449 results match your criteria Tissue Transfer Gracilis


Sequential propeller flaps in the treatment of post-traumatic soft tissue defects of the lower limb - a case series.

Injury 2020 Feb 15. Epub 2020 Feb 15.

Depatment of Hand and Plastic Surgery, Luzerner Kantonsspital, Spitalstrasse 6000 Luzern 16, Lucerne, Switzerland. Electronic address:

Introduction: Propeller flaps have gained great popularity among reconstructive surgeons; however, the inability to directly close the donor site of large propeller flaps constitutes a well-known limitation of this technique. Skin grafting of the donor area is not always feasible nor desirable. To address large propeller flaps secondary defects, we investigated the use of a second propeller flap harvested from a nearby region of relative skin redundancy to assist the donor site closure generated by the first. Read More

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http://dx.doi.org/10.1016/j.injury.2020.02.031DOI Listing
February 2020

Foot salvage using microsurgical free muscle flaps in severely crushed foot with soft tissue defects.

Injury 2019 Dec 23;50 Suppl 5:S17-S20. Epub 2019 Oct 23.

Orthopedics and Traumatology, Hand and Microsurgery Unit, Sohag University, Sohag, Egypt. Electronic address:

Objective: Management of complex foot injuries including skin, tendons, vessels, bone, with soft tissue defects is considered as an orthopedic challenge. Microsurgical free muscle flaps provide the best solution in such cases.

Patients And Methods: Thirty two consecutive cases of complex ankle and foot injuries were treated by skin grafted muscle free flap in one stage procedure after radical debridement. Read More

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http://dx.doi.org/10.1016/j.injury.2019.10.040DOI Listing
December 2019

The Inverted Free Functioning Gracilis Muscle Transfer For Restoration of Elbow Flexion Following Delayed Presentation or Failed Primary Nerve Reconstruction of Upper Trunk Injuries.

Tech Hand Up Extrem Surg 2020 Mar;24(1):26-31

Department of Surgery, Division of Plastic and Reconstructive Surgery.

Free functional gracilis transfer is a well-established technique for restoring active elbow flexion in brachial plexus injuries following delayed presentation or failed nerve reconstruction procedures. In cases of delayed presentation or failed nerve reconstruction following upper trunk injuries, the lower trunk intraplexal median and ulnar nerves are spared, thereby making them available to reinnervate the transferred gracilis. Therefore, we have inverted the conventional free functional gracilis orientation so as to orient the flap's recipient nerve in closer proximity to donor median or ulnar nerve fascicles to enable a short, tension-free coaptation in the middle to distal arm. Read More

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http://dx.doi.org/10.1097/BTH.0000000000000258DOI Listing
March 2020
2 Reads

Extensive Microsurgical Reconstruction of Chest Wall Defects for Locally Advanced Breast Cancer: A 10-Year Single-Unit Experience.

Ann Plast Surg 2020 03;84(3):293-299

From the Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan.

Background: Despite improvements in the early detection of breast cancer, locally advanced breast cancer (LABC) involving the chest wall exists in developing countries. Surgical resection remains a controversial management option. This study aims to demonstrate the value of chest wall reconstructive techniques for large LABC defects and report long-term outcomes. Read More

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http://dx.doi.org/10.1097/SAP.0000000000002000DOI Listing
March 2020
3 Reads
1.458 Impact Factor

Effectiveness and safety of the use of gracilis muscle for dynamic smile restoration in facial paralysis: A systematic review and meta-analysis.

J Plast Reconstr Aesthet Surg 2019 Aug 24;72(8):1254-1264. Epub 2019 May 24.

Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. Electronic address:

Background: Smiling is a fundamental component of social interactions. Significant challenges arise for patients with facial palsy. One of the key procedures for dynamic smile restoration is the microneurovascular transfer of a gracilis muscle. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S17486815193022
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http://dx.doi.org/10.1016/j.bjps.2019.05.027DOI Listing
August 2019
6 Reads

Combined delivery of VEGF and IGF-1 promotes functional innervation in mice and improves muscle transplantation in rabbits.

Biomaterials 2019 09 7;216:119246. Epub 2019 Jun 7.

John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA; Wyss Institute for Biologically Inspired Engineering at Harvard University, Cambridge,MA 02138, USA. Electronic address:

Microvascular muscle transfer is the gold standard for reanimation following chronic facial nerve paralysis, however, despite the regenerative capacity of peripheral motor axons, poor reinnervation often results in sub-optimal function. We hypothesized that injection of alginate hydrogels releasing growth factors directly into donor tissue would promote reinnervation, muscle regeneration, and function. A murine model of sciatic nerve ligation and neurorrhaphy was first used to assess the ability of gel delivery of vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1) to promote functional reinnervation. Read More

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http://dx.doi.org/10.1016/j.biomaterials.2019.119246DOI Listing
September 2019
20 Reads

Porcine experimental model for gracilis free flap transfer to the head and neck area with novel donor site description.

