Abstract:
:Microvascular free flap transfer has become a prevailing surgery with a failure rate of <5%. However, pedicle thrombosis occurs more frequently than indicated by the failure rate. This difference is due to the successful salvage of failing flaps. During exploration, thrombi are often encountered at anastomotic sites, whereas these causes could not explain vascular compromise in other patients. Thus, we hypothesized that thrombogenic processes might occur at remote sites, specifically within microvessels of the transferred flap. This study retrospectively evaluated 323 patients who underwent microvascular free flap transfer between March 2012 and October 2016 at Korea University Guro Hospital. All patients requiring emergency exploration within 7 days after surgery were retrospectively reviewed. Of patients, 15 required explorative surgery for suspected circulatory compromise. Eight were diagnosed with thrombosis at the perianastomotic site and salvaged in accordance with our protocol. There was no detectable thrombosis at the anastomotic site in seven patients, including one patient in whom thrombosis resolved with topical papaverine application and heparinization. The remaining six patients were diagnosed with intra-flap microthrombosis without discernable thrombosis at the anastomotic site. All patients were treated following our urokinase administration protocol and salvaged without complications. Possible external causes should first be evaluated when salvaging free flaps; in the absence of such evidence, urokinase administration may be utilized as a last resort. This study is the first report describing the effectiveness of pharmacological thrombolysis in resolving intra-flap microthrombosis. Furthermore, a safe and efficient urokinase administration protocol is suggested for perianastomotic thrombosis and intra-flap microthrombosis.
journal_name
J Plast Surg Hand Surgjournal_title
Journal of plastic surgery and hand surgeryauthors
Namgoong S,Yang JP,Jeong SH,Han SK,Kim WK,Dhong ESdoi
10.1080/2000656X.2018.1523177subject
Has Abstractpub_date
2018-12-01 00:00:00pages
367-374issue
6eissn
2000-656Xissn
2000-6764journal_volume
52pub_type
杂志文章abstract:BACKGROUND:In this study, markers of coagulation and fibrinolysis were assessed during early and delayed microsurgical reconstruction in patients with traumatic defects of their lower legs to analyse whether an imbalance of the hemostasis after trauma might predispose the development of vascular complications. METHODS...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.1080/2000656X.2017.1303499
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the accelerating effects of platelet-rich plasma-containing (PRP&) fragmin/protamine microparticles (F/P MPs) for repairing mitomycin C-treated healing-impaired wounds. Staining with terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling (TUNEL-staining)...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2015.1034723
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Carpal tunnel syndrome (CTS) and trigger digits are among the most common nontraumatic hand disorders treated by plastic surgeons. The onset of trigger digits after carpal tunnel release (CTR) has been inconsistently reported. This systematic review assessed the prevalence of trigger digits development in pa...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章,评审
doi:10.1080/2000656X.2017.1345751
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism is a well-documented complication of surgery, including plastic surgery. However, few consensus guidelines on thromboembolism prophylaxis exist in plastic surgery and, thus, the different approaches in the public as well as the private clinics in Denmark were investigated using a web-b...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.1080/2000656X.2016.1195745
更新日期:2017-04-01 00:00:00
abstract::Deep inferior epigastric artery perforator (DIEP) flap has become the gold standard in autologous breast reconstruction. Attention is now being focused on the impact of DIEP flap harvest technique on abdominal hernia rates. The aim of this study was to evaluate DIEP abdominal wall morbidity in relation to flap harvest...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.1080/2000656X.2018.1498790
更新日期:2018-12-01 00:00:00
abstract::Immediate breast reconstruction (IBR) combined with post-mastectomy radiotherapy (PMRT) is associated with an increased risk for complications. Here, we analyse whether IBR combined with PMRT is ethically acceptable. We employ normative analysis following reflective equilibrium and the principles of Beauchamp and Chil...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.1080/2000656X.2019.1688165
更新日期:2020-04-01 00:00:00
abstract::The levator and frontalis muscles lack interior muscle spindles, despite consisting of slow-twitch fibres that involuntarily sustain eyelid-opening and eyebrow-raising against gravity. To compensate for this anatomical defect, this study hypothetically proposes that initial voluntary contraction of the levator fast-tw...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2012.718282
