John P. Kirby MD, FACS, is the Director of Wound Healing Programs, Associate Professor of Surgery, Section of Acute and Critical Care Surgery, at Washington University School of Medicine, Barnes-Jewish Hospital, in St. Louis, Missouri.
Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital and Department of Immunology and Microbiology (ISIM), University of Copenhagen, Denmark.
Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet and Department of Immunology and Microbiology (ISIM), University of Copenhagen, Denmark.
There is little debate regarding the workhorse flaps for soft-tissue defects in head and neck reconstruction. However, in certain circumstances, the workhorse flaps are not available or suitable, and ...
The author performed a retrospective review of a single-surgeon experience with alternate soft-tissue flaps performed over a 10-year period....
Overall, 156 alternate soft-tissue free flaps were performed in 155 patients. The distribution of free flaps was 60 ulnar artery perforator (UAP), 28 lateral arm perforator (LAP), 33 medial sural arte...
Reconstructive microsurgeons performing high-volume head and neck reconstruction may need to incorporate alternate donor sites into their armamentarium when the primary workhorse flaps are not suitabl...
Therapeutic, IV....
Radial forearm flap (RFF) is widely used in oral reconstruction. However, the donor-site defect remains the main limit. In this paper, V-shaped kiss RFF (VRFF) is described as a novel technique to imp...
A total of 21 patients who underwent VRFF for oral reconstruction, and 23 patients who underwent conventional RFF from February 2016 to April 2018 were included in this study. Direct comparisons were ...
No skin grafts were used in the VRFF group, and 20 of 21 patients achieved primary healing at donor site, while all patients from the RFF group had skin grafts. And 18 of 23 patients achieved primary ...
VRFF is able to provide a new and simple method to close donor-site defect and realize a better healing in donor site....
Reconstructing complex soft tissue defects of the finger requires both functional and aesthetic aspects. There are many free tissue transfers as suitable options for digital resurfacing. The anterolat...
From May 2009 to March 2018, 10 patients with complete circumferential or semicircumcision defects in the fingers underwent reconstructive procedures that included thinned ALT flap transfer. Finger so...
The ALT flap sizes, averaging 4-9 cm wide and 6-12 cm long, were thinned to 4-7 mm. One perforator was included in the flaps with a pedicle length average of 6.1 cm. The flaps survived entirely in all...
The small thinned ALT perforator flap can be an excellent option for full circumferential or semicircumferential soft tissue defects of the finger. Follow-up showed this as an excellent alternative fo...
Increased lifespan and the improvement of medical treatment have given rise to research in reconstructive procedures in elderly patients. Higher postoperative complication rates, longer rehabilitation...
Patients were divided into two groups (YOUNG 0-59 years; OLD > 60 years). The endpoint was the survival of flaps and their dependence on patient- and surgery-specific parameters using multivariate ana...
A total of 110 patients (OLD...
The results confirm that free flap surgery can be indicated as a safe method for the elderly. Perioperative parameters such as two flaps in one surgery and transfusion regimens must be considered as r...
Free flap reconstruction for postoperative tissue defects in oral and maxillofacial tumors is a critical component of reconstructive surgery. Identifying risk factors for flap necrosis is essential fo...
To explore the clinical outcome of a free great toe nail flap (GTNF) combined with a second toe tissue flap (STTF) for fully shaped finger reconstruction (FSFR). From January 2013 to January 20, 2019,...
Durable and resilient soft tissue reconstruction of vast defects of the extremities or the torso....
Reconstruction of disproportionately large defects, particularly in cases of simultaneous bone and joint reconstruction....
History of surgery or irradiation of upper back and axilla, impossibility of surgery under lateral positioning; relative contraindications in wheelchair users, hemiplegics, or amputees....
General anesthesia and lateral positioning. First, the parascapular flap is harvested, with the initial skin incision made medially in order to identify the medial triangular space and the circumflex ...
Postoperative anticoagulation with low-molecular-weight heparin under anti-Xa monitoring (semitherapeutic in normal-risk and therapeutic in high-risk cases). Hourly clinical assessment of flap perfusi...
Between 2013 and 2018, 74 conjoined latissimus dorsi and parascapular flaps were transplanted to cover vast defects of the lower (n = 66) and upper extremity (n = 8). The mean defect size was 723 ± 48...
Free flaps are widely used for the repair of soft tissue defects in the lower limbs, but there is still a specific rate of necrosis. Few clinical retrospective studies have analyzed the nontechnical r...
Clinical data from 244 cases of soft tissue defects of the leg or foot that were repaired with a free flap from January 2011 to June 2020 were retrospectively analyzed. The flap results were divided i...
Of the 244 flaps, 32 suffered from partial or total necrosis, and 212 completely survived. Univariate analysis showed that age, smoking history, soft tissue defect site, and time from injury to flap c...
The risk of flap necrosis was significantly increased when the soft tissue defect was located in the proximal leg, the time from injury to flap coverage was >7 days, and the patient had a moderate-to-...
Microsurgery has become standard of care for increasingly complex techniques in tissue harvest, replantation, reconstruction, allotransplantation, and supermicrosurgery on submillimetric vessels. As t...
The Symani Surgical System (Medical Microinstruments, S.p.A, Calci, Pisa, Italy), a robotic platform designed for microsurgery, was used in a robot-assisted microsurgical free flap reconstruction usin...
The procedure was completed successfully, with vessels fully patent immediately following and 20 minutes after anastomosis. The flap was viable, no re-exploration of the anastomosis was necessary post...
This novel, dedicated robotic platform with wristed microsurgical instruments was shown to be feasible for carrying out robot-assisted anastomosis of veins and arteries less than 0.8 mm in diameter, i...
Outcomes and cost of soft tissue versus bony midface free flap reconstruction (MR) with and without virtual surgical planning (VSP) were evaluated....
Retrospective review of MR including ischemic time (IT), operative duration (OD), length of stay (LOS), and total cost (TC). Eighty-one soft tissue and 76 bony MR (VSP = 23) were reviewed....
Bony MR was used for higher complexity defects (p = 0.003) and was associated with higher IT (p < 0.001), OD (p < 0.001), LOS (p = 0.032), and TC (p < 0.001). VSP was associated with a mean 111.2 ± 37...
Bony MR was used for higher complexity MR and was associated with increased TC, LOS, OD, and IT. VSP shortened OD with no significant increase in TC....