J Plast Reconstr Aesthet Surg 2020 Jan 22;73(1):111-117. Epub 2019 May 22.

Head and Neck Surgery and Reconstructive Surgery Section of the Oto-rhino-laryngology Department, Hospital Universitario Donostia-Donostia Unibersitate Ospitalea, P° Dr. Begiristain 109, 20004 Donostia San Sebastián, Gipuzkoa, Spain.

Introduction: Functional free tissue transfer in the form of muscle free flap is a challenging surgical procedure and needs a steep learning curve. A porcine model for free muscle transfer and insetting in a distant area is of great interest in reconstructive microsurgery due to the experience and learning curve necessary to perform these surgeries. The aim of this study was to assess the feasibility of a swine model for gracilis muscle free transfer and to describe the donor site anatomy. Read More

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http://dx.doi.org/10.1016/j.bjps.2019.05.032DOI Listing
January 2020
9 Reads

[Primary revision with replasty of the anterior cruciate ligament].

Oper Orthop Traumatol 2019 Jun 6;31(3):221-247. Epub 2019 Jun 6.

Klinik für Orthopädie und Unfallchirurgie, Martin Luther Krankenhaus, Caspar Theysstraße 27-31, 14193, Berlin, Deutschland.

Objective: Restoration of knee stability after rerupture of an anterior cruciate ligament (ACL) graft.

Indication: Acute and chronic functional instability with rerupture of an ACL graft with subjective instability with anatomical or non-anatomical bone tunnel without tunnel widening.

Contraindications: Partial anatomical bone tunnels of the previous operation, significant tunnel widening of anatomical bone tunnels, local infection of the knee joint, local soft tissue damage. Read More

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http://dx.doi.org/10.1007/s00064-019-0606-8DOI Listing
June 2019
10 Reads

Late avulsion of a free flap in a patient with severe psychiatric illness: Establishing a successful salvage strategy.

Arch Plast Surg 2019 Apr 20:589-593. Epub 2019 Apr 20.

Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.

Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. Read More

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http://www.e-aps.org/journal/view.php?doi=10.5999/aps.2018.0
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http://dx.doi.org/10.5999/aps.2018.01039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882698PMC
April 2019
14 Reads

Facial reanimation with masseter nerve-innervated free gracilis muscle transfer in established facial palsy patients.

Arch Plast Surg 2019 Mar 31;46(2):122-128. Epub 2019 Mar 31.

Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background: The masseter nerve is a useful donor nerve for reconstruction in patients with established facial palsy, with numerous advantages including low morbidity, a strong motor impulse, high reliability, and fast reinnervation. In this study, we assessed the.

Results: of masseter nerve-innervated free gracilis muscle transfer in established facial palsy patients. Read More

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http://dx.doi.org/10.5999/aps.2018.00717DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446028PMC
March 2019
4 Reads

Microsurgical Reconstruction of the Lower Extremity.

Semin Plast Surg 2019 Feb 8;33(1):54-58. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

Reconstruction of bony and soft tissue defects of the lower extremity has been revolutionized by the advent of microsurgical tissue transfer. There are numerous options for reconstruction. Possibilities include transfer of soft tissue, composite (bone and soft tissue) tissue, and functional muscle. Read More

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http://dx.doi.org/10.1055/s-0039-1677878DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408237PMC
February 2019
18 Reads

Free Tissue Transfer for Upper Extremity Reconstruction.

Semin Plast Surg 2019 Feb 8;33(1):17-23. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

With the advent of the Industrial Revolution, traumatic injuries of the upper extremity increased exponentially. As a result, surgeons began to reevaluate amputation as the standard of care. Following the Second World War, local and regional pedicled flaps became common forms of traumatic upper extremity reconstruction. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1677702
Publisher Site
http://dx.doi.org/10.1055/s-0039-1677702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408247PMC
February 2019
28 Reads

Segmental Gracilis Muscle Transplantation for Midfacial Animation in Möbius Syndrome: A 29-Year Experience.

Plast Reconstr Surg 2019 03;143(3):581e-591e

Toronto and Ottawa, Ontario, Canada From the Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children; the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto; and the Faculty of Medicine, University of Ottawa.

Background: Möbius syndrome is a complex congenital disorder of unclear cause involving multiple cranial nerves and typically presenting with bilateral facial and abducens nerves palsies. At The Hospital for Sick Children, Toronto, Ontario, Canada, microneurovascular transfer of free-muscle transplant is the procedure of choice for midfacial animation. The primary aim of this study was to investigate surgical outcomes of the procedure in terms of complications, secondary revisions, and smile excursion gains. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005368DOI Listing
March 2019
16 Reads

Functional outcomes of traumatic lower extremity reconstruction.

J Clin Orthop Trauma 2019 Jan-Feb;10(1):178-181. Epub 2017 Aug 24.

