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One vs. two‐stage arteriovenous loops in lower extremity reconstruction with free flaps: Systematic review and metanalysis Microsurgery (IF 2.1) Pub Date : 2024-03-06 Sergio Asensio‐Ramos, Santiago Sanz‐Medrano, Francisco Soldado, Javier Buendía‐Pérez
BackgroundArteriovenous loops are one of the main therapeutic alternatives to address the absence of recipient vessels in lower extremity microsurgical reconstruction. However, there is no consensus on whether to perform them in one or two surgical stages. The objective of this work is to determine whether the outcome of lower limb free flaps anastomosed to vascular loops depends on the number of surgical
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Use of retrograde dorsalis pedis as recipient vessels for pediatric free flap lower leg reconstruction Microsurgery (IF 2.1) Pub Date : 2024-02-28 Abraham Zavala, Lucero Machaca, Ray Tornero, Wieslawa De Pawlikowski
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Efficacy of the enhanced recovery after surgery protocol on reducing surgical disparities related to overweight/obesity in deep inferior epigastric perforator flap breast reconstruction Microsurgery (IF 2.1) Pub Date : 2024-02-28 Juyoung Bae, Kyeong‐Tae Lee, Nawaf Alohaideb, Goo‐Hyun Mun
BackgroundWhen choosing a method of deep inferior epigastric perforator (DIEP) flap for breast reconstruction, concerns regarding the potentially detrimental effects of obesity on postoperative recovery remain. Enhanced recovery after surgery (ERAS) is known to facilitate rapid postoperative recovery. This study aimed to examine the effect of the ERAS protocol on the disparity between normal/underweight
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Comparison of a coupling system and the suture method in end‐to‐side microvascular anastomosis in head and neck reconstruction Microsurgery (IF 2.1) Pub Date : 2024-02-28 Seong Ae Kim, Junnyeon Kim, Chae Rim Lee, Deuk Young Oh, Young‐joon Jun, Suk‐Ho Moon
BackgroundUse of coupling devices in microvascular anastomosis continues to increase, but it is not yet actively used in end‐to‐side (ETS) anastomosis because there is no standard method. Therefore, we propose an easy and time‐saving ETS micro‐anastomosis method using coupling devices in head and neck reconstruction and compare it with the conventional suture method.Materials and MethodsWe retrospectively
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Second sensor to improve near‐infrared spectroscopy flap monitor utility: A prospective study Microsurgery (IF 2.1) Pub Date : 2024-02-20 Jonathan Harper, Emily Slade, Adrianne Cornette, Alexandra E. Kejner
ObjectiveThis study assesses whether use of continuous noninvasive near‐infrared spectroscopy (NIRS) sensor on head and neck free flap (FF) with a second sensor on nonoperated tissue improves distinction between systemic hypoperfusion and FF compromise.MethodsSingle‐institution, prospective study of patients undergoing head and neck FF reconstruction from December 2018 to April 2020. FFs were continuously
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Preoperative photoacoustic versus indocyanine green lymphography in lymphaticovenular anastomosis outcomes for lower extremity lymphedema: A pilot study Microsurgery (IF 2.1) Pub Date : 2024-02-20 Yushi Suzuki, Hiroki Kajita, Shiho Watanabe, Marika Otaki, Keisuke Okabe, Hisashi Sakuma, Nobuaki Imanishi, Kazuo Kishi
BackgroundIdentification of the proper lymphatics is important for successful lymphaticovenular anastomosis (LVA) for lymphedema; however, visualization of lymphatic vessels is challenging. Photoacoustic lymphangiography (PAL) can help visualize lymphatics more clearly than other modalities. Therefore, we investigated the usefulness of PAL and determined whether the clear and three‐dimensional image
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Rehabilitation protocols in neonates undergoing primary nerve surgery for upper brachial plexus palsy: A scoping review Microsurgery (IF 2.1) Pub Date : 2024-02-20 Dhruv Mendiratta, Michael F. Levidy, Alice Chu, Aleksandra McGrath
IntroductionSurgical management is recommended in patients with severe neonatal brachial plexus palsy (NBPP) within the first 6 months of age to regain best possible function. Rehabilitation post‐surgery remains relatively unexplored. This is a scoping review that explores, which rehabilitation modalities exist and how they vary for different microsurgical approaches in NBPP.Materials and MethodsA
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Intercostal nerve transfer in management of biceps and triceps co‐contraction in brachial plexus birth palsy Microsurgery (IF 2.1) Pub Date : 2024-02-20 Sayantani Misra, Takehiko Takagi, Sakura Yamaguchi, Yoko Anami, Shinichiro Takayama
