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 addresses both the concerns of monitoring the internal skin tube and replacing the external neck skin with one flap. This design has two skin islands, one that is tubed and the other left flat. The authors call this design "the paddle flap" because together its two components resemble a paddle. The tubed portion resembles the "handle" of a paddle that is used for esophageal reconstruction, and the cutaneous paddle is then folded over the "handle" to provide external skin. The external skin portion of the flap not only provides an external monitoring segment but releases tension on the neck apron incision and may replace compromised native neck skin. The length of esophageal defects ranged from 4 to 11 cm and the anterior cervical skin requirements ranged from 4 x 2 cm to 10 x 12 cm. Follow-up has been between 18 months and 4 years. There were no partial or complete flap losses. All patients are currently tolerating an oral diet. There was one case of partial donor-site skin graft loss which was treated with re-grafting. There were two cases of stricture formation which were treated successfully with neo-esophageal dilatation. This new simple, versatile design of a cutaneous free flap addresses both concerns of monitoring the internal skin tube and dealing with compromised overlying skin in patients undergoing pharyngoesophageal reconstruction. The paddle flap design can be utilized with any thin cutaneous free flap and may offer an advantage when an external monitor is desired and anterior neck skin requires supplementation or replacement.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Agarwal JP,Stenson KM,Gottlieb LJdoi
10.1055/s-2006-932504subject
Has Abstractpub_date
2006-02-01 00:00:00pages
105-12issue
2eissn
0743-684Xissn
1098-8947journal_volume
22pub_type
杂志文章abstract::Four methods of nerve terminolateral neurorrhaphy (TLN) were studied in rat experimental model. In Group A, the distal end of a severed peroneal nerve was sutured end-to-side with an intact tibial nerve trunk, without removal of the tibial epineurium at the suture site. In Group B, the distal end of a severed peroneal...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1063938
更新日期:1997-01-01 00:00:00
abstract::This study examined the use of freeze-thawed muscle as a nerve graft material in Sprague-Dawley rats. In Group 1 (n = 4), the sciatic nerve was isolated and the incision immediately closed. In Group 2 (n = 4), a 5-mm segment of the nerve was removed and immediately replaced. In Group 3 (n = 50), a 5-mm segment of nerv...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006580
更新日期:1994-05-01 00:00:00
abstract::Background Our recent work has demonstrated that the native motor zone (NMZ) within a given skeletal muscle is the best site for muscle reinnervation. This study was designed to explore the outcomes of direct nerve implantation (DNI) into the NMZ of denervated sternomastoid (SM) muscle in a rat model. Methods The righ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0036-1592362
更新日期:2017-02-01 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: Increased rates of both breast cancer and obesity have resulted in more obese women seeking breast reconstruction. Studies demonstrate that these women are at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who underwent breast reconstr...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1055/s-0038-1627449
更新日期:2018-06-01 00:00:00
abstract::Multiple level amputation has been described as a contraindication to replantation. This is a case report of a patient with a double level amputation through the palm and forearm that was successfully replanted. Because of the need for multiple stages of reconstructive surgery, it was not clear until the end result th...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007016
更新日期:1986-04-01 00:00:00
abstract::Apolipoprotein E (apo E) is thought to mediate the reutilization of myelin cholesterol for nerve regeneration. Prior research suggests that apo E is not essential for nerve regeneration following a nerve crush injury. This study was conducted to determine if apo E is essential for nerve regeneration after nerve transe...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-33321
更新日期:2002-08-01 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::The posterior calf region is a useful donor site for skin or composite flaps including muscle and/or nerves. We reported the first clinical use of the lateral gastrocnemius perforating artery flap including a vascularized sural nerve in 2003. This flap was elevated based on a perforator arising from the lateral head o...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1064930
更新日期:2008-01-01 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::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::The subject of ischemia-reperfusion has commonly been studied in rat hindlimb models. Unfortunately, in these experiments, the ischemia procedures lack standardization. For this reason, the authors evaluated the reliability of rat ischemia models described in the literature using scintigraphy. The study comprised six ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-830005
更新日期:2004-07-01 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: Investigating correlations between clinical, instrumental, and genetic features of primary lymphedema (PL) with the aim to facilitate the diagnosis, the staging, and the management of this subgroup of patients. METHODS: A prospective observational study was conducted from September 2016 to May 2018, includ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0039-1698748
更新日期:2020-03-01 00:00:00
abstract::The use of a free compound rib-latissimus dorsi osteomusculocutaneous flap is described, for reconstruction of the tibia and soft tissue of the leg. The entire flap depends on the thoracodorsal artery for its blood supply. Dye injection studies of the artery demonstrated continuity between it and the intercostal arter...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007032
更新日期:1986-10-01 00:00:00
abstract::Reconstruction of defects or wounds of the distal third of the leg with exposed bone, tendon, or hardware is challenging. Free tissue transfer has allowed limb salvage in many cases but requires a relatively healthy and stable patient, long operative times, and a significant expense. Small and moderate-size wounds of ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1223847
更新日期:2009-09-01 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::The use of interposition vein grafts has been associated in the literature with a high complication and flap failure rate. Ninety-three vein grafts in 55 patients over a 46-month period were analyzed to evaluate the clinical reliability of vein grafts in a predominantly trauma patient population (37/55). Fifty-two art...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006446
更新日期:1996-01-01 00:00:00
abstract::This study compares the acute intraoperative arterial elongation technique with the interposition vein-graft method for the closure of small arterial gaps that cannot be repaired by undermining alone. Ten conditioned female mongrel dogs were divided into two groups: a vein graft interposition group and an acute expans...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006523
更新日期:1995-03-01 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::The authors present two cases in which the venous drainage of transferred flaps was compromised and the flaps were salvaged by vein grafts. Traditionally, once transferred free flaps had become congestive, surgeons would re-anastomose the thrombosed veins, and administer anticoagulants or carry out peripheral vessel d...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-815639
更新日期:2003-11-01 00:00:00
abstract::The authors performed anastomoses of small vessels with the Nd-YAG laser, comparing these with conventional suture anastomoses. Some arteries were sutured with 10-0 nylon with about eight suture sites, and others were held by stay sutures at three points with laser irradiation performed between them. Two surgeons perf...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-8399
更新日期:2000-10-01 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::This study used quantitative PCR in the murine model to compare the ability of a limb allograft vs. a comparable dose of marrow suspension to induce chimerism. Female C57Bl/6 mice received a vascularized hindlimb allograft, a comparable dose of 5 x 10 (6) donor bone marrow cells, or a standard dose (20 x 10 (6)) of ma...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-946716
更新日期:2006-07-01 00:00:00
abstract::Sixteen rats underwent two procedures to test the efficacy of oblique vs. transverse nerve repair. On the left, the peroneal nerve was transected at an oblique angle (30-degree) with subsequent oblique end-to-end repair performed. On the right, the peroneal nerve was transected at a transverse angle (90-degree) with s...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-36503
更新日期:2002-11-01 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::The anatomy of the ascending branch of the deep circumflex iliac vessels is reported. This vasculature allows the design of a musculoperitoneal flap, not exceeding 7 cm x 14 cm, together with an osteomusculocutaneous groin flap. The procedure is particularly useful, if resection of an intraoral carcinoma has included ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006848
更新日期:1989-01-01 00:00:00
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::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