Department of Plastic Surgery, Los Angeles County + University of Southern California Medical Center, 1983 Marengo St, Los Angeles, CA 90033, United States.

Background: Lower extremity trauma accounts for over 300,000 injuries annually. While soft tissue transfer is a well-accepted practice for open fracture coverage, functional outcomes remain unclear.

Hypothesis: This study investigates functional outcomes following soft tissue reconstruction for open tibial fractures. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09765662173040
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http://dx.doi.org/10.1016/j.jcot.2017.08.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349574PMC
August 2017
19 Reads

Multivector functioning muscle transfer using superficial subslips of the serratus anterior muscle for longstanding facial paralysis.

J Plast Reconstr Aesthet Surg 2019 Jun 23;72(6):964-972. Epub 2018 Dec 23.

Department of Plastic and Reconstructive Surgery, Ryuku University School of Medicine, Japan.

Various donor muscles have been identified for restoring facial function due to longstanding facial paralysis. Donor muscles such as the gracilis and latissimus dorsi are frequently used and often produce one or two reliable vectors of force. However, there are drawbacks of using these muscles, including the instability of separating multivector functioning muscle units and limited amount of muscle contraction. Read More

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http://dx.doi.org/10.1016/j.bjps.2018.12.029DOI Listing
June 2019
8 Reads

Comparison between donor nerves to motorize the free functional gracilis muscle transfer for elbow flexion: Retrospective study of 38 consecutive cases in traumatic adult brachial plexus injuries.

Microsurgery 2019 Jul 22;39(5):400-404. Epub 2019 Jan 22.

Hand and Microsurgery Unit, Department of Orthopaedic Surgery, São Paulo University, São Paulo, Brazil.

Purpose: Elbow flexion deficit is a frequent problem in traumatic brachial plexus injuries and reestablishment of this function is the primary treatment goal. When management is delayed, or the initial acute approach fails, free functional transfer of the gracilis muscle for elbow flexion is the treatment of choice. In this report, the authors present the results of a comparison study on different donor nerves (spinal accessory and ulnar) in elbow flexion reconstruction with gracilis flap for traumatic adult brachial plexus injuries. Read More

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http://dx.doi.org/10.1002/micr.30426DOI Listing
July 2019
24 Reads

Microvascular reconstruction of pediatric lower extremity trauma using free tissue transfer.

Eur J Orthop Surg Traumatol 2019 Feb 16;29(2):285-293. Epub 2019 Jan 16.

Department of Plastic Surgery, University of Tennessee Health Science Center (UTHSC), 1068 Cresthaven Road Suite 500, Memphis, TN, 38119, USA.

While free tissue transfer has long been established as a reliable microsurgical technique in the adult population, its application in pediatric reconstruction is a relatively recent phenomenon. Despite initial concerns regarding minute vessel diameters, increased propensity for vasospasm, and limited tissue availability, pediatric free tissue transfer is now a widely used technique that has demonstrated an acceptable level of donor and recipient site morbidity in children. Five flaps commonly used in the reconstruction of lower extremity trauma are discussed in this paper: the latissimus dorsi, rectus abdominis, anterolateral thigh, gracilis, and the subscapular and parascapular flaps. Read More

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http://dx.doi.org/10.1007/s00590-019-02367-wDOI Listing
February 2019
4 Reads

Closed Loop Microfabricated Facial Reanimation Device Coupling EMG-Driven Facial Nerve Stimulation with a Chronically Implanted Multichannel Cuff Electrode.

Conf Proc IEEE Eng Med Biol Soc 2018 07;2018:2206-2209

Permanent facial paralysis and paresis (FP) results from damage to the facial nerve (FN), and is a debilitating condition with substantial functional and psychological consequences for the patient. Unfortunately, surgeons have few tools with which they can satisfactorily reanimate the face. Current strategies employ static (e. Read More

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http://dx.doi.org/10.1109/EMBC.2018.8512778DOI Listing
July 2018
7 Reads

Management of Bilateral Facial Palsy.

Otolaryngol Clin North Am 2018 Dec 27;51(6):1213-1226. Epub 2018 Aug 27.

Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. Electronic address:

Bilateral facial paralysis is a rare entity that occurs in both pediatric and adult patients and can have congenital or acquired causes. When paralysis does not resolve with conservative or medical management, surgical intervention may be indicated. This article presents the authors' preferred technique for facial reanimation in patients with bilateral congenital facial paralysis. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.014DOI Listing
December 2018
40 Reads

Free Gracilis Transfer and Static Facial Suspension for Midfacial Reanimation in Long-Standing Flaccid Facial Palsy.

Otolaryngol Clin North Am 2018 Dec 10;51(6):1129-1139. Epub 2018 Aug 10.

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.

This article presents an approach to reanimation of the midface in long-standing flaccid facial palsy by means of functional free gracilis transfer and static facial suspension. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665183013
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http://dx.doi.org/10.1016/j.otc.2018.07.009DOI Listing
December 2018
15 Reads

Secondary bladder exstrophy repair with a bilateral gracilis muscle flap in an adult female patient: Case report of an original procedure.

