TY - JOUR AB - Purpose: The purpose of this study was to understand the experience of exercise participation among patients following transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction surgery. Methods: A phenomenological method was used in this study. Exercise experiences for twelve patients, who had undergone TRAM flap breast reconstruction, were collected through focus group interviews. Results: The factors that contributed to exercise barriers in the experience of TRAM flap breast reconstruction patient exercise participation were categorized into 3 groups: 'fear of exercise after surgery', 'weakened emotional condition', and 'lack of exercise information'. Exercise facilitators after TRAM flap breast reconstruction were also categorized into 3 groups: 'desire to improve appearance', 'feasiable exercise program', and 'exercise experience'. Conclusion: The results of this study reveal the exercise barriers and facilitators for patients following TRAM flap breast reconstruction, which should be considered to develop effective exercise programs. AD - 연세대학교 스포츠 응용산업학과 연세대학교 의과대학 성형외과학교실 미래융합연구원 암당뇨운동의학센터 연세 암병원·암예방센터 AN - 143099335. Language: Korean. Entry Date: 20200511. Revision Date: 20200511. Publication Type: Article AU - 박하늬 AU - 연수진 AU - 민지희 AU - 변지용 AU - 민진주 AU - 송승용 AU - 이동원 AU - 전용관 DB - cin20 DO - 10.5388/aon.2020.20.1.50 DP - EBSCOhost IS - 1 KW - Breast Reconstruction -- Methods Surgical Flaps Exercise Consumer Participation Patient Attitudes Human Phenomenological Research Focus Groups Interviews Emotions Patient Education N1 - research; tables/charts. Journal Subset: Asia; Blind Peer Reviewed; Nursing; Peer Reviewed. PY - 2020 SN - 2287-2434 SP - 50-60 ST - 횡복직근 피부피판술을 받은 유방암 환자들의 운동 제약 및 촉진요인 T2 - Asian Oncology Nursing TI - 횡복직근 피부피판술을 받은 유방암 환자들의 운동 제약 및 촉진요인 UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=143099335&site=ehost-live&scope=site VL - 20 ID - 580 ER - TY - JOUR AD - Groote Schuur Hosp, Dept Plast Reconstruct & Maxillofacial Surg, ZA-7925 Cape Town, South Africa. Skoll, PJ (corresponding author), Groote Schuur Hosp, Dept Plast Reconstruct & Maxillofacial Surg, H53 Old Main Bldg, ZA-7925 Cape Town, South Africa. AN - WOS:000089824900049 AU - Skoll, P. J. AU - Hudson, D. A. DA - Oct DO - 10.1097/00006534-200010000-00052 IS - 5 J2 - Plast. Reconstr. Surg. KW - herpes-zoster cutaneous reinnervation sensory recovery tram flap sensibility Surgery LA - English M3 - Letter N1 - ISI Document Delivery No.: 363FR Times Cited: 7 Cited Reference Count: 10 Skoll, PJ Hudson, DA 7 0 Lippincott williams & wilkins Philadelphia PY - 2000 SN - 0032-1052 SP - 1218-1219 ST - Zoster following immediate transverse rectus abdominis myocutaneous breast reconstruction T2 - Plastic and Reconstructive Surgery TI - Zoster following immediate transverse rectus abdominis myocutaneous breast reconstruction UR - ://WOS:000089824900049 VL - 106 ID - 4046 ER - TY - JOUR AB - Improvement in the reliability of the lower transverse rectus abdominis musculocutaneous flap for breast reconstruction using autogenous tissues has been predicated on a thorough analysis of the vascularization of this flap and methods for its preservation. The arbitrary division of the skin paddle into zones based on relative perfusion has simplified an appreciation of the underlying vascular anatomy. Laser Doppler flowmetry has been used to confirm these anatomical findings and establish a single system based on descending values of observed blood flow. Zone I has been assigned to that region overlying the ipsilateral and zone III the contralateral rectus sheath, whereas zone II corresponds to the ipsilateral and zone IV the contralateral superficial inferior epigastric territory. AD - Dorothy Rider Pool Microsurgery and Laser Laboratory, Allentown, PA. AN - 1388343 AU - Hallock, G. G. DA - Aug DO - 10.1097/00000637-199208000-00004 DP - NLM ET - 1992/08/01 IS - 2 KW - Abdominal Muscles/blood supply Blood Flow Velocity/physiology Female Humans Mammaplasty/*methods Microsurgery/*methods Regional Blood Flow/physiology *Rheology Skin/blood supply Surgical Flaps/*physiology LA - eng N1 - Hallock, G G Journal Article United States Ann Plast Surg. 1992 Aug;29(2):117-21. doi: 10.1097/00000637-199208000-00004. PY - 1992 SN - 0148-7043 (Print) 0148-7043 SP - 117-21 ST - Zones of the lower transverse rectus abdominis musculocutaneous flap based on laser Doppler flowmetry T2 - Ann Plast Surg TI - Zones of the lower transverse rectus abdominis musculocutaneous flap based on laser Doppler flowmetry VL - 29 ID - 12553 ER - TY - JOUR AB - Introduction: Local perforator flaps have become a standard procedure in reconstructive surgery. They allow the transfer of large tissue units with minimal donor-site morbidity. However, clinical studies on flap perfusion changes over time are lacking. The aim of this study was to investigate the perfusion of free-style single perforator flaps with an eccentrically located main perforator by combined laser Doppler spectrophotometry. Patients and methods: Ten patients (six male, four female, 29-71 years) were included in this prospective clinical study. All flaps were based on one perforator. Flaps were harvested from the trunk (n = 6) or the proximal upper or lower extremity (n = 4). Flap perfusion was assessed using a combined laser Doppler spectrophotometry (CLDS) device (O2C, Oxygen to See, LEA Medizintechnik, Giessen, Germany) at days 0, 1, 7 and 14 in different zones. Results: Flap dimensions were 18.6 + 4.7 x 7.2 + 1.6 cm. Two flaps developed minor tip necroses (<10%), eight flaps survived completely. CLDS proved to be very sensitive for the detection of regional perfusion problems. A considerable perfusion gradient was observed at days 0 and 1. Here, reduced blood flow and post-capillary oxygen saturations were found at the tip when compared to the region above main perforator (RAMP). Blood flow remained stable proximally while it improved significantly from day 1 to 14 at the tip region. Conclusion: CLDS is an effective method for objective evaluation of flap perfusion. Although distal flap perfusion is diminished initially, the majority of perforator flaps with eccentrically located perforators survive completely. Obviously, flap perfusion improved between days 1 and 14. This clinical finding might be explained by reorganisation of the vascular system with opening of so-called connecting or choke vessels. This knowledge might influence decision making in perforator flap surgery. (C) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - [Kneser, Ulrich; Beier, Justus P.; Schmitz, Marweh; Arkudas, Andreas; Dragu, Adrian; Schmidt, Volker J.; Horch, Raymund E.] Univ Erlangen Nurnberg, Univ Hosp Erlangen, Dept Plast & Hand Surg, D-91054 Erlangen, Germany. [Kneser, Ulrich; Schmidt, Volker J.; Kremer, Thomas] BG Trauma Ctr Ludwigshafen, Burn Ctr, Dept Hand Plast & Reconstruct Surg, D-67071 Ludwigshafen, Germany. [Kneser, Ulrich; Schmidt, Volker J.; Kremer, Thomas] Heidelberg Univ, Dept Plast Surg, Heidelberg, Germany. Kneser, U (corresponding author), BG Trauma Ctr Ludwigshafen, Burn Ctr, Dept Hand Plast & Reconstruct Surg, Ludwig Guttmann Str 13, D-67071 Ludwigshafen, Germany. ulrich.kneser@bgu-ludwigshafen.de AN - WOS:000329208900002 AU - Kneser, U. AU - Beier, J. P. AU - Schmitz, M. AU - Arkudas, A. AU - Dragu, A. AU - Schmidt, V. J. AU - Kremer, T. AU - Horch, R. E. DA - Jan DO - 10.1016/j.bjps.2013.09.006 IS - 1 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - Perforator flap Propeller flap Flap perfusion Combined laser Doppler spectrophotometry (CLDS) anterolateral thigh flaps soft-tissue flap propeller flap breast reconstruction vascular anatomy pressure sores ct angiography experience gluteal surgery Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 282XU Times Cited: 28 Cited Reference Count: 37 Kneser, Ulrich Beier, Justus P. Schmitz, Marweh Arkudas, Andreas Dragu, Adrian Schmidt, Volker J. Kremer, Thomas Horch, Raymund E. Horch, Raymund E./H-8128-2019; Dragu, Adrian/AAH-3506-2019; Beier, Justus P/L-9094-2016 Horch, Raymund E./0000-0002-6561-2353; Beier, Justus P/0000-0002-0179-1962 28 0 8 Elsevier sci ltd Oxford 1878-0539 PY - 2014 SN - 1748-6815 SP - E9-E17 ST - Zonal perfusion patterns in pedicled free-style perforator flaps T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Zonal perfusion patterns in pedicled free-style perforator flaps UR - ://WOS:000329208900002 VL - 67 ID - 2486 ER - TY - JOUR AB - Introduction: Reconstruction following mastectomy has an important role in all ages but particularly young women with breast cancer. This study assessed patient reported outcomes following mastectomy and reconstruction utilizing Breast Q in predominantly young women. Methods: All consecutive Letterkenny Hospital patients undergoing mastectomy and breast reconstruction between August 2008 and February 2011 were invited to complete Breast-Q evaluation of their care. Collected data included: age; presenting complaint, height, weight, type of operation. RUMM 2020 program evaluated satisfaction where 0 is very dissatisfied to 100 very satisfied. Results: 30/33 (91%) patients completed Breast Q; mean age 43±11, the youngest 29, (range 29-64); mean BMI 27.3±5 (range 21.7- 43.1). 27 patients were symptomatic, and 3 were image detected. 23 had a latissimus dorsi reconstruction, 11 of these with implant augmentation, 5 had a DIEP and 2 implant only reconstruction. The mean satisfaction score of 79.7 indicating good to excellent results. Post reconstructive outcomes were not statistically different from pre-operative perceptions in key areas such as satisfaction with breasts, psychosocial and sexual well-being. Conclusion: This study identified outcomes as good as if not superior to international averages with preservation of satisfaction with breast and psycho social well being. AD - R. Sugrue, Letterkenny Hospital, Department of Breast Surgery, Letterkenny, Ireland AU - Sugrue, R. AU - MacGregor, G. AU - Curran, S. AU - Sugrue, M. AU - Murphy, L. DB - Embase KW - human female breast cancer breast reconstruction breast satisfaction mastectomy patient implant wellbeing weight height preservation latissimus dorsi muscle hospital patient LA - English M3 - Conference Abstract N1 - L71977467 2015-08-25 PY - 2012 SN - 0960-9776 SP - S16 ST - Young women with breast cancer do well following immediate breast reconstruction in a networked regional-tertiary service T2 - Breast TI - Young women with breast cancer do well following immediate breast reconstruction in a networked regional-tertiary service UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71977467&from=export VL - 21 ID - 7028 ER - TY - JOUR AB - Surgery remains the mainstay of treatment for breast cancer, including complete or partial mastectomy and lumpectomy. Breast reconstruction has gained popularity mainly due to its tremendous impact on the psychological status of the patients. Autologous fat grafting is a well-established method used in cosmetic surgery; however, fat re-absoprtion, fat necrosis, calcifications and oil-cyst formation are some usually encountered complications limiting the efficacy of this approach. Platelet-rich plasma (PRP) has recently been postulated as a promising method for tissue regeneration since it contains high levels of diverse human growth factors. To date, preliminary results from clinical studies regarding the combination of PRP and fat grafting in breast reconstruction have shown ambiguous results, whereas preclinical studies are more favorable. However, concerns have been raised regarding the extent of cellular promotion induced by PRP application and the corresponding potential malignant transformation. The aim of our study was to present, analyze and critically evaluate the role of PRP in breast reconstruction after breast cancer surgery in terms of efficacy and oncological safety highlighting the caution that needs to be taken in order to eliminate any chance of recurrence in patients who have theoretically undergone complete excision of the tumor burden. AD - [Spartalis, Eleftherios; Tsilimigras, Diamantis I.; Karachaliou, Georgia-Sofia; Spartalis, Michael; Bolkas, Vasileios; Nikiteas, Nikolaos] Univ Athens, Sch Med, Lab Expt Surg & Surg Res, Athens, Greece. [Spartalis, Eleftherios; Dimitroulis, Dimitrios; Nikiteas, Nikolaos] Univ Athens, Sch Med, Laiko Gen Hosp, Dept Propaedeut Surg 2, Athens, Greece. [Charalampoudis, Petros] Guys & St Thomas NHS Fdn Trust, Breast Unit, London, England. [Charalampoudis, Petros] Kings Coll London, Div Canc Studies, London, England. [Moris, Demetrios] Ohio State Univ, Wexner Med Ctr, Div Surg Oncol, Columbus, OH 43210 USA. [Moris, Demetrios] James Canc Hosp, Columbus, OH USA. [Moris, Demetrios] Solove Res Inst, Columbus, OH USA. [Athanasiou, Antonios] Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp, Dept Surg, Birmingham, W Midlands, England. Spartalis, E (corresponding author), Vasilissis Sofias 49, Athens 10676, Greece. eleftherios.spartalis@gmail.com AN - WOS:000417022100007 AU - Spartalis, E. AU - Tsilimigras, D. I. AU - Charalampoudis, P. AU - Karachaliou, G. S. AU - Moris, D. AU - Athanasiou, A. AU - Spartalis, M. AU - Bolkas, V. AU - Dimitroulis, D. AU - Nikiteas, N. DA - Dec DO - 10.21873/anticanres.12112 IS - 12 J2 - Anticancer Res. KW - Platelet-rich plasma breast reconstruction mastectomy breast cancer review autologous fat transplantation epigastric perforator flap stem-cells graft-survival safety proliferation efficacy surgery Oncology LA - English M3 - Review N1 - ISI Document Delivery No.: FO7AJ Times Cited: 7 Cited Reference Count: 55 Spartalis, Eleftherios Tsilimigras, Diamantis I. Charalampoudis, Petros Karachaliou, Georgia-Sofia Moris, Demetrios Athanasiou, Antonios Spartalis, Michael Bolkas, Vasileios Dimitroulis, Dimitrios Nikiteas, Nikolaos Spartalis, Eleftherios/W-8936-2018; Nikiteas, Nikolaos I/A-3165-2009; Spartalis, Michael/I-1713-2019 Spartalis, Eleftherios/0000-0003-4451-8074; Nikiteas, Nikolaos I/0000-0002-3996-1584; Spartalis, Michael/0000-0002-7442-838X; Moris, Demetrios/0000-0002-5276-0699 7 1 5 Int inst anticancer research Athens 1791-7530 PY - 2017 SN - 0250-7005 SP - 6557-6562 ST - The "Yin and Yang" of Platelet-rich Plasma in Breast Reconstruction After Mastectomy or Lumpectomy for Breast Cancer T2 - Anticancer Research TI - The "Yin and Yang" of Platelet-rich Plasma in Breast Reconstruction After Mastectomy or Lumpectomy for Breast Cancer UR - ://WOS:000417022100007 VL - 37 ID - 1725 ER - TY - JOUR AB - The video demonstrates the surgical technique for correcting dog-ear deformity resulting from a mastectomy wound. This technique is applicable for both medial and lateral deformities. AD - M. Gittleman, Coordinated Health-Breast Care Specialists, Allentown, PA 18104, USA. AU - Gittleman, M. DB - Medline DO - 10.1245/s10434-012-2526-9 IS - 10 KW - arthropathy article breast tumor female human mastectomy postoperative complication prognosis surgical flaps suture technique wound healing LA - English M3 - Article N1 - L366383145 2013-02-20 PY - 2012 SN - 1534-4681 SP - 3292 ST - Y-V oncoplastic wound repair of mastectomy dog-ear deformity T2 - Annals of surgical oncology TI - Y-V oncoplastic wound repair of mastectomy dog-ear deformity UR - https://www.embase.com/search/results?subaction=viewrecord&id=L366383145&from=export http://dx.doi.org/10.1245/s10434-012-2526-9 VL - 19 ID - 7044 ER - TY - JOUR AB - INTRODUCTION: Mastectomies closed with a linear scar can distort the resulting shape of the breast. We present our novel Y-peg-in-a-round-hole closure method of the mastectomy scar, which improves the shape of the reconstructed breast while maintaining reliable healing, implant coverage, and minimum scar size for covering by tattoo. MATERIALS AND METHODS: A retrospective review of all breast reconstruction cases performed by the senior surgeon during the period from January 2010 to January 2017 was undertaken. Data were analyzed for wound healing problems, infection rates and mastectomy skin flap necrosis. RESULTS: Data were extracted for 126 consecutive patients with 154 breast reconstructions. Twelve breasts (7.7%) experienced wound healing problems, for which 7 (4.5%) required revisionary surgery. Eighteen breasts (11.7%) developed an infection requiring antibiotics, of which 8 (5.2%) needed a further operation. Four breasts (2.6%) needed removal of the implant. No patients were lost to follow-up. CONCLUSION: After nipple resecting mastectomy, the Y-peg-in-a-round-hole scar minimizes radial size and contour deformity but allows for reliable wound healing. AU - Grinsell, D. AU - Baker, C. AU - Nielsen, H. H. M. AU - Alexander, K. S. DB - Medline DO - 10.1097/SAP.0000000000001690 IS - 2 KW - adult adverse event breast endoprosthesis breast reconstruction female follow up human mastectomy middle aged postoperative complication procedures retrospective study risk assessment subcutaneous mastectomy surgical flaps time factor tissue expander treatment outcome LA - English M3 - Article N1 - L625875621 2019-01-16 2020-03-27 PY - 2019 SN - 1536-3708 SP - 145-151 ST - Y-Peg-in-a-Round-Hole Closure for Immediate Periareolar Mastectomy Expander Reconstruction T2 - Annals of plastic surgery TI - Y-Peg-in-a-Round-Hole Closure for Immediate Periareolar Mastectomy Expander Reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L625875621&from=export http://dx.doi.org/10.1097/SAP.0000000000001690 VL - 82 ID - 5166 ER - TY - JOUR AB - Xanthogranulomatous inflammation is a rare clinico-pathological condition involving many organ systems. Breast involvement with this rare condition reported from a few cases of mastitis has been limited to only microscopic involvement on histology. We would like to report an unusual presentation of this inflammatory process presenting as a solid lump mimicking malignancy in latissimus dorsi donor site scar and implant-based breast reconstruction as a result of a ruptured silicone gel implant. To our knowledge there have been no previous reports on similar presentation published in the literature. This case highlights a rare complication of a leaked silicone gel implant triggering a xanthomatous response in the absence of the usual infective or obstructing etiologies. This condition is of benign nature with complete clearance on surgical excision and excellent clinical prognosis reported from other organ involvement. AD - Cancer Biology Proteomic Groups, University of Hull, HYMS, Hull, UK. tasadooq.hussain@gmail.com AN - 22906098 AU - Hussain, T. AU - Elahi, B. AU - Long, E. AU - Mahapatra, T. AU - McManus, P. L. AU - Kneeshaw, P. J. C2 - PMC3433352 DA - Aug 20 DO - 10.1186/1477-7819-10-166 DP - NLM ET - 2012/08/22 KW - Breast Implants/*adverse effects Breast Neoplasms/surgery Female Granuloma/*etiology/pathology/surgery Humans Inflammation/*etiology/pathology/surgery Mammaplasty/*adverse effects Middle Aged Postoperative Complications Review Literature as Topic Surgical Flaps/*adverse effects Xanthomatosis/*etiology/pathology/surgery LA - eng N1 - 1477-7819 Hussain, Tasadooq Elahi, Bilal Long, Ervine Mahapatra, Tapan McManus, Penelope L Kneeshaw, Peter J Case Reports Journal Article Review World J Surg Oncol. 2012 Aug 20;10:166. doi: 10.1186/1477-7819-10-166. PY - 2012 SN - 1477-7819 SP - 166 ST - Xanthogranulomatous inflammation involving latissimus dorsi donor site and implant breast reconstruction: case report and literature review T2 - World J Surg Oncol TI - Xanthogranulomatous inflammation involving latissimus dorsi donor site and implant breast reconstruction: case report and literature review VL - 10 ID - 12120 ER - TY - JOUR AD - A. Pérez-García, Department of Plastic Surgery and Burns, Hospital Universitario y Politécnico La Fe, Valencia, Spain AU - Ruiz-Cases, A. AU - Pérez-García, A. DB - Embase Medline DO - 10.1002/micr.30283 IS - 3 KW - oxidized regenerated cellulose fibrin glue artery thrombosis avulsion injury breast reconstruction deep inferior epigastric perforator flap hematoma human letter microsurgery obstruction pedicled skin flap priority journal surgical technique vein anastomosis vein thrombosis Surgicel LA - English M3 - Letter N1 - L620118046 2018-01-11 2018-04-26 PY - 2018 SN - 1098-2752 0738-1085 SP - 344 ST - Wrapped Surgicel as an aid in microsurgical flap pedicle positioning and kinking prevention T2 - Microsurgery TI - Wrapped Surgicel as an aid in microsurgical flap pedicle positioning and kinking prevention UR - https://www.embase.com/search/results?subaction=viewrecord&id=L620118046&from=export http://dx.doi.org/10.1002/micr.30283 VL - 38 ID - 5472 ER - TY - JOUR AB - Background Wound drains are often used after plastic and reconstructive surgery of the breast, in order to reduce potential complications. It is unclear whether there is any evidence to support this practice and we therefore undertook a systematic review of the best evidence available. Objectives To compare the safety and efficacy of the use of wound drains following elective plastic and reconstructive surgery procedures of the breast. Search methods For the first update of this review we searched the Cochrane Wounds Group Specialised Register (searched 4 March 2015); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2015, Issue 2); Ovid MEDLINE (2012 to March 3 2015); Ovid MEDLINE (In-Process & Other Non-Indexed Citations March 3 2015); Ovid EMBASE (2012 to March 3 2015); and EBSCO CINAHL (2012 to March 4 2015). There were no restrictions on the basis of date or language of publication. Selection criteria Three review authors undertook independent screening of the search results. All randomised trials (RCTs) that compared the use of a wound drain with no wound drain following plastic and reconstructive surgery of the breast (breast augmentation, breast reduction and breast reconstruction) in women were eligible. Data collection and analysis Two review authors undertook independent data extraction of study characteristics, methodological quality and outcomes (e.g. infection, other wound complications, pain, and length of hospital stay). Risk of bias was assessed independently by two review authors. We calculated the risk ratio (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, with 95% confidence intervals. Analysis was on an intention-to-treat basis. Main results Three randomised trials were identified and included in the review out of 190 studies that were initially screened; all evaluated wound drainage after breast reduction surgery. No new trials were identified for this first update. In total there were 306 women in the three trials, and 505 breasts were studied (254 drained, and 251 who were not drained). Apart from a significantly shorter duration of hospital stay for those participants who did not have drains (MD 0.77; 95% CI 0.40 to 1.14), there was no statistically significant impact of the use of drains on outcomes. Authors' conclusions The limited evidence available shows no significant benefit of using post-operative wound drains in reduction mammoplasty, though hospital stay may be shorter when drains are not used. No data are available for breast augmentation or breast reconstruction, and this requires investigation. AD - [Khan, Sameena M.] Univ York, Dept Hlth Sci, York YO10 5DD, N Yorkshire, England. [Smeulders, Mark J. C.; Van der Horst, Chantal M.] Univ Amsterdam, Acad Med Ctr, Dept Plast Reconstruct & Hand Surg, NL-1105 AZ Amsterdam, Netherlands. Khan, SM (corresponding author), Univ York, Dept Hlth Sci, York YO10 5DD, N Yorkshire, England. sameenamkhan@gmail.com AN - WOS:000366060300024 AU - Khan, S. M. AU - Smeulders, M. J. C. AU - Van der Horst, C. M. C7 - Cd007258 DO - 10.1002/14651858.CD007258.pub3 IS - 10 J2 - Cochrane Database Syst Rev. KW - Drainage Length of Stay Mammaplasty [adverse effects] Postoperative Complications [prevention & control] Randomized Controlled Trials as Topic Female Humans risk-factors reduction surgery routine drainage seroma formation tram flap complications metaanalysis multicenter mammaplasty colon General & Internal Medicine LA - English M3 - Review N1 - ISI Document Delivery No.: CX9XO Times Cited: 10 Cited Reference Count: 51 Khan, Sameena M. Smeulders, Mark J. C. Van der Horst, Chantal M. NIHR/Department of Health (England), (Cochrane Wounds Group), UKNational Institute for Health Research (NIHR); National Institute for Health ResearchNational Institute for Health Research (NIHR) [ACF-2012-11-003] Funding Source: researchfish External sources; NIHR/Department of Health (England), (Cochrane Wounds Group), UK. 11 0 2 Wiley Hoboken 1361-6137 PY - 2015 SN - 1469-493X SP - 35 ST - Wound drainage after plastic and reconstructive surgery of the breast T2 - Cochrane Database of Systematic Reviews TI - Wound drainage after plastic and reconstructive surgery of the breast UR - ://WOS:000366060300024 ID - 2332 ER - TY - JOUR AB - A retrospective study was done to evaluate the frequency and severity of wound complications in 112 patients with breast cancer who received adjuvant chemotherapy following mastectomy with immediate breast reconstruction. Data on wound complications were available for 120 mastectomies. The rate of complications in 36 mastectomies treated with chemotherapy after mastectomy and immediate reconstruction was compared to that in 84 mastectomies not receiving adjuvant therapy. There were 25 wound complications (20.8%) in the entire group. The rate of wound complications was 27.8% (10 of 36 mastectomies) in the group treated with adjuvant chemotherapy and 17.9% (15 of 84 mastectomies) in the group that did not receive adjuvant therapy (P = 0.13). No patient had a delay in the initiation of adjuvant therapy because of wound complications secondary to immediate reconstruction. Logistic regression analysis found no correlation between age, type of operation, tumor pathology, stage, number of lymph nodes harvested, type of prosthesis or chemotherapy, and wound complications in patients undergoing immediate breast reconstruction after mastectomy. The frequency of wound complications was not increased in patients receiving adjuvant chemotherapy after mastectomy and immediate breast reconstruction. The administration of adjuvant chemotherapy does not need to be delayed in patients who have had immediate breast reconstruction following mastectomy for breast cancer. AD - Department of Surgery, University of Connecticut School of Medicine, Farmington 06032. AN - 8176932 AU - Furey, P. C. AU - Macgillivray, D. C. AU - Castiglione, C. L. AU - Allen, L. DA - Mar DO - 10.1002/jso.2930550313 DP - NLM ET - 1994/03/01 IS - 3 KW - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use Breast Neoplasms/*drug therapy/*surgery Chemotherapy, Adjuvant Female Humans Logistic Models *Mammaplasty Mastectomy, Modified Radical Mastectomy, Simple Middle Aged Necrosis Retrospective Studies Risk Factors Surgical Flaps/*pathology Surgical Wound Infection/*epidemiology LA - eng N1 - Furey, P C Macgillivray, D C Castiglione, C L Allen, L Comparative Study Journal Article United States J Surg Oncol. 1994 Mar;55(3):194-7. doi: 10.1002/jso.2930550313. PY - 1994 SN - 0022-4790 (Print) 0022-4790 SP - 194-7 ST - Wound complications in patients receiving adjuvant chemotherapy after mastectomy and immediate breast reconstruction for breast cancer T2 - J Surg Oncol TI - Wound complications in patients receiving adjuvant chemotherapy after mastectomy and immediate breast reconstruction for breast cancer VL - 55 ID - 11878 ER - TY - JOUR AB - Defects of the thoracic or abdominal wall can be congenital or caused by trauma or tumour resection. There may be other problems, such as infection and irradiation effects. In most cases those defects can be closed by local cutaneous and fasciocutaneous or by muscle and myocutaneous flaps. In some rare instances, the use of pedicled flaps may be limited. The size of the defect, the impossibility of closing the donor site, an impaired blood supply, or poor quality of local tissues represent such limitations. In these cases microvascular flap transfer has enlarged our choice of alternative methods. Advantages of this method are the one-stage procedure and the wound coverage by well-vascularized tissue. This is especially beneficial in areas of infected or irradiated tissue. On the other hand microvascular flap transfer requires high technical skill and extensive perioperative and postoperative care. AD - H. Piza, Plastic/Reconstructive Surgery Dept., Krankenhaus Lainz, Wolkersbergenstrasse 1, 1130 Vienna, Austria AU - Piza, H. AU - Rath, T. AU - Hausmaniger, C. AU - Walzer, R. L. DB - Embase Medline IS - 4 KW - abdominal wall closure abdominal wall defect adult article breast cancer cancer surgery case report colon carcinoma free tissue graft human microvascular surgery plastic surgery postoperative care surgical technique thorax wall defect thorax wall reconstruction LA - English M3 - Article N1 - L23180794 1993-07-08 PY - 1993 SN - 0738-1085 SP - 260-265 ST - Wound closure at the trunk by microvascular free flap transfer T2 - Microsurgery TI - Wound closure at the trunk by microvascular free flap transfer UR - https://www.embase.com/search/results?subaction=viewrecord&id=L23180794&from=export VL - 14 ID - 8895 ER - TY - JOUR AB - Breast reconstruction is a crucial step in the treatment of breast cancer providing a durable solution for patients seeking to restore their physical and psychological integrity. If only part of the breast parenchyma is removed, local glandular flaps are used to restore breast shape and volume. After total mastectomy, when prosthetic reconstruction is contraindicated because of poor skin quality, distant flaps are preferred. Most of the time, two types of flaps are used : The pedicled myocutaneous latissimus dorsi flap and the deep inferior epigastric perforator (D.I.E.P.) free flap. The first flap is simple to execute and reliable, but requires some breast prosthetic material to add volume to the reconstruction. The second flap allows performing autologus reconstructions, providing a high quantity of supple tissues, while remaining a significantly more complex technique. AD - J.-V. Berthe, Hôpital Erasme, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Route de Lennik 808, 1070 Bruxelles, Belgium AU - Berthe, J. V. DB - Embase Medline IS - 4 KW - article breast reconstruction deep inferior epigastric perforator flap latissimus dorsi flap mastectomy pedicled myocutaneous latissimus dorsi flap LA - French M3 - Article N1 - L370373316 2013-12-06 2013-12-12 PY - 2013 SN - 0035-3639 SP - 271-277 ST - Workhorse flaps for breast reconstruction T2 - Revue Medicale de Bruxelles TI - Workhorse flaps for breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L370373316&from=export http://www.amub.be/rmb/download_pdf.php?article=927&filename=927.pdf VL - 34 ID - 6724 ER - TY - JOUR AB - Background: In the last decades, several surgical approaches have been used to improve the appearance and quality of life of female Poland syndrome patients. The aim of this study was to analyze the women's quality of life and long-term outcome after breast reconstruction. Methods: Forty-nine women with Poland syndrome who were treated surgically between 1974 and 2007 received standardized questionnaires to evaluate their quality of life and satisfaction after surgical treatment. Results: Patient response was 65%, with 32 completed questionnaires by 16 women who had pedicled latissimus dorsi myocutaneous (LDM) flaps, 12 with tissue expander or silicone implants, and 4 who had free transverse rectus abdominis myocutaneous (TRAM) flaps. Of these patients, 16 were satisfied or highly satisfied with their postoperative appearance (13 with LDM, 2 with prosthesis, and 1 with TRAM), 16 patients would recommend the same surgery to others under similar circumstances (10 with LDM, 5 with prosthesis, and 1 with TRAM), and 18 patients would choose the same method again (14 with LDM, 3 with prosthesis, and 1 with TRAM). Conclusions: In our study, we found that satisfactory outcome in breast reconstruction was achieved particularly when using the LDM flap, which remains the only method that recreates the anterior axillary fold. Future studies on reconstruction methods with autogenous tissue (e.g., TRAM, deep inferior epigastric perforator [DIEP] flap) are needed, however, to analyze quality of life and long-term outcome in patients with Poland syndrome. AD - Clinic for Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, , Munich, . Department of Gynecology, , Athens, . Department for Psychosomatic Medicine, Klinikum rechts der Isar, , Munich, . Department of Plastic and Reconstructive Surgery, , Athens, . AN - 104707438. Language: English. Entry Date: 20110616. Revision Date: 20200708. Publication Type: Journal Article AU - Papadopulos, Nikolaos A. AU - Eder, Maximilian AU - Stergioula, Sofia AU - Teymouri, Hamid R. AU - Mavroudis, Michalis C. AU - Herschbach, Peter AU - Henrich, Gerhard AU - Papadopoulos, Othon N. AU - Biemer, Edgar AU - Kovacs, Laszlo DB - cin20 DO - 10.1089/jwh.2010.2211 DP - EBSCOhost IS - 5 KW - Quality of Life Breast Reconstruction -- Methods -- Germany Breast -- Abnormalities Women Human Retrospective Design Questionnaires Personal Satisfaction Female Surgical Flaps -- Classification Germany Physical Examination Descriptive Statistics Comparative Studies Control Group N1 - pictorial; research; tables/charts. Journal Subset: Biomedical; Peer Reviewed; USA. NLM UID: 101159262. PMID: NLM21501086. PY - 2011 SN - 1540-9996 SP - 749-756 ST - Women's Quality of Life and Surgical Long-Term Outcome After Breast Reconstruction in Poland Syndrome Patients T2 - Journal of Women's Health (15409996) TI - Women's Quality of Life and Surgical Long-Term Outcome After Breast Reconstruction in Poland Syndrome Patients UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104707438&site=ehost-live&scope=site VL - 20 ID - 827 ER - TY - JOUR AB - Purpose/Objective: To provide the breast specialist nurse with statistically significant data outcomes when consulting a patient opting for breast reconstruction. Background/Rationale: It has been widely shown that reconstructive surgery has a huge influence on the patient's physical and mental recovery as well as quality of life. Most of the published data evaluating breast reconstruction options has not focused on long term patient specific aspects. The paucity of long term patient specific outcome information makes it difficult to provide the patient with proper counseling. Description/Methods/Evaluation: A retrospective questionnaire study was performed, under Helsinki Protocol, of 150 female breast cancer patients, between the years 2006-2012, at our institute. Four types of breast reconstruction methods were used: Silicone implant only, latissimus dorsimyocutaneous (LD) flapwith silicone implant, transverse abdominus myocutaneous (TRAM) flap, and the deep Inferior epigastric perforator (DIEP) flap. The validated Breast-Q questionnaire was chosen as a reliable toll for assessment and was sent and returned by 82% (150/ 183). This questionnaire surveys different aspects in every day habits, quality of life and satisfaction in women undergoing mastectomy and breast reconstruction. Outcome/Results/Findings: DIEP flap reconstruction scored the highest in general satisfaction and significantly highest (p<0.05) in the patient's opinion of “natural looking” of the breast without clothes; and in breast characteristics after surgery. No other operation scored significantly highest in any criteria. In all categories, the patient satisfaction score significantly decreased between 2-6 years after surgery (most obvious decrease in the LD flap group and least difference in DIEP flap group). As expected, patients who did not develop complications had significantly higher satisfaction scores than those with complications (p<0.01). No woman regretted the reconstruction and all would undergo it again. Conclusion/Discussion: Women are most satisfied with the DIEP in comparison to the other operations. Although the satisfaction decreases in all operations with time, all women would undergo the procedure again. AD - V. Swager, Plastic Surgery/Oncology, Rambam Medical Center, Natanya, Israel AU - Swager, V. AU - Zohar, H. AU - Eldor, L. AU - Filson, S. A. AU - Simonovitch, I. AU - Leiba, R. AU - Eilon, Y. DB - Embase DO - 10.1097/NCC.0000000000000441 IS - 6 KW - adult breast reconstruction cancer patient chronic patient clothing complication conference abstract controlled study counseling deep inferior epigastric perforator flap female habit human major clinical study mastectomy myocutaneous flap patient satisfaction perception quality of life questionnaire retrospective study silicone prosthesis surgery LA - English M3 - Conference Abstract N1 - L624589531 2018-10-31 PY - 2016 SN - 1538-9804 SP - S64-S65 ST - Women's perception, evaluation and satisfaction from breast reconstruction T2 - Cancer Nursing TI - Women's perception, evaluation and satisfaction from breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L624589531&from=export http://dx.doi.org/10.1097/NCC.0000000000000441 VL - 39 ID - 5892 ER - TY - JOUR AB - Objective: Understanding women's motives concerning breast reconstructive surgery will contribute to a better counselling and care for the increasing number of women choosing post-mastectomy breast reconstruction (BR). Methods: We interviewed 31 women who opted for implant or deep inferior epigastric perforator (DIEP)-flap BR after therapeutic or prophylactic mastectomy. Motives for BR in general and for the selected type of BR were investigated following a phenomenological qualitative research approach. Results: Women opting for implant BR were concerned with surgery-related issues, such as recovery time, number of scars and impact of surgery. They wanted to return to their daily life and restore their body image as soon as possible. Patients choosing DIEP-flap BR were more focussed on regaining a natural breast and wanted to benefit from the advantages of autologous tissue. Women scheduled for prophylactic mastectomy saw BR as an integral part of their treatment. Patients opting for BR after therapeutic mastectomy wanted to regain a complete body image with BR. Conclusions: Patients' motives for implant BR were primarily related to surgical issues, whereas women who chose DIEP-flap BR especially focussed on regaining a breast that resembles their own lost breast as well as possible. Clinical variables (such as therapeutic or prophylactic mastectomy, breast irradiation, and waiting lists) need to be taken into account when considering a certain type of BR, as these can be of great importance in the decisionmaking process. (C) 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - [Gopie, Jessica P.; Kleijne, Annelies; Tibben, Aad] Leiden Univ, Med Ctr, Ctr Human & Clin Genet, NL-2300 RC Leiden, Netherlands. [Hilhorst, Medard T.] Erasmus Univ, Med Ctr, Erasmus MC, Dept Med Eth & Philosophy, Rotterdam, Netherlands. [Timman, Reinier] Erasmus Univ, Med Ctr, Erasmus MC, Dept Med Psychol & Psychotherapy, Rotterdam, Netherlands. [Menke-Pluymers, Marian B. E.] Erasmus Univ, Med Ctr, Daniel den Hoed Canc Ctr, Dept Surg Oncol,Erasmus MC, Rotterdam, Netherlands. [Hofer, Stefan O. P.] Univ Toronto, Univ Hlth Network, Div Plast Surg, Toronto, ON, Canada. [Mureau, Marc A. M.] Erasmus Univ, Med Ctr, Erasmus MC, Dept Plast & Reconstruct Surg, Rotterdam, Netherlands. [Tibben, Aad] Erasmus Univ, Med Ctr, Dept Clin Genet, Rotterdam, Netherlands. Gopie, JP (corresponding author), Leiden Univ, Med Ctr, Ctr Human & Clin Genet, POB 9600, NL-2300 RC Leiden, Netherlands. j.p.gopie@lumc.nl AN - WOS:000293009100027 AU - Gopie, J. P. AU - Hilhorst, M. T. AU - Kleijne, A. AU - Timman, R. AU - Menke-Pluymers, M. B. E. AU - Hofer, S. O. P. AU - Mureau, M. A. M. AU - Tibben, A. DA - Aug DO - 10.1016/j.bjps.2011.03.030 IS - 8 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - Breast cancer Motivations Qualitative analysis Breast reconstruction Implant DIEP flap prophylactic mastectomy patient satisfaction body-image cancer immediate surgery impact information experience outcomes Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 795WM Times Cited: 28 Cited Reference Count: 39 Gopie, Jessica P. Hilhorst, Medard T. Kleijne, Annelies Timman, Reinier Menke-Pluymers, Marian B. E. Hofer, Stefan O. P. Mureau, Marc A. M. Tibben, Aad Hofer, Stefan/0000-0002-9653-2946; Tibben, Aad/0000-0002-4560-1710 Dutch Cancer SocietyKWF Kankerbestrijding [UL 2007-3726] We have no conflict of interest. This study was funded by the Dutch Cancer Society (UL 2007-3726) and ethics approval was obtained from all participating hospitals. 29 0 8 Elsevier sci ltd Oxford PY - 2011 SN - 1748-6815 SP - 1062-1067 ST - Women's motives to opt for either implant or DIEP-flap breast reconstruction T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Women's motives to opt for either implant or DIEP-flap breast reconstruction UR - ://WOS:000293009100027 VL - 64 ID - 2881 ER - TY - JOUR AB - Objective: Surgical procedures intended to treat breast cancer or reduce risk of developing the disease typically result in changes to appearance and scarring of the breast area, and any donor sites. The longer-term impact of these changes on body image and quality of life are well documented, but research in this field has failed to explore women's initial experiences of their appearance after surgery. This study used a qualitative approach to gain insight and better understand the experiences of women at this time point in their treatment pathway. Methods: Women (n=128) who had undergone mastectomy and/or breast reconstruction following a diagnosis of breast cancer or to reduce their risk of developing the disease completed an online survey. Open-ended questions asked participants about their experiences when seeing the postsurgical appearance of their breast/breast area (and donor site, if relevant) for the first time, and the support available to them. Results: Thematic analysis generated four key themes: “preparedness and support,” “first thoughts and emotions,” “loss and grief,” and “the reaction of others.”. Conclusions: There was considerable variability in women's experiences. Some felt prepared and emotionally supported at this time, whilst others felt this element of care was missing. The findings suggest that there is a need to ensure all women are informed and have the necessary support when looking at the results of their surgery for the first time. Areas for improvement were proposed, including preoperative discussions, increased preparation and support. This could potentially contribute to better patient outcomes overall. AD - B. Herring, Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom AU - Herring, B. AU - Paraskeva, N. AU - Tollow, P. AU - Harcourt, D. DB - Embase Medline DO - 10.1002/pon.5196 IS - 10 KW - breast endoprosthesis antineoplastic agent adult aged article breast cancer breast reconstruction cancer chemotherapy cancer hormone therapy cancer radiotherapy controlled study deep inferior epigastric perforator flap emotion female grief human intraductal carcinoma latissimus dorsi flap major clinical study mastectomy personal experience physical appearance postoperative period qualitative research transverse rectus abdominis musculocutaneous flap LA - English M3 - Article N1 - L2002592297 2019-08-29 2019-10-31 PY - 2019 SN - 1099-1611 1057-9249 SP - 2076-2082 ST - Women's initial experiences of their appearance after mastectomy and/or breast reconstruction: A qualitative study T2 - Psycho-Oncology TI - Women's initial experiences of their appearance after mastectomy and/or breast reconstruction: A qualitative study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002592297&from=export http://dx.doi.org/10.1002/pon.5196 VL - 28 ID - 4956 ER - TY - JOUR AB - BACKGROUND: Significant concern exists from clinicians in all fields that rates of bilateral mastectomy and prophylactic mastectomy are increasing. This study was performed to evaluate women's perception of breast appearance and its association with breast cancer operations. METHODS: From April 2012 to May 2013, all women attending a breast clinic were shown two breast pictures, "natural" and "augmented," and asked which photograph represented the current expected appearance of breasts. Among breast cancer patients, the choice of breast cancer operation was correlated with picture selection. RESULTS: Of 1,177 consecutive women, mean age was 45 years. Overall, 70 % of patients felt that the augmented appearance is expected. This impression was seen in all racial/ethnic groups: non-Hispanic White 65 %, African American 67 %, Hispanic 71 %, and other groups 70 %. Younger age was strongly associated with the augmented appearance (p < 0.0001). Patients older than age 60 years selected the augmented appearance only 51 % of the time. This percentage increased with each younger decade with patients younger than 40 years selecting the augmented appearance in 85 %. Among breast cancer patients, augmented appearance selection was more likely for patients who underwent reconstruction (92 %; p < 0.001), as well as for those undergoing bilateral mastectomy (74 %; p = 0.057) compared with mastectomy alone (49 %). CONCLUSIONS: Most women felt that the augmented appearance of breasts is currently expected, and this impression was more common in young women. This impression may be another factor contributing to the current trend of more extensive breast cancer operations and implant-based reconstructions. AD - Maricopa Medical Center, Phoenix, AZ, USA, Komenaka@hotmail.com. AN - 25398279 AU - Komenaka, I. K. AU - Winton, L. M. AU - Bouton, M. E. AU - Hsu, C. H. AU - Nodora, J. N. AU - Olson, L. AU - Maffi, T. R. AU - Nesset, E. M. AU - Martinez, M. E. DO - 10.1245/s10434-014-4233-1 DP - NLM ET - 2014/11/16 IS - 6 KW - Adult Age Factors Breast/*anatomy & histology Breast Neoplasms/*psychology/*surgery Ethnic Groups/*psychology Female Follow-Up Studies Humans Mammaplasty/*psychology Mastectomy/*psychology Middle Aged Prognosis *Surgical Flaps LA - eng N1 - 1534-4681 Komenaka, Ian K Winton, Lisa M Bouton, Marcia E Hsu, Chiu-Hsieh Nodora, Jesse N Olson, Loyd Maffi, Terry R Nesset, Elizabeth M Martinez, Maria Elena Journal Article United States Ann Surg Oncol. 2015;22(6):2010-6. doi: 10.1245/s10434-014-4233-1. Epub 2014 Nov 15. PY - 2015 SN - 1068-9265 SP - 2010-6 ST - Women's Impression of the Expected Breast Appearance and its Association with Breast Cancer Operations T2 - Ann Surg Oncol TI - Women's Impression of the Expected Breast Appearance and its Association with Breast Cancer Operations VL - 22 ID - 9295 ER - TY - JOUR AB - Clinical experience suggests that flap failure after autologous breast reconstruction can be a devastating experience for women. Previous research has examined women's experiences with autologous breast reconstruction with and without complications, and patients' experiences with suboptimal outcomes from other medical procedures. The authors aimed to examine the psychosocial experience of flap failure from the patient's perspective. Seven women who had experienced unilateral flap failure after deep inferior epigastric perforator flap surgery in the past 12 years completed semistructured interviews about their breast cancer treatments, their experiences with flap failure, the impact of flap failure on their lives, and the coping strategies they used. Interpretive phenomenological analysis, a type of qualitative analysis that provides an in-depth account of participant's experiences and their meanings, was used to analyze the interview data. From these data, patient-derived recommendations were developed for surgeons caring for women who have experienced flap failure. Three main themes (6 subthemes) emerged: coming to terms with flap failure (coping with emotions, body dissatisfaction); making meaning of flap failure experience (questioning, relationship with surgeon); and care providers acknowledging the emotional experience of flap failure (experience of being treated "mechanically," suggestions for improvement). In conclusion, flap failure in breast reconstruction is an emotionally difficult experience for women. Although there are similarities to other populations of patients experiencing suboptimal outcomes from medical procedures, there are also unique aspects of the flap failure experience. A better understanding of women's experiences with flap failure will assist in providing more appropriate supports. AD - [Higgins, Kristen S.; Chorney, Jill M.] Dalhousie Univ, IWK Hlth Ctr, Dept Psychol, Halifax, NS, Canada. [Higgins, Kristen S.; Chorney, Jill M.] Dalhousie Univ, IWK Hlth Ctr, Dept Neurosci, Halifax, NS, Canada. [Gillis, Joshua; Williams, Jason G.; LeBlanc, Martin; Bezuhly, Michael] Dalhousie Univ, IWK Hlth Ctr, Div Plast & Reconstruct Surg, Dept Surg, Halifax, NS, Canada. [Chorney, Jill M.] Dalhousie Univ, Dept Anesthesia Pain Management & Perioperat Med, IWK Hlth Ctr, Halifax, NS, Canada. Bezuhly, M (corresponding author), Dalhousie Univ, IWK Hlth Ctr, Div Plast & Reconstruct Surg, 5850-5980 Univ Ave,POB 9700, Halifax, NS B3K 6R8, Canada. mbezuhly@dal.ca AN - WOS:000401870800011 AU - Higgins, K. S. AU - Gillis, J. AU - Williams, J. G. AU - LeBlanc, M. AU - Bezuhly, M. AU - Chorney, J. M. DA - May DO - 10.1097/sap.0000000000000910 IS - 5 J2 - Ann. Plast. Surg. KW - breast reconstruction autologous complete flap failure qualitative research interpretive phenomenological analysis patient-reported outcomes tissue-expander/implant cancer patients surgery complications mastectomy outcomes impact Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: EV6HP Times Cited: 6 Cited Reference Count: 19 Higgins, Kristen S. Gillis, Joshua Williams, Jason G. LeBlanc, Martin Bezuhly, Michael Chorney, Jill M. Gillis, Joshua/K-9991-2019 Gillis, Joshua/0000-0002-8457-1374 6 0 2 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2017 SN - 0148-7043 SP - 521-525 ST - Women's Experiences With Flap Failure After Autologous Breast Reconstruction A Qualitative Analysis T2 - Annals of Plastic Surgery TI - Women's Experiences With Flap Failure After Autologous Breast Reconstruction A Qualitative Analysis UR - ://WOS:000401870800011 VL - 78 ID - 1841 ER - TY - GEN AN - NCT04886921 AU - Hospital, Kaohsiung Medical University Chung-Ho Memorial DA - February 24 KW - Breast Neoplasms N1 - No Results Available Behavioral: Abdominal muscle training Changes in thickness of abdominal wall muscles at 12-week|Changes in the cross-sectional area of the rectus abdominis muscle (RA) muscle at 12-week|Changes in strength of the trunk muscles at 12-week|Changes in endurance of the trunk muscles at 12-week|Changes in balanced functions at 12-week|Changes in muscle activity of selected trunk and limb muscles at 12-week Female Not Applicable 82 Other Allocation: Non-Randomized|Intervention Model: Parallel Assignment|Masking: None (Open Label)|Primary Purpose: Other KMUH-IRB-970469 September 8, 2014 PB - https://ClinicalTrials.gov/show/NCT04886921 PY - 2009 ST - Women Underwent TRAM Surgery: Its Influence on Abdominal Muscle Function and the Effects of Therapeutic Exercises TI - Women Underwent TRAM Surgery: Its Influence on Abdominal Muscle Function and the Effects of Therapeutic Exercises ID - 483 ER - TY - JOUR AB - BACKGROUND: Nipple hypertrophy is a common aesthetic issue for Asian women. Thus, methods to correct this problem are needed. Several nipple reduction procedures have been reported, but all have shortcomings. In this article, we propose a new method to reduce both the height and diameter of the nipple without affecting its function. METHODS: Sixteen female patients, between the ages of 24-41 years, underwent a new nipple reduction method in our department between May 17, 2010, and May 5, 2014. Three crescent-shaped lines were drawn from the top of the side wall of the nipple, extending to the areola. This design reduces both the diameter and height of the nipple with minimal tissue manipulation. RESULTS: Before surgery, the mean diameter and height of the nipple were 15.9 ± 2.7 and 18.3 ± 3.1 mm, respectively, with the patient in the supine position. Immediately after surgery, the mean diameter and height of the nipple were 9.1 ± 1.7 and 7.9 ± 2.1 mm, respectively. No major complications, such as nipple necrosis, infection, delayed wound healing, or loss of sensation, were noted. CONCLUSIONS: This new surgical technique allows the creation of a new nipple of the desired height and diameter with excellent aesthetic results and without significant complications. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . AU - Yu, Y. AU - Wei, L. AU - Shen, Y. AU - Xiao, W. AU - Huang, J. AU - Xu, J. DB - Medline DO - 10.1007/s00266-017-0860-9 IS - 4 KW - adult breast reconstruction esthetics female follow up human hypertrophy nipple pathology procedures reconstructive surgery risk assessment surgical flaps Taiwan transplantation treatment outcome vascularization young adult LA - English M3 - Article N1 - L622303041 2018-05-30 PY - 2017 SN - 1432-5241 SP - 788-792 ST - Windmill Flap Nipple Reduction: A New Method of Nipple Plasty T2 - Aesthetic plastic surgery TI - Windmill Flap Nipple Reduction: A New Method of Nipple Plasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622303041&from=export http://dx.doi.org/10.1007/s00266-017-0860-9 VL - 41 ID - 5673 ER - TY - JOUR AB - We compared the postoperative outcomes between wide local excision (WLE) and oncoplastic breast surgery (OBS), assuming 3 margin distances (2 mm, 1 mm, and 0 mm). The data from 201 patients were retrospectively reviewed, and the margin positivity and re-excision rates were compared. The incidence of margin positivity at 1 mm was significantly lower for OBS than for WLE. Thus, OBS is not inferior to WLE and offers additional benefits by expanding patient choice. Introduction: Oncoplastic breast surgery (OBS) can be applied in larger tumors or in patients with high tumor-to-breast ratio without compromising oncologic safety. Inherent larger excisions may increase the probability of clear margins. We compare postoperative outcomes between simple wide local excision (WLE) and OBS assuming 3 different margin distances. Patients and Methods: Single oncoplastic surgeon data between April 2014 and September 2016, including tumor and treatment details, for WLE or OBS were reviewed. Relative incidence of margin positivity at 3 assumed distinct margin distances (2, 1, and 0 mm) and reexcision rates were compared. Statistical comparisons were performed by the Student t and chi-square tests. Results: Available data from 201 patients revealed similar patient age and respective tumor phenotypes between 2 cohorts (166 WLE and 35 OBS). Though both the preoperative (30 vs. 16 mm, P <.001) and postoperative tumor (30 vs. 19 mm, P =.001) sizes were greater in the OBS group, margin positivity rates were significantly lower, at 1 mm (5.7% vs. 20.8%, P =.036). Though similar rates of reexcision were observed, completion mastectomies were required in 5.4% of WLE versus 0 OBS. Similar rates of margin positivity and reexcision were observed between mammoplasties and chest wall perforator flaps. Conclusion: OBS is not inferior to standard WLE at providing a safe and clear oncologic margin regardless of margin distance (up to 2 mm) despite larger tumor size. The additional benefit of improved cosmesis, particularly in patients with larger tumor-to-breast ratio, offers a suitable and safe alternative, thus increasing patient choice and reducing the incidence of reexcision and completion mastectomy. AD - A. Agrawal, Consultant Oncoplastic Breast Surgeon, The Cambridge Breast Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Box 97, Cambridge, United Kingdom AU - Bali, R. AU - Kankam, H. K. N. AU - Borkar, N. AU - Provenzano, E. AU - Agrawal, A. DB - Embase Medline DO - 10.1016/j.clbc.2018.06.004 IS - 5 KW - adult article breast reconstruction breast surgery cancer incidence cancer surgery chest wall perforator flap cohort analysis human intermethod comparison major clinical study mastectomy medical record review middle aged oncoplastic breast surgery outcome assessment perforator flap postoperative period preoperative period retrospective study surgeon surgical margin United Kingdom university hospital wide excision LA - English M3 - Article N1 - L2000933805 2018-07-13 2018-10-08 PY - 2018 SN - 1938-0666 1526-8209 SP - e1053-e1057 ST - Wide Local Excision Versus Oncoplastic Breast Surgery: Differences in Surgical Outcome for an Assumed Margin (0, 1, or 2 mm) Distance T2 - Clinical Breast Cancer TI - Wide Local Excision Versus Oncoplastic Breast Surgery: Differences in Surgical Outcome for an Assumed Margin (0, 1, or 2 mm) Distance UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2000933805&from=export http://dx.doi.org/10.1016/j.clbc.2018.06.004 VL - 18 ID - 5276 ER - TY - JOUR AB - Introduction: Oncoplastic breast surgery (OBS) can be applied in larger tumors or in patients with high tumor-to-breast ratio without compromising oncologic safety. Inherent larger excisions may increase the probability of clear margins. We compare postoperative outcomes between simple wide local excision (WLE) and OBS assuming 3 different margin distances.Patients and Methods: Single oncoplastic surgeon data between April 2014 and September 2016, including tumor and treatment details, for WLE or OBS were reviewed. Relative incidence of margin positivity at 3 assumed distinct margin distances (2, 1, and 0 mm) and reexcision rates were compared. Statistical comparisons were performed by the Student t and chi-square tests.Results: Available data from 201 patients revealed similar patient age and respective tumor phenotypes between 2 cohorts (166 WLE and 35 OBS). Though both the preoperative (30 vs. 16 mm, P < .001) and postoperative tumor (30 vs. 19 mm, P = .001) sizes were greater in the OBS group, margin positivity rates were significantly lower, at 1 mm (5.7% vs. 20.8%, P = .036). Though similar rates of reexcision were observed, completion mastectomies were required in 5.4% of WLE versus 0 OBS. Similar rates of margin positivity and reexcision were observed between mammoplasties and chest wall perforator flaps.Conclusion: OBS is not inferior to standard WLE at providing a safe and clear oncologic margin regardless of margin distance (up to 2 mm) despite larger tumor size. The additional benefit of improved cosmesis, particularly in patients with larger tumor-to-breast ratio, offers a suitable and safe alternative, thus increasing patient choice and reducing the incidence of reexcision and completion mastectomy. AD - University of Cambridge, School of Clinical Medicine, Cambridge, UK Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK AN - 132027952. Language: English. Entry Date: 20190814. Revision Date: 20191001. Publication Type: journal article. Journal Subset: Biomedical AU - Bali, Radhika AU - Kankam, Hadyn K. N. AU - Borkar, Nikhilesh AU - Provenzano, Elena AU - Agrawal, Amit DB - cin20 DO - 10.1016/j.clbc.2018.06.004 DP - EBSCOhost IS - 5 KW - Breast Neoplasms -- Surgery Breast Neoplasms -- Pathology Breast Reconstruction -- Methods Lumpectomy -- Methods Middle Age Retrospective Design Prospective Studies Female Aged Carcinoma -- Surgery Carcinoma -- Pathology Adult N1 - Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA. Instrumentation: Wide Range Achievement Test (WRAT). NLM UID: 100898731. PMID: NLM30006254. PY - 2018 SN - 1526-8209 SP - e1053-e1057 ST - Wide Local Excision Versus Oncoplastic Breast Surgery: Differences in Surgical Outcome for an Assumed Margin (0, 1, or 2 mm) Distance T2 - Clinical Breast Cancer TI - Wide Local Excision Versus Oncoplastic Breast Surgery: Differences in Surgical Outcome for an Assumed Margin (0, 1, or 2 mm) Distance UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=132027952&site=ehost-live&scope=site VL - 18 ID - 623 ER - TY - JOUR AB - The history of autogenous breast reconstruction is outlined followed by a review of the problems associated with prosthetic reconstructive techniques. The advantages of and indications for autogenous tissue reconstruction are highlighted and illustrated with clinical examples. AD - Department of Surgery, Emory Clinic, Emory University School of Medicine, Atlanta, Georgia. AN - 8187412 AU - Bostwick, J., 3rd AU - Jones, G. DA - Apr DP - NLM ET - 1994/04/01 IS - 2 KW - Female Humans Mammaplasty/*methods Prostheses and Implants/*adverse effects *Surgical Flaps/standards LA - eng N1 - Bostwick, J 3rd Jones, G Journal Article Review United States Clin Plast Surg. 1994 Apr;21(2):165-75. PY - 1994 SN - 0094-1298 (Print) 0094-1298 SP - 165-75 ST - Why I choose autogenous tissue in breast reconstruction T2 - Clin Plast Surg TI - Why I choose autogenous tissue in breast reconstruction VL - 21 ID - 11910 ER - TY - JOUR AB - Nipple-areola complex (NAC) loss is one of the most devastating complications of mastopexy or breast reduction, and it requires revisional procedures with poor aesthetic outcome. In high-risk patients, a free nipple graft could be a choice, but it is associated with the same aesthetic concerns for both patients and surgeons. We report our experience with the septum-supero-medial-based mammaplasty to treat 22 patients with severe breast ptosis (nipple-to-sternal-notch distance > 40 cm). No NAC loss was observed. The study highlights surgical technical details and discusses anatomical considerations to justify the successful result. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . AU - Bucaria, V. AU - Elia, R. AU - Maruccia, M. AU - Annoscia, P. AU - Boccuzzi, A. AU - Giudice, G. DB - Medline DO - 10.1007/s00266-018-1189-8 IS - 6 KW - adult adverse event breast breast reconstruction cohort analysis esthetics female follow up human hypertrophy middle aged nipple pathophysiology patient safety patient satisfaction physiology postoperative complication preoperative care procedures retrospective study surgical flaps time factor transplantation treatment outcome wound healing LA - English M3 - Article N1 - L625889786 2019-01-17 2019-09-20 PY - 2018 SN - 1432-5241 SP - 1439-1446 ST - Why Choose the Septum-Supero-Medial (SSM)-Based Mammaplasty in Patients with Severe Breast Ptosis: An Anatomical Point of View T2 - Aesthetic plastic surgery TI - Why Choose the Septum-Supero-Medial (SSM)-Based Mammaplasty in Patients with Severe Breast Ptosis: An Anatomical Point of View UR - https://www.embase.com/search/results?subaction=viewrecord&id=L625889786&from=export http://dx.doi.org/10.1007/s00266-018-1189-8 VL - 42 ID - 5241 ER - TY - JOUR AB - Although the latissimus flap is known for its simplicity and reliability, use of the fleur-de-lis pattern was plagued by undesirable T-shaped donor sites and small breast volumes in thin patients. We report a modified technique for optimal shaping of the standard latissimus with the successful application of a modified fleur-de-lis pattern. Because a "wet" tumescent infiltration was utilized and large amounts of subcutaneous fat were harvested, these changes permitted application to a wide variety of patients, with generous breast volumes reducing the size of the implant placed and resulting in excellent donor-site scars. This is a retrospective cohort study of 53 delayed or immediate reconstructions performed consecutively by the principal author (M.E.A.) on 48 patients at a university-based, urban hospital. Each case was analyzed between April of 1995 and February of 1999, with a follow-up from 2.5 to 44 months. All patients underwent injection of tumescent solution into the subcutaneous plane and harvest of large amounts of subcutaneous fat with the neurologically intact latissimus muscle. The last 25 reconstructions utilized the modified fleur-de-lis skin pattern, an inferiorly based vertical limb and replacement of skin deficiency in both axes. Of 11 perioperatively irradiated patients, none required skin grafting, whereas 6 percent of all native mastectomy flaps were grafted. There was one instance of minor distal tip flap necrosis in a nonirradiated patient. No implants became infected or were extruded. Donor sites were without wound complications and unveiled a 16 percent overall seroma rate.Through selective addition of harvested tissue, this modified technique, particularly the fleur-de-lis pattern, permits improved volume and projection in the inferior pole. The T-shaped donor-site closure is not only acceptable, but is also desirable, with reduced wound tension and minimization of dog-ear formation. With a relative paucity of complications, this conceptually ideal modification is technically simple and aesthetically comparable to our transverse rectus abdominis muscle flap results. AD - Department of Plastic and Reconstructive Surgery, Northwestern University Medical School, Chicago, IL 60611, USA. AN - 11818831 AU - Aitken, M. E. AU - Mustoe, T. A. DA - Feb DO - 10.1097/00006534-200202000-00018 DP - NLM ET - 2002/01/31 IS - 2 KW - Adult Aged Breast/abnormalities Breast Implants Female Humans Mammaplasty/adverse effects/*methods Mastectomy, Radical/rehabilitation Middle Aged Necrosis Postoperative Complications Retrospective Studies Skin/pathology *Surgical Flaps LA - eng N1 - Aitken, Marguerite E Mustoe, Thomas A Journal Article United States Plast Reconstr Surg. 2002 Feb;109(2):525-33; discussion 534-8. doi: 10.1097/00006534-200202000-00018. PY - 2002 SN - 0032-1052 (Print) 0032-1052 SP - 525-33; discussion 534-8 ST - Why change a good thing? Revisiting the fleur-de-lis reconstruction of the breast T2 - Plast Reconstr Surg TI - Why change a good thing? Revisiting the fleur-de-lis reconstruction of the breast VL - 109 ID - 10073 ER - TY - JOUR AB - Breast reconstruction with autologous tissue achieves more natural results and a better simulation of a real breast than reconstruction based on prosthetic implants. Unlike implant-based reconstructions, which tend to develop capsular contractures, the results of autologous tissue reconstruction tend to improve with time. Ln the long run, the costs of autologous breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flaps are equal to or lower than those of reconstruction with tissue expansion and implants. Consequently, autologous tissue is preferable for most patients, provided they are suitable candidates for the surgery required by autologous reconstruction. AD - Univ Texas, Md Anderson Canc Ctr, Dept Plast Surg, Houston, TX 77030 USA. Kroll, SS (corresponding author), Univ Texas, Md Anderson Canc Ctr, Dept Plast Surg, Box 62,1515 Holcombe Blvd, Houston, TX 77030 USA. AN - WOS:000074008100002 AU - Kroll, S. S. DA - Apr IS - 2 J2 - Clin. Plast. Surg. KW - flap breast reconstruction implants Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: ZR731 Times Cited: 38 Cited Reference Count: 12 Kroll, SS 39 0 4 W b saunders co Philadelphia PY - 1998 SN - 0094-1298 SP - 135-+ ST - Why autologous tissue? T2 - Clinics in Plastic Surgery TI - Why autologous tissue? UR - ://WOS:000074008100002 VL - 25 ID - 4176 ER - TY - JOUR AB - Skin flap necrosis is the most common complication following prosthesis-based breast reconstruction. Many studies have reported on the efficacy of laser-assisted indocyanine green angiography (SPY Elite System) in detecting flap necrosis. A cost-effectiveness analysis of laser-assisted indocyanine green angiography is lacking. The authors performed a retrospective review of all consecutive immediate postmastectomy prosthesis-based reconstructions at the Brigham and Women's Hospital over a 7-year 10-month period. The rate of mastectomy skin flap necrosis and related implant loss was determined for the entire cohort and for the subgroups of patients at increased risk for developing this complication: smokers, obese patients, and patients with large breasts. Cost of treating implant loss and skin flap necrosis was calculated based on the average treatment courses and costs at the authors' institution. The cost of the SPY was obtained from LifeCell Corp. From January of 2004 through October of 2011, 79 of 710 prosthesis-based breast reconstructions (11.1 percent) developed mastectomy skin flap necrosis requiring excision and reclosure. Performing laser-assisted indocyanine green angiography on the entire cohort would result in an additional cost of $1537.30 per case of flap necrosis prevented. If laser-assisted indocyanine green angiography was performed on only these high-risk subgroups, the cost savings per case of flap necrosis prevented is $2098.80 for smokers, $5162.30 for patients with a body mass index greater than 30, and $1892.70 for patients with mastectomy weight greater than 800 g. Laser-assisted indocyanine green angiography is not cost-effective as a preventative measure for flap necrosis if used indiscriminately on all patients undergoing prosthesis-based breast reconstructions, but it is cost-effective for high-risk patients, such as smokers, obese patients, and patients with large breasts. AD - A. Kanuri AU - Kanuri, A. AU - Liu, A. S. AU - Guo, L. DB - Medline IS - 4 KW - coloring agent diagnostic agent indocyanine green angiography article breast augmentation cost cost benefit analysis cost control economics female human laser mastectomy methodology pathology retrospective study risk assessment skin surgical flaps vascularization LA - English M3 - Article N1 - L373206016 2014-06-10 PY - 2014 SN - 1529-4242 SP - 448e-54e ST - Whom should we SPY? A cost analysis of laser-assisted indocyanine green angiography in prevention of mastectomy skin flap necrosis during prosthesis-based breast reconstruction T2 - Plastic and reconstructive surgery TI - Whom should we SPY? A cost analysis of laser-assisted indocyanine green angiography in prevention of mastectomy skin flap necrosis during prosthesis-based breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L373206016&from=export VL - 133 ID - 6538 ER - TY - JOUR AB - White light spectroscopy non-invasively measures hemoglobin saturation at the capillary level rendering an end-organ measurement of perfusion. We hypothesized this technology could be used after microvascular surgery to allow for early detection of ischemia and thrombosis. The Spectros T-Stat monitoring device, which utilizes white light spectroscopy, was compared with traditional flap monitoring techniques including pencil Doppler and clinical exam. Data were prospectively collected and analyzed. Results from 31 flaps revealed a normal capillary hemoglobin saturation of 40-75% with increase in saturation during the early postoperative period. One flap required return to the operating room 12 hours after microvascular anastomosis. The T-stat system recorded an acute decrease in saturation from ∼50% to less than 30% 50 min prior to identification by clinical exam. Prompt treatment resulted in flap salvage. The Spectros T-Stat monitor may be a useful adjunct for free flap monitoring providing continuous, accurate perfusion assessment postoperatively. © 2012 Wiley Periodicals, Inc. AD - G.K. Lee, MC: 5715, 770 Welch Road, Palo Alto, CA 94304-5715, United States AU - Fox, P. M. AU - Zeidler, K. AU - Carey, J. AU - Lee, G. K. DB - Embase Medline DO - 10.1002/micr.22069 IS - 3 KW - hemoglobin adult article blood vessel shunt breast reconstruction capillary clinical article deep inferior epigastric perforator flap early diagnosis female free tissue graft gracilis flap graft perfusion graft salvage head and neck surgery human human tissue male microvascular thrombosis microvascular ischemia microvascular surgery operating room postoperative period priority journal prospective study pulse oximeter pulse oximetry radial forearm flap spectroscopy tensor fascia lata flap tissue oxygenation tissue perfusion transverse rectus abdominis musculocutaneous flap venous congestion white light spectroscopy LA - English M3 - Article N1 - L52372561 2013-01-08 2013-03-29 PY - 2013 SN - 0738-1085 1098-2752 SP - 198-202 ST - White light spectroscopy for free flap monitoring T2 - Microsurgery TI - White light spectroscopy for free flap monitoring UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52372561&from=export http://dx.doi.org/10.1002/micr.22069 VL - 33 ID - 6893 ER - TY - JOUR AD - Y.B. Cihan, Department of Radiation Oncology, Kayseri Education and Research Hospital, Kayseri, Turkey AU - Baykan, H. AU - Tastan, B. AU - Cihan, Y. B. DB - Embase Medline IS - 3 KW - adjuvant radiotherapy breast cancer breast reconstruction cancer radiotherapy cancer resistance deep inferior epigastric perforator flap human letter patient history of radiotherapy perforator flap quality of life radiosensitivity superficial inferior epigastric artery flap superior gluteal artery perforator flap tissue flap transverse rectus abdominis musculocutaneous flap LA - English M3 - Letter N1 - L2002169618 2019-06-28 2019-07-02 PY - 2019 SN - 1107-0625 SP - 1309-1310 ST - Which type of flap is more resistant to radiotherapy in breast cancer? T2 - Journal of B.U.ON. TI - Which type of flap is more resistant to radiotherapy in breast cancer? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002169618&from=export VL - 24 ID - 5085 ER - TY - JOUR AB - Introduction. - Patient satisfaction is a good indicator to evaluate the success of breast reconstruction. The aim of this study was to compare the long-term satisfaction in patients who underwent four breast reconstruction techniques. Patient and methods. - Self-evaluation was achieved by patients in 147 breast reconstructions using a four-point score: very disappointed, disappointed, satisfied and very satisfied. The mean follow-up was 5.3 year (1 to 21.5 year). The surgical procedures used were: transverse rectus abdominis myocutaneous flap (TRAM) 15%, autologous latissimus dorsi flap (ALD) 14%, latissimus dorsi flap with implant (LDI) 32% and implant alone 39%. Patients' satisfaction was compared regarding the type of surgical procedure, the postoperative follow-up time; the immediate or delayed breast reconstruction and the radiation history. Results. - Thirty-five percent of the patients were very satisfied with their operation, 54% were satisfied, 7% were disappointed and 4% very disappointed. After a 5-year follow-up, autologous flaps showed better results (P < 0.001). Patients were more satisfied with TRAM flaps than with surgical techniques using latissimus dorsi flaps (ALD and LDI). Patients treated with implants alone were statistically less satisfied. Only in the implant series, patient satisfaction decreased significantly with time (P < 0.001) and preoperative radiation (P = 0.005). Conclusions. - Flap-based breast reconstructions show consistent long-term satisfaction although the surgery is initially more demanding. Our study matches the latest trends in the use of free perforator flaps for breast reconstruction. Indeed, these procedures combine good satisfaction and minor sequelae at the donor site. (C) 2010 Elsevier Masson SAS. All rights reserved. AD - [Bodin, F.; Zink, S.; Lutz, J-C.; Kadoch, V.; Wilk, A.; Bruant-Rodier, C.] Hop Univ Strasbourg, Hop Civil, Serv Chirurg Plast Reconstructrice & Esthet, F-67091 Strasbourg, France. Bodin, F (corresponding author), Hop Univ Strasbourg, Hop Civil, Serv Chirurg Plast Reconstructrice & Esthet, BP 426,1 Pl Hop, F-67091 Strasbourg, France. frederic.bodin@chru-strasbourg.fr AN - WOS:000285084600006 AU - Bodin, F. AU - Zink, S. AU - Lutz, J. C. AU - Kadoch, V. AU - Wilk, A. AU - Bruant-Rodier, C. DA - Dec DO - 10.1016/j.anplas.2010.09.013 IS - 6 J2 - Ann. Chir. Plast. Esthet. KW - Breast reconstruction Patient satisfaction TRAM flap Latissimus dorsi flap Breast implant patient satisfaction immediate flap tram complications determinants diep Surgery LA - French M3 - Article N1 - ISI Document Delivery No.: 691MM Times Cited: 23 Cited Reference Count: 25 Bodin, F. Zink, S. Lutz, J-C. Kadoch, V. Wilk, A. Bruant-Rodier, C. 24 0 6 Elsevier Bridgewater 1768-319x PY - 2010 SN - 0294-1260 SP - 547-552 ST - Which breast reconstruction procedure provides the best long-term satisfaction? T2 - Annales De Chirurgie Plastique Esthetique TI - Which breast reconstruction procedure provides the best long-term satisfaction? UR - ://WOS:000285084600006 VL - 55 ID - 3014 ER - TY - JOUR AB - Background: Breast reconstruction is an appropriate option offered to women who are diagnosed with breast cancer or gene mutations. It may be accomplished with implants or autologous procedures. This cross-sectional study evaluated the satisfaction and quality of life in addition to complications and secondary corrections in women after successful autologous or alloplastic (implant) breast reconstruction. Methods: Women were included after successful breast reconstruction. The BREAST-Q instrument and standardized questionnaires on depression, recurrence concerns, and anxiety were sent by mail to the participants. In addition, data were collected on complications and secondary corrections. Multiple regression analysis and chi-square tests were applied to evaluate differences between the autologous breast reconstruction group (n = 47) and the implant breast reconstruction group (n = 45). Results: Women with a successful autologous reconstruction were significantly more satisfied with their reconstructed breasts than women with successful alloplastic breast reconstruction as measured with the BREAST-Q satisfaction with breasts module (p = 0.023). More women with an autologous breast reconstruction required secondary correction than women with an implant breast reconstruction (p = 0.012). Other findings did not differ between the two groups. Conclusions: Autologous breast reconstruction leads to more satisfaction than does implant breast reconstruction, notwithstanding that women with an autologous breast reconstruction more often required a secondary correction. The study found no ideal breast reconstruction suitable for all patients. However, this study may inform patients and medical teams in making decisions about breast reconstruction. This pilot study indicated several questions that we plan to further investigate in a larger prospective study. AD - [Eltahir, Yassir; Werners, Lisanne L. C. H.; Dreise, Marieke M.; van Emmichoven, Ingeborg A. Zeiffmans; Werker, Paul M. N.; de Bock, Geertruida H.] Univ Groningen, Univ Med Ctr Groningen, Dept Plast Surg, NL-9700 RB Groningen, Netherlands. Eltahir, Y (corresponding author), Univ Groningen, Univ Med Ctr Groningen, Dept Plast Surg, Hanzepl 1,BB81, NL-9700 RB Groningen, Netherlands. y.eltahir@umcg.nl AN - WOS:000346911000047 AU - Eltahir, Y. AU - Werners, Llch AU - Dreise, M. M. AU - van Emmichoven, I. A. Z. AU - Werker, P. M. N. AU - de Bock, G. H. DA - Jan DO - 10.1097/prs.0000000000000804 IS - 1 J2 - Plast. Reconstr. Surg. KW - hospital anxiety depression scale satisfaction surgery diep validation experience recurrence mastectomy implant Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: AX4OG Times Cited: 51 Cited Reference Count: 25 Eltahir, Yassir Werners, Lisanne L. C. H. Dreise, Marieke M. van Emmichoven, Ingeborg A. Zeiffmans Werker, Paul M. N. de Bock, Geertruida H. de Bock, Geertruida Hendrika/F-6529-2014; Werker, Paul/L-6293-2019 de Bock, Geertruida Hendrika/0000-0003-3104-4471; 53 0 8 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2015 SN - 0032-1052 SP - 43-50 ST - Which Breast Is the Best? Successful Autologous or Alloplastic Breast Reconstruction: Patient-Reported Quality-of-Life Outcomes T2 - Plastic and Reconstructive Surgery TI - Which Breast Is the Best? Successful Autologous or Alloplastic Breast Reconstruction: Patient-Reported Quality-of-Life Outcomes UR - ://WOS:000346911000047 VL - 135 ID - 2325 ER - TY - JOUR AB - Purpose: A drain tube is commonly inserted during breast reconstruction surgery. This leads to a scar in addition to the scar on the breast. This study was performed to investigate how patients feel about the drain scar and to clarify its ideal location. Methods: A questionnaire survey about the drain scar was distributed to 38 consecutive breast reconstruction patients and a total of 104 female doctors and nurses engaged in breast reconstruction. The drain scars were evaluated using the Japan Scar Workshop (JSW) Scar Scale. Results: A total of 32% of the patients expressed some anxiety about the drain scar. Patients who were anxious about the drain scar had higher scores on the JSW Scar Scale than those who were not anxious. Younger doctors and nurses preferred the drain scar to be on the side of the chest, while older doctors and nurses preferred the drain scars to be at the axilla. Conclusions: About a third of the patients had some anxiety associated with their drain scar after breast reconstruction surgery, and this anxiety level was correlated with objective assessment of the scar. Thus, more patient involvement or the provision of more information regarding drain placement is required. AD - H. Nishioka, Department of Plastic and Reconstructive Surgery, Kofu Municipal Hospital, 366 Masutsubo Kofu, Yamanashi, Japan AU - Nishioka, H. AU - Yasunaga, Y. AU - Yanagisawa, D. AU - Yuzuriha, S. AU - Ito, K. I. DB - Embase Medline DO - 10.1007/s00595-020-02043-1 IS - 12 KW - Blake Silicone Drain Tube breast endoprosthesis breast tissue expander drainage tube silk suture abdomen adult aged anxiety article axilla breast reconstruction clinical article deep inferior epigastric perforator flap erythema female hematoma human hyperpigmentation latissimus dorsi flap nurse pain patient participation physician plastic surgeon pruritus questionnaire scar seroma skin necrosis skin redness thorax LA - English M3 - Article N1 - L2005165530 2020-06-30 2021-03-22 PY - 2020 SN - 1436-2813 0941-1291 SP - 1626-1632 ST - Where do you insert a drain tube during breast reconstruction? T2 - Surgery Today TI - Where do you insert a drain tube during breast reconstruction? