样式: 排序: IF: - GO 导出 标记为已读
-
The Role of Density in Achieving Volume and Weight Symmetry in Breast Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-03-06
Background Knowledge of tissue and implant density is crucial in obtaining both volume and weight symmetry in unilateral breast reconstruction. Therefore, the aim of this study was to determine and compare the density of abdominal and breast tissue specimens as well as of 5th generation breast implants. Methods Thirty-one breast tissue and 30 abdominal tissue specimens from 61 patients undergoing either
-
The Hidden Risks of Perioperative Transfusions in Traumatic Lower Extremity Free Flap Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-03-01 Kylie R. Swiekatowski, Arvind D. Manisundaram, Delani E. Woods, Jackson C Green, Mohin A. Bhadkamkar, Yuewei Wu-Fienberg
Background Blood transfusions have been associated with surgical complications; however, these studies are not specific to lower extremity (LE) reconstruction. We evaluated the effect of perioperative packed red blood cell (PRBC) transfusions on LE free flap outcomes in trauma patients. Methods Patients undergoing LE free flap reconstruction following acute injuries from 2016 to 2021 were retrospectively
-
Differential Diagnosis of “Foot Drop”: Implications for Peripheral Nerve Surgery J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-29 Mitchel Seruya
Background At least 128,000 patients in the United States each year suffer from foot drop. This is a debilitating condition, marked by the inability to dorsiflex and/or evert the affected ankle. Such patients are rendered to a lifetime of relying on an ankle-foot orthosis (AFO) for walking and nighttime to prevent an equinovarus contracture. Methods This narrative review explores the differential diagnosis
-
Quality of Life Outcomes after Free Fibula Flap Reconstruction of Mandibular Defects: A Longitudinal Examination J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-27 Kevin K. Zhang, Zack Cohen, Louise Cunningham, Minji Kim, Jasmine Monge, Michael Tecce, Jonas A. Nelson, Jennifer Cracchiolo, Evan Matros, Farooq Shahzad, Robert J. Allen Jr.
Background A comprehensive understanding of changes in health-related quality of life after head and neck cancer surgery is necessary for effective preoperative counseling. The goal of this study was to perform a longitudinal analysis of postoperative quality of life outcomes after fibula free flap (FFF) mandible reconstruction. Methods A retrospective review was performed for all patients who underwent
-
Does Steal Phenomenon Exist in Multiple Neurotization?—An Experimental Rat Study J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-27
Background Nerve transfers from one common donor nerve to recipient nerves with multiple target branches can yield slower and unpredictable recovery in the target nerves. Our hypothesis is that steal phenomenon exists when multiple nerve neurotization comes from one donor nerve. Methods In 30 Sprague-Dawley rats, the left ulnar nerve (UN) was selected as the donor nerve, and the musculocutaneous nerve
-
Perforator Dissection Porcine Abdominal Model: A Novel Simulator to Improve Microsurgical Training J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-23 Ellen C. Shaffrey, Weifeng Zeng, Peter J. Nicksic, Sahand C. Eftekari, Jennifer M. Frank, Aaron M. Dingle, Samuel O. Poore
Background Perforator dissection and flap elevation are routinely performed for microsurgical reconstruction; however, there is a steep learning curve to mastering these technical skills. Though live porcine models have been utilized as microsurgical training models, significant drawbacks limit their use. We recently developed a latex-perfused, nonliving, porcine abdomen perforator dissection simulation
-
Postoperative Magnesium Sulfate Repletion Decreases Narcotic Use in Abdominal-Based Free Flap Breast Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-23 Yi-Hsueh Lu, Jini Jeon, Lakshmi Mahajan, Yufan Yan, Katie E. Weichman, Joseph A. Ricci