Ann Chir Plast Esthet 2019 Feb 3;64(1):120-123. Epub 2018 Jul 3.

Service de chirurgie plastique reconstructrice et esthétique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France. Electronic address:

Classical bladder exstrophy (CBE), affecting 1 birth out of 30,000, is characterized by an evaginated bladder plate through a defect in the lower abdominal wall, multiple abdominal wall anomalies including a pubic bone arch dehiscence. Numerous approaches from childhood to adulthood are thus required, depending on the severity of the deformity, including the associated genital anomalies. We report the case of a 19-year-old woman with CBE with a history of three-failed primary closure. Read More

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http://dx.doi.org/10.1016/j.anplas.2018.06.008DOI Listing
February 2019
15 Reads

Surgical Refinement Following Free Gracilis Transfer for Smile Reanimation.

Ann Plast Surg 2018 09;81(3):329-334

From the Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA. Conflicts of interest and sources of funding: none declared.

Importance: Gracilis free muscle transfer is widely regarded as the gold standard functional smile reanimation in long-standing facial palsy. Although most patients achieve meaningful oral commissure movement, a subset has suboptimal aesthetic outcomes due to midfacial bulk or oral commissure malposition. Safe refinements that do not compromise excursion would be a welcome addition to the surgical armamentarium for this population. Read More

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http://Insights.ovid.com/crossref?an=00000637-201809000-0001
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http://dx.doi.org/10.1097/SAP.0000000000001545DOI Listing
September 2018
23 Reads

Free Reverse Gracilis Muscle Combined With Steindler Flexorplasty for Elbow Flexion Reconstruction After Failed Primary Repair of Extended Upper-Type Paralysis of the Brachial Plexus.

J Hand Surg Am 2019 Feb 20;44(2):112-120. Epub 2018 Jun 20.

Center of Biological and Health Sciences, Department of Neurosurgery, University of the South of Santa Catarina (Unisul), Tubarão, Brazil; Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florianópolis, Santa Catarina, Brazil; Department of Plastic Surgery, Joana de Gusmão Children's Hospital, Florianópolis, Santa Catarina, Brazil. Electronic address:

Purpose: To report the clinical outcomes of elbow flexion reconstruction using a reverse free gracilis muscle flap plus Steindler flexorplasty in patients with previously failed reconstruction of extended upper-type brachial plexus paralysis.

Methods: Twenty-four male patients were reoperated upon an average of 45 months (SD, ± 45 months) after brachial plexus repair. The gracilis tendon was secured to the acromion, and the muscle belly was sutured to the biceps distal tendon. Read More

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http://dx.doi.org/10.1016/j.jhsa.2018.05.016DOI Listing
February 2019
7 Reads

The Gracilis Free Flap Is a Viable Option for Large Extremity Wounds.

Ann Plast Surg 2018 09;81(3):322-326

Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.

Background: Traditionally, the gracilis free flap is used for coverage of small- to medium-sized wounds (<50 cm) or as a functional muscle transfer. The purpose of this study is to examine the use of the gracilis free flap in the reconstruction of large extremity wounds (>100 cm).

Methods: We retrospectively reviewed records of 34 patients who underwent extremity soft-tissue reconstruction using gracilis free flaps for wounds larger than 100 cm from 1998 to 2016. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001523DOI Listing
September 2018
10 Reads

Skin Paddles Improve Muscle Flap Salvage Rates After Microvascular Compromise in Lower Extremity Reconstruction.

Ann Plast Surg 2018 07;81(1):68-70

From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, New York, NY.

Purpose: Free tissue transfer after lower extremity trauma is associated with notoriously high complication rates. Theoretically, the inclusion of a cutaneous paddle on muscle free flaps may improve clinical flap monitoring. The effect of skin paddle presence on muscle free flap salvage outcomes after take-back was examined. Read More

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http://Insights.ovid.com/crossref?an=00000637-900000000-9739
Publisher Site
http://dx.doi.org/10.1097/SAP.0000000000001425DOI Listing
July 2018
51 Reads

Successful limb salvage through staged bypass combined with free gracilis muscle transfer for critical limb ischemia with osteomyelitis after failed endovascular therapy.

Surg Case Rep 2018 May 2;4(1):40. Epub 2018 May 2.

Department of Vascular Surgery, Asahikawa Medical University, 1-1-1, Midorigaoka-higashi-2jyo, Asahikawa, 078-8510, Japan.

Background: Critical limb ischemia with osteomyelitis is so difficult to treat that even appropriate revascularization and wound therapy cannot achieve limb salvage because of uncontrollable infection. It is still difficult to judge the possibility of limb salvage before revascularization.