ObjectiveBrachial plexus birth palsy (BPBP) is often caused by traction during birth. In some cases, reinnervation occurs during spontaneous recovery and it causes involuntary co‐contraction between antagonistic muscles. When it comes up between the biceps and triceps muscles, smooth active motion of the elbow joint is impaired. We are presenting outcomes of intercostal nerve (ICN) to radial nerve
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Anatomical features of a crossing vein connecting left and right internal mammary veins: A preliminary study with computerized tomography or magnetic resonance imaging Microsurgery (IF 2.1) Pub Date : 2024-02-11 Mayu Ueno, Hiroki Mori, Noriko Uemura, Sayuri Kato, Kentaro Tanaka
In breast reconstruction with free flaps, retrograde venous anastomosis into the internal mammary vein (IMV) is often unavoidable. Utility of a crossing vein between the right and left IMV, one of the anatomical foundations which make retrograde flow possible, has been reported but only with a few detailed features. This study evaluated the presence, actual location, and diameter of the crossing veins
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Microsurgical breast reconstruction and primary hypercoagulable disorders Microsurgery (IF 2.1) Pub Date : 2024-02-01 Rakel M. Zarb, Charles Lamberton, Aishwarya Ramamurthi, Vince Berry, Karri A. Adamson, Erin L. Doren, Patrick C. Hettinger, John B. Hijjawi, John A. LoGiudice
Primary hypercoagulable disorders pose a significant challenge to microsurgeons and have traditionally been regarded as a relative contraindication to free tissue transfer. Since free flaps offer numerous advantages in breast reconstruction, there is an effort to expand the population to whom these operations can be safely offered. The purpose of this study is to describe our chemoprophylaxis regimen
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Pedicled chimeric superficial circumflex iliac artery perforator (SCIP) flap with external oblique fascia for vesicocutaneous bladder fistula repair: A case report and literature review on the utility of pedicled chimeric SCIP Microsurgery (IF 2.1) Pub Date : 2024-02-01 Nicholas Jan Lichtenberg, Sandeep B, D. M. Taylor
Following its initial description by Koshima in 2004, the superficial circumflex iliac artery perforator (SCIP) flap has become a ubiquitous and extremely useful flap in coverage of defects whereby bulkiness must be avoided. It also allows direct closure and concealment of the donor site. Its use as a free tissue transfer has been demonstrated by various surgeons globally. Nevertheless, there are few
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Orthotopic vascularized lymph node transfer in breast cancer-related lymphedema treatment: Functional and life quality outcomes Microsurgery (IF 2.1) Pub Date : 2024-02-01 Federico Lo Torto, Juste Kaciulyte, Filippo Di Meglio, Marco Marcasciano, Manfredi Greco, Diego Ribuffo
Breast cancer-related lymphedema (BCRL) is a chronic disease that occurs up to 65% of breast cancer survivors. Traditional treatment is conservative, but new surgeries as lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT) are at disposal. This study aims to investigate the orthotopic VLNT efficacy in BCRL. Results in terms of limbs' reduction rates and quality of life improvement
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Assessment of x-ray efficacy for intraoperative microneedle retrieval using a cadaveric model Microsurgery (IF 2.1) Pub Date : 2024-02-01 Sara C. Chaker, Ya-Ching Hung, Ariel A. Vinson, Mariam Saad, Galen Perdikis, Panambur Laxminarayan Bhandari
Institutional protocols often mandate the use of x-rays when a microneedle is lost intraoperatively. Although x-rays can reliably show a macroneedle, the benefit of x-rays in detecting microneedles in human tissues has not been established as available data on this topic are investigated in anthropometric models. The current study aims to evaluate whether x-rays can reliably detect retained microneedles
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The cross-leg free flap: A systematic review of the literature Microsurgery (IF 2.1) Pub Date : 2024-02-01 Karel-Bart Celie, Sarah Guo, Jessica Raya, Artur Fahradyan, Joseph Carey, Ara A. Salibian
Free tissue transfer is a mainstay treatment for lower extremity soft tissue injuries. When the traditional cross-leg flap cannot provide enough coverage, a cross-leg free flap (CLFF) is a limb-saving alternative. The aim of this study is to conduct a systematic review of the literature published on the CLFF.