Background Microsurgical breast reconstruction after mastectomy is now the standard of care for breast cancer patients. However, the costs and resources involved in free flap reconstruction can vary across different medical settings. To enhance patient outcomes in a cost-effective manner, we investigated the effect of intravenous magnesium sulfate (IV Mg) on postoperative opioid usage in this context
-
The Ischemic Tolerance up to Four Hours of Free Jejunum Flap: A Retrospective Cohort Study J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-23 Yu Kagaya, Ryo Takanashi, Masaki Arikawa, Daisuke Kageyama, Takuya Higashino, Satoshi Akazawa
Background While free jejunum transfer (FJT) following total pharyngo-laryngo-esophagectomy (TPLE) is a reliable reconstruction technique, the jejunum flap is viewed as more susceptible to ischemia than a standard free flap. Animal studies have indicated that the jejunum can tolerate ischemia for as little as 2 to 3 hours. Clinical studies also reported increased complications after the FJT with more
-
Mapping of Thoracodorsal Artery Perforators: Accuracy of Thermography and Handheld Doppler J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-23 Claudius Illg, Johannes C. Heinzel, Markus Denzinger, Ruth C. Schäfer, Adrien Daigeler, Sabrina Krauss
Background The versatile musculocutaneous latissimus dorsi flap and the thoracodorsal artery (TDA) perforator flap have developed into indispensable approaches in reconstructive surgery. While the anatomy of the TDA is consistent, the skin perforators vary in location and course. Dynamic infrared thermography (DIRT) recently gained popularity for perforator identification; however, its use and accuracy
-
The Effects of Body Mass Index on Postoperative Complications in Patients Undergoing Autologous Free Flap Breast Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-23 Kassra Garoosi, YooJin Yoon, Julian Winocour, David W. Mathes, Christodoulos Kaoutzanis
Background The prevalence of obesity in the United States exceeds 40%, yet perioperative effects of higher body mass index (BMI) in autologous breast reconstruction remain poorly studied. The purpose of this study was to investigate BMI's impact on postop complications in abdominal and gluteal-based autologous breast reconstruction. Methods We conducted a retrospective study using TriNetX, a health
-
Co-surgeon versus Single-surgeon Outcomes in Free Tissue Breast Reconstruction: A Meta-analysis J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-21 Joshua Xu, Xi Ming Zhu, Kimberly C. Ng, Muayyad M. Alhefzi, Ronen Avram, Christopher J. Coroneos
Background Autologous breast reconstruction offers superior long-term patient reported outcomes compared with implant-based reconstruction. Universal adoption of free tissue transfer has been hindered by procedural complexity and long operative time with microsurgery. In many specialties, co-surgeon (CS) approaches are reported to decrease operative time while improving surgical outcomes. This systematic
-
Air Versus Saline in Tissue Expanders: A Systematic Review of the Literature J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-21 Erin J. Kim, Rosie Friedman, Sasha Nickman, Dylan J. Perry, Valeria P. Bustos, Bernard T. Lee
Background There has been a greater focus in recent literature proposing air to be a superior medium to saline in tissue expanders. This study aims to review the literature and assess the quality of data on the efficacy and safety of air as an alternative medium to saline in tissue expanders, in the setting of postmastectomy two-stage reconstruction. Methods A systematic review regarding air inflation
-
Comparisons of Impact of Vein Grafting with Different Indications on Outcomes of Reconstruction with Free Flaps J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-16
Background Prior studies have shown an increased risk of complications and flap loss with the use of vein grafts in microsurgery. We hypothesize that indication for use of a vein graft can affect flap complications and loss rates. Methods We performed a retrospective review of all patients at our institution from 2010 to 2020 who underwent free flap reconstruction and required use of a vein graft.
