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 review was conducted of subjects with coagulopathies or previous thrombotic events who underwent microvascular head and neck reconstruction. Outcomes studied were "flap-related complications" (arterial/venous compromise or flap loss) and "patient-related complications" (hematoma, deep venous thrombosis, pulmonary embolism, infection, stroke, or death). RESULTS: One hundred thirty-four microvascular flaps were performed in 117 subjects. Twenty-four subjects (20.5%) had a preoperative hypercoagulable condition and underwent 28 microvascular reconstructions. Twenty-three of 24 subjects had a previous thrombotic event, with five subjects identified with an inherited or acquired coagulopathy. All microvascular reconstructions were successful; however, complications occurred in 12 of 28 reconstructions (42.9%). Complications were "flap related" in four reconstructions (14.3%), "patient related" in nine reconstructions (32.1%), and both in one reconstruction (3.6%). Flap-related complications included small partial flap loss (n = 2), arterial compromise (n = 1), and venous compromise (n = 1), with all undergoing successful salvage. Patient-related complications included hematoma (n = 3), pulmonary embolism (n = 2), infection (n = 2), deep venous thrombosis (n = 1), and death (n = 1). Statistical analysis demonstrated that complications were more common in subjects with inferior vena cava filters (p = 0.06) and hematomas were associated with the use of therapeutic heparin infusion (p = 0.04). CONCLUSION: Microvascular head and neck reconstruction can be successfully performed in hypercoagulable subjects. However, patient-related complications remain a concern in these subjects.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Nguyen TT,Egan KG,Crowe DL,Nazir N,Przylecki WH,Andrews BTdoi
10.1055/s-0039-3401846subject
Has Abstractpub_date
2020-05-01 00:00:00pages
271-275issue
4eissn
0743-684Xissn
1098-8947journal_volume
36pub_type
杂志文章abstract::In a three-year-11-month-old girl, an excess big toe was transferred microsurgically to replace a congenital floating thumb. The reconstructed thumb was evaluated nine years after the transfer. It showed almost normal growth, compared with the contralateral side, and the aesthetic result was excellent. However, the pa...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006565
更新日期:1994-01-01 00:00:00
abstract::Injury to the radial nerve is not uncommonly associated with fractures of the humerus. Despite a considerable amount of information and literature regarding management of these associated injuries, a universally accepted algorithm for treatment remains elusive. This article assimilates the data and provides evidence-b...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1090623
更新日期:2008-11-01 00:00:00
abstract::Posttraumatic infected massive bone defects in lower extremities are difficult to repair because they frequently exhibit massive bone and/or soft tissue defects, serious bone infection, and excessive scar proliferation. This study aimed to determine whether these defects could be classified and repaired at a single st...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1348064
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND: Limb-threatening lower extremity traumatic injuries can be devastating events with a multifaceted impact on patients. Therefore, evaluating patient-reported outcomes (PROs) in addition to traditional surgical outcomes is important. However, currently available instruments are limited as they were not develo...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0040-1713669
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND: Face transplantation is a demanding operation requiring complex planning and expert technical performance. While the documentation of successes of the first transplants is impressive, there are lacunae in reporting of institutional protocols for other critical operation components, namely, immunosuppression...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0039-1691787
更新日期:2019-11-01 00:00:00
abstract::This study examined the efficacy of gene therapy on wound healing. The authors investigated whether delivery of the gene encoding a particular cytokine, known to be important in angiogenesis, could affect ischemic skin flaps. Anterior abdominal skin flaps, based solely on the epigastric artery and vein, were created i...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000196
更新日期:1998-08-01 00:00:00
abstract::The free extended lateral arm flap (ELAF) has gained increasing popularity thank to its slimness and versatility, longer neurovascular pedicle, and greater flap size when compared with the original flap design. The aim of this study was to assess the donor-site morbidity associated with this extended procedure. A retr...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1289165
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to identify whether intraoperative use of vasoactive medications increases the risk of free flap failure or complications through a systematic review and meta-analysis. MATERIALS AND METHODS:PubMed/MEDLINE, EMBASE, and Scopus databases were searched for studies published through...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1055/s-0035-1563381
更新日期:2016-02-01 00:00:00
abstract::The first clinical face allotransplantation was performed by Devauchelle et al in 2005, and currently 13 facial allotransplantations have been performed worldwide. Reports on almost half of the cases were published in the literature, focusing on technical details of facial allograft inset to the recipient face. There ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1272963
更新日期:2012-01-01 00:00:00
abstract::Radical resection of tongue and oropharyngeal carcinomas often results in complex defects that are challenging to reconstruct. Furthermore, remaining function should not be disturbed by the reconstruction. We introduce a new flap design and monitored swallowing and speech following reconstruction of complex oral defec...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1078691
更新日期:2008-04-01 00:00:00
abstract::The authors treated 14 patients (13 men and one woman), using a sensate radial forearm flap. Their ages at operation ranged from 27 to 67 years (mean: 52 years). Preoperative conditions were amputations in 10 cases, degloving injury in three, and crush injury in one. Reconstructive sites involved the thumb in nine cas...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-9375
更新日期:2000-11-01 00:00:00
abstract::Two patients with scleroderma, ischemic pain, non-healing digital ulceration, and digital arterial obstruction were successfully treated with peripheral sympathectomy and digital arterial reconstruction using a reversed small-caliber vein graft. Postoperatively, digital blood flow increased and ulceration healed in bo...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-30181