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A long-term follow up of the laparoscopically harvested free omental flap for breast reconstruction Microsurgery (IF 2.1) Pub Date : 2023-12-27 Anouk A. E. Claessens, Martijn A. van Onna, Sabrina Maaskant, Coralien L. Broekhuysen
There are different types of reconstruction after mastectomy and breast-conserving surgery. Autologous reconstructions are nowadays more often preferred over implant-based reconstructions for many reasons. A more natural looking breast with a durable long-term result is one of the advantages. The greater omentum is frequently used in the general field of reconstructive surgery but has not been widely
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Single-stage versus two-stage bone flap reconstruction in chronic osteomyelitis: Multicenter outcomes comparison Microsurgery (IF 2.1) Pub Date : 2023-12-27 Alice Piccato, Alessandro Crosio, Andrea Antonini, Bruno Battiston, Paolo Titolo, Pierluigi Tos, Davide Ciclamini
Chronic osteomyelitis is an invalidating disease, and its severity grows according to the infection's particular features. The Cierny-Maiden criteria classify it according to the anatomical aspects (I to IV) and also by physiological class (A host being in good immune condition and B hosts being locally (L) or systemically (S) compromised). The surgical approach to chronic osteomyelitis involves radical
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Clinical utility of the modified frailty index in predicting adverse outcomes in patients undergoing lower extremity free flap reconstruction Microsurgery (IF 2.1) Pub Date : 2023-12-20 Romina Deldar, Samuel S. Huffman, John D. Bovill, Nisha Gupta, Brian N. Truong, Zoë K. Haffner, Adaah A. Sayyed, Kenneth L. Fan, Karen K. Evans
Identifying at-risk patients for complications remains challenging in patients with chronic lower extremity (LE) wounds receiving free tissue transfer (FTT) for limb salvage. The modified-5 frailty index (mFI-5) has been utilized to predict postoperative complications, yet it has not been studied in this population. The aim of this study was to determine the utility of the mFI-5 in predicting adverse
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Soft tissue reconstruction of the trunk with pedicled perforator and musculocutaneous flaps: A single-center comparative retrospective study Microsurgery (IF 2.1) Pub Date : 2023-11-27 Emanuele Cammarata, Francesca Toia, Martina Maltese, Matteo Rossi, Massimiliano Tripoli, Adriana Cordova
Soft tissue trunk reconstruction is often challenging. Although free microvascular flaps are a feasible option in case of extensive defects involving deep structures, pedicled flaps represent a good alternative, especially if harvested and dissected with a “microsurgical” approach. The aim of this study is to evaluate the feasibility of trunk reconstruction with the use of pedicled flaps, according
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Comparison of the outcomes of split thickness skin graft versus thickness skin graft for closure of the radial forearm free flap donor site: A systematic review Microsurgery (IF 2.1) Pub Date : 2023-11-22 Camilo Mosquera, Ashleigh Weyh, Michael Malik, Rui Fernandes, Anthony Bunnell, Stacey Nedrud
Radial forearm free flap (RFFF) donor site closure is traditionally performed with split thickness skin grafts (STSG), which can be associated with poor aesthetics, wrist stiffness, paresthesia, reduced strength, and tendon exposure. Full thickness skin grafts (FTSG) are potentially beneficial as they provide a more durable coverage, and the skin graft donor site can be closed primarily, which is more
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Technical pearls and pitfalls of the posterior auricular artery free flap in facial reconstruction. Microsurgery (IF 2.1) Pub Date : 2023-11-12 Pedro Ciudad,Steven Kirschbaum-Rubin,Oscar J Manrique,Hung-Chi Chen
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Anatomical study of first palmar intermetacarpal flap in cadavers and application for congenital first web contracture in a child with Apert's syndrome Microsurgery (IF 2.1) Pub Date : 2023-11-12 Francisco Soldado, Juliana Rojas-Neira, Danilo Rivas-Nicolls, Ricardo Kaempf de Oliveira, Xiao F. Shen
Reconstructing severe first web contractures often involves using either pedicled forearm flaps, which can cause extensive scarring, or free flaps, which can be highly complex. In this study, we present a local palmar hand flap that overcomes both of these challenges.
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Comparative study of arterial and venous grafting for pedicle lengthening in head and neck microvascular reconstruction Microsurgery (IF 2.1) Pub Date : 2023-11-11 Chieh-Kai Chang, Cheng-Yeu Wu, Yi-Ling Lin, Chih-Shen Lai, Chen-Te Lu, Jung-Hsing Yen, I-Chen Chen, Yueh-Chi Tsai
In the field of head and neck microvascular reconstruction, no previous study has compared arterial and venous grafting as methods of anterolateral thigh (ALT) pedicle lengthening. Therefore, we conducted this comparative study to compare the outcomes between the two pedicle lengthening techniques.