-
Deep Circumflex Iliac Artery-vascularized Iliac Bone Graft for Femoral Head Osteonecrosis: Computed Tomography Anatomical Study J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-15 Jiale He, Yunxiang Lu, Yuxian Chen, You Peng, Qi Zhu, Zhiyong Li
Background Deep circumflex iliac artery (DCIA)-vascularized iliac graft transposition is a method for treating femoral head osteonecrosis but with inconsistent efficacy. We aim to improve the method of this surgery by recommending the optimal location of the iliac pedicle to satisfy the vascular length for transposition and the blood supply of the vascularized iliac graft. Methods The DCIA and its
-
“Dual-Innervated Gracilis Free Functional Muscle Transfers in Facial Palsy Patients: Comparing Long-Term Outcomes between One- versus Two-Stage Procedures” J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-15 Y. Edward Wen, Roshni L. Thachil, Adolfo Zamaro Madrazo, Cristina V. Sanchez, Joan S. Reisch, Shai M. Rozen
Background In facial reanimation, dual-innervated gracilis free functional muscle transfers (FFMTs) may have amalgamated increases in tone, excursion, synchroneity, and potentially spontaneity when compared with single innervation. The ideal staging of dual-innervated gracilis FFMTs has not been investigated. We aim to compare objective long-term outcomes following one- and two-stage dual-innervated
-
Lymphovenous Coupler-Assisted Bypass for Immediate Lymphatic Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-15
Background Breast cancer-related lymphedema is the most common cause of lymphedema in the United States and occurs in up to 50% of individuals receiving axillary lymph node dissection (ALND). Lymphovenous bypass (LVB) at the time of ALND may prevent lymphedema, but long-term results and anastomotic patency are unclear. This study evaluates the feasibility and outcomes of performing immediate lymphatic
-
Identifying Functional Lymph Nodes in Lower Extremity Lymphedema Patients: The Role of High-frequency Ultrasound J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-15 Feras Alshomer, Hyung Hwa Jeong, Changsik John Pak, Hyunsuk Peter Suh, Joon Pio Hong
Background Lymph nodes may play a potential role in lymphedema surgery. Radiologic evaluation of nodes may reveal the status of pathologic conditions but with limited accuracy. This study is the first to evaluate the efficacy of ultrasound in detecting functioning nodes in lymphedema patients and presents a criterion for determining the functionality of the lymph nodes. Methods This retrospective study
-
Split Anterolateral Thigh Flap: A New Classification of Anatomical Variants and a Surgical Planning Algorithm J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-13 Hsiang-Shun Shih, Ting-Han Chiu, Seng-Feng Jeng, Jill Chen
Background Split anterolateral thigh flap is a versatile reconstruction option, yet long underestimated as no practical perforator classification and no optimal strategy were present. Harvesting “capillary nonsizable perforators” could potentially expand flap splits to those with no existing multiple sizable perforators. Concerns over defect characteristics, recipient vessels, pedicle length, and split
-
Innovative Clinical Scenario Simulator for Step-by-Step Microsurgical Training J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-12
Background Microsurgical training should be implemented with consideration of operative difficulties that occur in actual clinical situations. We evaluated the effectiveness of a novel clinical scenario simulator for step-by-step microsurgical training that progressed from conventional training to escalated training with additional obstacles. Methods A training device was designed according to multiple
-
Assessment of Microsurgery Simulation Course Access in Plastic Surgery Training Programs J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-02 Ashlie A. Elver, Katie G. Egan, Brett T. Phillips
Background Microsurgery requires complex skill development with a steep learning curve for plastic surgery trainees. Flap dissection courses and simulation exercises are useful to acquire these skills. This study aims to assess plastic surgery training programs' access to and interest in microsurgical courses. Methods A survey was distributed to plastic surgery residency and microsurgery fellowship
-
DIEP Donor Site Satisfaction between Patients with and without History of Pregnancy J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-02-02 David Chon-Fok Cheong, Allen Wei-Jiat Wong, Shu-Wei Kao, Shu-Ying Chang, Jung-Ju Huang