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005165530&from=export http://dx.doi.org/10.1007/s00595-020-02043-1 VL - 50 ID - 4561 ER - TY - JOUR AB - This article reviews historical aspects of flap development, leading up to the exciting recognition of perforator flaps. The role and use of perforator-type flaps in the reconstructive armamentarium is reviewed as it pertains to different regions of the body. © 2010 Elsevier Inc. AD - J.J. Pribaz, Division of Plastic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States AU - Pribaz, J. J. AU - Chan, R. K. DB - Embase Medline DO - 10.1016/j.cps.2010.06.007 IS - 4 KW - arm breast reconstruction buttock cadaver clinical practice head and neck surgery human lower leg pelvis surgery perforator flap personal experience professional knowledge rectum abdominoperineal resection review skin blood flow skin blood vessel surgeon surgical anatomy thorax surgery tissue characterization trunk LA - English M3 - Review N1 - L359482917 2010-09-14 2010-10-01 PY - 2010 SN - 0094-1298 SP - 571-579 ST - Where do perforator flaps fit in our armamentarium? T2 - Clinics in Plastic Surgery TI - Where do perforator flaps fit in our armamentarium? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L359482917&from=export http://dx.doi.org/10.1016/j.cps.2010.06.007 VL - 37 ID - 7456 ER - TY - JOUR AB - Background: Although the indocyanine green angiography (ICGA) has been used for years in the assessment of Deep Inferior Epigastric Perforator (DIEP) perfusion, it has not yet been established when it should be performed during the surgery. The aim of this study is to evaluate whether it is better to perform the test on the donor or recipient sites. Methods: Intraoperative perfusion of 46 DIEP flaps was assessed twice, on the donor and recipient sites. Differences between both ischemic areas of each flap were statistically analyzed. In addition, perforator location and risk factors were evaluated in order to assess whether they are associated with changes in the perfusion of the flap between both sites. Results: Differences between ischemic areas on the donor and recipient sites were statistically significant (p = 0.012). However, in most cases (82.6%) the ischemic area was the same on both sites, and the final flap design only changed in two cases (4.3%) because of the ICGA findings on the recipient site. Besides, performing the ICGA on the donor site facilitated the identification of the best perfused areas, allowed a better planning of its placement into the recipient site, and also can be useful to choose the best perforator. Bilateral DIEP flap, lateral location of the perforator and tobacco use had a statistically significant association with lower probability to increase the perfusion area between both sites. Conclusions: several advantages have been found in performing the ICGA on the donor site to assess the perfusion of the DIEP flap. (C) 2019 Elsevier Ltd. All rights reserved. AD - [Malagon-Lopez, Paloma] Univ Autonoma Barcelona, Hosp Germans Trias & Pujol, Dept Plast Surg, Barcelona, Spain. [Carrasco-Lopez, Cristian; Garcia-Senosiain, Oihane; Vila, Jordi; Del-Rio, Maria; Priego, David] Hosp Badalona Germans Trias & Pujol, Dept Plast Surg, Barcelona, Spain. [Julian-Ibanez, Juan E.] Univ Autonoma Barcelona, Hosp Germans Trias & Pujol, Gen Surg Dept, Barcelona, Spain. [Higueras-Sune, Carmen] Hosp Badalona Germans Trias & Pujol, Plast Surg Dept, Barcelona, Spain. Malagon-Lopez, P (corresponding author), Hosp Badalona Germans Trias & Pujol, Canyet S-N, Barcelona 08916, Spain. pal.malagon@gmail.com AN - WOS:000482211900013 AU - Malagon-Lopez, P. AU - Carrasco-Lopez, C. AU - Garcia-Senosiain, O. AU - Vila, J. AU - Del-Rio, M. AU - Priego, D. AU - Julian-Ibanez, J. E. AU - Higueras-Sune, C. DA - Oct DO - 10.1016/j.breast.2019.07.009 J2 - Breast KW - DIEP Breast reconstruction Indocyanine green Free flap Perfusion Microsurgery independent risk-factors free-tissue transfer perforator flap tram flap vascular anatomy plastic-surgery ct-angiography blood-flow fluorescent angiography cigarette-smoking Oncology Obstetrics & Gynecology LA - English M3 - Article N1 - ISI Document Delivery No.: IS5SD Times Cited: 3 Cited Reference Count: 85 Malagon-Lopez, Paloma Carrasco-Lopez, Cristian Garcia-Senosiain, Oihane Vila, Jordi Del-Rio, Maria Priego, David Julian-Ibanez, Juan E. Higueras-Sune, Carmen Ibanez, Joan Francesc Julian/AAD-9523-2021 Ibanez, Joan Francesc Julian/0000-0003-2646-2791; Malagon-Lopez, Paloma/0000-0002-9797-4789 3 0 2 Churchill livingstone Edinburgh 1532-3080 PY - 2019 SN - 0960-9776 SP - 102-108 ST - When to assess the DIEP flap perfusion by intraoperative indocyanine green angiography in breast reconstruction? T2 - Breast TI - When to assess the DIEP flap perfusion by intraoperative indocyanine green angiography in breast reconstruction? UR - ://WOS:000482211900013 VL - 47 ID - 1320 ER - TY - JOUR AB - Background: It is controversial whether breast reconstruction with a microvascular free flap should be done without restrictions in patients who have not had radiotherapy. Many regard it as too expensive, but some consider it better and more economically advantageous than an implant reconstruction. Methods: Databases of publications were searched to find out under what conditions is it suitable to offer a deep inferior epigastric perforator (DIEP) or a transverse rectus abdominis myocutaneous flap to normalize the body's appearance in a woman whose breast(s) had been removed for cancer or to prevent the development of breast cancer. The effect of breast reconstruction with DIEP flaps was analyzed, taking account of the following factors: general satisfaction (quality of life), aesthetic satisfaction (cosmesis), and morbidity. To find out which factors were of potential importance, we recorded age, hypertension, whether scars from previous abdominal surgery were present, microcirculation, whether the patient was overweight or obese, and costs of the procedure. Results: Patients planning to have DIEP flaps should be willing to stop smoking at least 4 weeks before and after the procedure and have a body mass index of less than 30 kg/m(2) to avoid a higher risk of complications. Because of the paucity of papers, it is difficult to recommend one approach over the other when considering general satisfaction, aesthetic satisfaction, and health economics. However, economical long-term outcome is highly dependent on the initial costs of each procedure and the cumulative costs of complications for each reconstruction method. Conclusions: The scientific foundation of assessment of methods of techniques of breast reconstruction is weak. Therefore, it is important that future studies should present more comparable series, highlight the long-term effects in high-quality studies, to provide the patients with optimal results without undue risks and to avoid financial burdens on society. AD - [Lundberg, Jonas; Thorarinsson, Andri; Elander, Anna] Sahlgrens Univ Hosp, Dept Plast Surg, S-41345 Gothenburg, Sweden. [Karlsson, Per] Sahlgrens Univ Hosp, Dept Oncol, S-41345 Gothenburg, Sweden. [Ringberg, Anita] Skane Univ Hosp, Dept Plast & Reconstruct Surg, Malmo, Sweden. [Ringberg, Anita] Lund Univ, Malmo, Sweden. [Frisell, Jan] Karolinska Univ Hosp, Dept Breast Surg, Breast Sarcoma Sect, Stockholm, Sweden. [Hatschek, Thomas] Karolinska Univ Hosp, Dept Oncol, Breast Sarcoma Sect, Stockholm, Sweden. [Kallstrom, Ann-Christine] Helsingborg Hosp, Dept Surg, Helsingborg, Sweden. Lundberg, J (corresponding author), Sahlgrens Univ Hosp, Dept Plast Surg, S-41345 Gothenburg, Sweden. jonas.c.lundberg@vgregion.se AN - WOS:000338342000024 AU - Lundberg, J. AU - Thorarinsson, A. AU - Karlsson, P. AU - Ringberg, A. AU - Frisell, J. AU - Hatschek, T. AU - Kallstrom, A. C. AU - Elander, A. DA - Jul DO - 10.1097/SAP.0b013e31826cafd0 IS - 1 J2 - Ann. Plast. Surg. KW - deep inferior epigastric perforator (DIEP) transverse rectus abdominis myocutaneous (TRAM) breast reconstruction general satisfaction aesthetic satisfaction cosmesis complications age hypertension scars diabetes smoking overweight obesity health economics postmastectomy radiation-therapy skin-sparing mastectomy perforator diep flap quality-of-life free tram flaps risk-factors complication rates aesthetic satisfaction retrospective analysis immediate Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: AK3RI Times Cited: 6 Cited Reference Count: 90 Lundberg, Jonas Thorarinsson, Andri Karlsson, Per Ringberg, Anita Frisell, Jan Hatschek, Thomas Kallstrom, Ann-Christine Elander, Anna 6 0 5 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2014 SN - 0148-7043 SP - 105-113 ST - When Is the Deep Inferior Epigastric Artery Flap Indicated for Breast Reconstruction in Patients not Treated With Radiotherapy? T2 - Annals of Plastic Surgery TI - When Is the Deep Inferior Epigastric Artery Flap Indicated for Breast Reconstruction in Patients not Treated With Radiotherapy? UR - ://WOS:000338342000024 VL - 73 ID - 2400 ER - TY - JOUR AB - Background We developed a novel pedicled DIEP flap model in rat to explore the possible remedy for the distal necrosis of the flap. Methods A deep inferior epigastric perforator (DIEP) flap, based on the second right cranial perforator (P2) as the main pedicle, was elevated in 48 Sprague-Dawley rats. The rats were randomized into 4 groups: group I, the left P2 remaining intact as supercharging; group II, the left P2 artery alone kept as supercharging; group III, the left P2 vein alone kept as supercharging; group IV, no supercharging. Transcutaneous oxygen pressure (TcPO2) and transcutaneous carbon dioxide pressure (TcPCO2) were measured immediately after flap elevation, protein level of Hif- 1a was measured 48 hours later, and flap survival was assessed 7 days postoperatively. Results Blockade of artery led to significantly lower TcPO2, higher TcPCO2, and higher expression level of Hif- 1a in the distal side of the flap in group III and group IV, than those of group I and group II. At 7 days post surgery, significantly lower flap survival rates were observed in group III (81.9 +/- 5.7%) and group IV (78.4 +/- 6.5%), compared to observed in group I (97.2 +/- 3.0%) and group II (94.2 +/- 6.2%). Conclusions It might be arterial insufficiency, not venous congestion, which mainly caused the distal necrosis of the DIEP flap in rat. Arterial instead of venous supercharging might be a more effective procedure that improves circulation to zone IV of the flap. AD - [Zhang, Yi; Wang, Tingliang; Wei, Jiao; He, Jinguang; Wang, Tao; Liu, Ying; Xu, Hua; Dong, Jiasheng] Shanghai Jiao Tong Univ, Shanghai Peoples Hosp 9, Sch Med, Shanghai, Peoples R China. Xu, H (corresponding author), Shanghai Jiao Tong Univ, Shanghai Peoples Hosp 9, Sch Med, Shanghai, Peoples R China. doctorxuhua@hotmail.com; dongjiasheng_9y@163.com AN - WOS:000394244300033 AU - Zhang, Y. AU - Wang, T. L. AU - Wei, J. AU - He, J. G. AU - Wang, T. AU - Liu, Y. AU - Xu, H. AU - Dong, J. S. C7 - e0171651 DA - Feb DO - 10.1371/journal.pone.0171651 IS - 2 J2 - PLoS One KW - epigastric perforator flap unilateral breast reconstruction vascular augmentation model experience tram anastomosis angiosomes selection efficacy Science & Technology - Other Topics LA - English M3 - Article N1 - ISI Document Delivery No.: EK9KV Times Cited: 5 Cited Reference Count: 35 Zhang, Yi Wang, Tingliang Wei, Jiao He, Jinguang Wang, Tao Liu, Ying Xu, Hua Dong, Jiasheng Wang, Tingliang/0000-0001-7440-7119 7 1 4 Public library science San francisco PY - 2017 SN - 1932-6203 SP - 13 ST - What's the remedy for the distal necrosis of DIEP flap, better venous drain or more arterial supply? T2 - Plos One TI - What's the remedy for the distal necrosis of DIEP flap, better venous drain or more arterial supply? UR - ://WOS:000394244300033 VL - 12 ID - 1873 ER - TY - JOUR AB - This article describes new trends, techniques, and instrumentation in aesthetic surgery. Advances in our understanding of anatomy and the changes that come about with intrinsic and extrinsic factors are discussed. Specifically, anatomic approaches to rhytidectomy, the preservation of lid shape in blepharoplasty, and CO2 facial resurfacing are highlighted. Body contouring surgical techniques, including minimal scar breast reductions, endoscopic-assisted augmentation mammoplasty, and superficial liposuction, are reviewed. AD - Department of Surgery (Plastic), University of Miami School of Medicine, Florida, USA. AN - 8617029 AU - Baker, T. M. AU - Stuzin, J. M. AU - Baker, T. J. AU - Gordon, H. L. DA - Jan DP - NLM ET - 1996/01/01 IS - 1 KW - Antihypertensive Agents/therapeutic use Clonidine/therapeutic use Esthetics Eyelids/surgery Female Humans Laser Therapy Lipectomy Male Mammaplasty Preoperative Care Rhytidoplasty Surgery, Plastic/methods/*trends Surgical Flaps LA - eng N1 - Baker, T M Stuzin, J M Baker, T J Gordon, H L Journal Article Review United States Clin Plast Surg. 1996 Jan;23(1):3-16. PY - 1996 SN - 0094-1298 (Print) 0094-1298 SP - 3-16 ST - What's new in aesthetic surgery T2 - Clin Plast Surg TI - What's new in aesthetic surgery VL - 23 ID - 13550 ER - TY - JOUR AB - Background: Reconstruction after mastectomy is an important milestone for many women treated for breast cancer. However, because many surgeons only offer their preferred method of reconstruction, it is not clear which approach women would choose if offered a genuine choice. Methods: Between 1998 and 2010, the breast reconstruction service at a major Australian teaching hospital was staffed by a single plastic surgeon trained in both prosthetic and autologous breast reconstruction techniques. The choices of all 837 women who underwent reconstruction were compared across time for publicly and privately funded patients using binary logistic regression. Results: Overall, women chose prosthetic over autologous reconstruction at a ratio of 4.7: 1. This ratio increasingly favored prosthetic reconstruction over time, though less strongly for private patients who did not face a 3-year waiting list for autologous reconstruction. Conclusions: Financial constraints affected these women's reconstruction choices. Nevertheless, and in contrast to the situation in the United States, these women clearly favored prosthetic over autologous reconstruction. AD - [Lam, Thomas C.] Westmead Hosp, Dept Plast & Reconstruct Surg, Westmead, NSW, Australia. [Lam, Thomas C.; Winch, Caleb J.] Macquarie Univ, Fac Med & Hlth Sci, Dept Clin Med, Sydney, NSW, Australia. Lam, TC (corresponding author), Westmead Private Hosp, Suite 3,Darcy Rd, Westmead, NSW 2145, Australia. tlam@plasticsurgery.org.au AN - WOS:000388363200044 AU - Lam, T. C. AU - Winch, C. J. C7 - e1062 DA - Sep DO - 10.1097/gox.0000000000001062 IS - 9 J2 - Prs-Glob. Open KW - cancer patients tram flap mastectomy postmastectomy immediate satisfaction radiotherapy surgery rates association Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: EC8AV Times Cited: 5 Cited Reference Count: 33 Lam, Thomas C. Winch, Caleb J. Winch, Caleb/A-1519-2015 Winch, Caleb/0000-0002-0899-2708; Lam, Thomas C/0000-0002-3990-4213 5 0 4 Lippincott williams & wilkins Philadelphia PY - 2016 SN - 2169-7574 SP - 6 ST - What Would Women Choose When Given a Choice in Breast Reconstruction? T2 - Plastic and Reconstructive Surgery-Global Open TI - What Would Women Choose When Given a Choice in Breast Reconstruction? UR - ://WOS:000388363200044 VL - 4 ID - 1958 ER - TY - JOUR AB - Objective: To evaluate retrospectively the morbidity of four different surgical procedures for immediate breast reconstruction (IBR) in the setting of neoadjuvant chemotherapy and radiotherapy, and to determine which procedure is best adapted to these circumstances. Patients and methods: Immediate breast reconstruction was undertaken in 101 patients who had undergone neoadjuvant chemotherapy and radiotherapy for invasive breast carcinoma. IBR was accomplished by transverse rectus abdominis musculocutaneous flap (TRAM) in 38 patients, by latissimus dorsi musculocutaneous flap with prosthesis (LDMP) in 32, by autologous latissimus dorsi musculocutaneous flap (ALDM) in 15, and by simple prosthetic implant in 26. Results: The complication rates for TRAM. LDMP, ALDM and prosthesis were respectively 50%, 37.5%, 85%, and 62%. The need for additional surgical procedure(s) was respectively 29%, 15%, 6%, and 56%. The complication rate was significantly worse (p=0.013) for ALDM (RR=1.73, IC95%=1.12-2.69), and the need for surgical revision was worst (p=0.00087).for simple prosthetic implant (RR=1.99, IC95%=l.11-3.59). Conclusion: IBR using musculocutaneous flap is superior to the use of prosthetic implant in patients having undergone neoadjuvant chemotherapy and radiotherapy. AD - [Michy, T.] Ctr Rene Gauducheau Nantes, Nantes, France. [Gimbergues, P.; Le Bouedec, G.; Dauplat, J.] Ctr Jean Perrin Clermont Ferrand, Serv Chirurg Oncol, Clermont Ferrand, France. Michy, T (corresponding author), Ctr Rene Gauducheau, Blvd Jacques Monod, F-44805 St Herblain, France. tmichy@hotmail.com AN - WOS:000252061600007 AU - Michy, T. AU - Gimbergues, P. AU - Le Bouedec, G. AU - Dauplat, J. DA - Nov-Dec DO - 10.1016/s0021-7697(07)79777-6 IS - 6 J2 - J. Chir. KW - breast cancer immediate breast reconstruction musculocutaneous flap prosthesis radiotherapy neoadjuvant chemotherapy previously irradiated patients latissimus-dorsi flap musculocutaneous flap implants Surgery LA - French M3 - Article N1 - ISI Document Delivery No.: 247EZ Times Cited: 6 Cited Reference Count: 20 Michy, T. Gimbergues, P. Le Bouedec, G. Dauplat, J. 6 0 1 Masson editeur Moulineaux cedex 9 PY - 2007 SN - 0021-7697 SP - 511-515 ST - What surgical procedure for immediate breast reconstruction after preoperative radiotherapy and chemotherapy? T2 - Journal De Chirurgie TI - What surgical procedure for immediate breast reconstruction after preoperative radiotherapy and chemotherapy? UR - ://WOS:000252061600007 VL - 144 ID - 3497 ER - TY - JOUR AB - Purpose of Review: The purpose of this review is to highlight the major tenets of breast reconstruction and to summarize the existing state of the literature related to these. Recent Findings: Trends in breast reconstruction rates have recently reversed. Existing data cannot yet account for this. Current literature may not fully address the actual reality of breast reconstruction today. Outcome measures to define a successful breast reconstruction continue to be refined. Reconstruction choices related to type of reconstruction and timing, as well as oncologic treatment trends and device technology, are in constant evolution. Summary: A great diversity of reconstruction opportunities exists to suit patients’ needs. Careful understanding of the evidence base in breast reconstruction must be employed by plastic surgeons to maximize the benefit of reconstruction for each individual patient. AD - M.A. Manahan, Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, 601 N. Caroline St., Baltimore, MD, United States AU - Manahan, M. A. DB - Embase DO - 10.1007/s40137-020-00260-8 IS - 8 KW - silicone prosthesis surgical mesh tissue expander bacterium contamination biofilm breast cancer breast hypertrophy breast reconstruction cancer surgery graft survival hematoma hospitalization human immunosuppressive treatment liposuction mastectomy melanoma osseointegration patient advocacy patient satisfaction pedicled skin flap perforator flap prospective study quality of life rectus abdominis muscle review risk factor Short Form 36 skin expansion skin flap systematic review temperature tissue expansion transverse rectus abdominis musculocutaneous flap LA - English M3 - Review N1 - L2005151367 2020-06-11 2020-06-30 PY - 2020 SN - 2167-4817 ST - What Surgeons Should Know About Breast Reconstruction for Oncology Patients T2 - Current Surgery Reports TI - What Surgeons Should Know About Breast Reconstruction for Oncology Patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005151367&from=export http://dx.doi.org/10.1007/s40137-020-00260-8 VL - 8 ID - 4667 ER - TY - JOUR AB - In spite of the Gent consensus on perforator flap terminology, widespread confusion still exists regarding the true description of these flaps, making it hard to understand these surgical procedures in comparison with conventional flap techniques. The value of perforator flaps can be better understood by further clarifying certain aspects of previous descriptions. The authors would like to propose enriching the standard Gent nomenclature with optional terms that specify additional aspects of the perforator flap such as including the vessel of origin, the type of vascular dissection, the muscle involved, and the type of perforator vessel. When describing a new flap, these terms will help clarify the anatomical aspects and the surgical approach. Lastly, a better understanding will help in the ongoing debates on this type of surgery and will aid in its dissemination and adoption into reconstructive practice. (Plast. Reconstr. Surg. 126: 2258, 2010.) AD - Jules Verne Univ Picardie, Amiens N Hosp, Dept Plast, Amiens, France. Jules Verne Univ Picardie, Amiens N Hosp, Dept Reconstruct, Amiens, France. Jules Verne Univ Picardie, Amiens N Hosp, Dept Aesthet Surg, Amiens, France. Royal Devon & Exeter Hosp, Exeter EX2 5DW, Devon, England. Sinna, R (corresponding author), CHU Amiens, Hop Nord, Dept Plast Reconstruct & Aesthet Surg, Pl Victor Pauchet, F-80054 Amiens 01, France. raphaelsinna@gmail.com AN - WOS:000284832400082 AU - Sinna, R. AU - Boloorchi, A. AU - Mahajan, A. L. AU - Qassemyar, Q. AU - Robbe, M. DA - Dec DO - 10.1097/PRS.0b013e3181f61824 IS - 6 J2 - Plast. Reconstr. Surg. KW - soft-tissue flap breast reconstruction clinical-experience history body terminology angiosomes update Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 688EK Times Cited: 23 Cited Reference Count: 40 Sinna, Raphael Boloorchi, Armand Mahajan, Ajay L. Qassemyar, Quentin Robbe, Micheline Qassemyar, Quentin/AAF-5105-2019 33 0 3 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2010 SN - 0032-1052 SP - 2258-2263 ST - What Should Define a "Perforator Flap"? T2 - Plastic and Reconstructive Surgery TI - What Should Define a "Perforator Flap"? UR - ://WOS:000284832400082 VL - 126 ID - 3022 ER - TY - JOUR AB - The goal of plastic surgeons performing postmastectomy anatomic reconstruction is to create a breast structure that closely matches the shape and appearance of a patient's native breast. Tattoo artists have helped improve outcomes with nipple-areolar tattooing. Some patients now prefer to have more extensive, nonanatomic designs to help camouflage their scars. Two questions are considered here: What role should plastic surgeons have in supporting or performing nonanatomic reconstruction? And should insurance programs cover nonanatomic breast reconstruction options? AU - Kozlow, J. H. DB - Medline DO - 10.1001/journalofethics.2018.20.4.msoc1-1804 IS - 4 KW - adult breast reconstruction ethics female human patient satisfaction procedures scar surgical flaps tattooing LA - English M3 - Article N1 - L629407378 2021-01-20 PY - 2018 SN - 2376-6980 SP - 366-371 ST - What Should Be the Role of Plastic Surgeons in Nonanatomic Breast Reconstruction, including Tattooing? T2 - AMA journal of ethics TI - What Should Be the Role of Plastic Surgeons in Nonanatomic Breast Reconstruction, including Tattooing? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629407378&from=export http://dx.doi.org/10.1001/journalofethics.2018.20.4.msoc1-1804 VL - 20 ID - 5464 ER - TY - JOUR AB - Microsurgical free tissue transfer is regarded as the best available method of tissue reconstruction for intractable defects. The ideal soft tissue flap is thought to be the anterolateral thigh flap. On the basis of 334 procedures involving the latissimus dorsi (LD) flap, we discuss the advantages of the LD flap over the current universal option, and we aimed to establish whether the LD could also gain universal status in all reconstructive fields. Three hundred thirty-four reconstructive procedures using the LD flap were performed in 322 patients between September 2002 and July 2012. In accordance with defect characteristics, we performed 334 procedures using flaps, which included the LD muscle flap with skin graft, the myocutaneous flap, the muscle-sparing flap, the perforator flap, the chimeric flap, and the 2-flap technique using the serratus anterior branch. Flap-related complications occurred in 21 patients (6.3%), including total and partial flap failure. In 253 cases, the donor site was closed primarily, and in the remaining cases, we used split-thickness skin grafts. Donor-site complications occurred in 20 cases (6%). In 11 of the 182 cases, no suitable perforators were identified during surgery. The advantages of the LD as a donor site include the possibility of various harvesting positions without position change, versatility of components, availability of muscle to fill extensive defects, and presence of thick fascia to enable full abdominal reconstruction. On the basis of our experience, we concluded that this flap has the potential to be used as widely as, or in preference to, the anterolateral thigh flap in most reconstructive areas. AD - [Kim, Jeong Tae; Youn, Seungki; Kim, Youn Hwan] Hanyang Univ, Coll Med, Dept Plast & Reconstruct Surg, Seoul 133791, South Korea. [Kim, Sang Wha] Seoul Natl Univ, Coll Med, Seoul Natl Univ Hosp, Dept Plast & Reconstruct Surg, Seoul, South Korea. Kim, YH (corresponding author), Hanyang Univ, Coll Med, Dept Plast & Reconstruct Surg, 17 Haengdang Dong,133-792 Seongdong Gu, Seoul 133791, South Korea. sw1215@snu.ac.kr AN - WOS:000356665400011 AU - Kim, J. T. AU - Kim, S. W. AU - Youn, S. AU - Kim, Y. H. DA - Jul DO - 10.1097/sap.0000000000000010 IS - 1 J2 - Ann. Plast. Surg. KW - latissimus dorsi flap microsurgery donor anterolateral thigh anterolateral thigh flap artery perforator flap computed tomographic angiography breast reconstruction defects pedicle Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: CL0XC Times Cited: 13 Cited Reference Count: 30 Kim, Jeong Tae Kim, Sang Wha Youn, Seungki Kim, Youn Hwan 15 0 6 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2015 SN - 0148-7043 SP - 49-54 ST - What Is the Ideal Free Flap for Soft Tissue Reconstruction? A Ten-Year Experience of Microsurgical Reconstruction Using 334 Latissimus Dorsi Flaps From a Universal Donor Site T2 - Annals of Plastic Surgery TI - What Is the Ideal Free Flap for Soft Tissue Reconstruction? A Ten-Year Experience of Microsurgical Reconstruction Using 334 Latissimus Dorsi Flaps From a Universal Donor Site UR - ://WOS:000356665400011 VL - 75 ID - 2224 ER - TY - JOUR AB - INTRODUCTION: Breast conservation (BC) rates have been utilized as a quality metric, yet mastectomy rates have been noted to be increasing nationwide. The purpose of this study was to evaluate the factors associated with BC in 437 US breast centers surveyed by the National Accreditation Program of Breast Centers (NAPBC). METHODS: From 2006 to 2010, 437 breast centers across the US were surveyed by the NAPBC. At each center, annual data regarding BC rates were reported in the Survey Application Record (SAR) for patients with Stage 0-II breast cancer. We evaluated characteristics of breast centers including geographic location, volume of patients treated, therapeutic modalities provided, and center organizational relationships. Non-parametric statistical analyses were performed to determine factors associated with BC rates in this cohort. RESULTS: Among the 437 breast centers surveyed from 2006-2011, data on 77,248 patients with Stage 0-II were reported. The median number of Stage 0-II breast cancer patients per center was 149 (range; 10-891). The median proportion of these patients who underwent BC was 64.8% (range; 33-100%). No significant differences in median BC rate was noted over the six years of the study (range; 64.2% in 2006 - 67.1% in 2011, p = 0.788). However, significant regional variations were noted in median BC rates: 62.2% in the West (N = 59 centers), 63.8% in the South (N = 145 centers), 64.1% in the Midwest (N = 118 centers), and 70.8% in the Northeast (N = 104 centers), p < 0.001. There was no difference noted in BC rates between high volume ( 150 Stage 0-II cases/yr) and low volume (< 150 Stage 0-II cases/yr) centers (median 65.1% vs. 64.6%, respectively, p = 0.584). No differences in BC rate was noted between centers that referred vs. provided implant-based (p = 0.259), TRAM flap (p = 0.069), latissimus dorsi flap (p = 0.108) or DIEP/free flap (p = 0.324) reconstruction. Similarly, there was no difference noted in BC rates between centers who referred vs. provided whole breast radiation therapy (p = 0.224) and accelerated partial breast irradiation (p = 0.964). Centers that were affiliated with a hospital (N = 195) had a lower rate of BC than those that were not (n = 232); median 63.9% vs. 66.3%, p = 0.037. The majority of centers surveyed were also accredited by the Commission on Cancer (CoC; N=395); however, no differences were noted between these centers and those who were not CoC accredited in terms of BC rates (64.9% vs. 65.8%, respectively, p = 0.748). In a multivariate linear regression model, both region (p = 0.008) and hospital affiliation (p = 0.004) remained significant independent predictors of BC. CONCLUSION: Across 437 US breast centers, data from 77,248 patients demonstrate a national BC rate of 64.8%. While the rate does not seem to be varying significantly over time, variation in BC was noted between regions and between centers associated with hospitals vs. not. Rates of BC do not vary, however, by center volume, availability of reconstruction or radiation, nor by CoC accreditation status. These data suggest that patient choice, rather than the availability of radiation and reconstruction, is the driving force in surgical decision-making. AD - A.B. Chagpar AU - Chagpar, A. B. AU - Kaufman, C. S. AU - Connolly, J. AU - Burgin, C. AU - Granville, T. AU - Winchester, D. DB - Embase DO - 10.1158/0008-5472.SABCS12-PD04-04 IS - 24 KW - breast accreditation breast cancer United States human patient hospital radiation linear regression analysis statistical analysis neoplasm geography mastectomy irradiation radiotherapy latissimus dorsi flap transverse rectus abdominis musculocutaneous flap implant decision making model cancer patient LA - English M3 - Conference Abstract N1 - L71097692 2013-07-04 PY - 2012 SN - 0008-5472 ST - What is influencing breast conservation rates in the United States? data from the national accreditation program of breast centers T2 - Cancer Research TI - What is influencing breast conservation rates in the United States? data from the national accreditation program of breast centers UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71097692&from=export http://dx.doi.org/10.1158/0008-5472.SABCS12-PD04-04 http://cancerres.aacrjournals.org/cgi/content/meeting_abstract/72/24_MeetingAbstracts/PD04-04?sid=e0d8a1f2-78c9-4d07-9735-aec40229e2f3 VL - 72 ID - 6982 ER - TY - JOUR AB - Low-level laser therapy (LLLT) has been used with the aim of improving vascular perfusion of the skin and musculocutaneous flaps. This study evaluated the effect of LLLT on transverse rectus abdominis musculocutaneous flap (TRAM) viability, vascular angiogenesis, and VEGF release. Eighty-four Wistar rats were randomly divided into seven groups with 12 rats in each group. Group 1 received sham laser treatment; group 2, 3 J/cm(2) at 1 point; group 3, 3 J/cm(2) at 24 points; group 4, 72 J/cm(2) at 1 point; group 5, 6 J/cm(2) at 1 point; group 6, 6 J/cm(2) at 24 points; and group 7, 144 J/cm(2) at 1 point. All experimental groups underwent LLLT immediately after the TRAM operation and on the following 2 days; thus, animals underwent 3 days of treatment. The percentage of skin flap necrosis area was calculated on the fourth postoperative day using the paper template method, and two skin samples were collected using a 1-cm(2) punch to evaluate alpha smooth muscle actin (1A4) and VEGF levels in blood vessels. Significant differences were found in necrosis percentage, and higher values were seen in group 1 than in the other groups. Statistically significant differences were not found among groups 3 to 7 (p < 0.292). Groups 5 and 7 showed significantly higher VEGF levels compared to other groups. Groups 3 and 5 had an increase in levels of blood vessels compared to other groups. LLLT at energy densities of 6 to 144 J/cm(2) was efficient to increase angiogenesis and VEGF levels and promote viability in TRAM flaps in rats. AD - [Pinfildi, Carlos Eduardo] Univ Fed Sao Paulo UNIFESP, Dept Human Movement Sci, Sao Paulo, Brazil. [Pinfildi, Carlos Eduardo; Hochman, Bernardo S.; Nishioka, Michele Akemi; Sheliga, Tatiana Rodrigues; Invaldi Neves, Marco Aurelio; Liebano, Richard Eloin; Ferreira, Lydia Masako] Univ Fed Sao Paulo UNIFESP, Dept Plast Surg, Sao Paulo, Brazil. Pinfildi, CE (corresponding author), Alm Saldanha da Gama Av,89 Ponta da Praia, BR-11030400 Sao Paulo, Brazil. cepinfildi@hotmail.com AN - WOS:000318184600008 AU - Pinfildi, C. E. AU - Hochman, B. S. AU - Nishioka, M. A. AU - Sheliga, T. R. AU - Neves, M. A. I. AU - Liebano, R. E. AU - Ferreira, L. M. DA - May DO - 10.1007/s10103-012-1130-3 IS - 3 J2 - Lasers Med. Sci. KW - Phototherapy Low-level laser therapy Physical therapy VEGF Dosimetry Plastic surgery endothelial growth-factor level laser therapy electrical nerve-stimulation abdominis musculocutaneous flap helium-neon laser low-energy laser random skin flap breast reconstruction rat model myocutaneous flap Engineering Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 134BL Times Cited: 10 Cited Reference Count: 32 Pinfildi, Carlos Eduardo Hochman, Bernardo S. Nishioka, Michele Akemi Sheliga, Tatiana Rodrigues Invaldi Neves, Marco Aurelio Liebano, Richard Eloin Ferreira, Lydia Masako Liebano, Richard E/H-1177-2012; Pinfildi, Carlos E/D-3966-2012; Ferreira, Lydia Masako/B-7511-2012 Liebano, Richard E/0000-0003-4795-6723; Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPQ); Coordenacao de Aperfeicoamento de Pessoal de Nivel SuperiorCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) The authors gratefully acknowledge funding from the Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) and Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior. 10 1 6 Springer london ltd London PY - 2013 SN - 0268-8921 SP - 755-761 ST - What is better in TRAM flap survival: LLLT single or multi-irradiation? T2 - Lasers in Medical Science TI - What is better in TRAM flap survival: LLLT single or multi-irradiation? UR - ://WOS:000318184600008 VL - 28 ID - 2589 ER - TY - JOUR AB - Background: Venous thromboembolism (VTE) affects an estimated 350,000 to 600,000 individuals and causes approximately 100,000 deaths annually in the United States. Postoperative VTE is a core measure reported by The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP). The objective of this research was to assess the validity of VTE events reported by NSQIP. Materials and methods: This is a retrospective analysis using NSQIP data from January 2006 through December 2018 and the electronic health record system data from five adult hospitals in the Johns Hopkins Health System. We included patients aged 18 years and older with a VTE event identified in our NSQIP data set. The main outcome measure was the proportion of valid VTE events, defined as concordant between the NSQIP data set and medical chart review for clinical documentation. Results: Of 474 patients identified in our NSQIP database with a VTE, 26 (5.5%) did not meet the strict NSQIP definition of VTE. Nine had a preoperative history of DVT and no new postoperative event, seven had a negative workup for VTE, six had a peripheral arterial thrombus, two did not receive or refused therapy, one had an aortic thrombus, and one had a venous thrombosis in a surgical flap. Conclusions: We identified a considerable number of surgical patients misclassified as having a VTE in NSQIP, when did not truly. This highlights the need to improve definition specificity and standardize processes involved in data extraction, validation, and reporting to provide unbiased data for use in quality improvement. AD - E.R. Haut, Vice Chair of Quality, Safety & Service, Department of Surgery; Associate Professor of Surgery, Anesthesiology/Critical Care Medicine (ACCM) and Emergency Medicine; Division of Acute Care Surgery, Department of Surgery, The Johns Hopkins University School of Medicine; Associate Professor of Health Policy & Management, The Johns Hopkins University Bloomberg School of Public Health; Core Faculty, The Armstrong Institute for Patient Safety and Quality, JHM, 1800 Orleans Street, Sheikh Zayed 6107C, Baltimore, MD, United States AU - Florecki, K. L. AU - Owodunni, O. P. AU - Varasteh Kia, M. AU - Borja, M. C. AU - Holzmueller, C. G. AU - Lau, B. D. AU - Paul, M. AU - Streiff, M. B. AU - Haut, E. R. DB - Embase Medline DO - 10.1016/j.jss.2020.01.011 KW - adult aortic thrombosis artery thrombosis article breast reconstruction deep inferior epigastric perforator flap deep vein thrombosis female health program human major clinical study male mastectomy medical record review middle aged outcome assessment priority journal retrospective study surgical flaps total quality management validity vascular surgery vein thrombosis venous thromboembolism LA - English M3 - Article N1 - L2005075744 2020-03-03 2020-03-06 PY - 2020 SN - 1095-8673 0022-4804 SP - 94-99 ST - What Does Venous Thromboembolism Mean in the National Surgical Quality Improvement Program? T2 - Journal of Surgical Research TI - What Does Venous Thromboembolism Mean in the National Surgical Quality Improvement Program? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005075744&from=export http://dx.doi.org/10.1016/j.jss.2020.01.011 VL - 251 ID - 4687 ER - TY - JOUR AB - Background/Objective: Current guidelines recommend that patients diagnosed with breast cancer start receiving chemotherapy within 120 days of diagnosis to increase overall survival. Newer research suggests that triple-negative breast cancer patients may do better starting chemotherapy within 30 days. A patient's decision as to whether to undergo breast-conserving surgery versus mastectomy is a very personal decision that often takes time to reach. Many mastectomy patients elect to undergo reconstruction, including implant versus autologous approaches. The goal of our study was to look at what barriers, if any, there were to having patients start chemotherapy within this timeframe. Methods: Through a retrospective IRB approved study, we examined patients from our tumor registry during 2012-2017 who were diagnosed with breast cancer and subsequently treated with chemotherapy. Results: Of the 931 patients, 871 (93.6%) received their chemotherapy within 120 days. Of the 60 patients who received chemotherapy after 120 days (6.4%), 26 had a lumpectomy (43.3%), and 34 had mastectomy (56.7%). Of the 34 patients who had mastectomy, 5 had no reconstruction (14.7%), 12 had implants or expanders (35.3%), and 17 underwent autologous free flap reconstruction (50%). One hundred seventy-two of the 931 patients (18.5%) had triplenegative breast cancer. Of these, only 3 (1.7%) received their chemotherapy within 30 days. The average time between diagnosis and initiation of chemotherapy in triple-negative breast cancer patients was 74 days with a range of 15 to 159 days. Conclusions: Chemotherapy is an acknowledged important adjunct in breast cancer treatment, and the optimum time to begin chemotherapy is within 120 days of diagnosis. In our study, 93.6% of patients over a 6-year period received chemotherapy in this time interval. Of the 6.4% of patients whose chemotherapy was delayed, there was no single factor that could be identified. We could not support that multidisciplinary planning for breast reconstruction, type of breast reconstruction, obtaining second opinions, or wound complications resulted in a delay in chemotherapy. With this in mind, it is imperative that the surgeon recognizes the need for early referrals to chemotherapy, and to work in conjunction with other specialties, nurse navigators, and social workers to avoid delay and start chemotherapy promptly. AD - A. Erb, Bryn Mawr Hospital, Philadelphia, PA, United States AU - Erb, A. AU - Frazier, T. AU - Mays, S. AU - Sizer, L. DB - Embase DO - 10.1245/s10434-020-08630-3 KW - adult breast reconstruction cancer chemotherapy cancer patient cancer surgery conference abstract controlled study female free tissue graft human implant lumpectomy major clinical study nurse retrospective study social worker surgeon surgery triple negative breast cancer wound complication LA - English M3 - Conference Abstract N1 - L632966118 2020-10-01 PY - 2020 SN - 1534-4681 SP - S668 ST - What are the modifiable factors in getting patients to chemotherapy faster? T2 - Annals of Surgical Oncology TI - What are the modifiable factors in getting patients to chemotherapy faster? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L632966118&from=export http://dx.doi.org/10.1245/s10434-020-08630-3 VL - 27 ID - 4903 ER - TY - JOUR AB - Background Slim patients or those with large breasts may be ineligible for breast reconstruction with an abdominal flap, as the volume of the flap may be insufficient. This study aimed to establish that abdominal tissue-based breast reconstruction can be well suited for Korean patients, despite their thin body habitus. Methods A total of 252 patients who underwent postmastectomy breast reconstruction with an abdominal flap from October 2006 to May 2013 were retrospectively reviewed. The patients' age and body mass index were analyzed, and a correlation analysis was performed between the weight of the mastectomy specimen and that of the initial abdominal flap. Results The average weights of the mastectomy specimen and initial abdominal flap were 451.03 g and 644.95 g, respectively. The ratio of the weight of the mastectomy specimen to that of the initial flap was 0.71 +/- 0.23. There was a strong positive linear relationship between the weight of the mastectomy specimen and that of the initial flap (Pearson correlation coefficient, 0.728). Thirty nulliparous patients had a final-to-initial flap weight ratio of 0.66 +/- 0.11. The 25 patients who underwent a contralateral procedure had a ratio of 0.96 +/- 0.30. The adjusted ratio of the final flap weight to the initial flap weight was 0.66 +/- 0.12. Conclusions Breast weight had a strong positive relationship with abdominal flap weight in Koreans. Abdominal flaps provided sufficient soft tissue for breast reconstruction in most Korean patients, including nulliparous patients. However, when the mastectomy weight is estimated to be >700 g, a contralateral reduction procedure may be considered. AD - [Yun, Jiyoung] Inje Univ, Dept Plast & Reconstruct Surg, Busan Paik Hosp, Busan, South Korea. [Jeong, Hyung Hwa; Kim, Eun Key; Eom, Jin Sup; Han, Hyun Ho] Univ Ulsan, Asan Med Ctr, Dept Plast Surg, Coll Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea. [Cho, Jonghan] Seoul Plast Surg Clin, Kangnung, South Korea. Eom, JS (corresponding author), Univ Ulsan, Asan Med Ctr, Dept Plast Surg, Coll Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea. jinsupp@amc.seoul.kr AN - WOS:000432876100007 AU - Yun, J. AU - Jeong, H. H. AU - Cho, J. AU - Kim, E. K. AU - Eom, J. S. AU - Han, H. H. DA - May DO - 10.5999/aps.2017.01438 IS - 3 J2 - Arch. Plast. Surg.-APS KW - Mastectomy Mammoplasty Free tissue flaps Korea Body mass index epigastric perforator flap diep flap patient selection asian patients donor site tram outcomes artery experience Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: GG7KE Times Cited: 2 Cited Reference Count: 25 Yun, Jiyoung Jeong, Hyung Hwa Cho, Jonghan Kim, Eun Key Eom, Jin Sup Han, Hyun Ho 2 0 Korean soc plastic & reconstructive surgery Seoul 2234-6171 PY - 2018 SN - 2234-6163 SP - 246-252 ST - Weight analysis of mastectomy specimens and abdominal flaps used for breast reconstruction in Koreans T2 - Archives of Plastic Surgery-Aps TI - Weight analysis of mastectomy specimens and abdominal flaps used for breast reconstruction in Koreans UR - ://WOS:000432876100007 VL - 45 ID - 1627 ER - TY - JOUR AB - Traditional nipple reconstruction relies on local flap techniques. However, there are several problems associated with local flap reconstruction including loss of projection, widening of the base width, and difficulty working around the mastectomy scar. This study presents a variation of traditional local flap nipple reconstruction, which is termed the weave technique. Rather than using two flaps to create base width, the weave technique uses one. By controlling the base width, this may serve to sustain long-term projection. Second, filling the inside of the nipple with the second flap may contribute to longer term projection. Because there is no third flap, it is easier to orient the nipple with respect to the mastectomy scar. To date, the senior author has used this method to reconstruct 55 nipples in 40 patients, with 415 days (range 191-733) mean follow-up time. This includes 45 (82%) nipple reconstructions after tissue expander-implant reconstruction. The use of this technique has produced excellent aesthetic results with nipple projection and site healing. The majority of patients have been satisfied with their nipple reconstruction. Three patients had wound healing difficulties, including two (3.6%) that healed with conservative wound care and one (1.8%) in a radiated patient requiring surgical revision. There were no other revisions necessary and no infections. In summary, the weave technique is a suitable modification to the popular C-V technique that maintains the benefits and simplicity of the aforementioned flap while potentially reducing projection loss, conserving base width, and allowing greater flexibility for nipple placement. © 2013 Informa Healthcare. AD - J.Y.S. Kim, Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine, 675 N. Saint Clair St, Chicago, IL 60611, United States AU - Kim, J. Y. S. AU - Gust, M. J. AU - Connor, C. M. AU - Davila, A. AU - Hansen, N. M. AU - Nguyen, K. T. DB - Medline DO - 10.3109/2000656X.2012.730052 IS - 2 KW - adult aged article breast reconstruction female human methodology middle aged nipple patient satisfaction reoperation surgical flaps tissue expander treatment outcome LA - English M3 - Article N1 - L368585834 2013-06-17 PY - 2013 SN - 2000-656X SP - 135-138 ST - The weave technique for nipple reconstruction T2 - Journal of Plastic Surgery and Hand Surgery TI - The weave technique for nipple reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L368585834&from=export http://dx.doi.org/10.3109/2000656X.2012.730052 VL - 47 ID - 6851 ER - TY - JOUR AB - Premise. Modern approaches to skin-sparing mastectomy produce impressive esthetic results with high degree of symmetry. However, functional properties of reconstructed breast (haptic properties, consensual mobility) often leave much to be desired. The article presents an original technique of skin-sparing surgeries in case of breast cancer with single-step reconstruction of thoracodorsal flap which was preliminarily subjected to lipofilling. Methods. The trial involves 18 patients with breast cancer who had a skin-sparing mastectomy with relation to breast cancer with single-step reconstruction of thoracodorsal flap which was preliminarily subjected to lipofilling. The indications for this surgical intervention have been identified. Lipofilling technique within the projection of the future thoracodorsal flap, breast tissue cutting, flap dissection and formation of symmetrical breast has been described. Results. When using BCCT.core 3.0 software, excellent and good results were equally distributed. In 5 cases (27.8%) we managed to obtain absolutely symmetrical breasts not only in terms of visual perception but also in terms of haptic properties. A small percentage of complications allows to consider the suggested surgical intervention to be effective method for breast reconstruction. Conclusions. Replacement of lost breast capacity by thoracodorsal flap which was previously subjected to lipografting, as well as renunciation of combination of tissue graft with the implant produces high degree of symmetry not only visually but also in terms of haptic properties and consensual breast symmetry. AD - Y.V. Przhedetsky, Department of skin tumors, soft tissue tumors and breast tumors No. 2, Rostov-on-Don, Russian Federation AU - Przhedetsky, Y. V. AU - Borlakov, A. V. AU - Przhedetskaya, V. Y. DB - Embase DO - 10.5958/0974-360X.2018.00223.8 IS - 3 KW - adult article autotransplantation breast areola breast augmentation breast cancer breast reconstruction clinical article clinical outcome clinical trial esthetics female gamma radiation human hyperpigmentation partial mastectomy software teletherapy thoracodorsal artery perforator flap tissue graft touch LA - English M3 - Article N1 - L622505892 2018-06-20 2018-06-25 PY - 2018 SN - 0974-360X 0974-3618 SP - 1207-1213 ST - Ways to improve the aesthetic and functional results of reconstruction mammoplasty in cancer patients T2 - Research Journal of Pharmacy and Technology TI - Ways to improve the aesthetic and functional results of reconstruction mammoplasty in cancer patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622505892&from=export http://dx.doi.org/10.5958/0974-360X.2018.00223.8 VL - 11 ID - 5482 ER - TY - JOUR AB - Mesenchymal stem cells (MSCs) possess huge potential for regenerative medicine. For tissue engineering approaches, scaffolds and hydrogels are routinely used as extracellular matrix (ECM) carriers. The present study investigated the feasibility of using textile-reinforced hydrogels with adjustable porosity and elasticity as a versatile platform for soft tissue engineering. A warp-knitted poly (ethylene terephthalate) (PET) scaffold was developed and characterized with respect to morphology, porosity, and mechanics. The textile carrier was infiltrated with hydrogels and cells resulting in a fiber-reinforced matrix with adjustable biological as well as mechanical cues. Finally, the potential of this platform technology for regenerative medicine was tested on the example of fat tissue engineering. MSCs were seeded on the construct and exposed to adipogenic differentiation medium. Cell invasion was detected by two-photon microscopy, proliferation was measured by the PrestoBlue assay. Successful adipogenesis was demonstrated using Oil Red O staining as well as measurement of secreted adipokines. In conclusion, the given microenvironment featured optimal mechanical as well as biological properties for proliferation and differentiation of MSCs. Besides fat tissue, the textile-reinforced hydrogel system with adjustable mechanics could be a promising platform for future fabrication of versatile soft tissues, such as cartilage, tendon, or muscle. AD - [Schaefer, Benedikt; Ruhl, Tim; Obrecht, Astrid S.; Beier, Justus P.] Univ Hosp RWTH Aachen, Hand Surg Burn Ctr, Dept Plast Surg, D-52074 Aachen, Germany. [Emonts, Caroline; Glimpel, Nikola; Gries, Thomas; Blaeser, Andreas] Rhein Westfal TH Aachen, Inst Textiltech, D-52062 Aachen, Germany. [Jockenhoevel, Stefan; Blaeser, Andreas] Rhein Westfal TH Aachen, Helmholtz Inst, Dept Biohybrid & Med Text BioTex, Appl Med Engn, D-52074 Aachen, Germany. [Blaeser, Andreas] Tech Univ Darmstadt, Inst BioMed Printing Technol, D-64289 Darmstadt, Germany. [Blaeser, Andreas] Tech Univ Darmstadt, Ctr Synthet Biol, D-64289 Darmstadt, Germany. Blaeser, A (corresponding author), Rhein Westfal TH Aachen, Inst Textiltech, D-52062 Aachen, Germany.; Blaeser, A (corresponding author), Rhein Westfal TH Aachen, Helmholtz Inst, Dept Biohybrid & Med Text BioTex, Appl Med Engn, D-52074 Aachen, Germany.; Blaeser, A (corresponding author), Tech Univ Darmstadt, Inst BioMed Printing Technol, D-64289 Darmstadt, Germany.; Blaeser, A (corresponding author), Tech Univ Darmstadt, Ctr Synthet Biol, D-64289 Darmstadt, Germany. bschaefer@ukaachen.de; Caroline.Emonts@ita.rwth-aachen.de; Nikola.Glimpel@ita.rwth-aachen.de; truhl@ukaachen.de; aobrecht@ukaachen.de; jockenhoevel@ame.rwth-aachen.de; Thomas.Gries@ita.rwth-aachen.de; jbeier@ukaachen.de; blaeser@idd.tu-darmstadt.de AN - WOS:000565692600001 AU - Schafer, B. AU - Emonts, C. AU - Glimpel, N. AU - Ruhl, T. AU - Obrecht, A. S. AU - Jockenhoevel, S. AU - Gries, T. AU - Beier, J. P. AU - Blaeser, A. C7 - 3518 DA - Aug DO - 10.3390/ma13163518 IS - 16 J2 - Materials KW - tissue engineering biofabrication biohybrid scaffold textile engineering mesenchymal stem-cells autologous breast reconstruction human adipose-tissue stromal cells differentiation proliferation electrospun constructs perfusion diep Chemistry Materials Science Metallurgy & Metallurgical Engineering Physics LA - English M3 - Article N1 - ISI Document Delivery No.: NI9VB Times Cited: 0 Cited Reference Count: 38 Schaefer, Benedikt Emonts, Caroline Glimpel, Nikola Ruhl, Tim Obrecht, Astrid S. Jockenhoevel, Stefan Gries, Thomas Beier, Justus P. Blaeser, Andreas Gries, Thomas G./M-8206-2018 Gries, Thomas G./0000-0002-2480-8333; Jockenhoevel, Stefan/0000-0003-0584-9444 START-Program of RWTH Aachen Faculty of Medicine [691919/AZ 35/19] The presented work was partially funded by the START-Program of RWTH Aachen Faculty of Medicine, Grant number 691919/AZ 35/19. 0 5 9 Mdpi Basel 1996-1944 PY - 2020 SP - 16 ST - Warp-Knitted Spacer Fabrics: A Versatile Platform to Generate Fiber-Reinforced Hydrogels for 3D Tissue Engineering T2 - Materials TI - Warp-Knitted Spacer Fabrics: A Versatile Platform to Generate Fiber-Reinforced Hydrogels for 3D Tissue Engineering UR - ://WOS:000565692600001 VL - 13 ID - 1096 ER - TY - JOUR AB - Background: Patients find it helpful to hear about other patients' experience of surgery when deciding about their own, and will often request to meet with a fellow patient who has undergone the same surgery they are considering. Currently there are no schemes which offer this service formally, both locally and nationally. Meetings of this nature have tended to be organised on an informal, ad hoc basis, without any training for the volunteer patient. In order to address this need, staff at the Breast Unit in the Linda McCartney Centre, Royal Liverpool University Hospital, developed the 'Walking in my shoes' (WIMS) project. The aim of WIMS was to develop a structured, effective and safe service in order to provide a formal way for patients to share their experiences of breast surgery with patients who request this. Method: The WIMS project was developed by a multi-disciplinary staff team. Breast Cancer Care (BCC) was involved in an advisory role. We aimed to recruit volunteers with TRAM flap, LD flap and implant reconstructions. Potential volunteers were identified from surgery lists, which were screened by surgeons and breast care nurses, and patients were excluded if they were a) less than two years post-surgery and b) judged by the clinician as not appropriate to be approached (reasons included mental health/interpersonal difficulties). Eligible patients (N = 66) were then sent letters to ask if they would be interested in being involved. 29 opted in, and were invited to a taster evening. Those interested were invited to submit an application form. Of 18 applicants, 17 were invited for interview, and 14 were recruited as volunteers. Volunteers then attended an evaluated two-day training course developed by the WIMS team in collaboration with BCC. Trained volunteers were then matched by surgery type to patients requesting the service. Results: All recruited volunteers attended the training days. Evaluations of the training from volunteers were positive: 93% 'strongly agree [d]' that they understood their role and felt confident to meet with a patient. Three WIMS meetings between volunteer and patient have taken place so far. Evaluation of the service is ongoing. Preliminary response from patients, volunteers and staff has been positive. Conclusions: The WIMS project is the first formal, structured and multi-disciplinary led service aimed at providing a way for patients to speak with a trained volunteer about their experience of breast surgery. Future work will include formal evaluation of the service from both volunteers and patients. Further surgery groups, including gene carriers and mastectomy with no reconstruction, will also be recruited and trained. AD - H. Ullmer, Royal Liverpool University Hospital, Liverpool, United Kingdom AU - Ullmer, H. AU - Holcombe, S. AU - Gray, H. AU - Clark, L. DB - Embase DO - 10.1016/j.ejso.2012.02.174 IS - 5 KW - breast surgery shoe patient human walking volunteer surgery breast cancer training mastectomy transverse rectus abdominis musculocutaneous flap nurse university hospital breast care surgeon interview gene implant breast LA - English M3 - Conference Abstract N1 - L70737368 2012-05-16 PY - 2012 SN - 0748-7983 SP - 456 ST - 'Walking in my shoes': The development of a service to enable patients to share their experience of breast surgery T2 - European Journal of Surgical Oncology TI - 'Walking in my shoes': The development of a service to enable patients to share their experience of breast surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70737368&from=export http://dx.doi.org/10.1016/j.ejso.2012.02.174 VL - 38 ID - 7154 ER - TY - JOUR AB - Background: Body mass index is a universally recognized measure of obesity. However, it does not take body fat distribution (BFD) into account, which has been established as a significant risk factor in both medicine and surgery. The objective of this study was to compare previously developed anthropometric measures of BFD with body mass index in predicting morbidity with abdominally based microsurgical breast reconstruction. Methods: A review of patients who underwent abdominally based breast reconstruction was performed. Multivariate logistic regression was performed to determine the relationship between complications (recipient, donor, total) with body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio, conicity index, and abdominal volume index. Results: A total of 325 patients who underwent 442 flaps were analyzed. Waist circumference (OR, 1.16; 95% CI 1.07–1.76), waist-to-hip ratio (OR, 1.94; 95% CI 1.25-3.35), and waist-to-height ratio (OR, 1.19; 95% CI 1.01-1.70) were significant risk factors for recipient site complications. Body mass index (OR, 1.14; 95% CI 1.01-1.56), and waist-to-hip ratio (OR, 2.01; 95% CI 1.30-3.95) were significant risk factors for donor site complications. Waist-to-hip ratio (OR, 1.87; 95% CI 1.22-4.00) was the only measure found to be a significant risk factor for experiencing any complication. A waist-to-hip ratio >0.84 was associated with increased risk. Conclusions: Waist-to-hip ratio is a significant risk factor for recipient and donor site morbidity in abdominally based breast reconstruction. It is a readily calculable and clinically significant measure distinct from body mass index that should be considered for use in clinical care and research. AD - A.H. Chao, Department of Plastic Surgery, Ohio State University, Columbus, OH, United States AU - Wu, P. S. AU - Jordan, S. W. AU - Hodson, T. AU - Chao, A. H. DB - Embase Medline DO - 10.1002/micr.30346 IS - 7 KW - abdominal bulge abdominal volume index abdominal wall hernia adult anthropometric parameters article body fat distribution body mass breast reconstruction conicity index donor site female graft failure graft recipient heart infarction hematoma human major clinical study microsurgery morbidity necrosis pneumonia postoperative complication predictor variable priority journal seroma surgical flaps surgical infection surgical patient surgical risk urinary tract infection venous thromboembolism waist circumference waist hip ratio waist to height ratio wound dehiscence LA - English M3 - Article N1 - L623309299 2018-08-06 2018-10-31 PY - 2018 SN - 1098-2752 0738-1085 SP - 731-737 ST - Waist-to-hip ratio is a better predictor than body mass index for morbidity in abdominally based breast reconstruction T2 - Microsurgery TI - Waist-to-hip ratio is a better predictor than body mass index for morbidity in abdominally based breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623309299&from=export http://dx.doi.org/10.1002/micr.30346 VL - 38 ID - 5282 ER - TY - JOUR AB - Background: With growing concerns about the overuse of contralateral prophylactic mastectomy, optimizing unilateral mastectomy reconstruction outcomes becomes a priority. However, there remains a paucity of objective data that describe volumetric symmetry between a natural and autologous-reconstructed breast. Methods: We evaluated patients who underwent unilateral mastectomy reconstruction with free-flap abdominal tissue transfer from 04/2006 to 01/2015, and had at least 2 postoperative magnetic resonance images (MRIs; n = 28). Using these MRI data, volumetric measurements of the reconstructed and natural breast were performed at the first postoperative MRI (after all revisions were complete) and the most recent MRI. Relationships were analyzed using Spearman correlation coefficients. A symmetry score (SS) was calculated such that values closer to 1.0 reflected volumetric symmetry. Results: The mean age (years) and BMI of the patients was 44.8 and 26.8, respectively. The mean interval time between the MRIs was 3.03 years (range 0.43-6.6). After surgical revisions were complete, volumetric symmetry between reconstructed and nonreconstructed breasts was typically achieved (mean SS 0.92). This symmetry was also retained at the end of follow-up (mean SS 0.96), despite a mean change in BMI of 3.9% (range 1.1-7.7). Additionally, the mean number of flap revisions was 0.75 (range 0-2), and 39% of patients had a procedure performed on the natural breast. Conclusion: In patients undergoing unilateral abdominal-based breast reconstruction, volumetric symmetry is attainable; however, it can require flap revisions and procedures to natural breast. Interestingly, this study does show that initial symmetry is retained postoperatively, regardless of changes in BMI. AD - [Glener, Adam D.; Suresh, Visakha; Shammas, Ronnie L.; Sergesketter, Amanda; Taskindoust, Mahsa; Guo, Xiaoshuang; Hollenbeck, Scott T.] Duke Univ, Med Ctr, Div Plast Maxillofacial & Oral Surg, Durham, NC 27710 USA. [Broadwater, Gloria] Duke Univ, Med Ctr, Dept Biostat & Bioinfarmat, Durham, NC 27710 USA. Hollenbeck, ST (corresponding author), Duke Univ, Med Ctr, 133 Baker House, Durham, NC 27710 USA. scott.hollenbeck@duke.edu AN - WOS:000494276300002 AU - Glener, A. D. AU - Suresh, V. AU - Shammas, R. L. AU - Broadwater, G. AU - Sergesketter, A. AU - Taskindoust, M. AU - Guo, X. S. AU - Hollenbeck, S. T. DA - Sep DO - 10.1097/gox.0000000000002362 IS - 9 J2 - Prs-Glob. Open KW - patient satisfaction postmastectomy determinants surgery trends tram Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: JJ6PE Times Cited: 2 Cited Reference Count: 20 Glener, Adam D. Suresh, Visakha Shammas, Ronnie L. Broadwater, Gloria Sergesketter, Amanda Taskindoust, Mahsa Guo, Xiaoshuang Hollenbeck, Scott T. 2 0 Lippincott williams & wilkins Philadelphia PY - 2019 SN - 2169-7574 SP - 6 ST - Volumetric Symmetry after Unilateral Autologous Breast Reconstruction: A Reasonable Goal T2 - Plastic and Reconstructive Surgery-Global Open TI - Volumetric Symmetry after Unilateral Autologous Breast Reconstruction: A Reasonable Goal UR - ://WOS:000494276300002 VL - 7 ID - 1325 ER - TY - JOUR AB - Background: The present study evaluated outcomes of deep inferior epigastric perforator (DIEP) flap breast reconstruction using volumetric planning-which is preoperative planning based on volumetric data of the breast and flap estimated from computed tomographic angiography. Methods: A prospective review of three patient cohorts undergoing DIEP flap breast reconstruction from June of 2009 to February of 2015 was performed. Cohort 1 comprised 48 cases in which no volumetric planning was used. Cohort 2 included the next 101 consecutive cases undergoing breast reconstruction according to an algorithm based on volumetric planning. Cohort 3 consisted of the next 109 consecutive cases using a modified algorithm. The inset rate (weight ratio of the inset flap to harvested flap) was estimated during volumetric planning, and specific surgical strategies, such as incorporating multiple perforators, conducting venous augmentation (cohort 2), or harvesting bipedicled flaps (cohort 3), were used with reference to it. Rates of perfusion-related complications were compared. Results: All but one flap survived completely. Fat necrosis occurred in 9.7 percent. Overall, the perfusion-related complication rate was 22.9 percent of cohort 1, 10.9 percent in cohort 2, and 5.6 percent in cohort 3 (p = 0.006). The fat necrosis rates were 19.1, 9.9, and 5.6 percent in cohorts 1, 2, and 3, respectively (p = 0.032). A multivariate analysis demonstrated that volumetric planning had independent benefits for preventing perfusion-related complications (p = 0.003). Conclusion: The authors' results suggest that volumetric planning can facilitate elaborate planning and reduce perfusion-related complications, enabling reliable breast reconstruction using DIEP flaps. AD - [Lee, Kyeong-Tae; Mun, Goo-Hyun] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Plast Surg, Irwon Dong 50, Seoul 135710, South Korea. Mun, GH (corresponding author), Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Plast Surg, Irwon Dong 50, Seoul 135710, South Korea. supramicro@gmail.com AN - WOS:000375186400001 AU - Lee, K. T. AU - Mun, G. H. DA - May DO - 10.1097/prs.0000000000002045 IS - 5 J2 - Plast. Reconstr. Surg. KW - epigastric perforator flaps ct-angiography fat necrosis free tram metaanalysis experience survival donor scans Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: DK8OL Times Cited: 13 Cited Reference Count: 33 Lee, Kyeong-Tae Mun, Goo-Hyun Lee, Kyeong-Tae/AAJ-2478-2021; Mun, Goo-Hyun/I-2540-2019 Lee, Kyeong-Tae/0000-0002-9070-9296; Mun, Goo-Hyun/0000-0003-3481-7978 13 0 2 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2016 SN - 0032-1052 SP - 771E-780E ST - Volumetric Planning Using Computed Tomographic Angiography Improves Clinical Outcomes in DIEP Flap Breast Reconstruction T2 - Plastic and Reconstructive Surgery TI - Volumetric Planning Using Computed Tomographic Angiography Improves Clinical Outcomes in DIEP Flap Breast Reconstruction UR - ://WOS:000375186400001 VL - 137 ID - 2037 ER - TY - JOUR AB - Background Serial volumetric changes of reconstructed breasts have not been studied in detail. In this study, we analyzed serial volumetric changes of reconstructed and contralateral normal breasts during long-term follow-up, with a focus on the effect of various adjuvant therapies. Methods Among all patients who underwent immediate breast reconstruction with a unilateral pedicled transverse rectus abdominis musculocutaneous (p-TRAM) flap, 42 patients with valid data from >= 3 postoperative positron emission tomography-computed tomography (PET-CT) scans were included. The volumes of the reconstructed and normal breasts were measured, and the ratio of flap volume to that of the contralateral breast was calculated. Serial changes in volume and the volume ratio were described, and the effects of chemotherapy, radiation therapy, and hormone therapy on volumetric changes were analyzed. Results The mean interval between the initial reconstruction and each PET-CT scan was 16.5, 30, and 51 months respectively. Thirty-five, 36, and 10 patients received chemotherapy, hormone therapy, and radiation therapy, respectively. The flap volume at each measurement was 531.0, 539.6, and 538.0 cm(3), and the contralateral breast volume was 472.8, 486.4, and 500.8 cm(3), respectively. The volume ratio decreased from 115.1% to 113.4%, and finally to 109.6% (P=0.02). Adjuvant therapies showed no significant effects. Conclusions We demonstrated that the p-TRAM flap maintained its volume over a long-term follow up, while the volume of the contralateral native breast slowly increased. Moreover, adjuvant breast cancer therapies had no statistically significant effects on the volume of the reconstructed p-TRAM flaps or the contralateral native breasts. AD - [Lee, Taik Jong] Hongcheon Asan Hosp, Dept Plast Surg, Hongcheon, South Korea. [Cho, Jeong Mok; Jo, Taehee; Hate, Woo Yeon; Eon, Jin Sup; Kim, Eun Key] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast Surg, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea. [Maldonado, Andres A.] BG Unfallklin Frankfurt, Dept Plast & Land & Reconstruct Surg, Frankfurt, Germany. Kim, EK (corresponding author), Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast Surg, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea. nicekek@korea.com AN - WOS:000477769400002 AU - Lee, T. J. AU - Cho, J. M. AU - Jo, T. AU - Hate, W. Y. AU - Maldonado, A. A. AU - Eon, J. S. AU - Kim, E. K. DA - Jul DO - 10.14730/aaps.2019.01690 IS - 3 J2 - Arch. Aesthet. Plast. Surg. KW - Breast neoplasms Drug therapy Mammaplasty Radiotherapy Surgery, plastic body-composition postoperative radiotherapy reconstruction radiation therapy fat density weight women Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: IM1RO Times Cited: 1 Cited Reference Count: 30 Lee, Taik Jong Cho, Jeong Mok Jo, Taehee Hate, Woo Yeon Maldonado, Andres A. Eon, Jin Sup Kim, Eun Key Maldonado, Andres A./Q-8326-2019 Maldonado, Andres A./0000-0002-3703-5667; Han, WY/0000-0001-9550-2166; Cho, Jeong Mok/0000-0002-5957-467X 1 0 Korean soc aesthetic plastic surgery Seoul 2288-9337 PY - 2019 SN - 2234-0831 SP - 95-102 ST - Volumetric changes of the pedicled transverse rectus abdominis musculocutaneous flap and the contralateral native breast during long-term follow-up T2 - Archives of Aesthetic Plastic Surgery TI - Volumetric changes of the pedicled transverse rectus abdominis musculocutaneous flap and the contralateral native breast during long-term follow-up UR - ://WOS:000477769400002 VL - 25 ID - 1362 ER - TY - JOUR AD - [Sotsuka, Yohei; Fujikawa, Masakazu; Izumi, Ken] Osaka Gen Med Ctr, Dept Plast Surg, Sumiyoshi Ku, Osaka 5588558, Japan. Sotsuka, Y (corresponding author), Osaka Gen Med Ctr, Dept Plast Surg, Sumiyoshi Ku, 3-1-56 Bandai Higashi, Osaka 5588558, Japan. sotsu@sotsuka.com AN - WOS:000311682700038 AU - Sotsuka, Y. AU - Fujikawa, M. AU - Izumi, K. DA - Nov DO - 10.1016/j.bjps.2012.05.013 IS - 11 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - breast reconstruction Surgery LA - English M3 - Article; Proceedings Paper N1 - ISI Document Delivery No.: 045GF Times Cited: 4 Cited Reference Count: 3 Sotsuka, Yohei Fujikawa, Masakazu Izumi, Ken 52nd Annual Meeting of the Japan-Society-of-Plastic-and-Reconstructive-Surgery Apr 23, 2009 Yokohama, JAPAN Japan Soc Plast & Reconstruct Surg Sotsuka, Yohei/0000-0003-3871-7886 4 0 Elsevier sci ltd Oxford PY - 2012 SN - 1748-6815 SP - 1601-1603 ST - Volume of deep inferior epigastric perforator flap quantified preoperatively by using 64-multidetector-row computed tomography T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Volume of deep inferior epigastric perforator flap quantified preoperatively by using 64-multidetector-row computed tomography UR - ://WOS:000311682700038 VL - 65 ID - 2677 ER - TY - JOUR AB - Introduction Despite successful breast reconstruction with oversized latissimus dorsi muscle flap after breast-conserving surgery for breast cancer, esthetic problems continue to exist due to flap shrinkage. The purpose of this study was to evaluate the objective volume change of pedicled latissimus dorsi muscle flap when it is used in breast reconstruction. Methods Patients who were diagnosed with breast cancer and underwent a breast-conserving surgery with immediate breast reconstruction with pedicled latissimus dorsi myocutaneous flap between October 2009 and November 2015 were studied. Eleven patients who were followed up for more than 1year after operation were included in the study. We evaluated the volume of muscle portion of the latissimus dorsi myocutaneous flap with computed tomography (CT) scan. We analyzed the rate of volume change of the latissimus dorsi muscle every year until 5 years after the operation. Result The latissimus dorsi muscle flaps of all 11 patients showed a volume decrease over time. The rate of volume change of the latissimus dorsi muscle flaps decreased 8.04% in the first year, 6.36% in the second year, 5.05% in the third year, 2.88% in the fourth year, and 2.56% in the fifth year after operation in average. Conclusion This research shows the possibility of objectively evaluating the volume change of pedicled latissimus dorsi muscle flaps after breast reconstruction. The findings will be helpful in designing the size of the flaps to use on defects after breast-conserving surgery. AD - [Kang, Chang Min; Shim, Jeong Su] Catholic Univ Daegu, Sch Med, Dept Plast & Reconstruct Surg, Duryugongwon Ro 17 Gil, Daegu 705718, South Korea. Shim, JS (corresponding author), Catholic Univ Daegu, Sch Med, Dept Plast & Reconstruct Surg, Duryugongwon Ro 17 Gil, Daegu 705718, South Korea. 21csue@hanmail.net AN - WOS:000444590100015 AU - Kang, C. M. AU - Shim, J. S. DA - Oct DO - 10.1055/s-0038-1667176 IS - 8 J2 - J. Reconstr. Microsurg. KW - volume change pedicled latissimus dorsi muscle flap partial breast reconstruction epigastric perforator flap tram flap neck reconstruction radiation-therapy immediate radiotherapy cancer head glossectomy Surgery LA - English M3 - Article; Proceedings Paper N1 - ISI Document Delivery No.: GT5ZQ Times Cited: 4 Cited Reference Count: 23 Kang, Chang Min Shim, Jeong Su 9th Congress of the World-Society-for-Reconstructive-Microsurgery (WSRM) Jun 14-17, 2017 Seoul, SOUTH KOREA World Soc Reconstruct Microsurgery 5 0 Thieme medical publ inc New york 1098-8947 PY - 2018 SN - 0743-684X SP - 651-657 ST - Volume Change of Pedicled Latissimus Dorsi Muscle Flap after Partial Breast Reconstruction T2 - Journal of Reconstructive Microsurgery TI - Volume Change of Pedicled Latissimus Dorsi Muscle Flap after Partial Breast Reconstruction UR - ://WOS:000444590100015 VL - 34 ID - 1536 ER - TY - JOUR AB - Deep inferior epigastric perforator (DIEP) flap is associated with less donor site morbidity than transverse rectus abdominis myocutaneous flap. However, abdominal muscle atrophy and donor site complications caused by denervation during pedicle dissection cannot be avoided. This retrospective study investigated the change in the rectus abdominis muscle volume after DIEP flap harvest. Of 395 patients who underwent unilateral DIEP flap breast reconstruction between August 2007 and July 2017, 25 patients with >2-year postoperative abdominal computed tomography data were evaluated. Preoperative and postoperative images of the abdominal muscle after pedicle dissection and the nonoperated side were compared. The volume of the muscles from the lower margin to the umbilicus was determined by using OsiriX image analysis application. The muscle volumes on the side of pedicle dissection decreased from 72.63 +/- 23.29 cm(3) preoperation to 53.09 +/- 16.93 cm(3) postoperation (p < 0.001). The corresponding volumes on the side without dissection were 73.29 +/- 19.25 cm(3) and 60.89 +/- 18.79 cm(3) (p < 0.001). The percentage of postoperative retained volume relative to the preoperative retained volume was 75.65% +/- 19.18% on the pedicle dissection side and 84.65% +/- 19.00% on the contralateral side. The 9% difference was not statistically significant (p = 0.10). No major abdominal complications were observed. Despite nerve injury during DIEP flap surgery, the volume loss of the involved and contralateral muscles did not differ. More than 75% of the abdominal muscle volume was retained. Muscle integrity was well maintained without any postoperative complications. