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Outcomes of Total Knee Arthroplasty in Patients with Prior Hardware: A Case-Control Study Using Handheld Navigation.

J Knee Surg 2021 Apr 14. Epub 2021 Apr 14.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Presence of hardware in juxta-articular location poses challenge during total knee arthroplasty (TKA). When present in distal femur, it precludes the use of an intramedullary femoral jig during TKA often necessitating removal of hardware leading to prolonged surgery, higher risk of complications, and inferior results. We conducted a case-control study to assess the outcome of TKA among patients with post-traumatic arthritis using a handheld navigation system to perform bone cuts allowing retention of hardware in situ. Read More

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A Comparison of Patient-Reported Outcomes in Bipedicled Total Abdominal versus Unipedicled Hemiabdominal Free Flaps for Unilateral Breast Reconstruction.

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina.

Background:  While bipedicled free flaps enable increased soft tissue volume and potential for contralateral symmetry in unilateral breast reconstruction, the influence of bipedicled flap reconstruction on patient-reported outcomes remains unclear.

Methods:  Patients undergoing unilateral free flap breast reconstruction at a single institution from 2014 to 2019 were retrospectively reviewed and sent the BREAST-Q and Decision Regret Scale. Complication rates and the BREAST-Q and Decisional Regret Scale scores (0-100) were compared between patients receiving bipedicled total abdominal and unipedicled hemiabdominal free flaps. Read More

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Free Flap Reconstruction of Traumatic Pediatric Foot and Ankle Defects: An Analysis of Clinical and Functional Outcomes.

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri.

Background:  Traumatic lower extremity injuries involving the foot and ankle can have devastating consequences and represent a complex reconstructive challenge. To date, there are limited reports on microsurgical reconstruction for foot and ankle defects in children. This study aims to evaluate clinical and functional outcomes of free flaps for pediatric foot and ankle injuries. Read More

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Redefining the Reconstructive Ladder in Vulvoperineal Reconstruction: The Role of Pedicled Perforator Flaps.

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.

Background:  Gynecological reconstruction is difficult, particularly in cases with recurrence and received previous surgeries and/or radiotherapy and necessitate secondary reconstruction. Perforator flaps can preserve other donor sites for potential later reconstruction, and they also can be better tailored to the defect. We hypothesized that the use of perforator-based flaps can better restore the defect with less complications. Read More

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Stress urinary incontinence after urethral diverticulum repair without concomitant anti-incontinence procedure.

Urology 2021 Apr 11. Epub 2021 Apr 11.

Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110. Electronic address:

Objective: To review the rates of persistent and de novo stress urinary incontinence (SUI) following urethral diverticulum (UD) repairs performed without concomitant SUI surgical procedures.

Methods: Following IRB approval, charts of women who underwent UD excision by three FPMRS surgeons were reviewed. Data collected from the electronic medical record included demographic information, preoperative symptoms and evaluation (validated questionnaires [UDI-6, QoL]), imaging studies, operative details, post-operative symptoms, and subsequent surgical interventions. Read More

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[Update on Endoscopic Therapies for the Treatment of GERD: GERDX, MUSE, EsophyX].

Authors:
Andreas Tschoner

Zentralbl Chir 2021 Apr 13;146(2):188-193. Epub 2021 Apr 13.

Abteilung für Allgemein-, Viszeral-, Gefäß- und Thoraxchirurgie, Ordensklinikum Linz, Barmherzige Schwestern Hospital, Österreich.

Gastroesophageal reflux disease (GERD) has been a problem for patients throughout in recent decades worldwide and its prevalence is increasing. Until 20 years ago, the established treatments were the proton pump inhibitors (PPI) and varieties of laparoscopic fundoplication (LF). Increasing experience with endoscopy and knowledge of the oesophagogastric junction (EGJ) has led to new options in the treatment of GERD. Read More

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The penis transposed to the perineum with penile-prostatic anastomotic urethroplasty for the treatment of a long segment complex urethral strictures.