Background With the success of free autologous breast reconstruction, the abdominal donor site is now an important consideration, especially in patients of childbearing age. In our institution, there are increasing patients who have successfully undergone the deep inferior epigastric artery perforator (DIEP) flap despite previous pregnancy. This study aims to answer questions on the effect of the donor
-
Early Predictors of Fistula Formation Following Head and Neck Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-01-30 Daisuke Atomura, Takeo Osaki, Shigemichi Iwae, Shunsuke Sakakibara
Background Salivary fistula formation is a common and serious complication following head and neck reconstruction. Because it can cause delayed wound healing and infection and carotid artery rupture in severe cases, hence, early detection and treatment are crucial. This study was designed to identify early predictors of postoperative fistula formation. Methods We conducted a retrospective analysis
-
Trends in Hospital Billing for Mastectomy and Breast Reconstruction Procedures from 2013 to 2020 J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-01-24 Jung Ho Gong, Daniel J. Koh, Nikhil Sobti, Raman Mehrzad, Dardan Beqiri, Amy Maselli, Daniel Kwan
Background With greater acceptance of postmastectomy breast reconstruction (PMBR) as a safe and reliable treatment option, the role of plastic surgeons in breast cancer management continues to rise. As Medicare reimbursements for surgical procedures decline, hospitals may increase charges. Excessive markups can negatively affect uninsured and underinsured patients. We aimed to analyze mastectomy and
-
Comparative Study of Small Vessel (under 0.8 mm) Anastomosed Free Flap and Larger Vessel (over 0.8 mm) Anastomosed Free Flap; Does Supermicrosurgery Provide Sufficient Blood Flow to the Free Flap? J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2024-01-09 Hyung Bae Kim, Joon Pio Jp Hong, Hyunsuk Peter Suh
Background This study aimed to quantify the blood flow of free flaps and compare the blood flow of small vessel (<0.8 mm) and larger vessel (>0.8 mm) anastomosed free flaps. Methods This retrospective study included patients treated successfully with a perforator free flap in the lower extremity between June 2015 and March 2017. A color duplex ultrasound system measured the flow volume through the
-
Aesthetic Evaluation and Validation: Umbilicus Reconstruction after DIEP Flap J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-12-20 Nicholas T. Haddock, Cyrus Steppe, Sumeet S. Teotia
Background The most common method for autologous breast reconstruction is the deep inferior epigastric perforator (DIEP) flap. The umbilicus can be managed in various ways, including re-inset, neoumbilicus, and umbilectomy without reconstruction. This study evaluated the aesthetic differences in umbilicus reconstruction choice and variation in patients' postoperative satisfaction with their abdomen
-
Women in Microsurgery Fellowships: Trends and Impact on Future Practice Patterns J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-12-19
Background While the number of female plastic surgeons has continued to increase over time, plastic surgery has historically been a male-dominated profession with only 15% of practicing plastic surgeons being female. Microsurgery, as a subspecialty, has been long perceived as an even more male-centric career path. The objective of this study was to determine the representation of females in the subspecialty
-
From Augmented to Virtual Reality in Plastic Surgery: Blazing the Trail to a New Frontier J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-12-18 Janessa Sullivan, Rachel Skladman, Kaamya Varagur, Elijah Tenenbaum, Jacob L. Sacks, Cameron Martin, Terry Gordon, John Murphy, William R. Moritz, Justin M. Sacks
Background Augmented reality (AR) and virtual reality (VR)—termed mixed reality—have shown promise in the care of operative patients. Currently, AR and VR have well-known applications for craniofacial surgery, specifically in preoperative planning. However, the application of AR/VR technology to other reconstructive challenges has not been widely adopted. Thus, the purpose of this investigation is
-
Superficial Inferior Epigastric Artery Flap: Vascular Pattern and Territory Across the Midline J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-12-18 Suphalerk Lohasammakul, Warangkana Tonaree, Chaiyawat Suppasilp, Terasut Numwong, Rosarin Ratanalekha, Hyun Ho Han
Background Superficial inferior epigastric artery (SIEA) flap offers a significant advantage of lower donor site morbidity over other abdominal-based flaps for breast reconstruction. However, the inconsistent anatomy and territory across the midline remains a major issue. This study aimed to investigate the SIEA and determine its pattern and territory across the midline. Methods Twenty cadavers were