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A chimeric medial femoral condyle chondro-osseus flap with two thin periosteal flaps to reconstruct partial necrosis of talar body: A case report Microsurgery (IF 2.1) Pub Date : 2023-11-08 Andreoli Alice Letizia, Tamburello Sara, Bianco Stefano, Francesco Mori, Menichini Giulio
Total talar extrusion is a rare complication of high-energy traumas. A consequence of this injury can be avascular necrosis (AVN) of the talus. Patients are confronted with pain, limited range of motion and post-traumatic arthritis. As AVN progresses the talus is gradually destroyed. This report presents the use of a chimeric medial femoral condyle chondro-osseus flap with two thin periosteal flaps
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Cannabis use and flap reconstruction: A propensity score matched analysis. Microsurgery (IF 2.1) Pub Date : 2023-11-01 Olachi O Oleru,Nargiz Seyidova,Davis Mai,Peter J Taub
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The evolution of pediatric soft-tissue free flap reconstruction of the lower extremity after oncologic resection: A 30 year experience Microsurgery (IF 2.1) Pub Date : 2023-10-25 Zack Cohen, Ethan Plotsker, Francis Graziano, Peter Cordeiro, Joseph Disa, Babak Mehrara, Nicola Fabbri, Saïd C. Azoury, Farooq Shahzad
Limb salvage has become the standard of care for lower extremity tumors because of improvements in adjuvant treatments and reconstructive techniques. While there is literature assessing pediatric lower extremity free flap reconstruction in the setting of trauma, there is a paucity of literature that analyzes oncologic free flap reconstruction in this patient population. We report our long-term experience
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Conjoined thoracodorsal perforator-supercharged dorsal intercostal artery perforator propeller flap for reconstruction of a complex upper back defect: Case report and review of the literature on supercharged pedicled perforator flaps Microsurgery (IF 2.1) Pub Date : 2023-10-25 Beniamino Brunetti, Rosa Salzillo, Riccardo De Bernardis, Stefania Tenna, Chiara Camilloni, Paolo Persichetti
The reported complications' rate of perforator propeller flaps is variably high, but the etiology of distal flap necrosis, potentially linked to vascular insufficiency, is yet to be clarified. Vascular augmentation procedures have been previously described involving an extra anastomosis of a superficial vein, while a perforator-to-perforator supercharging approach has been only sporadically documented
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Free vascularized bone graft from the lateral epicondylar region of the humerus for treatment of scaphoid nonunion Microsurgery (IF 2.1) Pub Date : 2023-10-25 Nuo Chen, Yuling Wang, Juyu Tang
Free vascularized bone grafting (FVBG) has become one of the essential methods for treating scaphoid nonunion complicated by avascular necrosis. However, commonly used bone graft, including the medial femoral condyle bone graft and iliac crest bone graft, still present challenges such as a high rate of donor site complications and variations of vascular pedicle. In this study, we have introduced a
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Comparisons of the morbidities of a double gastrocnemius flap and a medial gastrocnemius flap in the orthoplastic reconstruction around the knee Microsurgery (IF 2.1) Pub Date : 2023-10-20 Mauro Maniglio, Michele Maruccia, Marco Morandi, Jérôme Martineau, Gianluca Sapino, Rossella Elia, Marco Pignatti, Pietro G. di Summa
The pedicled gastrocnemius flap is commonly used to treat lower limb defects. Either the medial, lateral, or both heads can be used. When extended soft tissue defects are present, a double gastrocnemius (DG) flap may be used. However, no data of the additional donor site morbidity compared to a medial gastrocnemius (MG) flap are available. The aim of this study was to compare the donor site morbidity
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Supra-arcuate free fascial MS-TRAM, a modified technique to reduce donor site morbidity in obese population-comparative study Microsurgery (IF 2.1) Pub Date : 2023-10-17 Ashraf A. Khalil, Omar A. ElSharkawy, Kareem Alsharkawy, Sherif Youssif, Haitham H. Khalil
Abdomen-based free flaps represent the gold standard option in the armamentarium of breast reconstruction. The natural evolution to more preservation with less invasive forms of these flaps has been driven by both patient and surgeon satisfaction. Nevertheless, obese patients are challenging due to the increased risk of compromised flap perfusion and donor site morbidity. This challenge is compounded
