1,583 results match your criteria flap transfers

Combined Sequential Bilateral Hypoglossal-to-facial and Masseter-to-facial Transfers for Bilateral Facial Paralysis.

Plast Reconstr Surg Glob Open 2021 Jul 12;9(7):e3689. Epub 2021 Jul 12.

Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain.

Bilateral facial paralysis is a challenging situation requiring complex management. Surgical treatment can include nerve transfers, mainly masseter-to-facial, or muscle transfers, gracilis free flap, or temporalis transposition. Deciding on the surgical option depends on the duration of the paralysis and the feasibility of facial muscles. Read More

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Single incision thenar muscle reconstruction using the free functional pronator quadratus flap.

BMC Surg 2021 Jul 12;21(1):310. Epub 2021 Jul 12.

Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.

Background: Injuries to the thenar muscle mass or the thenar branch of the median nerve and resulting loss of thumb opposition lead to a massive impairment of hand function. For decades, reconstructive approaches were based on tendon transfers. To broaden the reconstructive repertoire, we present the free functional pronator quadratus flap as a viable alternative for functional reconstruction and provide a specification for its indication. Read More

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Long-term clinical and radiographic outcomes after pial pericranial dural revascularization: a hybrid surgical technique for treatment of anterior cerebral territory ischemia in pediatric moyamoya disease.

J Neurosurg Pediatr 2021 Jul 2:1-9. Epub 2021 Jul 2.

Departments of1Neurosurgery and.

Objective: Isolated anterior cerebral artery (ACA) territory ischemia in pediatric moyamoya disease (MMD) is rare but has been increasingly recognized, particularly in children manifesting progression of disease in a delayed fashion after middle cerebral artery revascularization surgery. Surgical treatment is complicated by limited graft choices, with the small number of case series largely focused on complex, higher-risk operations (omental flap transfers, large interhemispheric rotational grafts); direct bypass (often untenable in children due to vessel size); or, alternatively, the technically simpler method of multiple burr holes (of limited efficacy outside of infants). Faced with the problem of a growing cohort of pediatric patients with MMD that could benefit from anterior cerebral revascularization, the authors sought to develop a solution that was specifically designed for children and that would be lower risk than the more complex approaches adapted from adult populations but more effective than simple burr holes. Read More

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Objectifying growth of vascularized bone transfers after mandibular reconstruction in the pediatric population.

J Plast Reconstr Aesthet Surg 2021 Jun 11. Epub 2021 Jun 11.

Department of Plastic and Reconstructive Surgery, University Hospital of Leuven, 49 Herestraat, Herestraat 3000 Leuven, Belgium. Electronic address:

Background: Autologous vascularized bone transfer is the preferred strategy for the reconstruction of mandibular defects in a pediatric population. The principal argument is the theoretical postoperative growth potential of the neomandible, which uses vascularized donor tissues.

Objectives: The purpose of this study was to objectify the veritable growth potential of vascularized bone transfers in children. Read More

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Abdominal-based free flaps in head and neck reconstruction.

Curr Opin Otolaryngol Head Neck Surg 2021 Aug;29(4):314-319

Department of Surgery, Division of Plastic Surgery, Tufts Medical Center, Boston, Massachusetts, USA.

Purpose Of Review: The head and neck reconstructive surgeon is intimately familiar with the anterolateral thigh, radial forearm, and parascapular flaps. This review serves to describe the major abdominal-based free tissue transfers in head and neck reconstruction that can be used as alternatives to these traditional workhorse flaps.

Recent Findings: Abdominal-based free flaps, while not traditionally used in head and neck reconstruction, are great alternatives or second-line flaps. Read More

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Anatomical variant of physeal blood supply to the fibula.

BMJ Case Rep 2021 Jun 7;14(6). Epub 2021 Jun 7.

Plastic Surgery, Guy's and St Thomas' Hospitals NHS Trust, London, UK.

Vascularised epiphysial fibula bone transfers in the paediatric population provides a solution to growth suppression in extremity reconstruction. We report a case of an anatomical variant to the epiphysial blood supply that has never been reported in literature. A 6-year-old girl underwent a free vascularised fibula flap for reconstruction of her right humerous following osteosarcoma resection. Read More

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A Case of Complex Facial Reconstruction Illuminates Paul Tessier's Surgical State of Mind.

J Craniofac Surg 2021 May 25. Epub 2021 May 25.

Department of Maxillofacial Surgery and Plastic Surgery, Necker - Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris; Faculté de Médecine, Université de Paris; Paris, France.