-
Billing and Utilization Trends in Reconstructive Microsurgery Indicate Worsening Access to Care J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-12-18 Daniel J. Koh, Jung Ho Gong, Nikhil Sobti, Raman Mehrzad, Dardan Beqiri, Sophia Ahn, Amy Maselli, Daniel Kwan
Background Within the last 20-years, Medicare reimbursements for microsurgery have been declining, while physician expenses continue to increase. As a result, hospitals may increase charges to offset revenue losses, which may impose a financial barrier to care. This study aimed to characterize the billing trends in microsurgery and their implications on patient care. Methods The 2013 to 2020 Provider
-
Patient-Reported Abdominal Morbidity Following Abdomen-Based Breast Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-12-14 Jacob Maus, Ivo A. Pestana
Background Abdominal wall morbidity occurs with increased frequency following flap harvest in the obese abdomen. Its impact on patient-reported outcomes (PROs) in breast reconstruction has been poorly characterized. Methods A retrospective review of obese patients undergoing abdominal-based free autologous breast reconstruction was conducted over 15 years. Patient operative characteristics were recorded
-
Implications of Single-Vessel Runoff on Long-Term Outcomes of Free Tissue Transfer for Lower Extremity Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-12-14 Samuel S. Huffman, John D. Bovill, Karen Li, Daisy L. Spoer, Lauren E. Berger, Jenna C. Bekeny, Cameron M. Akbari, Kenneth L. Fan, Karen K. Evans
Background Patients with complex lower extremity (LE) wounds and single-vessel LE runoff (1-VRO) are often considered for amputation. While more challenging, free tissue transfer (FTT) is a means for limb salvage. This study aims to demonstrate the feasibility of limb salvage with FTT in patients with 1-VRO. Methods Patients undergoing FTT by a single surgeon between 2011 and 2021 were retrospectively
-
Cryoanalgesia: Review with Respect to Peripheral Nerve J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-12-13
Background Cryoanalgesia is a tool being used by interventional radiology to treat chronic pain. Within a certain cold temperature range, peripheral nerve function is interrupted and recovers, without neuroma formation. Cryoanalgesia has most often been applied to the intercostal nerve. Cryoanalgesia has applications to peripheral nerve surgery, yet is poorly understood by reconstructive microsurgeons
-
Perfusion Dynamics during Secondary Flap Debulking with Liposuction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-12-13 Maxim Geeroms, Yun-Jui Lu, Chung-Chen Hsu, Ren-Wen Huang, Chih-Hung Lin, Cheng-Hung Lin
Background Lower extremity trauma often necessitates reconstruction with flap transfer. One of the reconstructive goals is a thin soft tissue coverage with appropriate contour. Therefore, a secondary debulking of the flap is usually performed. Methods Debulking through conventional lipectomy is compared with liposuction followed by excision of the defatted flap excess. Demographic data, surgical details
-
Surface to Perforator Index: Assessing the Importance of the Number of Perforators in Successful Harvesting of the Anterolateral Thigh Flap J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-12-07
Introduction The use of perforator flaps has become more popular with improvement of surgical technique, technology, as well as understanding of microvascular anatomy. The selection of well-perfused angiosomes is critical to the successful outcome of patients undergoing free tissue transfer. The number of perforators that are needed is dependent upon the surface area of the flap being harvested; however
-
Comparison of Arterial and Venous Interposition Grafting for Arterial Defects in a Rat Model J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-11-27 B.S. Sivakumar, K. Thatcher, I. Hughes, Anna Watson, B. Schick, D.J. Graham
Background Interposition microvascular grafting may be required to bridge arterial defects during digital replantation or revascularization and has traditionally been performed utilizing a venous autograft. Arterial interposition grafting has been shown to be superior in maintaining patency in large vessel surgery; there are case reports of its use in microsurgery. Methods Six fellowship-trained hand
-
Video-Based Assessment of Microsurgical Trainees: An Evaluation of Gender Bias J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-11-03 Eliana J. Schaefer, Mary K. Thayer, Anthony F. Colon, Kavya K. Sanghavi, Erika D. Sears, Aviram M. Giladi, Ryan D. Katz