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - [Han, Hyun Ho; Kang, Min Kyu; Song, Sin Young; Lee, Hyung Chul; Kim, Eun Key; Eom, Jin Sup] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast Surg, 88 Olymp Ro 43 Gil, Seoul, South Korea. Eom, JS (corresponding author), Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast Surg, 88 Olymp Ro 43 Gil, Seoul, South Korea. jinsupp@amc.seoul.kr AN - WOS:000443019600015 AU - Han, H. H. AU - Kang, M. K. AU - Song, S. Y. AU - Lee, H. C. AU - Kim, E. K. AU - Eom, J. S. DA - Sep DO - 10.1016/j.bjps.2018.06.003 IS - 9 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - Abdominal muscles Denervation Muscular atrophy Hernia donor-site morbidity breast reconstruction diep flap avoiding denervation free tram innervation nerves Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: GR8XM Times Cited: 1 Cited Reference Count: 31 Han, Hyun Ho Kang, Min Kyu Song, Sin Young Lee, Hyung Chul Kim, Eun Key Eom, Jin Sup Han, Hyun Ho/0000-0001-7072-9882 1 0 3 Elsevier sci ltd Oxford 1878-0539 PY - 2018 SN - 1748-6815 SP - 1310-1316 ST - Volume change in the rectus abdominis muscle after deep inferior epigastric perforator flap harvest T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Volume change in the rectus abdominis muscle after deep inferior epigastric perforator flap harvest UR - ://WOS:000443019600015 VL - 71 ID - 1556 ER - TY - JOUR AB - Surgery is an important part of breast cancer treatment. Most patients either go for mastectomy or lumpectomy + radiation (i.e., breast conserving surgery, BCS). It is well known that mastectomy and BCS have equal long-term outcomes, and more patients are choosing to get breast reconstruction. In this study, we analyzed experiences, concerns, complications and side effects in patients who have undergone breast cancer surgery and who shared their views on various online forums. Such forums have millions of freely shared messages and are rich sources of such information. However, this data is unstructured. We used our automated system, VoCP, that used techniques from Big Data science and artificial intelligence (e.g., deep learning, topic modeling, information retrieval, natural language processing) to analyze concerns and experiences of patients undergoing breast cancer surgeries. Methods: We collected 5.5 million messages from 174556 distinct users in 21 unrestricted breast cancer forums. We built specific ontology for different surgeries, reconstruction, side effects and sentiments and used our system, VoCP, to extract relevant information from these messages. Results: 52172 users shared 307966 messages regarding surgery and their views are summarized below. Lumpectomy (BCS): • 25850 users provided 98499 messages • 15771 users had lumpectomy and shared 50390 messages • 3760 users shared 6322 messages with complications • 2760 users mentioned need for additional surgery • 1447 users mentioned satisfaction with the outcome whereas 117 were dissatisfied Mastectomy: • 37544 users shared 198494 messages • 22716 users had mastectomy and shared 94595 messages • 5065 users shared 8983 messages regarding complications • 2730 patients expressed satisfaction with outcome whereas 286 patients were dissatisfied Reconstruction: • 23164 users provided 113568 messages regarding reconstruction • 9850 users had reconstruction and shared 32472 messages • 1904 users shared 2734 messages with complication • 1982 users had immediate reconstruction; 353 users mentioned delayed reconstruction • 2686 users had autologous tissue reconstruction and 3105 repot implant reconstruction • Type of Autologous Reconstruction reported : 759 TRAM flap, 296 Diep flap, 820 fat grafting, 108 Latissimus Dorsi flap, 89 SGAP Flap/hip Flap • 418 users expressed satisfaction whereas 40 were dissatisfied with outcome Complications reported View inline Conclusions: • Despite reports of equal long term outcomes between BCS and mastectomy, more patient had mastectomy. • Scar issues and pain is the most common complication from any surgery. • Most patients have expressed satisfaction from their chosen surgery. • VoCP reliably provides meaningful insights from the patient's point of view; it also gives insight into unmet needs where more resources and research should be focused. AD - S. Aggarwal AU - Aggarwal, S. AU - Sharma, R. AU - Bhoemick, J. AU - Singh, M. AU - Aggarwal, A. DB - Embase DO - 10.1158/1538-7445.SABCS18-P2-14-14 IS - 4 KW - adult artificial intelligence big data breast cancer cancer patient cancer surgery complication conference abstract controlled study deep inferior epigastric perforator flap deep learning female hip human implant information retrieval latissimus dorsi flap lumpectomy major clinical study natural language processing ontology pain satisfaction scar side effect superior gluteal artery perforator flap surgery transverse rectus abdominis musculocutaneous flap voice LA - English M3 - Conference Abstract N1 - L627464795 2019-05-14 PY - 2019 SN - 1538-7445 ST - Voice of cancer patients (VoCP): Analysis of experiences of cancer patients undergoing breast cancer surgery T2 - Cancer Research TI - Voice of cancer patients (VoCP): Analysis of experiences of cancer patients undergoing breast cancer surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L627464795&from=export http://dx.doi.org/10.1158/1538-7445.SABCS18-P2-14-14 VL - 79 ID - 5182 ER - TY - JOUR AB - Thoracodorsal artery perforator (TAP) flaps are versatile flaps that provide a consistent and aesthetically pleasing breast reconstruction. We prefer the TAP flap to the latissimus dorsi (LD) flap due to the morbidity associated with the LD flap. In this paper we aim to show how we perform bilateral TAP flap breast reconstruction and present our preliminary results from 32 bilateral reconstructions in 16 patients. The TAP flap breast reconstruction can be performed as a direct-to-implant or a delayed procedure depending on patient factors. Color Doppler ultrasonography (CDU) is used in the preoperative planning which promotes the safety and reliability of the flap by mapping perforators thus enabling faster dissection. The bilateral TAP flap breast reconstruction is usually performed in three steps: (I) raising the flaps at the recipient site; (II) rotating the TAP flaps and (III) completion of the breast reconstruction. AD - [Lorenzen, Mike Mikkelsen; Bille, Camilla; Sorensen, Jens Ahm] Odense Univ Hosp, Dept Plast Surg, Odense, Denmark. [Gunnarsson, Gudjon Leifur] Borgemarka 65, N-3711 Skien, Norway. [Tos, Tina] Herlev Hosp, Dept Plast Surg, Herlev, Denmark. [Koudahl, Vibeke; Rindom, Mikkel Borsen; Thomsen, Jorn Bo] Lillebaelt Hosp, Dept Plast Surg, Vejle, Denmark. [Koudahl, Vibeke; Rindom, Mikkel Borsen; Thomsen, Jorn Bo] Odense Univ Hosp, Vejle, Denmark. Thomsen, JB (corresponding author), Odense Univ Hosp, Dept Plast Surg, Vejle, Denmark.; Thomsen, JB (corresponding author), Lillebaelt Hosp, Vejle, Denmark. jornbothomsen@gmail.com AN - WOS:000493059600005 AU - Lorenzen, M. M. AU - Gunnarsson, G. L. AU - Bille, C. AU - Tos, T. AU - Koudahl, V. AU - Rindom, M. B. AU - Sorensen, J. A. AU - Thomsen, J. B. DA - Oct DO - 10.21037/gs.2019.04.05 J2 - Gland Surg. KW - Breast reconstruction bilateral thoracodorsal artery perforator flap (TAP flap) dorsi musculocutaneous flap tdap flap tap flap angiography implant Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: JH9AN Times Cited: 2 Cited Reference Count: 27 Lorenzen, Mike Mikkelsen Gunnarsson, Gudjon Leifur Bille, Camilla Tos, Tina Koudahl, Vibeke Rindom, Mikkel Borsen Sorensen, Jens Ahm Thomsen, Jorn Bo Sorensen, Jens Ahm/0000-0003-4903-0094 2 0 Ame publ co Shatin 2227-8575 4 PY - 2019 SN - 2227-684X SP - S262-S270 ST - Visualized bilateral breast reconstruction by propeller thoracodorsal artery perforator flaps T2 - Gland Surgery TI - Visualized bilateral breast reconstruction by propeller thoracodorsal artery perforator flaps UR - ://WOS:000493059600005 VL - 8 ID - 1307 ER - TY - JOUR AD - [Ishiura, Ryohei; Fujita, Minami; Furuya, Megumi; Banda, Chihena; Narushima, Mitsunaga] Univ Mie, Dept Plast & Reconstruct Surg, 2-174 Edobashi, Tsu, Mie, Japan. Ishiura, R (corresponding author), Univ Mie, Dept Plast & Reconstruct Surg, 2-174 Edobashi, Tsu, Mie, Japan. md106004@yahoo.co.jp AN - WOS:000440350800012 AU - Ishiura, R. AU - Fujita, M. AU - Furuya, M. AU - Banda, C. AU - Narushima, M. DA - Aug DO - 10.1016/j.bjps.2018.05.046 IS - 8 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - artery perforator flap breast reconstruction Surgery LA - English M3 - Letter N1 - ISI Document Delivery No.: GO8OO Times Cited: 1 Cited Reference Count: 6 Ishiura, Ryohei Fujita, Minami Furuya, Megumi Banda, Chihena Narushima, Mitsunaga Banda, Chihena/ABC-3932-2020 Banda, Chihena/0000-0002-2743-4218 1 0 Elsevier sci ltd Oxford 1878-0539 PY - 2018 SN - 1748-6815 SP - 1149-1150 ST - Visualization of lymphatic ducts with preoperative ICG lymphography prevents donor-site lymphedema following PAP flap T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Visualization of lymphatic ducts with preoperative ICG lymphography prevents donor-site lymphedema following PAP flap UR - ://WOS:000440350800012 VL - 71 ID - 1568 ER - TY - JOUR AD - S. Lowes, Breast Screening and Assessment Unit, Breast Screening and Assessment Unit, Queen Elizabeth Hospital, NE9 6SX, Gateshead, United Kingdom AU - Lowes, S. DB - Embase Medline DO - 10.1016/j.crad.2020.12.006 IS - 4 KW - Ki 67 antigen phosphatidylinositol 3 kinase protein p53 breast biopsy breast cancer breast examination breast reconstruction cancer diagnosis cancer radiotherapy clinical examination deep inferior epigastric perforator flap editorial estrogen receptor positive breast cancer fat necrosis health care quality high risk patient Hodgkin disease human magnetic resonance angiography mammography nuclear magnetic resonance imaging practice guideline priority journal problem solving quantitative analysis radiogenomics radiomics recurrent disease teleconsultation LA - English M3 - Editorial N1 - L2010787016 2021-02-02 PY - 2021 SN - 1365-229X 0009-9260 SP - 239-240 ST - Virtual special issue on breast MRI T2 - Clinical Radiology TI - Virtual special issue on breast MRI UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2010787016&from=export http://dx.doi.org/10.1016/j.crad.2020.12.006 VL - 76 ID - 4440 ER - TY - JOUR AB - Background The significant variation in the vascular anatomy of the abdominal wall makes preoperative imaging essential when raising a DIEP (deep inferior epigastric artery perforator) flap due to the potential for maximizing operative success, reducing intraoperative error and minimizing operative complications. Variability in perforator anatomy makes DIEP flap surgery a suitable candidate for computer and virtual reality bio models. In this context, a study was undertaken to determine the feasibility of CTA-guided by VirSSPA application. VirSSPA is a virtual reality tool developed in our Hospital for surgical planning and training. This application allows surgeons to generate the three-dimensional (3D) model of the patient. Objective In this paper, we present a study about VirSSPA tool for virtual reality navigation in DIEP flap surgery and compare findings with operative measurements. Methods We recruited 12 consecutive patients planned for an elective DIEP flap for breast reconstruction. Each patient underwent preoperative imaging of the anterior abdominal wall vasculature with both conventional CTA and VirSSPA 3D reconstruction. Imaging findings were compared to operative findings. Results 3D reconstruction of the abdominal wall with VirSSPA demonstrated a significant good correlation with perforator location compared to operative findings, showing an average error rate of 0.228 cm (95% CI, 0.17-0.30). The Pearson product-moment correlation coefficient was found to be 0.99 (p = 0.01), reflecting an almost linear relationship between the two distances, intraoperative and the one measured in the 3D reconstruction. Conclusion VirSSPA provides additional and potentially more accurate data over conventional CTA with regard to the site of the best perforators and its course through the muscle for DIEP micro-vascular surgery. AD - [Gomez-Cia, T.; Gacto-Sanchez, P.; Sicilia, D.] Hosp Univ Virgen del Rocio de Sevilla, Unidad Gest Clin Cirugia Plast & Reconstruct, Seville 41013, Spain. [Gomez-Cia, T.; Gacto-Sanchez, P.; Sicilia, D.] Hosp Univ Virgen del Rocio de Sevilla, Unidad Quemados, Seville 41013, Spain. [Suarez, C.; Parra, C.; De La Higuera, J.] Hosp Univ Virgen del Rocio de Sevilla, Grp Innovac Tecnol, Seville 41013, Spain. [Suarez, C.; Acha, B.; Serrano, C.] Escuela Tecn Super Ingenieros, Dept Teoria Senal & Comunicac, Seville 41092, Spain. Gomez-Cia, T (corresponding author), Hosp Univ Virgen del Rocio de Sevilla, Unidad Gest Clin Cirugia Plast & Reconstruct, Avda Manuel Siurot S-N, Seville 41013, Spain. tomas.gomez.sspa@juntadeandalucia.es AN - WOS:000207884700008 AU - Gomez-Cia, T. AU - Gacto-Sanchez, P. AU - Sicilia, D. AU - Suarez, C. AU - Acha, B. AU - Serrano, C. AU - Parra, C. AU - De La Higuera, J. DA - Jun DO - 10.1007/s11548-009-0311-4 IS - 4 J2 - Int. J. Comput. Assist. Radiol. Surg. KW - CT images Surgical planning Computer-assisted surgery Reconstructive surgical procedures Microsurgery DIEP breast reconstruction Engineering Radiology, Nuclear Medicine & Medical Imaging Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: V16QS Times Cited: 15 Cited Reference Count: 22 Gomez-Cia, T. Gacto-Sanchez, P. Sicilia, D. Suarez, C. Acha, B. Serrano, C. Parra, C. De La Higuera, J. Serrano, Carmen/I-1641-2015; Suarez-Mejias, Cristina/C-9347-2015; Calderon, Carlos Luis Parra/C-9315-2015; IBIS, PLANIFICACION/I-3334-2016; IBIS, ECONOMIA SALUD/I-5156-2016; Acha, Begona/I-1816-2015 Serrano, Carmen/0000-0003-3008-6231; Suarez-Mejias, Cristina/0000-0002-3190-4665; Calderon, Carlos Luis Parra/0000-0003-2609-575X; Acha, Begona/0000-0001-7838-5746 Andalusia Department of Health, Spain The modular software programming tools used in this study were developed by Alcala Innova and Reina Mercedes Foundation in collaboration with the University of Seville, Spain. The VirSSPA project is being developed and financed by the Andalusia Department of Health, Spain. 17 0 5 Springer heidelberg Heidelberg 1861-6429 PY - 2009 SN - 1861-6410 SP - 375-382 ST - The virtual reality tool VirSSPA in planning DIEP microsurgical breast reconstruction T2 - International Journal of Computer Assisted Radiology and Surgery TI - The virtual reality tool VirSSPA in planning DIEP microsurgical breast reconstruction UR - ://WOS:000207884700008 VL - 4 ID - 3281 ER - TY - JOUR AB - Background: Virtual and augmented reality (VR and AR) are fast-developing technologies that allow the three-dimensional visualization of digital information. Objective: This systematic review aimed to compare the application of VR and AR to conventional methods in preoperative planning of plastic surgical procedures. Method: A systematic literature search was conducted in Embase, Medline (Ovid), Web-of-Science, Cochrane, and Google Scholar databases on October 11, 2019. All literature comparing AR and/or VR with conventional methods for preoperative planning was collected. Only articles that studied at least one of the following outcomes were included: technical accuracy of the procedure, operative time, complications, and costs of total intervention. Results: No articles on VR were found. Six articles were found on interventions performed with AR assistance. AR showed to be significantly better for the accuracy of osteotomies in mandibular angle osteotomies and intraoral mandible distraction compared to conventional methods. For synostotic plagiocephaly and orbital hypertelorism correction, the use of AR demonstrated a precise osteotomy. Intraoperative perforator identification in DIEP flap procedures was more accurate with AR compared to Doppler ultrasound. Harvesting time (p < 0.012) and operative time (p < 0.01) in DIEP-flap procedures and mandibular angle osteotomies, respectively, were significantly reduced if AR was used. No articles were found regarding the costs of using AR for preoperative planning. Conclusion: AR technology has the potential to assist the plastic surgeon in operating more accurately, safely, and fast. Studies on VR technology for preoperative planning in plastic surgery are lacking. More comparative studies are necessary, including data on clinical outcomes and cost-effectiveness. (C) 2020 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Pub-lished by Elsevier Ltd. AD - [Vles, M. D.] Erasmus MC, Rotterdam, Netherlands. [Terng, N. C. O.] Leiden Univ, Med Ctr, Leiden, Netherlands. [Zijlstra, K.] Delft Univ Technol, Delft, Netherlands. [Mureau, M. A. M.; Corten, E. M. L.] Erasmus MC, Dept Plast & Reconstruct Surg, Univ Med Ctr Rotterdam, Off NA-2214,Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands. Corten, EML (corresponding author), Erasmus MC, Dept Plast & Reconstruct Surg, Univ Med Ctr Rotterdam, Off NA-2214,Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands. e.corten@erasmusmc.nl AN - WOS:000583316100005 AU - Vles, M. D. AU - Terng, N. C. O. AU - Zijlstra, K. AU - Mureau, M. A. M. AU - Corten, E. M. L. DA - Nov DO - 10.1016/j.bjps.2020.05.081 IS - 11 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - Augmented reality Preoperative planning Plastic surgery Reconstructive surgery flap breast reconstruction vascular anatomy complications increases impact time Surgery LA - English M3 - Review N1 - ISI Document Delivery No.: OI5KB Times Cited: 0 Cited Reference Count: 29 Vles, M. D. Terng, N. C. O. Zijlstra, K. Mureau, M. A. M. Corten, E. M. L. 0 Elsevier sci ltd Oxford 1878-0539 PY - 2020 SN - 1748-6815 SP - 1951-1959 ST - Virtual and augmented reality for preoperative planning in plastic surgical procedures: A systematic review T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Virtual and augmented reality for preoperative planning in plastic surgical procedures: A systematic review UR - ://WOS:000583316100005 VL - 73 ID - 1028 ER - TY - JOUR AB - Breast conserving therapy is the best method to the breast cancer treatment when concerning the psychological sequelae to the patient. Cosmetic results after conservative surgery are not always acceptable: about 20 % of patients need a revision operation and correcting the residual defect of the breast or asymmetry of the breasts afterwards. Oncoplastic surgery means that the methods familiar to plastic surgeon are used to increase the number of patients treated with conservative surgery without compromising the oncologic results. Even wider margins than in normal breast conservation can be gained, if local glandular flaps, musculocutaneous latissimus dorsi flaps or microvascular free TRAM flaps are used to immediately preserve the shape and symmetry of the breasts. With plastic surgery it is possible to reshape the breast, replace the nipple and gain breast symmetry. As we know every tenth woman will have a breast cancer during her lifetime, and 80 % of breast cancer women will survive. It is important to operate breast cancer immediately to save costs and help a patient feel that her breasts are still a part of her own body. AD - P. Mustonen, Department of Reconstructive Surgery, Kuopio University Hospital, Box 1777, FIN - 70211 Kuopio, Finland AU - Mustonen, P. AU - Härmä, M. DB - Embase Medline DO - 10.1177/145749690209100308 IS - 3 KW - breast cancer tumor invasion cancer surgery cancer survival free tissue graft human latissimus dorsi flap myocutaneous flap plastic surgery reoperation review LA - English M3 - Review N1 - L35285303 2002-11-21 PY - 2002 SN - 1457-4969 SP - 255-262 ST - Viewpoints on oncoplastic surgery in invasive breast cancer T2 - Scandinavian Journal of Surgery TI - Viewpoints on oncoplastic surgery in invasive breast cancer UR - https://www.embase.com/search/results?subaction=viewrecord&id=L35285303&from=export http://dx.doi.org/10.1177/145749690209100308 VL - 91 ID - 8372 ER - TY - JOUR AB - OBJECTIVE: To analyze therapeutic results of video-assisted breast-conserving surgery (VA-BCS) for early stage breast cancer. BACKGROUND: VA-BCS for breast cancer has been developed in Japan, and is indicated for breast cancer unaccompanied by skin involvement. The surgical incision is made at an inconspicuous site, followed by skin-sparing partial mastectomy (SSPM) and immediate reconstruction of the breast. This technique affords good cosmetic results. The long-term results are reported herein. METHODS: VA-BCS was performed on 551 patients. The skin incision was made as a peri-areolar incision or at the midaxillary line. Skin-sparing partial mastectomy was performed using an endoscope and the lifting and tunneling method. Morbidity, curability, and degree of satisfaction with regard to cosmesis were analyzed. RESULTS: Skin necrosis in 22 patients (4.0%) and necrosis of fatty tissue-muscle flap in 17 patients (3.1%) were recorded as postoperative complications. No other serious complications were encountered. Local recurrence occurred in 23 patients (4.2%) after a mean follow-up of 38.4 months. Distant-metastasis-free survival rate at 66 months was 100% for Tis, 95.5% for T1, and 90.7% for T2. Overall survival rate was 100% for Tis, 97.3% for T1, and 95.7% for T2. Degree of satisfaction with surgery as investigated by questionnaire was "good" for 76.1% of patients. CONCLUSION: VA-BCS for early stage breast cancer showed no association with increases in local or distant organ recurrence. The technique yielded improved cosmesis and a high degree of patient satisfaction. Follow-up observation of patients for a longer period is necessary, but VA-BCS seems useful for local treatment of breast cancer. AD - Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. hiro@koto.kpu-m.ac.jp AN - 19106682 AU - Nakajima, H. AU - Fujiwara, I. AU - Mizuta, N. AU - Sakaguchi, K. AU - Hachimine, Y. DA - Jan DO - 10.1097/SLA.0b013e31818e3fa6 DP - NLM ET - 2008/12/25 IS - 1 KW - Breast Neoplasms/*surgery Female Humans Mammaplasty/*methods Mastectomy Middle Aged *Surgical Flaps *Video-Assisted Surgery LA - eng N1 - 1528-1140 Nakajima, Hiroo Fujiwara, Ikuya Mizuta, Naruhiko Sakaguchi, Koichi Hachimine, Yasushi Journal Article United States Ann Surg. 2009 Jan;249(1):91-6. doi: 10.1097/SLA.0b013e31818e3fa6. PY - 2009 SN - 0003-4932 SP - 91-6 ST - Video-assisted skin-sparing breast-conserving surgery for breast cancer and immediate reconstruction with autologous tissue T2 - Ann Surg TI - Video-assisted skin-sparing breast-conserving surgery for breast cancer and immediate reconstruction with autologous tissue VL - 249 ID - 10453 ER - TY - JOUR AB - Background Autologous breast reconstruction is an integral part in the treatment of breast cancer. While computed tomography angiography (CTA) is an established preoperative diagnostic tool for microsurgeons, no study has so far evaluated and compared five different imaging methods and their value for the reconstructive team. In order to determine the feasibility of each of the tools for routine or specialized diagnostic application, the methods' efficiency and informative value were analyzed. Methods We retrospectively analyzed imaging data of 41 patients used for perforator location and assessment for regional perfusion and vessel patency in patients undergoing autologous breast reconstruction with deep inferior epigastric perforator flap (DIEP), transverse rectus abdominis muscle flap (TRAM), or transverse myocutaneous gracilis flap (TMG). Five different imaging techniques were used: hand held Doppler (HHD), CT angiography (CTA), macroscopic indocyanine green (ICG) video angiography, microscope-integrated ICG video angiography, and laser Doppler imaging (LDI). Results CTA proved to be the best tool for preoperative determination of the highly variable anatomy of the abdominal region, whereas HHD showed the same information on perforator localization with some false-positive results. Intraoperative HHD was an excellent tool for dissection and vessel patency judgment. Microscope-integrated ICG was an excellent tool to document the patency of microanastomoses. In our series, macroscopic perfusion measurement with ICG or LDI was only justified in special situations, where information on perfusion of abdominal or mastectomy flaps was required. LDI did not add any additional information. Conclusion Preoperative assessment should be performed by CTA with verification of the perforator location by HHD. Intraoperative HHD and microscope-integrated ICG contribute most toward the evaluation of vessel patency. ICG and LDI should only be used for special indications. AD - [Schroegendorfer, K. F.; Nickl, S.; Keck, M.; Lumenta, D. B.; Haslik, W.; Nedomansky, J.] Med Univ Vienna, Dept Surg, Div Plast & Reconstruct Surg, Wahringer Guertel 18-20, A-1090 Vienna, Austria. [Loewe, C.] Med Univ Vienna, Dept Radiol, Div Cardiovasc & Intervent Radiol, Vienna, Austria. [Gschwandtner, M.] Med Univ Vienna, Dept Angiol, Vienna, Austria. Haslik, W (corresponding author), Med Univ Vienna, Dept Surg, Div Plast & Reconstruct Surg, Wahringer Guertel 18-20, A-1090 Vienna, Austria. werner.haslik@meduniwien.ac.at AN - WOS:000390046700002 AU - Schrogendorfer, K. F. AU - Nickl, S. AU - Keck, M. AU - Lumenta, D. B. AU - Loewe, C. AU - Gschwandtner, M. AU - Haslik, W. AU - Nedomansky, J. DA - Dec DO - 10.1007/s10353-016-0449-6 IS - 6 J2 - Eur. Surg. KW - Autologous breast reconstruction Computed tomography angiography Laser Doppler imaging Indocyanine green Imaging methods preoperative ct angiography indocyanine green perforator flaps abdominal perforator patient satisfaction computed-tomography complications arterial surgery time Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: EF0WJ Times Cited: 4 Cited Reference Count: 26 Schroegendorfer, K. F. Nickl, S. Keck, M. Lumenta, D. B. Loewe, C. Gschwandtner, M. Haslik, W. Nedomansky, J. Lumenta, David Benjamin/AAD-5935-2019 Lumenta, David Benjamin/0000-0003-0903-252X; Loewe, Christian/0000-0003-2502-0676; Nickl, Stefanie/0000-0002-3762-4840 Medical University of Vienna Open access funding provided by Medical University of Vienna. 4 0 3 Springer wien Wien 1682-4016 PY - 2016 SN - 1682-8631 SP - 326-333 ST - Viability of five different pre- and intraoperative imaging methods for autologous breast reconstruction T2 - European Surgery-Acta Chirurgica Austriaca TI - Viability of five different pre- and intraoperative imaging methods for autologous breast reconstruction UR - ://WOS:000390046700002 VL - 48 ID - 1925 ER - TY - JOUR AB - Reduction mammaplasty with nipple-areolar transposition on a medial pedicle was designed as an alternative to amputation and free nipple graft for women with severe mammary hypertrophy. The purpose of this study was to review the viability and sensory outcome of the nipple-areolar complex (NAC) in 72 women (133 breasts) after medial pedicle and inferior pedicle reduction mammaplasty between 1996 and 2000. The medial pedicle was used for 41 women (79 breasts) with moderate to severe mammary hypertrophy. An inferior pedicle was used for 31 women (54 breasts) with mild to moderate mammary hypertrophy. Mean follow-up for all patients was 25 months. Total sensation of the NAC was obtained in 68 of 79 breasts (86%) after medial pedicle reduction mammaplasty and in 50 of 54 breasts (92%) after inferior pedicle reduction mammaplasty. Total viability of the NAC occurred in 74 of 79 breasts (94%) after medial pedicle reduction mammaplasty and in 53 of 54 breasts (98%) after inferior pedicle reduction mammaplasty. Quantitative sensory testing of the NAC using the pressure-specified sensory device demonstrated that static and moving sensory thresholds of the NAC are lowest in the inferior pedicle group followed by the control group and the medial pedicle group. It can be concluded from this study that the medial and inferior pedicle techniques are capable of supporting vascularity and innervation to the NAC. The medial pedicle technique for severe mammary hypertrophy is a good alternative to free nipple grafting. The amount of breast tissue removed does not correlate with sensory outcome for both inferior and medial pedicle techniques. The pressure-specified sensory device is an excellent means of assessing sensory outcome. AD - Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA. AN - 12142591 AU - Nahabedian, M. Y. AU - Mofid, M. M. DA - Jul DO - 10.1097/00000637-200207000-00004 DP - NLM ET - 2002/07/27 IS - 1 KW - Adult Breast Diseases/surgery Female Graft Survival Humans Mammaplasty/*methods Necrosis Neurologic Examination/instrumentation Nipples/*blood supply/*innervation/pathology Retrospective Studies Surgical Flaps/*blood supply/*innervation Treatment Outcome LA - eng N1 - Nahabedian, Maurice Y Mofid, Mehrdad M Journal Article United States Ann Plast Surg. 2002 Jul;49(1):24-31; discussion 31-2. doi: 10.1097/00000637-200207000-00004. PY - 2002 SN - 0148-7043 (Print) 0148-7043 SP - 24-31; discussion 31-2 ST - Viability and sensation of the nipple-areolar complex after reduction mammaplasty T2 - Ann Plast Surg TI - Viability and sensation of the nipple-areolar complex after reduction mammaplasty VL - 49 ID - 9699 ER - TY - JOUR AB - Pedicled transverse rectus abdominis myocutaneous (TRAM) flap is still a common procedure for breast reconstruction. To lessen the incidence of abdominal-wall abnormalities, the donor-site defect in the transverse rectus abdominis muscle is generally repaired with a prosthetic mesh. This carries the well-known risks of foreign-body implantation, the most serious of which is infection. We report here a case of a 46-year-old patient who presented with an infected mesh 6.5 years after pedicled transverse rectus abdominis myocutaneous (TRAM)-flap breast reconstruction, requiring subsequent removal of the mesh. This is the latest recorded presentation of an abdominal prosthetic mesh infection in the English literature. The onset of late mesh infection could be related to a transient systemic infection and bacteraemia. © 2011 by Begell House, Inc. AD - C. M. Malata, Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Box 186, Hills Road, Cambridge, CB2 2QQ, United Kingdom AU - Conroy, K. AU - Azzawi, K. AU - Malata, C. M. DB - Embase Medline DO - 10.1615/JLongTermEffMedImplants.v21.i2.20 IS - 2 KW - polytetrafluoroethylene adult article bacteremia breast reconstruction case report device removal donor site female human incidence morbidity pedicled skin flap prosthesis infection risk factor surgical equipment transverse rectus abdominis musculocutaneous flap LA - English M3 - Article N1 - L362826287 2011-11-04 2011-11-08 PY - 2011 SN - 1050-6934 SP - 123-126 ST - A very late infection of an abdominal mesh following a pedicled TRAM flap harvest T2 - Journal of Long-Term Effects of Medical Implants TI - A very late infection of an abdominal mesh following a pedicled TRAM flap harvest UR - https://www.embase.com/search/results?subaction=viewrecord&id=L362826287&from=export http://dx.doi.org/10.1615/JLongTermEffMedImplants.v21.i2.20 http://www.dl.begellhouse.com/download/article/46b8015a5c9123b9/JLT2961_final.pdf VL - 21 ID - 7248 ER - TY - JOUR AD - St. Helens & Knowsley Hospital Trust, United Kingdom. Electronic address: shetha.naji@gmail.com. St. Helens & Knowsley Hospital Trust, United Kingdom. AN - 25027941 AU - Naji, S. AU - Nassab, R. AU - Iqbal, A. DA - Oct DO - 10.1016/j.bjps.2014.06.004 DP - NLM ET - 2014/07/17 IS - 10 KW - Breast/*abnormalities/surgery Breast Implantation/*methods Female Humans Hypertrophy/*surgery Mastectomy Middle Aged *Surgical Flaps LA - eng N1 - 1878-0539 Naji, S Nassab, R Iqbal, A Case Reports Letter Netherlands J Plast Reconstr Aesthet Surg. 2014 Oct;67(10):e240-1. doi: 10.1016/j.bjps.2014.06.004. Epub 2014 Jul 2. PY - 2014 SN - 1748-6815 SP - e240-1 ST - Vertical-scar skin pattern with laterally-based dermal flaps for direct, implant-breast reconstruction following risk-reducing skin-sparing mastectomy in macromastia T2 - J Plast Reconstr Aesthet Surg TI - Vertical-scar skin pattern with laterally-based dermal flaps for direct, implant-breast reconstruction following risk-reducing skin-sparing mastectomy in macromastia VL - 67 ID - 9996 ER - TY - JOUR AB - Background: The present study aimed to evaluate the influence of vertical location and spacing of perforators within flaps on the outcomes of deep inferior epigastric perforator (DIEP) flap breast reconstruction. Methods: Patients who underwent unilateral breast reconstruction with unipedicle DIEP flaps were identified. They were categorized into cohorts based on the entry of perforators in the middle third (cohort 1), upper third (cohort 2), and multiple third parts (cohort 3) of the flaps. Perfusion-related complications including fat necrosis diagnosed with ultrasound and donor-site morbidity were compared between the cohorts. Results: A total of 287 patients were analyzed, including 51 in cohort 1, 75 in cohort 2, and 161 in cohort 3. The cohorts were well matched, except for a greater number of perforators and more frequent harvest of both medial and lateral row perforators in cohort 3. Rates of overall perfusion-related complications and fat necrosis differed significantly between cohorts, with the highest rates in cohort 2. Fat necrosis occurred predominantly in the caudal portion of the flap in cohort 2, whereas it was relatively evenly distributed in the cephalic and caudal portions in cohorts 1 and 3. Rates of donor-site complications were similar across the cohorts. Multivariate analyses demonstrated that vertical spacing of perforators had an independent influence on developing perfusion-related complications and fat necrosis, showing that cohort 2 had significantly higher odds compared with cohorts 1 and 3, respectively. Conclusion: Vertical spacing of perforators might affect the risk of perfusion-related complications in DIEP flap breast reconstruction. AD - [Lee, Kyeong-Tae; Eom, Yeseul; Jeon, Byung-Joon; Mun, Goo-Hyun] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Plast Surg, Ilwon Dong 50, Seoul 135710, South Korea. Mun, GH (corresponding author), Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Plast Surg, Ilwon Dong 50, Seoul 135710, South Korea. supramicro@gmail.com AN - WOS:000439943900034 AU - Lee, K. T. AU - Eom, Y. AU - Jeon, B. J. AU - Mun, G. H. DA - Aug DO - 10.1097/prs.0000000000004549 IS - 2 J2 - Plast. Reconstr. Surg. KW - medial row perforators diep flap fat necrosis intraoperative angiography clinical-implications vascular anatomy tram flaps perfusion selection single Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: GO4AY Times Cited: 9 Cited Reference Count: 21 Lee, Kyeong-Tae Eom, Yeseul Jeon, Byung-Joon Mun, Goo-Hyun Lee, Kyeong-Tae/AAJ-2478-2021; Mun, Goo-Hyun/I-2540-2019 Lee, Kyeong-Tae/0000-0002-9070-9296; Mun, Goo-Hyun/0000-0003-3481-7978 9 0 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2018 SN - 0032-1052 SP - 319-329 ST - Vertical Spacing of Perforators in Deep Inferior Epigastric Perforator Flap Breast Reconstruction Can Affect the Outcomes T2 - Plastic and Reconstructive Surgery TI - Vertical Spacing of Perforators in Deep Inferior Epigastric Perforator Flap Breast Reconstruction Can Affect the Outcomes UR - ://WOS:000439943900034 VL - 142 ID - 1573 ER - TY - JOUR AB - The latissimus dorsi myocutaneous flap is a reliable and frequently used option to bring vascularized skin and soft tissue to improve the stability and aesthetic result in breast reconstruction. Standard techniques with skin paddle inset in a horizontal or oblique fashion preferentially improve anterior projection (when inset at the mastectomy scar) or lower pole and inframammary fold constriction (when inset into the inframammary fold). Here, the authors describe a modification for inset of the latissimus dorsi myocutaneous flap that improves both anterior projection and lower pole/inframammary fold constriction, and also allows the latissimus muscle to fan out and provide complete implant coverage. The vertical inset modification brings new skin and soft tissue into both the inferior pole and the central mastectomy scar, allowing simultaneous improvement in both areas and full use of the latissimus muscle to cover the implant or expander. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. AD - Chicago, Ill. From Northwestern Specialists in Plastic Surgery. AN - 29135896 AU - Fracol, M. AU - Grim, M. AU - Lanier, S. T. AU - Fine, N. A. DA - Mar DO - 10.1097/prs.0000000000004103 DP - NLM ET - 2017/11/15 IS - 3 KW - Adolescent Adult Aged Aged, 80 and over Breast Neoplasms/surgery Female Humans Mammaplasty/*methods Middle Aged *Myocutaneous Flap Postoperative Complications/etiology/prevention & control Retrospective Studies Tissue Expansion Devices Young Adult LA - eng N1 - 1529-4242 Fracol, Megan Grim, Michelle Lanier, Steven T Fine, Neil A Journal Article United States Plast Reconstr Surg. 2018 Mar;141(3):598-601. doi: 10.1097/PRS.0000000000004103. PY - 2018 SN - 0032-1052 SP - 598-601 ST - Vertical Skin Paddle Orientation for the Latissimus Dorsi Flap in Breast Reconstruction: A Modification to Simultaneously Correct Inferior Pole Constriction and Improve Projection T2 - Plast Reconstr Surg TI - Vertical Skin Paddle Orientation for the Latissimus Dorsi Flap in Breast Reconstruction: A Modification to Simultaneously Correct Inferior Pole Constriction and Improve Projection VL - 141 ID - 11260 ER - TY - JOUR AB - BACKGROUND: Vertical scar reduction mammaplasty has the advantage of reduced scar burden and improved long-term projection of the breasts. The technique has been criticized for being restricted to cases of mild to moderate mammary hypertrophy and is considered more intuitive and difficult to learn when compared with more conventional inverted-T scar reduction mammaplasties. This article describes the technique used in the largest reported series of vertical scar reduction mammaplasties performed by a single surgeon. METHODS: The technique performed in this series uses a mosque dome skin marking pattern; transposition of the nipple-areola complex on a superior or medial dermoglandular pedicle, depending on its position with respect to the skin markings; an excision en bloc of skin, fat, and gland; postexcision liposuction; and wound closure in two planes, with gathering of the skin of the vertical wound. A chart review of 250 consecutive patients treated between November of 2000 and December of 2003 was performed. RESULTS: The average reduction per breast (including liposuction) was 636 g (range, 60 to 2020 g). Complications were minimal (5.6 percent of breasts), with no nipples being lost, attesting to the safety of this technique. CONCLUSIONS: This technique for vertical scar reduction mammaplasty has been applied to breast reductions of all sizes and has consistently produced good breast shape, with an operation that is shorter to perform and leaves less scarring than standard breast reductions. This technique is straightforward and easy to learn, and offers a safe, effective, and predictable way for treating mammary hypertrophy. AD - The Plastic Surgery Clinic, Mississauga, Ontario, Canada L5A 3N7. drlista@theplasticsurgeryclinic.com AN - 16772910 AU - Lista, F. AU - Ahmad, J. DA - Jun DO - 10.1097/01.prs.0000218173.16272.6c DP - NLM ET - 2006/06/15 IS - 7 KW - Adolescent Adult Aged Breast/pathology/*surgery Breast Diseases/*surgery Cicatrix/prevention & control Female Humans Hypertrophy Lipectomy Mammaplasty/*methods Middle Aged Postoperative Complications Preoperative Care Surgical Flaps Suture Techniques Treatment Outcome LA - eng N1 - 1529-4242 Lista, Frank Ahmad, Jamil Journal Article United States Plast Reconstr Surg. 2006 Jun;117(7):2152-65; discussion 2166-9. doi: 10.1097/01.prs.0000218173.16272.6c. PY - 2006 SN - 0032-1052 SP - 2152-65; discussion 2166-9 ST - Vertical scar reduction mammaplasty: a 15-year experience including a review of 250 consecutive cases T2 - Plast Reconstr Surg TI - Vertical scar reduction mammaplasty: a 15-year experience including a review of 250 consecutive cases VL - 117 ID - 10328 ER - TY - JOUR AB - Since 1996, the original technique of superior pedicle vertical scar mammaplasty described by Lejour has been modified by decreasing skin and glandular undermining, limiting liposuction, avoiding tight glandular stitches, and adding a small horizontal scar for very large breasts. Between 1996 and 2002, 115 consecutive patients underwent a bilateral reduction mammaplasty of more than 500 g per breast using the modified Lejour technique. The early, late, and delayed complications were studied according to four parameters: glandular resection, age, smoking habits, and body mass index (BMI). There was no difference in terms of complications according to the glandular resection. Patients with a high BMI were found to have a higher rate of wound dehiscence. The occurrence of partial areolar necrosis proved to be related to smoking habits. Patients younger than 20 years presented a lower rate of seroma. The modified Lejour technique has proved to be safe and effective for large breasts. AD - Department of Plastic, Aesthetic, and Reconstructive Surgery, Brugmann University Hospital, Place Van Gehuchten, Brussels, Belgium. AN - 17484062 AU - Azzam, C. AU - De Mey, A. DA - May-Jun DO - 10.1007/s00266-006-0227-0 DP - NLM ET - 2007/05/08 IS - 3 KW - Adolescent Adult Aged Cicatrix/*etiology *Dermatologic Surgical Procedures Follow-Up Studies Gynecomastia/*surgery Humans Male Mammaplasty/*adverse effects/methods Middle Aged Patient Satisfaction Postoperative Complications Retrospective Studies Skin Transplantation/methods Surgical Flaps Treatment Outcome LA - eng N1 - Azzam, Carole De Mey, Albert Journal Article United States Aesthetic Plast Surg. 2007 May-Jun;31(3):294-8. doi: 10.1007/s00266-006-0227-0. PY - 2007 SN - 0364-216X (Print) 0364-216x SP - 294-8 ST - Vertical scar mammaplasty in gigantomastia: retrospective study of 115 patients treated using the modified lejour technique T2 - Aesthetic Plast Surg TI - Vertical scar mammaplasty in gigantomastia: retrospective study of 115 patients treated using the modified lejour technique VL - 31 ID - 13157 ER - TY - JOUR AB - Vertical scar breast reduction is a well accepted technique which we believe improves the shape and projection of the breast and leaves no horizontal scars. Lassus and Lejour described superiorly based nipple flaps; we describe a medially based flap or glandular transposition of the nipple in small reductions. Fifty-seven consecutive patients are presented. Thirty-three patients had medial transposition of the nipple-areola with a mean resection of 608 g (range 220-1250 g). Twenty-four patients had a glandular transposition of the nipple-areola, with a mean resection of 380 g (range 220-600 g); transposition of the areola should be less than 5 cm in this group. After a short learning curve, the complications have been few and minor. AD - Department of Plastic and Reconstructive Surgery, Charing Cross Hospital, London, UK. AN - 8976741 AU - Asplund, O. A. AU - Davies, D. M. DA - Dec DO - 10.1016/s0007-1226(96)90126-5 DP - NLM ET - 1996/12/01 IS - 8 KW - Adult Breast/*abnormalities Cicatrix/pathology Esthetics Female Follow-Up Studies Humans Mammaplasty/*methods Middle Aged Nipples/*surgery Postoperative Complications Postoperative Period Surgical Flaps/*methods Treatment Outcome LA - eng N1 - Asplund, O A Davies, D M Journal Article England Br J Plast Surg. 1996 Dec;49(8):507-14. doi: 10.1016/s0007-1226(96)90126-5. PY - 1996 SN - 0007-1226 (Print) 0007-1226 SP - 507-14 ST - Vertical scar breast reduction with medial flap or glandular transposition of the nipple-areola T2 - Br J Plast Surg TI - Vertical scar breast reduction with medial flap or glandular transposition of the nipple-areola VL - 49 ID - 10058 ER - TY - JOUR AB - Vertical reduction mammaplasty using a superomedial pedicle is a well-accepted technique giving good results in mild to moderate breast hypertrophy. We describe modifications of the vertical reduction technique to achieve safe reductions even for very large breasts and minimize unsightly scarring, skin necrosis and poor shape. Over the past 4 years, 162 patients have undergone bilateral breast reduction using the vertical mammaplasty technique with a superomedial dermoglandular pedicle. We present a retrospective study of 23 cases of gigantomastia (reductions over 1100g) who underwent bilateral reduction mammaplasty, using our technique. The mean age was 49 years, BMIs ranged from 28 to 52 kg/m. The mean suprasternal notch-to-nipple distance was 40.5 cm on the right and 41.4 cm on the left. The average resection weight per breast was 1303 g on the right, and 1245 g on the left side. The suprasternal notch-to-nipple distance was reduced by between 13.2 and 36.0 cm (mean, 16.1 cm). Mean follow-up was 14 months. We observed a superficial infection in 2 patients, a deep hematoma in one patient, partial necrosis of the nipple-areola complex in 1, and 2 patients needed correction surgery due to dog-ear formation. By using the described modifications, the nipple and areola were safely transposed on a superomedial dermoglandular pedicle producing good breast shapes, while scarring and complications in vertical reduction mammaplasty for oversized breasts were effectively minimized. AD - Department of Plastic and Reconstructive Surgery, Hand Surgery and Burn Care Centre, Cologne City Hospitals (Merheim), University of Witten/Herdecke, Witten, Germany. AN - 20179473 AU - Amini, P. AU - Stasch, T. AU - Theodorou, P. AU - Altintas, A. A. AU - Phan, V. AU - Spilker, G. DA - Mar DO - 10.1097/SAP.0b013e3181b0a5d8 DP - NLM ET - 2010/02/25 IS - 3 KW - Breast/*abnormalities/*surgery Female Humans Mammaplasty/*methods Middle Aged Postoperative Complications/epidemiology *Surgical Flaps LA - eng N1 - 1536-3708 Amini, Peymaneh Stasch, Tilman Theodorou, Panagiotis Altintas, Ahmed Ali Phan, Vu Spilker, Gerald Journal Article United States Ann Plast Surg. 2010 Mar;64(3):279-85. doi: 10.1097/SAP.0b013e3181b0a5d8. PY - 2010 SN - 0148-7043 SP - 279-85 ST - Vertical reduction mammaplasty combined with a superomedial pedicle in gigantomastia T2 - Ann Plast Surg TI - Vertical reduction mammaplasty combined with a superomedial pedicle in gigantomastia VL - 64 ID - 9495 ER - TY - JOUR AB - We have used a contralateral vertical rectus abdominis musculocutaneous flap based upon the superior epigastric vessels in six patients to provide coverage after resection of locally recurrent breast carcinoma in irradiated tissues. Primary healing of defects as large as 16 cm X 35 cm has been obtained using this technique. Although there is no evidence to suggest that such a procedure significantly lengthens survival, it was clearly beneficial to the quality of life in these patients. Our results suggest that older patients with relatively indolent disease receive the greatest benefit from this procedure. AN - 2950597 AU - Reed, W. P. AU - Spence, R. J. DA - Mar DO - 10.1097/00007611-198703000-00003 DP - NLM ET - 1987/03/01 IS - 3 KW - Abdominal Muscles/transplantation Breast/pathology/radiation effects/*surgery Breast Neoplasms/surgery Female Humans Methods Necrosis Neoplasm Recurrence, Local/surgery Radiation Injuries/*surgery *Surgical Flaps LA - eng N1 - Reed, W P Spence, R J Journal Article United States South Med J. 1987 Mar;80(3):287-91. doi: 10.1097/00007611-198703000-00003. PY - 1987 SN - 0038-4348 (Print) 0038-4348 SP - 287-91 ST - Vertical rectus abdominis musculocutaneous flap for chest wall reconstruction after irradiation T2 - South Med J TI - Vertical rectus abdominis musculocutaneous flap for chest wall reconstruction after irradiation VL - 80 ID - 11544 ER - TY - JOUR AB - Background: The vertical posteromedial thigh (vPMT) perforator flap is a new reliable flap with versatility. The purpose of this article was to report our experience with the use of free vPMT flap for reconstruction of the breast. Patients and Methods: From May 2015 to December 2015, seven patients received immediate unilateral breast reconstruction with seven free vPMT flaps. The flaps were raised based on the first medial perforator of the profunda femoris artery (PFA). The internal mammary artery and vein were dissected as recipient vessels. Results: The flap sizes varied from 25 x 9 cm to 30 x 10 cm. The average weight of the flap and mastectomy specimen was 431 g (range: 390 to 470 g) and 410 g (range: 360 to 450 g) respectively. The average pedicle length was 10.4 cm (range, 8.5 to 12.5 cm) and the average arterial diameter was 2.1 mm (range, 1.8 to 2.6 mm). All of the flaps survived completely after surgery. The donor sites were all primarily closed with minimal morbidities. Follow-up observations were conducted from 3 to 9 months. All of patients were satisfactory with the reconstruction. Conclusion: The vertical vPMT is suitable for breast reconstruction in women with small to moderate breast size; the vertical pattern of the PMT avoids some of the problems related to other flaps with transverse patterns and represents an alternative design that can be successfully used for breast reconstruction. (C) 2016 Wiley Periodicals, Inc. AD - [Scaglioni, Mario F.; Lindenblatt, Nicole; Giovanoli, Pietro] Univ Hosp Zurich, Dept Plast & Hand Surg, Ramistr 100, CH-8091 Zurich, Switzerland. [Scaglioni, Mario F.; Chen, Yen-Chou] Kaohsiung Chang Gung Mem Hosp, Dept Plast & Reconstruct Surg, Kaohsiung, Taiwan. [Scaglioni, Mario F.; Chen, Yen-Chou] Chang Gung Univ, Coll Med, Kaohsiung, Taiwan. Scaglioni, MF (corresponding author), Univ Hosp Zurich, Dept Plast & Hand Surg, Ramistr 100, CH-8091 Zurich, Switzerland. Mario.scaglioni@gmail.com AN - WOS:000407105200002 AU - Scaglioni, M. F. AU - Chen, Y. C. AU - Lindenblatt, N. AU - Giovanoli, P. DA - Jul DO - 10.1002/micr.30074 IS - 5 J2 - Microsurgery KW - artery perforator flap clinical-applications gracilis option Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: FC8QG Times Cited: 14 Cited Reference Count: 16 Scaglioni, Mario F. Chen, Yen-Chou Lindenblatt, Nicole Giovanoli, Pietro 14 0 Wiley Hoboken 1098-2752 PY - 2017 SN - 0738-1085 SP - 371-376 ST - THE VERTICAL POSTEROMEDIAL THIGH (vPMT) FLAP FOR AUTOLOGOUS BREAST RECONSTRUCTION: A NOVEL FLAP DESIGN T2 - Microsurgery TI - THE VERTICAL POSTEROMEDIAL THIGH (vPMT) FLAP FOR AUTOLOGOUS BREAST RECONSTRUCTION: A NOVEL FLAP DESIGN UR - ://WOS:000407105200002 VL - 37 ID - 1792 ER - TY - JOUR AB - Our vertical mammaplasty technique for skin-sparing mastectomy results in attractive and symmetrical breast reconstructions. We used this technique to reconstruct nine breasts in eight patients. There were no serious complications, and no skin revisions were necessary on the reconstructed breasts. The vertical pattern skin-sparing mastectomy has improved the aesthetic results in our mastectomy patients with large or pendulous breasts. It offers several advantages over Wise pattern reconstructions, and can create attractive and symmetrical breast reconstructions. This is now our preferred method for reconstructing the moderately large or ptotic breasts in patients undergoing TRAM flap reconstruction. AD - K.B. Young, 2100 Webster Street, San Francisco, CA 94115, United States AU - Young, K. B. AU - Satovsky, N. DB - Embase Medline DO - 10.1097/01.PRS.0000164489.51776.BE IS - 7 KW - adult article breast malformation breast ptosis breast reconstruction breast reduction case report esthetic surgery female gynecomastia human incision mastectomy myocutaneous flap preoperative evaluation priority journal surgical technique transverse rectus abdominis musculocutaneous flap vertical pattern breast reconstruction LA - English M3 - Article N1 - L40770519 2005-06-21 PY - 2005 SN - 0032-1052 SP - 2052-2055 ST - The vertical pattern breast reconstruction for large or ptotic breasts T2 - Plastic and Reconstructive Surgery TI - The vertical pattern breast reconstruction for large or ptotic breasts UR - https://www.embase.com/search/results?subaction=viewrecord&id=L40770519&from=export http://dx.doi.org/10.1097/01.PRS.0000164489.51776.BE VL - 115 ID - 8177 ER - TY - JOUR AD - [Rivera-Serrano, Carlos M.; Aljaaly, Hattan A.; Wu, Jerry; Cheng, Ming-Huei] Chang Gung Mem Hosp, Dept Plast & Reconstruct Surg, 5 Fu Hsing St,Kweishan, Taoyuan 333, Taiwan. Cheng, MH (corresponding author), Chang Gung Mem Hosp, Dept Plast & Reconstruct Surg, 5 Fu Hsing St,Kweishan, Taoyuan 333, Taiwan. minghuei@cgmh.org.tw AN - WOS:000397416300019 AU - Rivera-Serrano, C. M. AU - Aljaaly, H. A. AU - Wu, J. AU - Cheng, M. H. C7 - e1189 DA - Feb DO - 10.1097/gox.0000000000001189 IS - 2 J2 - Prs-Glob. Open KW - Surgery LA - English M3 - Editorial Material N1 - ISI Document Delivery No.: EP5KB Times Cited: 4 Cited Reference Count: 5 Rivera-Serrano, Carlos M. Aljaaly, Hattan A. Wu, Jerry Cheng, Ming-Huei Cheng, Ming-Huei/AAD-8579-2019 4 0 1 Lippincott williams & wilkins Philadelphia PY - 2017 SN - 2169-7574 SP - 2 ST - Vertical PAP Flap: Simultaneous Longitudinal Profunda Artery Perforator Flaps for Bilateral Breast Reconstructions T2 - Plastic and Reconstructive Surgery-Global Open TI - Vertical PAP Flap: Simultaneous Longitudinal Profunda Artery Perforator Flaps for Bilateral Breast Reconstructions UR - ://WOS:000397416300019 VL - 5 ID - 1891 ER - TY - JOUR AB - The presence of any abdominal scar, in addition to obesity, a smoking history, and prior irradiation are considered the major known "risk factors" for predictable success or failure of the lower transverse rectus abdominis musculocutaneous (TRAM) flap. For many, a vertical midline scar has even been considered to be a relative contraindication. The possibility that the scar instead could effect some form of delay or by neovascularization permit reperfusion across the midline might negate this concern. The validity of this hypothesis was tested in 40 Sprague-Dawley (CD) rats using our standard rat TRAM flap model. Every rat initially had a vertical skin incision made from xiphoid to pubis. At a second stage, either immediately or after a delay of I week, 2 weeks, or 6 months, a superior-pedicled (dominant) or inferior-pedicled (nondominant) TRAM flap was raised, with five rats in each subgroup. For the inferior-pedicled group, the percentage of ipsilateral (muscle-pedicle half) flap survival approached 75% and had a trend toward greater survival with each increase in the time of delay, but any difference was not statistically significant (F = 0.653, P = 0.538). In the superior-pedicled group, the ipsilateral half of the flap always survived completely. In both groups, the contralateral or opposite side always underwent complete necrosis regardless of pedicle orientation or time constraints. The midline scar did not enhance even unilateral TRAM flap survival when compared with historic controls, and long-term transmidline reperfusion across the scar did not seem to occur. These findings corroborate the clinical observation that only a unilateral TRAM flap would be reliable in the presence of a vertical midline abdominal scar. AD - Nippon Med Coll, Dept Plast & Reconstruct Surg, Tokyo 113, Japan. Lehigh Valley Hosp, Adv Clin Technol Dept, Allentown, PA USA. Hallock, GG (corresponding author), 1230 S Cedar Crest Blvd,Suite 306, Allentown, PA 18103 USA. pbhallock@cs.com AN - WOS:000185879400014 AU - Sano, K. AU - Hallock, G. G. AU - Rice, D. C. DA - Oct DO - 10.1097/01.sap.0000067969.57450.CE IS - 4 J2 - Ann. Plast. Surg. KW - abdominis musculocutaneous flap breast reconstruction microvascular augmentation myocutaneous flap model experience delay complications anatomy pedicle Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 731HZ Times Cited: 9 Cited Reference Count: 24 Sano, K Hallock, GG Rice, DC 9 0 2 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2003 SN - 0148-7043 SP - 403-408 ST - A vertical midline scar is a 'high-risk' factor for maximum survival of the rat TRAM flap T2 - Annals of Plastic Surgery TI - A vertical midline scar is a 'high-risk' factor for maximum survival of the rat TRAM flap UR - ://WOS:000185879400014 VL - 51 ID - 3839 ER - TY - JOUR AB - Breast contouring surgery after massive weight loss is challenging because of unfavorable features such as inelastic skin, volume depletion, loss of upper pole fullness, and significant ptosis. An approach is presented for autoaugmentation using a lateral intercostal artery perforator (LICAP) flap secured with a pectoralis muscle sling, along with mastopexy based on vertical scar principles. In a total of 8 patients (average age: 39.3 years, range: 29-57; average body mass index: 30.8 kg/m(2), range: 25.7-39.1) with breast ptosis and volume depletion after a mean weight loss of 121.9 pounds (range: 80-210), LICAP flap (n = 16) was used with turnover flap design to increase breast volume under a pectoralis muscle sling. Vertical design mastopexy (n = 16) was achieved at the same time, resulting in an L-shaped final scar. All the patients were followed for at least 1 year after the surgery. Patient satisfaction was high at long-term follow-up (average: 16.8 months, range: 12-24), with stable and pleasing breast shape and a mean patient ranking for aesthetic outcome of 4.2 (of 5). None of the patients developed any flap necrosis or fat necrosis. An alternative approach is described for the combined treatment of breast ptosis and volume loss in the bariatric patient, with promising long-term results. The muscle sling seems to help prevent tissue descent, without evidence of pseudoptosis at long term. It is shown that vertical scar techniques can be successfully used even in bariatric patients. AD - [Akyurek, Mustafa] Univ Massachusetts, Sch Med, Div Plast Surg, Worcester, MA USA. Akyurek, M (corresponding author), UMass Med Ctr, Div Plast Surg, 281 Lincoln St, Worcester, MA 01605 USA. akyurekm@ummhc.org AN - WOS:000285502600008 AU - Akyurek, M. DA - Jan DO - 10.1097/SAP.0b013e3181d6e28a IS - 1 J2 - Ann. Plast. Surg. KW - mastopexy massive weight loss muscle sling intercostal artery perforator flap autologous tissue breast augmentation massive weight-loss reduction mammaplasty dermal suspension search shape surgery Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 697GZ Times Cited: 13 Cited Reference Count: 20 Akyurek, Mustafa 13 0 3 Lippincott williams & wilkins Philadelphia PY - 2011 SN - 0148-7043 SP - 29-35 ST - Vertical Mastopexy and Lateral Intercostal Artery Perforator (LICAP) Flap With Pectoralis Muscle Sling for Autologous Tissue Breast Augmentation in the Bariatric Patient T2 - Annals of Plastic Surgery TI - Vertical Mastopexy and Lateral Intercostal Artery Perforator (LICAP) Flap With Pectoralis Muscle Sling for Autologous Tissue Breast Augmentation in the Bariatric Patient UR - ://WOS:000285502600008 VL - 66 ID - 2992 ER - TY - JOUR AB - BACKGROUND: In a vertical mammaplasty, various types of pedicles have been proposed for the nipple-areola transposition. The preparation of any type of nipple-areola flap necessitates disconnecting the nipple-areola from the breast gland, except for the pedicle bearing glandular part. These flap-dependent techniques not only impair the functions of the breast but also do not provide enough fullness to the upper pole. METHOD: No specific nipple-areola flap preparation is made. Reduction is obtained by a transverse excision from the lowermost part of the breast gland. Apart from this, no cut into the gland is needed. Liposuction, wide skin elevation and extended retromammary dissection permit the en bloc suspension of the breast. PATIENTS AND RESULTS: The study enrolled a total of 85 patients with 170 breasts. Mastopexy or minor reduction less than 100 gr was applied for 49 breasts; moderate reduction, 100-399 gr, for 67 breasts; and a large reduction of more than 400 gr for 54 breasts. No complete or incomplete nipple-areola necrosis was seen. The success rate for achieving upper pole fullness was compared between groups for reduction amount, age and body mass index (BMI). CONCLUSION: The functions of the breast organ are preserved in the en bloc suspension technique. In patients with dense breasts, a good upper pole fullness was achieved with a high success rate. Young patients and patients with a body mass index below 25 are suitable for this technique. However, the same success rate could not be achieved in elderly patients with fatty breasts. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . AU - Seyhan, A. DB - Medline DO - 10.1007/s00266-020-01862-4 IS - 1 KW - aged breast breast reconstruction breast tumor esthetics female human mammary gland nipple retrospective study surgery surgical flaps treatment outcome LA - English M3 - Article N1 - L632360545 2020-07-24 2021-03-12 PY - 2021 SN - 1432-5241 SP - 78-91 ST - Vertical Mammaplasty with Retromammary En Bloc Breast Suspension T2 - Aesthetic plastic surgery TI - Vertical Mammaplasty with Retromammary En Bloc Breast Suspension UR - https://www.embase.com/search/results?subaction=viewrecord&id=L632360545&from=export http://dx.doi.org/10.1007/s00266-020-01862-4 VL - 45 ID - 4482 ER - TY - JOUR AB - PURPOSE: The skin paddle of the latissimus dorsi flap is typically inset horizontally (HILD) in breast reconstruction. We describe our experience with the vertical inset of the latissimus dorsi (VILD) and its aesthetic benefit. METHODS: We performed a case-control study comparing the most recent cases of both VILD and HILD. Scar, as seen on anterior-posterior photographs, was digitally measured and compared from 3 clinically relevant areas: (1) all visible scarring ("mirror view"), (2) scarring above the nipple ("self-view"), and (3) scarring above or medial to the nipple ("social view"). Demographics and outcomes were statistically compared. EXPERIENCE/RESULTS: Fifty of the most recent patients receiving HILD or VILD were selected for each group. Average patient age was 55.6 and 51.6 years (P = 0.32), and average follow-up was 531.6 and 606.7 days (P = 0.20), respectively. The VILD scar-length ratios were decreased by 17% in the mirror view (P ≤ 0.01), 37% in the self-view (P ≤ 0.01), and 37% in the social view (P ≤ 0.01). There were no statistically significant differences between groups regarding smoking (P = 0.75), diabetes (P = 0.70), body mass index (P = 0.74), seroma (P = 0.46), infection (P = 1.0), or flap necrosis (P = 0.70). CONCLUSIONS: The VILD is safe and reliable. Measurements from anterior-posterior photographs illustrate statistically significant decreases in overall scar burden (mirror view) and statistically significant reductions in the highly visible self-view and social view. Our study is the first to quantify a reduction in scar burden by using VILD technique. AU - Steffen, C. M. AU - Day, K. M. AU - Gilson, A. J. AU - Zoog, E. AU - Brzezienski, M. A. DB - Medline DO - 10.1097/SAP.0000000000001510 IS - 6S Suppl 6 KW - adult back muscle breast reconstruction comparative study esthetics female follow up free tissue graft human middle aged postoperative complication procedures retrospective study scar transplantation treatment outcome LA - English M3 - Article N1 - L629714888 2019-11-05 PY - 2018 SN - 1536-3708 SP - S365-S371 ST - Vertical Inset of the Latissimus Dorsi Flap Improves Reconstruction Aesthetics by Reducing Scar Burden in the "Social Breast" T2 - Annals of plastic surgery TI - Vertical Inset of the Latissimus Dorsi Flap Improves Reconstruction Aesthetics by Reducing Scar Burden in the "Social Breast" UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629714888&from=export http://dx.doi.org/10.1097/SAP.0000000000001510 VL - 80 ID - 5405 ER - TY - JOUR AB - BACKGROUND: Following unilateral breast cancer surgery, mastopexy and reduction of the unaffected breast are often performed to obtain symmetrical breasts. The use of implants in breast reconstruction results in a nonptotic breast. To achieve symmetry following the procedure, the unaffected side should be nonptotic too. However, no study has yet reported any indices for the design of mastopexy and reduction in this direction. We present a new method of preoperative design that uses vertical breast measurements to form nonptotic breasts according to individual breast shapes. METHODS: We performed vertical breast measurements of the unaffected breasts of 193 patients scheduled to undergo surgery for unilateral breast cancer. The vertical base dimension (VBD) and vertical surface dimension (VSD) of the ptotic and nonptotic breasts and the height of the nipple in the nonptotic breast were measured in centimeters. RESULTS: The borderline between ptotic and nonptotic breasts was expressed using the formula VSD = 1.13 × VBD + 1.86. The height of the nipple in nonptotic breasts was 0.8 times the distance between the sternal notch and lowest point of the inframammary fold on the midline. From these findings, we formulated a new method for forming a nonptotic breast from a ptotic breast using an inverted T design. CONCLUSION: These results can be used for the design of mastopexy and reduction when forming a nonptotic breast on the unaffected side. These procedures can be performed without significantly lifting the nipple-areolar complex if required during unilateral prosthetic breast reconstruction. AD - Department of Plastic Surgery, Morinomiya Hospital, Osaka, Japan. Electronic address: tfujiwara33@gmail.com. Department of Plastic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. Department of Breast and Endocrine Surgery, Morinomiya Hospital, Osaka, Japan. AN - 27876309 AU - Fujiwara, T. AU - Yano, K. AU - Tanji, Y. AU - Nomura, M. DA - Feb DO - 10.1016/j.bjps.2016.10.003 DP - NLM ET - 2016/11/24 IS - 2 KW - Adult Aged Breast/*diagnostic imaging *Breast Implants Breast Neoplasms/*surgery Female Follow-Up Studies Humans Mammaplasty/*methods Middle Aged Nipples/*surgery Retrospective Studies *Surgical Flaps Implant Mastopexy Nonptotic breast Reduction Unilateral prosthetic breast reconstruction Vertical breast measurement LA - eng N1 - 1878-0539 Fujiwara, Takashi Yano, Kenji Tanji, Yoshio Nomura, Masaya Journal Article Netherlands J Plast Reconstr Aesthet Surg. 2017 Feb;70(2):229-235. doi: 10.1016/j.bjps.2016.10.003. Epub 2016 Oct 26. PY - 2017 SN - 1748-6815 SP - 229-235 ST - Vertical breast measurement in East Asian women: A guide for mastopexy and reduction to form nonptotic breasts in unilateral prosthetic breast reconstruction T2 - J Plast Reconstr Aesthet Surg TI - Vertical breast measurement in East Asian women: A guide for mastopexy and reduction to form nonptotic breasts in unilateral prosthetic breast reconstruction VL - 70 ID - 9238 ER - TY - JOUR AD - Breast Care Centre, University Hospitals of Leicester, U.K., Department of Breast Surgery, Leicester, United Kingdom Breast Care Centre, University Hospitals of Leicester, U.K., Department of Radiology, Leicester, United Kingdom AN - 148119927. Language: English. Entry Date: 20210122. Revision Date: 20210122. Publication Type: Article AU - Seddon, T. AU - Dragoumis, D. AU - Al-Attar, M. AU - Valassiadou, K. DB - cin20 DO - 10.1016/S0959-8049(20)30621-3 DP - EBSCOhost KW - Breast Reconstruction -- Methods Perforator Flap Thorax Lumpectomy -- Methods Breast Neoplasms -- Surgery Treatment Outcomes Mammography Congresses and Conferences N1 - abstract; proceedings; research. Supplement Title: 2020 Supplement 1. Journal Subset: Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland. NLM UID: 9005373. PY - 2020 SN - 0959-8049 SP - S37-S38 ST - Versatility, clinical outcomes and mammographic follow-up of Chest Wall Perforator Flaps (CWPF): A single-centre experience...12th European Breast Cancer Virtual Conference (EBCC-12), October 2-3, 2020 T2 - European Journal of Cancer TI - Versatility, clinical outcomes and mammographic follow-up of Chest Wall Perforator Flaps (CWPF): A single-centre experience...12th European Breast Cancer Virtual Conference (EBCC-12), October 2-3, 2020 UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=148119927&site=ehost-live&scope=site VL - 138 ID - 542 ER - TY - JOUR AU - Seddon, T. AU - Dragoumis, D. AU - Al-Attar, M. AU - Valassiadou, K. DB - Embase DO - 10.1016/S0959-8049(20)30621-3 KW - article breast biopsy breast malformation breast reconstruction calcification cancer radiotherapy chest wall perforator flap clinical article clinical outcome demography follow up graft necrosis human human tissue intraductal carcinoma mammography mastectomy partial mastectomy perforator flap postoperative complication postoperative period priority journal prospective study recurrence risk reoperation retrospective study surgical infection thorax wall wide excision LA - English M3 - Article N1 - L2007973504 2020-10-12 2020-10-30 PY - 2020 SN - 1879-0852 0959-8049 SP - S37-S38 ST - Versatility, clinical outcomes and mammographic follow-up of Chest Wall Perforator Flaps (CWPF): A single-centre experience T2 - European Journal of Cancer TI - Versatility, clinical outcomes and mammographic follow-up of Chest Wall Perforator Flaps (CWPF): A single-centre experience UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2007973504&from=export http://dx.doi.org/10.1016/S0959-8049(20)30621-3 VL - 138 ID - 4627 ER - TY - JOUR AB - The deep inferior epigastric perforator (DIEP) flap is one of the most commonly used perforator flaps. However, when horizontally oriented, it has certain pitfalls such as sacrifice of the contralateral donor site, the need to discard soft tissue that will not be adequately perfused, and long operating times. To overcome these handicaps, the flap in a vertical orientation was designed and demonstrated the versatility of this technique in a number of different anatomical tissue restorations in this study. The vertical DIEP flaps were used in 8 patients (7 males and 1 female) in 3 years. Defects were located in the lower limb (4 cases), face (3 cases), and hip (1 cases). All flaps were transferred as free, except one in the hip that was pedicled. Flap sizes varied from 7 x 5 cm to 13 X 9 cm. All donor defects were closed primarily. The mean follow-up time was 13.6 months. All flaps survived totally, but one which had partial necrosis. A hematoma developed postoperatively in the donor site of the pedicled DIEP flap. Cosmetic outcomes were satisfactory in all patients. All donor site scars were acceptable with minimal contour irregularities. The vertical DIEP flap offers diverse opportunities in various soft tissue reconstructions and is candidate to be an important choice of free flap repertoire. The method can be proposed particularly for restoration of moderate sized defects rather than that of large defects as in postmastectomy breast reconstruction. (C) 2009 Wiley-Liss, Inc. Microsurgery 29:282-286, 2009. AD - Ataturk Univ, Fac Med, Dept Plast Reconstruct & Aesthet Surg, Erzurum, Turkey. Tan, O (corresponding author), Ataturk Univ, Tip Fak, Yakutiye Arastirma Hastanesi, Plast Rekonstruktif & Estet Cerrahi AD, TR-25240 Erzurum, Turkey. drondertan@yahoo.com AN - WOS:000266076500006 AU - Tan, O. DO - 10.1002/micr.20621 IS - 4 J2 - Microsurgery KW - breast reconstruction diep flap preliminary experience artery muscle limb Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 445UH Times Cited: 10 Cited Reference Count: 16 Tan, Onder 12 0 Wiley-liss Hoboken PY - 2009 SN - 0738-1085 SP - 282-286 ST - VERSATILITY OF THE VERTICAL DESIGNED DEEP INFERIOR EPIGASTRIC PERFORATOR FLAP T2 - Microsurgery TI - VERSATILITY OF THE VERTICAL DESIGNED DEEP INFERIOR EPIGASTRIC PERFORATOR FLAP UR - ://WOS:000266076500006 VL - 29 ID - 3344 ER - TY - JOUR AB - BACKGROUND: Management of the breast following massive weight loss is challenging. Specific issues include an unstable envelope (skin laxity) and an unstable mound (decent and volume loss). The evolution of a technique is presented. METHODS: A retrospective review of all massive weight loss patients who underwent superomedial pedicle mastopexy techniques was performed. The current procedure involves incorporating the lower pole of the breast and rotating it superiorly. The lateral breast flap is then advanced medially and plicated. This essentially (1) autoaugments the upper pole, (2) narrows the wide breast, (3) provides an internal sling, and (4) redefines and secures the inframammary fold. RESULTS: Thirty-five patients were included in the series. The average body mass index was 26.5, and the average weight loss was 121 pounds. Six patients (17 percent) had mastopexy augmentation. Wise pattern skin takeout was performed in 89 percent of patients. The revision rate for the series was 11 percent. The average follow-up was 1.7 years. CONCLUSIONS: The superomedial pedicle is a versatile, well-vascularized pedicle that allows for glandular plication of the lower pole and autoaugmentation of the upper pole once rotated. Parenchymal shaping through plication and suspension of the breast mound should improve breast shape over time, theoretically reducing the incidence of recurrent ptosis as breast shape relies less on the often inelastic skin envelope. It applies a familiar and reliable technique, with certain modifications, to improve results and maintain shape in the long, deflated, massive weight loss breast. AD - Atlanta, Ga. From the Division of Plastic and Reconstructive Surgery, Emory University School of Medicine. AN - 17805137 AU - Losken, A. AU - Holtz, D. J. DA - Sep 15 DO - 10.1097/01.prs.0000278004.24650.e6 DP - NLM ET - 2007/09/07 IS - 4 KW - Adult Aged Bariatric Surgery/*adverse effects Breast Diseases/*etiology/surgery Female Follow-Up Studies Humans Mammaplasty/*methods Middle Aged Organ Size Patient Satisfaction Retrospective Studies Risk Factors Surgical Flaps/*blood supply Treatment Outcome *Weight Loss LA - eng N1 - 1529-4242 Losken, Albert Holtz, Daniel J Journal Article United States Plast Reconstr Surg. 2007 Sep 15;120(4):1060-1068. doi: 10.1097/01.prs.0000278004.24650.e6. PY - 2007 SN - 0032-1052 SP - 1060-1068 ST - Versatility of the superomedial pedicle in managing the massive weight loss breast: the rotation-advancement technique T2 - Plast Reconstr Surg TI - Versatility of the superomedial pedicle in managing the massive weight loss breast: the rotation-advancement technique VL - 120 ID - 13261 ER - TY - JOUR AB - Following the TRAM and the DIEP the SIEA flap is the next logical step to reduce the donor site morbidity in autologous breast reconstruction. The vascular axis of the SIEA flap, however, is completely different from the deep epigastric pedicle, on which previous lower abdominal flaps were based. Therefore, a mapping of the vascular territory, which can be reliably harvested on this pedicle, seems mandatory before this new technique can become established. Aim: To chart the angiosome of the superficial inferior epigastric artery with regard to breast reconstruction and to evaluate the random extension of the vascular territory, which can be reliably raised on this pedicle. Study design: Clinical, prospective study in a university-affiliated department of plastic surgery. Patients: Ten patients undergoing autologous breast reconstruction with the superficial inferior epigastric perforator flap and five patients undergoing aesthetic abdominoplasty with isolation of the abdominal flap on the superficial epigastric vessels. Material and methods: After isolation of the abdominal panniculus on a single superficial inferior epigastric artery pedicle, the flap was divided in the four conventional zones according to Hartrampf. Perfusion in each of the four zones was measured on the table using the technique of dynamic laser-fluorescence videoangiography. Results: Perfusion of Hartrampf Zone III occurred first (25 s post-injection) and the perfusion index amounted median 89% of reference. Perfusion of Zone I occurred median 5 s later and the relative perfusion was 80%. Perfusion of the contralateral zones II and IV was dramatically reduced to 8% and zero, respectively, and this reduction was statistically significant (p < 0.0001). Conclusion: The true angiosome of the superficial epigastric artery is located laterally on the ipsilateral hemiabdomen. Its random extension is unreliable and ranges most frequently only to the midline. Based on the results of this study, survival of the skin and subcutaneous fat taken laterally to the border of the contralateral rectus sheath seems questionable. Therefore, the versatility of the SIEA flap for autologous breast reconstruction seems limited when compared with the conventional methods based on the deep inferior epigastric system. (c) 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - Tech Univ Munich, Klinikum Bogenhausen, Dept Plast Reconstruct & Hand Surg, Burn Ctr, D-81925 Munich, Germany. Holm, C (corresponding author), Tech Univ Munich, Klinikum Bogenhausen, Dept Plast Reconstruct & Hand Surg, Burn Ctr, Englschalkingerstr 77, D-81925 Munich, Germany. charlotte_olmjakobsen@hotmail.com AN - WOS:000248768800014 AU - Holm, C. AU - Mayr, M. AU - Hofter, E. AU - Ninkovic, M. DO - 10.1016/j.bjps.2005.12.066 IS - 8 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - SIEA flap angiosome breast reconstruction laser fluorescence indocyanine green free abdominoplasty flap breast reconstruction zones tram Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 200MZ Times Cited: 48 Cited Reference Count: 17 Holm, Charlotte Mayr, Martina Hoefter, Eugen Ninkovic, Milomir 52 0 1 Elsevier sci ltd Oxford PY - 2007 SN - 1748-6815 SP - 946-951 ST - The versatility of the SIEA flap: a clinical assessment of the vascular territory of the superficial epigastric inferior artery T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - The versatility of the SIEA flap: a clinical assessment of the vascular territory of the superficial epigastric inferior artery UR - ://WOS:000248768800014 VL - 60 ID - 3574 ER - TY - JOUR AB - Background: Flaps based on the profunda artery perforators were first used for reconstruction of pressure sores, burn contractures, and extremity wounds. Recently, a revised profunda artery perforator flap was introduced for breast reconstruction. However, the flap is rarely used despite interesting reports on its use. The authors present their experience with the profunda artery perforator flap, describing its versatile applications in breast reconstruction. Methods: The authors conducted a retrospective review of all patients of the lead author who underwent breast reconstruction with profunda artery perforator flaps before January of 2015. Patient demographics, perioperative data, and postoperative complications were recorded and analyzed. Results: Seventy-three consecutive profunda artery perforator flaps were used to reconstruct 71 breasts. In 21 breasts, a profunda artery perforator flap was used in conjunction with another flap-with a deep inferior epigastric perforator flap (n = 18), a superior gluteal artery perforator flap (n = 1), or as stacked profunda artery perforator flaps (n = 2). The flap failure rate was 2.7 percent. There was one case of clinically apparent fat necrosis. There were no other major flap complications. Donor-site complications included cellulitis in two thighs (2.7 percent) and minor wound dehiscence in six thighs (8.2 percent). All donor-site complications healed satisfactorily by secondary intention without any additional procedures. Conclusions: The profunda artery perforator flap is a safe and versatile option for breast reconstruction. It can be combined with other flaps when additional volume or skin requirements are present. Flap and donor-site complications are comparable to other free tissue breast reconstruction options. AD - [Haddock, Nicholas; Nagarkar, Purushottam; Teotia, Sumeet S.] Univ Texas Southwestern Med Ctr Dallas, Dept Plast Surg, 1800 Inwood Rd, Dallas, TX 75235 USA. Haddock, N (corresponding author), Univ Texas Southwestern Med Ctr Dallas, Dept Plast Surg, 1800 Inwood Rd, Dallas, TX 75235 USA. nicholas.haddock@utsouthwestern.edu AN - WOS:000395678200016 AU - Haddock, N. AU - Nagarkar, P. AU - Teotia, S. S. DA - Mar DO - 10.1097/prs.0000000000003053 IS - 3 J2 - Plast. Reconstr. Surg. KW - thigh Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: EN0CP Times Cited: 20 Cited Reference Count: 9 Haddock, Nicholas Nagarkar, Purushottam Teotia, Sumeet S. Haddock, Nicholas/0000-0003-4649-6147 21 0 2 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2017 SN - 0032-1052 SP - 606E-612E ST - Versatility of the Profunda Artery Perforator Flap: Creative Uses in Breast Reconstruction T2 - Plastic and Reconstructive Surgery TI - Versatility of the Profunda Artery Perforator Flap: Creative Uses in Breast Reconstruction UR - ://WOS:000395678200016 VL - 139 ID - 1865 ER - TY - JOUR AB - Background:

Flaps based on the profunda artery perforators were first used for reconstruction of pressure sores, burn contractures, and extremity wounds. Recently, a revised profunda artery perforator flap was introduced for breast reconstruction. However, the flap is rarely used despite interesting reports on its use. The authors present their experience with the profunda artery perforator flap, describing its versatile applications in breast reconstruction.

Methods:

The authors conducted a retrospective review of all patients of the lead author who underwent breast reconstruction with profunda artery perforator flaps before January of 2015. Patient demographics, perioperative data, and postoperative complications were recorded and analyzed.

Results:

Seventy-three consecutive profunda artery perforator flaps were used to reconstruct 71 breasts. In 21 breasts, a profunda artery perforator flap was used in conjunction with another flap—with a deep inferior epigastric perforator flap (n= 18), a superior gluteal artery perforator flap (n= 1), or as stacked profunda artery perforator flaps (n= 2). The flap failure rate was 2.7 percent. There was one case of clinically apparent fat necrosis. There were no other major flap complications. Donor-site complications included cellulitis in two thighs (2.7 percent) and minor wound dehiscence in six thighs (8.2 percent). All donor-site complications healed satisfactorily by secondary intention without any additional procedures.

Conclusions:

The profunda artery perforator flap is a safe and versatile option for breast reconstruction. It can be combined with other flaps when additional volume or skin requirements are present. Flap and donor-site complications are comparable to other free tissue breast reconstruction options.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.

AN - vdc_100042373304.0x000001 AU - Haddock, Nicholas AU - Nagarkar, Purushottam AU - Teotia, Sumeet S. CN - 617.95205 RD 6528.924000 LA - English N1 - Monthly: 9-14 issues per year United States Lippincott Williams and Wilkins PY - 2017 SN - 0032-1052 SP - 606e - 612e ST - Versatility of the Profunda Artery Perforator Flap T2 - Plastic and reconstructive surgery TI - Versatility of the Profunda Artery Perforator Flap VL - 139, NUMB 3 ID - 245 ER - TY - JOUR AB - Purpose The vertical rectus abdominis muscle (VRAM) flap is considered a safe and simple option to cover defects of the trunk and proximal thigh. Detailed long-time follow-up studies in oncologic patients including complications and donor site morbidity are rare. In this study, complications and donor site morbidity were analysed. Methods Data of 78 consecutive patients with oncologic disease, having received VRAM flaps, were analysed retrospectively. Patients with soft tissue sarcomas (n=38), radiation ulcers (n=18), carcinoma (n=10), wound-healing difficulties after tumour resection (n=8), breast reconstruction after ablation (n=3) and malignant melanoma (n=1) were included. Statistics concerning patients' satisfaction, the occurrence of wound-healing difficulties, incisional herniation, loss of abdominal wall strength in correlation to operative and (neo)adjuvant treatment and patients' history were performed. The mean follow-up time was 5.5 years. Results No complete flap loss was observed. A body mass index over 30 was positively correlated with wound-healing difficulties; radiation had no negative effect. A contralateral cutaneous pedicle could reduce the risk of lymphoedema in groin defect patients. Incisional hernia was present in 13%. Strength endurance of the abdominal wall was reduced compared to an age-matched control. Most patients were satisfied with the postoperative result. Conclusions VRAM flaps are reliable tools for defect coverage in the oncologic patient to prevent chronic ulceration, lymphangitis or more severe complications like septic rupture of femoral vessels and hip disarticulation. Donor site morbidity is tolerable, and patients' satisfaction is high. AD - [Daigeler, Adrien] BG Unfallkrankenhaus, Burn Ctr, Dept Hand Plast & Reconstruct Surg, D-67071 Ludwigshafen, Germany. [Daigeler, Adrien; Simidjiiska-Belyaeva, Maria; Goertz, Ole; Hirsch, Tobias; Soimaru, Christian; Lehnhardt, Marcus; Steinau, Hans-Ulrich] BG Univ Hosp Bergmannsheil, Sarcoma Reference Ctr, Burn Ctr, Dept Plast Surg, D-44789 Bochum, Germany. [Druecke, Daniel] Univ Hosp Schleswig Holstein, Div Plast Hand & Reconstruct Surg, D-24105 Kiel, Germany. Daigeler, A (corresponding author), BG Unfallkrankenhaus, Burn Ctr, Dept Hand Plast & Reconstruct Surg, Ludwig Guttmann Str 13, D-67071 Ludwigshafen, Germany. daigeler@hotmail.com AN - WOS:000297558100019 AU - Daigeler, A. AU - Simidjiiska-Belyaeva, M. AU - Drucke, D. AU - Goertz, O. AU - Hirsch, T. AU - Soimaru, C. AU - Lehnhardt, M. AU - Steinau, H. U. DA - Dec DO - 10.1007/s00423-011-0823-6 IS - 8 J2 - Langenbecks Arch. Surg. KW - VRAM Rectus abdominis muscle Trunk defect Groin defect Thoracic wall reconstruction donor-site morbidity tram flap breast reconstruction wall defects vram flap abdominoperineal resection consecutive patients radical resection surgery outcomes Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 855IU Times Cited: 43 Cited Reference Count: 47 Daigeler, Adrien Simidjiiska-Belyaeva, Maria Druecke, Daniel Goertz, Ole Hirsch, Tobias Soimaru, Christian Lehnhardt, Marcus Steinau, Hans-Ulrich Daigeler, Adrien/C-9417-2016 Daigeler, Adrien/0000-0002-0012-9870 45 0 3 Springer New york PY - 2011 SN - 1435-2443 SP - 1271-1279 ST - The versatility of the pedicled vertical rectus abdominis myocutaneous flap in oncologic patients T2 - Langenbecks Archives of Surgery TI - The versatility of the pedicled vertical rectus abdominis myocutaneous flap in oncologic patients UR - ://WOS:000297558100019 VL - 396 ID - 2838 ER - TY - JOUR AB - For the last decades, the latissimus dorsi skin-muscle flap has contributed to the efficient reconstruction of the loss of skin cover (especially in breast surgery) and in long-distance tissue defects. Unfortunately, the nonuse of such an important muscle as the latissimus dorsi for the patient, as well as the resulting thickness of the flap after reconstruction, has turned it into a second choice flap. However, this flap is still indicated in the reconstruction of areas which need a great amount of cutaneous and muscular tissue. The appearance of the perforator flaps and, specifically, thoracodorsal artery perforator (TDAP) flap, has meant a radical change in relation to lower morbidity of the donor site, thus highly ranking the use of these flaps in the reconstruction for similar defects. The aim of this publication is to present our experience with the pedicled TDAP flap in a series of 17 different cases. Of those, there were 14 cases of mammary reconstruction after sparing surgery, 2 cases of axillary reconstruction following severe recurrent hidradenitis, and a case of extensive substance loss in a patient's upper limbfollowing a severe crush injury. AD - Gen Univ Hosp Alicante, Reconstruct Plast & Aesthet Surg Dept, Alicante, Spain. Ortiz, CL (corresponding author), C Pintor Fernando Soria 18,Urbanizac Isla Verde B, Alicante 03540, Spain. laredo_car@gva.es AN - WOS:000244728000016 AU - Ortiz, C. L. AU - Mendoza, M. M. AU - Sempere, L. N. AU - Sanz, J. S. AU - Torres, A. N. AU - Barraquer, E. L. DA - Mar DO - 10.1097/01.sap.0000238260.11220.ab IS - 3 J2 - Ann. Plast. Surg. KW - perforator flaps pedicle flaps soft tissue reconstruction thoracodorsal vessels dorsi musculocutaneous flap breast reconstruction experience Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 143NB Times Cited: 23 Cited Reference Count: 21 Ortiz, C. Laredo Mendoza, M. Marquez Sempere, L. Navarro Sanz, J. Salvador Torres, A. Novo Barraquer, E. Lorda 31 0 1 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2007 SN - 0148-7043 SP - 315-320 ST - Versatility of the pedicled thoracodorsal artery perforator (TDAP) flap in soft tissue reconstruction T2 - Annals of Plastic Surgery TI - Versatility of the pedicled thoracodorsal artery perforator (TDAP) flap in soft tissue reconstruction UR - ://WOS:000244728000016 VL - 58 ID - 3547 ER - TY - JOUR AB - Introduction: Anatomy and classification of intercostal perforator flaps in addition to our experience with will be demonstrated for different indications. Material and methods: The intercostal vessels form an arcade between the aorta and the internal mammary vessels. Different pedicled perforator flaps can be raised on this neurovascular bundle to cover defects on the trunk. They are classified as following: dorsal intercostal artery perforator flap (DICAP); lateral intercostal artery perforator (LICAP); and anterior intercostal artery perforator (AICAP) flap. Results: Between 2001 and 2004, 20 pedicled (ICAP) flaps were harvested in 16 patients. The indications were: immediate partial breast reconstruction in eight patients who had a quadrantectomy for breast cancer; midline back and sternal defects in three patients who had radical excisions for a dermatofibrosarcoma or malignant melanoma; and autologous breast augmentation (four bilateral and one unilateral flap) in five post-bariatric-surgery patients. The average flap dimension was 18 X 8 cm(2) (range 8 X 5-24 X 12 cm(2)). There were two DICAP flaps, two (AICAP) flaps and 16 (LICAP) flaps. All but two flaps were based on one perforator. Mean harvesting time was 45 min for a single flap. Bilateral breast augmentation with LICAP flap necessitated longer operative time (range 2-3 h) depending whether it was combined or not with mastopoexy. Complete flaps survival was obtained. All donor sites were closed primarily. Conclusion: The (ICAP) flaps provide valuable options in breast surgery; and for challenging defects on the trunk without sacrifice of the underlying muscle. (C) 2006 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - State Univ Ghent Hosp, Dept Plast Surg, B-9000 Ghent, Belgium. Hamdi, M (corresponding author), State Univ Ghent Hosp, Dept Plast Surg, De Pintelaan 185, B-9000 Ghent, Belgium. moustapha.hamdi@ugent.be AN - WOS:000238132000014 AU - Hamdi, M. AU - Van Landuyt, K. AU - de Frene, B. AU - Roche, N. AU - Blondeel, P. AU - Monstrey, S. DO - 10.1016/j.bjps.2006.01.006 IS - 6 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - intercostal vessels perforator flaps pedicled flaps clinical experience management defects Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 051AG Times Cited: 114 Cited Reference Count: 18 Hamdi, M Van Landuyt, K de Frene, B Roche, N Blondeel, P Monstrey, S Blondeel, Phillip/AAG-4920-2021; Roche, Nathalie/L-9874-2019 Roche, Nathalie/0000-0001-9241-8583; Blondeel, Phillip/0000-0002-9236-4068 124 0 8 Elsevier sci ltd Oxford PY - 2006 SN - 1748-6815 SP - 644-652 ST - The versatility of the inter-costal artery perforator (ICAP) flaps T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - The versatility of the inter-costal artery perforator (ICAP) flaps UR - ://WOS:000238132000014 VL - 59 ID - 3670 ER - TY - JOUR AB - Background: The profunda feomris artery perforator (PAP) flap was recently revisited and gains popularity as an alternative method of autologous breast reconstruction. The purpose of this article is to demonstrate that PAP flap can be used reliably for reconstruction of various soft tissue defects. Methods: A total of 55 free PAP flaps and 16 pedicle PAP flaps were transferred in 63 patients. Each case was reviewed to verify a PAP flap was performed identifying defect location, flap size, flap design, and postoperative complications. Results: Seven flaps in five patients underwent breast reconstructions, 48 patients underwent head and neck reconstructions using free PAP flaps. The mean perforator number was 1.9, and the average pedicles length was 9.7 cm. The majority of perforators were musculocutaneous, and the others were septocutaneous. The mean ischemia time was 121.4 min. Minor complications included wound poor healing, flap partial necrosis, and pedicle vessels problems. Sixteen pedicle PAP flaps were transferred in 10 patients for vulvar reconstruction. Minor complications included urinary tract infection, poor wound healing, wound infection, hematoma. Conclusions: The anatomy and number of perforators of PAP flap are reliable with adequate pedicle length. This flap can be an excellent option for reconstruction of most soft tissue defects. J. Surg. Oncol. 2016;114:193–201. © 2016 Wiley Periodicals, Inc. AD - M.-H. Cheng, Department of Plastic and Reconstructive Surgery, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan AU - Ito, R. AU - Huang, J. J. AU - Wu, J. C. W. AU - Lin, M. C. Y. AU - Cheng, M. H. DB - Embase Medline DO - 10.1002/jso.24294 IS - 2 KW - adult article breast reconstruction cancer surgery deep femoral artery female head and neck surgery hematoma human ischemia major clinical study male myocutaneous flap outcome assessment perforator flap plastic surgery postoperative complication priority journal profunda femoral artery perforator flap surgical technique treatment outcome urinary tract infection wound healing impairment wound infection LA - English M3 - Article N1 - L611290525 2016-07-25 2016-08-05 PY - 2016 SN - 1096-9098 0022-4790 SP - 193-201 ST - The versatility of profunda femoral artery perforator flap for oncological reconstruction after cancer resection—Clinical cases and review of literature T2 - Journal of Surgical Oncology TI - The versatility of profunda femoral artery perforator flap for oncological reconstruction after cancer resection—Clinical cases and review of literature UR - https://www.embase.com/search/results?subaction=viewrecord&id=L611290525&from=export http://dx.doi.org/10.1002/jso.24294 VL - 114 ID - 5940 ER - TY - JOUR AB - Background: The profunda feomris artery perforator (PAP) flap was recently revisited and gains popularity as an alternative method of autologous breast reconstruction. The purpose of this article is to demonstrate that PAP flap can be used reliably for reconstruction of various soft tissue defects. Methods: A total of 55 free PAP flaps and 16 pedicle PAP flaps were transferred in 63 patients. Each case was reviewed to verify a PAP flap was performed identifying defect location, flap size, flap design, and postoperative complications. Results: Seven flaps in five patients underwent breast reconstructions, 48 patients underwent head and neck reconstructions using free PAP flaps. The mean perforator number was 1.9, and the average pedicles length was 9.7 cm. The majority of perforators were musculocutaneous, and the others were septocutaneous. The mean ischemia time was 121.4 min. Minor complications included wound poor healing, flap partial necrosis, and pedicle vessels problems. Sixteen pedicle PAP flaps were transferred in 10 patients for vulvar reconstruction. Minor complications included urinary tract infection, poor wound healing, wound infection, hematoma. Conclusions: The anatomy and number of perforators of PAP flap are reliable with adequate pedicle length. This flap can be an excellent option for reconstruction of most soft tissue defects. (C) 2016 Wiley Periodicals, Inc. AD - [Ito, Ran; Huang, Jung-Ju; Wu, Jerry Chih-Wei; Lin, Miffy Chia-Yu; Cheng, Ming-Huei] Chang Gung Univ, Chang Gung Mem Hosp, Dept Plast & Reconstruct Surg, Coll Med, Taoyuan, Taiwan. [Ito, Ran] Kyoto Univ, Dept Plast & Reconstruct Surg, Kyoto, Japan. [Huang, Jung-Ju; Wu, Jerry Chih-Wei; Cheng, Ming-Huei] Chang Gung Mem Hosp, Ctr Tissue Engn, Taoyuan, Taiwan. Cheng, MH (corresponding author), Chang Gung Univ, Chang Gung Mem Hosp, Div Reconstruct Microsurg, Dept Plast & Reconstruct Surg,Coll Med, 5 Fu Hsing St, Taoyuan 333, Taiwan. minghueicheng@gmail.com AN - WOS:000383779000012 AU - Ito, R. AU - Huang, J. J. AU - Wu, J. C. W. AU - Lin, M. C. Y. AU - Cheng, M. H. DA - Aug DO - 10.1002/jso.24294 IS - 2 J2 - J. Surg. Oncol. KW - PAP flap perforator flap reconstruction profunda artery microsurgery gluteal thigh flap ischial pressure sores soft-tissue flap breast reconstruction fasciocutaneous flaps perineal wounds posterior experience closure muscle Oncology Surgery LA - English M3 - Review N1 - ISI Document Delivery No.: DW6RQ Times Cited: 8 Cited Reference Count: 36 Ito, Ran Huang, Jung-Ju Wu, Jerry Chih-Wei Lin, Miffy Chia-Yu Cheng, Ming-Huei Cheng, Ming-Huei/AAD-8579-2019; Ito, Ran/S-3377-2016 Ito, Ran/0000-0003-0612-6168; Huang, Jung-ju/0000-0001-9568-7834 8 0 9 Wiley-blackwell Hoboken 1096-9098 PY - 2016 SN - 0022-4790 SP - 193-201 ST - The Versatility of Profunda Femoral Artery Perforator Flap for Oncological Reconstruction After Cancer Resection-Clinical Cases and Review of Literature T2 - Journal of Surgical Oncology TI - The Versatility of Profunda Femoral Artery Perforator Flap for Oncological Reconstruction After Cancer Resection-Clinical Cases and Review of Literature UR - ://WOS:000383779000012 VL - 114 ID - 1984 ER - TY - JOUR AN - 127251480. Language: English. Entry Date: In Process. Revision Date: 20190909. Publication Type: Article. Supplement Title: 2017 Supplement. Journal Subset: Asia AU - Gopinath, Srinivas AU - Mohammed, Noor AU - Swamy, Shivanand DB - cin20 DP - EBSCOhost N1 - Biomedical. NLM UID: 101249598. PY - 2017 SN - 0973-1482 SP - S251-S251 ST - Versatility Of Latissimus Dorsi Flaps In Breast Reconstruction: An Institutional Experience T2 - Journal of Cancer Research & Therapeutics TI - Versatility Of Latissimus Dorsi Flaps In Breast Reconstruction: An Institutional Experience UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=127251480&site=ehost-live&scope=site VL - 13 ID - 651 ER - TY - JOUR AB - The goals of upper extremity soft tissue reconstruction should go well beyond providing coverage and restoring function. As the field of reconstructive microsurgery has evolved, free cutaneous flaps (FCFs) are gaining wider application. The advantages of FCF include minimizing donor-site morbidity by preserving the muscle and fascia, improving versatility of flap design, and superior aesthetic results. This review highlights the application of anterolateral thigh, superficial circumflex iliac artery, deep inferior epigastric perforator, superficial inferior epigastric artery, and flow-through flaps for reconstruction of upper extremity defects. These flaps share several qualities in common: well-concealed donor sites, preservation of major arteries responsible of providing inflow to distal extremity, and potential for a two-team approach (donor and recipient sites). While the choice of flaps should be decided based on individual patient and defect characteristics, FCF should be considered as excellent options to achieve the goals of upper extremity reconstruction. AD - [Wang, Howard D.; Alonso-Escalante, Jose C.; Cho, Brian H.; DeJesus, Ramon A.] Johns Hopkins Univ Hosp, Dept Plast & Reconstruct Surg, Baltimore, MD 21287 USA. [DeJesus, Ramon A.] Univ Maryland, Sch Med, Div Plast Maxillofacial & Reconstruct Surg, R Adams Cowley Shock Trauma Ctr, Baltimore, MD 21201 USA. [DeJesus, Ramon A.] Natl Mil Ctr, Dept Plast & Reconstruct Surg, San Diego, CA USA. DeJesus, RA (corresponding author), R Adams Cowley Shock Trauma Ctr, Div Plast Maxillofacial & Reconstruct Surg, 22 S Greene St, Baltimore, MD 21201 USA. toe_2_hand@yahoo.com AN - WOS:000409109500002 AU - Wang, H. D. AU - Alonso-Escalante, J. C. AU - Cho, B. H. AU - DeJesus, R. A. DA - Aug DO - 10.1055/s-0037-1603918 IS - 2 J2 - J. Hand Microsurg. KW - free cutaneous flaps upper extremity reconstruction anterolateral thigh flap superficial circumflex iliac artery flap deep inferior epigastric perforator flap superficial inferior epigastric artery flap artery perforator flap anterolateral thigh flap arterialized venous flaps forearm free-flap breast reconstruction limb defects tram flaps coverage hand diep Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: FF6HZ Times Cited: 9 Cited Reference Count: 59 Wang, Howard D. Alonso-Escalante, Jose C. Cho, Brian H. DeJesus, Ramon A. 9 0 1 Georg thieme verlag kg Stuttgart 0974-6897 PY - 2017 SN - 0974-3227 SP - 58-66 ST - Versatility of Free Cutaneous Flaps for Upper Extremity Soft Tissue Reconstruction T2 - Journal of Hand and Microsurgery TI - Versatility of Free Cutaneous Flaps for Upper Extremity Soft Tissue Reconstruction UR - ://WOS:000409109500002 VL - 9 ID - 1772 ER - TY - JOUR AB - In this report, we describe the technique of muscle and nerve sparing latissimus dorsi (LD) flap and evaluate the outcomes of reconstruction of various defects with 12 free and 2 pedicled muscle and nerve sparing LD flaps in 14 patients. The LD muscle functions at operated and nonoperated muscles were evaluated clinically and with electroneuromyography. All flaps survived completely but one which had a partial necrosis. The mean follow-up time was 12.3 months. Adduction and extention ranges of the shoulders were the same bilaterally in all patients. In electroneuromyography, no significant difference was available statistically between the sides. This muscle and nerve sparing latissimus dorsi flap has advantages of thinness, muscle preservation and reliability, and thus can be a good option to other fasciocutaneous flaps in reconstruction surgery. (C) 2011 Wiley Periodicals, Inc. Microsurgery, 2012 AD - [Tan, Onder; Algan, Said; Kuduban, Selma Denktas; Cinal, Hakan; Barin, Ensar Zafer] Ataturk Univ, Dept Plast Reconstruct & Aesthet Surg, Fac Med, TR-25240 Erzurum, Turkey. [Ulvi, Hizir] Ataturk Univ, Dept Neurol, Fac Med, TR-25240 Erzurum, Turkey. Tan, O (corresponding author), Ataturk Univ, Tip Fak, Yakutiye Arastirma Hastanesi, Plast Rekonstruktif Cerrahi AD, TR-25240 Erzurum, Turkey. drondertan@yahoo.com AN - WOS:000299629400003 AU - Tan, O. AU - Algan, S. AU - Kuduban, S. D. AU - Cinal, H. AU - Barin, E. Z. AU - Ulvi, H. DA - Feb DO - 10.1002/micr.20953 IS - 2 J2 - Microsurgery KW - artery perforator flap donor site breast reconstruction functional-evaluation clinical-experience Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 883JE Times Cited: 13 Cited Reference Count: 19 Tan, Onder Algan, Said Kuduban, Selma Denktas Cinal, Hakan Barin, Ensar Zafer Ulvi, Hizir Cinal, hakan/0000-0002-9797-5730 13 0 2 Wiley-blackwell Malden PY - 2012 SN - 0738-1085 SP - 103-110 ST - Versatile use of the muscle and nerve sparing latissimus dorsi flap T2 - Microsurgery TI - Versatile use of the muscle and nerve sparing latissimus dorsi flap UR - ://WOS:000299629400003 VL - 32 ID - 2810 ER - TY - JOUR AB - The rectus abdominis muscle and musculocutaneous flaps have contributed to the efficient reconstruction of tissue defects that require a large amount of cutaneous and muscular tissue. In this article, outcomes of soft-tissue defects after reconstruction with the rectus abdominis muscle and musculocutaneous flaps were retrospectively analyzed. From August 2003 to June 2009, 25 flaps were transferred to reconstruct a wide variety of soft-tissue defects in the breast, chest wall, groin, perineal, and head and neck regions, as well as the upper and lower extremities. The rectus abdominis muscle and musculocutaneous flaps were used as part of 11 different approaches in 25 cases. There were 13 male and 12 female patients; the mean patient age was 44.2 years. The mean follow-up period was 8 months (range, 4–15 months). The overall success rate was 100%, and all flaps healed uneventfully. All reconstructive procedures were completed without any major complications. Rectus sheets were repaired primarily, and no mesh application was used. Minor complications related to transferred flaps were wound infection and dehiscence in one case, wound dehiscence in two cases, and flap lymphedema in one case. Minor complications related to the donor site were seroma in one case and wound infection and dehiscence in another case. This study presents our experience with the rectus abdominis muscle and musculocutaneous flaps in a series of 25 cases. The indications for the use of this particular flap with other flaps are discussed. AN - RN302185201 AU - Kulahci, Y. AU - Sever, C. AU - Evinc, R. AU - Uygur, F. AU - Şahin, C. AU - Öksüz, S. AU - Noyan, N. AU - Duman, H. AU - Yüksel, F. CN - 617.95 QC1 3829.736300 LA - English N1 - Annual: 1 issue per year Germany Springer Science + Business Media PY - 2011 SN - 0930-343X SP - 437 - 444 ST - Versatile use of rectus abdominis muscle and musculocutaneous flaps for soft-tissue reconstruction T2 - European Journal of Plastic Surgery TI - Versatile use of rectus abdominis muscle and musculocutaneous flaps for soft-tissue reconstruction VL - 34, NUMB 6 ID - 205 ER - TY - JOUR AB - The superficial inferior epigastric flap is a versatile free flap that has added to the techniques available for autogenous breast reconstruction. It is especially advantageous when previous thoracic radiation and/or abdominal surgery preclude the use of conventional transverse rectus abdominis musculocutaneous flaps. Eight superficial inferior epigastric flaps were used to reconstruct 7 breasts in 6 patients. In 4 patients the superficial inferior epigastric flap was used as part of a composite free flap. In 1 patient, a lower abdominal wall flap was transferred on bilateral pedicles. In another, bilateral flaps were raised to reconstruct both breasts. The superficial inferior epigastric flap offers several advantages. It uses relatively abundant lower abdominal wall skin and subcutaneous tissue while preserving the underlying fascia and rectus muscles. A cadaver study illustrates the clinical territory of this flap. The superficial inferior epigastric flap provides an excellent option for autogenous free flap reconstruction of the breast, alone or in combination with other flaps. AD - A.G. Volpe, Plastic/Reconstructive Surgery Div., Massachusetts Univ. Medical Center, 55 Lake Avenue North, Worcester, MA 01655, United States AU - Volpe, A. G. AU - Rothkopf, D. M. AU - Walton, R. L. DB - Embase Medline DO - 10.1097/00000637-199402000-00001 IS - 2 KW - abdominal wall musculature adult article breast reconstruction celiac plexus clinical article clinical trial composite skin graft esthetics fascia female free tissue graft graft failure human mastectomy medical record myocutaneous flap pedicled skin flap postoperative complication priority journal surgical technique LA - English M3 - Article N1 - L24057121 1994-03-04 PY - 1994 SN - 0148-7043 SP - 113-117 ST - The versatile superficial inferior epigastric flap for breast reconstruction T2 - Annals of Plastic Surgery TI - The versatile superficial inferior epigastric flap for breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L24057121&from=export http://dx.doi.org/10.1097/00000637-199402000-00001 VL - 32 ID - 8868 ER - TY - GEN AB - Breast ptosis commonly develops in response to ageing and breastfeeding. Clinical studies now focus on both filling the upper pole of the breast with parenchymal flaps and long-term maintenance of the breast projection without recurrence of upper pole concavity and a significant change in breast shape over time. This study presents a modification for a well-known mastopexy technique, the dermoglandular hammock flap, which provides not only autoaugmentation for the breast but also suspension for the breast parenchyma. This technical modification involving a hammock flap extended in both width and length dimensions, was performed in 17 patients aged 28-43 years with an average age of 31 years. They had minimal, moderate, and severe ptosis. Of these, eight patients had mastopexy only without needing any resection of the breast tissue. In four patients, there was significant asymmetry, needing excision of the breast tissue. In five patients, it was necessary to resect less than 290 g of glandular tissue from both breasts to provide enough reduction of the breast volume. There were no severe complications either in the early or late postoperative period, such as nipple-areolar necrosis, haematoma, infection, or dehiscence of the suture line. However, in one patient, skin depression developed at the end of the vertical scar line in one breast. In the follow-up, medial and upper pole fullness of the breast maintained without recurrence of the ptosis, providing satisfactory shape and projection. With this modification, dermoglandular suspension flap turns to be a more effective procedure and suitable for all types of ptosis. As the sagged lower pole of the breast is used as a flap behind the nipple-areola complex and upper pole, it makes not only parenchymal reposition, but also autoaugmentation in the breast, leading to successful breast fullness. © 2013 Informa Healthcare. AD - N. Gümüş AU - Gümüş, N. C5 - 23692130 DB - Medline DO - 10.3109/2000656X.2012.753080 J2 - J. Plastic Sur. Hand Sur. KW - adult article breast breast reconstruction epidemiology esthetics female human methodology pathophysiology patient satisfaction physiology risk assessment skin transplantation statistics surgical flaps suture technique vascularization wound healing LA - English M1 - (Gümüş N., gumus1970@hotmail.com) Plastic, Reconstructive and Aesthetic Surgery, Department of Cumhuriyet, University Medical Faculty, Sivas, Turkey M3 - Article N1 - L1369628929 2014-04-15 PY - 2013 SN - 2000-656X SP - 252-257 ST - A versatile modification of dermoglandular hammock flap for mastopexy: Extended hammock TI - A versatile modification of dermoglandular hammock flap for mastopexy: Extended hammock UR - https://www.embase.com/search/results?subaction=viewrecord&id=L1369628929&from=export http://dx.doi.org/10.3109/2000656X.2012.753080 VL - 47 ID - 6929 ER - TY - JOUR AB - In this series of 35 clinical cases, the versatility of the latissimus dorsal flap is demonstrated. Whilst its width is limited to approximately 10 cm to gain primary closure, its length extends from the axilla almost to the iliac crest. If a larger area of soft tissue cover is required, muscle only may be used covered with a split skin graft. Its safe rapid dissection, reliable blood supply and wide arc of rotation makes it suitable for many of the reconstructive needs in the trunk, head and neck. Its large vascular pedicle makes it particularly suitable for free flap transfer. The commonest indication for use of the flap has been reconstruction of the breast following radical surgery. The secondary morbidity at the donor site is negligible. AN - 6952862 AU - O'Brien, B. M. AU - Morrison, W. A. AU - Lawler, D. L. AU - MacLeod, A. AU - Newing, R. K. DA - Apr DO - 10.1111/j.1445-2197.1982.tb06097.x DP - NLM ET - 1982/04/01 IS - 2 KW - Adolescent Adult Aged Breast/*surgery Breast Neoplasms/surgery Burns/surgery Carcinoma, Squamous Cell/surgery Female Humans Mastectomy Middle Aged Muscles/surgery Surgery, Plastic/*methods *Surgical Flaps LA - eng N1 - O'Brien, B M Morrison, W A Lawler, D L MacLeod, A Newing, R K Journal Article Australia Aust N Z J Surg. 1982 Apr;52(2):174-82. doi: 10.1111/j.1445-2197.1982.tb06097.x. PY - 1982 SN - 0004-8682 (Print) 0004-8682 SP - 174-82 ST - The versatile latissimus dorsi myocutaneous flap in breast and other reconstruction T2 - Aust N Z J Surg TI - The versatile latissimus dorsi myocutaneous flap in breast and other reconstruction VL - 52 ID - 12041 ER - TY - JOUR AB - Background

The thoracodorsal artery perforator (TAP) flap is a versatile tool that can be used to reconstruct the breast. The authors use preoperative perforator mapping using color Doppler ultrasonography and present a safe, efficient harvesting technique to demonstrate reliable use of the TAP flap in reconstructive surgery.

Methods

A multicenter, retrospective review was performed on all patients undergoing TAP flap reconstruction from August 2011 to November 2014. Data were collected from patient records as well as outpatient interviews.

Results

A total of 106 TAP flaps were performed in 97 patients. The flaps were raised with either 1 perforator (42/106), 2 perforators (55/106), or three perforators (9/106), and turned as a propeller in 99 of 106 (93%) flaps or buried as a turnover in 7 of 106 (7%) of flaps. The mean operative time was 200 minutes (range, 60–485). Major complications occurred in 10 of 106 (10%) cases and included hematoma (1/108), venous congestion (2/108), and partial flap necrosis (7/108). The reconstructive goal was achieved in 103 of 106 (97%) flaps.

Conclusions

The TAP flap is a pedicled, fasciocutaneous flap that can be used for total breast reconstruction as well as breast conserving surgery. This large, multicenter series describes our techniques of preoperative perforator mapping and a fast, reliable harvest. Reconstructive goals are accomplished in the great majority of patients.

