Abstract:
BACKGROUND:Morphomics are three-dimensional measurements of aspects of the human anatomy generated by computed tomographic (CT) imaging. The purpose of this study was to generate preliminary data on the efficacy of morphomics, as a potential risk stratification tool, in predicting abdominal donor site wound-healing complications in patients undergoing abdominal perforator flap breast reconstruction. Patients and METHODS:In total, 58 consecutive patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction were evaluated. Using preoperative CT scan data, we quantified patients' body area, visceral and subcutaneous fat, fascia area, and body depth between T12 and L4. Associations between morphomic measures and complication rates were examined using t-tests and logistic regression. RESULTS:Of the 58 patients, 11 (19%) patients developed a wound dehiscence and 47 (81%) patients healed their abdominal incision without complications. Patients with a dehiscence had a significantly higher body mass index (BMI) (34.32 vs. 29.26 kg/m(2), p = 0.014) than patients without a dehiscence. Multiple morphometric measures including higher visceral fat area (p = 0.003) were significant predictors of abdominal donor site wound dehiscence. BMI (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.03-1.32; p = 0.017) and visceral fat area (OR, 1.24; 95% CI, 1.08-1.42; p = 0.002) were independently significant predictors for wound dehiscence in the entire sample. Only visceral fat area retained its predictive ability in patients with a BMI > 30 kg/m(2). CONCLUSIONS:Morphomic measurements correlate with the likelihood of developing postoperative donor site dehiscence after DIEP flap breast reconstruction. As a proof of concept study, this demonstrates that objective data obtained from CT scans may help in preoperatively assessing the risk for donor site wound healing complications in patients undergoing DIEP flap breast reconstruction.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Levi B,Rinkinen J,Kidwell KM,Benedict M,Stein IC,Lisiecki J,Enchakalody B,Wang SC,Kozlow JH,Momoh AOdoi
10.1055/s-0034-1376400subject
Has Abstractpub_date
2014-11-01 00:00:00pages
635-40issue
9eissn
0743-684Xissn
1098-8947journal_volume
30pub_type
杂志文章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
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doi:10.1055/s-2007-1006829
更新日期:1990-07-01 00:00:00
abstract::This paper describes a new technique for microvascular anastomosis, which involves the overlapping of the adventitias of the two ends of a severed blood vessel, and then painting a cyanoacrylate adhesive on the outer surface of the vessel around the anastomosed part. Sixteen anastomoses were performed in both radial a...
journal_title:Journal of reconstructive microsurgery
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doi:10.1055/s-2004-824890
更新日期:2004-05-01 00:00:00
abstract::Twenty patients with intractable diseases in the upper extremity were treated using free vascularized fibula grafts. There were 13 men and seven women. Three patients had traumatic bone defects, five had post-traumatic nonunions, two had congenital pseudoarthroses, seven had defects after tumor resection, and three ha...
journal_title:Journal of reconstructive microsurgery
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doi:10.1055/s-2007-1000131
更新日期:1999-10-01 00:00:00
abstract::From August 1996 to June 2000, 33 free thoracoumbilical flaps were transferred to reconstruct a variety of soft-tissue defects. The size of the flaps ranged from 10 to 40 cm in length and 8 to 25 cm in width. The blood supply to the skin island came from the largest periumbilical perforator of the deep inferior epigas...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-820768
更新日期:2004-02-01 00:00:00
abstract::Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-833500
更新日期:2004-08-01 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::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:BACKGROUND:The anterolateral thigh (ALT) flap has been widely used in reconstruction of soft tissue defects. The anatomic variations of perforators increase the difficulties of flap elevation. The ABC system has been described for locating the most common three perforators in Western populations. Less evidence has been...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1343496
更新日期:2013-06-01 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::The authors report the application of the flow-through concept to a distally-pedicled radial forearm flap for simultaneous thumb revascularization and soft-tissue coverage. A distally-pedicled radial forearm flap was used to cover a skin defect at the base of thumb and thenar area. The flap artery (reversed radial art...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000206
更新日期:1998-10-01 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 anterolateral thigh (ALT) flap is now considered a workhorse for head and neck reconstruction in many centers. However, designing and raising the ALT flap has been traditionally recognized as being difficult, tedious, and technically demanding due to its variation in perforator anatomy. Designing the ALT flap on d...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0029-1234023
更新日期:2010-01-01 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::Instead of conventional multiple-paddle or folded free flaps, the authors introduce three types of free combined tissue transfers for cosmetic and functional restoration of massively large facial defects. Three cases reported here were repaired with combined flaps consisting of two or more tissues, such as combined fr...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000221
