Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Jul 2004
Perforator flap breast reconstruction using internal mammary perforator branches as a recipient site: an anatomical and clinical analysis.
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. ⋯ 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.
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Plast. Reconstr. Surg. · Jul 2004
Letter Case Reports"Chunni burn": a rare mode of clothing-induced friction burn.
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Plast. Reconstr. Surg. · Jun 2004
Case ReportsImportance of additional microvascular anastomosis in esophageal reconstruction after salvage esophagectomy.
Esophageal reconstruction after salvage esophagectomy in patients who have undergone curative-intent chemoradiotherapy for esophageal cancer is associated with a significant risk of perioperative morbidity and mortality. In particular, anastomotic leakage can cause severe and potentially fatal complications, including mediastinitis and pneumonia. The authors performed esophageal reconstruction with a pedicled right colon graft after salvage esophagectomy in eight patients. ⋯ Postoperative swallowing function was satisfactory in all patients. Although the incidence of anastomotic leakage is reportedly high, the authors observed anastomotic leakage in only one of eight patients. The authors believe that additional microvascular anastomosis helps prevent anastomotic leakage, especially in patients who have undergone salvage esophagectomy after curative chemoradiotherapy.
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Plast. Reconstr. Surg. · Jun 2004
Basic fibroblast growth factor expression following surgical delay of rat transverse rectus abdominis myocutaneous flaps.
Partial transverse rectus abdominis myocutaneous (TRAM) flap loss in breast reconstruction can be a devastating complication for both patient and surgeon. Surgical delay of the TRAM flap has been shown to improve flap viability and has been advocated in "high-risk" patients seeking autogenous breast reconstruction. Despite extensive clinical evidence of the effectiveness of surgical delay of TRAM flaps, the mechanisms by which the delay phenomenon occurs remain poorly understood. ⋯ Surgical delay of rat TRAM flaps is associated with improved flap viability and significantly elevated levels of bFGF over nondelayed TRAM flaps at postoperative day 3 after TRAM surgery. The increases in bFGF noted at this time point suggests that bFGF may play a role in the improved TRAM flap viability observed after delay surgery. Further investigation is needed to evaluate the role bFGF may play in the delay phenomenon.
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Plast. Reconstr. Surg. · Jun 2004
Letter Case ReportsA lethal necrotizing fasciitis after human bite.