更新日期:2013-02-01 00:00:00
abstract::Septic arthritis of the sternoclavicular joint (SC) is rare. The most accepted technique for reconstruction of the defect after SC joint resection is the use of muscle flaps. We hypothesized that resection of ribs with the SC joint impacts timing, type and outcomes of reconstruction. This is a retrospective review of ...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.1080/2000656X.2020.1856672
更新日期:2020-12-16 00:00:00
abstract::Because of the lack of agreement on when rectus diastasis (RD) is pathologic, the aim was to investigate indications for surgical repair. This study presents classifications of RD, current knowledge on the relation to pregnancy, and conservative and surgical management. A systematic search in Pubmed, Embase, Cochrane,...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章,评审
doi:10.3109/2000656X.2013.859145
更新日期:2014-06-01 00:00:00
abstract::Neoadjuvant treatment and surgical resection for sarcoma patients can often leave devastating wounds necessitating soft-tissue coverage in the form of free flaps. There is still debate as to the optimal flap for reconstruction of defects in irradiated fields. We aim to describe our experiences with free fasciocutaneou...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.1080/2000656X.2020.1791893
更新日期:2020-12-01 00:00:00
abstract::Optimal vascularisation of the graft site is significant for improving the outcome of fat grafting. Adipose tissue, specifically the stromal vascular fraction (SVF), is known to regulate its own vascular network. In order to assess the production of angiogenetic growth factors, this study investigated the content of i...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2014.903196
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:Toe-to-hand transplantation is a reliable procedure that replaces like-with-like in cases of a lost thumb or finger. The aim of this study is to investigate the effects of toe transplantation on patients from the perspectives of quality of life (QOL) and disability. METHODS:Ten patients with traumatic amputa...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.1080/2000656X.2018.1520123
更新日期:2018-12-01 00:00:00
abstract::Experimental results have previously been reported for a new biological dressing consisting of concentrated plasma proteins and platelet-rich plasma (PRP), which is named Platelet-Protein film (PPF). This study reports clinical experience using PPF produced from the patients' own blood by the original technique. Ten p...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 临床试验,杂志文章
doi:10.3109/2000656X.2013.783485
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:While Realdo Colombo from Cremona, Italy has, to date, been acknowledged to be the first to describe the possible absence of the palmaris longus muscle in men in 1559, the authors found this absence to be recorded in the first edition of "De Humani Corporis Fabrica Libri Septum" by Andreas Vesalius, publishe...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 历史文章,杂志文章
doi:10.3109/2000656X.2015.1073156
更新日期:2016-01-01 00:00:00
abstract::Interposition arthroplasty with bioreplaceable poly-L-D-lactic acid (PLDLA) implants has yielded promising results in reconstruction of rheumatoid hands. In this prospective clinical study we compared the PLDLA implant arthroplasty (n = 17) with that of tendon interposition (n = 12) for destruction of the trapeziometa...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章,随机对照试验
doi:10.3109/2000656X.2012.669202
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:The internal mammary artery (IMA) is one of the most popular recipients for microsurgical breast reconstruction. However, it is often separated into sleeve-like layers when it is handled. This study tried to explain this unique behaviour of the IMA through histologic observation. METHODS:Nine pairs of IMAs ...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2015.1021815
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Premature sagittal synostosis (SS) can be surgically corrected using extensive cranioplasties or using less invasive methods, e.g. spring-assisted surgery (SAS). AIM:The aim of the present study was to perform a proper systematic review of springs in the treatment of SS. METHODS:A literature search was per...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章,评审
doi:10.3109/2000656X.2014.981268
更新日期:2015-06-01 00:00:00
abstract::Since the 1980s, prenatal detection of cleft lip with or without cleft palate (CLP) is possible with a transabdominal ultrasound. The improvement of prenatal detection has resulted in an increased demand for prenatal information and counselling. The aim of this study was to, by means of a questionnaire, evaluate how f...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2012.698416
更新日期:2012-09-01 00:00:00
