Abstract:
:There is increased clinical use of computer-assisted design (CAD) and computer-assisted modeling (CAM) for osseous flap reconstruction, particularly in the head and neck region. Limited information exists about methods to optimize the application of this new technology and for cases in which it may be advantageous over existing methods of osseous flap shaping. A consecutive series of osseous reconstructions planned with CAD/CAM over the past 5 years was analyzed. Conceptual considerations and refinements in the CAD/CAM process were evaluated. A total of 48 reconstructions were performed using CAD/CAM. The majority of cases were performed for head and neck tumor reconstruction or related complications whereas the remainder (4%) were performed for penetrating trauma. Defect location was the mandible (85%), maxilla (12.5%), and pelvis (2%). Reconstruction was performed immediately in 73% of the cases and delayed in 27% of the cases. The mean number of osseous flap bone segments used in reconstruction was 2.41. Areas of optimization include the following: mandible cutting guide placement, osteotomy creation, alternative planning, and saw blade optimization. Identified benefits of CAD/CAM over current techniques include the following: delayed timing, anterior mandible defects, specimen distortion, osteotomy creation in three dimensions, osteotomy junction overlap, plate adaptation, and maxillary reconstruction. Experience with CAD/CAM for osseous reconstruction has identified tools for technique optimization and cases where this technology may prove beneficial over existing methods. Knowledge of these facts may contribute to improved use and main-stream adoption of CAD/CAM virtual surgical planning by reconstructive surgeons.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Matros E,Albornoz CR,Rensberger M,Weimer K,Garfein ESdoi
10.1055/s-0033-1358789subject
Has Abstractpub_date
2014-06-01 00:00:00pages
289-96issue
5eissn
0743-684Xissn
1098-8947journal_volume
30pub_type
杂志文章abstract::This is the first in a series of studies designed to investigate the simultaneous changes in blood flow and microcirculation in an island flap during ischemia, in an ischemia-reperfusion model in the rabbit. An island groin flap based on the inferior epigastric vessels was harvested in 17 rabbits. The flap was rendere...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006414
更新日期:1997-07-01 00:00:00
abstract::9-0 absorbable polydioxanone (PDS) has been compared to 9-0 nonabsorbable Prolene in order to evaluate any advantages of either suture in microvascular surgery. In each of 29 rats, one carotid artery was anastomosed end-to-end with PDS and the other with Prolene. Specimens were harvested 48 hr, 14 days, and three, and...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006833
更新日期:1990-07-01 00:00:00
abstract::The authors conducted a two-part study to determine whether transcutaneous oxygen pressure (TcPO (2)) and transcutaneous carbon dioxide pressure (TcPCO (2)) can be used to monitor flap viability after transplantation. The first part was an animal study in which TcPO (2) and TcPCO (2) were measured in 10 epigastric isl...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-985208
更新日期:2007-07-01 00:00:00
abstract::Achilles-tendon repair wounds are prone to breakdowns and secondary infections, compromising the integrity of the repair and the ultimate function of the repaired tendon. Unlike defects resulting from tumor excision, burns, or trauma, Achilles-tendon repair wounds have their own special considerations. The dissection ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-8389
更新日期:2000-10-01 00:00:00
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:BACKGROUND: Injury or compression of a sensory nerve is an under-reported source of disabling pain in the lower limb. It is known that peripheral nerve microsurgeons can reconstruct and rewire injured nerves to relieve chronic pain but this option remains not completely understood and ignored by most orthopaedic surgeo...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0040-1717100
更新日期:2020-10-07 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: 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 sur...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1649508
更新日期:2019-01-01 00:00:00
abstract::The authors present 20 microvascular flaps based on arteriovenous perfusion, harvested from the distal anterior forearm, and configured in three different designs. Indications were small palmar, dorsal, and commissural defects, when other conventional procedures were not available; problematic cases of open reduction ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000235
更新日期:1997-05-01 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::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::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
pub_type: 杂志文章
doi:10.1055/s-2007-1000131
更新日期:1999-10-01 00:00:00
abstract::Facial paralysis (FP) remains today one of the most disturbing cranial nerve disorders. The present study utilized the rat model of FP and examined a dual approach of combining the current microsurgical treatment of cross-facial nerve graft (CFNG) with local administration of insulin-like growth factor-I (IGF-I). The ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2001-16028
更新日期:2001-07-01 00:00:00
