Abstract:
BACKGROUND:Although postoperative monitoring of microsurgical reconstruction is key to discovering early vascular compromise, monitoring a buried flap can be problematic. METHODS:A single surgeon's tracheal and pharyngoesophageal reconstructions with fasciocutaneous free flaps performed between 2002 and 2007 are reviewed, and different monitoring techniques are described. RESULTS:Eighty-six cases of pharyngoesophageal and eight tracheal reconstructions were identified. The anterolateral thigh flap was used in 78 patients and the radial forearm flap was used in 16 patients. Three different monitoring techniques were used. In group I, a component of the flap used for neck resurfacing simultaneously served as a monitoring segment in 59 patients. No flap compromise or failure occurred. In group II, either an implantable or handheld Doppler device was used to monitor a completely buried flap in 29 patients. The implantable Doppler had a false-positive rate of 31 percent, leading to unnecessary surgical exploration. One case each of unrecognized flap loss occurred with the implantable and handheld Doppler methods. In group III, a segment of tissue separate from the main flap but sharing the same source vessels was temporarily externalized for monitoring and removed before patient discharge in six patients. This technique was also used in a patient with an anterolateral thigh flap for temporal reconstruction. There was no thrombosis or flap loss in these patients. CONCLUSIONS:Temporarily externalizing a segment of tissue is an easy and reliable method for monitoring a buried fasciocutaneous free flap. It is important, however, to avoid obstruction at the perforator level beyond the common source vessels.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Ferguson REH Jr,Yu Pdoi
10.1097/PRS.0b013e318196b9a3subject
Has Abstractpub_date
2009-02-01 00:00:00pages
525-532issue
2eissn
0032-1052issn
1529-4242pii
00006534-200902000-00012journal_volume
123pub_type
杂志文章abstract::Prosthetic vascular complications such as exposure and infection represent one of the most challenging and devastating complications in surgery. Nineteen patients underwent a retrospective review of the efficacy of soft-tissue flap coverage in the management of vascular prostheses complications. These patients were di...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-06-01 00:00:00
abstract::The stage at diagnosis and the survival experience of 41 women who developed breast cancer after cosmetic breast augmentation were compared with those of all other patients with breast cancer (n = 13,246) diagnosed in Alberta from 1973 to 1990 (inclusive). The tumors in women with breast implants were smaller (65.9 pe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::The zygomatic ligaments (McGregor's patch) anchor the skin of the cheek to the inferior border of the zygoma just posterior to the origin of the zygomaticus minor muscle. The mandibular ligaments tether the overlying skin to the anterior mandible. Both these ligaments are obstacles to surgical maneuvers intended to ad...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198901000-00003
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the influence of hypertonic and hyperoncotic saline solutions on ischemia-reperfusion injury after free tissue transfer. METHODS:Twenty-eight Sprague-Dawley rats were used to design an inferior epigastric flap. After skin incision, microcirculation was investigated ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31817743a1
更新日期:2008-07-01 00:00:00
abstract::In the case of multiple fingertip reconstruction requiring toe transfer, double toes can be elevated in the syndactylic fashion with a single vascular pedicle for transfer, followed by separation a few weeks later. The biggest advantage of this procedure is that the problem of limitation of recipient arteries for mult...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract::This experimental study demonstrates that iontophoresis can be used to transport biologically active gentamicin into auricular cartilage. Fifty female New Zealand White rabbits were divided into three groups: live controls with unburned ears, live animals with burn-injured ears (deep or partial-thickness), and euthani...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::This study describes the treatment protocol for and the outcome of the management of complex wounds around total knee replacements. An analysis of 28 patients (29 knees) with complex defects who had surgery between January 1, 1986, and July 30, 1996, was performed. A specific management protocol was applied to each kn...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199911000-00012
更新日期:1999-11-01 00:00:00
abstract::Rule of thumb criteria for tongue-lip adhesion in the Pierre Robin anomalad have been formulated on the basis of a review of 38 cases. Babies with this anomalad who do not show a progressive gain in strength and weight after 7 days of nonoperative intensive care or who cannot be successfully extubated after 3 days sho...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198208000-00017
更新日期:1982-08-01 00:00:00
abstract:LEARNING OBJECTIVES:After reading this article, participant should be able to: 1. Describe the technique of replantation for very distal amputation of the digit and salvage procedures for venous drainage. 2. Perform single-digit replantation after viewing the videos. 3. Recognize appropriate cases for joint salvage tec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000006134
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Arteriovenous loops are an indispensable tool in free flap surgery when appropriate recipient vessels are missing. In this study, the authors analyzed whether the outcome differs when flaps were transferred simultaneously or subsequently after construction of arteriovenous loops. METHODS:Twenty-seven patien...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000282102.19951.6f
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:The financial reimbursement for breast reconstruction is perceived to be low. The authors evaluated the financial impact of providing breast reconstruction for an academic medical practice and health care system. METHODS:The authors examined the billing records for 97 patients undergoing postmastectomy brea...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181a0722d
更新日期:2009-05-01 00:00:00
abstract::This study investigated where leprosy affects the posterior tibial nerve and whether neurolysis is beneficial. Nine patients with bilateral posterior tibial leprous neuropathy with no sensorimotor recovery were studied. Preoperative sensory-muscle and nerve conduction velocity testing revealed the tarsal tunnel to be ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200106000-00012
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Narcotic pain medications are a significant component of most postoperative pain control regimens. Although they are usually effective, they produce several untoward side effects and sometimes provide inadequate analgesia. The continuous infusion of local anesthetic agents (via pain pump) has been used to su...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.prs.0000299372.91051.1b