Abstract: Successful head and neck reconstructions tackle both morphological and functional issues within treatment plans involving multiple coordinated steps. Nowadays, biomaterials, computer-assisted surgery, and free tissue transfers have greatly increased the potentialities of craniofacial surgeons. In the 1970s, when Paul Tessier, one of the founders of modern plastic surgery, was at the peak of his career, complex reconstructions had little technology to rely on. Read More

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Dual-innervated multivector muscle transfer using two superficial subslips of the serratus anterior muscle for long-standing facial paralysis.

Arch Plast Surg 2021 May 15;48(3):282-286. Epub 2021 May 15.

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

Recent reports have described several cases of double muscle transfers to restore natural, symmetrical smiles in patients with long-standing facial paralysis. However, these complex procedures sometimes result in cheek bulkiness owing to the double muscle transfer. We present the case of a 67-year-old woman with long-standing facial paralysis, who underwent two-stage facial reanimation using two superficial subslips of the serratus anterior muscle innervated by the masseteric and contralateral facial nerves via a sural nerve graft. Read More

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Recipient vessel selection for multiple free flap transfers in head and neck reconstruction at different periods.

Microsurgery 2021 Jul 14;41(5):438-447. Epub 2021 May 14.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.

Background: Treatment decisions can be challenging in patients undergoing multiple oropharyngeal microsurgical reconstructions at different periods by various causes. We, retrospectively, reviewed patients with at least three consecutive free flap reconstructions to determine the optimal strategy for selecting recipient vessels.

Methods: Then, 36 patients (33 men and 3 women) who underwent at least 3 microsurgical reconstructions with a total of 51 free flap transfers for head and neck defects were included in this report. Read More

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Total nasal reconstruction with pre-laminated, super-thin anterolateral thigh flap: A case report.

Microsurgery 2021 Apr 22. Epub 2021 Apr 22.

Plastic Reconstructive and Aesthetic Surgery, Manisa Celal Bayar University, Manisa, Turkey.

Many techniques for nasal reconstruction have been described to achieve aesthetically and functionally favorable results. Local tissues, specifically the forehead flap, provide the best tissue match with the nose. However, when local tissue donor sites are limited, alternative options such as free tissue transfers should be considered. Read More

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Outcomes and Utility of Intracranial Free Tissue Transfer.

Ann Otol Rhinol Laryngol 2021 Apr 21:34894211008699. Epub 2021 Apr 21.

Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, KS, USA.

Objective: Complications associated with intracranial vault compromise can be neurologically and systemically devastating. Primary and secondary repair of these deficits require an air and watertight barrier between the intracranial and extracranial environments. This study evaluated the outcomes and utility of using intracranial free tissue transfer as both primary and salvage surgical repair of reconstruction. Read More

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Reconstruction of mutilating hand injuries by microsurgical free tissue transfers from the foot.

Injury 2021 Mar 30. Epub 2021 Mar 30.

Emot Hospital 1418 sok No14 Kahramanlar. İzmir, Turkey.

Introduction: The aim of this study is to present various hand reconstruction methods and provide technical notes regarding the treatment of mutilating hand injuries using free-tissue transfers from the foot and to investigate whether these transfers provide patients with a usable hand or not.

Patients And Methods: Ninety patients with mutilating hand injuries were included in the study. A total of 101 procedures were performed. Read More

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Neglected Achilles Tendon Ruptures.

Clin Podiatr Med Surg 2021 Apr;38(2):261-277

Florida Orthopedic Foot and Ankle Center, 1630 South Tuttle Avenue, Sarasota, FL 34239, USA.

Achilles tendon ruptures are a common ailment and often missed in upwards of 25% of cases. Neglected Achilles injuries can be treated both conservatively and surgically. Physical therapy, bracing, and custom ankle-foot orthoses are some options to consider. Read More

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Hand Surgery in Japan.

J Hand Microsurg 2021 Jan 7;13(1):42-48. Epub 2021 Mar 7.

Department of Hand Surgery, Kansai Medical University, Osaka, Japan.

Japan has faced the most challenging times in the past. Through precise diligence by stalwarts and doyens of initial hand surgeons, it led an incredible path for the most significant moments of hand surgery. This article describes the early phase of development of Japanese Society for Surgery of the hand, substantial and innovative contributions from surgeons. Read More

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January 2021

Reconstructive surgery for sequellae of Mycobacterium ulcerans infection (Buruli ulcer) of the upper limb.

J Plast Surg Hand Surg 2021 Mar 1:1-6. Epub 2021 Mar 1.

Institut de Chirurgie Reconstructive, Abidjan, Côte d'Ivoire.