abstract::The use of an inferolateral extension technique of a groin flap has previously been reported. This technique involves harvesting an extended portion from the anterolateral thigh, including the lateral femoral cutaneous nerve (LFCN) and its accompanying vessels, attached to a groin flap via communications between the L...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0030-1263288
更新日期:2010-11-01 00:00:00
abstract::Background Although flap transfer is a popular reconstructive procedure with a high success rate, it is associated with a high complication rate and low salvage rate. During the past decade, negative-pressure wound therapy (NPWT) has been increasingly applied to facilitate flap transfer and salvage flaps threatened by...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1599076
更新日期:2017-06-01 00:00:00
abstract::In microsurgical arterial anastomoses, there are some occasions in which the diameter of the distal artery is much larger than that of the proximal one. A fish-mouth incision technique is useful when there is considerable size discrepancy. However, this method cannot be used when the distal artery is much larger than ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006576
更新日期:1994-03-01 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::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::Patient safety is defined as freedom from accidental or preventable harm produced by medical care. The identification of patient- and procedure-related risk factors enables the surgical team to carry out prophylactic measures to reduce the rate of complications and adverse events.The purpose of this review is to ident...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1693142
更新日期:2019-11-01 00:00:00
abstract::Perforator flaps based on either musculocutaneous or septocutaneous perforators are no longer a curiosity, but rather in the past decade have become "workhorse" soft tissue alternatives. Yet a keener understanding of their anatomy abetted by sophisticated imaging techniques has revealed other deep fascia perforators w...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1315777
更新日期:2012-10-01 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::A seven-year-old-boy received a digit replantation after 26 hours of warm ischemia and showed good recovery of motor and sensory functions. In the case reported, replantation was performed after a much longer ischemic time than had been considered an indication for the procedure in previous reports. Successful replant...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006977
更新日期:1987-01-01 00:00:00
abstract::Blood flow distribution in conventional and vascularized canine nerve grafts was analyzed. Between 4 and 6 days after operation, blood flow at both the fascicular (endoneural) and the nerve-sheath (epineural) levels was significantly greater in the nonvascularized nerve grafts than in their vascularized counterparts (...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007044
更新日期:1985-10-01 00:00:00
abstract::Orbital exenteration is a devastating procedure because of the social impact and psychological stress put upon the patient. Besides cancer ablative surgery, reconstruction after removal of the tumor constitutes a major problem and the final aesthetic result is quite important. Both obliteration of the orbital cavity a...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-956232
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Clinical diagnosis of sensory disturbances is extremely challenging, partly because the utility of sensory tests is questionable. Transection of C7 nerve root provides an objective assessment model to determine the diagnostic accuracy of sensory tests. The purpose of this study was to investigate the diagnos...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0034-1384819
更新日期:2015-01-01 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:BACKGROUND:Multiple studies have detailed promising smile restoration following gracilis free muscle transfer for facial reanimation but information detailing the potential complications is lacking. The aim of this study is to systematically review the literature to evaluate the reported complication rate associated wi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1555139
更新日期:2015-10-01 00:00:00
abstract::Controversy surrounds the question whether free flaps remain dependent for blood supply on their vascular pedicle or if there is an autonomization by neovascularization from the surrounding wound bed. This becomes important when flap shaping or repositioning are performed. Our study involved 23 patients who received a...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0028-1103500
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:The "neural loop" describes a digital artery passing through a digital nerve, after which both the structures progress distally to supply the digit. While rare, past descriptions refer to neural loops located around the common palmar digital arteries, with no reports of more distal loops. METHODS:We describ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1348899
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND: Subfascial anterolateral thigh (ALT) flap thickness can be problematic with regards to bulk, oral competence, shoe-fit, or as a potential source of recurrent wound breakdown. We have utilized distinct upper thigh fascial planes to fashion thin (suprafascial) or super-thin (periscarpal) ALT flaps to improve ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0037-1607426
更新日期:2018-03-01 00:00:00