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Combined use of lower medial thigh perforator (LMTP) flap and pedicled medial sural artery perforator flap (MSAP) for lateral knee defects coverage after sarcoma resection: A case report and literature review of soft tissue defect around knee reconstruction Microsurgery (IF 2.1) Pub Date : 2023-10-13 Alice Alban, Matteo Meroni, Bruno Fuchs, Mario F. Scaglioni
Reconstruction of knee defects still represents a challenge for reconstructive surgeons. After an extensive resection, the primary aim is to reach a stable result, while maintaining a good range of motion and aesthetic unity. The use of pedicled perforator-based flaps makes it possible to achieve these goals. Many are the flaps that can be used in this region, and the pedicle medial sural artery perforator
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Thigh reconstruction between form and function: An algorithm for flap selection based on a series of 70 oncological patients Microsurgery (IF 2.1) Pub Date : 2023-10-06 Beniamino Brunetti, Marco Morelli Coppola, Stefania Tenna, Rosa Salzillo, Valeria Petrucci, Matteo Pazzaglia, Sergio Valeri, Rossana Alloni, Bruno Vincenzi, Giuseppe Tonini, Federico Perquoti, Paolo Persichetti
Thigh reconstruction after oncological resection represents a challenge in terms of ideal morphological and functional outcomes to aim for. Very few papers presented a comprehensive approach to this topic, most of them being only small cases series. The purpose of this article was to review our institutional experience in the field of thigh soft-tissue reconstruction, proposing an algorithm to choose
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Bilateral gluteal reconstruction with deep inferior epigastric perforator flaps and saphenofemoral arteriovenous loops Microsurgery (IF 2.1) Pub Date : 2023-10-05 J. Reed McGraw, Ivan A. Jaimez, Elizabeth Card, Michael Holland, Saïd C. Azoury, Stephen J. Kovach
The use of liquid silicone injections for soft tissue augmentation harbors numerous risks and is not approved by the FDA. Still, such injections are frequently performed by unlicensed providers, often in the gluteal region, and can lead to infection, soft-tissue breakdown, scarring, and disfigurement. The purpose of this case report was to demonstrate the use of immediate, abdominally based free flaps
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Local heating-induced cutaneous vasodilation in reinnervated and noninnervated deep inferior epigastric perforator flaps Microsurgery (IF 2.1) Pub Date : 2023-10-03 Hansje P. Smeele, Lisa Martin, Sander M. J. van Kuijk, Pieter R. Zwanenburg, René R. W. J. van der Hulst, Stefania M. H. Tuinder, Bérengère Fromy
Cutaneous vascular reactivity to local heating in free flaps has not been characterized. We aimed to assess local heating-induced cutaneous vasodilation in reinnervated and noninnervated deep inferior epigastric perforator (DIEP) flaps.
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Evaluation of modulation of immunity by lymph node transfer: A preliminary histological evidence in lymphedema patients Microsurgery (IF 2.1) Pub Date : 2023-10-03 Rossella Elia, Hung-Chi Chen, Gerardo Cazzato, Pietro G. Di Summa, Giuseppe Giudice, Michele Maruccia
The exact knowledge of the local biological and immunological effects of vascularized lymph node transfer (VLNT) continues to be an emerging science but a positive control positive control over infectious and immune-mediated processes is often advocated. Knowing the characterization of the inflammatory infiltrate associated with lymphedema, the aim of this paper is to verify the hypothesis that VLNT
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Turbocharging as a strategy to boost extended perforator flap vascularity in head and neck reconstruction—A report of two cases Microsurgery (IF 2.1) Pub Date : 2023-09-30 Savitha Ramachandran, Chao-Wei Chang, Yu-Chi Wang, Chao-Hsin Huang, Khong Yik Chew, Yur-Ren Kuo
Perforator flap has been applied as the most common flap for soft tissue defect reconstruction. Here, we presented two cases using turbocharging procedure of perforator to perforator as a salvage strategy. The first case was a 54-year-old male with recurrent squamous cell carcinoma (SCC) in the left buccal area and mouth floor. A 6 × 22 cm posteromedial thigh (PMT) flap was designed for reconstruction
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Does supercharging with cross-face nerve graft enhance smile in non-flaccid facial paralysis patients undergoing selective neurectomy? Microsurgery (IF 2.1) Pub Date : 2023-09-29 Tal Kaufman Goldberg, Lauren O. Trzcinski, Elizabeth R. McGonagle, Tessa A. Hadlock
Cross face nerve grafting (CFNG) is a well-established nerve transfer technique in facial reanimation; however, no study has assessed outcome of supercharging the smile with CFNG in patients with synkinesis. The goal of this study was to examine the smile outcome in non-flaccid facial paralysis (NFFP) patients after supercharging with CFNG during selective neurectomy.
