background: Free flaps have been a useful modality in the management of lower extremity osteomyelitis particularly in limb salvage. This study aimed to determine the factors affecting the outcome of free flap reconstruction in the treatment of osteomyelitis. Methods: This retrospective study assessed 65 osteomyelitis patients treated with free flap transfer from 2015 to 2020. The treatment outcomes were evaluated in terms of the flap survival rate, recurrence rate of osteomyelitis, and amputation rate. The correlation between outcomes and comorbidities, causes of osteomyelitis, and treatment modalities was analyzed. The following factors were considered: smoking, peripheral artery occlusive disease, renal disease, diabetic foot ulcer, flap types, using antibiotic beads, and negative pressure wound therapy. Result: Among the 65 patients, 21 had a severe peripheral arterial occlusive disease. Osteomyelitis developed from diabetic foot ulcers in 28 patients. Total flap failure was noted in six patients, and osteomyelitis recurrence was noted in eight patients, for which two patients underwent amputation surgery during the follow-up period. Only end-stage renal disease had a significant correlation with the recurrence rate (odds ratio = 16.5, p = 0.011). There was no significant relationship between outcomes and the other factors. Conclusion: This study showed that free flaps could be safely used for the treatment of osteomyelitis in patients with comorbidities and those who had osteomyelitis developing from diabetic foot ulcers.