Expanding the applications of the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for extensive defects.


BACKGROUND:The medial thigh is a well-hidden area. The two most common flaps from this area are the transverse upper gracilis (TUG) and profunda artery perforator (PAP) flaps. Herein, we explored the applications of combined TUGPAP flap to reconstruct large and complex defects in different regions. METHODS:Between November 2015 and May 2017, 28 patients who underwent reconstruction and extensive soft tissue coverage with the TUGPAP flap for the breasts, head and neck, and pelvi-perineal regions were included. The defects size ranged from 22 to 29 × 6-8 cm. All flaps were based on the two pedicles: the medial circumflex femoral artery for TUG flap and the profunda artery perforator for PAP flap. They were each anastomosed to a set of recipient vessels. A "Y"-shaped interposition vein graft (YVG) was used if only one recipient artery was available. RESULTS:The harvested skin paddle had dimensions ranged from 20 to 30 × 6-9 cm and all flaps survived completely. Postoperative complications included one case each of donor and recipient site seroma, and one case of wound dehiscence. They were all successfully managed conservatively. During an average follow-up period of 12.7 months, one patient reported permanent paresthesia in the donor site and another developed hypertrophic scar. All patients were able to resume daily activity without major concerns. CONCLUSION:The combined TUGPAP flap is a safe, effective, and a good alternative to the common workhorse flaps as it offers the potential for a large skin paddle and decent soft tissue volume with low donor site morbidity in a well-concealed area.






Ciudad P,Huang TC,Manrique OJ,Agko M,Sapountzis S,Nicoli F,Diya Sabbagh M,Pont LP,Moran SL,Chen HC




Has Abstract


2019-05-01 00:00:00












  • Free flap monitoring using an implantable anastomotic venous flow coupler: Analysis of 119 consecutive abdominal-based free flaps for breast reconstruction.

    abstract:PURPOSE:The purpose of this study is to evaluate the use of the venous anastomotic Flow Coupler in monitoring free flaps used for breast reconstruction in a consecutive series of patients. METHODS:Retrospective data were collected on patients undergoing free flap breast reconstruction from May 2012 to March 2014. The ...


    pub_type: 杂志文章


    authors: Kempton SJ,Poore SO,Chen JT,Afifi AM

    更新日期:2015-07-01 00:00:00

  • Reduction of reperfusion injury edema with corticotropin-releasing factor (CRF): a pilot study.

    abstract::Regulation of capillary permeability with ischemic reperfusion injury is a complex interaction between vascular endothelium and circulating blood factors. Corticotropin-releasing factor (CRF), a 41 -amino acid peptide CNS neurotransmitter known to modulate the pituitary-adrenal axis during stress response, has been sh...


    pub_type: 杂志文章


    authors: Whitney TM,Bentz ML,Johnson PC

    更新日期:1998-01-01 00:00:00

  • Treatment of fibrous dysplasia of the proximal femur by means of pedicled iliac crest bone graft: a case report.

    abstract::In this report, we present a case of treatment of fibrous dysplasia (FD) of the proximal femur with the pedicled iliac crest bone graft. An 18-year-old patient presented with hip pain and polyostotic dysplasia with involvement of the proximal femur and a history of pathological fracture. The patient was operated on us...


    pub_type: 杂志文章


    authors: Perea-Tortosa D,García-López A,Saura-Sánchez E,Aguirre-Pastor A

    更新日期:2011-01-01 00:00:00

  • Pharmacological thrombolysis: one more weapon for free-flap salvage.

    abstract::Despite the high success rate of free-tissue transfer, thrombosis still complicates 5-30% of cases. Meticoulous technique, careful vessel selection, and pharmacological prophylaxis are not always enough to avoid thrombosis. Early diagnosis and reintervention provide the only way to salvage a thrombosed free flap, in c...


    pub_type: 杂志文章


    authors: D'Arpa S,Cordova A,Moschella F

    更新日期:2005-01-01 00:00:00

  • Modified trichrome staining technique of the nerve to determine proximal nerve viability.

    abstract::Normal myelinated fibers are stained "red" by modified trichrome staining of the frozen section of the nerve. We have used this technique for rapid assessment of the anatomical integrity of the proximal nerve stump by identifying well-preserved myelinated fibers. This technique can also identify degenerating and degen...


    pub_type: 杂志文章


    authors: Meyer R,Claussen GC,Oh SJ

    更新日期:1995-01-01 00:00:00

  • The free vascularised fibular transfer as a definitive treatment in femoral septic non-unions.