更新日期:2002-05-01 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:BACKGROUND: In 2017, our institution initiated a cadaver laboratory-based course dedicated to teaching reconstructive microsurgery indications, preoperative planning, and flap dissection. The goals of this study are to describe the demographics and experience of participants/instructors and to evaluate the learning obj...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0040-1716320
更新日期:2021-02-01 00:00:00
abstract::An experimental study was conducted using rat soleus muscles to characterize reinnervation of the denervated muscles by direct muscle neurotization. Also studied was whether there is any difference in the regeneration process between original (tibial) and foreign (peroneal) nerve neurotization. For functional evaluati...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-7349
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND: To determine the role of mechanical allodynia (MA) in predicting good surgical outcome for painful diabetic peripheral neuropathy (DPN). MATERIALS AND METHODS: Data of 192 patients with painful DPN were collected in this study, with 148 surgical patients and 44 patients in the control group. Both groups we...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1636938
更新日期:2018-07-01 00:00:00
abstract::The subject of ischemia-reperfusion has commonly been studied in rat hindlimb models. Unfortunately, in these experiments, the ischemia procedures lack standardization. For this reason, the authors evaluated the reliability of rat ischemia models described in the literature using scintigraphy. The study comprised six ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-830005
更新日期:2004-07-01 00:00:00
abstract::This study examined the use of freeze-thawed muscle as a nerve graft material in Sprague-Dawley rats. In Group 1 (n = 4), the sciatic nerve was isolated and the incision immediately closed. In Group 2 (n = 4), a 5-mm segment of the nerve was removed and immediately replaced. In Group 3 (n = 50), a 5-mm segment of nerv...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006580
更新日期:1994-05-01 00:00:00
abstract::In both vascular and microvascular surgery, there is a need for a non-thrombogenic, small-caliber, arterial substitute. Clinically, most vessel substitutes with diameters under 4 mm have low patency rates. An arterial conduit made from a biocompatible human acellular dermis may be useful as a small vessel conduit. The...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006491
更新日期:1996-07-01 00:00:00
abstract::Composite tissue transplantation has emerged as a viable alternative to prosthetics and complex reconstructive surgery. Thus far it is reserved for cases which cannot be effectively reconstructed and where it offers some benefits over prostheses. It has been used in the upper extremity with encouraging results and, mo...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-939928
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND: Investigating correlations between clinical, instrumental, and genetic features of primary lymphedema (PL) with the aim to facilitate the diagnosis, the staging, and the management of this subgroup of patients. METHODS: A prospective observational study was conducted from September 2016 to May 2018, includ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0039-1698748
更新日期:2020-03-01 00:00:00
abstract::The spinal cord cannot heal after severance because the central nervous system is "non-permissive" to the advancement of axons that regrow from presynaptic motoneurons. With the aim of overcoming paraplegia, the author has carried out extensive experimental research since 1980, first in rats and subsequently in monkey...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2001-18873
更新日期:2001-11-01 00:00:00
abstract::Systematic scanning electron microscopic observations of the healing mechanism in the endothelium of rat carotid arteries were carried out at the site of anastomosis. The site of needle holes and stitches are the main locations for thrombocyte adhesion and aggregation in normal vascular anastomosis. The repair process...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract::Multilayered tubes fabricated from human amnion were placed subcutaneously and/or longitudinally in contact with an axial artery and vein in rats. Histologic evaluation at the third postoperative week showed that the tubes had incorporated with the surrounding fibrovascular tissue. New capillary formation within the t...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006749
更新日期:1993-11-01 00:00:00
abstract::The feasibility of rat ear replantation and its inherent advantages as an experimental model have previously been demonstrated. The purpose of this study was to validate the technical feasibility of rat ear transplantation. To eliminate immunologic rejection as a complicating factor, highly inbred Lewis rats (strain L...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006636
更新日期:1993-01-01 00:00:00
abstract::The ideal monitoring tool to evaluate free flap success should be noninvasive, continuous, and reliable. A new device, the ViOptix Tissue Oximeter (ODISsey) based on near-infrared spectroscopy was evaluated in 30 patients undergoing autologous tissue perforator free flap breast reconstruction with continuous monitorin...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-974655
更新日期:2007-05-01 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::During the last seven years, 17 patients underwent microsurgical reconstruction of 14 hepatic and four superior mesenteric arterial systems following extended pancreatectomy or hepatectomy, and in living-related liver transplantations (LRLT). All microvascular anastomoses in this series were performed using a back wal...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000109
更新日期:1999-07-01 00:00:00
abstract::Techniques for autologous breast reconstruction have evolved to minimize donor-site morbidity and reduce flap-specific complications. When available, the superficial inferior epigastric artery (SIEA) flap represents the optimal method to achieve the former. However, many microsurgeons have been reluctant to adopt this...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0030-1249604
更新日期:2010-08-01 00:00:00
abstract::The lateral forearm flap is being increasingly used for covering minor-to-moderate-sized defects for which soft and thin skin is required. Within the framework of an anatomic study carried out on 28 cadaveric arms, the authors investigated the principal artery that supplies blood to this flap namely, the posterior rad...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-7537
更新日期:2000-01-01 00:00:00