Abstract:
:A variety of useful recipient sites exist for breast reconstruction with free flaps, and correct selection remains a significant decision for the surgeon. Among the main pedicles, the disadvantages of the internal mammary vessels are the necessity of costal cartilage resection and the impairment of future cardiac bypass. This study was designed to reduce morbidity and to seek alternative recipient vessels. In the anatomical part of the study, 32 parasternal regions from 16 fresh cadavers were used. The locations and components of internal mammary perforator branches were measured and a histomorphometric analysis was performed. In the clinical part of the study, 36 patients underwent 38 deep inferior epigastric perforator (DIEP) flap and two superior gluteal artery perforator flap breast reconstructions (31 immediate and four bilateral). The recipient vessels were evaluated. In the anatomical study, there were 22 perforating vessels, with 14 (63.6 percent) on the second intercostal space and 11 (50 percent) with one artery and vein. The average (+/-SD) internal and external perforator artery diameters were 598.48 +/- 176.68 microm and 848.97 +/- 276.68 microm, respectively. In the clinical study, 13 successful anastomoses (32.5 percent) were performed at the internal mammary perforator branches (second and third intercostal spaces) with 12 DIEP flaps and one superior gluteal artery perforator flap (all performed as immediate reconstructions). One case of intraoperative vein thrombosis and one case of pedicle avulsion during flap molding were observed. The anatomic and clinical studies demonstrated that the internal mammary perforator branch as a recipient site is a further refinement to free flap breast reconstruction. However, it is neither a reproducible technique nor potentially applicable in all patients. Preoperative planning between the general surgeon and the plastic surgeon is crucial to preserve the main perforator branches during mastectomy. The procedure was not demonstrable in late reconstructions. The main advantages of internal mammary perforator branches used as recipient sites are sparing of the internal mammary vessels for a possible future cardiac surgery, prevention of thoracic deformities, and reduction of the operative time by limited dissection. Despite this, limited surgical exposure, caliber incompatibility, and technical difficulties have to be considered as the main restrictions.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Munhoz AM,Ishida LH,Montag E,Sturtz GP,Saito FL,Rodrigues L,Gemperli R,Ferreira MCdoi
10.1097/01.prs.0000129074.88594.d7subject
Has Abstractpub_date
2004-07-01 00:00:00pages
62-8issue
1eissn
0032-1052issn
1529-4242pii
00006534-200407000-00012journal_volume
114pub_type
杂志文章abstract::When neurofibroma involves the face, it can lead to a most disfiguring, destructive, and debilitating condition. Because of the unique aesthetic and functional properties of the face, the surgeon might hesitate to remove all of the involved soft tissues and facial nerves in a radical procedure. Involvement of the cran...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200204010-00002
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:On January 1, 2011, New York State amended the Public Health Law to ensure that patients receive "information and access to breast reconstruction surgery." The purposes of this study were to investigate the early impact of this legislation on reconstruction rates and to evaluate the influence of patient vari...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000888
更新日期:2015-02-01 00:00:00
abstract::A retrospective study was undertaken to assess speech outcomes in patients undergoing Furlow palatoplasty. Since 1994, the authors have used the position of the levator veli palatini musculature to determine type of surgical intervention recommended for the management of velopharyngeal insufficiency. Furlow palatoplas...
