Intramuscular perforator dissection with the hydrodissection technique.

Abstract:

BACKGROUND:Perforator flap breast reconstruction requires increased time for safe perforator dissection, especially the intramuscular course. We describe an adjunctive technique using hydrodissection to assist with the intramuscular perforator dissection. METHODS:Hydrodissection techniques were used for perforator dissection in 45 consecutive patients (64 flaps) undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction. These patients were compared with 39 patients (55 flaps) immediately prior to the use of this technique. The study time frame was between March 2008 and March 2010. Patient demographics, complications, and operative times were collected through an extensive chart review. RESULTS:There were no major differences in complications between groups; there were no flap losses encountered during this series, and fat necrosis rates were similar (9.4% with hydrodissection and 14.5% without, p = 0.41). Total operative time for bilateral reconstructions decreased by 59 minutes (p = 0.13) and 21 minutes (p = 0.57) for unilateral reconstructions with the utilization of hydrodissection, though this was not statistically significant. CONCLUSIONS:The use of hydrodissection to assist with intramuscular perforator vessel dissection is safe to perform, as there was no increase in complications. The procedures utilizing hydrodissection were faster, and surgeons using this technique found it easier to visualize the perforators and dissect through the intramuscular course.

journal_name

J Reconstr Microsurg

authors

Singhal D,Momoh AO,Colakoglu S,Qureshi A,Tobias AM,Lee BT

doi

10.1055/s-0032-1326738

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

45-9

issue

1

eissn

0743-684X

issn

1098-8947

journal_volume

29

pub_type

杂志文章
  • Microsurgical reconstruction of the hepatic and superior mesenteric arteries using a back wall technique.

    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

    authors: Yamamoto Y,Sugihara T,Sasaki S,Furukawa H,Furukawa H,Okushiba S,Nohira K

    更新日期:1999-07-01 00:00:00

  • Short-term response of a skeletal growth plate to heterotopic microvascular transfer.

    abstract::The capacity of the epiphyseal growth cartilage from the dog fibula to retain its growth potential after heterotopic transfer to a distal radial defect was investigated and compared to orthotopically transferred controls. Autoradiographs of the physes cultured in 3H-thymidine indicated continued proliferation of the g...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1007072

    authors: Nettelblad H,Randolph MA,Weiland AJ

    更新日期:1985-01-01 00:00:00

  • Free combined anterolateral thigh flap and vascularized iliac bone graft with double vascular pedicle.

    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

    authors: Koshima I,Fukuda H,Soeda S

    更新日期:1989-01-01 00:00:00

  • Characterization of neurotrophic activity in the silicone-chamber model for nerve regeneration.

    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

    authors: Danielsen N,Varon S

    更新日期:1995-05-01 00:00:00

  • Quantification of neutrophil adhesion to skeletal muscle venules following ischemia-reperfusion.

    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

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006829

    authors: Goldberg M,Serafin D,Klitzman B

    更新日期:1990-07-01 00:00:00

  • Blood flow in a chronic entrapment neuropathy model in the rabbit sciatic nerve.

    abstract::A model of chronic entrapment neuropathy in the rabbit sciatic nerve was developed to try to elucidate the pathogenesis of chronic nerve entrapment. A non-compressive Silastic cuff was wrapped around the nerve at the mid-thigh level in eight rabbits. A sham operation that only elevated the sciatic nerve was performed ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1000070

    authors: Aziz W,Firrell JC,Ogden L,Breidenbach WC

    更新日期:1999-01-01 00:00:00

  • Preclinical efficacy of slow-release bFGF in ischemia-reperfusion injury in a Dorsal Island skin flap model.

    abstract::The effect of slow-release basic fibroblast growth factor (bFGF) on ischemia-reperfusion injury was examined using an island skin flap model in rats. Paired rectangular island skin flaps were elevated on the dorsum of 30 Fischer rats. The flaps were subjected to 6 hours of ischemia. Before reperfusion the flaps were i...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0033-1343830

    authors: Wang Y,Orbay H,Huang C,Tobita M,Hyakusoku H,Myamoto M,Tabata Y,Mizuno H

    更新日期:2013-06-01 00:00:00

  • The impact of current immunosuppression strategies in renal transplantation on the field of reconstructive transplantation.

    abstract::Composite tissue allograft (CTA) transplantation, such as the clinical face and hand transplants, has now been performed in multiple centers across the world. The transplants have successfully treated complex injuries that have either failed conventional approaches or where autologous reconstruction could not restore ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,评审

    doi:10.1055/s-0031-1285988

    authors: Chang J,Davis CL,Mathes DW

    更新日期:2012-01-01 00:00:00

  • Female urethral reconstruction using a tubed rectus abdominis myocutaneous flap.

    abstract::We describe the novel use of a rectus abdominis myocutaneous flap for reconstruction of the female urethra following an oncological pelvic resection. Reconstruction of the female urethra from the bladder neck to external urethral orifice was successfully performed, avoiding the need for a urostomy. To our knowledge, t...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0032-1313771

    authors: Kozlow JH,Chang DW

    更新日期:2012-07-01 00:00:00

  • Blood flow and microcirculatory changes in an ischemia-reperfusion injury model: experimental study in the rabbit.