Background Gender bias in graduate medical evaluations remains a challenging issue. This study evaluates implicit gender bias in video-based evaluations of microsurgical technique, which has not previously been described in the literature. Methods Two videos were recorded of microsurgical anastomosis; the first was performed by a hand/microsurgery fellow and the second by an expert microsurgeon. A
-
Lymphedema Surgical Education and Faculty Demographics in United States Plastic Surgery Residency Programs J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-11-03 Emily R. Finkelstein, Meaghan Clark, Michael Ha, Devinder Singh, Kyle Y. Xu, Juan Mella-Catinchi, Yvonne Rasko
Background Recent advancements in supermicrosurgery and promising preliminary outcomes have led to a surge in physiologic lymphedema surgery. This study is the first to evaluate lymphedema surgical education among U.S. plastic surgery residency programs, along with the background and experience of plastic surgeons subspecializing in the field. Methods Cross-sectional evaluation of 103 accredited U
-
The Influence of the Superficial Venous System on DIEP Flap Drainage in Breast Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-11-03 Esther Mihwa Oh Choi, Renan Diego Américo Ribeiro, Eduardo Montag, Thiago Ueda, Alberto Yoshikazu Okada, Alexandre Mendonça Munhoz, Fabio de Freitas Busnardo, Rolf Gemperli
Background Autologous tissue has become the gold standard in breast reconstruction. The use of a deep inferior epigastric perforator (DIEP) flap has the advantages of giving a natural appearance to the reconstructed breast and being associated with lower morbidity at the donor site when compared with the transverse rectus abdominis myocutaneous flap. Venous complications such as venous thrombosis and
-
The Impact of Timing of Delayed Autologous Breast Reconstruction following Postmastectomy Radiation Therapy on Postoperative Morbidity J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-11-01 Humza N. Mirza, Nicholas L. Berlin, Kristoffer B. Sugg, Jung-Shen Chen, Kevin C. Chung, Adeyiza O. Momoh
Background The ideal time to perform reconstruction after the completion of postmastectomy radiation therapy (PMRT) in patients with locally advanced breast cancer is currently unknown. We evaluate the association between the timing of delayed autologous breast reconstruction following PMRT and postoperative complications. Methods Patients who underwent mastectomy, PMRT, and then delayed autologous
-
Preoperative Risk Factors for Lymphedema in Inflammatory Breast Cancer J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-11-01 Libby R. Copeland-Halperin, Colby J. Hyland, Goutam K. Gadiraju, David H. Xiang, Jennifer R. Bellon, Filipa Lynce, Tanujit Dey, Elizabeth P. Troll, Sean J. Ryan, Faina Nakhlis, Justin M. Broyles
Background Prophylactic lymphatic bypass or LYMPHA (LYmphatic Microsurgical Preventive Healing Approach) is increasingly offered to prevent lymphedema following breast cancer treatment, which develops in up to 47% of patients. Previous studies focused on intraoperative and postoperative lymphedema risk factors, which are often unknown preoperatively when the decision to perform LYMPHA is made. This
-
Trends of Medicare Reimbursement Rates for Lower Extremity Procedures J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-10-16 Charalampos Siotos, Amir Aminzada, Natalia Whitney, Daniel Najafali, John A. Toms III, Anastasios Mpontozis, George Kokosis, Deana S. Shenaq, Gordon H. Derman, Amir H. Dorafshar, David E. Kurlander
Introduction Data collected across many surgical specialties suggest that Medicare reimbursement for physicians consistently lags inflation. Studies are needed that describe reimbursement rates for lower extremity procedures. Our goal is to analyze the trends in Medicare reimbursement rates from 2010 to 2021 for both lower extremity amputation and salvage surgeries. Methods The Physician Fee Schedule
-
Beyond Borders: A Global Microsurgery Training and Case Exposure Survey J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-10-09 Chad Chang, Christopher Jones, Juan Enrique Berner, Maniram Ragbir, Omar A. Ahmed
Background Microsurgery is essential in modern reconstructive surgery and plastic surgery training. Surgeon's proficiency and experience are crucial for effective microsurgical interventions. Despite anecdotal evidence of varying quality of microsurgery training globally, no empirical studies have investigated this. We conducted a global survey to investigate microsurgical training and clinical case
-
A Novel Approach to Optimise Length Preservation in Cross Leg Vascular Bridge Flap by AV-Shunting. J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-10-04 Chad Chang,Filippo Di Meglio,Alex Sorkin,Wei-Ling Jan,Hung-Chi Chen
N/A.
