Abstract:
:Although the effectiveness of cooling in extending tolerable ischemia time is well-established experimentally, most free-flap surgeons are still concerned about this problem and try to limit the ischemic period to less than 1 hr. Clinically, contact-surface cooling has been used empirically to prolong the limits of ischemia time; however, its applications are unproven. It also remains unknown whether contact-surface cooling has detrimental effects on flap tissue, such as vessel spasm leading to thrombosis. The purpose of this study was to determine, in a clinical setting, if skin, muscle, and bone free flaps of considerable size could tolerate prolonged cold ischemia without adverse effects. Flap size, cold ischemia time, and surgical outcomes were studied in 189 consecutive free flaps. Microvascular thrombosis occurred in 5/378 (1.3 percent) of anastomoses. The overall flap complication/flap loss rate was 7/189 (3.7 percent). Mean ischemia time for all flaps was 2 hr and 6 min (range: 30 min to 5 hr, with one case at 6 hr and 8 min). The mean ischemia time for cases with flap complications was 2 hr 20 min, while ischemia time for cases with thrombosis averaged 2 hr 13 min. The one flap loss had an ischemia time of 1 hr 35 min. No statistically significant correlations existed between duration of ischemia time or duration of contact-surface cooling and the incidence of thrombosis, flap complication, or flap failure. Among the conclusions were that, within a 4-hr period of cold ischemia, the application of the surface-cooling technique is not detrimental to free flap surgery; thus, concern for ischemia, and especially the "no reflow" phenomenon, generally should not interfere with efficient and orderly free-flap surgery.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Shaw WW,Ko CY,Ahn CY,Markowitz BLdoi
10.1055/s-2007-1006613subject
Has Abstractpub_date
1996-10-01 00:00:00pages
421-4issue
7eissn
0743-684Xissn
1098-8947journal_volume
12pub_type
杂志文章abstract::Background Topical vasodilators are frequently used during free tissue transfer to prevent and treat vasospasm and microvascular thrombosis. A variety of agents have been studied and are available, yet most microsurgeons select an agent based on anecdotal evidence or personal training. Our aim was to review the litera...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1592191
更新日期:2017-01-01 00:00:00
abstract::Considerable controversy persists regarding the optimal technique for hypopharyngeal reconstruction. The ideal procedure should provide low mortality and morbidity, short hospitalization, a high success rate, few complications, and the greatest potential for neopharyngeal speech and deglutition. In this study, a varie...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-19702
更新日期:2002-01-01 00:00:00
abstract::Osteochondral vascularized proximal femoral allografts were orthotopically transplanted in five adult beagles (four experimental and one control). The experimental animals were placed on 0.1 mg/kg of FK506 intravenously for 7 days, and then converted to 1.0 mg/kg orally. Biopsies of the femoral heads were taken at 3 w...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2001-12701
更新日期:2001-02-01 00:00:00
abstract::Anatomic variations in branching pattern of axillary artery (AxA) are common and typically involve subscapular artery (SsA) and posterior circumflex humeral artery (PCHA). Several skin and muscle flaps are based on the branches of AxA. Furthermore, these branches are frequently used as recipient vessels in functioning...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1351354
更新日期:2013-10-01 00:00:00
abstract::A retrospective evaluation of the functional results after reconstructive treatment with levator scapulae transfer and scapulo-spinal fasciodesis by fascia lata slings for complete chronic trapezius palsy is presented. Five patients (ages 6 to 40 years) were operated on between 1988 and 1991 because of incapacitating ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006544
更新日期:1995-07-01 00:00:00
abstract::A continuous epidural bupivacaine infusion was used for anesthesia in 20 patients who underwent lower extremity free tissue transfer. In 60 percent of the patients, general anesthesia supplementation with nitrous oxide was used for comfort during prolonged lying on the operating table. In all cases, this technique pro...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006939
更新日期:1988-07-01 00:00:00
abstract::The use of growth factors in inducing angiogenesis and enhancing flap viability has provided promising results. Targeted gene therapy has evolved in hopes of increasing the longevity and effectiveness of these growth factor treatments. The purpose of this study was to examine the effect of preoperative treatment by va...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2005-915207