Introduction: Infection by Mycobacterium ulcerans constitutes a neglected tropical disease whose prevalence seems to have overrun those of cutaneous tuberculosis and leprosy. Its aggressivity depends on a mycolactone toxin. Lesions may involve skin, tendon and bone with a large spectrum of manifestations: non-ulcerative (papules, nodules, plaques), ulcerative and oedematous presentations as well as osteomyelitis with muscular contraction and ankylosis. Read More

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Subdermal Dissection for Elevation of Pure Skin Perforator Flaps and Superthin Flaps: The Dermis as a Landmark for the Most Superficial Dissection Plane.

Plast Reconstr Surg 2021 03;147(3):470-478

From the Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine; the Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital; and the Department of Plastic Surgery, Noda Hospital.

Background: Pure skin perforator and superthin flaps have been reported and are becoming popular, as they allow one-stage thin skin reconstruction even from a thick donor site. However, currently reported elevation procedures use proximal-to-distal dissection requiring free-style perforator selection and primary thinning procedures. With distal-to-proximal dissection using the dermis as a landmark for dissection plane, it is expected that elevation of pure skin perforator or superthin flaps can be simplified. Read More

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Lip and Perioral Trauma: Principles of Aesthetic and Functional Reconstruction.

Facial Plast Surg 2021 Aug 22;37(4):500-509. Epub 2021 Feb 22.

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan.

Successful management of lip and perioral trauma requires a nuanced understanding of anatomy and surgical techniques. Surgical correction is particularly challenging in instances of tissue loss, due to a narrow tolerance for aesthetic deformity and highly specialized functions of the perioral region, including facial expression, communication, and oral competence. Restoring continuity of the orbicularis oris musculature is critical for dynamic sphincter function of the upper and lower lips. Read More

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Role of plastic surgeons in the trauma center: national level I trauma center startup experience in South Korea.

Medicine (Baltimore) 2021 Feb;100(5):e24357

Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Suwon-si, Republic of Korea.

Abstract: Although it is well recognized that other surgical specialties perform various procedures related to trauma care, there is a lack of analyses focusing on the role of plastic surgical management in trauma centers. This retrospective study was designed to investigate the scope of plastic surgery services in acute trauma care, using clinical data obtained from a single, regional, level I trauma center.This study included patients who presented to a single, regional, level I trauma center between March 1, 2016 and February 28, 2018. Read More

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February 2021

Vein Grafting in Microsurgical Lower Extremity Reconstruction: Outcome Analysis of Primary versus Secondary Salvage Procedures.

J Reconstr Microsurg 2021 Feb 16. Epub 2021 Feb 16.

Department of Hand, Plastic and Reconstructive Surgery, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.

Objective:  Many microsurgeons fear high complication rates and free flap loss when vein grafting is necessary to restore blood flow at the recipient site. The aims of this study were to comparatively analyze surgical outcomes of interposition vein grafts (VG) in microsurgical primary lower extremity reconstruction and secondary salvage procedures.

Patients And Methods:  A retrospective study was conducted on 58 patients undergoing free flap transfers with vein grafting for primary lower extremity reconstruction (cohort 1) and secondary salvage procedures (cohort 2) between 2002 and 2016. Read More

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February 2021

Microvascular anastomotic arterial coupling: A systematic review.

J Plast Reconstr Aesthet Surg 2021 Jun 12;74(6):1286-1302. Epub 2021 Jan 12.

Group for Academic Plastic Surgery, The Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Department of Plastic Surgery, Emergency Care and Trauma Division, The Royal London Hospital, Bart's Health NHS Trust, London, UK.

Introduction: There are several reasons microsurgeons may not use a coupler device in arterial anastomosis: may be thick-walled, non-pliable due to atherosclerotic calcification or present vessel geometrical discrepancies. This review summarises the current applications, efficacy and troubleshooting of microvascular coupler devices in arterial end-to-end anastomosis.

Methods: A systematic review of the literature was performed in November 2020 across 4 electronic databases and in accordance with the PRISMA guidelines. Read More

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The secretome of stressed peripheral blood mononuclear cells increases tissue survival in a rodent epigastric flap model.

Bioeng Transl Med 2021 Jan 22;6(1):e10186. Epub 2020 Sep 22.

Christian Doppler Laboratory for Cardiac and Thoracic Diagnosis and Regeneration Vienna Austria.