-
Rat Microvascular Model is Tolerant to Technical Errors J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-09-26 Joseph R. Paladino, YuanDian Zheng, Konstantinos Gasteratos, John J. Corvi, Katherine H. Park, Yelena Akelina
Background Extensive studies have been conducted using the rat model to understand the potential technical errors that lead to anastomotic failure. However, current literature indicates that the rat model has excellent tolerance to diverse errors committed by microsurgeons. The error-investigating rat model is often created by one or two experienced surgeons, and only one isolated technical error is
-
Thermal Challenges in Dynamic Infrared Thermography Used for Perforator Mapping J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-09-26 Olivia M. Lin, David J. Hunter-Smith, Warren M. Rozen
Background The aim of this study is to investigate the different approaches to thermal challenges, both cold and warm, used in dynamic infrared thermography for reconstructive surgery, and explore whether it affects the success of preoperative perforator mapping. Methods Literature was collected from Ovid Medline, Embase, PubMed, and Cochrane. The references of the full-text articles located from the
-
Tourniquet Use in Extremity-Based Microsurgery J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-09-26
Background The use of tourniquets and their role in extremity-based microsurgery has not been thoroughly investigated. The purpose of this study was to investigate tourniquet use and its associated outcomes and complications. The authors hypothesize that tourniquets enhance visualization, bloodless approaches to vessel harvest, flap elevation, and anastomosis without added complications. Methods A
-
Muscle versus Fascia Free Tissue Transfer for Treatment of Chronic Osteomyelitis in the Comorbid Population J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-09-25 Samuel S. Huffman, Lauren E. Berger, Karen Li, Daisy L. Spoer, Nisha J. Gupta, Brian N. Truong, Cameron M. Akbari, Karen K. Evans
Background In patients with chronic lower extremity (LE) wounds, chronic osteomyelitis confers additional complexity to achieving adequate treatment. Previous reviews demonstrate increased rates of osteomyelitis recurrence in patients who receive muscle flaps compared with fasciocutaneous flaps for LE limb salvage; however, these studies were not limited to atraumatic populations who receive exclusively
-
Immediate Lymphatic Reconstruction in 77 Consecutive Breast Cancer Patients: 2-year Follow-up J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-09-22 Nicole K. Le, Brielle Weinstein, Jeegan Parikh, Lokesh A. Coomar, D'Arcy Wainwright, Langfeier Liu, Jamila Mammadova, Tina Tavares, Nicholas J. Panetta
Background Breast cancer-related lymphedema (BCRL) is a cyclical, progressive disease that begins at the time of axillary dissection and worsens in the setting of adjuvant oncologic therapies. The paradigm of lymphedema management in these patients is shifting from therapeutic surgeries and decongestive therapy to preventative surgery with immediate lymphatic reconstruction (ILR). Methods After institutional
-
Pedicled Flaps for High-Risk Open Vascular Procedures of the Lower Extremity: An Analysis of The National Surgical Quality Improvement Project Database J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-09-22 Shannon R. Garvey, Lauren Valentine, Allan A. Weidman, Amy Chen, Asha D. Nanda, Daniela Lee, Samuel J. Lin, Bernard T. Lee, Patric Liang, Ryan P. Cauley
Background Use of pedicled flaps in vascular procedures is associated with decreased infection and wound breakdown. We evaluated the risk profile and postoperative complications associated with lower extremity open vascular procedures with and without pedicled flaps. Methods The American College of Surgeons National Surgical Quality Improvement Program database (2010–2020) was queried for Current Procedural
-
Learning from Abdominoplasty to Reduce the Seroma Rate following Deep Inferior Epigastric Perforator Flap with Umbilectomy. J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-09-20 Konstantinos Seretis
-
Operative Time Predicts Long-Term Abdominal Morbidity and Complication Requiring Treatment after DIEP Flap Breast Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-09-11 Y. Edward Wen, Cyrus Steppe, Sumeet S. Teotia, Nicholas T. Haddock
Introduction The relationship between skin-to-skin operative time and long-term complications, as well as complications requiring treatment, after deep inferior epigastric perforator (DIEP) flap breast reconstructions has not been thoroughly investigated. The study objective was to evaluate if operative time would independently prognosticate the type and number of treated complications, as well as
-
Photochemical Tissue Bonding of Amnion Allograft Membranes for Peripheral Nerve Repair: A Biomechanical Analysis J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-09-11
Background Photochemical tissue bonding (PTB) is a technique for peripheral nerve repair in which a collagenous membrane is bonded around approximated nerve ends. Studies using PTB with cryopreserved human amnion have shown promising results in a rat sciatic nerve transection model including a more rapid and complete return of function, larger axon size, and thicker myelination than suture repair.