更新日期:2005-08-01 00:00:00
abstract::The purpose of the present study was to analyze our long-term results of lateral calcaneal artery flap transfer for hindfoot reconstruction. A total of four patients (average age, 48 years) underwent lateral calcaneal artery flap transfer. The etiologies were heat injury of the lateral malleolus in one patient and ski...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1078690
更新日期:2008-05-01 00:00:00
abstract::Background The lateral branch of the thoracodorsal nerve (LBTN) is used for nerve transfer in facial, musculocutaneous, axillary nerve injuries and for irreparable C5, C6 spinal nerve lesions and accessory nerve defects. For a successful surgical outcome, the nerve to be used in nerve transfer should be of adequate le...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0036-1579541
更新日期:2016-06-01 00:00:00
abstract::Background To date, only a few reports have been published on idiopathic lymphedema, and most of these are case reports. In this time, we performed a retrospective review of idiopathic lymphedema patients. Methods Forty patients presented with idiopathic lymphedema that was unrelated to surgery, injury, and medical co...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0036-1586257
更新日期:2017-01-01 00:00:00
abstract::Twenty-eight vascularized toe-joint transfers performed on 25 patients were reviewed. A number of different techniques were used: proximal interphalangeal joint or metacarpophalangeal joint reconstruction, one-stage double joint transfer, and interphalangeal thumb or trapezometacarpal joint replacement. Using these ty...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006819
更新日期:1990-07-01 00:00:00
abstract::A free-flap model in rats is presented, that consists of gracilis and semitendinosus muscles pedicled on the femoral vessels, in continuation with deep femoral and saphenous vessels. This flap was transferred to the contralateral side in 40 rats and yielded a 95 percent survival rate. The weight of the flaps averaged ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000175
更新日期:1998-05-01 00:00:00
abstract::An "off the shelf" vascular conduit for free flap surgery that remained patent until the flap is vascularized from the recipient bed would be useful to avoid autograft donor-site morbidity and reduce operation time. To date, no successful studies of microvascular prostheses in low-flow states exist. This study investi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-985210
更新日期:2007-08-01 00:00:00
abstract::The time course of revascularization of grafted nerves, and the possible dependence of this revascularization on the length of the graft are two related questions that are addressed. Survival of Schwann cells in the nerve graft and a timely revascularization must be seen as a precondition for an optimal regeneration p...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006938
更新日期:1988-07-01 00:00:00
abstract::A retrospective analysis of 100 consecutive patients undergoing free fibula harvest at the Mayo Clinic is presented. Every patient was analyzed by reviewing postoperative physical examination data. All patients were evaluated and followed in the early postoperative course by the physical medicine and rehabilitation se...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-7544
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND: Inherited coagulopathies and previous thrombotic events are often considered relative contraindications to microvascular reconstruction. We hypothesize that with planning, head and neck microvascular reconstruction can be successfully performed in hypercoagulable individuals. METHODS: A retrospective revie...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0039-3401846
更新日期:2020-05-01 00:00:00
abstract::The preoperative identification of perforators can facilitate the appropriate design of perforator flaps from the lower extremity. Although computed tomographic arteriography can now be considered the gold standard in this regard, this technology is not universally available or inexpensive, with a nonnegligible risk f...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0029-1220860
更新日期:2009-07-01 00:00:00
abstract::In this paper the authors describe and illustrate a rare anatomic variation of the ulnar artery, a superficial ulnar artery. The possible embryologic events responsible for this variation are discussed. In addition, they describe the surgical considerations that should be kept in mind when this abnormality is encounte...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000120
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND: Reconstruction of craniofacial bone defects is a primary focus of craniofacial surgery. Although autogenous bone grafts remain as the gold standard, alloplastic materials have also gained widespread popularity due to their off-the-shelf availability, ease of use, and durability. In addition to replacing the...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0037-1598254