    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

    authors: Gürlek A,Schusterman MA,Evans GR,Gherardini G

    更新日期:1997-07-01 00:00:00

  • Vascularized nerve tube: an experimental alternative for vascularized nerve grafts over short gaps.

    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

    authors: Ozcan G,Shenaq S,Spira M

    更新日期:1993-11-01 00:00:00

  • Free vascularized fibula grafts in surgery of the upper limb.

    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

    authors: Yajima H,Tamai S,Ono H,Kizaki K,Yamauchi T

    更新日期:1999-10-01 00:00:00

  • Fasciocutaneous free flaps for hypopharyngeal reconstruction.

    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

    authors: Amin AA,Bassiouny M,Elsebai H,Riffat M,Fakhry S,Hewidi S,Khafagy M

    更新日期:2002-01-01 00:00:00

  • Nerve graft prefabrication: preliminary study.

    abstract::This study aimed to produce prefabricated nerve graft as effective as autologous nerve graft without donor site morbidity for repairing segmental nerve defects. Thirty rats were used and were separated into three groups. In the first group, vein graft excised from jugular vein was sutured to make a bridge between epin...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2008-1076087

    authors: Ulkur E,Karagoz H,Celikoz B,Turan P,Arbak S,Yapar M

    更新日期:2008-02-01 00:00:00

  • Extra and Intramuscular Distribution of the Thoracodorsal Nerve with Regard to Nerve Reconstruction Surgeries.

    abstract::Background The lateral branch of the thoracodorsal nerve (LBTN) is used for nerve transfer in facial, musculocutaneous, axillary nerve injuries and for irreparable C5, C6 spinal nerve lesions and accessory nerve defects. For a successful surgical outcome, the nerve to be used in nerve transfer should be of adequate le...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0036-1579541

    authors: Malalasekera A,Beneragama T,Kanesu S,Sahathevan V,Jayasekara R

    更新日期:2016-06-01 00:00:00

  • Vascularized orthotopic osteochondral transplantation of the canine proximal femur.

    abstract::Osteochondral vascularized proximal femoral allografts were orthotopically transplanted in five adult beagles (four experimental and one control). The experimental animals were placed on 0.1 mg/kg of FK506 intravenously for 7 days, and then converted to 1.0 mg/kg orally. Biopsies of the femoral heads were taken at 3 w...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2001-12701

    authors: Sotereanos NG,Varitimidis SE,Sewecke JJ,Sotereanos DG,Demeo PJ,Berger RA

    更新日期:2001-02-01 00:00:00

  • A Retrospective Study of an Updated and Traditional Surgical Approach of the Distally Based Sural Flap.

    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

    authors: Xu H,Cao X,Kiu-Huen S,Zhu Z,Chen J,Chi Z,Zhang Y

    更新日期:2020-09-17 00:00:00

  • The effect of ammonium sulfate injection on peripheral nerve.

    abstract::Local anesthetic drugs with prolonged nerve-block effect would have clinical application for postoperative or neuromatous pain relief. This study evaluated the possibility of peripheral nerve neurotoxicity by injection of 10 percent ammonium sulfate. Both intrafascicular and extrafascicular injection of 10 percent amm...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006418

    authors: Kobayashi J,Mackinnon SE,Langer JC,Hertl MC,Hunter DA,Tarasidis G

    更新日期:1997-08-01 00:00:00

  • Standardized templates for shaping the fibula free flap in mandible reconstruction.

