Abstract:
BACKGROUND: The volume of the profunda femoris artery perforator (PAP) flap limits its indications to small- and medium-sized breast reconstructions after modified radical mastectomy for cancer. We report a modified PAP flap design, including not only a vertical extension that increases its volume but also the skin surface, which suits larger breasts requiring immediate or delayed breast reconstructions and compare the results with our horizontal skin paddle PAP flap experience. PATIENTS AND METHODS: In our center between November 2014 and November 2016, 51 consecutive patients underwent a PAP flap breast reconstruction following breast cancer. A retrospective analysis on the collected data was performed to compare 34 patients with a bra cup smaller than C who underwent 41 horizontal PAP flap procedures, with those (n = 17) of a bra cup greater than or equal to C who underwent 21 fleur-de-lys PAP flap procedures. Demographic, anthropometric, flap and surgical characteristics, postoperative complication rates, and hospital stay were compared between the two groups. RESULTS: The average flap weight was 480 g (range: 340-735 g) for the fleur-de-lys PAP flap group compared with 222 g (range: 187-325 g) for the horizontal PAP flap procedure (p < 0.001). The mean flap dimensions were 25 × 18 cm for the fleur-de-lys PAP flap group compared with 25 × 7 cm in the horizontal PAP flap group. No flap failure was observed in the fleur-de-lys PAP flap group compared with two flap failures secondary to venous thrombosis in the horizontal PAP flap group (NS). Three patients (14%) experienced delayed healing at the donor site compared with four patients (10%) in the horizontal PAP flap group (NS). CONCLUSION: The fleur-de-lys skin paddle design not only allows an increase of the horizontal PAP flap volume, but also increases the skin surface, with an acceptable donor site morbidity. For medium- or large-sized breasts, the fleur-de-lys PAP flap seems to be ideal when a DIEP flap-based reconstruction is contraindicated.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Hunsinger V,Lhuaire M,Haddad K,Wirz FS,Abedalthaqafi S,Obadia D,Derder M,Marchac A,Benjoar MD,Hivelin M,Lantieri Ldoi
10.1055/s-0038-1649508subject
Has Abstractpub_date
2019-01-01 00:00:00pages
8-14issue
1eissn
0743-684Xissn
1098-8947journal_volume
35pub_type
杂志文章abstract::When faced with venous insufficiency following replantation or free-tissue transfer, the surgeons' first choice is surgical repair. When repair is not possible, medicinal leeches may be applied to relieve congestion. However, leeches increase the possibility of infection through their gut contents, and there are times...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006511
更新日期:1995-01-01 00:00:00
abstract::Aberrant reinnervation of target organs caused by misdirected axonal growth at the repair site is a major reason for the poor functional outcome usually seen after peripheral nerve transection and repair. This study investigates whether the criss-crossing of regenerating rat sciatic nerve axons between tibial and pero...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-861524
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Reverse homodigital dorsoradial (RHD) flap has been developed to repair soft-tissue defects of the thumb. However, few articles have reported this flap with long-term follow-up. This retrospective study was designed to evaluate the RHD flap and investigate factors affecting sensory recovery. METHODS:From Fe...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0035-1548743
更新日期:2015-07-01 00:00:00
abstract::To evaluate the root neurotization properties of extraplexal donor nerves, an avulsion injury model of brachial plexus was created and repaired by C 3,4 nerve-root transfers in the rabbit. Eighteen rabbits were divided into three groups. In Group 1 (n = 6), the right C 5,6 nerve roots were avulsed and bridged by a ner...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2003-40583
更新日期:2003-05-01 00:00:00
abstract::In the present study, the authors reevaluated the temporal course and properties of neurotrophic activities present in the fluid accumulating in the silicone-chamber model for nerve regeneration. The fluid collected from silicone chambers was tested in four different dissociated neuronal cell cultures. Furthermore, th...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006537
更新日期:1995-05-01 00:00:00
abstract::Peripheral nerve injury may result in injury without gaps or injury with gaps between nerve stumps. In the presence of a nerve defect, the placement of an autologous nerve graft is the current gold standard for nerve restoration. The clinical employment of tubes as an alternative to autogenous nerve grafts is mainly j...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1333316
更新日期:2013-03-01 00:00:00
abstract::A practical use of personal digital cameras for taking digital photographs in the microsurgical field through an operating microscope is described. This inexpensive and practical method for acquiring microscopic images at the desired magnification combines the advantages of the digital camera and the operating microsc...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2003-42500
更新日期:2003-07-01 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::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::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::Traumatic damage to the common peroneal nerve due to sharp injury, gunshot wound, sciatic nerve tumor, radiculopathy, or hip replacement surgery may result in foot drop. We present an alternative strategy for reanimation of foot drop following deep peroneal nerve palsy, successfully restoring voluntary movement. Fourt...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0028-1082894