更新日期:2018-06-01 00:00:00
abstract::In this study, the authors examined the effects of fibronectin and laminin on sciatic nerve regeneration in rats. Sixty-eight Sprague-Dawley rats underwent bilateral sciatic nerve transections and silicone tubulizations, with a 10-mm gap between the proximal and distal nerve stumps. Thirty rats (n=30) received 10 micr...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2003-44635
更新日期:2003-10-01 00:00:00
abstract::A case of degloving injury of the whole hand reconstructed by a combination of an anterolateral thigh (ALT) flap and a groin flap applied as a pedicled distant flap was reported. Despite complications of congestion of the ALT flap and superficial infection, both flaps were severed at 4 weeks after transplantation, and...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1278708
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Open injuries of the Achilles tendon, which can be complicated by skin and bone injuries, continue to be a great challenge for surgeons. This study aims to report our experience with treatment of open Achilles tendon defects, focusing on the injury mechanisms, soft tissue coverage and late complications. ME...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1358787
更新日期:2014-10-01 00:00:00
abstract::Successful reconstruction of diabetic ulcers using free flap surgery can prevent further amputation and promote limb salvage to maintain normal gait of the patient and increase the quality of life after surgery. To minimize the postoperative complication and days of stay in hospital, surgeons should thoroughly investi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0040-1714431
更新日期:2021-01-01 00:00:00
abstract::Vascularized periosteal graft is a frequently applied flap model for bone prefabrication studies due to its inhabitance of osteoprogenitor cells and osteoinductive potential. Various bones such as rib and fibula are reported as a potential source for the harvest of the periosteal flap in experimental studies on higher...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1301068
更新日期:2012-03-01 00:00:00
abstract::Ischemia-reperfusion is encountered in a wide variety of surgical situations. The damage resulting from ischemia-reperfusion may be due, in part, to the infiltration and activation of neutrophils into the reperfused tissue. The purpose of the study was to examine ischemia-reperfusion induced neutrophil activation in s...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006829
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND: Various reports suggest the augmentation of venous drainage through performing two venous anastomoses as a means of reducing the rate of thrombosis in free flap surgery. However, some suggest dual venous drainage may actually reduce venous blood flow velocity causing a potential risk for thrombosis. METHOD...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1055/s-0034-1372368
更新日期:2014-07-01 00:00:00
abstract::Four methods of nerve terminolateral neurorrhaphy (TLN) were studied in rat experimental model. In Group A, the distal end of a severed peroneal nerve was sutured end-to-side with an intact tibial nerve trunk, without removal of the tibial epineurium at the suture site. In Group B, the distal end of a severed peroneal...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1063938
更新日期:1997-01-01 00:00:00
abstract::Endorectal ileo-anal anastomosis has become a mainstay of continent bowel reconstruction after total colectomy. However, the procedure is often aborted because of lack of vessel length for the formation of the ileal pouch. The use of microsurgical techniques to lengthen mesenteric vessels and to allow completion of th...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006944
更新日期:1988-10-01 00:00:00
abstract::The authors' experience indicates that good functional results are achievable in cases with wide resection of the knee extensor mechanism. They report a low-grade myxoid fibrosarcoma patient in whom a one-stage functional reconstruction was carried out by transfer of a free latissimus dorsi flap without secondary surg...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2005-871749
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND: There is an increasing trend toward bilateral breast reconstruction. Using the National Surgical Quality Improvement Program (NSQIP) database, we sought to understand the association between unilateral and bilateral free flap breast reconstruction and operative time and flap failure. METHODS: We selected a...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1627445
更新日期:2018-07-01 00:00:00