    abstract::Free vascularised bone transfer (fibula, iliac crest, or rib) is an accepted method of bone grafting in malignant and non-union bone surgery. The vascular microanastomoses have transformed the bone healing by creeping substitution seen after non-vascularised grafting (a long and often insufficient process) into normal...


    pub_type: 杂志文章


    authors: Nonnenmacher J,Bahm J,Moui Y

    更新日期:1995-01-01 00:00:00

  • Experimental investigation of cross-nerve transfers relating to repair of brachial plexus avulsion injuries.

    abstract::There is a lack of agreement regarding the potential for peripheral nerve cells with short axons to regenerate and innervate the terminal end organs of nerve cells with long axons. We designed a study to evaluate experimentally the possibility of neurons to reconstitute much longer axonal segments. Twenty Wistar rats ...


    pub_type: 杂志文章


    authors: Battiston B,Guizzi P,Vigasio A,Brunelli G

    更新日期:1990-01-01 00:00:00

  • Eight years experience in crush and avulsion type finger amputation.

    abstract::Between July 1986 and July 1994, we studied 125 total finger amputations due to crush and avulsion type injuries at the Izmir Hand and Microsurgery Hospital. Of the 125 fingers replanted, 88 were successful, for a general survival rate of 70.4%. In the period between 1986 and 1991, we performed end-to-end anastomoses ...


    pub_type: 杂志文章


    authors: Ozerkan F,Ada S,Bora A,Kaplan I,Ademoglu Y

    更新日期:1995-01-01 00:00:00

  • Dual innervated index to thumb cross finger or island flap reconstruction.

    abstract::Partial volar amputations of the entire thumb pulp require soft tissue coverage that provides not only padding and protection for exposed bone and tendons, but also restoration of discriminative sensation. A modification of the radial sensory innervated cross finger flap from index to thumb is described, which include...


    pub_type: 杂志文章


    authors: Hastings H 2nd

    更新日期:1987-01-01 00:00:00

  • Experimental orthotopic small bowel transplantation: a revised model.

    abstract::Small bowel transplantation is emerging as an alternative treatment for end-stage intestinal failure. To date, immunological and technical problems are still hampering clinical success. Functional experimental small bowel transplantation models have traditionally been plagued with a high technical complication rate. T...


    pub_type: 杂志文章


    authors: Scholten E,Werker PM,Green CJ,Kon M

    更新日期:1996-01-01 00:00:00

  • Double free-flap reconstruction of massive defects involving the lip, chin, and mandible.

    abstract::Two patients with massive, composite defects of the total lower lip, chin, and anterior mandible underwent double free-flap reconstruction. A fibular osteoseptocutaneous flap was used to reconstruct the mandible and floor of the mouth and a radial forearm fasciocutaneous composite flap, including the palmaris longus t...


    pub_type: 杂志文章


    authors: Kuzon WM Jr,Jejurikar S,Wilkins EG,Swartz WM

    更新日期:1998-01-01 00:00:00

  • Free and island flap transfer for soft tissue defects in the hand and forearm.

    abstract::Two hundred twenty patients with soft tissue defects in the hand and forearm were treated with 226 free and island flap transfers. Reconstructed sites involved the thumb in 74 cases, the fingers in 117, the hand in 30, and the forearm in 5. Seventy-nine patients received 82 free flaps, and 141 patients received 144 is...


    pub_type: 杂志文章


    authors: Yajima H,Tamai S,Fukui A,Ono H,Inada Y

    更新日期:1996-01-01 00:00:00

  • Changes in arterial blood flow of free flaps after the administration of sildenafil in swine.

    abstract::We evaluated blood flow changes after experimental free tissue transfer and the potential hemodynamic effect of sildenafil on the free flap. Sixteen swine were used for free transfer of a latissimus dorsi myocutaneous flap to the chest that was anastomosed to the internal mammary vessels, and were randomized into cont...


    pub_type: 杂志文章


    authors: Gravvanis A,Papalois A,Delikonstantinou I,Pentilas N,Zogogiannis I,Tsoutsos D,Karakitsos D

    更新日期:2011-09-01 00:00:00

  • Relationship between lymphatic and venous pressure in normal and lymphedematous rabbit ears.

    abstract::Studies of lymphatic and venous pressures of normal and lymphedematous rabbit ears reveal the end pressure of lymphatics to be higher than the venous pressure. Massage of the related rabbit ear increases the lymphatic pressures and can markedly raise the side and end pressures within the lymphatic wall. The venous pre...


    pub_type: 杂志文章


    authors: Huang GK,Hsin YP

    更新日期:1984-01-01 00:00:00

  • Continuous- and interrupted-suture technique in microsurgical end-to-end anastomosis.