AN - vdc_100035752767.0x000001 AU - Jacobs, Jordan AU - Børsen-Koch, Mikkel AU - Gunnarsson, Gudjon Leifur AU - Tos, Tina AU - Siim, Elsebeth AU - Udesen, Ann AU - Hölmich, Lisbet Rosenkrantz AU - Salzberg, Andrew AU - Thomsen, Jørn Bo CN - 617.95205 RD118.AL 1043.525000 LA - English N1 - Monthly: 9-14 issues per year United States Lippincott Williams and Wilkins PY - 2016 SN - 0148-7043 SP - 396 - 400 ST - The Versatile Extended Thoracodorsal Artery Perforator Flap for Breast Reconstruction T2 - Annals of plastic surgery TI - The Versatile Extended Thoracodorsal Artery Perforator Flap for Breast Reconstruction VL - 77, NUMB 4 ID - 234 ER - TY - JOUR AB - The deep inferior epigastric perforator (DIEP) flap gained widespread popularity as a free flap in breast reconstruction. It is also a versatile and reliable supply of a large amount of skin and soft-tissue, which can be used in other types of reconstruction. We present 25 consecutive cases (28 DIEP flaps) performed in our service during the past 5 years for different indications in lower extremity aesthetic and functional reconstruction, both as pedicled or free flaps. The amount of tissue provided, its reliable vascular supply and Long and adequately sized pedicles, together with its limited donor-site morbidity make it a useful alternative free flap. (C) 2004 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - State Univ Ghent Hosp, Dept Plast & Reconstruct Surg, B-9000 Ghent, Belgium. Coupure Ctr Plast Chirurg, B-9000 Ghent, Belgium. Van Landuyt, K (corresponding author), State Univ Ghent Hosp, Dept Plast & Reconstruct Surg, De Pintelaan 185, B-9000 Ghent, Belgium. koenraad.vanlanduyt@ugent.be AN - WOS:000226825300002 AU - Van Landuyt, K. AU - Blondeel, P. AU - Hamdi, M. AU - Tonnard, P. AU - Verpaele, A. AU - Monstrey, S. DA - Jan DO - 10.1016/j.bjps.2004.06.003 IS - 1 J2 - Br. J. Plast. Surg. KW - deep inferior epigastric perforator flap lower extremity reconstruction abdominis musculocutaneous flap free tram flap inferior epigastric flap perforator flap defect augmentation coverage flow Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 894XQ Times Cited: 49 Cited Reference Count: 28 Van Landuyt, K Blondeel, P Hamdi, M Tonnard, P Verpaele, A Monstrey, S Blondeel, Phillip/AAG-4920-2021 Blondeel, Phillip/0000-0002-9236-4068 52 0 1 Churchill livingstone Edinburgh PY - 2005 SN - 0007-1226 SP - 2-13 ST - The versatile DIEP flap: its use in lower extremity reconstruction T2 - British Journal of Plastic Surgery TI - The versatile DIEP flap: its use in lower extremity reconstruction UR - ://WOS:000226825300002 VL - 58 ID - 3743 ER - TY - JOUR AB - In 1986, the combined use of the lateral thoracodorsal flap and an implant was introduced as an alternative method of delayed reconstruction of small to medium-size breasts for postmastectomy patients who are reluctant or unable to consider reconstruction by tissue expansion or by more extensive autologous tissue transplantation. So far, the technique has only been proven reproducible in Sweden. Postmastectomy radiotherapy has been proven to increase the risk of wound-healing complications after lateral thoracodorsal transplantation, and additional risk factors such as advanced age, obesity, smoking, and some general health characteristics have been indicated. The authors initiated a prospective study to assess the reproducibility of this technique outside Sweden and to confirm the proven risk factor, prove or refute the alleged ones, and possibly identify additional factors. Additionally, they applied the technique for immediate breast reconstruction and tried to expand the indications and applications of the lateral thoracodorsal flap even further. The authors report on their initial experience with 60 lateral thoracodorsal flaps and conclude that the use of this flap is a well-reproducible technique for breast reconstruction, with few complications leading to failure. Using the lateral thoracodorsal flap in combination with tissue expanders allows for reconstruction of breasts of larger than medium size. Moreover, the authors successfully applied fully deepithelialized lateral thoracodorsal flaps for additional indications. The statistical significance of postmastectomy radiotherapy as a risk factor could not be confirmed, but some general health characteristics were found to be significant patient-related risk factors. Out of five procedure-related characteristics, only increased flap length was proven to negatively influence the outcome of the procedure. AD - Department of Plastic and Reconstructive Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Academic Medical Center, Amsterdam. AN - 14707637 AU - Woerdeman, L. A. AU - van Schijndel, A. W. AU - Hage, J. J. AU - Smeulders, M. J. DA - Jan DO - 10.1097/01.Prs.0000097257.47540.D0 DP - NLM ET - 2004/01/07 IS - 1 KW - Adult Aged Breast Neoplasms/radiotherapy/surgery Female Humans Mammaplasty/adverse effects/*methods Mastectomy/rehabilitation Middle Aged Odds Ratio Postoperative Complications Risk Factors *Surgical Flaps Tissue Expansion LA - eng N1 - Woerdeman, Leonie A E van Schijndel, Anne W Hage, J Joris Smeulders, Mark J C Journal Article United States Plast Reconstr Surg. 2004 Jan;113(1):196-203; discussion 204-5. doi: 10.1097/01.PRS.0000097257.47540.D0. PY - 2004 SN - 0032-1052 (Print) 0032-1052 SP - 196-203; discussion 204-5 ST - Verifying surgical results and risk factors of the lateral thoracodorsal flap T2 - Plast Reconstr Surg TI - Verifying surgical results and risk factors of the lateral thoracodorsal flap VL - 113 ID - 10562 ER - TY - JOUR AB - Transverse rectus abdominus myocutaneous (TRAM) flap is one of the commonly used techniques for breast reconstruction. Postoperative pain relief is of paramount importance following TRAM flap breast reconstruction to avoid potentially preventable complications like chest infection. Several methods of pain control are available, including intrapleural anesthesia. Here we report a case of a patient who developed ventricular standstill as a complication of intrapleural bupivacaine. © 2007 Lippincott Williams & Wilkins, Inc. AD - J. Jagadeesan, 57 Great Park Drive, Leyland, Lancashire, United Kingdom AU - Jagadeesan, J. AU - Kannan, R. AU - Dujon, D. DB - Embase Medline DO - 10.1097/SAP.0b013e31802fa932 IS - 4 KW - epinephrine bupivacaine adult analgesia anesthesia article breast reconstruction case report chest infection dizziness drug mechanism female heart arrest heart block human myocutaneous flap nausea postoperative pain priority journal rectus abdominis muscle LA - English M3 - Article N1 - L47494134 2007-10-01 PY - 2007 SN - 0148-7043 SP - 445-446 ST - Ventricular standstill: A complication of intrapleural anesthesia using bupivacaine in a patient with free transverse rectus abdominus myocutaneous flap breast reconstruction T2 - Annals of Plastic Surgery TI - Ventricular standstill: A complication of intrapleural anesthesia using bupivacaine in a patient with free transverse rectus abdominus myocutaneous flap breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L47494134&from=export http://dx.doi.org/10.1097/SAP.0b013e31802fa932 VL - 59 ID - 7961 ER - TY - JOUR AB - Transverse rectus abdominus myocutaneous (TRAM) flap is one of the commonly used techniques for breast reconstruction. Postoperative pain relief is of paramount importance following TRAM flap breast reconstruction to avoid potentially preventable complications like chest infection. Several methods of pain control are available, including intrapleural anesthesia. Here we report a case of a patient who developed ventricular standstill as a complication. of intrapleural bupivacaine. AD - No Gen Hosp, Dept Burns & Plast Surg, Sheffield S5 7AU, S Yorkshire, England. Jagadeesan, J (corresponding author), 57 Great Pk Dr, Leyland, Lancs, England. drjjag@yahoo.com AN - WOS:000249702300017 AU - Jagadeesan, J. AU - Kannan, R. AU - Dujon, D. DA - Oct DO - 10.1097/SAP.0b013e31802fa932 IS - 4 J2 - Ann. Plast. Surg. KW - intrapleural anesthesia complications ventricular standstill TRAM flap breast reconstruction analgesia Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 213YD Times Cited: 3 Cited Reference Count: 10 Jagadeesan, Jagajeevan Kannan, Ruben Dujon, David 3 0 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2007 SN - 0148-7043 SP - 445-446 ST - Ventricular standstill - A complication of intrapleural Anesthesia using bupivacaine in a patient with free transverse rectus abdominus myocutaneous flap breast reconstruction T2 - Annals of Plastic Surgery TI - Ventricular standstill - A complication of intrapleural Anesthesia using bupivacaine in a patient with free transverse rectus abdominus myocutaneous flap breast reconstruction UR - ://WOS:000249702300017 VL - 59 ID - 3504 ER - TY - JOUR AB - Background The anastomotic coupling device has demonstrated safety and efficacy; however, the coupler has never been compared directly to handsewn venous anastomoses exclusively in breast reconstruction. We hypothesized that rates of venous thrombosis would be lower using the coupler versus handsewn anastomoses in free flap breast reconstruction. Methods We performed a retrospective review utilizing clinic records, hospital records, and operative reports for 857 consecutive breast free flaps at a single institution from 1997 to 2012. Data were collected on reconstruction type, recipient vessels, timing, laterality, preoperative radiation, chemotherapy, venous thrombosis, and flap outcome. We compared rates of venous thrombosis between handsewn and coupled anastomoses for breast free flaps. Chi-square test was used to calculate statistical significance. Results A total of 857 consecutive free flaps were performed for breast reconstruction in 647 patients over 16 years. The venous anastomosis was handsewn in 303 flaps, and the anastomotic coupler was used in 554 flaps. The rate of venous thrombosis requiring anastomotic revision in the handsewn group was 0.04% (12/303), compared with 0.01% in the coupled group (8/554; p = 0.02). Conclusion The anastomotic coupler was more effective in preventing venous thrombosis than handsewn anastomoses in our series. While our study demonstrates improved patency rates using the venous coupler in breast reconstruction, we were unable to definitively separate this finding from potential confounding variables due to the low rates of thrombosis in both the groups. Our data are consistent with current literature, which suggests that the coupler is a safe and effective alternative to hand sutured anastomoses. AD - [Kulkarni, Anita R.; Mehrara, Babak J.; Pusic, Andrea L.; Cordeiro, Peter G.; Matros, Evan; McCarthy, Colleen M.; Disa, Joseph J.] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA. Disa, JJ (corresponding author), 1275 York Ave, New York, NY 10065 USA. disaj@mskcc.org AN - WOS:000370994500002 AU - Kulkarni, A. R. AU - Mehrara, B. J. AU - Pusic, A. L. AU - Cordeiro, P. G. AU - Matros, E. AU - McCarthy, C. M. AU - Disa, J. J. DA - Mar DO - 10.1055/s-0035-1563737 IS - 3 J2 - J. Reconstr. Microsurg. KW - venous thrombosis anastomotic coupling device breast reconstruction free-tissue transfer neck reconstruction clinical-experience microvascular coupler device head transfers utility Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: DE9XZ Times Cited: 24 Cited Reference Count: 19 Kulkarni, Anita R. Mehrara, Babak J. Pusic, Andrea L. Cordeiro, Peter G. Matros, Evan McCarthy, Colleen M. Disa, Joseph J. NATIONAL CANCER INSTITUTEUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Cancer Institute (NCI) [P30CA008748] Funding Source: NIH RePORTER; NCI NIH HHSUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Cancer Institute (NCI) [P30 CA008748] Funding Source: Medline 25 2 6 Thieme medical publ inc New york 1098-8947 PY - 2016 SN - 0743-684X SP - 178-182 ST - Venous Thrombosis in Handsewn versus Coupled Venous Anastomoses in 857 Consecutive Breast Free Flaps T2 - Journal of Reconstructive Microsurgery TI - Venous Thrombosis in Handsewn versus Coupled Venous Anastomoses in 857 Consecutive Breast Free Flaps UR - ://WOS:000370994500002 VL - 32 ID - 2075 ER - TY - JOUR AD - E.S. Craig, Surgery-Administration/Academic Affairs, P.O. Box 208062, New Haven, CT 06520-8062, United States AU - Craig, E. S. AU - Walker, M. E. AU - Fusi, S. DB - Embase Medline DO - 10.1002/micr.21979 IS - 4 KW - antineoplastic agent breast cancer cancer chemotherapy cancer patient deep inferior epigastric perforator flap hospitalization human length of stay letter lung embolism operation duration priority journal risk assessment risk factor venous thromboembolism LA - English M3 - Letter N1 - L51927495 2012-03-27 2012-05-22 PY - 2012 SN - 0738-1085 1098-2752 SP - 334-335 ST - Venous thromboembolism risk factors in breast cancer patients undergoing deep inferior epigastric perforator flap reconstruction T2 - Microsurgery TI - Venous thromboembolism risk factors in breast cancer patients undergoing deep inferior epigastric perforator flap reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L51927495&from=export http://dx.doi.org/10.1002/micr.21979 VL - 32 ID - 7143 ER - TY - JOUR AU - Gilleard, O. AU - Askouni, E. AU - Tavsanoglu, Y. AU - Jones, M. E. DB - Embase Medline DO - 10.1016/j.bjps.2013.12.009 IS - 5 KW - acetylsalicylic acid low molecular weight heparin tamoxifen breast cancer breast reconstruction compression stocking drug withdrawal free tissue graft gold standard human intermittent pneumatic compression device letter lung embolism mastectomy mobilization practice guideline priority journal prophylaxis survival rate venous thromboembolism LA - English M3 - Letter N1 - L52940103 2014-01-03 2014-04-25 PY - 2014 SN - 1878-0539 1748-6815 SP - 733-735 ST - Venous thromboembolism prophylaxis for abdominal free tissue breast reconstruction: A multicenter survey T2 - Journal of Plastic, Reconstructive and Aesthetic Surgery TI - Venous thromboembolism prophylaxis for abdominal free tissue breast reconstruction: A multicenter survey UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52940103&from=export http://dx.doi.org/10.1016/j.bjps.2013.12.009 VL - 67 ID - 6577 ER - TY - JOUR AD - C.Y. Loh AU - Loh, C. Y. AU - Lim, P. C. AU - Lam, D. G. DB - Medline IS - 3 KW - anticoagulant agent low molecular weight heparin breast reconstruction female free tissue graft human leg mastectomy note postoperative complication vascularization vein thrombosis venous thromboembolism LA - English M3 - Note N1 - L364649969 2012-04-26 PY - 2012 SN - 1529-4242 SP - 550e-551e; author reply 551e-552e ST - Venous thromboembolism following microsurgical breast reconstruction: an objective analysis in 225 consecutive patients using low-molecular-weight heparin prophylaxis T2 - Plastic and reconstructive surgery TI - Venous thromboembolism following microsurgical breast reconstruction: an objective analysis in 225 consecutive patients using low-molecular-weight heparin prophylaxis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L364649969&from=export VL - 129 ID - 7178 ER - TY - JOUR AB - Background: Free flap breast reconstruction involves major risk factors for postsurgical venous thromboembolism. The main study objectives were (1) to estimate objectively the incidence of symptomatic and asymptomatic lower extremity deep vein thrombosis in patients who received postoperative thromboprophylaxis after free flap breast reconstruction, (2) to evaluate the safety of low-molecular-weight heparin postoperatively, and (3) to assess the incidence of symptomatic pulmonary embolism or sudden death. Methods: A cohort study of 225 consecutive patients who underwent abdominally based free flap breast reconstruction at a single cancer center was conducted. The postoperative thromboprophylaxis regimen was based on the American College of Chest Physicians guidelines. A study group of 118 patients systematically underwent bilateral lower extremity duplex ultrasound before hospital discharge to assess objectively the status of the lower extremity deep venous system. A retrospective cohort of 107 women who were not systematically screened for deep vein thrombosis was used for comparison. Results: The incidence of postoperative deep vein thrombosis confirmed by duplex ultrasound was 3.4 percent in the study group, all events being clinically silent. Bleeding complications in the entire patient sample were estimated at 5.3 percent. Partial flap loss and total flap loss rates were 2.7 and 1.9 percent, respectively. No venous thromboembolism event was diagnosed in the control group. Conclusions: This report shows that the objective incidence of deep vein thrombosis was 3.4 percent within 5 postoperative days in this patient population. The authors' findings support the use of triple thromboprophylaxis and demonstrate that low-molecular-weight heparin is a safe and effective method for prevention of venous thromboembolism in this population. (Mast. Reconstr. Swig. 127: 1399, 2011.) AD - [Lemaine, Valerie; McCarthy, Colleen; Kaplan, Karly; Mehrara, Babak; Pusic, Andrea L.; Cordeiro, Peter G.; Disa, Joseph J.] Mem Sloan Kettering Canc Ctr, New York, NY 10065 USA. Disa, JJ (corresponding author), Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10065 USA. disaj@mskcc.org AN - WOS:000288840200001 AU - Lemaine, V. AU - McCarthy, C. AU - Kaplan, K. AU - Mehrara, B. AU - Pusic, A. L. AU - Cordeiro, P. G. AU - Disa, J. J. DA - Apr DO - 10.1097/PRS.0b013e318208d025 IS - 4 J2 - Plast. Reconstr. Surg. KW - deep-vein thrombosis risk-assessment tram flap cancer-patients surgery prevention efficacy anticoagulation complications immediate Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 741CH Times Cited: 51 Cited Reference Count: 36 Lemaine, Valerie McCarthy, Colleen Kaplan, Karly Mehrara, Babak Pusic, Andrea L. Cordeiro, Peter G. Disa, Joseph J. 51 0 2 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2011 SN - 0032-1052 SP - 1399-1406 ST - Venous Thromboembolism following Microsurgical Breast Reconstruction: An Objective Analysis in 225 Consecutive Patients Using Low-Molecular-Weight Heparin Prophylaxis T2 - Plastic and Reconstructive Surgery TI - Venous Thromboembolism following Microsurgical Breast Reconstruction: An Objective Analysis in 225 Consecutive Patients Using Low-Molecular-Weight Heparin Prophylaxis UR - ://WOS:000288840200001 VL - 127 ID - 2935 ER - TY - JOUR AB - Background. - Patient candidates for breast reconstruction with free deep inferior epigastric perforator flap (DIEP) may present several risk factors for venous thromboembolism (VTE). Risk identification is essential for appropriate VTE prophylaxis measures to be put in place. This study aims to investigate VTE incidence after DIEP flap breast reconstruction and to assess the accuracy of the Caprini Risk Assessment Model (RAM), which is the unique score validated to assess the VTE risk for plastic surgery procedures and identify patients at high VTE risk. Methods. - A chart review was conducted of 192 consecutive patients who underwent breast reconstruction with a DIEP flap from 1999 to 2016. VTE rate was assessed and the Caprini score was calculated for each patient and correlated with the VTE incidence. Results. - During the 90 post-operative days, four patients presented a pulmonary embolism (2.1%) and two patients (1%) had deep venous thrombosis (overall VTE incidence of 3.1%). Most patients (92.2%) were assessed as high-risk (Caprini score > 5) and all VTE occurred among this group. Apart from the Caprini score, no specific single risk factor could be identified for VTE. Conclusions. - Our data confirm that the Caprini RAM is a valuable assessment tool for VTE risk measurement among all patients undergoing autologous breast reconstruction. As most candidates for DIEP flap belong to the high-risk group, combined anticoagulation prophylaxis methods are required for most cases, particularly chemoprophylaxis up to four weeks postoperatively. (C) 2017 Elsevier Masson SAS. All rights reserved. AD - [Modarressi, A.; Schettini, A. -V.; Ruegg, E. M.; Pittet-Cuenod, B.] Hop Univ Geneva, Dept Chirurg Plast Reconstruct & Esthet, 4 Rue Gabrielle Perret Gentil, CH-1205 Geneva, Switzerland. Modarressi, A (corresponding author), Hop Univ Geneva, Dept Chirurg Plast Reconstruct & Esthet, 4 Rue Gabrielle Perret Gentil, CH-1205 Geneva, Switzerland. ali.modarressi@hcuge.ch AN - WOS:000425875800002 AU - Modarressi, A. AU - Schettini, A. V. AU - Ruegg, E. M. AU - Pittet-Cuenod, B. DA - Feb DO - 10.1016/j.anplas.2017.11.001 IS - 1 J2 - Ann. Chir. Plast. Esthet. KW - Venous thromboembolism Breast reconstruction DIEP plastic-surgery patients patients antithrombotic therapy clinical-practice guidelines ed american-college tram flap postoperative enoxaparin thrombosis prophylaxis surgical-patients risk experience Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: FX2FV Times Cited: 5 Cited Reference Count: 42 Modarressi, A. Schettini, A. -V. Ruegg, E. M. Pittet-Cuenod, B. 5 0 4 Elsevier Bridgewater 1768-319x PY - 2018 SN - 0294-1260 SP - 11-19 ST - Venous thromboembolism events after breast reconstructions with DIEP free flaps in 192 consecutive case T2 - Annales De Chirurgie Plastique Esthetique TI - Venous thromboembolism events after breast reconstructions with DIEP free flaps in 192 consecutive case UR - ://WOS:000425875800002 VL - 63 ID - 1660 ER - TY - JOUR AB - Venous thromboembolic disease (VTE) is a cause of significant morbidity and mortality in patients with cancer. Large studies have estimated that VTE occurs in up to 1.1% of patients undergoing breast cancer turner extirpation and in up to 1.5% of patients undergoing breast cancer reconstruction. This study sought to retrospectively review the experience of a large university practice with TRAM, DIEP, and latissimus flap reconstruction for mastectomy defects and evaluate our rate of VTE. In our series of 271 consecutive patients, 2 had deep venous thromboses, 2 had both deep venous thromboses and pulmonary emboli, and 2 had pulmonary embolus alone. VTE incidence was 2.2%; a relatively high rate compared with previously published, large population studies of VTE in breast reconstruction patients. Review of the literature suggests that physicians have poor compliance with established guidelines for prophylaxis and treatment of VTE in general and orthopedic surgery populations. Unfortunately, no specific guidelines are available for patients undergoing operative intervention for breast cancer or autogenous tissue based reconstruction. VTE is significantly under-diagnosed: clinical findings alone are unreliable, and the true prevalence may be greater than twice what is reported. Further research is needed in this largerly unexplored field to determine appropriate means of VTE prophylaxis and treatment in the breast cancer population. AD - [Pannucci, Christopher J.; Chang, Edwin Y.; Wilkins, Edwin G.] Univ Michigan, Dept Surg, Sect Plast Surg, Ann Arbor, MI 48109 USA. Pannucci, CJ (corresponding author), 1500 E Med Ctr Dr,2130 Taubman Ctr,Box 0340, Ann Arbor, MI 48109 USA. cpannucc@umich.edu AN - WOS:000267338100010 AU - Pannucci, C. J. AU - Chang, E. Y. AU - Wilkins, E. G. DA - Jul DO - 10.1097/SAP.0b013e318188bedf IS - 1 J2 - Ann. Plast. Surg. KW - venous thromboembolic disease deep venous thrombosis pulmonary embolism breast cancer autogenous tissue reconstruction deep-vein thrombosis donor-site complications pulmonary-embolism tram flap cancer-surgery plastic-surgery prophylaxis prevention diagnosis survival Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 462GD Times Cited: 40 Cited Reference Count: 49 Pannucci, Christopher J. Chang, Edwin Y. Wilkins, Edwin G. 40 0 1 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2009 SN - 0148-7043 SP - 34-38 ST - Venous Thromboembolic Disease in Autogenous Breast Reconstruction T2 - Annals of Plastic Surgery TI - Venous Thromboembolic Disease in Autogenous Breast Reconstruction UR - ://WOS:000267338100010 VL - 63 ID - 3268 ER - TY - JOUR AB - Background: Abdominal seroma formation after deep inferior epigastric perforator (DIEP) flap breast reconstruction is a common donor-site complication. Additional dissection of one or both of the superficial inferior epigastric veins (SIEVs) in DIEP flap breast reconstruction allows an additional anastomosis for venous superdrainage if venous congestion occurs. However, generally, SIEV dissection involves greater invasiveness into the inguinal region, which can traumatize lymphatic tissue and lead to lymph accumulation. The aim of this study was to evaluate the impact of SIEV dissection on the incidence of postoperative abdominal seroma. Methods: A series of 100 consecutive cases performed by the Department of Plastic and Reconstructive Surgery at the Medical University of Vienna from 2001 to 2016 was analyzed. Patients were divided into three groups: unilateral, bilateral, and no SIEV dissection. Abdominal seroma rates, length of hospital stay, abdominal drainage duration, and drainage fluid volumes were compared retrospectively. Results: Seromas were observed in 11.5 percent of patients without SIEV dissection, 17.2 percent of patients with unilateral SIEV dissection (p = 0.45 versus no SIEV), and 40 percent of patients with bilateral SIEV dissection (p = 0.02 versus no SIEV). The SIEV was anastomosed to salvage a congested DIEP flap twice. All seromas that developed could be treated with, on average, two fine-needle aspirations without any complications. Conclusions: Bilateral, but not unilateral, SIEV dissection increased abdominal seroma rates significantly. Venous congestion was observed rarely, but when it did occur, it endangered flap viability. Because an additional anastomosis of the SIEV can salvage a flap, unilateral SIEV dissection should be considered when raising a DIEP flap. AD - [Nedomansky, Jakob; Nickl, Stefanie; Radtke, Christine; Haslik, Werner; Schroegendorfer, Klaus F.] Med Univ Vienna, Dept Surg, Div Plast & Reconstruct Surg, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Haslik, W (corresponding author), Med Univ Vienna, Dept Surg, Div Plast & Reconstruct Surg, Waehringer Guertel 18-20, A-1090 Vienna, Austria. werner.haslik@meduniwien.ac.at AN - WOS:000425474200001 AU - Nedomansky, J. AU - Nickl, S. AU - Radtke, C. AU - Haslik, W. AU - Schroegendorfer, K. F. DA - Feb DO - 10.1097/prs.0000000000004017 IS - 2 J2 - Plast. Reconstr. Surg. KW - perforator flap free tram prevention experience lymphedema outcomes surgery drains limb Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: FW7BM Times Cited: 7 Cited Reference Count: 26 Nedomansky, Jakob Nickl, Stefanie Radtke, Christine Haslik, Werner Schroegendorfer, Klaus F. ; Radtke, Christine/B-8491-2018 Nickl, Stefanie/0000-0002-3762-4840; Radtke, Christine/0000-0001-6877-5038 7 1 2 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2018 SN - 0032-1052 SP - 206E-212E ST - Venous Superdrainage in DIEP Flap Breast Reconstruction: The Impact of Superficial Inferior Epigastric Vein Dissection on Abdominal Seroma Formation T2 - Plastic and Reconstructive Surgery TI - Venous Superdrainage in DIEP Flap Breast Reconstruction: The Impact of Superficial Inferior Epigastric Vein Dissection on Abdominal Seroma Formation UR - ://WOS:000425474200001 VL - 141 ID - 1657 ER - TY - JOUR AD - Leopold Franzens Univ, Univ Innsbruck Hosp, Ludwig Boltzmann Qualitatssicherung Plast & Wiede, A-6020 Innsbruck, Austria. Univ Innsbruck Hosp, Ludwig Boltzmann Inst Qualitatssicherung Plast &, A-6020 Innsbruck, Austria. Wechselberger, G (corresponding author), Univ Clin, Dept Plast & Reconstruct Surg, Anichstr 35, A-6020 Innsbruck, Austria. AN - WOS:000169477300026 AU - Wechselberger, G. AU - Schoeller, T. AU - Bauer, T. AU - Ninkovic, M. AU - Otto, A. AU - Ninkovic, M. DA - Jul DO - 10.1097/00006534-200107000-00026 IS - 1 J2 - Plast. Reconstr. Surg. KW - internal mammary vessels experience drainage artery system Surgery LA - English M3 - Editorial Material N1 - ISI Document Delivery No.: 445UQ Times Cited: 81 Cited Reference Count: 15 Wechselberger, G Schoeller, T Bauer, T Ninkovic, M Otto, A Ninkovic, M 85 0 Lippincott williams & wilkins Philadelphia PY - 2001 SN - 0032-1052 SP - 162-166 ST - Venous superdrainage in deep inferior epigastric perforator flap breast reconstruction T2 - Plastic and Reconstructive Surgery TI - Venous superdrainage in deep inferior epigastric perforator flap breast reconstruction UR - ://WOS:000169477300026 VL - 108 ID - 3996 ER - TY - JOUR AB - Background The use of distally based neurocutaneous sural flaps (DBNCSF) is one of the most common methods of reconstructing the distal lower leg. However, they have developed a bad reputation because of their propensity for venous engorgement. Venous congestion that can lead to distal necrosis can be prevented by venous supercharging. Using a prospective comparative study, we thus explored the effect of venous supercharging on the reliability of these useful workhorse flaps. Methods We prospectively included 38 patients who received a conventional DBNCSF and 38 patients who received a supercharged version of this flap (sDBNCSF) between January 2012 and July 2016. Results No significant difference was identified between the groups in terms of age, sex, comorbidity, or defect origin. The main reconstruction etiology was traumatic (open fracture, scar disunion, and chronic osteitis). The flap size was noticeably larger in the sDBNCSF group, albeit without significance. The length-width ratio was significantly greater in the sDBNCSF group (6.08 vs. 5.53, p = 0.022). Venous congestion was significantly more common in the non-supercharged group (28.6 vs. 2.6%, p = 0.01), as was coverage failure (23.7 vs. 2.6%, p = 0.035). Conclusion There are significant benefits to using venous supercharging of DBNCSF, when technically feasible. In our experience, venous supercharging increases reliability, allows the raise of larger skin paddles with much narrower pedicles limiting the morbidity of the procedure, and improves the functional and esthetic results. AD - [Herlin, Christian; Bekara, Farid] Lapeyronie Univ Hosp, Dept Plast & Reconstruct Surg & Burns, Ave Doyen Gaston Giraud, Montpellier, France. [Herlin, Christian; Bekara, Farid] Lapeyronie Univ Hosp, Dept Plast & Craniofacial Pediat Surg, Ave Doyen Gaston Giraud, Montpellier, France. [Bertheuil, Nicolas] South Univ Hosp, Dept Plast Reconstruct & Aesthet Surg, Rennes, France. [Carloni, Raphael] Charles Nicolle Hosp, Dept Plast Reconstruct & Hand Surg, Rouen, France. [Dast, Sandy; Sinna, Raphael] CHU Picardie, Dept Plast Reconstruct & Aesthet Surg, Amiens, France. [Chaput, Benoit] CHU Rangueil, Dept Plast Reconstruct & Aesthet Surg, Toulouse, France. Herlin, C (corresponding author), CHU Montpellier, Plast & Craniofacial Pediat Surg Unit, Plast & Reconstruct Surg Unit, Ave Doyen Gaston Giraud, Montpellier, France.; Herlin, C (corresponding author), CHU Montpellier, Plast & Craniofacial Pediat Surg Unit, Burns Unit, Ave Doyen Gaston Giraud, Montpellier, France. drchristianherlin@gmail.com AN - WOS:000401683300006 AU - Herlin, C. AU - Bekara, F. AU - Bertheuil, N. AU - Carloni, R. AU - Dast, S. AU - Sinna, R. AU - Chaput, B. DA - Jun DO - 10.1055/s-0037-1598620 IS - 5 J2 - J. Reconstr. Microsurg. KW - sural flap venous supercharging reliability epigastric perforator flap artery flap ankle reconstruction lower-leg staged reconstruction breast reconstruction clinical-implications fasciocutaneous flap heel reconstruction foot Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: EV3TZ Times Cited: 14 Cited Reference Count: 44 Herlin, Christian Bekara, Farid Bertheuil, Nicolas Carloni, Raphael Dast, Sandy Sinna, Raphael Chaput, Benoit CHAPUT, benoit/0000-0002-8567-3479 19 0 1 Thieme medical publ inc New york 1098-8947 PY - 2017 SN - 0743-684X SP - 343-351 ST - Venous Supercharging Reduces Complications and Improves Outcomes of Distally Based Sural Flaps T2 - Journal of Reconstructive Microsurgery TI - Venous Supercharging Reduces Complications and Improves Outcomes of Distally Based Sural Flaps UR - ://WOS:000401683300006 VL - 33 ID - 1828 ER - TY - JOUR AB - Background: The DIEAP flap has gained popularity for breast reconstruction worldwide. Despite DIEAP flap arterial anatomy being well known, venous congestion is still an important complication and the literature on DIEAP flap venous anatomy is lacking. Venous drainage is less predictable and research on venous perforators is of increasing interest. The aim of this study was to investigate the anatomical distribution, diameters and relationships between arterial and venous perforators and their source vessels using Duplex ultrasonography, in order to evaluate the potential benefits of pre-operative evaluation of DIEAP flap venous perforators. Methods: Prospectively, 140 patients undergoing DIEAP flap breast reconstruction, were pre-operatively assessed using Duplex ultrasonography for location and diameter of arterial and venous perforators, DIEA, DIEV, and SIEV. Perforators were plotted laterally and inferiorly from the umbilicus. Means were compared using t-tests. Pearson's correlation coefficients were calculated. Results: We identified 702 arterial and 355 venous perforators in 280 lower hemi-abdomens. No venous perforators were identified in 9 (6.5%) patients; none on the right in 25 (17.9%) and none on the left in 36 (25.7%). Venous perforators were larger on the right (p=0.031) but DIEV and SIEV diameters were not statistically different on either sides. The diameters of DIEA, DIEV, perforating arteries and veins were correlated, but unrelated to the diameter of the SIEV. When a medium/large perforator vein is identified first, there is a 93.5% chance of finding an associated medium/large perforator artery; this reduces to 69.8% when a medium/large perforator artery is first identified. Conclusions: There is no correlation between the sizes of perforator veins and DIEV, and the size of the SIEV. Our data suggests that first identifying a medium/large venous perforator increases the chances of finding a better suitable perforator complex. Pre-operative evaluation of venous perforators may be of great interest for its potential clinical benefits. (C) 2012 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. AD - [Figus, Andrea; Wade, Ryckie G.; Gorton, Louise; Griffiths, Matthew G.; Ramakrishnan, Venkat V.] St Andrews Ctr Plast Surg & Burns, Chelmsford, Essex, England. [Rubino, Corrado] Univ Sassari, Dept Plast Surg, I-07100 Sassari, Italy. Figus, A (corresponding author), Univ E Anglia, Norwich Med Sch, Norfolk & Norwich Univ Hosp NHS Fdn Trust, Dept Plast & Reconstruct Surg, Colney Lane, Norwich NR4 7UY, Norfolk, England. andreafigus@hotmail.com AN - WOS:000306484300017 AU - Figus, A. AU - Wade, R. G. AU - Gorton, L. AU - Rubino, C. AU - Griffiths, M. G. AU - Ramakrishnan, V. V. DA - Aug DO - 10.1016/j.bjps.2012.02.026 IS - 8 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - Duplex Perforator Doppler DIEAP DIEP SIEA SIEV Breast Reconstruction inferior epigastric perforator anterior abdominal-wall free tram hemodynamic-changes doppler flowmetry artery perforator flow reconstruction complications congestion Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 975CL Times Cited: 15 Cited Reference Count: 40 Figus, Andrea Wade, Ryckie G. Gorton, Louise Rubino, Corrado Griffiths, Matthew G. Ramakrishnan, Venkat V. Wade, Ryckie George/H-9277-2016 Wade, Ryckie George/0000-0001-8365-6547; Rubino, Corrado/0000-0002-2410-6083 16 0 3 Elsevier sci ltd Oxford 1878-0539 PY - 2012 SN - 1748-6815 SP - 1051-1059 ST - Venous perforators in DIEAP flaps: An observational anatomical study using duplex ultrasonography T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Venous perforators in DIEAP flaps: An observational anatomical study using duplex ultrasonography UR - ://WOS:000306484300017 VL - 65 ID - 2718 ER - TY - JOUR AB - Staged division of any or all inferior dominant pedicles to the human lower transverse rectus abdominis musculocutaneous (TRAM) flap has previously been attempted to invoke the delay phenomenon to enhance the rate of success with the superior-pedicled version, especially for patients at high risk for complications. Regardless of the specific vessels ligated, this has usually been accomplished by division of the source artery and its accompanying vein. Whether division of both vessels is essential remains unclear, however. This issue was investigated by using the authors' standard rat TRAM flap model in 43 female Sprague-Dawley rats, which were randomly assigned to four groups. In group A, both the predominant ipsilateral cranial epigastric artery and the cranial epigastric vein were divided 2 weeks before elevation of the TRAM flaps In group B, only the artery was divided, in group C, only the vein was divided. In an undelayed control group, the TRAM flap was elevated immediately, with no prior pedicle division. The percentages of flap survival in group A (89.3 +/- 7.0 percent) and group B (883 +/- 6.5 percent) (both with division of the predominant artery) were significantly greater than that in the control group (64.6 +/- 20.5 percent) (p < 0.001) or that in the group in which the vein alone was divided (73.9 +/- 11.3 percent) (p < 0,01). There was no significant difference between the group that underwent vein division only and the control group (p = 0102). The clinical implication is that arterial division is critical for TRAM flap delay and that arbitrary venous interruption is unnecessary. AD - Nippon Med Coll, Dept Plast & Reconstruct Surg, Tokyo 113, Japan. Lehigh Valley Hosp, Div Plast Surg, Allentown, PA USA. Hallock, GG (corresponding author), 1230 S Cedar Crest Blvd,Suite 306, Allentown, PA 18103 USA. AN - WOS:000180191700051 AU - Sano, K. AU - Hallock, G. G. AU - Rice, D. C. DA - Jan DO - 10.1097/01.Prs.0000033103.44872.A8 IS - 1 J2 - Plast. Reconstr. Surg. KW - abdominis musculocutaneous flap breast reconstruction myocutaneous flap surgical delay microvascular augmentation island flap pedicle survival Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 631WY Times Cited: 6 Cited Reference Count: 34 Sano, K Hallock, GG Rice, DC 6 0 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2003 SN - 0032-1052 SP - 300-305 ST - Venous interruption is unnecessary to achieve an adequate delay in the rat TRAM flap model T2 - Plastic and Reconstructive Surgery TI - Venous interruption is unnecessary to achieve an adequate delay in the rat TRAM flap model UR - ://WOS:000180191700051 VL - 111 ID - 3914 ER - TY - JOUR AB - The transverse rectus abdominis musculocutaneous (TRAM) flap has been widely used for reconstruction of the breast. Partial loss of the flap is still a problem, however, and venous congestion may cause partial necrosis of the flap. There are few studies of the venous anatomy of the TRAM flap that compares with that of the arterial system, so the aim of this study was to investigate the venous anatomy of the TRAM flap and assess its drainage pathway using venography. A mixture of barium and gelatin were injected through the cutaneous veins such as the superficial inferior epigastric vein (SIEV), the superficial circumflex iliac vein (SCIV), or the perforating branch of the deep inferior epigastric vein (DIEV) in 11 hemiTRAM flaps. Venograms of TRAM flaps were taken, and the venous anatomy evaluated. The study showed that it consisted of the dominant superficial venous system, the SIEV and SCIV, and the secondary deep venous system, and the perforating vein of DIEV (DIEV perforator). In addition, we saw the large communicating veins between the SIEV and DIEV perforator near the umbilicus. We think that these communicating veins, which are considered as the DIEV perforators between the superficial and deep venous system, are an important venous drainage pathway after the TRAM flap has been raised. © 2009 Informa UK Ltd. AD - H. Chang, Department of Plastic and Reconstructive Surgery, Research Institute of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea AU - Kwon, S. S. AU - Chang, H. AU - Minn, K. W. AU - Lee, T. J. DB - Medline DO - 10.1080/02844310902955821 IS - 6 KW - contrast medium diagnostic agent adult article breast reconstruction epidemiology female histology human image quality methodology middle aged phlebography plastic surgery rectus abdominis muscle sensitivity and specificity vascularization vein LA - English M3 - Article N1 - L355837752 2010-03-05 PY - 2009 SN - 0284-4311 1651-2073 SP - 312-314 ST - Venous drainage system of the transverse rectus abdominis musculocutaneous flap T2 - Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery TI - Venous drainage system of the transverse rectus abdominis musculocutaneous flap UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355837752&from=export http://dx.doi.org/10.1080/02844310902955821 VL - 43 ID - 7627 ER - TY - JOUR AB - PurposeThe purpose of this report was to present the results of comparisons of anastomotic data and flap complications in the use of venous coupler in breast reconstruction with the transverse musculocutaneous gracilis (TMG) flap and the deep inferior epigastric perforator (DIEP) flap. MethodsOver a three-year period, 95 patients suffering from breast cancer were treated with mastectomy and breast reconstruction using free flaps. We performed 121 mechanical venous anastomoses for 105 flap procedures (80 DIEP and 25 TMG). The coupler size, anastomotic duration, number of anastomoses and postoperative complications were assessed for the entire series. ResultsThe coupling device was perfectly suitable for all end-to-end anastomoses between the vein(s) of the flap and the internal mammary vein(s). No venous thrombosis occurred. The mean anastomotic time did not significantly differ between the DIEP (330 seconds) and TMG flap procedures (352 seconds) (P=0.069). Additionally, there were no differences in coupling time observed following a comparison of seven coupler sizes (P=0.066). The mean coupler size used during the TMG flap procedure was smaller than that used with the DIEP (2.4 mm versus 2.8 mm) (P<0.001). The mean size was also smaller when double venous anastomoses were required compared to single anastomosis (2.4 mm versus 2.9 mm) (P<0.001). The double branching was more frequent with the TMG flap (28%) than with the DIEP flap (11%). ConclusionsThe coupler size used was smaller for the TMG procedure and when double venous anastomosis was performed. Additionally, anastomotic time was not affected by the flap type or coupler size used or by anastomosis number. (c) 2014 Wiley Periodicals, Inc. Microsurgery 35:295-299, 2015. AD - [Bodin, Frederic; Dissaux, Caroline; Bruant-Rodier, Catherine] Strasbourg Acad Hosp, Dept Plast Surg, Strasbourg, France. [Brunetti, Stefania; Facca, Sybille; Liverneaux, Philippe] Strasbourg Acad Hosp, Dept Hand Surg, Strasbourg, France. [Erik, A. Sauleau] Strasbourg Acad Hosp, Dept Biostatist, Strasbourg, France. Bodin, F (corresponding author), Hop Civil, Serv Chirurg Plast & Reconstruct, 1 Pl Hop,BP 426, F-67091 Strasbourg, France. frederic.bodin@chru-strasbourg.fr AN - WOS:000355135900007 AU - Bodin, F. AU - Brunetti, S. AU - Dissaux, C. AU - Erik, A. S. AU - Facca, S. AU - Bruant-Rodier, C. AU - Liverneaux, P. DA - May DO - 10.1002/micr.22350 IS - 4 J2 - Microsurgery KW - microvascular anastomotic coupler musculocutaneous gracilis flap free-tissue transfers clinical-experience perforator flap device arteries veins surgery system Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: CJ0BF Times Cited: 12 Cited Reference Count: 31 Bodin, Frederic Brunetti, Stefania Dissaux, Caroline Erik, A. Sauleau Facca, Sybille Bruant-Rodier, Catherine Liverneaux, Philippe Sauleau, Erik A/0000-0003-1178-1060 13 0 2 Wiley-blackwell Hoboken 1098-2752 PY - 2015 SN - 0738-1085 SP - 295-299 ST - Venous coupler use for free-flap breast reconstructions: Specific analyses of TMG and DIEP flaps T2 - Microsurgery TI - Venous coupler use for free-flap breast reconstructions: Specific analyses of TMG and DIEP flaps UR - ://WOS:000355135900007 VL - 35 ID - 2248 ER - TY - JOUR AB - BACKGROUND: Autologous microvascular breast reconstruction is an increasingly common procedure. While arterial anastomoses are traditionally being hand-sewn, venous anastomoses are often completed with a coupler device. The largest coupler size possible should be used, as determined by the smaller of either the donor or recipient vein. While its efficacy has been shown using 3.0-mm size and greater couplers, little is known about the consequences of using coupler sizes less than or equal to 2.5 mm. METHODS: A retrospective chart review of patients undergoing autologous breast reconstruction was conducted at NYU Medical Center between November 2007 and November 2011. Flaps were divided into cohorts based on coupler size used: 2.0 mm, 2.5 mm, and 3.0 mm. Outcomes included incidence of arterial or venous insufficiency, hematoma, fat necrosis, partial flap loss, full flap loss, and need for future fat grafting. RESULTS: One-hundred ninety-seven patients underwent 392 flaps during the study period. Patients were similar in age, type of flap, smoking status, and radiation history. Coupler size less than or equal to 2.0 mm was found to be a significant risk factor for venous insufficiency (P = 0.038), as well as for development of fat necrosis (P = 0.041) and future need for fat grafting (P = 0.050). In multivariate analysis, body mass index was found to be an independent risk factor for skin flap necrosis (P = 0.010) and full flap loss (P = 0.035). CONCLUSIONS: Complications were significantly increased in patients where couplers of 2.0 mm or less were used, therefore to be avoided whenever possible. When needed, more aggressive vessel exposure through rib harvest, the use of thoracodorsal vessels or hand-sewing the anastomosis should be considered in cases of internal mammary vein caliber of 2.0 mm or less. CLINICAL QUESTION: Therapeutic. LEVEL OF EVIDENCE: Level III. AD - Institute of Reconstructive Plastic Surgery, New York University, New York, NY, USA. Institute of Reconstructive Plastic Surgery, New York University, New York, NY. Department of Surgery, Long Island Jewish Hospital, Manhasset, NY. Department of Surgery, North Shore University Hospital, Manhasset, NY. Department of Epidemiology and Biostatistics, Yale University, New Haven, CT. AN - 24038542 AU - Broer, P. N. AU - Weichman, K. E. AU - Tanna, N. AU - Wilson, S. AU - Ng, R. AU - Ahn, C. AU - Choi, M. AU - Karp, N. S. AU - Levine, J. P. AU - Allen, R. J. DA - Oct DO - 10.1002/micr.22169 DP - NLM ET - 2013/09/17 IS - 7 KW - Academic Medical Centers Adult Anastomosis, Surgical/instrumentation Cohort Studies Databases, Factual Equipment Design Equipment Safety Female Free Tissue Flaps/blood supply/*transplantation Graft Rejection Graft Survival Humans Mammaplasty/adverse effects/*instrumentation/*methods Mammary Arteries/surgery Microsurgery/adverse effects/*instrumentation Middle Aged New York City Postoperative Complications/physiopathology/therapy Prognosis Retrospective Studies *Surgical Instruments Transplantation, Autologous Treatment Outcome Veins/surgery LA - eng N1 - 1098-2752 Broer, P Niclas Weichman, Katie E Tanna, Neil Wilson, Stelios Ng, Reuben Ahn, Christina Choi, Mihye Karp, Nolan S Levine, Jamie P Allen, Robert J Journal Article United States Microsurgery. 2013 Oct;33(7):514-8. doi: 10.1002/micr.22169. Epub 2013 Sep 3. PY - 2013 SN - 0738-1085 SP - 514-8 ST - Venous coupler size in autologous breast reconstruction--does it matter? T2 - Microsurgery TI - Venous coupler size in autologous breast reconstruction--does it matter? VL - 33 ID - 12523 ER - TY - JOUR AB - Since the advent of microvascular free tissue transfer, adjunctive surgical techniques have become sought as a means to improving overall surgical time and outcomes in oncological surgery. Anastomotic devices have provided one such avenue, with staples and coupling devices suggested as an alternative to traditional suturing. We describe our experience with two such devices, automatic staples and the anastomotic ring coupler, in 1,000 cases of free tissue transfer. In 1,400 anastomoses, there was a significant reduction in anastomotic time from suturing (22 minutes) with the use of staples (15 minutes) or the ring coupler (4 minutes), p<0.01. This was without any increase in complication rates. These findings support the use of these devices and suggest an increasing role for modern devices in microvascular surgery. AD - [Rozen, Warren M.] Univ Melbourne, Dept Anat & Cell Biol, Jack Brockhoff Reconstruct Plast Surg Res Unit, Parkville, Vic 3050, Australia. [Whitaker, Iain S.] Morriston Hosp, Welsh Natl Plast Surg Unit, Dept Plast Reconstruct & Burns Surg, Swansea, W Glam, Wales. [Acosta, Rafael] Uppsala Clin Hosp, Dept Plast Surg, S-75185 Uppsala, Sweden. Rozen, WM (corresponding author), Univ Melbourne, Dept Anat & Cell Biol, Jack Brockhoff Reconstruct Plast Surg Res Unit, Room E533,Grattan St, Parkville, Vic 3050, Australia. warrenrozen@hotmail.com AN - WOS:000278686600036 AU - Rozen, W. M. AU - Whitaker, I. S. AU - Acosta, R. DA - Apr IS - 4 J2 - Anticancer Res. KW - Breast reconstruction deep inferior epigastric artery perforator flap venous arterial anastomosis breast reconstruction perforator flaps angiography experience Oncology LA - English M3 - Article N1 - ISI Document Delivery No.: 609VS Times Cited: 58 Cited Reference Count: 10 Rozen, Warren M. Whitaker, Iain S. Acosta, Rafael Acosta, Rafael/AAA-5161-2021; Whitaker, Iain/O-5896-2019 Whitaker, Iain/0000-0002-3922-2079; Rozen, Warren/0000-0002-4092-182X 72 0 3 Int inst anticancer research Athens 1791-7530 PY - 2010 SN - 0250-7005 SP - 1293-1294 ST - Venous Coupler for Free-Flap Anastomosis: Outcomes of 1,000 Cases T2 - Anticancer Research TI - Venous Coupler for Free-Flap Anastomosis: Outcomes of 1,000 Cases UR - ://WOS:000278686600036 VL - 30 ID - 3107 ER - TY - JOUR AB - Free-flap surgery has become a routine procedure in breast reconstruction. The microvascular surgical anastomosis remains one of the technically sensitive aspects of free-tissue transfers. Between December 2006 and September 2007, 12 anastomoses were performed with a venous coupling device from Synovis. There were no free-flap failures. Venous congestion occurred in only one case and was managed successfully with leeches. No major complications were observed. The Synovis venous coupling device system allowed a time-efficient and safe venous anastomosis in breast reconstruction. AD - [Camara, O.; Herrmann, J.; Egbe, A.; Koch, I.; Runnebaum, I. B.] Univ Jena, Dept Obstet & Gynaecol, D-07740 Jena, Germany. [Gajda, M.] Univ Jena, Inst Pathol, D-07740 Jena, Germany. Camara, O (corresponding author), Univ Jena, Dept Obstet & Gynaecol, Bachstr 18, D-07740 Jena, Germany. oumar.camara@med.uni-jena.de AN - WOS:000268104100061 AU - Camara, O. AU - Herrmann, J. AU - Egbe, A. AU - Koch, I. AU - Gajda, M. AU - Runnebaum, I. B. DA - Jul IS - 7 J2 - Anticancer Res. KW - Venous coupler free flap breast reconstruction epigastric perforator flap free tissue transfer free tram flap breast reconstruction device discrepancy management Oncology LA - English M3 - Article; Proceedings Paper N1 - ISI Document Delivery No.: 472BM Times Cited: 21 Cited Reference Count: 15 Camara, O. Herrmann, J. Egbe, A. Koch, I. Gajda, M. Runnebaum, I. B. 8th International Conference of Anticancer Research Oct 17-22, 2008 Kos Isl, GREECE 29 0 1 Int inst anticancer research Athens PY - 2009 SN - 0250-7005 SP - 2827-2830 ST - Venous Coupler for Free-flap Anastomosis T2 - Anticancer Research TI - Venous Coupler for Free-flap Anastomosis UR - ://WOS:000268104100061 VL - 29 ID - 3269 ER - TY - JOUR AN - 21296041 AU - Chan, R. K. AU - Liu, A. AU - Bojovic, B. AU - Chun, Y. AU - Guo, L. AU - Caterson, S. A. AU - Orgill, D. P. AU - Pribaz, J. J. DA - May DO - 10.1016/j.bjps.2010.12.017 DP - NLM ET - 2011/02/08 IS - 5 KW - Abdominal Muscles/blood supply/*transplantation Catheterization/*methods Female Follow-Up Studies Humans Hyperemia/*etiology/therapy Mammaplasty/*adverse effects Reoperation/methods Surgical Flaps/*blood supply LA - eng N1 - 1878-0539 Chan, Rodney K Liu, Allen Bojovic, Branko Chun, Yoon Guo, Lifei Caterson, Stephanie A Orgill, Dennis P Pribaz, Julian J Letter Netherlands J Plast Reconstr Aesthet Surg. 2011 May;64(5):e135-6. doi: 10.1016/j.bjps.2010.12.017. Epub 2011 Feb 4. PY - 2011 SN - 1748-6815 SP - e135-6 ST - Venous congestion in abdominal flap breast reconstructions--a simple treatment for a temporary problem T2 - J Plast Reconstr Aesthet Surg TI - Venous congestion in abdominal flap breast reconstructions--a simple treatment for a temporary problem VL - 64 ID - 10258 ER - TY - JOUR AB - A series of 240 deep inferior epigastric perforator (DIEP) flaps and 271 free transverse rectus abdominis myocutaneous (TRAM) flaps from two institutions was reviewed to determine the incidence of diffuse venous insufficiency that threatened flap survival and required a microvascular anastomosis to drain the superficial inferior epigastric vein. This problem occurred in five DIEP flaps and did not occur in any of the free TRAM flaps. In each of these cases, the presence of a superficial inferior epigastric vein that was larger than usual was noted. It is therefore suggested that if an unusually large superficial inferior epigastric vein is noted when a DIEP flap is elevated, the vein should be preserved for possible use in flap salvage. Anatomical studies with Microfil injections of the superficial venous system of the DIEP or TRAM nap were also performed in 15 cadaver and 3 abdominoplasty specimens to help determine why venous circulation (and flap survival) in zone TV of the flaps is so variable. Large lateral branches crossing the midline were found in only 18 percent of cases, whereas 45 percent had indirect connections through a deeper network of smaller veins and 36 percent had no demonstrable crossing branches at all. This absence of crossing branches in many patients may explain why survival of the zone TV portion of such flaps is so variable and unpredictable. AD - State Univ Ghent Hosp, Dept Plast & Reconstruct Surg, B-9000 Ghent, Belgium. State Univ Ghent Hosp, Dept Radiol, B-9000 Ghent, Belgium. Univ Texas, MD Anderson Canc Ctr, Dept Plast & Reconstruct Surg, Houston, TX 77030 USA. Blondeel, PN (corresponding author), State Univ Ghent Hosp, Dept Plast & Reconstruct Surg, De Pintelaan 185, B-9000 Ghent, Belgium. AN - WOS:000165121600009 AU - Blondeel, P. N. AU - Arnstein, M. AU - Verstraete, K. AU - Depuydt, K. AU - Van Landuyt, K. H. AU - Monstrey, S. J. AU - Kroll, S. S. DA - Nov DO - 10.1097/00006534-200011000-00009 IS - 6 J2 - Plast. Reconstr. Surg. KW - breast reconstruction experience Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 370KD Times Cited: 240 Cited Reference Count: 11 Blondeel, PN Arnstein, M Verstraete, K Depuydt, K Van Landuyt, KH Monstrey, SJ Kroll, SS Blondeel, Phillip/AAG-4920-2021 Blondeel, Phillip/0000-0002-9236-4068 249 0 10 Lippincott williams & wilkins Philadelphia PY - 2000 SN - 0032-1052 SP - 1295-1299 ST - Venous congestion and blood flow in free transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flaps T2 - Plastic and Reconstructive Surgery TI - Venous congestion and blood flow in free transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flaps UR - ://WOS:000165121600009 VL - 106 ID - 4039 ER - TY - JOUR AD - P.N. Blondeel, Dept. of Plastic/Reconst. Surgery, University Hospital Gent, De Pintelaan 185, B-9000 Gent, Belgium AU - Blondell, P. N. DB - Embase Medline DO - 10.1054/bjps.2001.3718 IS - 1 KW - abdominal wall breast reconstruction controlled study letter myocutaneous flap postoperative period priority journal publishing surgical approach venous circulation LA - English M3 - Letter N1 - L34071918 2002-01-30 PY - 2002 SN - 0007-1226 SP - 87 ST - Venous augmentation of the free TRAM flap [1] T2 - British Journal of Plastic Surgery TI - Venous augmentation of the free TRAM flap [1] UR - https://www.embase.com/search/results?subaction=viewrecord&id=L34071918&from=export http://dx.doi.org/10.1054/bjps.2001.3718 VL - 55 ID - 8420 ER - TY - JOUR AB - Venous congestion in a free TRAM or DIEP flap when the main pedicle is still patent (both the artery and the vein) is an occasional dire situation. Here, we describe ways of salvaging the free TRAM or DIEP flap from imminent loss. In the last 4 years, we have had three patients who developed venous congestion after the use of the TRAM or DIEP flap for breast reconstruction. This was detected as late as the third postoperative day in our first patient. On exploration, patent arterial and venous anastomoses were found. Fortunately, the opposite pedicle had been dissected and preserved with the flap. The patent congested vein in this pedicle was anastomosed to the cephalic vein using an interpositional vein graft, relieving he congestion. In the other two patients congestion was detected earlier and relieved using the superficial inferior epigastric vein. It has been our policy to dissect a length of the opposite pedicle and/or preserve a length of the superficial inferior epigastric vein or the superficial circumflex iliac vein. These can then be used to augment venous drainage if inadequacy is noted at the end of the operation or during the postoperative period. (C) 2001 The British Association of Plastic Surgeons. AD - Broomfield Hosp, St Andrews Ctr Plast Surg, Chelmsford CM1 7ET, Essex, England. Niranjan, NS (corresponding author), Weatherby,Goat Hall Lane, Chelmsford CM2 8PG, Essex, England. AN - WOS:000169057300012 AU - Niranjan, N. S. AU - Khandwala, A. R. AU - Mackenzie, D. M. DA - Jun DO - 10.1054/bjps.2000.3587 IS - 4 J2 - Br. J. Plast. Surg. KW - venous augmentation free TRAM flap free DIEP flap venous congestion abdominis musculocutaneous flaps breast reconstruction microvascular augmentation Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 438MH Times Cited: 47 Cited Reference Count: 13 Niranjan, NS Khandwala, AR Mackenzie, DM 49 0 1 Churchill livingstone Edinburgh PY - 2001 SN - 0007-1226 SP - 335-337 ST - Venous augmentation of the free TRAM flap T2 - British Journal of Plastic Surgery TI - Venous augmentation of the free TRAM flap UR - ://WOS:000169057300012 VL - 54 ID - 4000 ER - TY - JOUR AB - Background: Despite improving outcomes, venous problems in the harvest of deep inferior epigastric artery perforator (DIEP) flaps remain the more common vascular complications. However, it is apparent that the venous anatomy of the anterior abdominal wall has not been described to the same extent as the arterial anatomy. Previous anatomical studies have focused on cadaveric anatomy or excisional specimens. The current study uses in vivo computed tomographic angiography to evaluate this anatomy, in combination with a cadaveric radiographic study. Methods: Both cadaveric and in vivo studies were undertaken using eight whole fresh cadaveric specimens (16 sides) and 100 patients undergoing DIEP flap breast reconstruction (200 sides). The cadaveric component used direct catheter venography and the in vivo studies were undertaken using preoperative computed tomographic angiography, mapping in vivo venous flow. Results: The location, caliber, course, and distribution of the superficial and deep inferior epigastric veins were recorded. The dominance of each system and their direction of drainage were described. Mechanisms for poor venous drainage were postulated, including perforator size, midline crossover of the superficial inferior epigastric vein, and the superficial and deep inferior epigastric vein communications. The incidence of each of these anatomical factors was evaluated. Conclusion: The cause of venous compromise is multifactorial, with the current study showing that preoperative computed tomographic angiography may predict venous problems during flap harvest, by demonstrating perforator diameter, midline crossover, and deep-superficial venous communications. (Plast. Reconstr. Surg. 124: 848, 2009.) AD - [Rozen, Warren M.; Pan, Wei-Ren; Le Roux, Cara M.; Taylor, G. Ian; Ashton, Mark W.] Univ Melbourne, Dept Anat & Cell Biol, Jack Brockhoff Reconstruct Plast Surg Res Unit, Parkville, Vic 3050, Australia. Rozen, WM (corresponding author), Univ Melbourne, Dept Anat & Cell Biol, Jack Brockhoff Reconstruct Plast Surg Res Unit, Room E533,Grattan St, Parkville, Vic 3050, Australia. warrenrozen@hotmail.com AN - WOS:000269485200018 AU - Rozen, W. M. AU - Pan, W. R. AU - Le Roux, C. M. AU - Taylor, G. I. AU - Ashton, M. W. DA - Sep DO - 10.1097/PRS.0b013e3181b037a2 IS - 3 J2 - Plast. Reconstr. Surg. KW - inferior epigastric perforator flap breast reconstruction diep flap tram flap artery superdrainage territories drainage system Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 490FT Times Cited: 52 Cited Reference Count: 23 Rozen, Warren M. Pan, Wei-Ren Le Roux, Cara M. Taylor, G. Ian Ashton, Mark W. Rozen, Warren/0000-0002-4092-182X 53 0 5 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2009 SN - 0032-1052 SP - 848-853 ST - The Venous Anatomy of the Anterior Abdominal Wall: An Anatomical and Clinical Study T2 - Plastic and Reconstructive Surgery TI - The Venous Anatomy of the Anterior Abdominal Wall: An Anatomical and Clinical Study UR - ://WOS:000269485200018 VL - 124 ID - 3255 ER - TY - JOUR AB - Background: Despite improving outcomes, venous problems in the harvest of deep inferior epigastric artery perforator (DIEP) flaps remain the more common vascular complications. However, it is apparent that the venous anatomy of the anterior abdominal wall has not been described to the same extent as the arterial anatomy. Cadaveric dissection studies of venous anatomy frequently lack the detail of their arterial counterparts. Venous valves complicate retrograde injection, resulting in poor quality studies with limited anatomical information. Methods: The current manuscript comprises a review of the literature, highlighting key features of the anatomy of the venous drainage of the abdominal wall integument, with particular pertinence to DIEP flaps. Both cadaveric and clinical studies are included in this review. Our own cadaveric and in-vivo studies were undertaken and included in detail in this manuscript, with the cadaveric component utilizing direct catheter venography and the in-vivo studies were undertaken using preoperative computed tomographic angiography (CTA), mapping in-vivo venous flow. Results: Several key features of the venous anatomy of the abdominal wall render it different to other regions, and are of particular importance to DIEP flap transfer. Conclusions: The cause of venous compromise is multi-factorial, with perforator diameter, midline crossover, and deep-superficial venous communications all important. Venous cadaveric studies as well as clinical CTA preoperatively can identify these anomalies. AD - [Rozen, Warren M.; Ashton, Mark W.] Taylor Lab, Dept Anat & Neurosci, Room E533,Grattan St, Parkville, Vic 3050, Australia. Rozen, WM (corresponding author), Taylor Lab, Dept Anat & Neurosci, Room E533,Grattan St, Parkville, Vic 3050, Australia. warrenrozen@hotmail.com AN - WOS:000218837900006 AU - Rozen, W. M. AU - Ashton, M. W. DA - Aug DO - 10.3978/j.issn.2227-684X.2012.06.01 IS - 2 J2 - Gland Surg. KW - Abdominal wall Deep inferior epigastric artery perforator flap DIEA perforator flap venous drainage abdomen vein Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: V4D7C Times Cited: 16 Cited Reference Count: 52 Rozen, Warren M. Ashton, Mark W. Rozen, Warren/0000-0002-4092-182X 16 0 1 Ame publ co Shatin 2227-8575 PY - 2012 SN - 2227-684X SP - 92-110 ST - The venous anatomy of the abdominal wall for Deep Inferior Epigastric Artery (DIEP) flaps in breast reconstruction T2 - Gland Surgery TI - The venous anatomy of the abdominal wall for Deep Inferior Epigastric Artery (DIEP) flaps in breast reconstruction UR - ://WOS:000218837900006 VL - 1 ID - 2720 ER - TY - JOUR AB - Background: Distally based flaps are useful for the treatment of skin defects of the extremities. However, congestion in the peripheral part of the flap due to reverse flow can cause partial flap necrosis. Previously, we reported on the effectiveness of venous anastomoses to rescue peripheral congestion of distally based flaps and applied this idea in a clinical setting. In this report, we present clinical cases of distally based flaps with venous supercharge anastomoses for changing the reverse venous flow into physiological flow, thereby reducing venous congestion. Methods: Four patients with skin defects of the extremities (2 cases with defects of the knee and the upper third of the lower leg, 1 case of the lower third of the lower leg, and 1 case of the distal third of the forearm) were treated with local flaps (2 cases with distally based greater saphenous venoadipofascial sartorius muscle combined flaps, 1 case with a distally based lesser saphenous venoadipofascial flap, and 1 case with a distally based ulnar artery perforator flap). In each reconstruction, 1 or 2 veins in the flaps were anastomosed with superficial veins in the recipient area to change the reverse venous flow into a normal, physiologic flow. Result: All flaps healed completely without any obvious venous congestion or flap necrosis. The coverage quality provided by these defects was satisfactory. Conclusions: Adding venous anastomoses may reduce the risk of venous congestion and improve the outcomes of the distally based flaps. AD - [Ihara, Jun] Keio Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, 35 Shinanomachi, Tokyo 1608582, Japan. [Imanishi, Nobuaki] Keio Univ, Dept Anat, Shinjuku Ku, Tokyo, Japan. [Kishi, Kazuo] Keio Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, Tokyo, Japan. Ihara, J (corresponding author), Keio Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, 35 Shinanomachi, Tokyo 1608582, Japan. junihara423@yahoo.co.jp AN - WOS:000423959400043 AU - Ihara, J. AU - Imanishi, N. AU - Kishi, K. C7 - e1585 DA - Dec DO - 10.1097/gox.0000000000001585 IS - 12 J2 - Prs-Glob. Open KW - breast reconstruction Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: FU6JR Times Cited: 1 Cited Reference Count: 9 Ihara, Jun Imanishi, Nobuaki Kishi, Kazuo 1 0 Lippincott williams & wilkins Philadelphia PY - 2017 SN - 2169-7574 SP - 5 ST - Venous Anastomosis for Prevention of Venous Congestion in Distally Based Flaps T2 - Plastic and Reconstructive Surgery-Global Open TI - Venous Anastomosis for Prevention of Venous Congestion in Distally Based Flaps UR - ://WOS:000423959400043 VL - 5 ID - 1710 ER - TY - JOUR AB - Adequate delay of a pedicled transverse rectus abdominis musculocutaneous (TRAM) flap might not necessarily require interruption of the venous system. The retained ipsilateral deep vein of the dominant pedicle could then be used as a secondary outflow source for potential salvage of a congested flap. A venous "super-charged" rat TRAM flap model has been designed to evaluate the efficacy of this maneuver. Seventy-two female Sprague-Dawley rats (CD) were equally divided into two major groups, differing only in whether a delay by division of the dominant cranial epigastric artery had first been performed. An inferior-based TRAM flap (nondominant) was raised for each rat, with three subsets of 12 rats in each group, ie, with the cranial epigastric vein subsequently divided (group control), retained (supercharged), or retained but the inferior pedicle divided (venous flap). Both supercharged subsets had significantly augmented flap survival when compared with flaps in their group raised without the cranial epigastric vein, whether a delay maneuver had (96 +/- 6% vs 89 +/- 7%; P = 0.012) or not (80 +/- 8% vs 65 +/- 21 %; P = 0.034) been performed. Flaps with only a cranial epigastric vein pedicle totally necrosed, implying that the observed enhancement in flap viability was not the result of transformation into a venous flap, but perhaps as a crossover flap where an adjacent venosome was captured. Venous supercharging can be accomplished by inclusion of the ipsilateral dominant deep vein, and should be a consideration in the clinical planning of delay maneuvers and for treatment of the compromised TRAM flap. AD - Nippon Med Coll, Dept Plast & Reconstruct Surg, Tokyo 113, Japan. Lehigh Valley Hosp, Div Plast Surg, Allentown, PA USA. Lehigh Valley Hosp, Adv Clin Technol Dept, Allentown, PA USA. Hallock, GG (corresponding author), 1230 S Cedar Crest Blvd,Suite 306, Allentown, PA 18103 USA. pbhallock@cs.com AN - WOS:000185879400013 AU - Sano, K. AU - Hallock, G. G. AU - Rice, D. C. DA - Oct DO - 10.1097/01.Sap.0000068111.83104.7f IS - 4 J2 - Ann. Plast. Surg. KW - abdominis musculocutaneous flap immediate breast reconstruction ventral island flap model viability arterial drainage pedicle tissue Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 731HZ Times Cited: 17 Cited Reference Count: 29 Sano, K Hallock, GG Rice, DC 18 0 3 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2003 SN - 0148-7043 SP - 398-402 ST - Venous "supercharging" rat augments survival of the delayed TRAM flap T2 - Annals of Plastic Surgery TI - Venous "supercharging" rat augments survival of the delayed TRAM flap UR - ://WOS:000185879400013 VL - 51 ID - 3838 ER - TY - JOUR AB - Introduction: There is limited data on the indications, outcomes, and associated complications with use of interpositional vein grafts (IVG) in microsurgery. This study sought to critically examine and update the utility of this microsurgical technique. Methods: All microsurgical cases at a single institution from 2005 to 2011 were examined for use of IVGs in the primary procedure or during take back or salvage attempts. We examined the cohort overall and performed a subgroup analysis by timing of initial IVG. Results: In the study period, 1718 patients underwent 2368 free flaps. 