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Contralateral internal mammary artery perforator flap for large inner chest wall defect repair and immediate breast reconstruction after excision of large malignant inner breast tumors Microsurgery (IF 2.1) Pub Date : 2023-09-25 Jingjing Sun, Xiaodong Wu, Jing Yang, Jiahui Liang, Min Ren
Large breast tumor resection can cause chest wall defects that are difficult to close. A combination of oncoplastic techniques is required to repair chest wall defects and immediately reconstruct the breast. In this report, we present the use of the contralateral internal mammary artery perforator (IMAP) flap to repair large chest wall defects and perform breast reconstruction for a series of patients
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Combined perforator flaps and lymphatic procedures in reconstructions after sarcoma resection Microsurgery (IF 2.1) Pub Date : 2023-09-24 Audrius Poskevicius, Matteo Meroni, Bruno Fuchs, Mario F. Scaglioni
Soft tissue sarcomas are a subtle category of tumors that often require an extensive surgical resection for definitive treatment. This kind of intervention inevitably leads to large tissue damage and, when regions with rich lymphatic network are involved, postoperative complications such as lymphocele or lymphedema are quite common. In this report we present our experience with the combination of lymphatic
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Cover Image Microsurgery (IF 2.1) Pub Date : 2023-09-18 Shoichi Tsuzaka, Takeshi Aiyama, Hirofumi Kamachi, Tatsuhiko Kakisaka, Tatsuya Orimo, Akihisa Nagatsu, Yoh Asahi, Taku Maeda, Toshiya Kamiyama, Akinobu Taketomi
The cover image is based on the Case Study Lymphaticovenous anastomosis for treatment of refractory chylous ascites: A case report by Shoichi Tsuzaka MD et al., https://doi.org/10.1002/micr.31042.
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Use of super-thin anterolateral thigh flap in intra-oral reconstruction of soft tissue defects Microsurgery (IF 2.1) Pub Date : 2023-09-19 Aniket Dave, Pratyusha Priyadarshini, Kamlesh Wadhwani, Murtuza Laxmidhar, Ravi Naga Vijay Kumar Vanjarapu
Traditional sub-fascial anterolateral thigh (ALT) flaps are bulky and often give unsatisfactory outcomes in several head and neck reconstructions where thin pliable flaps are required. As a result, despite high incidence of donor site complications, radial forearm flap is still commonly used for tongue, buccal mucosa and lip defects where a traditional ALT flap would be too bulky. The objective of
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Dorso-ulnar reverse flow pedicled osseous flap for reconstruction of the distal phalanx of the thumb: A case report Microsurgery (IF 2.1) Pub Date : 2023-09-15 Daniele Tosi, Luca Patanè, Pietro Francesco Delle Femmine, Matteo Ornelli, Giovanni Ruocco, Nicola Felici
Reconstruction of osseous defects of the distal phalanx of the thumb is usually addressed with free bone grafts or free vascularized bone flaps. Some reports demonstrated the possibility to harvest an osteo-cutaneous flap in the dorso-ulnar side of the first metacarpal bone with success. In the same manner, no reports are present in the literature in which bone deficits were reconstructed with this
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Customizable foam-based background for leveling the field to perform microvascular anastomosis. Microsurgery (IF 2.1) Pub Date : 2023-09-14 Chad Chang,Marco Marcasciano,Alex Sorkin,Filippo Di Meglio,Hung-Chi Chen
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Evaluating mesh use for abdominal donor site closure after deep inferior epigastric perforator flap breast reconstruction: A systematic review and meta-analysis Microsurgery (IF 2.1) Pub Date : 2023-09-12 Nisha Parmeshwar, Melinda Lem, Catherine L Dugan, Merisa Piper
Despite improvement in abdominal morbidity with deep inferior epigastric perforator (DIEP) flap breast reconstruction compared to prior abdominally-based free flap breast reconstruction, abdominal bulge, and hernia rates have been cited anywhere from 2% to 33%. As a result, some surgeons utilize mesh or other reinforcement upon donor-site closure, but its benefit in preventing abdominal wall morbidity
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Supercharged deep inferior epigastric perforator flap for reconstruction of soft tissue defect after excision of giant invasive squamous cell carcinoma of the thigh in a refractory diabetic with Pseudomonas aeruginosa infection Microsurgery (IF 2.1) Pub Date : 2023-09-09 Aldin Malkoc, Mark Jonathan Landau, Savannah Hodgkin, Darren Sze Mynn Leong, Samir Dankha Johna, Walter Ting-Yu Chang
Patients with large defects after oncologic surgery often require enhanced surgical planning to optimize reconstructive outcomes. As such, medically complex patients require innovative solutions when utilizing abdominal flaps due to concern for ischemia of the distal tissue. Vascular augmentations, such as supercharging or turbocharging, serve to increase perfusion in these medical complex patients