abstract::The present study compared the height of the palatal vault in dental casts from 320 10-year-old children with unilateral cleft lip and palate (UCLP) operated on with the push-back technique according to Wardill-Kilner (W-K) with patients operated on with delayed hard palate closure (DHPC). The palatal height in patien...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2012.683796
更新日期:2012-09-01 00:00:00
abstract:INTRODUCTION:In our study, we aimed to search and compare the effects of valsartan and enalapril on the pathological scar formation on the basis of histomorphological parameters. MATERIALS AND METHODS:Nine New Zealand albino male rabbits, which were divided into three groups, were included in the study. A previously d...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.1080/2000656X.2020.1814312
更新日期:2020-12-01 00:00:00
abstract::We compared an uncemented joint replacement (Elektra) with trapeziectomy (with ligament reconstruction and tendon interposition, LRTI) for the treatment of primary osteoarthritis in the first carpometacarpal joint (CMC1) in a randomised controlled trial. Forty patients were included (20 in each group) and followed for...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章,随机对照试验
doi:10.1080/2000656X.2019.1635490
更新日期:2019-12-01 00:00:00
abstract::Breast ptosis commonly develops in response to ageing and breastfeeding. Clinical studies now focus on both filling the upper pole of the breast with parenchymal flaps and long-term maintenance of the breast projection without recurrence of upper pole concavity and a significant change in breast shape over time. This ...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2012.753080
更新日期:2013-09-01 00:00:00
abstract::Dog bites to the hand and forearm are common. Although bites are usually minor, aggressive dogs may cause extensive bites developing to a public health problem. In a database review of dog bites to the hand applied to Emergency Department or to the Department of Hand Surgery in Malmö, Sweden 2008-2009, we found 81 cas...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2011.558735
更新日期:2011-04-01 00:00:00
abstract::We present a case of post-traumatic osteonecrosis of the lunate after fracture of the distal radius. Post-traumatic osteonecrosis of the carpal lunate after a fracture of the distal radius has, to our knowledge, not been reported previously. We treated the patient with vascularised bone graft from the distal radius, w...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2013.812763
更新日期:2014-12-01 00:00:00
abstract::Abdominal wall hernias are often diagnosed on clinical examination or encountered intraoperatively during an abdominoplasty. The aim of this study is to evaluate the long-term results of the use of dermal automesh for the repair of incidental hernias during abdominoplasty operations, and to perform a comparative analy...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2014.976571
更新日期:2015-06-01 00:00:00
abstract::The rate of margins involvement and the associated recurrence risk in basal cell carcinomas (BCCs) varies widely in published works (7%-25% and 26%-67%, respectively). This study investigated the risk factors associated with incomplete excision and their relevance in surgical management when positive margins occur in ...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2013.800526
更新日期:2014-02-01 00:00:00
abstract::We present three patients with major defects of the eyelid who subsequently had them reconstructed. They included a defect of the lateral upper lid, a defect of the medial upper and lower lids, and a defect of the medial lower lid, cheek, and nose. ...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/02844311.2010.504072
更新日期:2011-02-01 00:00:00
abstract::Encephalocraniocutaneous lipomatosis (ECCL) is a rare neurocutaneous syndrome that include skin, ocular, and neurological disorders. This study describes the case of a 16-year-old girl that came to observation for the treatment of a congenital alopecia causing great psychological distress. After two expansion procedur...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2013.842293
更新日期:2014-12-01 00:00:00
abstract::The accurate diagnosis of ulnar collateral ligament (UCL) injuries of the thumb is important in identifying patients requiring surgery. Stener lesion, the most severe form of such injuries, is debilitating and leads to chronic instability if misdiagnosed. We evaluated the diagnostic accuracy of ultrasonography (USS) i...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.1080/2000656X.2020.1838295
更新日期:2020-11-06 00:00:00
abstract::Mycobacterium marinum infection of the hand is rare. We report the case of a 39-year-old man with M marinum infection that resulted in a chronic soft tissue infection, extensor tendon synovitis, and arthritis of the metacarpophalangeal (MCP) joints. The cause was probably tropical freshwater fishes. ...
journal_title:Journal of plastic surgery and hand surgery
pub_type: 杂志文章
doi:10.3109/2000656X.2013.779801
更新日期:2013-12-01 00:00:00