51 IVGs were utilized in 38 patients (2.2%) and 38 flaps (1.6%). Eight (42.1%) of the primary procedure IVGs (n=19) were planned preoperatively. Nine total flap losses (24%) occurred when IVGs were utilized, 89% of which occurred in the take back cohort (p=0.02). However, planned IVG had a 100% success rate, and IVG utilized in the primary procedure overall had a 95% success rate. Importantly, A significantly higher rate of thrombotic events was noted in all primary cases where IVGs were utilized (p=0.005). Conclusions: This study demonstrates that IVGs can be utilized in primary free flap reconstructions with success rates exceeding 95%. However, in salvage procedures, the use of vein grafts does not approach the same rate of success likely due to multiple factors. Yet when utilized appropriately with thrombectomy and resection of the thrombosed vessel to healthy intima, IVGs can provide an important tool for flap salvage. Level of Evidence: prognostic/risk category, level II. (C) 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - [Nelson, Jonas A.; Fischer, John P.; Kovach, Stephen J.; Low, David W.; Kanchwala, Suhail K.; Levin, L. Scott; Serletti, Joseph M.; Wu, Liza C.] Hosp Univ Penn, Div Plast Surg, Philadelphia, PA 19104 USA. [Kovach, Stephen J.; Levin, L. Scott] Hosp Univ Penn, Dept Orthopaed Surg, Philadelphia, PA 19104 USA. [Grover, Ritwik] Cleveland Clin, Dept Plast Surg, Cleveland, OH 44106 USA. Nelson, JA (corresponding author), Univ Penn, Div Plast Surg, Perelman Sch Med, 3400 Spruce St, Philadelphia, PA 19104 USA. jonas.nelson@uphs.upenn.edu AN - WOS:000355093400018 AU - Nelson, J. A. AU - Fischer, J. P. AU - Grover, R. AU - Kovach, S. J. AU - Low, D. W. AU - Kanchwala, S. K. AU - Levin, L. S. AU - Serletti, J. M. AU - Wu, L. C. DA - Jun DO - 10.1016/j.bjps.2015.02.008 IS - 6 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - Microsurgery Vein graft Salvage Interpositional Free flap initial platelet deposition free-tissue transfer breast reconstruction lower-extremity microvascular anastomosis perforator flap salvage survival coupler Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: CI9ME Times Cited: 19 Cited Reference Count: 26 Nelson, Jonas A. Fischer, John P. Grover, Ritwik Kovach, Stephen J. Low, David W. Kanchwala, Suhail K. Levin, L. Scott Serletti, Joseph M. Wu, Liza C. Nelson, Jonas/0000-0003-0329-4422 19 0 1 Elsevier sci ltd Oxford 1878-0539 PY - 2015 SN - 1748-6815 SP - 830-836 ST - Vein grafting your way out of trouble: Examining the utility and efficacy of vein grafts in microsurgery T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Vein grafting your way out of trouble: Examining the utility and efficacy of vein grafts in microsurgery UR - ://WOS:000355093400018 VL - 68 ID - 2232 ER - TY - JOUR AB - Background: The vascular anatomy of the anterolateral thigh flap has been well studied, but no study has evaluated the effect of the vastus lateralis motor nerve anatomy on anterolateral thigh flap harvest. Methods: A retrospective review was performed of all anterolateral thigh flaps from January of 2003 through December of 2004. Information regarding the motor nerve to the vastus lateralis muscle was recorded, along with its influence on anterolateral thigh flap harvest. Results: Forty-three anterolateral thigh flap procedures were performed over a 2-year period. In three cases (7 percent), the course of the motor nerve to the vastus lateralis resulted in a significant modification in anterolateral thigh flap harvest. In one case, the motor nerve passed between the venae comitantes of the descending branch of the lateral femoral circumflex artery just proximal to the midperforator origin. In two cases, large skin islands were raised with two perforators included in each flap. The motor nerve passed between the two perforators in these cases. Conclusions: Two patterns ofvastus lateralis motor nerve anatomy can adversely influence anterolateral thigh flap elevation. One involves the motor nerve passing through the main vascular pedicle. The other occurs when multiple perforators are required to support large flaps with the motor nerve passing between these perforators. In some cases, the course of the nerve may require transection of the nerve, with a subsequent deficit in vastus lateralis function. In similar cases, if the nerve is preserved, the vascular pedicle may require significant modification, which may possibly compromise flap perfusion. AD - Mayo Clin, Div Plast & Reconstruct Surg, Scottsdale, AZ 85259 USA. Mayo Clin, Dept Gen Surg, Scottsdale, AZ 85259 USA. Mayo Clin, Dept Otolaryngol, Scottsdale, AZ 85259 USA. Univ Manitoba, Plast & Reconstruct Surg Sect, Winnipeg, MB, Canada. Casey, WJ (corresponding author), Mayo Clin, Div Plast & Reconstruct Surg, 13400 E Shea Blvd, Scottsdale, AZ 85259 USA. casey.williamjoseph@mayo.edu AN - WOS:000247388000026 AU - Casey, W. J. AU - Rebecca, A. M. AU - Smith, A. A. AU - Craft, R. O. AU - Hayden, R. E. AU - Buchel, E. W. DA - Jul DO - 10.1097/01.prs.0000264098.05399.6a IS - 1 J2 - Plast. Reconstr. Surg. KW - femoral arterial system soft-tissue flap breast reconstruction neck defects donor site free tram head ideal perforators experience Surgery LA - English M3 - Article; Proceedings Paper N1 - ISI Document Delivery No.: 180TD Times Cited: 17 Cited Reference Count: 25 Casey, William J., III Rebecca, Alanna M. Smith, Anthony A. Craft, Randall O. Hayden, Richard E. Buchel, Edward W. 9th International Perforator Flap Conference Oct, 2005 Barcelona, SPAIN 18 0 2 Lippincott williams & wilkins Philadelphia PY - 2007 SN - 0032-1052 SP - 196-201 ST - Vastus lateralis motor nerve can adversely affect anterolateral thigh flap harvest T2 - Plastic and Reconstructive Surgery TI - Vastus lateralis motor nerve can adversely affect anterolateral thigh flap harvest UR - ://WOS:000247388000026 VL - 120 ID - 3527 ER - TY - JOUR AB - BACKGROUND: Perioperatively, patients' hemodynamics are modulated predominantly by intravenous fluid administration and vasoactive pharmacological support. Vasopressor agents are suspected to be detrimental on free flap survival by the cause of vasoconstriction of the pedicle with consecutive reduced overall flap perfusion and by aggravation of flap dissection. OBJECTIVE: A novel, standardized fluid restrictive perioperative hemodynamic management was assessed for its feasibility in clinical practice in free flap patients undergoing breast reconstruction. METHODS: Patients were randomized to two perioperative regimens with different fluid and vasopressor limits. The primary endpoint regarded flap survival. Secondary endpoints included surgery times, time of patient ambulation and length of hospital stay. RESULTS: There was one total flap failure with liberal fluid administration (LFA). No total or partial flap failure was noted in the fluid restrictive regimen with norepinephrine administration up to 0.04μg/kg/min (FRV). No delay regarding operation time (p = 0.217), patient mobilization (p = 0.550) or hospital discharge (p = 0.662) was registered in the FRV study subpopulation compared to LFA. CONCLUSIONS: The results of this prospective interventional trial could not detect any negative impact of vasopressors, neither for the primary endpoint of flap survival nor for the overall patient outcome. The fear of vasopressor associated flap complications has led to a traditional liberal fluid administration, which failed to demonstrate any benefits when compared to a fluid restrictive vasopressor strategy. AN - CN-01605734 AU - Anker, A. M. AU - Prantl, L. AU - Strauss, C. AU - Brébant, V. AU - Heine, N. AU - Lamby, P. AU - Geis, S. AU - Schenkhoff, F. AU - Pawlik, M. AU - Klein, S. M. DO - 10.3233/CH-189129 IS - 1‐2 KW - *breast reconstruction *deep inferior epigastric perforator flap *hypertension/dt [Drug Therapy] *hypertension/pc [Prevention] *infusion fluid *noradrenalin/ae [Adverse Drug Reaction] *noradrenalin/dt [Drug Therapy] Adult Anastomotic device Article Atracurium besilate Blood pressure monitoring Clinical article Clinical outcome Controlled study Epigastric Arteries [*physiopathology] Feasibility study Female Foley balloon catheter Free Tissue Flaps [blood supply, *surgery] Graft failure/si [Side Effect] Graft perfusion Hemodynamics Hospital discharge Human Humans Hypertension/dt [Drug Therapy] Hypodermoclysis [*methods] Length of stay Male Mammaplasty [*methods] Middle Aged Mobilization Perforator Flap [blood supply, *surgery] Propofol Prospective Studies Randomized controlled trial Sevoflurane Sufentanil Surgical technique Treatment duration Vasoconstriction Vasoconstrictor Agents [pharmacology, *therapeutic use] M3 - Journal Article; Randomized Controlled Trial PY - 2018 SP - 37‐44 ST - Vasopressor support vs. liberal fluid administration in deep inferior epigastric perforator (DIEP) free flap breast reconstruction - a randomized controlled trial T2 - Clinical hemorheology and microcirculation TI - Vasopressor support vs. liberal fluid administration in deep inferior epigastric perforator (DIEP) free flap breast reconstruction - a randomized controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01605734/full VL - 69 ID - 96 ER - TY - JOUR AB - Based on the dissection of 20 fresh cadaver legs, the authors have further defined the vascular anatomy of the peroneal artery and its cutaneous perforator vessels. They identified a total of 95 cutaneous perforators of the peroneal artery greater then 0.3 mm in 20 legs. The average number of cutaneous perforators was 4.8 (range: three to seven) per leg. The cutaneous perforators were either musculocutaneous (34 percent) or septocutaneous (66 percent). The musculocutaneous perforators were found predominantly in the upper two-thirds of the lower leg; the septocutaneous perforators were located in the lower two-thirds of the leg. The external diameter of the cutaneous perforators at the posterior border of the fibula was 0.6 (range: 0.3 to 1.5) mm. The blood supply of the proximal fibula epiphysis and fibula head was found not to be in the vascular territory of the peroneal artery. These results are the basis of the established osteoseptocutaneous fibula transfer, the peroneal fasciocutaneous free flap, and the double-paddle peroneal tissue transfer that all require dissection of highly vascularized tissue adjacent to the fibula, in order to reach the peroneal vessels. These constant anatomic findings should encourage the surgeon to harvest skin flaps just to the level of the posterior border of the fibula, thereby creating perforator flaps based on the peroneal system. AD - Univ Heidelberg, BG Trauma Ctr Ludwigshafen, Dept Plast Reconstruct & Hand Surg, D-67071 Ludwigshafen, Germany. Duke Univ, Med Ctr, Div Plast Reconstruct Maxillofacial & Oral Surg, Durham, NC USA. Heitmann, C (corresponding author), Univ Heidelberg, BG Trauma Ctr Ludwigshafen, Dept Plast Reconstruct & Hand Surg, Ludwig Guttman Str 13, D-67071 Ludwigshafen, Germany. AN - WOS:000182976900005 AU - Heitmann, C. AU - Khan, F. N. AU - Levin, L. S. DA - Apr IS - 3 J2 - J. Reconstr. Microsurg. KW - peroneal artery vasculature perforator vessels perforator flaps breast reconstruction tissue transfer skin flap fibula defects leg Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 680KP Times Cited: 47 Cited Reference Count: 23 Heitmann, C Khan, FN Levin, LS 54 0 3 Thieme medical publ inc New york PY - 2003 SN - 0743-684X SP - 157-162 ST - Vasculature of the peroneal artery: An Anatomic study focused on the perforator vessels T2 - Journal of Reconstructive Microsurgery TI - Vasculature of the peroneal artery: An Anatomic study focused on the perforator vessels UR - ://WOS:000182976900005 VL - 19 ID - 3887 ER - TY - JOUR AB - Only a few reports describe chest wall reconstruction after sternal resection using Gore-Tex dual mesh, and very few reports describe the use of a vascularized rib to support the thoracic cage. We present a case of a breast cancer patient who underwent anterior chest wall resection for recurrent sternal cancer. Her sternoclavicular joints bilaterally and lower sternum were divided using an electric saw. The bony chest wall was reconstructed using Gore-Tex dual mesh, and a vascularized rib was used to bridge the space between the clavicular heads to support the thoracic cage. The patient's postoperative course was uneventful, without complications, such as paradoxical respiration or pneumonia. AD - Department of Surgery, Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa, Chiba 277-8567, Japan. akiba@jikei.ac.jp AN - 21873364 AU - Akiba, T. AU - Takeishi, M. AU - Kinoshita, S. AU - Morikawa, T. DA - Nov DO - 10.1510/icvts.2011.275479 DP - NLM ET - 2011/08/30 IS - 5 KW - Bone Neoplasms/diagnostic imaging/secondary/*surgery Breast Neoplasms/pathology Equipment Design Female Humans Middle Aged Neoplasm Recurrence, Local *Osteotomy *Polytetrafluoroethylene Reconstructive Surgical Procedures/*instrumentation Ribs/*blood supply/*surgery Sternoclavicular Joint/surgery Sternum/diagnostic imaging/pathology/*surgery Surgical Flaps *Surgical Mesh Tomography, X-Ray Computed Treatment Outcome LA - eng N1 - 1569-9285 Akiba, Tadashi Takeishi, Meisei Kinoshita, Satoki Morikawa, Toshiaki Case Reports Journal Article England Interact Cardiovasc Thorac Surg. 2011 Nov;13(5):536-8. doi: 10.1510/icvts.2011.275479. Epub 2011 Aug 26. PY - 2011 SN - 1569-9285 SP - 536-8 ST - Vascularized rib support for chest wall reconstruction using Gore-Tex dual mesh after wide sternochondral resection T2 - Interact Cardiovasc Thorac Surg TI - Vascularized rib support for chest wall reconstruction using Gore-Tex dual mesh after wide sternochondral resection VL - 13 ID - 13832 ER - TY - JOUR AB - BACKGROUND: Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema. Multiple methods have been described and each has significant disadvantages. STUDY DESIGN: We performed VLNT in patients with upper extremity lymphedema resulting from breast cancer surgery. We used lymph nodes of the greater curvature of the stomach (VLNTg). We describe outcomes of the patients suffering from postmastectomy lymphedema who received VLNTg for treatment of lymphedema. Harvest from the periphery of the left gastroepiploic vessel was conducted. RESULTS: We retrospectively reviewed data of 24 female patients suffering from lymphedema following breast cancer treatment who underwent lymph node transplantation from 2012 to 2017. Axillary lymphadenectomy had been performed in all cases. In 18 patients, upper limb lymphedema was present for at least 1 year (mean = 5.6 years; range, 1-15 years). In 6 patients, it was present for only a few months (mean = 5 months; range, 3-8 months). CONCLUSIONS: The greater curvature of the stomach nodes (VLNTg) is an excellent option for the treatment of upper extremity lymphedema because there is no risk of complications and the scar is easily concealed. Improvement from lymphedema can be expected in a majority of patients. AD - Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AN - 31309574 AU - Mousavi, S. R. AU - Akbari, M. E. AU - Zarrintan, S. DA - Jan DO - 10.1002/jso.25607 DP - NLM ET - 2019/07/17 IS - 1 KW - Adult Aged Breast Cancer Lymphedema/*surgery Breast Neoplasms/surgery Female Humans Lymph Nodes/*blood supply/surgery/*transplantation Mastectomy/adverse effects Middle Aged Postoperative Complications/etiology/surgery Retrospective Studies Surgical Flaps/*blood supply/*surgery Upper Extremity lymphedema nodes of the greater curvature of the stomach postmastectomy LA - eng N1 - 1096-9098 Mousavi, Seyed R Orcid: 0000-0002-7796-863x Akbari, Mohammad E Zarrintan, Sina Journal Article United States J Surg Oncol. 2020 Jan;121(1):163-167. doi: 10.1002/jso.25607. Epub 2019 Jul 16. PY - 2020 SN - 0022-4790 SP - 163-167 ST - Vascularized gastroepiploic lymph node transfer significantly improves breast cancer-related lymphedema T2 - J Surg Oncol TI - Vascularized gastroepiploic lymph node transfer significantly improves breast cancer-related lymphedema VL - 121 ID - 13515 ER - TY - JOUR AB - PURPOSE: The transverse upper gracilis (TUG) myocutaneous flap has served as an alternative to abdominally based autologous breast reconstruction since its introduction by Yousif et al in 1992. The reliability of the overlying skin paddle of the gracilis myocutaneous flap depends on the perforator anatomy as well as the vascular pedicle. Although much attention recently has been given to variations in the septocutaneous as well as myocutaneous perforators, we believe that relevant variations in pedicle anatomy have been underappreciated. We would like to report our experience with pedicle variability. METHODS: A retrospective review of records was performed on patients undergoing a TUG flap for autologous breast reconstruction from July 2006 and November 2011 by a single surgeon (L.C.W.). RESULTS: A total of 36 TUG flaps were performed on 24 patients. Twelve patients underwent bilateral simultaneous TUG reconstruction, and 12 patients underwent unilateral TUG reconstruction. Pedicle variability was found in 6 (17%) of 36 dissections. In 5.5% of dissections, there was a split pedicle and 11% were found to have a double main pedicle. There was 1 partial flap loss that resulted in a failed breast reconstruction. Four limbs had some degree of resultant lymphedema as a consequence of flap harvest. CONCLUSIONS: Although still a viable alternative to abdominally based autologous reconstruction, we find that the variability of the main pedicle has been quite underestimated in earlier reports. We also present a logical algorithm for flap dissection when the microsurgeon encounters such aberrancies. AD - From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA. AN - 24401804 AU - Natoli, N. B. AU - Wu, L. C. DA - May DO - 10.1097/01.sap.0000435501.19566.75 DP - NLM ET - 2014/01/10 IS - 5 KW - Adult Algorithms Decision Support Techniques Female Femoral Artery/*abnormalities/surgery Humans Mammaplasty/*methods Middle Aged Myocutaneous Flap/*blood supply Retrospective Studies Thigh/*blood supply LA - eng N1 - 1536-3708 Natoli, Noël Blythe Wu, Liza C Case Reports Journal Article United States Ann Plast Surg. 2015 May;74(5):528-31. doi: 10.1097/01.sap.0000435501.19566.75. PY - 2015 SN - 0148-7043 SP - 528-31 ST - Vascular variations of the transverse upper gracilis flap in consideration for breast reconstruction T2 - Ann Plast Surg TI - Vascular variations of the transverse upper gracilis flap in consideration for breast reconstruction VL - 74 ID - 13159 ER - TY - JOUR AB - The vascular territories of the superior and the deep inferior epigastric arteries were investigated by dye injection, dissection, and barium radiographic studies. By these means it was established that the deep inferior epigastric artery was more significant than the superior epigastric artery in supplying the skin of the anterior abdominal wall. Segmental branches of the deep epigastric system pass upward and outward into the neurovascular plane of the lateral abdominal wall, where they anastomose with the terminal branches of the lower six intercostal arteries and the ascending branch of the deep circumflex iliac artery. The anastomoses consist of multiple narrow "choke" vessels. Similar connections are seen between the superior and the deep inferior epigastric arteries within the rectus abdominis muscle well above the level of the umbilicus. Many perforating arteries emerge through the anterior rectus sheath, but the highest concentration of major perforators is in the paraumbilical area. These vessels are terminal branches of the deep inferior epigastric artery. They feed into a subcutaneous vascular network that radiates from the umbilicus like the spokes of a wheel. Once again, choke connections exist with adjacent territories: inferiorly with the superficial inferior epigastric artery, inferolaterally with the superficial circumflex iliac artery, and superiorly with the superficial superior epigastric artery. The dominant connections, however, are superolaterally with the lateral cutaneous branches of the intercostal arteries. For breast reconstruction, it would appear that prior ligation of the deep inferior epigastric artery would be of advantage when elevating the lower abdominal skin on a superiorly based rectus abdominis musculocutaneous flap. The vascularity of this flap would be further increased by positioning some part of the skin paddle over the dense pack of large paraumbilical perforators. Based on these anatomic studies, the relative merits of the superior and deep inferior epigastric arteries with respect to local and distant tissue transfer using various elements of the abdominal wall are discussed in detail. AN - 6197716 AU - Boyd, J. B. AU - Taylor, G. I. AU - Corlett, R. DA - Jan DO - 10.1097/00006534-198401000-00001 DP - NLM ET - 1984/01/01 IS - 1 KW - Abdominal Muscles/anatomy & histology/*blood supply Arteries/anatomy & histology Barium Sulfate Cadaver *Carbon Coloring Agents Dissection Humans Skin/blood supply Staining and Labeling Surgical Flaps LA - eng N1 - Boyd, J B Taylor, G I Corlett, R Journal Article Research Support, Non-U.S. Gov't United States Plast Reconstr Surg. 1984 Jan;73(1):1-16. doi: 10.1097/00006534-198401000-00001. PY - 1984 SN - 0032-1052 (Print) 0032-1052 SP - 1-16 ST - The vascular territories of the superior epigastric and the deep inferior epigastric systems T2 - Plast Reconstr Surg TI - The vascular territories of the superior epigastric and the deep inferior epigastric systems VL - 73 ID - 13928 ER - TY - JOUR AB - In case blood perfusion compromises, vascular enhancement with arterial supercharge or venous superdrainage can increase viability of the flap. In this study, vascular pressure monitorization was used in a rat extended abdominal perforator flap model to reveal intraoperative vascular compromise and the need for vascular augmentation. A rat abdominal perforator flap was designed, which was based on the right second cranial perforator of epigastric artery. Vascular pressures of the flap were monitored continuously for 60 min, by catheters placed in the right superficial inferior epigastric artery and vein. Forty rats were divided into four experimental groups, as follows: group 1 (n = 10, no vascular augmentation), group II (n = 10, arterial supercharge), group III (n = 10, venous superdrainage), and group IV (n = 10, arterial and venous augmentation). Arterial supercharge and/or venous superdrainage were performed by using the left superficial inferior epigastric artery and vein. After the rats were sacrificed on the 7th day, total flap area and necrotic regions were evaluated. Mean arterial blood pressure was found significantly lower (P < 0.05) and mean venous blood pressure was measured significantly higher (P < 0.05) in group I than the groups II, III, and IV. Flap survival area was also larger in the groups II, III, and IV than the group I (P < 0.05). The results of this experimental study demonstrate that arterial insufficiency and venous congestion are almost always present in the rat extended abdominal perforator flap model, similar to deep inferior epigastric perforator flap. When such an extended perforator flap is used, arterial and venous pressure monitorization may be considered as a tool to support intraoperative clinical findings to reveal the need of vascular augmentation and ascertain flap viability. (C) 2012 Wiley Periodicals, Inc. Microsurgery, 2012. AD - [Gumus, Nazim] Cumhuriyet Univ, Dept Plast Reconstruct & Aesthet Surg, Fac Med, Sivas, Turkey. [Erkan, Muhammet] Trabzon State Hosp, Dept Reconstruct & Aesthet Surg, Trabzon, Turkey. [Ercocen, Ali Riza] Bayindir Hosp, Dept Plast Reconstruct & Aesthet Surg, Istanbul, Turkey. Gumus, N (corresponding author), Cumhuriyet Univ, Dept Plast Reconstruct & Aesthet Surg, Fac Med, Sivas, Turkey. gumus1970@hotmail.com AN - WOS:000303746900008 AU - Gumus, N. AU - Erkan, M. AU - Ercocen, A. R. DA - May DO - 10.1002/micr.21952 IS - 4 J2 - Microsurgery KW - breast reconstruction survival tram flow Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 938QB Times Cited: 2 Cited Reference Count: 13 Gumus, Nazim Erkan, Muhammet Ercocen, Ali Riza Gumus, Nazim/P-8570-2019; Gumus, Nazim/Q-1709-2017 Gumus, Nazim/0000-0002-2422-6456; Gumus, Nazim/0000-0002-2422-6456 3 0 7 Wiley Hoboken 1098-2752 PY - 2012 SN - 0738-1085 SP - 303-308 ST - Vascular pressure monitorization for necessity of vascular augmentation in a rat extended abdominal perforator flap model T2 - Microsurgery TI - Vascular pressure monitorization for necessity of vascular augmentation in a rat extended abdominal perforator flap model UR - ://WOS:000303746900008 VL - 32 ID - 2758 ER - TY - JOUR AB - Free flap vascular pedicle avulsion represents an extremely rare complication in reconstructive microsurgery. Very few cases have been reported in the literature, most of them identified in free flap breast reconstruction. As a result, little data is currently available on the etiology and treatment of this rare complication. Herein, we report a unique case of early venous anastomosis avulsion following free DIEP flap transfer for delayed breast reconstruction. Venous outflow was successfully restored with the use of an interposition vein graft, and the flap survived completely. In addition, the relevant literature is reviewed; and the possible causes, preventive strategies, and management options are analyzed. (C)2010 Wiley-Liss, Inc. Microsurgery 30:233-237, 2010. AD - [Lykoudis, Efstathios G.; Ziogas, Dimosthenis E.; Papanikolaou, George E.] Univ Ioannina, Sch Med, Dept Plast Surg, GR-45110 Ioannina, Greece. Lykoudis, EG (corresponding author), Univ Ioannina, Sch Med, Dept Plast Surg, Univ Campus, GR-45110 Ioannina, Greece. elykoudi@cc.uoi.gr AN - WOS:000275924400011 AU - Lykoudis, E. G. AU - Ziogas, D. E. AU - Papanikolaou, G. E. DO - 10.1002/micr.20738 IS - 3 J2 - Microsurgery KW - plasminogen-activator survival thrombosis injury patient repair site Surgery LA - English M3 - Review N1 - ISI Document Delivery No.: 573OS Times Cited: 3 Cited Reference Count: 26 Lykoudis, Efstathios G. Ziogas, Dimosthenis E. Papanikolaou, George E. Ziogas, Demosthenes E./D-7973-2011; Papanikolaou, Georgios/AAI-3868-2020 Ziogas, Demosthenes E./0000-0003-2234-8393; 3 0 2 Wiley-liss Hoboken PY - 2010 SN - 0738-1085 SP - 233-237 ST - VASCULAR PEDICLE AVULSION IN FREE FLAP BREAST RECONSTRUCTION: A CASE OF DIEP FLAP SALVAGE FOLLOWING EARLY AVULSION OF VENOUS ANASTOMOSIS AND LITERATURE REVIEW T2 - Microsurgery TI - VASCULAR PEDICLE AVULSION IN FREE FLAP BREAST RECONSTRUCTION: A CASE OF DIEP FLAP SALVAGE FOLLOWING EARLY AVULSION OF VENOUS ANASTOMOSIS AND LITERATURE REVIEW UR - ://WOS:000275924400011 VL - 30 ID - 3175 ER - TY - JOUR AB - Objective: Cytokines may be a mechanism by which surgical delay can increase flap survival. We previously found that preoperative vascular endothelium growth factor (VEGF) administration in the rat transverse rectus abdominis myocutaneous (TRAM) flap could improve skin paddle survival. In this study, we used partial elevation of the rat TRAM flap as a surgical delay to assess endogenous cytokine expression and tissue survival comparable to undelayed TRAM flaps. Methods: In Part I, TRAM flaps underwent surgical delay procedures; 7 days later, the flaps were completely elevated and reinset. At the same time, other flaps were raised and reinset without delay. Skin paddle survival in both groups was evaluated at 7 days. In Part II, skin biopsies from TRAM zones I to IV were taken at the time of delay and at intervals of 12, 24, 48, and 72 hours. Specimens were assessed for selected cytokine gene expression by reverse transcription-polymerase chain reaction analysis (TR-PCR). Results: Surgical delay significantly (P < 0.001) increased skin paddle survival in the delayed TRAM flaps (16.14 +/- 1.53 cm, 81.9%) compared with undelayed flaps (7.68 +/- 3.16 cm, 40.9%). TGF-beta and PDGF expressions were not changed by surgical delay, but basic fibroblast growth factor (bFGF) and VEGF expressions increased significantly (P < 0.05 and P < 0.01) after delay. Conclusions: In the rat TRAM model, surgical delay resulted in increased VEGF expression and increased skin paddle survival. These results correlate with previous studies showing the preoperative injection of VEGF increases skin paddle survival. VEGF may be an important element in the delay phenomenon and may be an agent for pharmacological delay. AD - Univ Mississippi, Med Ctr, Div Plast Surg, Jackson, MS 39216 USA. Lineaweaver, WC (corresponding author), Univ Mississippi, Med Ctr, Div Plast Surg, 2500 N State St, Jackson, MS 39216 USA. wlineaweaver@surgery.umsmed.edu AN - WOS:000221622600026 AU - Lineaweaver, W. C. AU - Lei, M. P. AU - Mustain, W. AU - Oswald, T. M. AU - Cui, D. M. AU - Zhang, F. DA - Jun DO - 10.1097/01.sla.0000128682.53915.92 IS - 6 J2 - Ann. Surg. KW - unipedicled tram flap blood-flow breast reconstruction myocutaneous flap factor vegf factor-beta rats angiogenesis model hemodynamics Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 823OM Times Cited: 84 Cited Reference Count: 50 Lineaweaver, WC Lei, MP Mustain, W Oswald, TM Cui, DM Zhang, F 88 0 Lippincott williams & wilkins Philadelphia PY - 2004 SN - 0003-4932 SP - 866-873 ST - Vascular endothelium growth factor, surgical delay, and skin flap survival T2 - Annals of Surgery TI - Vascular endothelium growth factor, surgical delay, and skin flap survival UR - ://WOS:000221622600026 VL - 239 ID - 3791 ER - TY - JOUR AB - Background: Vascular thrombosis with flap loss is the most dreaded complication of microvascular free tissue transfer. Thrombolytic agents such as tissue plasminogen activator have been used clinically for free flap salvage in cases of pedicle thrombosis. Yet, there is a paucity of data in the literature validating the benefit of their use. Methods: A retrospective review of the breast reconstruction free flap database was performed at a single institution between the years of 1991-2010. The incidence of vascular complications (arterial and/or venous thrombosis) was examined to determine the role of adjuvant thrombolytic therapy in flap salvage. Pathologic examination was used to determine the incidence of fat necrosis after secondary revision procedures. Results: Seventy-four cases were identified during the study period. In 41 cases, revision of the anastamoses was performed alone without thrombolytics with 38 cases of successful flap salvage (92.7%). In 33 cases, anastamotic revision was performed with adjuvant thrombolytic therapy, and successful flap salvage occurred in 28of these cases (84.8%). Thrombolysis did not appear to significantly affect flap salvage. Interestingly, only two of the salvaged flaps that had received thrombolysis developed fat necrosis, whereas 11 of the nonthrombolysed flaps developed some amount fat necrosis (7.1% vs. 28.9%, P < 0.05). Conclusions: The decreased incidence of fat necrosis may be attributable to dissolution of thrombi in the microvasculature with the administration of thrombolytics. Although the use of adjuvant thrombolytic therapy does not appear to impact the rate of flap salvage, their use may have secondary benefits on overall flap outcomes. © 2011 Wiley-Liss, Inc. Microsurgery. AD - C.A. Crisera, UCLA Division of Plastic and Reconstructive Surgery, 200 UCLA Medical Center Plaza, Los Angeles, CA 90095, United States AU - Chang, E. I. AU - Mehrara, B. J. AU - Festekjian, J. H. AU - Da Lio, A. L. AU - Crisera, C. A. DB - Embase Medline DO - 10.1002/micr.20905 IS - 7 KW - fibrinolytic agent artery thrombosis blood clot lysis breast surgery fat necrosis free tissue graft histopathology human major clinical study microvascular free tissue transfer microvascularization priority journal retrospective study review salvage therapy vascular disease vein thrombosis LA - English M3 - Review N1 - L51456349 2011-06-04 2011-10-18 PY - 2011 SN - 0738-1085 1098-2752 SP - 505-509 ST - Vascular complications and microvascular free flap salvage: The role of thrombolytic agents T2 - Microsurgery TI - Vascular complications and microvascular free flap salvage: The role of thrombolytic agents UR - https://www.embase.com/search/results?subaction=viewrecord&id=L51456349&from=export http://dx.doi.org/10.1002/micr.20905 VL - 31 ID - 7267 ER - TY - JOUR AB - Background: Perforator flaps based on the integument of the trunk have been well described in the literature; however, the anatomy of many donor sites has yet to be adequately documented. The integument of the lateral lumbar region of the trunk is supplied by a number of source arteries (lower posterior intercostal, lumbar, superior epigastric, deep inferior epigastric, superficial inferior epigastric, superficial circumflex iliac, deep circumflex iliac) whose large perforators may be suitable for perforator flap harvest. The purpose of the current study was to describe the vascular anatomy of these perforators in the lateral lumbar region. Methods: A series of five fresh human cadavers were studied using a lead oxide-gelatin injection technique. The integument of the trunk (10 sides or hemitrunk specimens) was dissected, and the perforating vessels (diameter >= 0.5 mm) were identified, noting vascular origin, diameter, and pedicle length. Radiographs of tissue specimens were digitally analyzed using the software Scion Image for Windows (Scion Corp., Frederick, Md.) to determine vascular territories. Results: The source vessels contributed a summed mean of 33 perforators per hemitrunk, with a mean emerging vessel diameter of 0.7 +/- 0.2 mm and a corresponding mean superficial pedicle length of 31 +/- 24 mm. The total area of skin supplied directly by these 33 perforators was 1200 cm(2), equating to a mean area of 37 cm 2 per perforator. Conclusion: The authors have comprehensively described the anatomy of perforators of the lateral lumbar region of the trunk. AD - Dalhousie Univ, Dept Anat & Neurobiol, Halifax, NS B3H 3J5, Canada. Dalhousie Univ, Dept Surg, Halifax, NS B3H 3J5, Canada. Morris, SF (corresponding author), Div Plast Surg, 1796 Summer St,Room 4443, Halifax, NS B3H 3A7, Canada. sfmorris@dal.ca AN - WOS:000228884600024 AU - Offman, S. L. AU - Geddes, C. R. AU - Tang, M. L. AU - Morris, S. F. DA - May DO - 10.1097/01.Prs.0000161464.11134.C1 IS - 6 J2 - Plast. Reconstr. Surg. KW - breast reconstruction lumbosacral defects iliac crest island flap skin flaps muscle experience coverage design Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 923BV Times Cited: 44 Cited Reference Count: 33 Offman, SL Geddes, CR Tang, ML Morris, SF Geddes, Christopher/0000-0002-8015-2586 49 0 2 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2005 SN - 0032-1052 SP - 1651-1659 ST - The vascular basis of perforator flaps based on the source arteries of the lateral lumbar region T2 - Plastic and Reconstructive Surgery TI - The vascular basis of perforator flaps based on the source arteries of the lateral lumbar region UR - ://WOS:000228884600024 VL - 115 ID - 3721 ER - TY - JOUR AB - The extended latissimus dorsi (LD) flap, which includes adipofascial tissue around the posterior iliac crest, is a good option to reconstruct a large breast. However, poor vascularity in the extended part may cause partial fat necrosis. To minimise this problem, vascular augmentation of the extended adipofascial part was performed. When dissecting under the LD muscle, a single perforator from the 11th intercostal vessels was secured and traced upwards along the rib. After the flap was transferred to the chest, the intercostal vessels were anastomosed to the serratus branches of thoracodorsal vessels. This vascular supercharged extended LD flap technique was applied for selected patients. Intraoperative angiography showed that the contrast medium injected into the intercostal artery spread across the lumbar adipofascial part of the flap. This implies that vascular supercharge through the 11th intercostal vessel promotes the vascularity of the extended LD flap and may help to reduce the flap complication rate. © 2013 Informa Healthcare. AD - S. Takagi, Department of Plastic, Reconstructive, and Aesthetic Surgery, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan AU - Takagi, S. AU - Oyama, T. AU - Yamazumi, K. AU - Eto, A. AU - Ohjimi, H. DB - Medline DO - 10.3109/2000656X.2012.738608 IS - 2 KW - aged anastomosis angiography article breast reconstruction case report computer assisted surgery female human methodology patient monitoring rib skeletal muscle surgical flaps transplantation vascularization LA - English M3 - Article N1 - L368585840 2013-06-17 PY - 2013 SN - 2000-656X SP - 123-125 ST - Vascular augmentation of an extended latissimus dorsi myocutaneous flap through an intercostal vessel: A preliminary report T2 - Journal of Plastic Surgery and Hand Surgery TI - Vascular augmentation of an extended latissimus dorsi myocutaneous flap through an intercostal vessel: A preliminary report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L368585840&from=export http://dx.doi.org/10.3109/2000656X.2012.738608 VL - 47 ID - 6853 ER - TY - JOUR AB - Abstract The extended latissimus dorsi (LD) flap, which includes adipofascial tissue around the posterior iliac crest, is a good option to reconstruct a large breast. However, poor vascularity in the extended part may cause partial fat necrosis. To minimise this problem, vascular augmentation of the extended adipofascial part was performed. When dissecting under the LD muscle, a single perforator from the 11th intercostal vessels was secured and traced upwards along the rib. After the flap was transferred to the chest, the intercostal vessels were anastomosed to the serratus branches of thoracodorsal vessels. This vascular supercharged extended LD flap technique was applied for selected patients. Intraoperative angiography showed that the contrast medium injected into the intercostal artery spread across the lumbar adipofascial part of the flap. This implies that vascular supercharge through the 11th intercostal vessel promotes the vascularity of the extended LD flap and may help to reduce the flap complication rate. AN - RN329403407 AU - Takagi, S. AU - Oyama, T. AU - Yamazumi, K. AU - Eto, A. AU - Ohjimi, H. CN - 617.95 TP 5040.696000 LA - English N1 - Bi-monthly: 5-8 issues per year United Kingdom Informa Healthcare PY - 2013 SN - 2000-656X SP - 123 - 125 ST - Vascular augmentation of an extended latissimus dorsi myocutaneous flap through an intercostal vessel T2 - Journal of Plastic Surgery and Hand Surgery TI - Vascular augmentation of an extended latissimus dorsi myocutaneous flap through an intercostal vessel VL - 47, NUMB 2 ID - 215 ER - TY - JOUR AD - C. Hill AU - Hill, C. AU - Millar, R. DB - Medline DO - 10.1097/00006534-199704000-00061 IS - 4 KW - breast reconstruction case report female human letter methodology middle aged plastic surgery LA - English M3 - Letter N1 - L127238008 1997-04-08 PY - 1997 SN - 0032-1052 SP - 1199-1200 ST - Vascular assymetry in a "circummuscular" free tram pedicle--a potential hazard T2 - Plastic and reconstructive surgery TI - Vascular assymetry in a "circummuscular" free tram pedicle--a potential hazard UR - https://www.embase.com/search/results?subaction=viewrecord&id=L127238008&from=export http://dx.doi.org/10.1097/00006534-199704000-00061 VL - 99 ID - 8705 ER - TY - JOUR AB - 50 anatomical dissections on 30 fresh cadavers with blue dye coloration of the pedicle, angiography and vascular visualization by methyl methacrylate have been performed. The transverse branch of the lateral circumflex femoral artery (LCFA) was found to be the dominant vessel to the trochanteric area. The length of the pedicle was always more than 6 cm and the caliber more than 2 mm. The main branch of the pedicle reaches the fat tissue as a large perforator vessel after leaving minor branches to the tensor fascia lata muscle (TFL). We believe that it is possible to raise the fat tissue of the trochanteric area as a lateral circumflex femoral perforator flap (LCFP-flap). AD - Ferdinand Sauerbruch Klinikum, Dept Plast & Hand Surg, D-42117 Wuppertal, Germany. Heitmann, C (corresponding author), Ferdinand Sauerbruch Klinikum, Dept Plast & Hand Surg, Arrenbergstr 20, D-42117 Wuppertal, Germany. AN - WOS:000074674100001 AU - Heitmann, C. AU - Kawajah, S. AU - Felmerer, G. AU - Ingianni, G. DA - Jun DO - 10.1007/s002380050074 IS - 5 J2 - Eur. J. Plast. Surg. KW - perforator flap lateral circumflex femoral artery trochanteric area breast reconstruction Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: ZY903 Times Cited: 4 Cited Reference Count: 7 Heitmann, C Kawajah, S Felmerer, G Ingianni, G 4 0 Springer verlag New york PY - 1998 SN - 0930-343X SP - 219-221 ST - Vascular anatomy of the trochanteric region: a possible donor area for free perforator flaps T2 - European Journal of Plastic Surgery TI - Vascular anatomy of the trochanteric region: a possible donor area for free perforator flaps UR - ://WOS:000074674100001 VL - 21 ID - 4164 ER - TY - JOUR AB - Background: The deep inferior epigastric artery perforator (DIEP) flap is one of the most commonly used perforator flaps for reconstruction. The anatomy of the flap varies considerably between patients and even within patients. The authors conducted a comprehensive review to fully describe the vascular anatomy of the DIEP flap. Methods: The authors performed MEDLINE, Ovid, and PubMed searches for articles published between 1993 and 2012 on the vascular anatomy of the DIEP flap. Abstracts were screened first, then entire articles, followed by manual reference check. A total of 60 relevant articles were identified and reviewed in their entirety. The authors synthesized all descriptions of DIEP flap vascular anatomy. Results: The perforators originating from the deep inferior epigastric artery can be categorized as musculocutaneous or extramuscular. Musculocutaneous perforators are the most common (33 to 100 percent), followed by extramuscular (0 to 67.6 percent). Of the musculocutaneous perforators, a short intramuscular course (<4 cm) is most common (61 to 80 percent), followed by a long intramuscular course (>4 cm; 9 to 26 percent) and a perpendicular course (3 to 26 percent). Two subfascial patterns have been described, with direct fascial penetration more common than a subfascial course. The two extramuscular perforator types, paramedian (<46.4 percent) and tendinous (<67.6 percent), are the most desirable for dissection. Conclusions: The vascular anatomy of the DIEP flap shows significant variability. Despite this, several patterns of musculocutaneous and extramuscular-type perforators have been found. A greater understanding of these patterns will improve knowledge of the anatomical variation and will enhance the use of evidence-based perforator selection. AD - Univ Texas Southwestern Med Ctr, Dept Plast Surg, Dallas, TX USA. Georgetown Univ, Med Ctr, Dept Plast Surg, Washington, DC 20057 USA. [Saint-Cyr, Michel] Mayo Clin, Div Plast & Reconstruct Surg, Rochester, MN 55905 USA. Saint-Cyr, M (corresponding author), Mayo Clin, Div Plast & Reconstruct Surg, 200 First St SW, Rochester, MN 55905 USA. saintcyr.michel@mayo.edu AN - WOS:000344546000018 AU - Ireton, J. E. AU - Lakhiani, C. AU - Saint-Cyr, M. DA - Nov DO - 10.1097/prs.0000000000000625 IS - 5 J2 - Plast. Reconstr. Surg. KW - computed tomographic angiography magnetic-resonance angiography microsurgical breast reconstruction free tram flaps medial row perforators diep flap rectus-abdominis clinical-application doppler sonography functional impact Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: AS9EN Times Cited: 25 Cited Reference Count: 60 Ireton, Jordan E. Lakhiani, Chrisovalantis Saint-Cyr, Michel 28 0 8 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2014 SN - 0032-1052 SP - 810E-821E ST - Vascular Anatomy of the Deep Inferior Epigastric Artery Perforator Flap: A Systematic Review T2 - Plastic and Reconstructive Surgery TI - Vascular Anatomy of the Deep Inferior Epigastric Artery Perforator Flap: A Systematic Review UR - ://WOS:000344546000018 VL - 134 ID - 2349 ER - TY - JOUR AB - Objective To explore the relationship between latissimus dorsi myocutaneous flap and blood supply, so as to provide a scientific basis for the re-division, transposition and transplantation of latissimus dorsi myocutaneous flap. Methods The latissimus dorsi muscle of 48 cadavers were observed by anatomy and angiography. The clinical applications of latissimus dorsi myocutaneous flap in 31 cases were reviewed. Results The latissimus dorsi myocutaneous flap had many sources of blood supply. The main thoracodorsal artery was distributed in the upper and outer latissimus dorsi muscle. The medial and lateral branches were separated steadily with their respective distribution areas. The inner and lower parts of latissimus dorsi muscle were supplied by intercostal and lumbar arteries. The anastomosis between them and the branches of thoracodorsal artery was obvious according to X-ray angiography. The caliber was between 320-550 μm. The blood supply of the skin superficial to the latissimus dorsi muscle was from the myocutaneous artery. But the anastomosis between the perforating branches was sparse and the caliber was small near the inner and lower parts. Myocutaneous flaps were applied for wound repair, breast reconstruction and leg defect repair after mass excision in 31 cases. Thirty cases of myocutaneous flaps survived completely post-operation. One case of myocutaneous flap had early signs of partial blood flow disturbance. After treatment, blood flow gradually improved and wound healing delayed. Conclusion The latissimus dorsi myocutaneous flap can be divided into 3 parts according to their arterial branches and anastomotic characteristics, which can provide the vascular anatomical basis for whole or partial separation, transposition or transplantation and preservation of muscle function. AD - B. Li, Department of Human Anatomy and Histology and Embryology, Peking University School of Basic Medical Sciences, Beijing, China W.-G. Zhang, Department of Human Anatomy and Histology and Embryology, Peking University School of Basic Medical Sciences, Beijing, China AU - Xia, Y. C. AU - Li, B. AU - Chen, X. X. AU - Yang, X. AU - Ma, J. X. AU - Zou, L. J. AU - Wang, J. W. AU - Zhang, W. G. DB - Embase DO - 10.16098/j.issn.0529-1356.2020.01.016 IS - 1 KW - anastomosis anatomical concepts angiography article blood flow breast reconstruction clinical article human latissimus dorsi flap latissimus dorsi muscle lumbar artery thoracodorsal artery transplantation vascularization wound healing X ray LA - Chinese M3 - Article N1 - L633417930 2020-11-23 2021-03-22 PY - 2020 SN - 0529-1356 SP - 93-97 ST - Vascular anatomy and clinical application of latissimus dorsi myocutaneous flap T2 - Acta Anatomica Sinica TI - Vascular anatomy and clinical application of latissimus dorsi myocutaneous flap UR - https://www.embase.com/search/results?subaction=viewrecord&id=L633417930&from=export http://dx.doi.org/10.16098/j.issn.0529-1356.2020.01.016 VL - 51 ID - 4851 ER - TY - JOUR AD - Abteilung für Plastische Chirurgie, St. Markus-Krankenhaus Frankfurt/Main. AN - 2680329 AU - Lemperle, G. AU - Exner, K. DA - Sep DP - NLM ET - 1989/09/01 IS - 9 KW - Breast/*surgery Breast Neoplasms/*surgery Female Humans *Mastectomy, Radical Nipples/*surgery Surgery, Plastic/*methods Surgical Flaps Suture Techniques Tattooing LA - ger N1 - Lemperle, G Exner, K Journal Article Germany Chirurg. 1989 Sep;60(9):627-30. OP - Verschiedene Möglichkeiten der Mamillenrekonstruktion. PY - 1989 SN - 0009-4722 (Print) 0009-4722 SP - 627-30 ST - [Various possibilities of nipple reconstruction] T2 - Chirurg TI - [Various possibilities of nipple reconstruction] VL - 60 ID - 11249 ER - TY - JOUR AB - Free autologous tissue transfer has been used in mastectomized patients for high-quality reconstruction. Since the deep inferior epigastric perforator flap was developed, it has been considered preferable owing to reduced donor site morbidity At our institution, anastomosis of internal mammary vessels has been top priority because of better positioning and shorter pedicle length. We publish our experiences with various technical modifications that assure internal mammary vessel anastomosis From 2003 to 2008, 35 patients received free deep inferior epigastric perforator flap for breast reconstruction by anastomosis with internal mammary vessels. Twenty-nine reconstructions were done immediately upon mastectomy whereas six were delayed The patterns of anastomosis between the flap pedicle and internal mammary vessel were categorized and the results were followed by flap survival and complications. These deep inferior epigastric perforator flaps were all supplied by a single pedicle artery. Twenty-five of them were drained by a single pedicle vein, and the venous anastomosis pattern was end to end to the single internal mammary vein (IMV) (type I, n=25). However, the other nine flaps were drained by one pedicle vein anastomosed end to end to double IMV (type II, n=2), end to end to both proximal and distal ends of single IMV (type ill, n=5), end to end and end to side to single IMV (type IV, n=2), and end to end to single IMV without anastomosing the other (type V, n=1) All flaps were successful, except in one patient with type 1 anastomosis who received vascular reexploration due to pedicle twisting Another patient with type 1 anastomosis needed revision due to partial fat necrosis of the flap. No other complications were found. Various modifications of internal mammary vessel anastomosis can be used to ensure the safety of deep inferior epigastric perforator flap in breast reconstruction AD - [Chen, Yueh-Bih Tang] Natl Taiwan Univ, Dept Surg, Div Plast Surg, Natl Taiwan Univ Hosp, Taipei 100, Taiwan. [Chen, Chen-Kun] Taipei Med Univ, Dept Plast Surg, Shuang Ho Hosp, Taipei, Taiwan. Chen, YBT (corresponding author), Natl Taiwan Univ, Dept Surg, Div Plast Surg, Natl Taiwan Univ Hosp, 7 Jhongshan S Rd, Taipei 100, Taiwan. AN - WOS:000277181600002 AU - Chen, C. K. AU - Tai, H. C. AU - Chien, H. F. AU - Chen, Y. B. T. DA - May DO - 10.1055/s-0030-1248229 IS - 4 J2 - J. Reconstr. Microsurg. KW - DIEP internal mammary vessels vascular anastomosis recipient vessels algorithm diep Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 589VF Times Cited: 7 Cited Reference Count: 14 Chen, Chen-Kun Tai, Hao-Chih Chien, Hsiung-Fei Chen, Yueh-Bih Tang Tai, Hao-Chih/0000-0001-8155-3077 7 0 Thieme medical publ inc New york 1098-8947 PY - 2010 SN - 0743-684X SP - 219-223 ST - Various Modifications to Internal Mammary Vessel Anastomosis in Breast Reconstruction with Deep Inferior Epigastric Perforator Flap T2 - Journal of Reconstructive Microsurgery TI - Various Modifications to Internal Mammary Vessel Anastomosis in Breast Reconstruction with Deep Inferior Epigastric Perforator Flap UR - ://WOS:000277181600002 VL - 26 ID - 3097 ER - TY - JOUR AB - This study is an economic comparison of various methods of breast reconstruction after mastectomy. The hospital bills of 287 patients undergoing breast reconstruction at three institutions from June of 1988 to March of 1991 were analyzed. The procedures examined included mastectomy, implant and tissue-expander reconstruction, and TRAM and latissimus pedicle flaps, as well as free TRAM and free gluteal flaps. These procedures were subdivided into those which were performed at the time of mastectomy and those performed at a later admission. In addition, auxiliary procedures (i.e., revision, nipple reconstruction, tissue-expander exchange, and contralateral mastopexy/reduction) also were examined. Where appropriate, these procedures were subdivided into those performed under general or local anesthesia and by inpatient or outpatient status. Data from the three institutions were converted to N.Y.U. Medical Center costs for standardization. A table is presented that summarizes the costs of each individual procedure with all the pertinent variations. In addition, a unique and novel method of analyzing the data was developed. This paper describes a menu system whereby other data regarding morbidity, mortality, and revision rates may be superimposed. With this information, the final cost of reconstruction can be extrapolated and the various methods of reconstruction can be compared. This method can be applied to almost any complex series of multiple procedures. The most salient points elucidated by this study are as follows: The savings generated by performing immediate reconstruction varies between $5092 (p < 0.05) for free gluteal flaps and $10,616 (p < 0.05) for pedicled TRAM flaps. Depending on specific procedure, outpatient surgery offers an approximate $5000 savings as compared with the same procedure performed on an inpatient basis. Lastly, we point out numerous economic inefficiencies in an effort to lower the financial cost of the surgical treatment of breast cancer and the subsequent reconstruction. Among our suggestions are to perform immediate reconstruction when medically feasible and acceptable for the patient, to perform outpatient procedures when possible, and to perform multiple procedures when technically feasible. AD - A. Elkowitz, 155 East Thirty-eighth Street, New York, NY 10016, United States AU - Elkowitz, A. AU - Colen, S. AU - Slavin, S. AU - Seibert, J. AU - Weinstein, M. AU - Shaw, W. DB - Embase Medline IS - 1 KW - article breast reconstruction comparative study data analysis economic aspect female health care cost human implantation mastectomy myocutaneous flap priority journal tissue expansion LA - English M3 - Article N1 - L23188916 1993-07-15 PY - 1993 SN - 0032-1052 SP - 77-83 ST - Various methods of breast reconstruction after mastectomy: An economic comparison T2 - Plastic and Reconstructive Surgery TI - Various methods of breast reconstruction after mastectomy: An economic comparison UR - https://www.embase.com/search/results?subaction=viewrecord&id=L23188916&from=export VL - 92 ID - 8893 ER - TY - JOUR AB - This study is an economic comparison of various methods of breast reconstruction after mastectomy. The hospital bills of 287 patients undergoing breast reconstruction at three institutions from June of 1988 to March of 1991 were analyzed. The procedures examined included mastectomy, implant and tissue-expander reconstruction, and TRAM and latissimus pedicle flaps, as well as free TRAM and free gluteal flaps. These procedures were subdivided into those which were performed at the time of mastectomy and those performed at a later admission. In addition, auxiliary procedures (i.e., revision, nipple reconstruction, tissue-expander exchange, and contralateral mastopexy/reduction) also were examined. Where appropriate, these procedures were subdivided into those performed under general or local anesthesia and by inpatient or outpatient status. Data from the three institutions were converted to N.Y.U. Medical Center costs for standardization. A table is presented that summarizes the costs of each individual procedure with all the pertinent variations. In addition, a unique and novel method of analyzing the data was developed. This paper describes a menu system whereby other data regarding morbidity, mortality, and revision rates may be superimposed. With this information, the final cost of reconstruction can be extrapolated and the various methods of reconstruction can be compared. This method can be applied to almost any complex series of multiple procedures. The most salient points elucidated by this study are as follows: The savings generated by performing immediate reconstruction varies between $5092 (p < 0.05) for free gluteal flaps and $10,616 (p < 0.05) for pedicled TRAM flaps. Depending on specific procedure, outpatient surgery offers an approximate $5000 savings as compared with the same procedure performed on an inpatient basis. Lastly, we point out numerous economic inefficiencies in an effort to lower the financial cost of the surgical treatment of breast cancer and the subsequent reconstruction. Among our suggestions are to perform immediate reconstruction when medically feasible and acceptable for the patient, to perform outpatient procedures when possible, and to perform multiple procedures when technically feasible. AD - NYU MED CTR,DEPT SURG,NEW YORK,NY 10016. NYU MED CTR,DEPT PLAST SURG,NEW YORK,NY 10016. UNIV CALIF LOS ANGELES,MED CTR,DEPT PLAST SURG,LOS ANGELES,CA 90024. BETH ISRAEL MED CTR,DEPT PLAST SURG,BROOKLINE,MA. AN - WOS:A1993LK12700011 AU - Elkowitz, A. AU - Colen, S. AU - Slavin, S. AU - Seibert, J. AU - Weinstein, M. AU - Shaw, W. DA - Jul DO - 10.1097/00006534-199307000-00011 IS - 1 J2 - Plast. Reconstr. Surg. KW - abdominis musculocutaneous flap tissue expansion appraisal Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: LK127 Times Cited: 55 Cited Reference Count: 12 Elkowitz, a colen, s slavin, s seibert, j weinstein, m shaw, w 56 0 1 Williams & wilkins Baltimore PY - 1993 SN - 0032-1052 SP - 77-83 ST - VARIOUS METHODS OF BREAST RECONSTRUCTION AFTER MASTECTOMY - AN ECONOMIC COMPARISON T2 - Plastic and Reconstructive Surgery TI - VARIOUS METHODS OF BREAST RECONSTRUCTION AFTER MASTECTOMY - AN ECONOMIC COMPARISON UR - ://WOS:A1993LK12700011 VL - 92 ID - 4371 ER - TY - JOUR AN - 4069265 AU - van Twisk, R. DA - Oct 19 DP - NLM ET - 1985/10/19 IS - 42 KW - Adult Breast/*surgery Female Humans Mastectomy/*rehabilitation Methods Middle Aged Nipples/surgery *Prostheses and Implants *Surgical Flaps LA - dut N1 - van Twisk, R Journal Article Netherlands Ned Tijdschr Geneeskd. 1985 Oct 19;129(42):2006-9. OP - Enkele aspecten van borstreconstructie. PY - 1985 SN - 0028-2162 (Print) 0028-2162 SP - 2006-9 ST - [Various aspects of breast reconstruction] T2 - Ned Tijdschr Geneeskd TI - [Various aspects of breast reconstruction] VL - 129 ID - 12873 ER - TY - JOUR AD - T.H. Park, Department of Plastic and Reconstructive Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, South Korea AU - Kim, C. W. AU - Kim, J. H. AU - Lee, J. W. AU - Park, T. H. DB - Embase Medline DO - 10.1111/iwj.12998 IS - 2 KW - gabapentin paracetamol tramadol adult breast cancer cancer chemotherapy cancer hormone therapy cancer radiotherapy cancer recurrence cancer staging cancer surgery case report clinical article female herpes zoster human laminectomy letter middle aged polymerase chain reaction priority journal radiation dose radical mastectomy rash spinal cord compression spinal cord tumor surgical flaps virus reactivation wound healing LA - English M3 - Letter N1 - L624004875 2018-09-27 2019-03-29 PY - 2019 SN - 1742-481X 1742-4801 SP - 566-569 ST - Varicella zoster reactivation immediately following keystone flap reconstruction of a radiated back wound T2 - International Wound Journal TI - Varicella zoster reactivation immediately following keystone flap reconstruction of a radiated back wound UR - https://www.embase.com/search/results?subaction=viewrecord&id=L624004875&from=export http://dx.doi.org/10.1111/iwj.12998 VL - 16 ID - 5116 ER - TY - JOUR AN - 7316417 AU - Millard, D. R., Jr. DA - Oct DO - 10.1097/00000637-198110000-00003 DP - NLM ET - 1981/10/01 IS - 4 KW - Breast/*surgery Female Humans *Mastectomy Methods *Surgical Flaps LA - eng N1 - Millard, D R Jr Journal Article United States Ann Plast Surg. 1981 Oct;7(4):269-71. doi: 10.1097/00000637-198110000-00003. PY - 1981 SN - 0148-7043 (Print) 0148-7043 SP - 269-71 ST - Variations in the design of the latissimus dorsi flap in breast reconstruction T2 - Ann Plast Surg TI - Variations in the design of the latissimus dorsi flap in breast reconstruction VL - 7 ID - 12680 ER - TY - JOUR AB - The latissimus dorsi myocutaneous flap has proved valuable in breast reconstruction after radical mastectomy. The procedure has been used often and successfully at the Breast Reconstruction Center of Memorial Sloan-Kettering Cancer Center. Since the axis of the mastectomy scar often varies, we have found that adjusting the orientation and location of the skin islands is necessary to achieve maximal coverage on the chest wall and to place the transposed skin without tension precisely where it is most needed. These different skin island designs may necessitate a scar on the back that is not covered by a brassiere. This paper discusses and illustrates with clinical examples modifications that produce superior reconstructive results. AN - 7235541 AU - Ruetschi, M. S. AU - LeWinn, L. R. AU - Chaglassian, T. A. DA - Mar DO - 10.1097/00000637-198103000-00001 DP - NLM ET - 1981/03/01 IS - 3 KW - Adult Breast/*surgery Female Humans Mastectomy Middle Aged Postoperative Complications *Surgery, Plastic *Surgical Flaps LA - eng N1 - Ruetschi, M S LeWinn, L R Chaglassian, T A Journal Article United States Ann Plast Surg. 1981 Mar;6(3):171-8. doi: 10.1097/00000637-198103000-00001. PY - 1981 SN - 0148-7043 (Print) 0148-7043 SP - 171-8 ST - Variation of latissimus dorsi skin island design for postmastectomy reconstruction T2 - Ann Plast Surg TI - Variation of latissimus dorsi skin island design for postmastectomy reconstruction VL - 6 ID - 12896 ER - TY - JOUR AB - INTRODUCTION: Abdominal-based microvascular breast reconstruction constitutes approximately one-fifth of reconstructions following mastectomy for breast cancer. Enhanced recovery after surgery (ERAS) protocols have been implemented to improve patient care. The aim of this project was to identify variation in the perioperative care of women undergoing microvascular breast reconstruction to inform development of an ERAS protocol. METHODS: Surveys were developed for plastic surgeons, anaesthetists and the lead clinician for breast reconstruction at each unit. These assessed most aspects of perioperative care. A team of medical student collaborators was identified. This team created a list of surgeons and anaesthetists in the United Kingdom by unit. REDCap was used to record their responses. RESULTS: Nineteen (19/39, 49%) lead clinicians, 83 (83/134, 62%) plastic surgeons and 71 (71/100, 71%) anaesthetists from units across the UK completed the surveys. Marked variation was identified in the clinician responses when compared with the national and international guidelines. This variation covered many aspects of patient care including antibiotic and fluid prescribing, surgical technique, post-operative care and recording of patient outcomes. CONCLUSIONS: The optiFLAPP national practice survey has demonstrated variation in the perioperative care of women undergoing abdominal-based microvascular breast reconstruction. We propose a large prospective audit to assess current protocols and support development of randomised controlled trials. AN - 30292696 DA - Jan DO - 10.1016/j.bjps.2018.08.007 DP - NLM ET - 2018/10/08 IS - 1 KW - Analgesics/therapeutic use Anti-Inflammatory Agents, Non-Steroidal/therapeutic use Bandages Breast Neoplasms/surgery Clinical Protocols Female Fluid Therapy/methods Graft Survival/physiology Hemodynamics/physiology Humans Intraoperative Care/methods Mammaplasty/*methods Microsurgery/*methods *Perforator Flap Rectus Abdominis/transplantation United Kingdom Wound Closure Techniques Breast reconstruction Deep inferior epigastric perforator flap Microsurgery Perioperative LA - eng N1 - 1878-0539 optiFLAPP Collaborative Journal Article Multicenter Study Netherlands J Plast Reconstr Aesthet Surg. 2019 Jan;72(1):35-42. doi: 10.1016/j.bjps.2018.08.007. Epub 2018 Aug 25. PY - 2019 SN - 1748-6815 SP - 35-42 ST - Variation in the perioperative care of women undergoing abdominal-based microvascular breast reconstruction in the United Kingdom (The optiFLAPP Study) T2 - J Plast Reconstr Aesthet Surg TI - Variation in the perioperative care of women undergoing abdominal-based microvascular breast reconstruction in the United Kingdom (The optiFLAPP Study) VL - 72 ID - 12066 ER - TY - JOUR AB - Aim of the study: Incisions through the abdominal wall are based on anatomical principles and Rectus abdominis muscle provides an excellent myocutaneous flap. The present work was proposed to identify variations in numbers and location of tendinous intersections of the Rectus Abdominis muscle in the cadavers as a guide to the surgical procedures. Materials and Methods: The study was conducted on 54 cadavers of North Indian origin allotted to undergraduate medical student for Anatomy dissection classes. Manual dissection was done to identify tendinous intersections of the Rectus Abdominis muscle with reference to number and location. Results: In the present study one cadaver had five tendinous intersections (1.85%), one cadaver had four tendinous intersections (1.85%) and 52 cadavers had three tendinous intersections (96.29%). Conclusion: The present study is an effort to provide data about the anatomical variation in numbers and location of tendinous intersections of the Rectus Abdomini muscles. Rectus abdominis muscle provides an excellent myocutaneous flap because the muscle belly is separated from surrounding tissue within the rectus sheath. This study is representative of a small study of the human population and only serves to illustrate the variations in the anatomy of the tendinous intersections. More extensive studies are required to establish a definitive pattern among local populations to serve as a guide for surgical procedures. AD - [Anita; Haque, Mahboobul; Gupta, Amrita; Nasar, Areeba] Shri Ram Murti Smarak Inst Med Sci, Dept Anat, Bareilly 243202, Uttar Pradesh, India. Anita (corresponding author), Shri Ram Murti Smarak Inst Med Sci, Dept Anat, Bareilly 243202, Uttar Pradesh, India. dr.anita.1709@gmail.com AN - WOS:000422589400003 AU - Anita AU - Haque, M. AU - Gupta, A. AU - Nasar, A. DA - Jun DO - 10.7860/jcdr/2015/14027.6028 IS - 6 J2 - J. Clin. Diagn. Res. KW - Breast reconstruction Surgical Flaps TRAM Flaps General & Internal Medicine LA - English M3 - Article N1 - ISI Document Delivery No.: V9W5R Times Cited: 2 Cited Reference Count: 12 Anita Haque, Mahboobul Gupta, Amrita Nasar, Areeba 2 0 Premchand shantidevi research foundation Delhi 0973-709x PY - 2015 SN - 2249-782X SP - AC10-AC12 ST - Variation in Tendinous Intersections of Rectus Abdominis Muscle in North Indian Population with Clinical Implications T2 - Journal of Clinical and Diagnostic Research TI - Variation in Tendinous Intersections of Rectus Abdominis Muscle in North Indian Population with Clinical Implications UR - ://WOS:000422589400003 VL - 9 ID - 2243 ER - TY - JOUR AB - Background: Commercial payments for implant-based breast reconstruction have increased within the past decade, whereas reimbursements have stagnated for microsurgical techniques. The physician payment-to-work relative value unit ratio allows for standardization when comparing procedures of differing complexity. This study aimed to characterize payment per work relative value unit for common breast and nonbreast microsurgical procedures. Methods: The Massachusetts All-Payer Claims Database was queried from 2010 to 2014 for Current Procedural Terminology (CPT) codes related to microsurgical and breast reconstruction. International Classification of Diseases codes were further used to categorize procedures by anatomical region, including head and neck, breast, trunk, and extremities. Physician payments, both commercial and governmental, were aggregated by anatomical region and CPT code. Payment distributions were described with means and medians and compared using statistical tests. Results: Among 3435 commercial claims, distributions of physician payments per work relative value unit for microsurgical and common breast procedures differed only for breast free flaps billed through S codes (p < 0.001). Microsurgical breast procedures (CPT code 19364) had significantly greater median payments per work relative value unit compared to microsurgery of the head and neck, trunk, and upper extremities (p = 0.004). Payment per work relative value unit for common breast and nonbreast microsurgical procedures did not differ significantly among governmental claims (p = 0.103). Conclusions: Adjustment of physician payments by work relative value units did not show significant variability across common breast procedures, except for S codes, suggesting that payments are mostly driven by differences in work relative value units and individual contractual negotiations. Lower payments per work relative value unit for other regions compared to breast suggests an opportunity for negotiation with commercial payers. AD - [Matros, Evan] Mem Sloan Kettering Canc Ctr, Dept Surg, Plast & Reconstruct Surg Serv, 1275 York Ave,MRI 1036, New York, NY 10065 USA. Mem Sloan Kettering Canc Ctr, Dept Finance, New York, NY 10065 USA. Stanford Univ, Div Plast & Reconstruct Surg, Med Ctr, Stanford, CA 94305 USA. Univ Michigan Hlth Syst, Dept Surg, Sect Plast Surg, Ann Arbor, MI USA. Matros, E (corresponding author), Mem Sloan Kettering Canc Ctr, Dept Surg, Plast & Reconstruct Surg Serv, 1275 York Ave,MRI 1036, New York, NY 10065 USA. matrose@mskcc.org AN - WOS:000639317100014 AU - Shamsunder, M. G. AU - Sheckter, C. C. AU - Sheinin, A. AU - Rubin, D. AU - Berlin, N. L. AU - Mehrara, B. AU - Matros, E. DA - Mar DO - 10.1097/prs.0000000000007679 IS - 3 J2 - Plast. Reconstr. Surg. KW - Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: RL9XT Times Cited: 0 Cited Reference Count: 18 Shamsunder, Meghana G. Sheckter, Clifford C. Sheinin, Avraham Rubin, David Berlin, Nicholas L. Mehrara, Babak Matros, Evan National Institutes of Health/National Cancer Institute Cancer Center Support Grant [P30 CA008748] This research was funded in part through National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748. 