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Revolutionizing patient education: ChatGPT outperforms Google in answering patient queries on free flap reconstruction. Microsurgery (IF 2.1) Pub Date : 2023-09-08 Tiffany Jeong,Hilary Liu,Mario Alessandri-Bonetti,Sumaarg Pandya,Vu T Nguyen,Francesco M Egro
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Utilization of the internal mammary perforators as the recipient vessels for microsurgical breast reconstruction: A systematic review and meta-analysis of the literature Microsurgery (IF 2.1) Pub Date : 2023-09-07 Michail Vourvachis, Mohammad R. Goodarzi, Mario F. Scaglioni, Justyna Tartanus, Alex Jones, Hsu-Tang Cheng, Mohamed Abdelrahman
The selection of reliable recipient vessels is essential for successful free tissue transfer. The use of internal mammary intercostal perforators (IMAPs), instead of the internal mammary vessels as the recipient vessels, has been described in breast reconstruction. Debates exist regarding the reliability of these perforators as recipient vessels because of their variability in location and caliber
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Reconstruction of circumferential fingertip defect using free superficial palmar branch of the radial artery flap: Report of two cases Microsurgery (IF 2.1) Pub Date : 2023-09-05 Ju Hee Kim, Kyeong-Tae Lee
Wide local excision of noninvasive malignant melanomas has been increasingly performed instead of digit amputation, which often results in extensive fingertip defects. Owing to the unique anatomical characteristics of the fingertips, achieving favorable outcomes in both function and cosmesis is challenging during reconstruction. The free superficial palmar branch of the radial artery (SPBRA) flap is
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Complex reconstruction of the clavicle with a prefabricated medial femur condyle chimeric flap including a superficial circumflex iliac artery perforator flap: A case report Microsurgery (IF 2.1) Pub Date : 2023-09-05 Thomas Giesen, Francesco Costa, Elmar Fritsche
The medial femur condyle (MFC) cortico-periosteal flap is a popular flap for bone reconstruction. The use of a chimeric version of this flap with a skin island has been described, but anatomical arterial variation can occur that prevent its harvest. Furthermore, the donor area of the skin paddle has been debated as poor because of the scarring in a visible area and because of the difficulty in obtaining
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Surgical lymphedema models in the mice hindlimb—A systematic review and quality assessment Microsurgery (IF 2.1) Pub Date : 2023-09-04 Amar Bucan, Martin Frendø, Mikaella Ty Ngo, Jens Ahm Sørensen, Lisbet Rosenkrantz Hölmich
Lymphedema constitutes a major unsolved problem in plastic surgery. To identify novel lymphedema treatments, preclinical studies are vital. The surgical mouse lymphedema model is popular and cost-effective; nonetheless, a synthesis and overview of the literature with evidence-based guidelines is needed. The aim of this review was to perform a systematic review to establish best practice and support
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Selective nerve transfers to restore shoulder abduction and flexion in acute flaccid myelitis: A case report Microsurgery (IF 2.1) Pub Date : 2023-08-30 Yusha Liu, Benjamin B. Massenburg, Catherine E. Otten, Marisa B. Osorio, Sarah P. Lewis, Janine Hottovy, Raymond W. Tse
Acute flaccid myelitis (AFM) is a polio-like condition predominantly affecting children that is characterized by acute-onset, asymmetric flaccid paralysis, often preceded by a prodromal fever or viral illness. With prompt diagnosis and early surgical referral, nerve transfers may be performed to improve function. Highly selective nerve transfers are ideal to preserve existing functions while targeting
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Latissimus dorsi myocutaneous free flap for post-sacrectomy reconstruction: Outcomes compared with gluteal muscle flap Microsurgery (IF 2.1) Pub Date : 2023-08-28 Dianne Dong Un Lee, Se-Jun Park, Kyeong-Tae Lee
Excision of sacral tumor results in extensive defects and vital organ exposure, requiring soft tissue reconstruction for dead space obliteration. Diverse reconstruction options, mainly regional flaps, have been utilized but are limited by high postoperative morbidity. A reliable reconstructive method with low morbidity and facilitated recovery has yet been sought for. In this study, we aimed to evaluate
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Pedicled circumflex scapular artery perforator flap with intra-axillary tunneling for axillary defect coverage after surgical excision of hidradenitis suppurativa: A case report and literature review Microsurgery (IF 2.1) Pub Date : 2023-08-25 Matteo Meroni, Mario F. Scaglioni