journal_title:Plastic and reconstructive surgery
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doi:10.1097/00006534-200107000-00004
更新日期:2001-07-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318182370b
更新日期:2008-09-01 00:00:00
abstract::This investigation suggests that free autogenous grafts, when placed in preformed silicone rubber pseudosheath pockets, will survive as well, if not better, than in delayed or immediate surgical pockets. This supports the clinical assumption that silicone rubber implants can be used and exchanged periodically for larg...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197612000-00008
更新日期:1976-12-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004327
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Free sensate thoracodorsal artery perforator flaps that include the posterior divisions of the lateral cutaneous branches of the intercostal nerves have been described. The authors used preoperative color Doppler sonography to identify the nerves and demonstrate its clinical value. METHODS:Fourteen free sen...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181909c34
更新日期:2009-01-01 00:00:00
abstract::Fewer than 100 cases of desmoid tumor of the breast have been reported. We report the first recorded case of desmoid associated with silicone gel-filled implants. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006022
更新日期:2019-10-01 00:00:00
abstract::Breast-conserving therapy is widely accepted as an appropriate method of primary treatment of T1 and T2 breast cancers that measure up to 5 cm. For safe and cosmetically acceptable breast-conserving therapy in patients with larger breast cancers, the tumor volume has to be reduced preoperatively, and lost tissue volum...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2004-05-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318205f41b
更新日期:2011-03-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:Although much has been published with regard to the columella assessed on the frontal and lateral views, a paucity of literature exists regarding the basal view of the columella. The objective of this study was to evaluate the spectrum of columella deformities and devise a working classification system based...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000022
更新日期:2014-04-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000775
更新日期:2015-01-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000210679.77449.7d
更新日期:2006-05-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/PRS.0000000000001772
更新日期:2015-12-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181881f70
更新日期:2008-11-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000304600.23129.d3
更新日期:2008-04-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 共识发展会议,杂志文章
doi:10.1097/PRS.0b013e3182a80586
更新日期:2013-12-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000101505.66716.DF
更新日期:2004-02-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/00006534-200203000-00027
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Le Fort III osteotomy represents the foundation of surgical correction for midface hypoplasia. One serious complication of Le Fort III osteotomy is severing the internal maxillary artery or its branches during osteotome advancement for pterygomaxillary dysjunction. This study sought to characterize the relev...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003084
更新日期:2017-03-01 00:00:00
abstract::Guided bone regeneration is a promising means for reconstructing bone defects in the cranium. The present study was performed to better define those factors that affect osteogenesis in the cranium. The authors studied a single animal model, investigating the contribution of the dura, the pericranium, and the adjacent ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000070728.56716.51
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:The major intrinsic cause of facial skin degeneration is age, associated with extrinsic factors such as exposure to sun. Its major pathologic causes are degeneration of the elastin matrix, with loss of oxytalan and elaunin fibers in the subepidermal region, and actinic degeneration of elastin fibers that los...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/PRS.0000000000006867
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Reestablishment of the peripheral nervous system occurs in parallel with wound healing. With accelerated wound healing seen with the vacuum-assisted closure device, the authors studied its effects on nerve fiber regeneration, nerve sprouting, and the stimulation of neuropeptides and neurotrophins. METHODS:A...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181da86d0
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:The maxillary artery is recognized as the main vascular supply of the facial bones; nonetheless, clinical evidence supports a codominant role for the facial artery. This study explores the extent of the facial skeleton within a facial allograft that can be harvested based on the facial artery. METHODS:Twent...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000111
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Distraction osteogenesis has widespread clinical use in the treatment of congenital and acquired craniofacial deformities. Nonetheless, during the prolonged consolidation period, the newly regenerated bone carries the risk of complications. A known method for enhancing bone healing is extracorporeal shock wa...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004980
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Breast reconstruction is most frequently performed using implants or expanders. Adjunctive materials such as acellular dermal matrix and synthetic meshes are used to support the implant or expander. A paucity of large studies exist on the use of synthetic mesh for breast reconstruction. METHODS:A retrospect...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007384
更新日期:2020-12-01 00:00:00
abstract::Fourteen patients with uncontrolled drooling were treated with bilateral excision of the submaxillary glands and either transfer or ligation of the parotid ducts. In this small series, all had good results but the duct ligation group was slightly better. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197810000-00004
更新日期:1978-10-01 00:00:00
abstract::The fibula osteoseptocutaneous flap is a workhorse flap for bone reconstruction. Mastery of the flap is essential for a rewarding reconstruction. However, there is no complete work on this versatile flap. The authors provide a concise review of the literature, address the myths and challenges associated with the flap,...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000005065
更新日期:2018-12-01 00:00:00