Case Presentation: A 73-year-old male complained of a small ulcer on his left toe, which was treated with multiple endovascular therapy. Read More

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http://dx.doi.org/10.1186/s40792-018-0449-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5930295PMC
May 2018
7 Reads

Incomplete Facial Paralysis: The Use of the Ipsilateral Residual Facial Nerve as a Donor Nerve for Facial Reanimation.

Plast Reconstr Surg 2018 07;142(1):202-214

Tel Aviv, Israel; and Toronto, Ontario, Canada From the Department of Plastic and Reconstructive Surgery, Microsurgery Unit, Tel Aviv Sourasky Medical Center affiliated with the Sackler Faculty of Medicine, Tel Aviv University; and the Division of Plastic Surgery, The Hospital for Sick Children, University of Toronto.

Background: The reconstructive approach for incomplete facial paralysis is not yet determined. In this article, the authors present a new surgical approach for patients with incomplete facial paralysis in which residual, ineffective movement is detected preoperatively in the ipsilateral buccozygomatic territory of the paretic facial nerve.

Methods: Sixteen patients with incomplete facial paralysis were found eligible for the procedure and underwent one-stage facial reanimation performed by the senior author (E. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004536DOI Listing
July 2018
21 Reads

Comparison of symmetry after smile reconstruction for flaccid facial paralysis with combined fascia lata grafts and functional gracilis transfer for static suspension or gracilis transfer alone.

Microsurgery 2018 Sep 30;38(6):634-642. Epub 2018 Mar 30.

Department of Plastic and Hand Surgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.

Purpose: Facial paralysis has a profound impact on functionality and esthetics of the oral region. In patients with strong skin laxity and soft tissue ptosis, functional smile reconstruction is challenging due to the accentuated asymmetry at rest. Thus, the purpose of the study was to analyze facial symmetry in this patient clientele following a combination of dynamic reanimation with fascial strips for static suspension compared to functional gracilis transfer alone. Read More

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http://dx.doi.org/10.1002/micr.30324DOI Listing
September 2018
7 Reads

Application of Quantitative Microstructural MR Imaging with Atlas-based Analysis for the Spinal Cord in Cervical Spondylotic Myelopathy.

Sci Rep 2018 03 26;8(1):5213. Epub 2018 Mar 26.

Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan.

Mapping of MR fiber g-ratio, which is the ratio of the diameter of the axon to the diameter of the neuronal fiber, is introduced in this article. We investigated the MR fiber g-ratio, the axon volume fraction (AVF) and the myelin volume fraction (MVF) to evaluate microstructural changes in the spinal cord in patients with cervical spondylotic myelopathy (CSM) in vivo, using atlas-based analysis. We used diffusion MRI data acquired with a new simultaneous multi-slice accelerated readout-segmented echo planar imaging sequence for diffusion analysis for AVF calculation and magnetization transfer saturation imaging for MVF calculation. Read More

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http://dx.doi.org/10.1038/s41598-018-23527-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5979956PMC
March 2018
7 Reads

Tibialis Anterior Reconstruction With Hamstring Autograft Using a Minimally Invasive Approach.

Foot Ankle Int 2018 05 9;39(5):535-541. Epub 2018 Mar 9.

1 Hospital for Special Surgery, New York, NY, USA.

Background: Tibialis anterior tendon ruptures are rare and can cause significant dysfunction. Often, conservative measures are prescribed because of the morbidity of a tendon transfer as an operative solution. We present a novel reconstruction technique using hamstring autograft, which may obviate the need for local tendon transfer and long-term bracing. Read More

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http://dx.doi.org/10.1177/1071100717750883DOI Listing
May 2018
8 Reads

The Distal Stump of the Intramuscular Motor Branch of the Obturator Nerve Is Useful for the Reconstruction of Long-Standing Facial Paralysis Using a Double-Powered Free Gracilis Muscle Flap Transfer.

J Craniofac Surg 2018 Mar;29(2):476-481

Department of Plastic Surgery, Faculty of Medicine, Oita University, Oita, Japan.

Background: Double innervation of the transferred muscle with the contralateral facial nerve and the ipsilateral masseteric nerve has recently been reported by some authors. The aim of this study was to assess the utility of our procedure of double innervation of free gracilis muscle for reconstruction of long-standing facial palsy.

Patients And Methods: In our department, 6 cases of long-standing facial paralysis (4 cases of complete palsy and 2 of incomplete palsy) were reconstructed using a free gracilis muscle double innervated with the masseteric and contralateral facial nerves. Read More

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http://dx.doi.org/10.1097/SCS.0000000000004064DOI Listing
March 2018
5 Reads

Free flaps for head and neck cancer in paediatric and neonatal patients.

Curr Opin Otolaryngol Head Neck Surg 2018 Apr;26(2):127-133

Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Birmingham, West Midlands, UK.

Purpose Of Review: To review recent literature on the subject of free tissue transfer options in paediatric head and neck surgery, with a particular emphasis on highlighting the advantages and disadvantages of different reconstructions in the paediatric patient.