Transl Androl Urol 2021 Mar;10(3):1040-1047

Department of Urology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.

Background: To present our experience of transposing the penis to the perineum, with penile-prostatic anastomotic urethroplasty, for the treatment of complex bulbo-membranous urethral strictures.

Methods: Between January 2002 and December 2018, 20 patients with long segment urethral strictures (mean 8.6 cm, range 7. Read More

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Early single-stage surgical revascularization of pulmonary artery in unilateral absence of a pulmonary artery.

J Cardiothorac Surg 2021 Apr 13;16(1):80. Epub 2021 Apr 13.

Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9# Jinsui Road, Guangzhou, 510623, China.

Background: This research aims to summarize the findings of the early single-stage revascularization of remnant pulmonary artery in unilateral absent intrapericardial pulmonary artery.

Methods: We retrospectively analyzed the medical records of 10 patients with unilateral absent pulmonary artery, in which 7 were right and 3 were left, the median age and mean weight at surgery was 4 months and 5.6 kg, respectively. Read More

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Traumatic displacement of laser in situ keratomileusis flaps: an integrated clinical case presentation.

BMC Ophthalmol 2021 Apr 13;21(1):177. Epub 2021 Apr 13.

Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, 813, Kaohsiung City, Taiwan.

Background: Traumatic dislocation of laser-assisted in situ keratomileusis (LASIK) corneal flaps is an uncommon postoperative complication that could occur any time after LASIK, and could be visually devastating. We evaluated the visual outcomes, corneal sensation, tear function, and dry eye questionnaire results of patients with traumatic dislocation of LASIK flaps, including one LASIK flap amputation.

Methods: This is a retrospective case series. Read More

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Free vascularized parascapular fat flap for parotidectomy reconstruction.

Am J Otolaryngol 2021 Apr 7;42(5):103028. Epub 2021 Apr 7.

Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO, USA. Electronic address:

Objective: The contour defect resulting after parotidectomy can be cosmetically unappealing. Multiple reconstructive efforts have been reported to mitigate this problem. We describe a novel technique of vascularized parascapular fat reconstruction based on the circumflex scapular vessels and evaluate its outcomes. Read More

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Complete corporeal preservation clitoroplasty: new insights into feminizing genitoplasty.

Int Braz J Urol 2021 Jul-Aug;47(4):861-867

Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogota, Colombia.

Introduction: 46,XX Congenital adrenal hyperplasia (CAH) remains the first cause of genital virilization and current surgical techniques aim to restore female aspect of genitalia while preserving dorsal neurovascular bundle but not at the expense of not preserving erectile tissue. We aim to report our experience with a new surgical technique for clitoroplasty, completely preserving corporeal bodies, neurovascular bundles without dismembering the clitoris, in four patients with over a year follow up.

Materials And Methods: After IRB approval four patients with 46,XX CAH and Prader 5 and 3 external genitalia, underwent feminizing genitoplasty. Read More

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September 2020

Buccal Pedicle Flap Combined with Porcine Collagen Matrix: a Follow-up of 2 years on 40 Consecutive Cases.

Clin Adv Periodontics 2021 Apr 13. Epub 2021 Apr 13.

Director O.R.E.C.-Oral Reconstruction and Education Center Rome (Italy), Via Rovereto 6, Rome, 00198, Italy.

Introduction: A thick peri-implant mucosa is of importance to prevent recession, color alterations, bone remodeling and promote "creeping attachment". A volume stable porcine cross-linked collagen matrix has been recently introduced for soft tissue regeneration and volume maintenance. The aim of this study was to investigate peri-implant soft tissue healing and stability on 40 consecutive patients treated with buccal pedicle flap combined with the use of the collagen matrix. Read More

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Magnitude of radial forearm free flaps and factors associated with loss of volume in oral cancer reconstructive surgery: A prospective study.

Head Neck 2021 Apr 13. Epub 2021 Apr 13.