    abstract::Microsurgical end-to-end anastomosis of the carotid artery of the rat is discussed. The continuous-suture technique is found to be less time consuming than the interrupted-suture technique. Comparison of the flow rate of each anastomosis doesn't reveal a marked difference. Patency rate of each technique is 100%. ...


    pub_type: 杂志文章


    authors: Firsching R,Terhaag PD,Müller W,Frowein RA

    更新日期:1984-01-01 00:00:00

  • The outcome of free tissue transfers in patients with hematological diseases: 20-year experiences in single microsurgical center.

    abstract:BACKGROUND:Free tissue transfers performed in patients with hematological diseases represent significant challenges for micro-surgeons. There are rare literatures that address the outcome in these patients. Therefore, we collected our database, analyzed the outcome, reliability, and related-management of microsurgical ...


    pub_type: 杂志文章


    authors: Lin PY,Cabrera R,Chew KY,Kuo YR

    更新日期:2014-10-01 00:00:00

  • A pedicled muscle flap based solely on a neural pedicle.

    abstract::We tested the hypothesis that the intrinsic vascular plexus of the motor nerve could support viability in a rat hindlimb muscle flap. In a preliminary study, we examined the course and vascularity of the sciatic nerve, the peroneal nerve, and the peroneous longus muscle in the rat hindlimb via anatomic dissection, mic...


    pub_type: 杂志文章


    authors: Avci G,Akan M,Akoz T,Kuzon W,Gul AE

    更新日期:2009-01-01 00:00:00

  • Lateral lower leg perforator flaps: an anatomical study to localize and classify lateral lower leg perforators.

    abstract::Despite increasing use of lateral lower leg perforator flaps, comprehensive anatomical data are still lacking. The aim of this article was to comprehensively document the pattern of usable lateral lower leg perforators. Systematic mapping of 16 cadaver leg perforators in a well-defined area was performed to elucidate ...


    pub_type: 杂志文章


    authors: Hupkens P,Schijns W,Van Abeelen M,Kooloos JG,Slater NJ,Ulrich DJ

    更新日期:2015-02-01 00:00:00

  • Reconstruction of a long defect of the ulnar artery and nerve with an arterialized neurovenous free flap in a teenager: A case report and literature review.

    abstract::There is evidence that nerve flaps are superior to nerve grafts for bridging long nerve defects. Moreover, arterialized neurovenous flaps (ANVFs) have multiple potential advantages over traditional nerve flaps in this context. This paper describes a case of reconstruction of a long defect of the ulnar artery and nerve...


    pub_type: 杂志文章,评审


    authors: Casal D,Pais D,Mota-Silva E,Pelliccia G,Iria I,Videira PA,Mendes MM,Goyri-O'Neill J,Mouzinho MM

    更新日期:2018-02-01 00:00:00

  • Experimental peripheral nerve repair: environmental control directed at the cellular level.

    abstract::This study recognizes recent advances in the understanding of the anatomy and physiology of peripheral nerves at the cellular level. It has reproduced study conditions originally advocated by de Medinaceli and coworkers, with modifications. Eighty-four rats were divided into three groups. Group A underwent sciatic ner...


    pub_type: 杂志文章


    authors: Zellem RT,Miller DW,Kenning JA,Hoenig EM,Buchheit WA

    更新日期:1989-01-01 00:00:00

  • Combined single-stage enterolysis with pedicle seromuscular bowel flaps, myocutaneous and fasciocutaneous flaps to repair recurrent enterocutaneous fistulas in complex abdominal Wall defects.

    abstract:INTRODUCTION:Reconstruction of abdominal wall defects with enterocutaneous fistulas (ECF) remains challenging. The purpose of this report is to describe a single-stage approach using combined microscopic enterolysis, pedicle seromuscular bowel flaps, mesh, fasciocutaneous, and myocutaneous flaps. METHODS:Between 1990 ...


    pub_type: 杂志文章


    authors: Adabi K,Manrique OJ,Vijayasekaran A,Moran SL,Ciudad P,Huang TCT,Nicoli F,Bishop S,Chen HC

    更新日期:2020-01-01 00:00:00

  • Meta-analysis of the effects of venous super-drainage in deep inferior epigastric artery perforator flaps for breast reconstruction.

    abstract:INTRODUCTION:Venous congestion is the most common vascular complication of the deep inferior epigastric artery perforator (DIEP) flaps. Adding a second venous drainage by anastomosing a flap vein and a recipient vein (super-drainage) is considered the solution of choice. Evidence to support this procedure, had not yet ...