-
Impact of Nicotine Replacement Therapy on Breast Surgery Outcomes J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-08-31 Seema M. Patel, Alexandra Junn, Daniel Sasson, Jacob Dinis, Kaiti Duan, Sara Islam, Lisa Fucito, Steven L. Bernstein, Henry C. Hsia
Background Smoking cessation therapy, including nicotine replacement therapy (NRT), is used perioperatively to assist patients to reduce their tobacco smoke intake and consequently decrease their risk of smoking-associated complications. There are, however, theoretical concerns that nicotine-induced peripheral vasoconstriction could impair wound healing. This study investigated the effect of NRT on
-
Preoperative Imaging Mapping of DIEP Perforators and Intraoperative Selection: Does It Correlate? J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-08-10 Paula Gravina, Aspinder Singh, Christopher Conlon, Aldona Spiegel
Background Preoperative imaging prior to deep inferior epigastric perforator (DIEP) flap harvest is a common practice to locate perforators and identify aberrant anatomy. Methods We report a retrospective review of 320 consecutive patients who underwent preoperative computed tomographic angiography (CTA) or magnetic resonance angiography prior to DIEP flap breast reconstruction. The locations relative
-
Impact of High-Fidelity Microvascular Surgery Simulation on Resident Training J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-08-03 Matthew T. Joy, Matthew A. Applebaum, William M. Anderson, Joseph M. Serletti, Anthony E. Capito
Background Microsurgery requires a high level of skill achieved only through repeated practice. With duty-hour restrictions and supervision requirements, trainees require more opportunities for practice outside the operating room. Studies show simulation training improves knowledge and skills. While numerous microvascular simulation models exist, virtually all lack the combination of human tissue and
-
Negative Pressure Wound Therapy in Free Muscle Flaps—Risk or Benefit? J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-07-26 Ulf Dornseifer, Peter Paul Pfeiler, Lukas Kargl, Philipp Moog, Arndt F. Schilling, Milomir Ninkovic
Background Application of negative pressure wound therapy (NPWT) on free flaps not only reduces edema but also increases the pressure from outside. The impact of these opposite effects on flap perfusion remains elusive. This study evaluates the NPWT system's influence on macro- and microcirculation of free flaps and edema reduction to better assess the clinical value of this therapy in microsurgical
-
Learning Sensory Nerve Coaptation in Free Flap Breast Reconstruction J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-07-17 Hansje P. Smeele, Jop Beugels, Sander M. J. van Kuijk, René R. W. J. van der Hulst, Stefania M. H. Tuinder
Background The aims of this study were to assess whether sensory nerve coaptation in free flap breast reconstruction is subject to learning, and to elucidate challenges of this technique. Methods In this single-center retrospective cohort study, we reviewed consecutive free flap breast reconstructions performed between March 2015 and August 2018. Data were extracted from medical records, and missing
-
Does Frailty Predict Outcomes in Patients Undergoing Free or Pedicled Flap Procedures for Lower Extremity Limb Salvage? An Analysis of the American College of Surgeons National Surgical Quality Improvement Program Database J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-07-12 Emmeline Jia, Shannon R. Garvey, Amy Chen, Valeria P. Bustos, Monica Morgenstern, Rosie Friedman, Bernard T. Lee, Arriyan S. Dowlatshahi, Ryan P. Cauley
Background Older and frailer patients are increasingly undergoing free or pedicled tissue transfer for lower extremity (LE) limb salvage. This novel study examines the impact of frailty on postoperative outcomes in LE limb salvage patients undergoing free or pedicled tissue transfer. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2010–2020)
-
Skull and Scalp En-Bloc Harvest Protects Calvarial Perfusion: A Cadaveric Study J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-07-10 Christopher D. Lopez, Alisa O. Girard, Isabel V. Lake, Visakha Suresh, Hossam Abdou, Jonathan J. Morrison, Robin Yang, Chad R. Gordon, Richard J. Redett
Background Calvarial defects are severe injuries that can result from a wide array of etiologies. Reconstructive modalities for these clinical challenges include autologous bone grafting or cranioplasty with biocompatible alloplastic materials. Unfortunately, both approaches are limited by factors such as donor site morbidly, tissue availability, and infection. Calvarial transplantation offers the
-
Safety of Drainless Donor Closure in DIEP Flap-Based Breast Reconstruction: A Prospective Analysis Using Ultrasound J. Reconstr. Microsurg. (IF 2.1) Pub Date : 2023-07-10 Jina Kim, Kyeong-Tae Lee, Goo-Hyun Mun
Background Although drainless donor closure with progressive tension suture (PTS) technique has been attempted to further reduce donor morbidity in deep inferior epigastric perforator (DIEP) flap-based breast reconstruction, its clinical safety has not yet been fully elucidated. This study prospectively investigated donor morbidity after DIEP flap elevation and drain-free donor closure. Methods A prospective