更新日期:2008-08-01 00:00:00
abstract:AIM:To understand the practical difficulties encountered while performing hepatic artery anastomosis by microsurgical technique in living donor liver transplantation. MATERIALS AND METHODS:We undertook a retrospective study of 10 cases of hepatic artery anastomosis done at the level of bifurcation of the right hepatic...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0032-1313763
更新日期:2012-07-01 00:00:00
abstract::The authors report eight microsurgical operations to repair soft tissue defects of the fingers using free neurovascular autografts taken from the lateral surfaces of digits 3 and 4. In seven cases, the transferred flaps survived, and one case resulted in necrosis of the transplant. Follow-ups were from one to 12 month...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006691
更新日期:1992-03-01 00:00:00
abstract::Recent articles have strongly emphasized the superiority of distal nerve transfers despite indefinite assessment. I would like to introduce the problems associated with functional evaluation following nerve transfers. ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1639369
更新日期:2018-11-01 00:00:00
abstract::Abdominal flaps have recently gained considerable popularity in breast reconstruction, and their importance and advantages have been widely accepted. Given the unreliability of the distal parts in these flaps and the advancement of microsurgery, many modifications and improvements have been made. To get a better under...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1289162
更新日期:2012-02-01 00:00:00
abstract::The effects of piracetam on flap survival, ischemia-reperfusion (I/R) injury, and vascular endothelial growth factor (VEGF) expression were evaluated in this study. Unipedicled epigastric flap model was used in 36 rats and was evaluated within 4 groups. The flap was elevated and untreated in Group 1. Postoperative pir...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1281523
更新日期:2011-09-01 00:00:00
abstract::The ascending branch of the lateral circumflex artery may be of potential value as an alternative recipient vessel in the free-flap transfer to hip region. The anatomy of the ascending branch of the lateral circumflex femoral vessels has been reviewed with regards to size, location, and length and on the basis of prev...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0030-1249321
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND: The distally based sural flap (DBSF) is one of the armamentarium in the lower limb reconstruction. However, the flap has not gained popularity due to concerns about its reliability and donor site morbidity. Based on the anatomy characterization, we combined and developed five modifications to improve the va...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0040-1716744
更新日期:2020-09-17 00:00:00
abstract::Ischemia/reperfusion (I/R) injury is one of the factors determining tissue survival in replantation and transplantation surgery. However, more than 20 methods have been used to evaluate I/R injury in muscle. The aim of this study was to examine I/R injury in muscle tissue in a model of composite tissue allotransplanta...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-823113
更新日期:2004-04-01 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::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::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: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::Although often a life-saving therapeutic maneuver, there is minimal data available that details the effects of intraoperative packed red blood cell transfusion (IOT) after microvascular free tissue transfer. The National Surgical Quality Improvement Program database was queried to identify all patients who underwent m...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0033-1357275
更新日期:2014-02-01 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::The authors' experiences with 34 free lower TRAM flap transfers, in which 19 primary reconstructions and 15 secondary reconstructions were successfully achieved, are reviewed. The free TRAM flap yielded better results than the pedicled TRAM flap in cases where reconstruction of the infraclavicular and anterior axillar...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006676
更新日期:1992-01-01 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:BACKGROUND: During reconstructive surgery, anterolateral thigh (ALT) flap harvest is challenging due to variation and uncertainty in perforator distribution. We performed a pilot study to identify the predictive value of catheter-based computed tomography angiography (C-CTA) and traditional CTA (T-CTA) in ALT perforato...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1672129
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Lymphedema leads to early deposition of adipose tissue. This may explain why conservative therapies such as complex decongestive therapy (CDT) and controlled compression therapy (CCT), as well as various forms of microsurgical reconstructions, cannot completely remove the excess volume in patients with a lar...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1549158
更新日期:2016-01-01 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