更新日期:1997-02-01 00:00:00
abstract::In recent years microvascular free tissue transfer has become a well accepted reconstructive technique. The current trend in flap research seems to be the development of more refined flaps to meet specific needs with minimal donor site morbidity. The internal oblique muscle provides a broad, thin, well-vascularized fl...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007012
更新日期:1986-01-01 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::A case of right lower-leg replantation after 42-hr ischemia is presented. Revascularization of the other foot with circulatory decompensation after 36-hr ischemia was carried out simultaneously. The replanted lower leg survived. Following its shortening in replantation by 12 cm, right lower-leg lengthening by 8 cm was...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006729
更新日期:1992-11-01 00:00:00
abstract::Microsurgical treatment of ring avulsion injuries is often difficult, due to widespread intimal damage of the digital vascular bundles. Thirty-one patients with such injuries in varying degrees were treated during the period 1986 to 1992: of these, 15 underwent microsurgical revascularization. In addition to the tradi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006475
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND: Secondary to vascular disease, oncological resection, or devastating trauma, lower extremity amputations are performed globally at a yearly rate exceeding 1 million patients. Three-quarters of these patients will develop chronic pain or phantom pain, which presents a functional limitation for prosthetic use...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0039-1700559
更新日期:2020-05-01 00:00:00
abstract::A method of fixation for replanted digits is described. It consists of axial fixation with a wire passed longitudinally through the replanted digit, supplemented with a transverse wire passed across all the digits. In this way, splinting is provided and rotation is controlled. The method is simple, rapidly applied, an...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007067
更新日期:1984-10-01 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::Multidetector-row computed tomography angiography (MDCTA) can be used to visualize small vessels and has been used to search for perforators in deep inferior epigastric artery perforator flaps and anterolateral thigh flaps. Fibula osteocutaneous flaps are often used for mandibular reconstruction, but questions remain ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0030-1267380
更新日期:2011-01-01 00:00:00
abstract::Although free vascularized iliac bone graft has been successfully used for the reconstruction of large bone defect with microvascular surgery, there is a serious problem of how to repair in one-stage, those cases having a large bone defect with a very wide skin defect. A free combined anterolateral flap and vasculariz...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006851
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:The authors presented their clinical experience and demonstrated surgical methods for reconstructing complex bone and soft tissue defects of the hand by using modified chimeric radial collateral artery perforator flaps. METHODS:Surgical procedures that employed 16 modified chimeric radial collateral artery ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0034-1390324
更新日期:2015-03-01 00:00:00
abstract::Conversion of the straight fibula bone flap into the parabolic mandible shape can be performed using customized acrylic templates made from a 1:1 mandible computed tomography scan and lateral cephalogram. The premise of the current study is to objectively quantify the variability in a series of acrylic templates used ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1356645
更新日期:2013-11-01 00:00:00
abstract::From 1991 to 1996, four free vascularized fibular grafts (FVFG) and four callus distraction (CD) techniques were performed for post-traumatic tibial defects at the authors' institute. They attempted to discern any differences of results between FVFGs and CDs for post-traumatic tibial defects. The mean defect length of...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2001-12684
更新日期:2001-01-01 00:00:00
abstract::Reconstruction of the pharyngoesophagus and pharynx can be especially challenging in patients with prior irradiation, recurrent disease, and compromised or deficient anterior neck skin. The authors report their experience with seven patients who underwent pharyngoesophageal reconstruction with a new flap design that a...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-932504
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:We present the clinical application of the sixth internal mammary artery perforator (IMAP) and superior epigastric artery perforator (SEAP) flaps for the treatment of defects resulting from the excision of large lower sternal and upper abdominal keloids. Perforator selection and flap design were based solely...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0035-1556078
更新日期:2015-11-01 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
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更新日期:2019-03-01 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