Reconstructive surgery transfers viable tissue to cover defects and to restore aesthetic and functional properties. Failure rates after free flap surgery range from 3 to 7%. Co-morbidities such as diabetes mellitus or peripheral vascular disease increase the risk of flap failure up to 4. Read More

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January 2021

Reconstruction of a secondary scalp defect using the crane principle and a split-thickness skin graft.

BMC Surg 2021 Jan 18;21(1):41. Epub 2021 Jan 18.

School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Background: Scalp reconstruction is a common challenge for surgeons, and there are many different treatment choices. The "crane principle" is a technique that temporarily transfers a scalp flap to the defect to deposit subcutaneous tissue. The flap is then returned to its original location, leaving behind a layer of soft tissue that is used to nourish a skin graft. Read More

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January 2021

The folded, bipaddled pectoralis major myocutaneous flap for complex oral cavity defects: Undiminished relevance in the era of free flaps.

JPRAS Open 2021 Mar 25;27:108-118. Epub 2020 Nov 25.

Department of Head and Neck Surgery, Unit-2, Christian Medical College, Vellore, Tamil Nadu, 632004 India.

Oral cancer often presents at an advanced stage, requiring extensive resection and complex reconstruction, such as free tissue transfers, which may not be available in a remote or resource-constrained facility. The common alternative in these cases is the use of the workhorse flap, the pectoralis major myocutaneous (PMMC) flap for lining and a second regional flap for cover. The results are variable, increase operative time and cost, and may cause additional donor site morbidity. Read More

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Treatment of Recurrent Tracheocutaneous Fistulas in the Irradiated Neck with a Two Layers-Two Flaps Combined Technique.

Indian J Plast Surg 2020 Dec 28;53(3):423-426. Epub 2020 Jul 28.

Department of Plastic Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.

The development of a tracheocutaneous fistula (TCF) is a well-documented complication after tracheostomy, especially in chronic morbid patients, in whom tubes or cannulas are left in place over time, or in irradiated patients. Surgical treatments are therefore needed which range from simple curettage and dressings to local skin flaps, muscle flaps and, in the more complex cases, microsurgical free tissue transfers. We present a novel combined technique used to successfully treat recurrent TCFs in irradiated patients, involving a superiorly based turnover fistula flap and a sternocleidomastoid transposition flap. Read More

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December 2020

Plastic Surgery Reconstruction of Chronic/Non-Healing Wounds.

Surg Technol Int 2020 12 28;38. Epub 2020 Dec 28.

Department of Plastic Surgery, Hand Surgery - Burn Center, University Hospital RWTH Aachen, Aachen, Germany.

In western countries, approximately 1 % of individuals are affected by chronic wounds during their lifetime. Due to changing demographics, this incidence will likely increase in the future. Additionally, the high prevalence is accompanied by substantial treatment expenditures. Read More

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December 2020

Outcomes following Microvascular Mandibular Reconstruction in Pediatric Patients and Young Adults.

Plast Reconstr Surg Glob Open 2020 Nov 30;8(11):e3243. Epub 2020 Nov 30.

Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Mass.

The etiology and treatment of complex mandibular defects in children differ markedly from those of adults, although treatment with free bone flaps is historical in both groups. While adult outcomes and complication rates are well known, few pediatric data exist, especially for patients with congenital deficiencies. This study reports early and late outcomes from a cohort of young, primarily syndromic patients undergoing microvascular mandibular reconstruction. Read More

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November 2020

Effects of pre-existing abdominal scar on postoperative complications after autologous breast reconstruction using abdominal flaps: A systematic review and meta-analysis.

J Plast Reconstr Aesthet Surg 2021 02 21;74(2):277-289. Epub 2020 Nov 21.

Department of Plastic and Reconstructive Surgery, Korea University Hospital, Seoul, Republic of Korea. Electronic address:

Background: A previous abdominal scar is generally considered as a challenge for breast reconstruction using abdominal flaps. Since it may interfere with the perfusion of abdominal tissue and weaken the abdominal fascia, many plastic surgeons are concerned about the theoretical risk of postoperative complications. This study aims to assess the effects of previous scar on complications in abdominal flap-based breast reconstruction. Read More

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February 2021

Incidence of Major Arterial Abnormality in Patients with Wound Dehiscence after Lower Extremity Orthopedic Procedures.

Plast Reconstr Surg 2020 12;146(6):1382-1390

From Georgetown University School of Medicine; and the Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital.

Background: Surgical dehiscence can occur after lower extremity orthopedic procedures. Underlying vascular aberrancy and localized ischemia contribute to chronic wound development requiring advanced techniques such as free tissue transfer. Localized vascular abnormality is an underrecognized contributing factor to such dehiscence. Read More

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December 2020