Department of Oral Maxillofacial-Head and Neck Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China.

Background: Adequate flap volume is key to maintaining oral function after oral cancer surgery. This study aimed to evaluate changes in radial forearm free flap (RFFF) volumes after 1 year of follow-up following ablative tumor surgery in the head and neck.

Methods: A prospective study that recorded the clinical data of 20 patients with head and neck cancer who underwent RFFF reconstruction. Read More

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Long-term Effect of Individualized Titanium Mesh in Orbital Floor Reconstruction After Maxillectomy.

Laryngoscope 2021 Apr 13. Epub 2021 Apr 13.

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.

Objective: The aim of this study was to determine the clinical outcomes and long-term stability of individualized titanium mesh combined with free flap for orbital floor reconstruction after maxillectomy and to identify the risk factors for titanium mesh exposure.

Material And Methods: The data of 66 patients who underwent maxillectomy and orbital floor defect reconstruction by individualized titanium mesh in Peking University School and Hospital of Stomatology between 2011 and 2019 were retrospectively reviewed. Postoperative ophthalmic function and success of aesthetic restoration were assessed. Read More

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Unicuspid aortic valve with false aortic dissection appearance: A case report.

Turk Kardiyol Dern Ars 2021 Apr;49(3):242-244

Department of Cardiology, Koşuyolu High Specialization Training and Research Hospital, İstanbul, Turkey.

Summary- Unicuspid aortic valve (UAV) is a rare congenital anomaly that usually presents with aortic stenosis or mixed stenosis and regurgitation early in life. Ascending aortic aneurysm and aortic dissection are important complications of UAVs. A 27-year-old man presented to the emergency department with a complaint of acute chest pain. Read More

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Classification of pedicle ossification after maxillofacial reconstruction with bony free flap: An observational study.

J Stomatol Oral Maxillofac Surg 2021 Apr 9. Epub 2021 Apr 9.

University of Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterials, Lille, France.

Introduction: Maxillofacial reconstruction with bony free flap is a classical technique. However, pedicle ossification after such reconstruction is a misunderstood complication that is rarely reported in the literature. It is usually manifested as trismus, neck pain, and hard swelling, but it is predominantly asymptomatic and, thus, mainly incidentally discovered at a later stage. Read More

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Superior epigastric artery perforator flap for reconstruction of deep sternal wound infection.

Microsurgery 2021 Apr 12. Epub 2021 Apr 12.

Department of Plastic, Reconstructive and Aesthetic Surgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium.

Background: The treatment of deep wound sternal infection requires loco-regional pedicled flaps, usually with muscular flaps. Perforator propeller flaps represent the ultimate progress in the history of reconstructive surgery. We report here our experience with the superior epigastric artery perforator (SEAP) flaps to repair sternal defect. Read More

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Vacuum-Assisted Closure with Temporalis Muscle Reconstruction for Recurrent Scalp Erosion Following Deep Brain Stimulation: A Case Report.

J Parkinsons Dis 2021 Apr 2. Epub 2021 Apr 2.

Department of Neuroscience, Graduate School, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.

Background: Scalp erosion is not an uncommon complication of deep brain stimulation (DBS) surgery. Although various methods have been proposed to prevent and manage complications, there are still challenges. We introduce a case of recurrent scalp erosion after DBS surgery treated with vacuum-assisted closure. Read More

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A case report of reconstruction of ocular and complete upper eyelid avulsion with severe facial soft tissue injuries using anterolateral thigh free flap.

Int J Surg Case Rep 2021 Apr 1;82:105856. Epub 2021 Apr 1.

Reconstructive Microsurgery Section, Division of Plastic Surgery, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.

Introduction And Importance: Ocular injury is second mostly caused by motor vehicle accident (MVA) and often leads to severe ocular injury even to visual loss and various aesthetic problems. The outcome is determined by the magnitude of the initial damage and treatment availability. Treating ocular and facial injury due to MVA is challenging given the scope of the damage and may result in various outcomes. Read More

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Single Stage Reconstruction of Large Calvarial Exposure after Tumor Resection: A 3-Year Experience.