Axillary defects represent a rather common issue in plastic surgery practice. Surgical resections related to skin disease are frequent in this region and their extension often requires soft tissue transfer for coverage. In this setting, locoregional pedicled flaps are usually preferred. The nearby tissues offer pliable but still resistant skin, which satisfy the “like-with-like” reconstructive principle
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The use of hammock method for an end-to-side arterial anastomosis in lower extremity flap transfers. Microsurgery (IF 2.1) Pub Date : 2023-08-24 Burak Ozkan,Suleyman Savran,Abbas Albayati,Çağrı A Uysal
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Inverted gracilis muscle free flap with intraoral vascular anastomoses for facial reanimation in vessel depleted neck: A case report Microsurgery (IF 2.1) Pub Date : 2023-08-24 Davide De Cicco, Gian Battista Bottini, Daniele Lizambri, Alexander Gaggl
The reinnervated gracilis muscle free flap represents a workhorse of facial reanimation. This procedure is carried out secondarily to parotid resections, due to advanced tumors that spread to the surrounding structures. Finding recipient vessels might be problematic if other reconstructive procedures are needed to address the defects. This paper describes a procedure to inset a reinnervated gracilis
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Osteocutaneous superficial circumflex iliac perforator flap for the lower extremity bone and soft tissue reconstruction with perforator-to-perforator anastomosis after radical debridement of tibia osteomyelitis: A case report Microsurgery (IF 2.1) Pub Date : 2023-08-21 Hirofumi Imai, Shuhei Yoshida, Toshiro Mese, Solji Roh, Ayano Sasaki, Shogo Nagamatsu, Isao Koshima
Reconstruction of soft tissue and bone defects in tibia chronic osteomyelitis is challenging and often managed by free flap with bone graft. However, the use of osteocutaneous free flap combined with perforator-to-perforator anastomosis has not been reported. We report the case of a 62-year-old man presenting with soft tissue and bone defects with right tibial chronic osteomyelitis, which was successfully
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Perioperative anticoagulation in head and neck free flap reconstructions: Experience of an anticoagulative scheme and its modification Microsurgery (IF 2.1) Pub Date : 2023-08-21 Florian D. Grill, Lisa Pilstl, Lucas M. Ritschl, Achim von Bomhard, Herbert Stimmer, Andreas Kolk, Denys J. Loeffelbein, Klaus-Dietrich Wolff, Thomas Mücke, Andreas M. Fichter
Microvascular anastomoses in microvascular reconstructions induce rheological changes in the anastomosed vessels and are usually counteracted by anticoagulative medication. There is no regimen commonly agreed on. This study provides an easy to use anticoagulative regimen.
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Educational quality of YouTube content on brachial plexus injury and treatment Microsurgery (IF 2.1) Pub Date : 2023-08-14 Dhruv Mendiratta, Daniel F. Liggio, Michael F. Levidy, Jasmine Mahajan, Alice Chu, Aleksandra McGrath
While surgical literature exists on birth-related brachial plexus injury (BPI), there are not validated sources of information on BPI for patients, which can impact patient autonomy and decision-making. With YouTube as a popular source for patients to research diagnoses, this study aims to evaluate the quality of information regarding BPI and its treatment available on the platform.
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DIEP flap perfusion assessment using microdialysis versus Doppler ultrasonography: A comparative study Microsurgery (IF 2.1) Pub Date : 2023-08-03 Michail Sorotos, Guido Firmani, Roberta Tornambene, Domenico Marrella, Guido Paolini, Fabio Santanelli di Pompeo
The increasing number of buried free-tissue transfer procedures and the need for an objective method to evaluate vascular complications of free flaps has led to the development of new technologies. Microdialysis has been used to monitor free flaps using interstitial biological markers. Previous uses mainly focused on muscular flaps. Our aim is to compare external Doppler ultrasonography (EDU) evaluation
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Anterolateral thigh flow-through flap: A versatile method for reconstruction of complex extremity defects Microsurgery (IF 2.1) Pub Date : 2023-07-21 Kaixuan Dong, Ya Zhou, Yong-qing Xu, Xiao-yan Xu, Xiao-qing He
Flow-through flaps have been widely applied only for the reconstruction of complex defects in the extremities because they can be used for arterial reconstruction and soft tissue coverage simultaneously. This report attempts to fully demonstrate the role of the anterolateral thigh (ALT) flow-through flap as a versatile method for reconstructing complex defects in the extremities.