    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

    authors: Matros E,Santamaria E,Cordeiro PG

    更新日期:2013-11-01 00:00:00

  • CO2 laser-assisted microvascular anastomosis: biomechanical studies and clinical applications.

    abstract::Experiments have been performed using CO2 laser-assisted microvascular anastomoses, and they demonstrated the following features, in comparison with conventional anastomoses: ease in technique; less time consumption; less tissue inflammation; early wound healing; equivalency of patency rate and inner pressure toleranc...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006783

    authors: Kiyoshige Y,Tsuchida H,Hamasaki M,Takayanagi M,Watanabe Y

    更新日期:1991-07-01 00:00:00

  • Single-stage reconstruction of the flexor mechanism of the fingers with a free vascularized tendon flap: case report.

    abstract::The reconstruction of the flexor tendon in zones I and II of a ring finger in a single stage, using a free vascularized tendon graft, is reported in a single clinical case. The flexor digitorum superficialis (FDS) tendon of the same finger was freely transferred based on a vascular branch off the ulnar vessels. The ul...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2006-931905

    authors: Cavadas PC,Mir X

    更新日期:2006-01-01 00:00:00

  • Tips and Outcomes of a New DIEP Flap Inset in Delayed Breast Reconstruction: The Dual-Plane Technique.

    abstract::Purpose The dual-plane deep inferior epigastric perforator (DIEP) flap inset technique is herein presented with tips for optimizing the aesthetic outcome in delayed autologous breast reconstruction after radiation therapy. Patients and Methods A total of 42 women who underwent microsurgical reconstruction with a free ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 临床试验,杂志文章

    doi:10.1055/s-0036-1581076

    authors: Gravvanis A,Kakagia D,Samouris G,Galani E,Tsoutsos D

    更新日期:2016-06-01 00:00:00

  • Denervation of Pacinian corpuscles: electron microscopic observations in the rat following nerve transection.

    abstract::Nerve transection using rat sciatic nerves was employed to observe morphologic changes in the periodic denervation of Pacinian corpuscles. During periods of from 1 to 20 weeks after surgery, a total of 15 corpuscles were obtained under the operating microscope and processed for morphologic analysis using light and ele...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1000101

    authors: Koshima I,Moriguchi T

    更新日期:1999-05-01 00:00:00

  • Successful management of foot drop by nerve transfers to the deep peroneal nerve.

    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

    authors: Nath RK,Lyons AB,Paizi M

    更新日期:2008-08-01 00:00:00

  • Regenerated Nerve Defects with a Nerve Conduit Containing Dental Pulp Stem Cells in Pigs: An Immunohistochemical and Electrophysiological Evaluation.

    abstract:BACKGROUND:Dental pulp stem cells (DPSCs) present an exciting new tool in the field of peripheral nerve regeneration due to their close embryonic origin. In this study, we examined their potential in pigs, using biodegradable collagen conduits filled with DPSCs. To our knowledge, this is the first time DPCSs are tested...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0035-1555751

    authors: Spyridopoulos T,Lambropoulou M,Pagonopoulou O,Birbilis T,Tsaroucha AK,Kouzi-Koliakou K,Botaitis S,Deftereou TE,Gaitanidis A,Pitiakoudis M

    更新日期:2015-09-01 00:00:00

  • Surgical tattooing as an aesthetic improvement in facial reconstruction with a free radial forearm flap.

    abstract::Free flaps are usually needed for the reconstruction of extensive facial burns, but the final result is often a poor texture and color match. The authors report a burn case managed with a radial forearm free flap. The aesthetic result was improved by surgical tattooing of the flap, including the appearance of a beard....

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006739

    authors: Coessens B,Van Geertruyden J,De Mey A

    更新日期:1993-09-01 00:00:00

  • Chronic Knee and Ankle Pain Treatment through Selective Microsurgical Approaches: A Minimally Invasive Option in the Treatment Algorithm for Refractory Lower Limb Pain.

    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

    authors: Pietramaggiori G,Sapino G,De Santis G,Bassetto F,Scherer S

    更新日期:2020-10-07 00:00:00

  • L-arginine reduces neointimal hyperplasia in cold-stored arterial allografts in a rabbit low-flow-through model.

    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

    authors: Dowd MB,Hemmrich K,Morrison WA

    更新日期:2007-08-01 00:00:00

  • Decellularized Nerves for Upper Limb Nerve Reconstruction: A Systematic Review of Functional Outcomes.

    abstract:BACKGROUND:This is a systematic review for evaluating the evidence for functional outcomes after decellularized nerve use in clinical setting. Decellularized nerves are allografts whose antigenic components have been removed, leaving only a scaffold that promotes the full regeneration of axons. METHODS:Literature rese...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,评审

    doi:10.1055/s-0035-1558463

    authors: Deslivia MF,Lee HJ,Adikrishna A,Jeon IH

    更新日期:2015-11-01 00:00:00

  • Radial forearm free flap for salvage of Achilles-tendon repair wounds.

    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

    authors: Chun JK,Margoles SL,Birnbaum JW

    更新日期:2000-10-01 00:00:00