Authors:
Wael H Mahmoud

World J Plast Surg 2021 Jan;10(1):30-36

Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.

Background: We aimed to review the treatment and outcome of patients' undergone reconstruction of large full thickness scalp defects with exposed calvarium after oncologic resection with the combined local flap and split-thickness skin graft (STSG) technique.

Methods: A retrospective review of 45 patients with scalp defects secondary to tumor extirpation was performed at the Plastic Surgery Department, Tanta University Hospital, Tanta, Egypt from Nov 2016 to Nov 2019. Patients, with large (>50 cm2) and full-thickness (exposed calvarium) scalp defects, who underwent scalp reconstruction with the combined local flap and STSG technique and had completed their medical records were enrolled. Read More

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January 2021

Does the Use of Intraoperative Angiography Reduce the Incidence of Postoperative Wound and Flap Complications in Complex Lower Extremity Oncologic Reconstruction?

Ann Plast Surg 2021 Mar 18. Epub 2021 Mar 18.

From the Division of Plastic and Reconstructive Surgery, Department of Surgery Division of Orthopedic Oncology, Department of Orthopedics, Rutgers-New Jersey Medical School, Newark, NJ.

Introduction: Intraoperative laser angiography via indocyanine green (ICG) has become a valuable tool in objectively assessing tissue perfusion in reconstructive procedures. Studies have demonstrated the utility of ICG angiography (ICGA) for decreasing both mastectomy skin flap necrosis and wound healing complications in abdominal wall reconstruction. This tool has not been studied in lower extremity oncologic reconstruction. Read More

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Modified Posterior Arm Flap for Axillary Hidradenitis Suppurativa.

Ann Plast Surg 2021 Mar 24. Epub 2021 Mar 24.

From the Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead St George's Medical School Department of Plastic Surgery, St George's Hospital, London, United Kingdom.

Introduction: Hidradenitis suppurativa (HS) is a chronic, inflammatory condition of the apocrine sweat glands present in 1% to 4% of the adult population, with twice greater prevalence in females. Surgical excision is the criterion-standard treatment for advanced, grade III disease, characterized by extensive and recurrent abscesses and interconnected sinus tracts. Numerous reconstructive methods have been used to cover the resulting defects, including secondary intention healing, use of skin grafts, and a wide range of locoregional flaps. Read More

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Utilization of a Newly Designed Asymmetric Dorsal Gull Wing Flap for the Treatment of Postoperative Web Creep After Syndactyly Surgery.

Ann Plast Surg 2021 Apr 5. Epub 2021 Apr 5.

From the Department of Burns and Plastic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, P.R. China.

Background: Web creep is the most common long-term complication requiring revision after syndactyly surgery; however, few methods have been reported. The aim of this study was to introduce a newly designed asymmetric dorsal gull wing flap to reconstruct web for the postoperative web creep.

Methods: A retrospective analysis was performed for 20 patients from January 2016 to May 2019. Read More

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Aortic Intimo-intimal Intussusception: A Pooled Analysis of Published Reports.

Ann Vasc Surg 2021 Apr 5. Epub 2021 Apr 5.

Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R.China. Electronic address:

Aim: Aortic intimo-intimal intussusception (AoII) is a rare manifestation of aortic dissection with high mortality. This study aimed to obtain a comprehensive understanding of AoII.

Methods: Three databases (Pubmed, Scopus, Embase) were searched with predefined search terms ["intimal intussusception", "aortic intussusception", "(circumferential) AND (intimal dissection)" and "(circumferential) AND (aortic dissection)"]. Read More

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Robot-assisted boari flap and psoas hitch ureteral reimplantation: Technique insight and outcomes of a case series with at least 1 year of follow-up.

BJU Int 2021 Apr 8. Epub 2021 Apr 8.