0 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2021 SN - 0032-1052 SP - 505E-513E ST - Variation in Payment per Work Relative Value Unit for Breast Reconstruction and Nonbreast Microsurgical Reconstruction: An All-Payer Claims Database Analysis T2 - Plastic and Reconstructive Surgery TI - Variation in Payment per Work Relative Value Unit for Breast Reconstruction and Nonbreast Microsurgical Reconstruction: An All-Payer Claims Database Analysis UR - ://WOS:000639317100014 VL - 147 ID - 969 ER - TY - JOUR AB - BACKGROUND: The pectoralis major muscle plays a crucial role in implant-based breast reconstruction. The goal of this study is to document variations of the origin of the pectoralis major muscle (PM). We hope to understand how many women have anatomy allowing for total submuscular coverage of an implant with the PM alone in immediate breast reconstruction. METHODS: Fifty patients undergoing mastectomy were recruited. Breast width and the costal origin of the natural inframammary fold (IMF) were measured preoperatively and intraoperatively. The PM width at its origin and the rib origin of the PM were measured intraoperatively. A ratio of the PM origin width to breast width was calculated. RESULTS: Forty-four percent of breasts studied had the IMF at the level of the seventh rib, 53% at the sixth rib, and 3% at the fifth rib. Twenty percent of PM muscles originated from the seventh rib, 68% from the sixth rib, and 12% from the fifth rib. Thirty-six percent of chests showed a PM originating one rib level above the IMF, 61% at the same level, and 3% one level below the IMF. Seventy-seven percent of chests showed a PM origin width to breast width ratio of <0.8. CONCLUSIONS: Overall, 72% of chests had either a high origin of the PM, a narrow PM relative to the breast width, or both. This anatomy is suboptimal for implant coverage using the PM alone. Surgeons performing implant-based breast reconstruction should be prepared to utilize wide dissection, alternative muscle recruitment, or supplemental acellular dermal matrix. AU - Madsen, R. J. AU - Chim, J. AU - Ang, B. AU - Fisher, O. AU - Hansen, J. DB - Medline DO - 10.1097/SAP.0b013e3182858881 IS - 1 KW - adolescent adult aged anatomy and histology breast augmentation female human mastectomy middle aged pectoral muscle pectoralis major muscle surgery surgical flaps young adult LA - English M3 - Article N1 - L605698394 2016-12-16 PY - 2015 SN - 1536-3708 SP - 111-113 ST - Variance in the origin of the pectoralis major muscle: implications for implant-based breast reconstruction T2 - Annals of plastic surgery TI - Variance in the origin of the pectoralis major muscle: implications for implant-based breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L605698394&from=export http://dx.doi.org/10.1097/SAP.0b013e3182858881 VL - 74 ID - 6370 ER - TY - JOUR AB - Postoperative flap monitoring is a key component for successful free tissue transfer. Tissue oxygen saturation measurement (TOx) with near-infrared spectrophotometry (NIRS) is a method used for this purpose. The aim of this study was to identify external variables that can affect TOx. Patients who had breast reconstruction with free flaps were monitored prospectively and intra-operative details were recorded. Flap TOx was recorded with NIRS pre-extubation, postextubation, and then every four hours for 36 hours. At each of these time points, blood oxygen saturation (SO2), amount of supplemental oxygen, and blood pressure were recorded. Thirty flaps were monitored. Initially, a significant trend over time was detected such that for every increase of 24 hours, TOx decreased on average by 2.1% (P = 0.025). However, when accounting for SO2 levels, this decrease was no longer significant (P = 0.19). An increase by 1% in SO2 produced an increase in TOx reading of 0.36 (P = 0.007). The amount of supplemental O2, systolic blood pressure, and diastolic blood pressure did not have a significant impact on TOx (P > 0.05). The TOx values were highest in the free TRAM flaps and were lower in decreasing order in the muscle-sparing TRAM, DIEP, and SIEA flaps (P > 0.05). The TOx values did not significantly correlate with vessel size, perforator number, or perforator row. Postoperative flap TOx was found to correlate with SO2 and was not significantly dependent on blood pressure, supplemental O2, or surgical variables. Careful interpretation of oximetry values is essential in decision making during postoperative flap monitoring. (c) 2014 Wiley Periodicals, Inc. Microsurgery 35:123-128, 2015. AD - [Ozturk, Cemile Nurdan; Ozturk, Can] Roswell Pk Canc Inst, Buffalo, NY 14263 USA. [Ledinh, Wayne; Bozkurt, Mehmet; Schwarz, Graham; Djohan, Risal] Cleveland Clin, Dept Plast Surg, Cleveland, OH 44195 USA. [O'Rourke, Colin] Cleveland Clin, Dept Quantitat Hlth Sci, Cleveland, OH 44195 USA. Djohan, R (corresponding author), Cleveland Clin, Dept Plast Surg, 9500 Euclid Ave,Desk A60, Cleveland, OH 44195 USA. djohanr@ccf.org AN - WOS:000350143500006 AU - Ozturk, C. N. AU - Ozturk, C. AU - Ledinh, W. AU - Bozkurt, M. AU - Schwarz, G. AU - O'Rourke, C. AU - Djohan, R. DA - Feb DO - 10.1002/micr.22276 IS - 2 J2 - Microsurgery KW - near-infrared spectroscopy oxygen-saturation vascular compromise light spectroscopy perforator flaps cost-analysis blood-flow oximetry experience viability Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: CC1ZH Times Cited: 12 Cited Reference Count: 52 Ozturk, Cemile Nurdan Ozturk, Can Ledinh, Wayne Bozkurt, Mehmet Schwarz, Graham O'Rourke, Colin Djohan, Risal 12 0 1 Wiley Hoboken 1098-2752 PY - 2015 SN - 0738-1085 SP - 123-128 ST - VARIABLES AFFECTING POSTOPERATIVE TISSUE PERFUSION MONITORING IN FREE FLAP BREAST RECONSTRUCTION T2 - Microsurgery TI - VARIABLES AFFECTING POSTOPERATIVE TISSUE PERFUSION MONITORING IN FREE FLAP BREAST RECONSTRUCTION UR - ://WOS:000350143500006 VL - 35 ID - 2299 ER - TY - JOUR AB - OBJECTIVE. The purpose of this article is to illustrate the varying appearances of fat necrosis on MRI. CONCLUSION. Fat necrosis may mimic malignancy with varying appearances on MRI. Suspicious morphologic and kinetic features may be present, necessitating biopsy to exclude new or recurrent breast cancer. © American Roentgen Ray Society. AD - C. P. Daly, Department of Radiology, Mercy Medical Center, Baltimore, MD 21202, United States AU - Daly, C. P. AU - Jaeger, B. AU - Sill D, D. S. DB - Embase Medline DO - 10.2214/AJR.07.4051 IS - 5 KW - arteritis article breast breast reconstruction cell proliferation coinfection fat necrosis free tissue graft histopathology human human tissue needle biopsy nuclear magnetic resonance imaging partial mastectomy pedicled skin flap priority journal risk factor L1 - internal-pdf://4232741524/1374.txt LA - English M3 - Article N1 - L352628068 2008-12-03 PY - 2008 SN - 0361-803X SP - 1374-1380 ST - Variable appearances of fat necrosis on breast MRI T2 - American Journal of Roentgenology TI - Variable appearances of fat necrosis on breast MRI UR - https://www.embase.com/search/results?subaction=viewrecord&id=L352628068&from=export http://dx.doi.org/10.2214/AJR.07.4051 VL - 191 ID - 7804 ER - TY - JOUR AB - Introduction: The superficial inferior epigastric artery (SIEA) is a useful pedicle in supply to the lower abdominal integument, with its use sparing damage to rectus abdominis muscle or sheath. However, it is limited in usefulness due to its anatomical variability. While previous anatomical studies have been limited in number and study design, the use of preoperative imaging has enabled the analysis of this vasculature in large numbers and greater anatomical detail. Methods: A clinical anatomical study of 500 hemi-abdominal walls in 250 consecutive patients undergoing preoperative computed tomographic angiography (CTA) prior to autologous breast reconstruction was undertaken. The presence, size, location, and branching pattern of the SIEA were assessed in each case. Results: The SIEA was identified in 468 cases, an incidence of 94%. Its mean diameter was 0.6 mm, and in 24% of cases was of a diameter >1.5 mm. SIEA location was highly variable, with mean position 2-cm lateral to the linea semilunaris (range 0-8 cm lateral), and relationship to the superficial inferior epigastric vein (SIEV) was also highly variable, with the distance between them ranging from 0.3 to 8.5 cm apart. SIEA branches directly crossed the abdominal midline in 5% of cases. Larger SIEA diameters correlated with a decrease in diameter of ipsilateral DIEA perforators. Conclusion: The SIEA is present more frequently than previously demonstrated, but is typically too small for use in free tissue transfer. The variable degree of SIEA branching suggests that its territory of supply is also variable, and that preoperative imaging may be useful in planning SIEA flaps. (C) 2010 Wiley-Liss, Inc. Microsurgery 30:386-391, 2010. AD - [Rozen, Warren M.; Chubb, Daniel; Grinsell, Damien; Ashton, Mark W.] Univ Melbourne, Jack Brockhoff Reconstruct Plast Surg Res Unit, Dept Anat & Cell Biol, Parkville, Vic 3050, Australia. Rozen, WM (corresponding author), Univ Melbourne, Jack Brockhoff Reconstruct Plast Surg Res Unit, Dept Anat & Cell Biol, Room E533, Parkville, Vic 3050, Australia. warrenrozen@hotmail.com AN - WOS:000280085900008 AU - Rozen, W. M. AU - Chubb, D. AU - Grinsell, D. AU - Ashton, M. W. DO - 10.1002/micr.20750 IS - 5 J2 - Microsurgery KW - computed tomographic angiography free abdominoplasty flap breast reconstruction rectus-abdominis diep flap interindividual variability avoiding denervation free tram perforators abdomen Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 628AI Times Cited: 30 Cited Reference Count: 32 Rozen, Warren M. Chubb, Daniel Grinsell, Damien Ashton, Mark W. Rozen, Warren/0000-0002-4092-182X 32 1 2 Wiley Hoboken 1098-2752 PY - 2010 SN - 0738-1085 SP - 386-391 ST - THE VARIABILITY OF THE SUPERFICIAL INFERIOR EPIGASTRIC ARTERY (SIEA) AND ITS ANGIOSOME: A CLINICAL ANATOMICAL STUDY T2 - Microsurgery TI - THE VARIABILITY OF THE SUPERFICIAL INFERIOR EPIGASTRIC ARTERY (SIEA) AND ITS ANGIOSOME: A CLINICAL ANATOMICAL STUDY UR - ://WOS:000280085900008 VL - 30 ID - 3179 ER - TY - JOUR AB - SESSION TITLE: Fellows Disorders of the Pleura Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: October 18-21, 2020 INTRODUCTION: We describe a patient who developed bilateral right greater than left pleural effusions after surgical alteration of her prior silicone breast implants. She had near-complete resolution of her effusion with a course of non-steroidal anti-inflammatory drugs (NSAIDs). CASE PRESENTATION: We describe a 42 y/o lady, former 5.5 pack-year smoker, triple-negative breast cancer in remission, status-post bilateral mastectomy and silicone breast implantation. She since had bilateral breast reconstruction, involving superior gluteal artery perforator (SGAP) flap. She developed dyspnea and pleuritic pain within 2 weeks of her SGAP procedure, and presented to our center. She had stable vitals on admission, and did not require supplemental oxygen; however, her dyspnea and pleuritic pain were affecting her daily activities. Chest X-ray revealed a moderate right and a small left pleural effusion, confirmed on PE protocol CT scan, which was negative for PE. She was initially treated with diuretics which failed to improve her symptoms or pleural effusion size. Right thoracentesis was then performed, yielding 800 mL of serous yellow fluid. Fluid studies were consistent with an exudative effusion, with negative cytology and no bacterial or fungal growth, pH 7.48, LDH 200, glucose 88, total protein 4.1. Immediate post-procedure chest x-ray showed significant improvement in right effusion, and dyspnea was alleviated. Within 24 hours, the effusion on the right re-accumulated to a size equivalent to prior to thoracentesis. She was once again dyspneic. Suspecting an underlying inflammatory process, the patient was started on ibuprofen 600 mg QID. Within 2 days, patient felt symptomatic improvement. Outpatient follow-up chest X-ray 10 days after NSAID initiation was revealing of near-complete resolution of right effusion and symptoms. NSAID taper was then initiated. Repeat chest-XR 1 month after first dose of NSAID’s showed total resolution of pleural effusions. DISCUSSION: Foreign body reaction (FBR), or an inflammatory response to non-native entities such as breast implants, has been described as a cause of systemic release of inflammatory factors [1]. One report describes the development of pleural effusion 6 weeks after silicone breast implants [2]. We postulate the SGAP flap procedure resulted in manipulation of her prior silicone implants, resulting in an FBR. Neither IV diuretics nor therapeutic thoracentesis resulted in lasting resolution of her effusion, making fluid overload less likely. Pleural fluid studies were negative for cancer cells. The marked improvement with NSAIDs suggests an underlying systemic inflammatory response, not unlike Dressler’s Syndrome. CONCLUSIONS: Clinicians should be aware of pleural effusions that are secondary to a foreign body reaction, and consideration of a course of non-steroidal anti-inflammatory drugs should be considered if other causes of effusion have been ruled out. Reference #1: Tralhão, António et al. “The return of a disappearing entity: Dressler's syndrome after transvenous pacemaker implantation.” BMJ case reports vol. 2014 bcr2013203401. 20 Mar. 2014, doi:10.1136/bcr-2013-203401 Reference #2: Silicone Breast Implants: A Rare Cause of Pleural Effusion Shaik, Imam et al. CHEST, Volume 148, Issue 4, 444A DISCLOSURES: no disclosure on file for Alexander Geyer; No relevant relationships by Saamia Hossain, source=Web Response AU - Hossain, S. AU - Geyer, A. DB - Embase DO - 10.1016/j.chest.2020.08.1130 IS - 4 KW - diuretic agent glucose ibuprofen oxygen protein silicone adult bacterial growth breast augmentation cancer cell cancer patient cancer surgery conference abstract cytology daily life activity Dressler syndrome drug therapy dyspnea female follow up foreign body reaction fungus growth human major clinical study mastectomy outpatient pacemaker implantation pain pleura effusion pleura fluid remission silicone breast implant smoking superior gluteal artery perforator flap surgery thoracocentesis thorax radiography triple negative breast cancer x-ray computed tomography LA - English M3 - Conference Abstract N1 - L2008025389 2020-10-19 PY - 2020 SN - 1931-3543 0012-3692 SP - A1241 ST - VANISHING PLEURAL EFFUSION: DRESSLER-LIKE SYNDROME IN PATIENT WITH FOREIGN BODY REACTION T2 - Chest TI - VANISHING PLEURAL EFFUSION: DRESSLER-LIKE SYNDROME IN PATIENT WITH FOREIGN BODY REACTION UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2008025389&from=export http://dx.doi.org/10.1016/j.chest.2020.08.1130 VL - 158 ID - 4629 ER - TY - JOUR AB - Backgrounds: Breast reconstruction after mastectomy with TRAM (transversus rectus abdominis musculocutanneous) flap became a standard in many plastic surgery units in Czech Republic. However, breast reconstruction is performed in a small percentage of potential candidates. The value of this procedure is unknown for patients with breast carcinoma and is questionable in patients whose metastatic disease develops in the postoperative period. Design: 1. We attempted to measure the value of breast reconstruction by defining the number of years of life following breast reconstruction that would compensate all negatives associated with the reconstructive surgery and recovery. 2. We compared the value of reconstruction with the aesthetic result for each patient. Subjects: 78 patients who underwent breast reconstruction after mastectomy using TRAM flap at the Clinic of Plastic and Aesthetic Surgery, St. Anna's Faculty Hospital in Brno during period of years 1990-1996. Method: A questionnaire was sent that consisted of 8 questions which should define the length of life with reconstructed breast that would compensate all negatives associated with surgery and recovery, We have compared this value with the objective evaluation of the aesthetic result of each patient. Result and Conclusion: 1. We have found that most commonly 2,5 years of life following the breast reconstruction were worth the surgery and recovery. This value was very individual but, when compared with the life expectancy, it may help determine the indication for breast reconstruction in patients with poor prognosis of survival of the disease. 2. Nearly all patients appreciate reconstruction highly and positively and they would recommended it to the other patients with breast cancer. 3. There was a substantially weak correlation between the value of reconstruction and the objective evaluation of aesthetic result of each patient. Most patients appreciate mainly restauration of basic symetry of their breast. AD - Klinika Plasticke a Esteticke Chir., FN U SV. Anny v Brně AU - Dražan, L. AU - Dungelová, E. AU - Konečný, Y. DB - Embase IS - 6 KW - adult article breast carcinoma breast reconstruction Czech Republic female follow up human life expectancy major clinical study mastectomy metastasis myocutaneous flap plastic surgery questionnaire rectus abdominis muscle LA - Czech M3 - Article N1 - L40066103 2005-01-18 PY - 2004 SN - 0862-495X SP - 208-212 ST - The value of the TRAM flap breast reconstruction in patients with breast carcinoma T2 - Klinicka Onkologie TI - The value of the TRAM flap breast reconstruction in patients with breast carcinoma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L40066103&from=export VL - 17 ID - 8213 ER - TY - JOUR AB - A preoperative abdominal wall study was conducted using a multidetector scanner in 162 women who had undergone breast reconstruction with abdominal perforator flaps. A map of the abdominal perforator vessels dependent on the deep inferior epigastric artery was created. In the first 36 cases, anatomic dissection of all perforators was performed during surgery. The outcome was then compared with the radiologic findings. In the following 126 cases, the perforator vessel chosen preoperatively by the multidetector scanner was located and dissected directly.In the first 36 cases, an absolute correlation was observed between the radiologic information and intraoperative findings. In the following 126 cases, surgery time and the rate of postoperative complications decreased significantly.The multidetector scanner provides valuable preoperative information enabling identification of the most suitable perforator in view of its caliber, location, course, and anatomic relationships. Once located, we can proceed directly to its dissection during surgery, making it a faster and safer technique. © 2008 Lippincott Williams & Wilkins, Inc. AD - J. Masia, Sant Antoni M. Claret 167, 08025 Barcelona, Spain AU - Masia, J. AU - Larrañaga, J. AU - Clavero, J. A. AU - Vives, L. AU - Pons, G. AU - Pons, J. M. DB - Embase Medline DO - 10.1097/SAP.0b013e31805003c2 IS - 1 KW - adult article breast cancer breast reconstruction breast surgery controlled study female human imaging system inferior epigastric artery major clinical study multidetector computed tomography outcome assessment perforator flap peroperative care preoperative care priority journal surgical technique LA - English M3 - Article N1 - L351317745 2008-03-25 PY - 2008 SN - 0148-7043 SP - 29-36 ST - The value of the multidetector row computed tomography for the preoperative planning of deep inferior epigastric artery perforator flap: Our experience in 162 cases T2 - Annals of Plastic Surgery TI - The value of the multidetector row computed tomography for the preoperative planning of deep inferior epigastric artery perforator flap: Our experience in 162 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L351317745&from=export http://dx.doi.org/10.1097/SAP.0b013e31805003c2 VL - 60 ID - 7930 ER - TY - JOUR AB - A preoperative abdominal wall study was conducted using a multidetector scanner in 162 women who had undergone breast reconstruction with abdominal perforator flaps. A map of the abdominal perforator vessels dependent on the deep inferior epigastric artery was created. In the first 36 cases, anatomic dissection of all perforators was performed during surgery. The outcome was then compared with the radiologic findings. In the following 126 cases, the perforator vessel chosen preoperatively by the multidetector scanner was located and dissected directly. In the first 36 cases, an absolute correlation was observed between the radiologic information and intraoperative findings. In the following 126 cases, surgery time and the rate of postoperative complications decreased significantly. The multidetector scanner provides valuable preoperative information enabling identification of the most suitable perforator in view of its caliber, location, course, and anatomic relationships. Once located, we can proceed directly to its dissection during surgery, making it a faster and safer technique. AD - [Masia, Jaume; Larranaga, Jose; Vives, Lorena; Pons, Gemma; Maria Pons, Jose] Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Plast Surg, E-08193 Barcelona, Spain. [Clavero, Juan Angel] Clin Creu Blanca, Dept Radiol, Barcelona, Spain. Masia, J (corresponding author), St Antoni M Claret 167, Barcelona 08025, Spain. jmasia@santpau.es AN - WOS:000251822700009 AU - Masia, J. AU - Larranaga, J. AU - Clavero, J. A. AU - Vives, L. AU - Pons, G. AU - Pons, J. M. DA - Jan DO - 10.1097/SAP.0b013e31805003c2 IS - 1 J2 - Ann. Plast. Surg. KW - perforator flap preoperative planning multidetector row tomography doppler sonography Surgery LA - English M3 - Article; Proceedings Paper N1 - ISI Document Delivery No.: 243UL Times Cited: 82 Cited Reference Count: 9 Masia, Jaume Larranaga, Jose Clavero, Juan Angel Vives, Lorena Pons, Gemma Maria Pons, Jose 10th International Course of Perforator Flaps Sep 06, 2006 Ankara, TURKEY 91 0 3 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2008 SN - 0148-7043 SP - 29-36 ST - The value of the multidetector row computed tomography for the preoperative planning of deep inferior epigastric artery perforator flap - Our experience in 162 cases T2 - Annals of Plastic Surgery TI - The value of the multidetector row computed tomography for the preoperative planning of deep inferior epigastric artery perforator flap - Our experience in 162 cases UR - ://WOS:000251822700009 VL - 60 ID - 3462 ER - TY - JOUR AB - The transverse rectus abdominis musculocutaneous TRAM flap is an interesting alternative for breast reconstruction after mastectomy for cancer disease in patients who refuse mammary prosthesis and when the clinical situation allows it. There is however a risk of unpredictable partial necrosis even after rigorous surgical procedure. Some authors have proposed a Doppler evaluation before reconstruction surgery to better identify the vascular network and optimize patient selection. We performed a preliminary study in 45 patients between January 1996 and December 1999. An echo-Doppler Ultramark 9 HDI (Advanced Technology Laboratories) equipped with a high frequency (10 MHz) linear probe was used to compare blood flow and vessel caliber in the superior epigastric artery and the perforating vessels (number, localization, peak flow). The results obtained in this series could be used to determine indications for TRAM flap with or without delay procedure. AD - Service de chirurgie plastique et reconstructrice, hôpital Sud, Rennes, France. AN - 11094829 AU - Georgieu, N. AU - Watier, E. AU - Fadhul, S. AU - Rolland, Y. AU - Pailheret, J. P. DA - Oct DP - NLM ET - 2000/11/30 IS - 5 KW - Female Graft Rejection/prevention & control Humans *Mammaplasty Middle Aged Patient Selection Preoperative Care/*methods Rectus Abdominis/*transplantation Risk Factors *Surgical Flaps *Ultrasonography, Doppler, Color/*methods Ultrasonography, Doppler, Pulsed/*methods Vascular Patency LA - fre N1 - Georgieu, N Watier, E Fadhul, S Rolland, Y Pailheret, J P Evaluation Study Journal Article France Ann Chir Plast Esthet. 2000 Oct;45(5):516-21. OP - Apport du Doppler pulsé couleur avant reconstruction mammaire par lambeau myocutané de grand droit de l'abdomen. A propos de 45 cas. PY - 2000 SN - 0294-1260 (Print) 0294-1260 SP - 516-21 ST - [Value of pulsed color Doppler before transverse rectus abdominis musculocutaneous flap breast reconstruction. 45 cases] T2 - Ann Chir Plast Esthet TI - [Value of pulsed color Doppler before transverse rectus abdominis musculocutaneous flap breast reconstruction. 45 cases] VL - 45 ID - 13241 ER - TY - JOUR AB - The individual perforating vessels have a high degree of anatomical variation, therefore it is desirable to conduct a careful examination of them before undertaking a perforator flap operation. Because locating the vessels beforehand makes performing the operative procedure much easier, the aim of the present study was to assess the value of using simple acoustic Doppler sonography to plan a perforator flap operation. The vessel examinations were carried out before taking 46 free microvascular flaps from either the lower abdominal wall or the buttock for reconstructive breast surgery. The perforating vessels located were marked, and their position relative to the umbilicus or the most cranial point of the rima ani recorded using a coordinate system. In 40 patients, a perforator flap operation (deep inferior epigastric perforator flap, n = 32; superior gluteal artery perforator flap, n = 8) was actually carded out; in six of these patients, a myocutaneous flap was used because of the insufficient availability of perforating vessels. Before the operation, perforating vessels were marked for each patient, with an average of 7.3 for the deep inferior epigastric perforator flap and 6.5 for the superior gluteal artery perforator flap. Out of 286 vessels marked for later perforator flaps, 162 were identified during the operation. A preoperatively marked vessel was used in 37 of 40 patients. In the remaining patients, a vessel was used that had not been previously marked. The vertical and horizontal distance between the perforating vessels identified during the operation and the preoperative marks averaged 0.8 cm. The results show preoperative Doppler sonography to be useful for locating the position of individual perforating vessels, making it much easier to find them during the operation. AD - R.E. Giunta, Abteilung fur Plastische Chirurgie, Behandlungszentrum Vogtareuth, Krankenhausstrasse 20, D-83569 Vogtareuth, Germany AU - Giunta, R. E. AU - Geisweid, A. AU - Feller, A. M. DB - Embase Medline DO - 10.1097/00006534-200006000-00011 IS - 7 KW - adult anatomical variation article blood vessel graft breast carcinoma clinical article clinical trial Doppler ultrasonography female free tissue graft human inferior epigastric artery perforator flap preoperative evaluation priority journal surgical technique SONODOP 3000 system LA - English M3 - Article N1 - L30351116 2000-07-02 PY - 2000 SN - 0032-1052 SP - 2381-2386 ST - The value of preoperative doppler sonography for planning free perforator flaps T2 - Plastic and Reconstructive Surgery TI - The value of preoperative doppler sonography for planning free perforator flaps UR - https://www.embase.com/search/results?subaction=viewrecord&id=L30351116&from=export http://dx.doi.org/10.1097/00006534-200006000-00011 VL - 105 ID - 8525 ER - TY - JOUR AD - Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires School of Medicine, Peron 4190, 1st. floor (1181), Buenos Aires, Argentina. Electronic address: horacio.mayer@hospitalitaliano.org.ar. Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires School of Medicine, Peron 4190, 1st. floor (1181), Buenos Aires, Argentina. AN - 32948492 AU - Mayer, H. F. AU - Piedra Buena, I. AU - Petersen, M. L. DA - Nov DO - 10.1016/j.bjps.2020.08.096 DP - NLM ET - 2020/09/20 IS - 11 KW - Axilla Axillary Artery/*diagnostic imaging Computed Tomography Angiography/*methods Female Humans Intraoperative Complications/*prevention & control Lymph Node Excision/*adverse effects/methods Lymph Nodes/radiation effects/surgery *Mammaplasty/adverse effects/methods Middle Aged Radiotherapy/*adverse effects Risk Adjustment/methods *Superficial Back Muscles/blood supply/transplantation *Surgical Flaps *Breast reconstruction *cta *Computed tomographic angiography *Latissimus dorsi flap *Pedicle injury *Thoracodorsal pedicle in relationship to the content of this presentation LA - eng N1 - 1878-0539 Mayer, Horacio F Piedra Buena, Ignacio Petersen, Maria Laura Letter Netherlands J Plast Reconstr Aesthet Surg. 2020 Nov;73(11):2086-2102. doi: 10.1016/j.bjps.2020.08.096. Epub 2020 Sep 11. PY - 2020 SN - 1748-6815 SP - 2086-2102 ST - The value of preoperative computed tomography angiography (CT-A) in patients undergoing delayed latissimus dorsi flap breast reconstruction after axillary lymph node dissection or irradiation and suspicion of pedicle injury T2 - J Plast Reconstr Aesthet Surg TI - The value of preoperative computed tomography angiography (CT-A) in patients undergoing delayed latissimus dorsi flap breast reconstruction after axillary lymph node dissection or irradiation and suspicion of pedicle injury VL - 73 ID - 13345 ER - TY - JOUR AB - The deep inferior epigastric artery perforator (DIEP) flap has recently become the first option for breast reconstruction. However, the anatomy of the deep inferior epigastric artery varies greatly from one individual to another and even from one hemiabdomen to the other. An optimal pre-operative evaluation method that adequately maps the underlying vasculature has been lacking. The advent of multidetector-row CT (MDCT) angiography has proven highly accurate at detailing the vasculature, but no reports have documented its value during pre-operative planning. From December 2006 to May 2008, 22 consecutive patients who underwent MDCT angiography before breast reconstruction using DIEP flaps were selected as the test group, and 22 former patients who did not undergo MDCT before the same procedure were selected as the control group. The two groups were evaluated for the ratio of pre-operative redesign, intra-operative method changes, time spent on flap harvest and the ratio of flap-associated complications. The pre-operative redesign ratio was 22.7% in the test group and 0% in the control group. The intra-operative method change ratio was 0% in the test group and 13.6% in the control group. The mean time spent on flap harvest was 2.8 +/- 0.2 h in the test group and 4.4 +/- 0.2 h in the control group (p<0.05). The flap complication rate was 1/22 in the test group and 3/22 in the control group (p=0.04). In conclusion, use of MDCT angiography during pre-operative planning promotes a significant reduction in operating time and complication rate. AD - [Xin Minqiang; Mu Lanhua; Luan Jie; Mu Dali] Chinese Acad Med Sci, Peking Union Med Coll, Plast Surg Hosp, Breast Plast & Reconstruct Surg Ctr, Beijing 100037, Peoples R China. [Lu Jinguo] Chinese Acad Med Sci, Peking Union Med Coll, Fu Wai Cardiovasc Hosp, Radiol Ctr, Beijing 100037, Peoples R China. Mu, LH (corresponding author), Badachu Rd, Beijing 100144, Peoples R China. mulan666@yahoo.cn AN - WOS:000275070700008 AU - Xin, M. Q. AU - Mu, L. H. AU - Luan, J. AU - Mu, D. L. AU - Lu, J. G. DA - Jan DO - 10.1259/bjr/29140440 IS - 985 J2 - Br. J. Radiol. KW - computed tomographic angiography Radiology, Nuclear Medicine & Medical Imaging LA - English M3 - Article N1 - ISI Document Delivery No.: 562RF Times Cited: 27 Cited Reference Count: 10 Xin Minqiang Mu Lanhua Luan Jie Mu Dali Lu Jinguo 32 0 British inst radiology London 1748-880x PY - 2010 SN - 0007-1285 SP - 40-43 ST - The value of multidetector-row CT angiography for pre-operative planning of breast reconstruction with deep inferior epigastric arterial perforator flaps T2 - British Journal of Radiology TI - The value of multidetector-row CT angiography for pre-operative planning of breast reconstruction with deep inferior epigastric arterial perforator flaps UR - ://WOS:000275070700008 VL - 83 ID - 3153 ER - TY - JOUR AB - Microsurgical abdominally-based reconstruction is considered the gold standard in autologous breast reconstruction. Despite refined surgical procedures, donor-site complications still occur, reducing patient satisfaction and quality of life. Recent work has outlined the potential of morphometric measurements in risk assessment for postoperative hernia development. With rising demand for personalised treatment, the goal of this study was to investigate their potential in risk assessment for any donor site complication. In this retrospective cohort study, 90 patients were included who each received microsurgical breast reconstruction at the hands of one surgeon between January 2015 and May 2017. Donor-site complications formed the primary outcome and were classified according to Clavien-Dindo. Morphometric measurements were taken on a routinely performed computed tomographic angiogram. Complications occurred in 13 of the 90 (14.4%) cases studied. All patients who developed any type of postoperative donor site complication had a history of abdominal surgery. The risk of postoperative complications increased by 3% with every square centimetre of omental fat tissue (OR 1.03, 95% CI 1.00-1.06, andp-value = 0.022). Morphometric measurements provide valuable information in risk assessment for donor-site complications in abdominally-based breast reconstruction. They may help identify personalised reconstructive options for maximal postoperative patient satisfaction and quality of life. AD - [Meyer, Muriel O.; Handschin, Tristan M.; Schaefer, Dirk J.; Haug, Martin D.; Kappos, Elisabeth A.] Univ Hosp Basel, Dept Plast Reconstruct Aesthet & Hand Surg, CH-4031 Basel, Switzerland. [Meyer, Muriel O.; Handschin, Tristan M.; Schaefer, Dirk J.; Haug, Martin D.; Kappos, Elisabeth A.] Univ Basel, Fac Med, CH-4051 Basel, Switzerland. [Boll, Daniel T.] Univ Hosp Basel, Dept Radiol, CH-4031 Basel, Switzerland. [Boll, Daniel T.] Univ Hosp Basel, Nucl Med Clin, CH-4031 Basel, Switzerland. [Chammartin, Frederique] Univ Hosp, Basel Inst Clin Epidemiol & Biostat, Dept Clin Res, CH-4031 Basel, Switzerland. [Chammartin, Frederique] Univ Basel, CH-4031 Basel, Switzerland. [Haug, Martin D.; Kappos, Elisabeth A.] Univ Hosp Basel, Breast Ctr, CH-4031 Basel, Switzerland. Kappos, EA (corresponding author), Univ Hosp Basel, Dept Plast Reconstruct Aesthet & Hand Surg, CH-4031 Basel, Switzerland.; Kappos, EA (corresponding author), Univ Basel, Fac Med, CH-4051 Basel, Switzerland.; Kappos, EA (corresponding author), Univ Hosp Basel, Breast Ctr, CH-4031 Basel, Switzerland. muriel.meyer@stud.unibas.ch; tristan.handschin@stud.unibas.ch; daniel.boll@usb.ch; frederiquesophie.chammartin-basnet@usb.ch; dirk.schaefer@usb.ch; martin.haug@usb.ch; elisabeth.kappos@usb.ch AN - WOS:000564797100001 AU - Meyer, M. O. AU - Handschin, T. M. AU - Boll, D. T. AU - Chammartin, F. AU - Schaefer, D. J. AU - Haug, M. D. AU - Kappos, E. A. C7 - 2645 DA - Aug DO - 10.3390/jcm9082645 IS - 8 J2 - J. Clin. Med. KW - breast reconstruction autologous reconstruction deep inferior epigastric perforator flap muscle-sparing transverse rectus abdominis myocutaneus flap donor-site complications risk assessment morphometric measurements core muscle size neoadjuvant chemotherapy intraabdominal pressure perforator flap diep flap visceral obesity outcomes frailty tram association General & Internal Medicine LA - English M3 - Article N1 - ISI Document Delivery No.: NH6SC Times Cited: 0 Cited Reference Count: 63 Meyer, Muriel O. Handschin, Tristan M. Boll, Daniel T. Chammartin, Frederique Schaefer, Dirk J. Haug, Martin D. Kappos, Elisabeth A. Meyer, Muriel Olivia/0000-0003-0988-2022; Chammartin, Frederique/0000-0001-8959-2724 Department of Surgery, University Hospital of Basel This work was funded by the Department of Surgery, University Hospital of Basel. This source of funding had no involvement in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; nor in the decision to submit the article for publication. 0 1 Mdpi Basel 2077-0383 PY - 2020 SP - 14 ST - The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction T2 - Journal of Clinical Medicine TI - The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction UR - ://WOS:000564797100001 VL - 9 ID - 1095 ER - TY - JOUR AB - BACKGROUND: Prolonged and excessive drainage of serous fluid and seroma formation constitute the most common complications after mastectomy for breast carcinoma. Seroma formation delays wound healing, increases susceptibility to infection, skin flap necrosis, persistent pain and prolongs convalescence. For this, several techniques have been investigated to improve primary healing and minimize seroma formation. MATERIALS AND METHODS: Between June 2009 and July 2010 forty patients with breast carcinoma, scheduled for modified radical mastectomy, were randomly divided into 2 groups, the study group (20) and the control group (20). In the study group; the mastectomy flaps were fixed to the underlying muscles in raws, at various parts of the flap and at the wound edge using fine absorbable sutures. In the control group; the wound was closed in the conventional method at the edges. Closed suction drains were used in both groups. Patients, tumor characteristics and operative related factors were recorded. The amount and color of drained fluid were recorded daily. The drains were removed when the amount become less than 50 cc. The total amount and duration of drained fluid and the formation of seroma were recorded and the results were compared between the two groups. RESULTS: In the flap fixation group, the drain was removed in significantly shorter time compared to the control group (p < 0.001). Also, the total amount of fluid drained was significantly lower in the flap fixation group (p < 0.001). The flap fixation group showed a significantly lower frequency of seroma formation compared to the control group, both clinically (p = 0.028) and ultrasonographically (p = 0.047). CONCLUSIONS: The mastectomy flap fixation technique is a valuable procedure that significantly decreases the incidence of seroma formation, and reduces the duration and amount of drained fluid. However, it should be tried on a much wider scale to prove its validity. AN - CN-00830771 AU - Sakkary, M. A. DO - 10.1186/1477-7819-10-8 KW - *breast cancer/su [Surgery] Absorbable suture Adult Aged Article Breast Neoplasms [complications, pathology, *surgery] Cancer patient Carcinoma, Ductal, Breast [complications, pathology, surgery] Carcinoma, Lobular [complications, pathology, surgery] Clinical article Controlled study Drainage Exudates and Transudates Female Human Humans Mastectomy Mastectomy, Modified Radical Middle Aged Neoplasm Grading Neoplasm Staging Postoperative Complications Prognosis Prospective Studies Seroma Seroma [*etiology, *prevention & control] Skin flap Surgical Flaps Surgical Wound Dehiscence [etiology, *prevention & control] Tumor Wound Healing Wound closure M3 - Journal Article; Randomized Controlled Trial PY - 2012 SP - 8 ST - The value of mastectomy flap fixation in reducing fluid drainage and seroma formation in breast cancer patients T2 - World journal of surgical oncology TI - The value of mastectomy flap fixation in reducing fluid drainage and seroma formation in breast cancer patients UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00830771/full VL - 10 ID - 177 ER - TY - JOUR AB - Introduction: Among the complications of spinal surgery, the problems of disunity and exposure of osteosynthesis material continue to pose a great challenge, particularly in irradiated skin. Trimming and washing of osteosynthesis material associated with targeted antibiotic treatment following sampling is essential. Coverage may utilise muscle flaps, the success rate of which is highly variable. Depending on the site involved, the most widely used flaps rely on the paraspinal or latimus dorsi, trapezius or gluteal muscles. A poorly-known alternative to these muscle flaps is the use of thoracic and lumbar perforator rotational flaps, which have the advantage of providing large quantities of skin without sacrificing muscle (particularly the latimus dorsi muscle in paraplegic patients) or important vessels, and they do not require further thickness-reduction procedures. Rotational flaps are skin-fat flaps that enable displacement of supple good-quality skin to the desired site by rotation around a small perforator vessel up to a limit of 220°. Materials and methods: We set out the experiences of the University Orthoplasty Group regarding coverage of spinal substance loss, illustrated by clinical case studies. Results: We present a series of four rotational perforator flaps (3 thoracic and 1 lumbar) successively used for extensive substance deficit with exposure of osteosynthesis material following oncological surgery (breast cancer metastases, chondrosarcoma) involving the upper dorsal spine in 3 cases, as well as 1 case of exposure following burns next to the area of osteosynthesis in a paraplegic patient. The largest area of substance deficit measured 31 cm 9 9 cm while the smallest measured 17 cm × 6 cm. We present the anatomical bases and surgical techniques, while discussing the value of such flaps in these particular indications. Conclusion: We present cases and surgical techniques enabling skin coverage without extensive sacrifice of muscle or blood vessels in patients presenting large-scale substance deficit, while stressing the value of collaboration between orthopaedic and plastic surgery specialists. AD - M. Atlan, Paris, France AU - Atlan, M. AU - Pascal-Mousselard, H. DB - Embase DO - 10.1007/s00586-018-5676-z IS - 9 KW - adult breast cancer burn cancer surgery case report chondrosarcoma clinical article conference abstract female gluteus muscle human metastasis muscle blood vessel muscle flap osteosynthesis material paraplegia perforator flap rotation spine surgery surgical technique thickness trapezius muscle LA - English M3 - Conference Abstract N1 - L623901933 2018-09-20 PY - 2018 SN - 1432-0932 SP - 2384 ST - Value of lumbar and thoracic perforator flaps in coverage of spinal substance deficit T2 - European Spine Journal TI - Value of lumbar and thoracic perforator flaps in coverage of spinal substance deficit UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623901933&from=export http://dx.doi.org/10.1007/s00586-018-5676-z VL - 27 ID - 5309 ER - TY - JOUR AB - Total mastectomy is usually indicated after breast conservative treatment cancer recurrence. Breast reconstruction in this group can be performed with many options. We did 63 latissimus dorsi flap with implants reconstructions between 2001-2007. All of them were performed in breast cancer recurrence cases after breast conservative treatment and preceded for total mastectomy. The patient age range from 31 to 71 years old (50.1 ± 7.3 years). The follow-up was 36.5 ± 14.9 months (22-141 months). Neither flap loss nor significant major donor-site complication was recorded. The capsular contraction Baker's grade III was observed in 2 cases (3.1%). The rest were grade I-II and there was no grade IV contracture. We purpose that LD flap with implant can be performed in irradiated breast with low capsular contracture rate. It is suitable in total mastectomy reconstruction after conservative breast cancer surgery recurrence. AD - Division of Plastic Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milano, Italy. cristina.garusi@ieo.it AN - 21074437 AU - Garusi, C. AU - Lohsiriwat, V. AU - Brenelli, F. AU - Galimberti, V. E. AU - De Lorenzi, F. AU - Rietjens, M. AU - Rossetto, F. AU - Petit, J. Y. DA - Apr DO - 10.1016/j.breast.2010.10.007 DP - NLM ET - 2010/11/16 IS - 2 KW - Adult Aged Breast Implantation Breast Neoplasms/radiotherapy/*surgery Female Humans Implant Capsular Contracture/epidemiology/surgery Mammaplasty/instrumentation/*methods *Mastectomy Middle Aged Neoplasm Recurrence, Local/*surgery Retrospective Studies *Surgical Flaps Treatment Outcome LA - eng N1 - 1532-3080 Garusi, Cristina Lohsiriwat, Visnu Brenelli, Fabricio Galimberti, Viviana Enrica De Lorenzi, Francesca Rietjens, Mario Rossetto, Fabio Petit, Jean Yves Journal Article Netherlands Breast. 2011 Apr;20(2):141-4. doi: 10.1016/j.breast.2010.10.007. Epub 2010 Nov 11. PY - 2011 SN - 0960-9776 SP - 141-4 ST - The value of latissimus dorsi flap with implant reconstruction for total mastectomy after conservative breast cancer surgery recurrence T2 - Breast TI - The value of latissimus dorsi flap with implant reconstruction for total mastectomy after conservative breast cancer surgery recurrence VL - 20 ID - 10896 ER - TY - JOUR AB - The aim of this paper is to evaluate dynamic infrared thermography (DIRT) as a technique to assist in preoperative perforator selection and planning of free deep inferior epigastric perforator (DIEP) flaps. Twenty-seven patients, scheduled for secondary autologous breast reconstruction with either a free DIEP flap or superficial inferior epigastric artery flap, were included in this prospective clinical study. Preoperative mapping of perforators was performed with a hand-held Doppler and DIRT. A multidetector computer tomography scan was additionally carried out in the last 8 patients. In 23 patients a DIEP flap was used. The perforator as selected from DIRT was a suitable perforator in all DIEP flaps. The location and quality of the selected perforator from DIRT corresponded well with the multidetector computer tomography scan results. Preoperative perforator selection and planning of DIEP flaps is facilitated with the use of DIRT. The technique is noninvasive and easy to use. AD - [de Weerd, Louis] Univ Hosp N Norway, Dept Plast Surg & Hand Surg, Tromso, Norway. [Weum, Sven; Mercer, James B.] Univ Hosp N Norway, Dept Radiol, Tromso, Norway. [Mercer, James B.] Univ Tromso, Fac Med, Dept Med Physiol, N-9001 Tromso, Norway. de Weerd, L (corresponding author), Sykelius Veien 38,Post Box 66, N-9038 Tromso, Norway. louis.deweerd@unn.no AN - WOS:000269331500008 AU - de Weerd, L. AU - Weum, S. AU - Mercer, J. B. DA - Sep DO - 10.1097/SAP.0b013e318190321e IS - 3 J2 - Ann. Plast. Surg. KW - dynamic infrared thermography DIRT perforator planning DIEP flap donor site morbidity breast reconstruction clinical-applications free tram perfusion angiography experience vessels abdomen Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 488EI Times Cited: 61 Cited Reference Count: 28 de Weerd, Louis Weum, Sven Mercer, James B. 61 0 9 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2009 SN - 0148-7043 SP - 274-279 ST - The Value of Dynamic Infrared Thermography (DIRT) in Perforator Selection and Planning of Free DIEP Flaps T2 - Annals of Plastic Surgery TI - The Value of Dynamic Infrared Thermography (DIRT) in Perforator Selection and Planning of Free DIEP Flaps UR - ://WOS:000269331500008 VL - 63 ID - 3242 ER - TY - JOUR AD - Department of Plastic and Reconstructive Surgery; Royal Free Hospital; London, United Kingdom (Sojitra) Department of Plastic Surgery; H. Hart Ziekenhuis, and Department of Plastic Surgery; Universitair Ziekenhuis Gasthuisberg; Leuven, Belgium (Fabre, Vandevoort). AN - 20124817 AU - Sojitra, N. M. AU - Fabre, G. AU - Vandevoort, M. DA - Feb DO - 10.1097/PRS.0b013e3181c725d2 DP - NLM ET - 2010/02/04 IS - 2 KW - Breast/blood supply/surgery Female Humans Mammaplasty/*methods Mammary Arteries/*surgery Mastectomy Microsurgery/*methods Postoperative Complications/*prevention & control Surgical Flaps/*blood supply LA - eng N1 - 1529-4242 Sojitra, Nilesh M Fabre, Gerd Vandevoort, Marc Journal Article United States Plast Reconstr Surg. 2010 Feb;125(2):77e-78e. doi: 10.1097/PRS.0b013e3181c725d2. PY - 2010 SN - 0032-1052 SP - 77e-78e ST - A valuable method for exposure of the recipient internal mammary vessels for microvascular breast reconstruction T2 - Plast Reconstr Surg TI - A valuable method for exposure of the recipient internal mammary vessels for microvascular breast reconstruction VL - 125 ID - 9465 ER - TY - JOUR AB - Background: Specific International Classification of Diseases, Ninth Revision codes for different methods of autologous breast reconstruction have been introduced recently, prompting investigators to use discharge databases to evaluate outcomes of autologous breast reconstruction. The accuracy and validity of these data sources have not been evaluated. Methods: All patients who underwent autologous breast reconstruction in a single center from October of 2008 to April of 2013 were retrospectively included. Patient medical records were used as the criterion standard to identify specific autologous procedure performed and any perioperative reoperations. These findings were compared against procedure codes documented in the coded discharge data obtained from hospital billing. Results: A total of 163 autologous procedures were performed in 115 patients, including 40 pedicled and 37 free transverse rectus abdominis musculocutaneous, 74 deep inferior epigastric perforator, five superficial inferior epigastric artery, four transverse upper gracilis, and three superior gluteal artery perforator flaps. Only 126 of 163 flaps (77 percent) were coded correctly. Twenty-two of 48 bilateral procedures had coding for only one flap. An additional 16 cases were either incorrectly coded as another type of reconstruction or not coded at all. Only 19 of 21 reoperations (90 percent) could be captured by review of the coding alone. Conclusions: Using International Classification of Diseases, Ninth Revision, codes alone to evaluate autologous breast reconstructions could result in an incomplete and inaccurate data set, with exclusion of many bilateral flaps. Reoperations during the same hospital stay may also be missed if identified only by a discharge code, thus limiting the evaluation of acute complications. AD - [Talia, Jordan; Agarwal, Shailesh; Momoh, Adeyiza O.; Wilkins, Edwin G.; Kozlow, Jeffrey H.] Univ Michigan, Sch Med, Sect Plast Surg, Ann Arbor, MI USA. Kozlow, JH (corresponding author), 2130 Taubman Ctr, 1500 East Med Ctr Dr,SPC 5340, Ann Arbor, MI 48109 USA. jkozlow@umich.edu AN - WOS:000348763800050 AU - Talia, J. AU - Agarwal, S. AU - Momoh, A. O. AU - Wilkins, E. G. AU - Kozlow, J. H. DA - Feb DO - 10.1097/prs.0000000000000894 IS - 2 J2 - Plast. Reconstr. Surg. KW - administrative data american-college predictive-value diagnoses outcomes volume Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: CA2UQ Times Cited: 9 Cited Reference Count: 18 Talia, Jordan Agarwal, Shailesh Momoh, Adeyiza O. Wilkins, Edwin G. Kozlow, Jeffrey H. 9 0 1 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2015 SN - 0032-1052 SP - 368-374 ST - The Validity of Hospital Discharge Data for Autologous Breast Reconstruction Research T2 - Plastic and Reconstructive Surgery TI - The Validity of Hospital Discharge Data for Autologous Breast Reconstruction Research UR - ://WOS:000348763800050 VL - 135 ID - 2302 ER - TY - JOUR AB - BACKGROUND: The Venous Thromboembolism Prevention Study (VTEPS) Network is a consortium of 5 tertiary referral centers established to examine venous thromboembolism (VTE) in plastic surgery patients. We report our midterm analyses of the study's control group to evaluate the incidence of VTE in patients who receive no chemoprophylaxis, and validate the Caprini Risk Assessment Model (RAM) in plastic surgery patients. STUDY DESIGN: Medical record review was performed at VTEPS centers for all eligible plastic surgery patients between March 2006 and June 2009. Inclusion criteria were Caprini score >= 3, surgery under general anesthesia, and postoperative hospital admission. Patients who received chemoprophylaxis were excluded. Dependent variables included symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) within the first 60 postoperative days and time to DVT or PE. RESULTS: We identified 1,126 historic control patients. The overall VTE incidence was 1.69%. Approximately 1 in 9 (11.3%) patients with Caprini score >8 had a VTE event. Patients with Caprini score >8 were significantly more likely to develop VTE when compared with patients with Caprini score of 3 to 4 (odds ratio [OR] 20.9, p < 0.001), 5 to 6 (OR9.9, p < 0.001), or 7 to 8 (OR4.6, p = 0.015). Among patients with Caprini score 7 to 8 or Caprini score >8, VTE risk was not limited to the immediate postoperative period (postoperative days 1-14). In these high-risk patients, more than 50% of VTE events were diagnosed in the late (days 15-60) postoperative period. CONCLUSIONS: The Caprini RAM effectively risk-stratifies plastic and reconstructive surgery patients for VTE risk. Among patients with Caprini score >8, 11.3% have a postoperative VTE when chemoprophylaxis is not provided. In higher risk patients, there was no evidence that VTE risk is limited to the immediate postoperative period. (J Am Coll Surg 2011;212:105-112. (C) 2011 by the American College of Surgeons) AD - [Pannucci, Christopher J.] Univ Michigan, Dept Surg, Sect Plast Surg, Taubman Ctr 2130, Ann Arbor, MI 48105 USA. [Bailey, Steven H.; Hoxworth, Ronald E.] Univ Texas SW, Dept Plast Surg, Dallas, TX USA. [Dreszer, George; Kalliainen, Loree K.] Reg Hosp, Dept Plast & Hand Surg, St Paul, MN USA. [Wachtman, Christine Fisher; Rubin, J. Peter] Univ Pittsburgh, Div Plast & Reconstruct Surg, Pittsburgh, PA USA. [Hamill, Jennifer B.] JBH Consulting, Shohola, PA USA. [Hume, Keith M.] Amer Soc Plast Surg, Arlington Hts, IL USA. [Neligan, Peter C.] Univ Washington, Div Plast Surg, Seattle, WA 98195 USA. [Pusic, Andrea L.] Mem Sloan Kettering Canc Ctr, Plast & Reconstruct Surg Serv, New York, NY 10021 USA. Pannucci, CJ (corresponding author), Univ Michigan, Dept Surg, Sect Plast Surg, Taubman Ctr 2130, 1500 E Med Ctr Dr, Ann Arbor, MI 48105 USA. AN - WOS:000286129100013 AU - Pannucci, C. J. AU - Bailey, S. H. AU - Dreszer, G. AU - Wachtman, C. F. AU - Zumsteg, J. W. AU - Jaber, R. M. AU - Hamill, J. B. AU - Hume, K. M. AU - Rubin, J. P. AU - Neligan, P. C. AU - Kalliainen, L. K. AU - Hoxworth, R. E. AU - Pusic, A. L. AU - Wilkins, E. G. DA - Jan DO - 10.1016/j.jamcollsurg.2010.08.018 IS - 1 J2 - J. Am. Coll. Surg. KW - deep-vein thrombosis venous thromboembolism prophylaxis breast reconstruction pulmonary-embolism tram flap prevention efficacy cancer guide complications Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 705LE Times Cited: 220 Cited Reference Count: 48 Pannucci, Christopher J. Bailey, Steven H. Dreszer, George Wachtman, Christine Fisher Zumsteg, Justin W. Jaber, Reda M. Hamill, Jennifer B. Hume, Keith M. Rubin, J. Peter Neligan, Peter C. Kalliainen, Loree K. Hoxworth, Ronald E. Pusic, Andrea L. Wilkins, Edwin G. Neligan, Peter/ABD-7219-2020 Plastic Surgery Educational Foundation; NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [T32 GM-08616]; NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCESUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of General Medical Sciences (NIGMS) [T32GM008616] Funding Source: NIH RePORTER This study was funded by the Plastic Surgery Educational Foundation. Dr Pannucci receives salary support through NIH grant T32 GM-08616. 234 0 25 Elsevier science inc New york 1879-1190 PY - 2011 SN - 1072-7515 SP - 105-112 ST - Validation of the Caprini Risk Assessment Model in Plastic and Reconstructive Surgery Patients T2 - Journal of the American College of Surgeons TI - Validation of the Caprini Risk Assessment Model in Plastic and Reconstructive Surgery Patients UR - ://WOS:000286129100013 VL - 212 ID - 3003 ER - TY - JOUR AB - Autologous reconstruction using abdominal flaps remains the most popular method for breast reconstruction worldwide. We aimed to evaluate a prediction model using machine-learning methods and to determine which factors increase abdominal flap donor site complications with logistic regression. We evaluated the predictive ability of different machine learning packages, reviewing a cohort of breast reconstruction patients who underwent abdominal flaps. We analyzed 13 treatment variables for effects on the abdominal donor site complication rates. To overcome data imbalances, random over sampling example (ROSE) method was used. Data were divided into training and testing sets. Prediction accuracy, sensitivity, specificity, and predictive power (AUC) were measured by applying neuralnet, nnet, and RSNNS machine learning packages. A total of 568 patients were analyzed. The supervised learning package that performed the most effective prediction was neuralnet. Factors that significantly affected donor-related complication was size of the fascial defect, history of diabetes, muscle sparing type, and presence or absence of adjuvant chemotherapy. The risk cutoff value for fascial defect was 37.5 cm(2). High-risk group complication rates analyzed by statistical method were significant compared to the low-risk group (26% vs 1.7%). These results may help surgeons to achieve better surgical outcomes and reduce postoperative burden. AD - Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea. psdrj2h@gmail.com. AN - 33692412 AU - Myung, Y. AU - Jeon, S. AU - Heo, C. AU - Kim, E. K. AU - Kang, E. AU - Shin, H. C. AU - Yang, E. J. AU - Jeong, J. H. C2 - PMC7946880 DA - Mar 10 DO - 10.1038/s41598-021-85155-z DP - NLM ET - 2021/03/12 IS - 1 LA - eng N1 - 2045-2322 Myung, Yujin Jeon, Sungmi Heo, Chanyeong Kim, Eun-Kyu Kang, Eunyoung Shin, Hee-Chul Yang, Eun-Joo Jeong, Jae Hoon 09-2020-002/Seoul National University Bundang Hospital Research Fund/ Journal Article Sci Rep. 2021 Mar 10;11(1):5615. doi: 10.1038/s41598-021-85155-z. PY - 2021 SN - 2045-2322 SP - 5615 ST - Validating machine learning approaches for prediction of donor related complication in microsurgical breast reconstruction: a retrospective cohort study T2 - Sci Rep TI - Validating machine learning approaches for prediction of donor related complication in microsurgical breast reconstruction: a retrospective cohort study VL - 11 ID - 14236 ER - TY - JOUR AB - Vaginal reconstruction after pelvic exenteration (PE) represents a challenge for the oncologic surgeon. Since the introduction of perforator flaps, using pedicled vertical DIEP (deep inferior epigastric perforator) flap allows to reduce the donor site complication rate. From November 2012 to December 2014, 27 PEs were performed in our institution. 13 patients who underwent PE with vaginal reconstruction and programmed DIEP procedure for gynecologic malignancies were registered. Nine patients underwent PE for recurrent disease and four for primary treatment. Six of the 13 patients have a preoperative fistula. Anterior PE was performed in 10 patients, and total PE in 3 patients. A vertical DIEP flap was performed in 10 patients using one or two medial perforators. The reasons for abortion of vertical DIEP flap procedure were: failure to localizing perforator vessels in two cases, and unavailability of plastic surgeon in one case. A vertical fascia-sparring rectus abdominis myocutaneous flap was then harvested. Median length of surgery was 335 min, and 60 min for DIEP harvesting and vaginal reconstruction. No flap necrosis occurred. One patient in the VRAM (vertical rectus abdominis myocutaneous) group experienced a late incisional hernia and one patient in the DIEP flap group required revision for vaginal stenosis. In our experience, DIEP flap represents our preferred choice of flap for circumferential vaginal reconstruction after PE. To achieve a high reproducibility, the technically demanding pedicled vertical DIEP flap has to be harvested by a trained surgeon, after strict evaluation of the preoperative imaging with identification and localization of perforator vessels. (C) 2015 Published by Elsevier Inc. AD - [Ferron, Gwenael; Gangloff, Dimitri; Querleu, Denis; Frigenza, Melanie; Torrent, Juan Jose; Picaud, Laetitia; Martinez, Alejandra] Inst Univ Canc, Inst Claudius Regaud, Dept Surg Oncol, F-31000 Toulouse 09, France. [Querleu, Denis] Inst Bergonie, Dept Surg Oncol, F-33000 Bordeaux, France. [Torrent, Juan Jose] Hosp Univ Germans Trios & Pujol, Dept Gynecol, Barcelona 08916, Spain. [Gladieff, Laurence] Inst Univ Canc, Inst Claudius Regaud, Dept Med Oncol, F-31000 Toulouse 09, France. [Gladieff, Laurence] Inst Univ Canc, Inst Claudius Regaud, Dept Radiat Therapy, F-31000 Toulouse 09, France. [Mery, Eliane] Inst Univ Canc, Inst Claudius Regaud, Dept Surg Pathol, F-31000 Toulouse 09, France. [Boulet, Berenice; Balague, Gisele] Inst Univ Canc, Inst Claudius Regaud, Dept Radiol, F-31000 Toulouse 09, France. Ferron, G (corresponding author), Inst Univ Canc, Inst Claudius Regaud, Dept Surg Oncol, 1 Ave Irene Joliot Curie, F-31059 Toulouse 9, France. ferron.gwenael@iuct-oncolople.fr AN - WOS:000361269300020 AU - Ferron, G. AU - Gangloff, D. AU - Querleu, D. AU - Frigenza, M. AU - Torrent, J. J. AU - Picaud, L. AU - Gladieff, L. AU - Delannes, M. AU - Mery, E. AU - Boulet, B. AU - Balague, G. AU - Martinez, A. DA - Sep DO - 10.1016/j.ygyno.2015.06.031 IS - 3 J2 - Gynecol. Oncol. KW - Pelvic exenteration Vaginal reconstruction DIEP VRAM abdominis myocutaneous flap quality-of-life patient-reported outcomes perineal reconstruction breast reconstructions surgical outcomes sexual function vram flap surgery complications Oncology Obstetrics & Gynecology LA - English M3 - Article N1 - ISI Document Delivery No.: CR3YP Times Cited: 11 Cited Reference Count: 33 Ferron, Gwenael Gangloff, Dimitri Querleu, Denis Frigenza, Melanie Torrent, Juan Jose Picaud, Laetitia Gladieff, Laurence Delannes, Martine Mery, Eliane Boulet, Berenice Balague, Gisele Martinez, Alejandra Martinez, Alejandra/A-4097-2015 Martinez, Alejandra/0000-0002-7633-3536 13 0 4 Academic press inc elsevier science San diego 1095-6859 PY - 2015 SN - 0090-8258 SP - 603-608 ST - Vaginal reconstruction with pedicled vertical deep inferior epigastric perforator flap (diep) after pelvic exenteration. A consecutive case series T2 - Gynecologic Oncology TI - Vaginal reconstruction with pedicled vertical deep inferior epigastric perforator flap (diep) after pelvic exenteration. A consecutive case series UR - ://WOS:000361269300020 VL - 138 ID - 2186 ER - TY - JOUR AD - Wright State Univ, Miami Valley Hosp, Dept Surg, Div Plast Surg, Dayton, OH 45409 USA. Wright State Univ, Miami Valley Hosp, Dept Obstet & Gynecol, Dayton, OH 45409 USA. Johnson, RM (corresponding author), Wright State Univ, Miami Valley Hosp, Dept Surg, Div Plast Surg, 1 Wyoming St,CHE7000, Dayton, OH 45409 USA. AN - WOS:000174827900025 AU - Johnson, R. M. AU - Barney, L. M. AU - King, J. C. DA - Apr DO - 10.1097/00006534-200204150-00025 IS - 5 J2 - Plast. Reconstr. Surg. KW - pregnancy flap cancer Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 538RB Times Cited: 7 Cited Reference Count: 10 Johnson, RM Barney, LM King, JC 9 0 Lippincott williams & wilkins Philadelphia PY - 2002 SN - 0032-1052 SP - 1653-1654 ST - Vaginal delivery of monozygotic twins after bilateral pedicle TRAM breast reconstruction T2 - Plastic and Reconstructive Surgery TI - Vaginal delivery of monozygotic twins after bilateral pedicle TRAM breast reconstruction UR - ://WOS:000174827900025 VL - 109 ID - 3952 ER - TY - JOUR AD - A.R. Gagnon, Department of Plastic Surgery, University Hospital Gent, De Pintelaan 185, 9000 Gent, Belgium AU - Gagnon, A. R. AU - Hamdi, M. DB - Embase Medline DO - 10.1016/j.bjps.2006.05.010 IS - 3 KW - bleeding breast reconstruction cauterization dissection experience free tissue graft human letter medical decision making patient safety postoperative complication priority journal seroma superior gluteal artery perforator flap surgical technique vacuum aspiration vascular pedicle LA - English M3 - Letter N1 - L46206867 2007-03-05 PY - 2007 SN - 1748-6815 SP - 330-331 ST - Vacuum-assisted lipodissection in free flap harvesting T2 - Journal of Plastic, Reconstructive and Aesthetic Surgery TI - Vacuum-assisted lipodissection in free flap harvesting UR - https://www.embase.com/search/results?subaction=viewrecord&id=L46206867&from=export http://dx.doi.org/10.1016/j.bjps.2006.05.010 VL - 60 ID - 8004 ER - TY - JOUR AB - Complex breast wounds are a constant problem for surgeons. Wound vacuum-assisted closure therapy (VAC) has been shown to be effective for a variety of complex wounds. Our goal was to evaluate our experience with the (VAC) device in the treatment of open breast wounds. We retrospectively identified 18 patients with complex breast wounds treated with the VAC. We analyzed the data regarding the nature and management of these wounds using the VAC device. Fifteen of 18 patients were treated effectively using the VAC. Two patients required muscle flap coverage. One patient had the VAC dressing discontinued secondary to a denial by an insurance company for VAC in the home setting. VAC therapy is an effective treatment for complex wounds. Specifically, our experience shows it to be effective in the treatment of complex breast wounds. Utilization of VAC therapy should be considered for the management of these challenging wounds. AD - Surgical Oncology Service, Wake Forest University School of Medicine, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina 27157, USA. AN - 16443363 AU - Stoeckel, W. T. AU - David, L. AU - Levine, E. A. AU - Argenta, A. E. AU - Perrier, N. D. DA - Oct DO - 10.1016/j.breast.2005.11.006 DP - NLM ET - 2006/01/31 IS - 5 KW - Breast Neoplasms/epidemiology/pathology/*surgery Female Humans Mastectomy/*methods/statistics & numerical data Medical Records Middle Aged North Carolina/epidemiology Retrospective Studies Surgical Flaps Suture Techniques/instrumentation/*statistics & numerical data Vacuum Wound Healing LA - eng N1 - Stoeckel, William T David, Lisa Levine, Edward A Argenta, Anne E Perrier, Nancy D Journal Article Netherlands Breast. 2006 Oct;15(5):610-3. doi: 10.1016/j.breast.2005.11.006. Epub 2006 Jan 27. PY - 2006 SN - 0960-9776 (Print) 0960-9776 SP - 610-3 ST - Vacuum-assisted closure for the treatment of complex breast wounds T2 - Breast TI - Vacuum-assisted closure for the treatment of complex breast wounds VL - 15 ID - 13639 ER - TY - JOUR AB - Vacuum Assisted Closure (V.A.C.) is a sound strategy to control severe post-sternotomy infection. Secondary re-wiring of the sternal bone or reconstructive surgery may be required later to achieve complete wound closure. Ten patients with severe sternal bone infection underwent initial V.A.C. therapy and delayed surgery for wound closure. Complete wound healing was achieved in all cases. As a case report we describe a patient with right-sided mastectomy and irradiation for breast cancer, who developed severe post-sternotomy infection and sternal bone necrosis following CABG. A combination of V.A.C. therapy and surgical reconstruction using a pedicled latissimus dorsi musculocutaneous flap led to complete wound closure. AD - Abteilung für Herz-, Thorax- und Gefässchirurgie, Klinikum Braunschweig. i.kutschka@klinikum-braunschweig.de AN - 16575663 AU - Kutschka, I. AU - Dziadzka, S. AU - El Essawi, A. AU - Flory, P. J. AU - Harringer, W. DA - Apr DO - 10.1055/s-2006-921427 DP - NLM ET - 2006/04/01 KW - Abscess/surgery Aged Bone Wires Breast Neoplasms/radiotherapy/surgery Combined Modality Therapy Debridement Female Humans Male Manubrium/surgery Mastectomy, Radical Middle Aged *Occlusive Dressings Osteomyelitis/*surgery Postoperative Care Radiodermatitis/surgery Radiotherapy, Adjuvant Recurrence Reoperation Respiration, Artificial Risk Factors Sternum/*surgery *Surgical Flaps Surgical Wound Infection/*surgery Vacuum LA - ger N1 - Kutschka, I Dziadzka, S El Essawi, A Flory, P-J Harringer, W Case Reports English Abstract Journal Article Germany Zentralbl Chir. 2006 Apr;131 Suppl 1:S129-32. doi: 10.1055/s-2006-921427. OP - Vakuumtherapie bei sternaler Wundinfektion -- Initiale Therapie zur Infektkontrolle und Uberbrückung zur plastisch chirurgischen Rekonstruktion. PY - 2006 SN - 0044-409X (Print) 0044-409x SP - S129-32 ST - [Vacuum assisted closure for the treatment of sternal wound infections -- rapid infection control and bridging to reconstructive surgery] T2 - Zentralbl Chir TI - [Vacuum assisted closure for the treatment of sternal wound infections -- rapid infection control and bridging to reconstructive surgery] VL - 131 Suppl 1 ID - 13412 ER - TY - JOUR AB - Posterior chest wall defects are frequently encountered after excision of tumors as a result of trauma or in the setting of wound dehiscence after spine surgery. Various pedicled fasciocutaneous and musculocutaneous flaps have been described for the coverage of these wounds. The advent of perforator flaps has allowed the preservation of muscle function but their bulk is limited. Musculocutaneous flaps remain widely employed. The trapezius and the latissimus dorsi (LD) flaps have been used extensively for upper and middle posterior chest wounds, respectively. Their bulk allows for obliteration of the dead space in deep wounds. The average width of the LD skin paddle is limited to 10-12 cm if closure of the donor site is expected without skin grafting. In 2001 a modification of the skin paddle design was introduced in order to allow large flaps to be raised without requiring grafts or flaps for donor site closure. This V-Y pattern allows coverage of large anterior chest defects after mastectomy. We have modified this flap to allow its use for posterior chest wall defects. We describe the flap design, its indications, and its limitations with three clinical cases. AD - [Christen, T.; Koch, N.; Raffoul, W.] Univ Lausanne Hosp, Dept Plast Reconstruct & Aesthet Surg, CH-1011 Lausanne, Switzerland. [Philandrianos, C.; Ramirez, R.; Casanova, D.] Univ Hosp Marseille, Dept Plast Reconstruct & Aesthet Surg, North Hosp, F-13915 Marseille 20, France. Christen, T (corresponding author), Univ Lausanne Hosp, Dept Plast Reconstruct & Aesthet Surg, 46 Rue Bugnon, CH-1011 Lausanne, Switzerland. thierry.christen@chuv.ch AN - WOS:000304203800021 AU - Christen, T. AU - Koch, N. AU - Philandrianos, C. AU - Ramirez, R. AU - Raffoul, W. AU - Beldi, M. AU - Casanova, D. DA - Jun DO - 10.1007/s00266-011-9866-x IS - 3 J2 - Aesthet. Plast. Surg. KW - Latissimus dorsi Posterior chest wall defect V-Y design breast reconstruction island flap closure muscle neck Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 944LN Times Cited: 4 Cited Reference Count: 20 Christen, T. Koch, N. Philandrianos, C. Ramirez, R. Raffoul, W. Beldi, M. Casanova, D. 5 0 Springer New york 1432-5241 PY - 2012 SN - 0364-216X SP - 618-622 ST - The V-Y Latissimus Dorsi Musculocutaneous Flap in the Reconstruction of Large Posterior Chest Wall Defects T2 - Aesthetic Plastic Surgery TI - The V-Y Latissimus Dorsi Musculocutaneous Flap in the Reconstruction of Large Posterior Chest Wall Defects UR - ://WOS:000304203800021 VL - 36 ID - 2751 ER - TY - JOUR AN - 23587677 AU - Witt, P. AU - Dujon, D. G. DA - Jul DO - 10.1016/j.bjps.2013.03.001 DP - NLM ET - 2013/04/17 IS - 7 KW - Esthetics Female Humans Mammaplasty/*methods Nipples/*surgery Risk Assessment Skin Transplantation/*methods Surgical Flaps/*blood supply Tattooing/methods Wound Healing/physiology LA - eng N1 - 1878-0539 Witt, P Dujon, D G Letter Netherlands J Plast Reconstr Aesthet Surg. 2013 Jul;66(7):1009-10. doi: 10.1016/j.bjps.2013.03.001. Epub 2013 Apr 12. PY - 2013 SN - 1748-6815 SP - 1009-10 ST - The V-V flap--a simple modification of the C-V flap for nipple reconstruction T2 - J Plast Reconstr Aesthet Surg TI - The V-V flap--a simple modification of the C-V flap for nipple reconstruction VL - 66 ID - 10692 ER - TY - JOUR AD - Morsani College of Medicine, University of South Florida, Tampa. Division of Plastic Surgery, Department of Surgery, Morsani College of Medicine, University of South Florida, Tampa. AN - 30455783 AU - Zhang, A. AU - Kuc, A. AU - Triggs, W. AU - Dayicioglu, D. C2 - PMC6232948 DP - NLM ET - 2018/11/21 KW - additional venous drainage for DIEP flap breast reconstruction chemotherapy catheter malposition deep inferior epigastric perforator (DIEP) flap venous congestion LA - eng N1 - 1937-5719 Zhang, Angie Kuc, Amra Triggs, Wilton Dayicioglu, Deniz Case Reports Eplasty. 2018 Oct 29;18:ic23. eCollection 2018. PY - 2018 SN - 1937-5719 (Print) 1937-5719 SP - ic23 ST - Utilizing the Retrograde Descending Internal Mammary Vein in DIEP Flap Anastomosis T2 - Eplasty TI - Utilizing the Retrograde Descending Internal Mammary Vein in DIEP Flap Anastomosis VL - 18 ID - 14025 ER - TY - JOUR AB - Background Venous congestion is a leading cause for free flap failure and still relies on clinical observation as the diagnostic gold standard. We sought to characterize blood flow in a variable venous congestion murine hind limb model using indocyanine green (ICG, SPY Pack, LifeCell, Branchburg, NJ) angiography. Methods Male Sprague Dawley rats (Charles River, Hudson, NY) underwent bilateral partial amputation at the inguinal ligament, leaving only the femoral vessels and femur intact. Complete unilateral venous occlusion was achieved via suture ligation, while partial occlusion was achieved by surrounding the femoral vein with a synthetic microtube to achieve 25, 75, 85, or 92% occlusion. Relative blood flow of occluded and control limbs was tracked with ICG angiography throughout a 90-minute time course. Results ICG angiography detected statistically significant (p < 0.05) reductions in limb blood flow 1 and 2 minutes following ICG injection in the 100, 92, and 85% occluded limbs when compared with contralateral control limbs. Dynamic tracking using the slope of ICG inflow for 45 seconds postinjection reflected this same significant difference. No statistically significant change in limb blood flow or dye influx rate was observed in the 25 and 75% occlusion groups. Conclusions ICG angiography can detect venous congestion in a rat lower extremity model reliably at occlusion rates >= 85%. This method may offer surgeons an intra-operative diagnostic tool to identify venous congestion at extremely early time points, allowing for immediate intervention. Further investigation and characterization is warranted in a larger animal model before clinical adaptation. AD - [Nasser, Ahmed] SUNY Stony Brook, Dept Surg, Med Ctr, Stony Brook, NY 11794 USA. [Fourman, Mitchell S.] Univ Pittsburgh, Med Ctr, Dept Orthopaed Surg, Pittsburgh, PA 15213 USA. [Gersch, Robert P.] Hosp Univ Penn, Dept Surg, Philadelphia, PA 19104 USA. [Phillips, Brett T.] Duke Univ, Med Ctr, Dept Surg, Div Plast Surg, Durham, NC 27710 USA. [Hsi, Hsingli Kai] SUNY Stony Brook, Sch Med, Med Ctr, Stony Brook, NY 11794 USA. [Khan, Sami U.; Gelfand, Mark A.; Dagum, Alexander B.; Bui, Duc T.] SUNY Stony Brook, Dept Surg, Med Ctr, Div Plast Surg, Stony Brook, NY 11794 USA. Fourman, MS (corresponding author), Univ Pittsburgh, Med Ctr, Dept Orthopaed Surg, Suite 911,Kaufmann Med Bldg,3471 Fifth Ave, Pittsburgh, PA 15213 USA. fourmanm@upmc.edu AN - WOS:000361412200006 AU - Nasser, A. AU - Fourman, M. S. AU - Gersch, R. P. AU - Phillips, B. T. AU - Hsi, H. K. AU - Khan, S. U. AU - Gelfand, M. A. AU - Dagum, A. B. AU - Bui, D. T. DA - Oct DO - 10.1055/s-0035-1558869 IS - 8 J2 - J. Reconstr. Microsurg. KW - venous occlusion rat model indocyanine green infrared fluorescence angiography perforator flap breast reconstruction imaging-system quantitative assessment vascular compromise perfusion salvage design diep Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: CR5VJ Times Cited: 12 Cited Reference Count: 27 Nasser, Ahmed Fourman, Mitchell S. Gersch, Robert P. Phillips, Brett T. Hsi, Hsingli Kai Khan, Sami U. Gelfand, Mark A. Dagum, Alexander B. Bui, Duc T. Fourman, Mitchell/0000-0001-5886-546X; Phillips, Brett/0000-0001-9765-2600 Innovative Studies and Investigational Support (ISIS) All protocols described in this study were funded via the Innovative Studies and Investigational Support (ISIS) program hosted by the LifeCell Corporation-awarded to Duc T. Bui. No author has any financial interest in the outcomes of this study including any products, drugs, or technologies described in this article. 