Recent Findings: Free tissue transfer in paediatric patients is predictable and applicable for a wide range of congenital and acquired defects in the head and neck. The free fibula flap is a mainstay of mandibular reconstruction and allows excellent implant-supported prosthodontic rehabilitation and growth potential at the recipient site with little or no donor site morbidity. Read More

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http://dx.doi.org/10.1097/MOO.0000000000000434DOI Listing
April 2018
14 Reads

Transfer of a Radial Nerve Branch to the Brachialis Nerve for Restoration of Elbow Flexion.

Tech Hand Up Extrem Surg 2018 Jun;22(2):65-67

MetroHealth Medical Center, Cleveland, OH.

Nerve transfers for brachial plexus reconstruction and the treatment of peripheral nerve injury have demonstrated excellent clinical outcomes and may be superior to nerve grafting. Previously described nerve transfers for restoration of elbow flexion include the Oberlin (ulnar to musculocutaneous) and double fasicular (median to biceps and ulnar to brachialis) transfers. However, these transfers cannot be performed in patients with loss of elbow flexion and concomitant high median and ulnar nerve injury. Read More

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http://dx.doi.org/10.1097/BTH.0000000000000186DOI Listing
June 2018
6 Reads

[A Novel Technique for the Preparation of a 3- or 5-Stranded Hamstring Graft for Individualised Single-Bundle ACL or PCL Reconstruction].

Z Orthop Unfall 2017 Dec 12;155(6):735-736. Epub 2017 Dec 12.

Klinik für Orthopädie und Rheumatologie, Universitätsklinikum Gießen und Marburg, Marburg.

Development of a preparation technique for hamstring tendons to ensure a maximum of intraoperative flexibility during individualised cruciate ligament surgery. Primary ACL- and PCL-reconstruction as well as cases of later revision. Three- or five-stranded grafts can be obtained with the use of semitendinosus and gracilis tendons with fiber tape enforcement and use of a conventional femoral cortical suspensory fixation device. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-119899
Publisher Site
http://dx.doi.org/10.1055/s-0043-119899DOI Listing
December 2017
12 Reads

Free gracilis muscle transfer for smile reanimation after treatment for advanced parotid malignancy.

Head Neck 2018 03 20;40(3):561-568. Epub 2017 Nov 20.

Department of Facial Plastic Reconstructive Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.

Background: The purpose of this study was to characterize the outcomes of free gracilis muscle transfer for delayed smile reanimation after radical parotidectomy.

Methods: A retrospective chart review of patients who underwent free gracilis muscle transfer for smile reanimation after radical parotidectomy between 2003 and 2016 was performed. Patient-reported quality of life (Facial Clinimetric Evaluation Scale [FaCE]), physician-reported facial function ("eFACE" facial grading scale), and oral commissure excursion were compared preoperatively and postoperatively. Read More

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http://dx.doi.org/10.1002/hed.25022DOI Listing
March 2018
15 Reads

Reconstructive microsurgical approach for the treatment of pyoderma gangrenosum.

J Plast Reconstr Aesthet Surg 2018 Jan 16;71(1):44-52. Epub 2017 Aug 16.

Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital Barmherzige Brüder Salzburg, Paracelsus Medical University (PMU), Kajetanerplatz 1, 5020, Salzburg, Austria.

Introduction: Pyoderma gangrenosum (PG) is a rare type of autoimmune disease that results in progressive ulcers with or without previous trauma. However, PG is not well understood to date, and its treatment therefore remains a challenge. Because of the disease's systemic characteristic and the unpredictability of the clinical course, no gold standard treatment is available, especially concerning the surgical procedures to treat pyodermic lesions. Read More

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http://dx.doi.org/10.1016/j.bjps.2017.08.013DOI Listing
January 2018
24 Reads

Primary facial reanimation in head and neck cancer.

Oral Oncol 2017 11 12;74:171-180. Epub 2017 Sep 12.

Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. Electronic address:

Facial Paralysis (FP) profoundly impairs the life of individuals, both functionally and psychosocially. Surgical approaches to treat this condition are myriad, but the ultimate goal is to restore symmetry and movement. Ablative surgery for tumors of the head and neck region are amongst the most common etiologies causing FP and this group of patients represents unique challenges. Read More

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http://dx.doi.org/10.1016/j.oraloncology.2017.08.013DOI Listing
November 2017
10 Reads

Modified adductor sling technique: A surgical therapy for patellar instability in skeletally immature patients.

Knee 2017 Dec 1;24(6):1282-1288. Epub 2017 Sep 1.

Department of Trauma and Reconstructive Surgery with Division of Knee and Shoulder Surgery, Sports Traumatology, Asklepios Clinic St. Georg, Hamburg, Germany.