Department of Urology, Onze Lieve Vrouw Hospital, Aalst, Belgium.

Objective: To describe step-by-step surgical techniques and report outcomes of the largest single centre series of patients with distal ureteral disease exclusively treated with robot-assisted ureteral reimplantation (RAUR) with Boari Flap (RABFUR) and Psoas Hitch (RAPHUR), with a minimum follow-up of 1 year and complete postoperative data.

Subjects/patients And Methods: 37 patients with distal ureteral disease were treated between 2010 and 2018. Of these, 81 and 19% underwent RAPHUR and RABFUR, respectively. Read More

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A Case of Large Aplasia Cutis Congenita with Underlying Skull Defect: Effective Surgical Treatment with Integra® Dermal Regeneration Template.

Pediatr Neurosurg 2021 Apr 7:1-6. Epub 2021 Apr 7.

Department of Plastic Surgery, Niguarda Ca' Granda Hospital, Milan, Italy.

Introduction: Aplasia cutis congenita (ACC) is a rare congenital abnormality characterized by the absence of a portion of skin at birth which most commonly involves the scalp and can affect the galea, the pericranium, the bone, and the dura mater. It can be an isolated condition or associated with other disorders.

Case Report: We present a case of ACC with a large defect of the scalp and the underlying bone treated with the use of Integra® Dermal regeneration template. Read More

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Long-term survival after head and neck cancer surgery with immediate free flap reconstruction.

Ann Chir Plast Esthet 2021 Apr 3. Epub 2021 Apr 3.

Department of Oncologic Surgery "Institut de Cancérologie de Lorraine", Nancy, France.

Background: Head and neck cancer is one of the most frequent cancers worldwide. A combination treatment including surgery is known to have a better survival rate than exclusive radiotherapy-chemotherapy. In extreme cases of non-metastatic patients who have voluminous tumor, or complex location, surgery with immediate reconstruction by free flap could be an option to improve long term survival. Read More

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Robotic Peritoneal Flap Revision Vaginoplasty in Transgender Women: a Novel Technique for Treating Neovaginal Stenosis.

Urology 2021 Apr 3. Epub 2021 Apr 3.

Department of Urology, New York University Langone Medical Center, New York, NY. Electronic address:

Objectives: To present the technique and early outcomes of salvage neovaginal reconstruction using robotic dissection and peritoneal flap mobilization.

Methods: Twenty-four patients underwent robotic peritoneal flap revision vaginoplasty from 2017-2020. A canal is dissected between the bladder and rectum towards the stenosed vaginal cavity, which is incised and widened. Read More

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Clinical Outcomes of a Combined Robotic Transabdominal and Open Transperineal Approach for Anastomotic Posterior Urethroplasty.

J Endourol 2021 Apr 5. Epub 2021 Apr 5.

New York University Medical Center, 12297, Urology, New York, New York, United States;

Background Robotic pelvic surgery is increasingly utilized for reconstruction proximal to the genitourinary diaphragm. We describe a combined robotic transabdominal and open transperineal approach for complex anastomotic posterior urethroplasty. Methods We performed a multi-institutional retrospective study of patients who underwent anastomotic posterior urethroplasty by a combined robotic transabdominal and open transperineal approach between 1/2012 and 12/2018. Read More

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Clinical Efficacy of Gingival Thickening Following the Use of Allogeneic Acellular and Xenogeneic Collagen Matrix: A 12-Month Randomized Clinical Trial.

Int J Periodontics Restorative Dent 2021 Mar-Apr;41(2):e63-e71

This randomized controlled clinical trial with a 1-year follow-up evaluated gingival thickness changes around teeth after use of dermal allograft and xenograft matrix. A total of 116 teeth (19 patients) were separated into two groups. One group received xenogeneic collagen matrix (n = 48), while the other received allogeneic acellular dermal matrix (n = 68) via a coronally advanced flap (CAF). Read More

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