更新日期:2008-03-01 00:00:00
abstract::We report the use of a gracilis myocutaneous flap from the same thigh to repair a defect of the lower leg. This could be a useful alternative in well selected cases. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197910000-00032
更新日期:1979-10-01 00:00:00
abstract::Surgical treatment of lymphatic malformations in the nasolabial region of children has produced disappointing results. Attempts to remove them through a preauricular incision have generally required a synchronous superficial parotidectomy in an attempt to prevent facial nerve injury. However, incomplete removal with t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199507000-00007
更新日期:1995-07-01 00:00:00
abstract::Although surgical release and reconstruction have been used extensively to treat severe postburn knee flexion contractures, the degree of correction is sometimes unsatisfactory, and the procedure is not exempt from significant complications. Based on the principle of slow, gradual external fixation distraction, we hav...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199304001-00036
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Lymphedema is a common and debilitating condition. Management options for lymphedema are limited and controversial. The purpose of this prospective study was to provide a preliminary analysis of lymphaticovenular bypass for the treatment of upper limb lymphedema in breast cancer patients. METHODS:Twenty pat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181e5f6a9
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Understanding and optimizing psychosocial functioning in children with craniofacial anomalies are essential components of their reconstructive care. This work compared parental perceptions to pediatric self-reported psychosocial functioning in children with craniofacial anomalies. METHODS:Two hundred twenty...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006388
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:The occipitocervicopectoral flap has a local skin pedicle in the occipital region, with the distal portion of the flap in the pectoral region. One disadvantage of the occipitocervicopectoral flap is its limited flap length. To overcome this disadvantage, a perforator supercharging technique was applied to en...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318244230b
更新日期:2012-04-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Understand the principles involved in canthal support for patients undergoing cosmetic and reconstructive surgery. 2. Understand the variations in surgical techniques required to perform canthal anchoring in differing patients. 3. De...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000066340.85485.DF
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Extensive spinal neoplasms are difficult to manage. Following resection, arthrodesis of the spine can be performed with instrumentation, but this often fails in the setting of radiation therapy. Use of the free fibula flap for anterior spinal fusion to correct deformities has been described in multiple studi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31820cf4a6
更新日期:2011-05-01 00:00:00
abstract::Xeroradiography, because of its unique phenomenon of "edge enhancement," has some advantages for assessing facial fractures. In 17 of the 19 patients in our pilot study group, this technique was as valuable as, or more so than, plain films. The xerogram done prior to laminagraphy is a useful "map" for the radiologist ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197808000-00008
更新日期:1978-08-01 00:00:00
abstract::A method for measuring skin removed during rhytidectomy is presented based on analysis of 50 female patients. More skin was removed in primary rhytidectomies than in subsequent ones. Younger patients, aged 30 to 39 years, had measurably more skin removed than any other group between 40 and 69. The amounts of skin remo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198204000-00005
更新日期:1982-04-01 00:00:00
abstract::We present a case of occupation-related carcinoma of the scrotum (chimney sweeper's disease) in a black man. The history of this disease is outlined. ...
journal_title:Plastic and reconstructive surgery
pub_type: 历史文章,杂志文章
doi:
更新日期:1978-02-01 00:00:00
abstract:SUMMARY:Gynecomastia, or persistent enlargement of the male breast, is a common occurrence during early sexual development. Typically, two types of tissue can be identified during this period of growth. Initially, a dense fibrous growth of supporting stroma and breast tissue forms directly under the areola, creating a ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181aa2dc7
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:There have been relatively few articles in the English language on secondary Middle Eastern rhinoplasty. This article analyzes the cause and treatment of secondary Middle Eastern rhinoplasty. METHODS:A prospective study of 40 consecutive female secondary Middle Eastern rhinoplasty patients was completed. R...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181babcd1
更新日期:2009-11-01 00:00:00
abstract::A 7-year-old girl who was unable to flex her left thumb at the interphalangeal joint proved to have an extremely hypoplastic flexor pollicis longus with normal thenar muscles, which is very rare. The flexor digitorum superficialis of the ring finger was transferred to the inserting portion of the flexor pollicis longu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198503000-00021
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND:The purpose of the study was to investigate the morphologic changes of distraction osteogenesis performed on the mandible in growing minipigs. METHODS:Eighteen piglets were divided into four groups. In group A (n = 6), animals received unilateral osteotomy and the distractor device was activated for 2 weeks...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000163326.63031.30
更新日期:2005-06-01 00:00:00
abstract::Currently, spinal cord stimulation is used to treat ischemia and ischemic pain, with the best results observed in vasospastic cases. It was earlier demonstrated that spinal cord stimulation may attenuate experimentally induced vasospasm in an island flap in the rat. The present study was designed to investigate whethe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199904040-00018
更新日期:1999-04-01 00:00:00
abstract::The objective of this retrospective follow-up study was to evaluate the outcome of patients with soft-tissue sarcoma treated by the authors' protocol, which consists of a selective combination of conservative surgery and radiotherapy. Patients who relapsed were especially evaluated to improve treatment results. The au...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000095946.90511.1D
更新日期:2004-01-01 00:00:00