Background: Due to open femoral physis the therapy of patellar instability in skeletally immature patients is challenging. We developed a modified surgical technique of the 'Adductor-Sling-Approach' by Sillanpää. The purpose of this study was to evaluate the clinical outcome of the operative technique and to analyse the reasons for failure. Read More

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http://dx.doi.org/10.1016/j.knee.2017.08.051DOI Listing
December 2017
53 Reads

Salvage of postcranioplasty implant exposure using free tissue transfer.

Head Neck 2017 08 17;39(8):1655-1661. Epub 2017 May 17.

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.

Background: Refractory implant exposure is frustrating after cranioplasty. The purpose of this study was for the authors to present their experience with free tissue transfer for salvage of postcranioplasty implant exposure.

Methods: A retrospective medical chart review was conducted on all free tissue transfers performed for exposed implant coverage after cranioplasty between January 2004 and February 2016. Read More

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http://dx.doi.org/10.1002/hed.24813DOI Listing
August 2017
66 Reads

Rectus Abdominis Motor Nerves as Donor Option for Free Functional Muscle Transfer: A Cadaver Study and Case Series.

Hand (N Y) 2018 Mar 7;13(2):150-155. Epub 2017 Apr 7.

1 Washington University School of Medicine, St Louis, MO, USA.

Background: Current management of brachial plexus injuries includes nerve grafts and nerve transfers. However, in cases of late presentation or pan plexus injuries, free functional muscle transfers are an option to restore function. The purpose of our study was to describe and evaluate the rectus abdominis motor nerves histomorphologically and functionally as a donor nerve option for free functional muscle transfer for the reconstruction of brachial plexus injuries. Read More

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http://dx.doi.org/10.1177/1558944717702467DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5950971PMC
March 2018
10 Reads

Microsurgical Tissue Transfer in Breast Reconstruction.

Clin Plast Surg 2017 Apr 13;44(2):345-359. Epub 2017 Feb 13.

St. Andrew's Centre for Plastic Surgery & Burns, Broomfield Hospital, Court Road, Chelmsford, Essex CM1 7ET, UK.

Autologous breast reconstructions have grown in popularity because of their durability, aesthetic outcomes, symmetry, increase in external beam radiotherapy use, and potential aesthetic enhancement at the donor site. Increasing patient expectations for predictable high aesthetic outcomes with minimal complications or need for further procedures has been met by refinement in the use of flaps. The authors' microsurgical breast reconstruction center aims to provide this while delivering efficient service. Read More

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http://dx.doi.org/10.1016/j.cps.2016.12.002DOI Listing
April 2017
5 Reads

Severe Crush Injury to the Forearm and Hand: The Role of Microsurgery.

Clin Plast Surg 2017 Apr 1;44(2):233-255. Epub 2017 Feb 1.

Instituto de Cirugía Plástica y de la Mano, Private Practice, Hospital La Luz and Hospital Mutua Montañesa, Madrid/Santander, Spain; Department of Traumatology and Orthopedics, Clinical Hospital, Warsaw, Otwock, Poland.

The main goals of treating severe crush injuries are debriding away devitalized tissue and filling any resultant dead space with vascularized tissue. In the authors' experience, the most ideal methods for soft tissue coverage in treating crush injuries are the iliac flap, the adipofascial lateral arm flap, and the gracilis flap. Accompanying bone defects respond very well to free corticoperiosteal flaps. Read More

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http://dx.doi.org/10.1016/j.cps.2016.11.002DOI Listing
April 2017
8 Reads

[Thinning of the free muscle flaps for the treatment of hand and foot defects].

Zhonghua Zheng Xing Wai Ke Za Zhi 2017 Mar;33(2):112-5

Objective: To investigate the feasibility of one-stage thinning of latissimus dorsi muscle, rectus abdominis muscle and gracilis flap in reconstruction of the hand and foot defects.

Methods: From June 2009 to April 2015,24 free muscle flaps were thinned during transfer operation by removing their superficial muscle layers on the basis of their vessel pedicles running in the deep surface of flaps. The surface of the muscle flaps were covered by split-thickness skin grafts. Read More

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March 2017
7 Reads

Analysis of a Surgical Treatment for Persistent Urorectal Fistulas after Radical Cancer Surgery: A Comparison of Prostate Cancer and Rectal Cancer.

Urol Int 2017 24;99(1):56-62. Epub 2017 Feb 24.

Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan.

Introduction: The study aimed to present our experience of surgical treatment for urorectal fistulas (URF) that develop after cancer surgery.

Materials And Methods: Fourteen patients with URF who were treated at our institution from 2005 through 2015 were retrospectively analyzed. Among these, 7 patients had previous surgical treatment of prostate cancer (PC) and the other 7 had been treated for rectal cancer (RC). Read More

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http://dx.doi.org/10.1159/000457835DOI Listing
May 2018
19 Reads

Analysis of the ideal muscle weight of gracilis muscle transplants for facial reanimation surgery with regard to the donor nerve and outcome.

J Plast Reconstr Aesthet Surg 2017 Apr 9;70(4):459-468. Epub 2017 Jan 9.

Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Faculty of Medicine, Freiburg, Germany. Electronic address:

Background: Free functional muscle transfers represent the 'criterion standard' for smile reconstruction in facial paralysis. The gracilis muscle is a common donor muscle; however, no data exist regarding the volume of the muscle tissue that is necessary for symmetric commissure excursion.

Methods: All patients with facial paralysis receiving a free functional muscle transfer for facial reanimation surgery between January 2009 and November 2015 were retrospectively analysed. Read More

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http://dx.doi.org/10.1016/j.bjps.2016.12.005DOI Listing
April 2017
7 Reads

Single innervated segmented vastus lateralis for midfacial reanimation during radical parotidectomy.

Head Neck 2017 03 9;39(3):602-604. Epub 2017 Jan 9.

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.

Background: Innervated free muscle transfer using the gracilis muscle or temporalis myoplasty has been successfully utilized for facial reanimation in chronic facial palsy. These techniques are less suited to immediate facial reconstruction in the setting of radical parotidectomy, in which the complexity of the defect, patient age, postoperative radiotherapy, and limited life expectancy pose particular challenges.

Methods: We present a novel description of the use of a chimeric anterolateral thigh (ALT) flap and innervated vastus lateralis to achieve midface static suspension and dynamic reanimation in the setting of radical parotidectomy. Read More

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http://dx.doi.org/10.1002/hed.24668DOI Listing
March 2017
11 Reads

Free Functioning Gracilis Muscle Transfer for Elbow Flexion Reconstruction after Traumatic Adult Brachial Pan-Plexus Injury: Where Is the Optimal Distal Tendon Attachment for Elbow Flexion?

Plast Reconstr Surg 2017 Jan;139(1):128-136

Rochester, Minn. From the Department of Orthopedic Surgery, Division of Hand Surgery, the Department of Neurologic Surgery, and the Center for Innovation, Mayo Clinic.

Background: Reconstruction after pan-plexus root avulsions often includes gracilis free functioning muscle transfer. For elbow flexion reconstruction, the free functioning muscle transfer distal tendon is inserted into the biceps tendon or more distally (i.e. Read More

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http://dx.doi.org/10.1097/PRS.0000000000002864DOI Listing
January 2017
36 Reads

Correction of Residual Static and Dynamic Labial Deviations in a Paralyzed Face After Free Gracilis Muscle Transplantation.

J Craniofac Surg 2016 Nov;27(8):2143-2145

Department of Plastic, Reconstructive and Maxillo-Facial Surgery, and Burn Unity, Centro Hospitalar de São João, Faculty of Medicine-Porto University, Alameda Professor Hernâni Monteiro, Porto, Portugal.

Free muscle flap transfer is currently the procedure of choice for longstanding facial paralysis to restore symmetry both at rest and when smiling. However, movements obtained are generally localized, unidirectional, and philtrum centralization and lower lip movement is not proportionally achieved. The stability of free flap insertion at the lips also interferes with the results, as gradual disinsertion and shifting of the nasolabial fold can be caused by repetitive movements. Read More

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http://dx.doi.org/10.1097/SCS.0000000000002970DOI Listing
November 2016
9 Reads

Semitendinosus and gracilis free muscle-tendon graft for repair of massive rotator cuff tears: surgical technique.

Joints 2016 Jul-Sep;4(3):189-192. Epub 2016 Sep 21.

Clinical Orthopaedics, Department of Clinical and Molecular Science DISCLIMO, Polytechnic University of Marche, Ancona, Italy.

Massive rotator cuff tears are difficult to treat surgically due to retraction, degeneration and fraying of the ends of torn tendons, severe fatty infiltration and atrophy of the respective muscles. Procedures developed to close the gap between the rotator cuff and the greater tuberosity of the humerus, such as soft tissue release may be inadequate for large tears. Human or porcine dermal allografts still have uncertain benefits, and tendon transfers seem to be associated with poor outcomes, donor site morbidity and altered mechanics. Read More

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http://dx.doi.org/10.11138/jts/2016.4.3.189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5115245PMC
September 2016
23 Reads

One versus two venous anastomoses in microvascular lower extremity reconstruction using gracilis muscle or anterolateral thigh flaps.

Injury 2016 Dec 17;47(12):2828-2832. Epub 2016 Oct 17.

Department of Plastic, Reconstructive, Hand and Burn Surgery, StKM-Klinikum Bogenhausen, Academic Teaching Hospital Technical University Munich, Germany.

Introduction: Free tissue transfers are a highly reliable procedure routinely performed for reconstruction of a wide range of defects. Main complication in free flap surgery is usually venous thrombosis. Many technical controversies exist regarding the technical details of the microvascular anastomosis in order to prevent occurrence of thrombosis and optimize outcomes. Read More

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http://dx.doi.org/10.1016/j.injury.2016.10.015DOI Listing
December 2016
37 Reads