    pub_type: 杂志文章,评审


    authors: Pignatti M,Pinto V,Giorgini FA,Lozano Miralles ME,Cannamela G,D'Arpa S,Cipriani R,De Santis G

    更新日期:2020-11-10 00:00:00

  • Current status of topical antithrombotic agents in microvascular surgery.

    abstract::Several technical advances over the years have allowed microsurgery to be successful. However, thrombosis, particularly at the anastomosis site, remains a complication of microvascular surgery. Various preventive measures, including drugs, have been used to improve microvascular surgical anastomotic patency rates. The...


    pub_type: 杂志文章,评审


    authors: Das SK,Miller JH

    更新日期:1994-01-01 00:00:00

  • An analysis of free flap failure using the ACS NSQIP database. Does flap site and flap type matter?

    abstract:PURPOSE:We sought to use the NSQIP database to determine the national rate and predictors of free flap failure based upon flap sites and flap types. METHODS:Free flaps were identified using the 2005-2010 NSQIP database. We examined overall flap failure rates as well as failure rates based upon flap sites (head and nec...


    pub_type: 杂志文章


    authors: Kwok AC,Agarwal JP

    更新日期:2017-09-01 00:00:00

  • Surgical treatment for total root avulsion type brachial plexus injuries by neurotization: a prospective comparison study between total and hemicontralateral C7 nerve root transfer.

    abstract:PURPOSE:We conducted a clinical study to evaluate the effects of neurotization, especially comparing the total contralateral C7 (CC7) root transfer to hemi-CC7 transfer, on total root avulsion brachial plexus injuries (BPI). METHODS:Forty patients who received neurotization for BPI were enrolled in this prospective st...


    pub_type: 杂志文章,随机对照试验


    authors: Tu YK,Tsai YJ,Chang CH,Su FC,Hsiao CK,Tan JS

    更新日期:2014-02-01 00:00:00

  • A second superior gluteal artery perforator flap with previous liposuction to the same breast after resection of initial SGAP breast reconstruction due to cancer recurrence.

    abstract::Free superior gluteal artery perforator (SGAP) flaps are a reliable option for breast reconstruction in patients with insufficient abdominal tissue or abdominal scarring. Liposuction in a donor site is a relative contraindication for harvesting a free flap, despite current case reports challenging this tenet. We descr...


    pub_type: 杂志文章


    authors: Avashia YJ,Desrosiers AE 3rd,Flores JI

    更新日期:2012-09-01 00:00:00

  • Evaluation of 389 patients following free-flap lower extremity reconstruction with respect to secondary refinement procedures.

    abstract:INTRODUCTION:Primary functional and aesthetic results after free-flap salvage of lower extremities are occasionally suboptimal. The objective of this study was to identify predictors for secondary refinement procedures such as liposuction, dermolipectomy, or direct excision. In addition, patient-reported long-term sati...


    pub_type: 杂志文章


    authors: Kotsougiani D,Platte J,Bigdeli AK,Hoener B,Kremer T,Kneser U,Harhaus L

    更新日期:2018-03-01 00:00:00

  • Spiral interrupted suturing technique for microvascular anastomosis: a comparative study.

    abstract::This is an experimental study comparing the suturing time and patency rate of a spiral interrupted suturing technique to those of conventional interrupted and continuous suturing technique in end-to-end as well as end-to-side anastomosis. The spiral interrupted suturing technique requires less time for either end-to-e...


    pub_type: 杂志文章


    authors: Chen L,Chiu DT

    更新日期:1986-01-01 00:00:00

  • Effect of isovolemic hemodilution with 3% albumin on thrombus formation at venous microanastomosis in rats.

    abstract::The present investigation was undertaken to evaluate the effect of isovolemic hemodilution with 3% albumin per se on the prevention of microvascular venous thrombosis, using an experimental model in rats mimicking the thrombotic mechanisms similar to those in clinical situations. Male Wistar rats were allocated into t...


    pub_type: 杂志文章


    authors: Farina JA Jr,Piccinato CE,Rossi MA,Mazzer N,Llorach-Velludo MA

    更新日期:2002-01-01 00:00:00

  • Free flap failure due to venous occlusion secondary to previous intravenous cannulation: a case report.

    abstract::A case of failure of a free radial forearm flap is presented. It is surmised that this was due to venous thrombosis in the cephalic vein which showed evidence of recanalization of an old thrombus. The patient had received intravenous erythromycin some months previously. ...


    pub_type: 杂志文章


    authors: Beckingham IJ,Wilson GR,McLean NR,Soames JV

    更新日期:1992-01-01 00:00:00