13 0 1 Thieme medical publ inc New york 1098-8947 PY - 2015 SN - 0743-684X SP - 590-596 ST - Utilizing Indocyanine Green Dye Angiography to Detect Simulated Flap Venous Congestion in a Novel Experimental Rat Model T2 - Journal of Reconstructive Microsurgery TI - Utilizing Indocyanine Green Dye Angiography to Detect Simulated Flap Venous Congestion in a Novel Experimental Rat Model UR - ://WOS:000361412200006 VL - 31 ID - 2175 ER - TY - JOUR AB - The Utilization of a More Cosmetically Acceptable Deep Inferior Epigastric Artery Perforator (DIEAP) Flap For Head and Neck Soft Tissue Defects Reconstruction Abstract: Various free flaps have been utilized for the reconstruction of the maxillofacial defects.The deep inferior epigastric perforator flap (DIEP) is utilized as a potential source of soft tissue for head and neck reconstruction. In addition to its ability to provide a large skin paddle, bulky adipose tissue, it has the advantage of adding improvement in the cosmetic outcome at the donor site with minimal morbidity. The aim of this retrospective chart review study is to share our experience with this reconstructive technique in head and neck surgery. Patients and Methods: The present studywas a retrospective chart review for patients treated at the Oral and Maxillofacial Surgery Department at the University of Miami Miller School of Medicine, during a one-year period between 2011 and 2012. We identified five patients, (1 man, 3 women), the age range from (28 to 65), and the defect sizes ranged from (20cm2 to 600cm2). Surgical defects treated were the result from a variety of different pathologies, including temporal meningioma with cranial bone osteomyelitis, Adenoid cystic carcinoma, neck fibrosis and scar excision, and a gun shut wound to the face with multiple infections. All caseswere reconstructed with a deep inferior epigastric artery perforator (DIEAP) flap. The flap was harvested following the same principles as for breast reconstruction. Results: We report a 100% success rate related to primary flap survival, No major complication of the donor site was observed. However, one patient had minor abdominal wound dehiscence that was treated with local wound care with the need for revisional surgery.Patientreported satisfaction at 6 months was excellent in all cases. All abdominal incisions healed with good cosmetic results compared to the vertical incision scar resulted when vertical or oblique incisions were used for harvesting. Concusion: We conclude that in select cases, the DIEAP flap is a reliable alternative for head and neck soft tissue defects. It provides a large volume of soft tissue for transfer with predictable, good functional result, and excellent donor site cosmesis, with low morbidity. AD - R. Tursun, University of Mlami, Jackson Memorial Hospital, United States AU - Tursun, R. AU - Melville, J. C. AU - Waite, O. AU - Hew, D. AU - Marx, R. E. DB - Embase DO - 10.1016/j.joms.2014.06.337 IS - 9 KW - cosmetic soft tissue defect neck maxillofacial surgery deep inferior epigastric perforator flap human patient incision donor site morbidity scar medical record review soft tissue meningioma free tissue graft pathology satisfaction school wound dehiscence abdominal injury university survival breast reconstruction adipose tissue wound excision skin fibrosis male coinfection adenoid cystic carcinoma osteomyelitis female wound care skull harvesting head and neck surgery LA - English M3 - Conference Abstract N1 - L71597366 2014-08-31 PY - 2014 SN - 0278-2391 SP - e210 ST - The utilization of a more cosmetically acceptable deep inferior epigastric artery perforator (DIEAP) flap for head and neck soft tissue defects reconstruction T2 - Journal of Oral and Maxillofacial Surgery TI - The utilization of a more cosmetically acceptable deep inferior epigastric artery perforator (DIEAP) flap for head and neck soft tissue defects reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71597366&from=export http://dx.doi.org/10.1016/j.joms.2014.06.337 VL - 72 ID - 6435 ER - TY - JOUR AB - New methods for the reconstruction of the ear, nose, and breast using omentum to vascularize appropriate tissue composites of skin, bone, and cartilage are described. The initial investigation demonstrated that it is possible to obtain an island composite flap with omentum-costal cartilage-skin flap and preserve cartilage viability inside the omentum. The ear and nose were reconstructed in two stages. In the first stage, the appropriately carved cartilage and/or bony framework was covered with omentum and a skin graft, leaving the tissue composite buried subcutaneously. In the second stage, the newly reconstructed organ was exteriorized and diagnostic studies were done. The breast reconstruction was undertaken in two stages, first creating an omental island skin flap and subsequently either implanting a standard prosthesis under the flap or transferring the entire composite superiorly to better simulate the clinical reconstruction wherein the lower abdominal skin with omentum would be moved to the anterior chest. In each reconstruction a variety of diagnostic studies, including intravenous fluorescein dye, radioactive isotope uptake, and microangiography, were performed. AN - 7280103 AU - Erol, O. O. AU - Spira, M. DA - Oct DO - 10.1097/00006534-198110000-00015 DP - NLM ET - 1981/10/01 IS - 4 KW - Animals Breast/surgery Cartilage/surgery Ear, External/surgery Nose/surgery Omentum/blood supply/*surgery Prostheses and Implants *Surgery, Plastic Surgical Flaps Swine LA - eng N1 - Erol, O O Spira, M NIH GRANT NO. 630/608443/PHS HHS/United States Journal Article Research Support, U.S. Gov't, P.H.S. United States Plast Reconstr Surg. 1981 Oct;68(4):561-70. doi: 10.1097/00006534-198110000-00015. PY - 1981 SN - 0032-1052 (Print) 0032-1052 SP - 561-70 ST - Utilization of a composite island flap employing omentum in organ reconstruction: an experimental investigation T2 - Plast Reconstr Surg TI - Utilization of a composite island flap employing omentum in organ reconstruction: an experimental investigation VL - 68 ID - 13383 ER - TY - JOUR AB - Background: Immediate partial breast reconstruction after breast-conserving surgery has become a new paradigm in treating breast cancer. Among the volume replacement techniques used for small to moderate-sized breasts, the perforator flap method has many advantages. The authors present anatomical studies and two surgical techniques using lateral intercostal artery perforator flaps. Methods: Data from 40 patients who underwent breast reconstruction using the lateral intercostal artery perforator flap between January of 2011 and June of 2016 were included. The authors conducted comparative analyses of the propeller flap and the turnover flap. They used three-dimensional computed tomography in lateral intercostal artery perforator flap anatomical studies, analyzing the distribution probability of the dominant perforator, the vertical distance from the axillary fold, and the horizontal distance from the anterior border of the latissimus dorsi. Results: The most dominant perforator used for lateral intercostal artery perforator flaps was the sixth lateral intercostal artery perforator (43.6 percent of cases), followed by the seventh lateral intercostal artery perforator (39.1 percent of cases); their mean distances from the latissimus dorsi and the axillary folds were determined and reported. Complications included three cases requiring additional treatment for fat necrosis (propeller method, two cases; turnover method, one case) and venous congestion in only two cases that used the propeller method. Cosmetic satisfaction was 90 percent or greater for both techniques, indicating that results were rated as either excellent or good. Conclusion: The authors believe that their study results can broaden the application of partial breast reconstruction by using the lateral intercostal artery perforator flap after breast-conserving surgery, with three-dimensional computed tomography for anatomical studies, and using one of the authors' two described surgical techniques. (Plast. Reconstr. Surg. 143: 477e, 2019.) AD - [Yang, Jung Dug] Kyungpook Natl Univ, Sch Med, Dept Plast & Reconstruct Surg, 130 Dongdeok Ro, Daegu 41944, South Korea. Kyungpook Natl Univ, Sch Med, Dept Surg, Daegu, South Korea. Yang, JD (corresponding author), Kyungpook Natl Univ, Sch Med, Dept Plast & Reconstruct Surg, 130 Dongdeok Ro, Daegu 41944, South Korea. lambyang@knu.ac.kr AN - WOS:000459804400002 AU - Kim, J. B. AU - Eom, J. R. AU - Lee, J. W. AU - Lee, J. AU - Park, H. Y. AU - Yang, J. D. DA - Mar DO - 10.1097/prs.0000000000005374 IS - 3 J2 - Plast. Reconstr. Surg. KW - mastectomy cancer augmentation trends Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: HM9KZ Times Cited: 2 Cited Reference Count: 17 Kim, Jae Bong Eom, Jeung Ryeol Lee, Jeong Woo Lee, Jeeyeon Park, Ho Yong Yang, Jung Dug Yang, Jung dug/R-7806-2019 2 0 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2019 SN - 0032-1052 SP - 477E-487E ST - Utility of Two Surgical Techniques Using a Lateral Intercostal Artery Perforator Flap after Breast-Conserving Surgery: A Single-Center Retrospective Study T2 - Plastic and Reconstructive Surgery TI - Utility of Two Surgical Techniques Using a Lateral Intercostal Artery Perforator Flap after Breast-Conserving Surgery: A Single-Center Retrospective Study UR - ://WOS:000459804400002 VL - 143 ID - 1435 ER - TY - JOUR AB - Background Three-dimensional (3D) model printing improves visualization of anatomical structures in space compared to two-dimensional (2D) data and creates an exact model of the surgical site that can be used for reference during surgery. There is limited evidence on the effects of using 3D models in microsurgical reconstruction on improving clinical outcomes. Methods A retrospective review of patients undergoing reconstructive breast microsurgery procedures from 2017 to 2019 who received computed tomography angiography (CTA) scans only or with 3D models for preoperative surgical planning were performed. Preoperative decision-making to undergo a deep inferior epigastric perforator (DIEP) versus muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flap, as well as whether the decision changed during flap harvest and postoperative complications were tracked based on the preoperative imaging used. In addition, we describe three example cases showing direct application of 3D mold as an accurate model to guide intraoperative dissection in complex microsurgical reconstruction. Results Fifty-eight abdominal-based breast free-flaps performed using conventional CTA were compared with a matched cohort of 58 breast free-flaps performed with 3D model print. There was no flap loss in either group. There was a significant reduction in flap harvest time with use of 3D model (CTA vs. 3D, 117.7 +/- 14.2 minutes vs. 109.8 +/- 11.6 minutes; P=0.001). In addition, there was no change in preoperative decision on type of flap harvested in all cases in 3D print group (0%), compared with 24.1% change in conventional CTA group. Conclusions Use of 3D print model improves accuracy of preoperative planning and reduces flap harvest time with similar postoperative complications in complex microsurgical reconstruction. AD - [Ogunleye, Adeyemi A.] Univ N Carolina, Div Plast Surg, Chapel Hill, NC USA. [Deptula, Peter L.; Nguyen, Dung H.] Stanford Univ, Div Plast Surg, 770 Welch Rd Suite 400, Palo Alto, CA 94304 USA. [Inchauste, Suzie M.] Univ Washington, Div Plast Surg, Seattle, WA USA. [Zelones, Justin T.] Plast & Hand Surg Associates, South Portland, ME USA. [Walters, Shannon; Gifford, Kyle; LeCastillo, Chris; Napel, Sandy; Fleischmann, Dominik] Stanford Univ, Dept Radiol, 3D & Quantitat Imaging Lab, Palo Alto, CA 94304 USA. Nguyen, DH (corresponding author), Stanford Univ, Div Plast Surg, 770 Welch Rd Suite 400, Palo Alto, CA 94304 USA. nguyendh@stanford.edu AN - WOS:000574331200007 AU - Ogunleye, A. A. AU - Deptula, P. L. AU - Inchauste, S. M. AU - Zelones, J. T. AU - Walters, S. AU - Gifford, K. AU - LeCastillo, C. AU - Napel, S. AU - Fleischmann, D. AU - Nguyen, D. H. DA - Sep DO - 10.5999/aps.2020.00829 IS - 5 J2 - Arch. Plast. Surg.-APS KW - Microsurgery Breast Lymphedema breast reconstruction perforator flap Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: NV4ZH Times Cited: 1 Cited Reference Count: 19 Ogunleye, Adeyemi A. Deptula, Peter L. Inchauste, Suzie M. Zelones, Justin T. Walters, Shannon Gifford, Kyle LeCastillo, Chris Napel, Sandy Fleischmann, Dominik Nguyen, Dung H. Walters, Shannon/0000-0002-1348-6009; Nguyen, Dung/0000-0002-9494-7523; Zelones, Justin/0000-0002-7451-2987; Deptula, Peter/0000-0001-6555-0300; Fleischmann, Dominik/0000-0003-0715-0952 1 0 Korean soc plastic & reconstructive surgery Seoul 2234-6171 PY - 2020 SN - 2234-6163 SP - 428-434 ST - The utility of three-dimensional models in complex microsurgical reconstruction T2 - Archives of Plastic Surgery-Aps TI - The utility of three-dimensional models in complex microsurgical reconstruction UR - ://WOS:000574331200007 VL - 47 ID - 1074 ER - TY - JOUR AB - Abstract: Breast cancer chest wall recurrence is often treated with chemotherapy, radical surgery, and radiation. Extensive chest wall resection requires soft-tissue reconstruction with tissue that provides chest wall stability and durability for additional radiation. Local and regional muscle and musculocutaneous flaps are often used for reconstruction. Free flaps, such as the transverse rectus abdominis musculocutaneous flap, are used for large defects, although donor site morbidity can result. The free deep inferior epigastric perforator (DIEP) flap provides coverage for large defects and may have less donor site morbidity. We describe the use of the free DIEP flap to reconstruct large chest wall defects (mean, 501 cm2 defects) after the resection of recurrent breast cancer in two patients. One patient had 2% flap loss. No donor site morbidity occurred. The free DIEP flap is a durable and reliable flap that provided immediate and complete coverage of these large chest wall defects with no donor site morbidity and did not delay the administration of adjuvant therapy. AN - RN200661370 AU - Sullivan, S. R. AU - Truxillo, T. M. AU - Mann, G. N. AU - Isik, F. F. CN - 618.19 RC280 2277.494100 LA - English N1 - Bi-monthly: 5-8 issues per year United States Blackwell Publishing Ltd PY - 2007 SN - 1075-122X SP - 50 - 54 ST - Utility of the Free Deep Inferior Epigastric Perforator Flap in Chest Wall Reconstruction T2 - Breast Journal TI - Utility of the Free Deep Inferior Epigastric Perforator Flap in Chest Wall Reconstruction VL - 13, NUMB 1 ID - 191 ER - TY - JOUR AB - Background: Google Trends (GT) is a free, open-source tool that permits customizable analysis of search termvolumes entered into the Google search engine. Google Trends data may offer useful and actionable insight to plastic surgeons pertaining to worldwide, national, and regional evolution of patient interest for breast procedures and other common surgeries. Methods: Search terms were generated using the "related queries" feature of GT. Google Trends data were collected for breast lift, breast reduction, breast reconstruction, and male breast reduction from January 2004 to September 2017. Case volumes for respective procedures were obtained from the American Society of Plastic Surgeons (ASPS) annual statistics reports for the calendar year 2006 to 2016. Trend analysis was performed using univariate linear regression analysis of ASPS statistics and GT search data. Results: Total search volume varied geographically and temporally during the study period. Statistically significant positive correlations between GT and ASPS data were as follows: breast lift: "mastopexy" (R-2 = 0.445, P = 0.025); male breast reduction: "gynecomastia surgery" (R-2 = 0.45, P = 0.024); and breast reconstruction: " tissue expander" (R-2 = 0.806, P = 0.001) and " TRAM flap reconstruction" (R-2 = 0.764, P = 0.002). For several search terms, no significant correlation was detected, highlighting the importance for careful selection of terms. AD - [Tijerina, Jonathan D.; Vail, Daniel G.] Stanford Univ, Sch Med, Stanford, CA USA. [Morrison, Shane D.] Univ Washington, Sch Med, Dept Surg, Div Plast Surg, Seattle, WA 98195 USA. [Lee, Gordon K.; Nazerali, Rahim] Stanford Univ, Sch Med, Dept Surg, Div Plast Surg, Stanford, CA USA. Nazerali, R (corresponding author), 770 Welch Rd,Suite 400, Palo Alto, CA 94304 USA. rahimn@stanford.edu AN - WOS:000473280700011 AU - Tijerina, J. D. AU - Morrison, S. D. AU - Vail, D. G. AU - Lee, G. K. AU - Nazerali, R. DA - May DO - 10.1097/sap.0000000000001806 J2 - Ann. Plast. Surg. KW - breast Google Trends gynecomastia mammaplasty mastectomy public interest united-states surgery search Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: IF7RE Times Cited: 13 Cited Reference Count: 18 Tijerina, Jonathan D. Morrison, Shane D. Vail, Daniel G. Lee, Gordon K. Nazerali, Rahim Vail, Daniel/0000-0001-8769-2369 13 0 2 Lippincott williams & wilkins Philadelphia 1536-3708 4 PY - 2019 SN - 0148-7043 SP - S325-S331 ST - The Utility of Google Trends Data for Analyzing Public Interest in Breast Procedures T2 - Annals of Plastic Surgery TI - The Utility of Google Trends Data for Analyzing Public Interest in Breast Procedures UR - ://WOS:000473280700011 VL - 82 ID - 1397 ER - TY - JOUR AD - T. Sorin, Department of Plastic, Reconstructive and Aesthetic Surgery, AP-HP, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux F-75010, Paris, France AU - Sorin, T. AU - Ozil, C. AU - Madar, Y. AU - Binder, J. P. AU - Revol, M. AU - Mazouz Dorval, S. DB - Embase DO - 10.1002/micr.22473 IS - 5 KW - anastomosis breast reconstruction deep inferior epigastric perforator flap elastic spacer hook human internal mammary artery letter pedicled skin flap priority journal rib resection self retaining retractor surgical patient Lone Star LA - English M3 - Letter N1 - L605801248 2015-09-02 2016-10-26 PY - 2016 SN - 1098-2752 0738-1085 SP - 439-440 ST - The utility of elastic spacer hooks in internal mammary vessel preparation for diep anastomosis T2 - Microsurgery TI - The utility of elastic spacer hooks in internal mammary vessel preparation for diep anastomosis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L605801248&from=export http://dx.doi.org/10.1002/micr.22473 VL - 36 ID - 5956 ER - TY - JOUR AB - OBJECTIVE: To evaluate the utility of dual‐energy spectral computed tomography (CT) and low‐iodine intake in CT angiography (CTA) of deep inferior epigastric perforator (DIEP) flaps. METHODS: In this prospective study, 40 patients with a BMI <28.0 kg/m(2) underwent CTA examination for breast reconstruction and were randomly assigned into two groups (n=20 for each group) as follows: Group A was submitted to dual‐energy spectral CT and iodixanol (270 mg I/mL) and Group B was submitted to conventional high iodine contrast agent iohexol (350 mg I/mL). The volume CT dose index (CTDIvol ) and dose length product were recorded and the effective dose (ED) was calculated. The best mono‐spectrum images of Group A were selected according to the optimal contrast to noise ratio (CNR). Both mono‐spectrum images of Group A and polychromatic images of Group B were used to reconstruct maximum intensity projection (MIP) and volume rendering (VR) images of the perforating artery, respectively. Two radiologists evaluated subjective image quality using a 4‐point score. The diameter of the perforating artery, CT value and SD value for the common femoral artery were measured and the CNR was calculated. The total iodine intake and radiation doses of the two groups were calculated and compared. RESULTS: The best mono‐spectrum energy with the optimal CNR of the perforating artery was 63 keV. The CT value of common femoral artery in Group A (380.96±42.75HU) was 7.40% higher than in Group B (354.71±42.01 HU) but with no statistical significance (P>.05). The CNR of the common femoral artery in Group A (23.84±6.73) was 6.88% lower than in Group B (25.60±6.20), with no significant difference (P>.05). The diameters of the perforator vessels were 2.44±0.15 and 2.49±0.14 mm, respectively, with no significant difference (P>.05). Subjective image qualities for the two groups were both good for diagnostics, and the scores for Group A and Group B were (3.88±0.28) and (3.93±0.18), respectively. The scores of the two radiologists were consistent (kappa=0.634). The effective radiation dose in Group A (9.09±0 mSv) was 10.62% lower than in Group B (10.17±1.91 mSv). The total iodine intake in Group A (27 000 mg) was 22.86% lower than in Group B (35 000 mg). CONCLUSIONS: The combination of dual‐energy spectral CT and low‐iodine intake in CTA of DIEP flap examination with the optimal CNR technology can meet the requirements of clinical diagnostics, with a 22.86% reduction in total iodine intake and an 11.01% reduction in radiation dose. AN - CN-01411184 AU - Gao, Z. AU - Meng, D. AU - Lu, H. AU - Yao, B. AU - Huang, N. AU - Ye, Z. DO - 10.1111/ijcp.12855 KW - Absorptiometry, Photon [methods] Adult Computed Tomography Angiography [*methods] Contrast Media [*administration & dosage] Female Femoral Artery [diagnostic imaging] Humans Mammaplasty [methods] Middle Aged Perforator Flap [blood supply] Prospective Studies Radiation Dosage Signal‐To‐Noise Ratio Triiodobenzoic Acids [administration & dosage] M3 - Journal Article; Randomized Controlled Trial PY - 2016 SP - B64‐71 ST - Utility of dual-energy spectral CT and low-iodine contrast medium in DIEP angiography T2 - International journal of clinical practice TI - Utility of dual-energy spectral CT and low-iodine contrast medium in DIEP angiography UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01411184/full VL - 70 Suppl 9B ID - 138 ER - TY - JOUR AD - M. Mihara, Department of Plastic and Reconstructive Surgery, Tokyo University, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan AU - Mihara, M. AU - Nakanishi, M. AU - Nakashima, M. AU - Narushima, M. AU - Koshima, I. DB - Embase Medline DO - 10.1097/PRS.0b013e3181774607 IS - 1 KW - breast reconstruction deep inferior epigastric perforator flap letter multidetector computed tomography postoperative care preoperative care priority journal rectus abdominis muscle three-dimensional imaging treatment planning LA - English M3 - Letter N1 - L355000598 2009-09-07 PY - 2008 SN - 0032-1052 SP - 40e-41e ST - Utility and anatomical examination of the diep flap's three-dimensional image with multidetector computed tomography T2 - Plastic and Reconstructive Surgery TI - Utility and anatomical examination of the diep flap's three-dimensional image with multidetector computed tomography UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355000598&from=export http://dx.doi.org/10.1097/PRS.0b013e3181774607 VL - 122 ID - 7861 ER - TY - JOUR AD - Department of Radiology, Hull Royal Infirmary, Anlaby Road, HU3 2JZ, Hull, UK Department of Plastic Surgery, Hull Royal Infirmary, Anlaby Road, HU3 2JZ, Hull, UK AN - 136152325. Language: English. Entry Date: 20200318. Revision Date: 20190504. Publication Type: Article. Journal Subset: Biomedical AU - Chong, L. W. AU - Lakshminarayan, R. AU - Akali, A. DB - cin20 DO - 10.1016/j.crad.2019.01.027 DP - EBSCOhost IS - 6 N1 - Double Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland. NLM UID: 1306016. PY - 2019 SN - 0009-9260 SP - 445-449 ST - Utilisation of contrast-enhanced magnetic resonance angiography in the assessment of deep inferior epigastric artery perforator flap for breast reconstruction surgery T2 - Clinical Radiology TI - Utilisation of contrast-enhanced magnetic resonance angiography in the assessment of deep inferior epigastric artery perforator flap for breast reconstruction surgery UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=136152325&site=ehost-live&scope=site VL - 74 ID - 600 ER - TY - JOUR AB - Breast mound reconstruction can be a particularly difficult procedure in patients who have delayed reconstruction. A technique in which two flaps are used is described. The lateral thoracodorsal flap is used to create a breast pocket, and the latissimus dorsi flap is used to fill this breast pocket. The advantages of the technique are one-stage autologous reconstruction with a skin envelope similar in color and texture to the opposite breast. The disadvantages include a larger scar. AD - Department of Plastic and Reconstructive Surgery, Groote Schuur Hospital and University Cape Town, South Africa. AN - 12187347 AU - Hudson, D. A. AU - Ndobe, E. DA - Aug DO - 10.1097/00000637-200208000-00012 DP - NLM ET - 2002/08/21 IS - 2 KW - Adult Breast Neoplasms/*surgery Female Humans Mammaplasty/*methods Mastectomy, Radical *Surgical Flaps Treatment Outcome LA - eng N1 - Hudson, Donald A Ndobe, Elias Case Reports Journal Article United States Ann Plast Surg. 2002 Aug;49(2):189-92. doi: 10.1097/00000637-200208000-00012. PY - 2002 SN - 0148-7043 (Print) 0148-7043 SP - 189-92 ST - Using two flaps to achieve aesthetic autologous breast mound reconstruction T2 - Ann Plast Surg TI - Using two flaps to achieve aesthetic autologous breast mound reconstruction VL - 49 ID - 10510 ER - TY - JOUR AB - The most common recipient vessels for autologous free flap breast reconstruction are the internal mammary vessels. At times, there are problems with the exposed internal mammary vein (IMV) that require other options such as using the contralateral IMV, superior rib resection to access proximal IMV, retrograde IMV use, and thoracodorsal vein access with or without a vein graft. This case demonstrates using the pectoral branch of the thoracoacromial venous system without a vein graft as a lifeboat option when the IMV is not suitable for anastomosis. C.W. was a 65-year-old female who underwent right-sided mastectomy with placement of a tissue expander. After adjuvant radiation therapy, C.W. underwent deep inferior epigastric perforator free flap breast reconstruction. During exposure of the internal mammary artery and IMV, an iatrogenic venotomy occurred that precluded the use of this vessel as a reliable recipient. The deep inferior epigastric perforator flap pedicle was then dissected proximal to isolate the artery and vein, and the vein was successfully anastomosed to the venous pectoral branch of the thoracoacromial system. The postoperative course was uneventful and patient was discharged home on postoperative day 4. Using the venous pectoral branch of the thoracoacromial is a safe and valuable option that can be considered in difficult situations when the IMV is not a suitable option. AD - [Tarakji, Michael; Bartow, Matthew J.; Dupin, Charles; Tessler, Oren] Louisiana State Univ, Hlth Sci Ctr New Orleans, 1542 Tulane Ave Rm 734, New Orleans, LA 70112 USA. Tessler, O (corresponding author), Louisiana State Univ, Hlth Sci Ctr New Orleans, 1542 Tulane Ave Rm 734, New Orleans, LA 70112 USA. o_tessler@hotmail.com AN - WOS:000405592800035 AU - Tarakji, M. AU - Bartow, M. J. AU - Dupin, C. AU - Tessler, O. C7 - e1367 DA - Jun DO - 10.1097/gox.0000000000001367 IS - 6 J2 - Prs-Glob. Open KW - vessels Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: FA6ZD Times Cited: 2 Cited Reference Count: 5 Tarakji, Michael Bartow, Matthew J. Dupin, Charles Tessler, Oren 2 0 Lippincott williams & wilkins Philadelphia PY - 2017 SN - 2169-7574 SP - 4 ST - Using the Venous Pectoral Branch from the Thoracoacromial System as a Lifeboat in Autologous Breast Reconstruction T2 - Plastic and Reconstructive Surgery-Global Open TI - Using the Venous Pectoral Branch from the Thoracoacromial System as a Lifeboat in Autologous Breast Reconstruction UR - ://WOS:000405592800035 VL - 5 ID - 1814 ER - TY - JOUR AB - Over the years, although methods of breast reconstruction have improved, the ability to build a symmetrical projecting breast has not. When stacked Meme implants were used, better projection was obtained. Folding the transverse rectus abdominis musculocutaneous flaps allows for good projection; however, the breast is then quite wide and large. For smaller breast women with projection and some larger breasted women as well, splitting and stacked flaps give a much better result. We now do this procedure with simultaneous Latram and mastectomy surgery in fewer than 3 hours. AD - Department of Plastic Surgery, North Shore University Hospital, Manhasset, NY, USA. AN - 7793782 AU - Neumann, P. R. AU - Cooper, R. A. AU - Chang, D. W. AU - DeRisi, D. D. AU - Conte, C. C. DA - Apr DO - 10.1097/00000637-199504000-00006 DP - NLM ET - 1995/04/01 IS - 4 KW - Breast Neoplasms/surgery Female Humans Mammaplasty/*methods Mastectomy/methods Surgical Flaps/*methods Time Factors LA - eng N1 - Neumann, P R Cooper, R A Chang, D W DeRisi, D D Conte, C C Journal Article United States Ann Plast Surg. 1995 Apr;34(4):376-8. doi: 10.1097/00000637-199504000-00006. PY - 1995 SN - 0148-7043 (Print) 0148-7043 SP - 376-8 ST - Using the split Latram for better breast projection in breast reconstruction T2 - Ann Plast Surg TI - Using the split Latram for better breast projection in breast reconstruction VL - 34 ID - 9884 ER - TY - JOUR AB - Background: Abdominal tissue is the preferred donor source for autologous breast reconstruction, but in select patients with inadequate tissue, additional volume must be recruited to achieve optimal outcomes. Stacked flaps are an effective approach in these cases, but can be limited by the need for adequate recipient vessels. This article reports outcomes for the use of the retrograde internal mammary system for stacked flap breast reconstruction in a large number of consecutive patients. Methods: Fifty-three patients underwent stacked autologous tissue breast reconstruction with a total of 142 free flaps. Thirty patients underwent unilateral stacked deep inferior epigastric perforator (DIEP) flap reconstruction, five had unilateral stacked profunda artery perforator flap reconstruction, one had bilateral stacked DIEP/superior gluteal artery perforator flap reconstruction, and 17 underwent bilateral stacked DIEP/profunda artery perforator flap reconstruction. In all cases, the antegrade and retrograde internal mammary vessels were used for anastomoses. In situ manometry studies were also conducted comparing the retrograde internal mammary arteries in 10 patients to the corresponding systemic pressures. Results: There were three total flap losses (97.9 percent flap survival rate), two partial flap losses, four reexplorations for venous congestion, and three patients with operable fat necrosis. The mean weight of the stacked flaps for each reconstructed breast was 622.8 g. The retrograde internal mammary mean arterial pressures were on average 76.6 percent of the systemic mean arterial pressures. Conclusions: The results demonstrate that the retrograde internal mammary system is capable of independently supporting free tissue transfer. These vessels provide for convenient dissection and improved efficiency of these cases, with successful postsurgical outcomes. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. AD - Louisiana State Univ, Ctr Hlth Sci, Div Plast & Reconstruct Surg, Baton Rouge, LA 70803 USA. NYU, Sch Med, Inst Reconstruct Plast Surg, New York, NY 10003 USA. Sadeghi, A (corresponding author), 3434 Prytania St,Suite 420, New Orleans, LA 70115 USA. drs@arbreastcenter.com AN - WOS:000369443600001 AU - Stalder, M. W. AU - Lam, J. AU - Allen, R. J. AU - Sadeghi, A. DA - Feb DO - 10.1097/01.prs.0000475743.08559.b6 IS - 2 J2 - Plast. Reconstr. Surg. KW - free-tissue-transfer free tram flap unilateral breast diep flap recipient vessels coronary-bypass outflow option artery vein limb Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: DC8AZ Times Cited: 36 Cited Reference Count: 27 Stalder, Mark W. Lam, Jonathan Allen, Robert J. Sadeghi, Alireza 39 0 1 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2016 SN - 0032-1052 SP - 265E-277E ST - Using the Retrograde Internal Mammary System for Stacked Perforator Flap Breast Reconstruction: 71 Breast Reconstructions in 53 Consecutive Patients T2 - Plastic and Reconstructive Surgery TI - Using the Retrograde Internal Mammary System for Stacked Perforator Flap Breast Reconstruction: 71 Breast Reconstructions in 53 Consecutive Patients UR - ://WOS:000369443600001 VL - 137 ID - 2091 ER - TY - JOUR AB - The preferred method of breast reconstruction is the simplest type that can meet the patient's needs and expectations (Bostwiek, 1989). Several breast reconstruction procedures are presented in this issue. In this article, only breast reconstruction using the latissimus dorsi flap is discussed. AD - Department of Anesthesia, PACU, William Beaumont Hospital, Royal Oak, MI AN - 107319022. Language: English. Entry Date: 19970401. Revision Date: 20150819. Publication Type: Journal Article AU - Spencer, K. W. DA - 1996 Fall DB - cin20 DP - EBSCOhost IS - 3 KW - Breast Reconstruction -- Methods Surgical Flaps Muscles -- Transplantation Surgical Nursing, Plastic Education, Continuing (Credit) Breast Reconstruction -- Adverse Effects Nipples -- Surgery Postoperative Complications Postoperative Care Mastectomy Female N1 - CEU; exam questions; pictorial. Journal Subset: Core Nursing; Nursing; Peer Reviewed; USA. NLM UID: 8403490. PMID: NLM9060754. PY - 1996 SN - 0741-5206 SP - 147-178 ST - Using the latissimus dorsi flap for breast reconstruction T2 - Plastic Surgical Nursing TI - Using the latissimus dorsi flap for breast reconstruction UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=107319022&site=ehost-live&scope=site VL - 16 ID - 937 ER - TY - JOUR AD - S. Otiv AU - Otiv, S. DB - Medline IS - 6 KW - breast reconstruction breast tumor female fluid therapy free tissue graft human intraductal carcinoma methodology microsurgery note Paget nipple disease postoperative complication LA - English M3 - Note N1 - L365369005 2012-08-10 PY - 2012 SN - 1529-4242 SP - 1008e-1009e; author reply 1009e-1010e ST - Using statistical models to their full potential T2 - Plastic and reconstructive surgery TI - Using statistical models to their full potential UR - https://www.embase.com/search/results?subaction=viewrecord&id=L365369005&from=export VL - 129 ID - 7115 ER - TY - JOUR AB - Background: Previous studies comparing muscle-sparing transverse rectus abdominis myocutaneous (TRAM) versus deep inferior epigastric artery perforator (DIEP) free flaps have not considered procedure selection bias. Propensity score analysis provides a statistical approach to consider preoperative factors in flap selection, and was used to compare major complications (breast and abdominal) between these microsurgical breast reconstruction (free muscle-sparing TRAM versus DIEP). Methods: This study evaluated major breast and abdominal complications in 292 consecutive patients (428 free abdominal flaps). Propensity scores were calculated for patient differences affecting flap selection (DIEP versus free muscle-sparing TRAM). Multivariate logistic models using selected covariates separately analyzed breast and abdominal complications between flap methods. Results: There were 83 major complications (28 percent): breast, 20 percent; abdomen, 8 percent. Using propensity scores, the adjusted odds of abdominal complications were significantly higher in free muscle-sparing TRAM than in DIEP flaps (OR, 2.73; 95 percent CI, 1.01 to 7.07). With prior chemotherapy, body mass index significantly increased abdominal complications (OR, 1.16; 95 percent CI, 1.01 to 1.34). Using propensity scores, there was no significant association between reconstruction method and breast complications; diabetics had significantly increased breast complications (OR, 4.19; 95 percent CI, 1.14 to 15.98). Previous abdominal operations (OR, 1.77; 95 percent CI, 0.96 to 3.30) and immediate reconstruction (OR, 1.86; 95 percent CI, 0.94 to 3.71) approached significance. Conclusions: Propensity score analysis indicated significantly higher abdominal complications in free muscle-sparing TRAM compared with DIEP flaps. This study highlights the importance of separately evaluating recipient breast and donor abdominal complications and use of propensity scores to minimize procedure selection bias. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III. AD - Univ Hlth Network, Div Plast & Reconstruct Surg, Dept Surg & Surg Oncol, Toronto, ON M5G 2C4, Canada. Univ Toronto, Div Plast & Reconstruct Surg, Toronto, ON, Canada. Univ Toronto, Lawrence S Bloomberg Fac Nursing, Toronto, ON, Canada. Zhong, T (corresponding author), Univ Hlth Network, 8NU 871,200 Elizabeth St, Toronto, ON M5G 2C4, Canada. toni.zhong@uhn.ca AN - WOS:000335988600029 AU - Zhong, T. AU - Novak, C. B. AU - Bagher, S. AU - Maass, Swmc AU - Zhang, J. AU - Arad, U. AU - O'Neill, A. C. AU - Metcalfe, K. A. AU - Hofer, S. O. P. DA - Apr DO - 10.1097/prs.0000000000000024 IS - 4 J2 - Plast. Reconstr. Surg. KW - epigastric perforator flap cancer mastectomy outcomes Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: AH2YR Times Cited: 19 Cited Reference Count: 31 Zhong, Toni Novak, Christine B. Bagher, Shaghayegh Maass, Saskia W. M. C. Zhang, Jing Arad, Udi O'Neill, Anne C. Metcalfe, Kelly A. Hofer, Stefan O. P. Novak, Christine/AAE-7148-2019 Hofer, Stefan/0000-0002-9653-2946; Maass, Saskia/0000-0001-8715-734X American Society of Clinical Oncology; Conquer Cancer Foundation Career Development Award; Wharton Chair in Plastic and Reconstructive Surgery at the University Health Network; Canadian Breast Cancer FoundationCanadian Cancer Society (CCS); Canadian Institutes of Health ResearchCanadian Institutes of Health Research (CIHR) Dr. Zhong is supported by an American Society of Clinical Oncology, Conquer Cancer Foundation Career Development Award, and Dr. Hofer is supported by the Wharton Chair in Plastic and Reconstructive Surgery at the University Health Network. Dr. Hofer, Dr. Metcalfe, and Dr. Zhong are supported by grant funding from the Canadian Breast Cancer Foundation and the Canadian Institutes of Health Research. The other authors do not have a financial interest to declare. None of the authors has a financial interest in any of the products or devices mentioned in this article. 19 0 1 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2014 SN - 0032-1052 SP - 774-782 ST - Using Propensity Score Analysis to Compare Major Complications between DIEP and Free Muscle-Sparing TRAM Flap Breast Reconstructions T2 - Plastic and Reconstructive Surgery TI - Using Propensity Score Analysis to Compare Major Complications between DIEP and Free Muscle-Sparing TRAM Flap Breast Reconstructions UR - ://WOS:000335988600029 VL - 133 ID - 2430 ER - TY - JOUR AB - The purpose of this article is to evaluate the feasibility of a perforator as a recipient vessel to reconstruct soft tissue defects of the knee region. From December of 2006 to August of 2008, total of 25 patients underwent reconstructive procedure using either an anterolateral thigh or an upper medial thigh perforator flap. The flaps were anastomosed in a perforator to perforator manner using supermicrosurgery technique. Minimum of 3 perforators were traced around the knee defect. All flaps survived attached to a recipient perforator with artery diameter ranging from 0.4 to 0.9 mm and accompanying veins ranging from 0.4 to 1.2 mm. This approach allowed reduction in time for pedicle and recipient vessel dissection and minimized the trauma involved during isolation of the vessels. Using the perforator as recipient vessel allows an increase in selection for choice of recipient. By using a perforator as recipient, less time is consumed to secure the vessel, does not need long pedicles for flap, is not bound by the condition of major arteries, and minimizes any risk for major vessel injury while having acceptable flap survival. AD - [Hong, Joon Pio] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast & Reconstruct Surg, Seoul 138736, South Korea. [Koshima, Isao] Univ Tokyo, Grad Sch Med, Dept Plast & Reconstruct Surg, Tokyo, Japan. Hong, JP (corresponding author), Univ Ulsan, Asan Med Ctr, Dept Plast Surg, Poongnap2 Dong 338-1, Seoul 138736, South Korea. joonphong@amc.seoul.kr AN - WOS:000275061800007 AU - Hong, J. P. AU - Koshima, I. DA - Mar DO - 10.1097/SAP.0b013e3181ac4263 IS - 3 J2 - Ann. Plast. Surg. KW - supermicrosurgery perforator-to-perforator anastomosis knee reconstruction breast reconstruction experience coverage salvage leg Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 562OL Times Cited: 69 Cited Reference Count: 20 Hong, Joon Pio Koshima, Isao 70 0 3 Lippincott williams & wilkins Philadelphia PY - 2010 SN - 0148-7043 SP - 291-293 ST - Using Perforators as Recipient Vessels (Supermicrosurgery) for Free Flap Reconstruction of the Knee Region T2 - Annals of Plastic Surgery TI - Using Perforators as Recipient Vessels (Supermicrosurgery) for Free Flap Reconstruction of the Knee Region UR - ://WOS:000275061800007 VL - 64 ID - 3122 ER - TY - JOUR AB - Background Pedicled transverse rectus abdominismyocutaneous (TRAM) breast reconstruction is associated with increased abdominal wall morbidity. We present a method of abdominal wall reconstruction using an adjunct technique to validated procedures of hernia repair. Methods This study is a retrospective, single-surgeon analysis of 21 patients between 2005 and 2012. Patients had bony suture anchoring of synthetic polypropylene mesh to the anterior superior iliac spine bilaterally and the pubic symphysis after the abdominal fascia was reconstructed. Results Patient mean follow- up was 62 months. Of the series, five patients underwent bilateral pedicled TRAM breast reconstruction. None of the 21 patients developed abdominal wall hernias. One patient developed postoperative bulging, which was retreated successfully. Two patients developed mesh infections; none required radical removal of mesh. There were no flap failures or loss in the series. Conclusions The BARS technique for abdominal wall reconstruction provides excellent reinforcement of abdominal reconstruction in conjunction with pedicled TRAM breast reconstruction. Level of Evidence: Level IV, therapeutic study. AD - [Elkwood, Andrew I.; Ashinoff, Russell L.; Kaufman, Matthew R.; Rose, Michael I.; Cece, John; Patel, Tushar R.; Otake, Leo R.] Inst Adv Reconstruct, Plast Surg Ctr, 535 Sycamore Ave, Shrewsbury, NJ 07702 USA. [Elkwood, Andrew I.] Drexel Univ, Coll Med, Surg, Philadelphia, PA 19104 USA. Elkwood, AI (corresponding author), Inst Adv Reconstruct, Plast Surg Ctr, 535 Sycamore Ave, Shrewsbury, NJ 07702 USA. aelkwood@hotmail.com AN - WOS:000217737500004 AU - Elkwood, A. I. AU - Ashinoff, R. L. AU - Kaufman, M. R. AU - Rose, M. I. AU - Cece, J. AU - Patel, T. R. AU - Otake, L. R. DA - Jul DO - 10.1007/s00238-014-0960-6 IS - 7 J2 - Eur. J. Plast. Surg. KW - TRAM Mesh Abdominal Reconstruction Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: V2N3W Times Cited: 1 Cited Reference Count: 21 Elkwood, Andrew I. Ashinoff, Russell L. Kaufman, Matthew R. Rose, Michael I. Cece, John Patel, Tushar R. Otake, Leo R. Patel, Tushar/0000-0001-9074-6380; Rose, Michael/0000-0002-3320-8479 1 0 Springer New york 1435-0130 PY - 2014 SN - 0930-343X SP - 381-386 ST - Using pedicled TRAM flap in conjunction with the bony anchoring reinforcement system (BARS) for abdominal wall reconstruction T2 - European Journal of Plastic Surgery TI - Using pedicled TRAM flap in conjunction with the bony anchoring reinforcement system (BARS) for abdominal wall reconstruction UR - ://WOS:000217737500004 VL - 37 ID - 2407 ER - TY - JOUR AB - Introduction: Abdominal wall integrity may be compromised after abdominal flap harvest for breast reconstruction, leading to bulging or herniation due to weakening of the abdominalwall and dissection through the rectus muscle. Mesh can be used to reinforce the abdominalwall to reduce the risk of hernia formation postoperatively, especially in patients who may be at high risk. In this study, we describe this institution's experience with the use of mesh in the abdominal wall and critically evaluate its impact on patient outcomes and complications. Methods: We retrospectively reviewed all patients with an abdominal free flap harvested for breast reconstruction at Stanford Health Care from 2005 to 2015. Multivariate-adjusted logistic regression analysis was used to compare the odds of abdominal complications-infection, bulging, and herniation-between patients with and without an abdominal mesh implanted during breast reconstruction. Results: Three hundred eighty patientsmet inclusion criteria. One hundred sixtyone patients received mesh, whereas 219 received no reinforcement. In the mesh group, there were 7 (4.3%) cases of postoperative abdominal bulging, 11 (6.8%) cases of abdominal infection, and no (0.0%) cases of herniation. In the group without mesh, there were 17 (7.8%) cases of abdominal bulging, 11 (5.0%) cases of abdominal infection, and 5 (2.3%) cases of herniation. There was a significant difference in the odds of bulging (odds ratio [OR], 0.30; P = 0.01). Therewas not a significant difference in the odds of herniation (OR, 2.26E-10; P = 0.99) or infection (OR, 1.21; P = 0.69). Conclusions: In our current treatment algorithm, patients who received mesh were selected based upon several criteria, including obesity, weak fascia identified during surgery, and extensive muscle dissection. We confirm that the risk of bulging and herniation is decreased in patients receiving mesh. Furthermore, the risk of wound infection was not associated with the use of mesh; instead, a patient's elevated body mass index, as well as tension of closure, and other comorbidities are more likely causes of superficial wound complications. We find the use of mesh to be safe and beneficial in select patients undergoing abdominal free flap breast reconstruction who are at risk for hernias and bulges. AD - [Leon, Daniel Sotelo; Nazerali, Rahim; Lee, Gordon Kwanlyp] Stanford Univ, Sch Med, Dept Plast & Reconstruct Surg, Stanford, CA 94305 USA. Leon, DS (corresponding author), Apt 1216,737 Campus Dr, Stanford, CA 94305 USA. desotelo@stanford.edu AN - WOS:000473114300014 AU - Leon, D. S. AU - Nazerali, R. AU - Lee, G. K. DA - May DO - 10.1097/sap.0000000000001468 J2 - Ann. Plast. Surg. KW - abdominal mesh breast reconstruction abdominal free flap herniation bulging abdominal infection obesity donor-site morbidity pedicled tram flaps quality-of-life diep flap follow-up repair outcomes cancer mastectomy Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: IF5IK Times Cited: 3 Cited Reference Count: 21 Leon, Daniel Sotelo Nazerali, Rahim Lee, Gordon Kwanlyp 3 0 Lippincott williams & wilkins Philadelphia 1536-3708 5 PY - 2018 SN - 0148-7043 SP - S295-S298 ST - Using Mesh to Reinforce the Abdominal Wall in Abdominal Free Flaps for Breast Reconstruction Is There a Benefit? What are the Risks? T2 - Annals of Plastic Surgery TI - Using Mesh to Reinforce the Abdominal Wall in Abdominal Free Flaps for Breast Reconstruction Is There a Benefit? What are the Risks? UR - ://WOS:000473114300014 VL - 80 ID - 1629 ER - TY - JOUR AB - Background Surgical ablation for locally advanced breast cancer results in large chest wall defects, which can then be managed with local flaps or skin grafts. The purpose of this article is to evaluate the outcomes of three types of local skin flaps. Methods Among 25 local flaps in 24 patients, 6 were bilateral advancement (BA) flaps, 9 were thoracoabdominal (TA) flaps, and 10 were thoracoepigastric (TE) flaps. Clinical outcomes were compared including complications, the need for a secondary surgical intervention, and the timing of adjuvant therapy. Results The mean defect size was 436.2 cm(2). Two patients with TA flaps and 6 patients with TE flaps developed distal flap necrosis, and skin grafts were needed to treat 2 patients with TE flaps. Radiation was administered to the BA, TA, and TE patients after average postoperative durations of 28, 30, or 41 days, respectively. The incidence of flap necrosis tended to be higher in TE patients, which lead to significant delays in adjuvant radiation therapy (P=0.02). Conclusions Three types of local skin flaps can be used to treat large chest wall defects after the excision of locally advanced breast cancer. Each flap has its own merits and demerits, and selecting flaps should be based on strict indications based on the dimensions and locations of the defects. AD - [Park, Joo Seok; Kim, Eun Key] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast Surg, 88 Olympic Ro 43-Gil, Seoul 138736, South Korea. [Ahn, Sei Hyun; Son, Byung Ho] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Surg, Seoul, South Korea. Kim, EK (corresponding author), Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast Surg, 88 Olympic Ro 43-Gil, Seoul 138736, South Korea. nicekek@korea.com AN - WOS:000219293700005 AU - Park, J. S. AU - Ahn, S. H. AU - Son, B. H. AU - Kim, E. K. DA - May DO - 10.5999/aps.2015.42.3.288 IS - 3 J2 - Arch. Plast. Surg.-APS KW - Breast neoplasms Mammaplasty Thoracic wall Surgical flaps Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: V4V2K Times Cited: 11 Cited Reference Count: 16 Park, Joo Seok Ahn, Sei Hyun Son, Byung Ho Kim, Eun Key 11 0 1 Korean soc plastic & reconstructive surgery Seoul 2234-6171 PY - 2015 SN - 2234-6163 SP - 288-294 ST - Using Local Flaps in a Chest Wall Reconstruction after Mastectomy for Locally Advanced Breast Cancer T2 - Archives of Plastic Surgery-Aps TI - Using Local Flaps in a Chest Wall Reconstruction after Mastectomy for Locally Advanced Breast Cancer UR - ://WOS:000219293700005 VL - 42 ID - 2258 ER - TY - JOUR AB - We represent a series of 18 cases with different breast malignancies which required local flaps for coverage of large defects after excision. The cases were 4 quadrant carcinoma (12 cases), cystosarcoma phylloides (3 cases), aggressive local recurrence (3 cases). All cases were subjected to multidisciplinary team meeting where the decision of mastectomy or excision of the recurrence was mandatory either for palliation of the patients symptoms - 7 cases - (e.g. bleeding, ulcerations), failure of down staging by neoadjuvant medications - 8 cases - or because the proper line of treatment was mastectomy (3 cases of cystosarcoma phylloides). Reconstruction methods were either latissmus dorsi flap (LD) or transverses abdominis myocutaneous flap (TRAM). The aim of surgery was palliative rather than radical in some cases. Morbidity ranged from minor (superficial wound infection, wound dehissaence either donor or recipient) to major (severe infection or partial loss of the flap). Mortality occured in 1 case 3 months following surgery due to brain matastasis. Conclusion: local flaps as TRAM and LD are good options for covering the chest wall defects following mastectomy or excision of local recurrence. AD - M. Alhussini, Surgical Oncology Unit, Alexandria University, Alexandria, Egypt AU - Alhussini, M. AU - Tarek, A. AU - Ghozlan, N. AU - Abdelateef, A. AU - Fayed, H. AU - Kholosy, H. AU - Elhusseiny, G. DB - Embase DO - 10.1016/S0960-9776(13)70061-4 KW - breast lesion consensus breast cancer excision mastectomy phyllodes tumor surgery bleeding human patient wound infection recipient ulcer palliative therapy carcinoma morbidity myocutaneous flap wound donor thorax wall defect infection mortality brain drug therapy staging breast LA - English M3 - Conference Abstract N1 - L71271463 2013-12-31 PY - 2013 SN - 0960-9776 SP - S35 ST - Using local flaps for coverage of defects after excision of advanced malignant breast lesions T2 - Breast TI - Using local flaps for coverage of defects after excision of advanced malignant breast lesions UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71271463&from=export http://dx.doi.org/10.1016/S0960-9776(13)70061-4 VL - 22 ID - 6705 ER - TY - JOUR AB - This study described a technique for the reconstruction of large lateral thoracic defects after local advanced breast cancer resection that allows for complete cover of the defect and primary closure of the donor site. The authors performed reconstruction using the newly designed KISS flap in 2 women for coverage of their large skin defect (15 × 13 cm each) following mastectomies with extensive tissue resection. The KISS flap consisting of 2 skin islands (marked Flap A and Flap B; 15 × 6 cm each) was designed and transferred to the thoracic defect through the subcutaneous tunnel, and based on the same vessel. The flap covered properly without causing excessive tension and allowed primary closure of chest wound and donor defect. The security it brings is comparable with that of classical radical mastectomy, and its success rate is similar to that of single skin flap transplantation. Compared with the conventional pedicled latissimus-dorsi-musculocutaneous flap, we believe that the donor zone tension decreases, wherein the KISS flaps can reduce the incidence of incision dehiscence and nonhealing complications to some extent. The study reported good results from this technique and discussed the techniques that referenced previous reports. AD - Binzhou Medical University Hospital, Binzhou, Shandong, People's Republic of China AN - 141167621. Language: English. Entry Date: 20201107. Revision Date: 20201107. Publication Type: journal article. Journal Subset: Biomedical AU - Song, Jia AU - Han, Yong AU - Liu, Jian AU - Cheng, Kai AU - Gao, Qiang AU - Wang, Xiaohong AU - Yang, Zhen-Lin DB - cin20 DO - 10.1177/1553350619877299 DP - EBSCOhost IS - 1 KW - Thorax Surgical Flaps Surgery, Reconstructive -- Methods Breast Neoplasms -- Surgery Mastectomy -- Methods Female Adult Middle Age Muscle, Skeletal -- Transplantation N1 - Peer Reviewed; USA. NLM UID: 101233809. PMID: NLM31631789. PY - 2020 SN - 1553-3506 SP - 5-10 ST - Using KISS Flaps in a Chest Wall Reconstruction After Mastectomy for Locally Advanced Breast Cancer: A New Technique T2 - Surgical Innovation TI - Using KISS Flaps in a Chest Wall Reconstruction After Mastectomy for Locally Advanced Breast Cancer: A New Technique UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=141167621&site=ehost-live&scope=site VL - 27 ID - 576 ER - TY - JOUR AB - The article reports on analyzing patient search interest in implant‐based and autologous breast reconstruction using Google trend. Topics include Google Trends is a tool which tracks activity of various search topics over time, offering valuable insights into the interests and expectations of the general public; and the goal of this study was to use Google Trends to analyze search interest in breast reconstruction procedures involving implants and autologous flaps. AD - Division of Plastic Surgery, Albany Medical Center, Albany NY, , USA AN - 143381254. Language: English. Entry Date: 20200527. Revision Date: 20210503. Publication Type: Article AU - Whipple, Lauren A. AU - Kotamarti, Vasanth S. AU - Heiman, Adee J. AU - Patel, Ashit AU - Ricci, Joseph A. DB - cin20 DO - 10.1111/tbj.13675 DP - EBSCOhost IS - 5 KW - Internet Information Seeking Behavior Breast Reconstruction Autografts Breast Implants Web Search Engines Cancer Patients Human Surgery, Plastic Spearman's Rank Correlation Coefficient Data Analysis Software Surgical Flaps Silicones N1 - research; tables/charts. Journal Subset: Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Peer Reviewed; USA. NLM UID: 9505539. PY - 2020 SN - 1075-122X SP - 1093-1095 ST - Using Google Trends to analyze patient search interest in implant‐based and autologous breast reconstruction T2 - Breast Journal TI - Using Google Trends to analyze patient search interest in implant‐based and autologous breast reconstruction UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=143381254&site=ehost-live&scope=site VL - 26 ID - 564 ER - TY - JOUR AD - J.A. Ricci, Division of Plastic Surgery, Albany Medical Center, Albany, NY, United States AU - Whipple, L. A. AU - Kotamarti, V. S. AU - Heiman, A. J. AU - Patel, A. AU - Ricci, J. A. DB - Embase Medline DO - 10.1111/tbj.13675 IS - 5 KW - breast endoprosthesis breast tissue expander saline breast implant silicone prosthesis breast reconstruction deep inferior epigastric perforator flap human Internet latissimus dorsi flap note search engine surgical volume transverse rectus abdominis musculocutaneous flap LA - English M3 - Note N1 - L2003540818 2019-11-15 2020-06-05 PY - 2020 SN - 1524-4741 1075-122X SP - 1093-1095 ST - Using Google Trends to analyze patient search interest in implant-based and autologous breast reconstruction T2 - Breast Journal TI - Using Google Trends to analyze patient search interest in implant-based and autologous breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2003540818&from=export http://dx.doi.org/10.1111/tbj.13675 VL - 26 ID - 4749 ER - TY - JOUR AB - Aims: The high technical demands associated with perforator flaps demand a precise preoperative identification and evaluation of perforator vessels. Color Doppler Ultrasonography (CDU) and Dynamic Infrared Thermography (DIRT) are currently used for preoperative perforator mapping. Each individual technique has advantages and disadvantages. The purpose of this paper is to analyze the value of combining the two methods in order to optimize the process of preoperative perforator mapping. Material and methods: CDU and DIRT were used for preoperative perforator mapping in 10 pigs. The results were compared to intraoperative findings. Total number of perforators, localization, and identification of the dominant perforator was analyzed for each method. The examination time was recorded for each procedure. Results: Both methods had a high sensitivity in determining the number and localization of perforators when compared to those identified during surgery. DIRT produced a higher number of false positive results. CDU accurately identified the emergence of the perforators in the fascia in all cases. Both methods correctly identified the dominant perforator. The sensitivity, positive predictive value, and accuracy of CDU were 93.56%, 97%, and 91.30% respectively and for DIRT 95.05%, 80.67%, and 77.41% respectively. The average examination was 39.76 minutes for CDU and 10.24 minutes for DIRT. The average time taken into account for the analysis of a single perforator in order to confirm DIRT findings was 1.83 minutes. Conclusions: Preoperative perforator mapping has become a compulsory step in nearly all reconstructive procedures. In our study, both CDU and DIRT correctly identified the dominant perforator in all cases. By combining the two examinations overall mapping time can be reduced significantly. A reduced examination time translates into increased patient compliance and a lower procedure cost. The combined mapping technique facilitates the selection of the ideal perforator in all cases. Correctly identifying the dominant perforator preoperatively reduces operative time, lowers complication rates and ensures an overall better result. AD - [Muntean, Maximilian Vlad; Ardelean, Filip; Georgescu, Alexandru] Iuliu Hatieganu Univ Med & Pharm, Dept Plast Surg, Cluj Napoca 400437, Romania. [Strilciuc, Stefan] Univ Babes Bolyai, Ctr Hlth Policy & Publ Hlth, R-3400 Cluj Napoca, Romania. [Pestean, Cosmin] Univ Agr Sci & Vet Med, Dept Anesthesiol & Reanimat, Cluj Napoca, Romania. [Lacatus, Radu] Univ Agr Sci & Vet Med, Dept Radiol & Med Imaging, Cluj Napoca, Romania. [Badea, Alexandru Florin] Univ Med & Pharm Iuliu Hatieganu, Dept Anat & Embryol, Cluj Napoca, Romania. Ardelean, F (corresponding author), Iuliu Hatieganu Univ Med & Pharm, Dept Plast Surg, 46-50 Viilor St, Cluj Napoca 400437, Romania. flpardelean@gmail.com AN - WOS:000365549400014 AU - Muntean, M. V. AU - Strilciuc, S. AU - Ardelean, F. AU - Pestean, C. AU - Lacatus, R. AU - Badea, A. F. AU - Georgescu, A. DA - Dec DO - 10.11152/mu.2013.2066.174.dyn IS - 4 J2 - Med. Ultrason. KW - dynamic infrared thermography color Doppler ultrasonography perforator flap anterolateral thigh flap inferior epigastric artery microsurgical breast reconstruction computed tomographic angiography preoperative ct angiography abdominal perforator fluorescent angiography clinical-applications duplex sonography angiosomes Acoustics Radiology, Nuclear Medicine & Medical Imaging LA - English M3 - Article N1 - ISI Document Delivery No.: CX2TJ Times Cited: 9 Cited Reference Count: 33 Muntean, Maximilian Vlad Strilciuc, Stefan Ardelean, Filip Pestean, Cosmin Lacatus, Radu Badea, Alexandru Florin Georgescu, Alexandru Strilciuc, Stefan/AAC-6253-2019; Georgescu, Alexandru/D-4843-2013 Strilciuc, Stefan/0000-0001-6112-0223; Georgescu, Alexandru/0000-0003-1233-2742; Radu, Lacatus/0000-0003-0491-9180 POSDRU [159/1.5/s/138776] The study was partially funded by the POSDRU 159/1.5/s/138776 grant. 12 1 6 Soc romana ultrasonografe medicina biologie-srumb Cluj-napoca 2066-8643 PY - 2015 SN - 1844-4172 SP - 503-508 ST - Using dynamic infrared thermography to optimize color Doppler ultrasound mapping of cutaneous perforators T2 - Medical Ultrasonography TI - Using dynamic infrared thermography to optimize color Doppler ultrasound mapping of cutaneous perforators UR - ://WOS:000365549400014 VL - 17 ID - 2148 ER - TY - JOUR AB - Cystosarcoma phyllodes is an uncommon type of breast tumour. Both benign and malignant types of this tumour have been described. The majority of studies agree that benign tumours are predominant (approximately 80-85%) and the malignant form only accounts for 15-20%. Of all types of breast cancers, cystosarcoma phyllodes only accounts for about 1%; however, it is the most frequent non-epithelial breast tumour. The case report presents a young woman diagnosed with cystosarcoma phyllodes in whom a DIEP flap was used to reconstruct the breast. AD - T. Kempnỳ, Klinika Wels, Grieskirahnerstrasse 42, Wels, Austria AU - Kempnỳ, T. AU - Lipovỳ, B. AU - Bartošková, J. AU - Gregorová, N. AU - Brychta, P. DB - Embase IS - 4 KW - article breast reconstruction case report phyllodes tumor deep inferior epigastric perforator flap disease association female human outcome assessment treatment response tumor ablation tumor differentiation LA - Czech M3 - Article N1 - L602245057 2015-02-19 2015-02-23 PY - 2014 SN - 1803-5345 1802-4475 SP - 169-171 ST - Using DIEP flap to reconstruct breast after ablation for cystosarcoma phyllodes T2 - Onkologie (Czech Republic) TI - Using DIEP flap to reconstruct breast after ablation for cystosarcoma phyllodes UR - https://www.embase.com/search/results?subaction=viewrecord&id=L602245057&from=export VL - 8 ID - 6645 ER - TY - JOUR AU - Hirase, T. AU - Falco, J. J. AU - Boulter, T. D. AU - Rude, M. J. DB - Medline DO - 10.1097/PRS.0000000000001465 IS - 2 KW - bandage breast tumor breast reconstruction cohort analysis esthetics female human mastectomy nipple pathology physiology postoperative care procedures retrospective study surgical flaps suture technique transplantation wound healing LA - English M3 - Article N1 - L606500111 2015-10-26 PY - 2015 SN - 1529-4242 SP - 284e-285e ST - Using Callus Cushions as a Simple Approach for Postoperative Dressing after Nipple Reconstruction T2 - Plastic and reconstructive surgery TI - Using Callus Cushions as a Simple Approach for Postoperative Dressing after Nipple Reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L606500111&from=export http://dx.doi.org/10.1097/PRS.0000000000001465 VL - 136 ID - 6202 ER - TY - JOUR AB - Deep inferior epigastric artery perforator (DIEP) flaps have become an attractive option for autologous breast reconstruction. The internal mammary artery (IMA) is the usual artery of choice for reconstruction. Unfortunately, there are certain situations when the IMA may not be suitable for usage as in previous radiation or diminutive size. Several options have been documented, such as using the thoracodorsal vessels. In this case report, we report usage of the distal and proximal ends of a contralateral single mammary artery to supply antegrade and retrograde flow to bilateral DIEP flaps. With increasing complexity of patient populations, the use of alternate approaches to recipient vessel in DIEP reconstruction becomes essential for effective outcomes. AD - [Tyrell, Richard; Leong, Rachelle Y.; Sathyanarayana, Sandeep A.; Korn, Peter; Kadison, Alan S.] Hofstra Univ, Sch Med, North Shore Long Isl Jewish Hlth Syst, Dept Gen Surg, Hempstead, NY 11550 USA. Tyrell, R (corresponding author), Hofstra North Shore LIJ Sch Med, Dept Surg, 300 Community Dr, Manhasset, NY 11030 USA. Rtyrell@nshs.edu AN - WOS:000391120400027 AU - Tyrell, R. AU - Leong, R. Y. AU - Sathyanarayana, S. A. AU - Korn, P. AU - Kadison, A. S. DA - Dec DO - 10.1055/s-0034-1390085 IS - 5 J2 - Int. J. Angiol. KW - DIEP internal mammary artery antegrade retrograde breast reconstruction breast reconstruction diep anastomosis flaps Cardiovascular System & Cardiology LA - English M3 - Article N1 - ISI Document Delivery No.: EG5YJ Times Cited: 1 Cited Reference Count: 6 Tyrell, Richard Leong, Rachelle Y. Sathyanarayana, Sandeep A. Korn, Peter Kadison, Alan S. 2 0 Thieme medical publ inc New york 1615-5939 PY - 2016 SN - 1061-1711 SP - E87-E88 ST - Using a Single Internal Mammary Artery as Retrograde and Antegrade Flow for Bilateral Deep Inferior Epigastric Artery Perforator Reconstruction: A Case Report T2 - International Journal of Angiology TI - Using a Single Internal Mammary Artery as Retrograde and Antegrade Flow for Bilateral Deep Inferior Epigastric Artery Perforator Reconstruction: A Case Report UR - ://WOS:000391120400027 VL - 25 ID - 1924 ER - TY - JOUR AB - Rationale: A pedicle pectoralis major musculocutaneous (PMMC) flap is one of the strategies for head and neck reconstruction. Seldom studies reported the case in which the skin area of previous modified radical mastectomy (MRM) had been used as a PMMC flap in head and neck reconstruction.Patient Concerns: An 84-year-old female who had suffered from left breast cancer and undergone a left modified radical mastectomy (MRM) more than 20 years earlier.Diagnoses: She had squamous cell carcinoma of the tongue and had undergone partial glossection and left modified radial neck dissection. Four months later, a left submandibular mass was noted with progressive enlargement and the biopsy revealed recurrent carcinoma.Interventions: Left marginal mandibulectomy with radical neck dissection was performed and the neck area was reconstructed by a left pedicle PMMC flap harvested from the left chest wall which had the previous MRM scar.Outcomes: The post-operative course was uneventful with complete survival of the flap. The patient received post-operative adjuvant radiotherapy at the left neck and no delayed wound disruption or flap necrosis was noted six months after surgery.Lessons: A pedicle PMMC flap may be harvested to achieve a functionally as well as an aesthetically pleasing outcome without compromising its viability despite the previous MRM. AD - Department of Surgery, National Yang-Ming University Hospital, National Yang- Ming University, Yi-Lan, Taipei, Taiwan Institute of Emergency and Critical Care Medicine, School of Medicine, Taipei, Taiwan Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan Department of Pediatrics, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan aDepartment of Surgery, National Yang-Ming University Hospital, National Yang-Ming University, Yi-Lan bInstitute of Emergency and Critical Care Medicine, School of Medicine cInstitute of Biomedical Informatics, National Yang-Ming University dDepartment of Pediatrics, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan AN - 122595998. Language: English. Entry Date: 20170430. Revision Date: 20210110. Publication Type: journal article AU - Jen-Wu, Huang AU - Nai-Yuan, Wu AU - Yi-Ying, Lin AU - Huang, Jen-Wu AU - Wu, Nai-Yuan AU - Lin, Yi-Ying DB - cin20 DO - 10.1097/MD.0000000000006313 DP - EBSCOhost IS - 15 KW - Surgery, Reconstructive -- Methods Surgical Flaps Head and Neck Neoplasms -- Surgery Carcinoma, Squamous Cell -- Surgery Pectoralis Muscles -- Transplantation Surgery, Oral -- Methods Female Aged, 80 and Over Mastectomy -- Methods Mandible -- Surgery Breast Neoplasms -- Surgery Neck Dissection -- Methods N1 - case study; pictorial. Journal Subset: Biomedical; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA. NLM UID: 2985248R. PMID: NLM28403069. PY - 2017 SN - 0025-7974 SP - 1-3 ST - Using a pedicle pectoralis major musculocutaneous flap in head and neck reconstruction after modified radical mastectomy: A case report T2 - Medicine TI - Using a pedicle pectoralis major musculocutaneous flap in head and neck reconstruction after modified radical mastectomy: A case report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=122595998&site=ehost-live&scope=site VL - 96 ID - 684 ER - TY - JOUR AB - Rationale: A pedicle pectoralis major musculocutaneous (PMMC) flap is one of the strategies for head and neck reconstruction. Seldom studies reported the case in which the skin area of previous modified radical mastectomy (MRM) had been used as a PMMC flap in head and neck reconstruction. Patient concerns: An 84-year-old female who had suffered from left breast cancer and undergone a left modified radical mastectomy (MRM) more than 20 years earlier. Diagnoses: She had squamous cell carcinoma of the tongue and had undergone partial glossection and left modified radial neck dissection. Four months later, a left submandibular mass was noted with progressive enlargement and the biopsy revealed recurrent carcinoma. Interventions: Left marginal mandibulectomy with radical neck dissection was performed and the neck area was reconstructed by a left pedicle PMMC flap harvested from the left chest wall which had the previous MRM scar. Outcomes: The post-operative course was uneventful with complete survival of the flap. The patient received post-operative adjuvant radiotherapy at the left neck and no delayed wound disruption or flap necrosis was noted six months after surgery. Lessons: A pedicle PMMC flap may be harvested to achieve a functionally as well as an aesthetically pleasing outcome without compromising its viability despite the previous MRM. AD - Y.-Y. Lin, Department of Pediatrics, Heping Fuyou Branch, Taipei City Hospital, No. 33, Section 2, Zhonghua Road, Zhongzheng District, Taipei, Taiwan AU - Huang, J. W. AU - Wu, N. Y. AU - Lin, Y. Y. DB - Embase Medline DO - 10.1097/MD.0000000000006313 IS - 15 KW - ablation therapy adjuvant radiotherapy aged article breast cancer cancer radiotherapy cancer recurrence cancer surgery case report female graft survival human human tissue mandible resection myocutaneous flap neck dissection oral biopsy patient history of mastectomy pectoralis major muscle pedicle pectoralis major musculocutaneous flap postoperative care postoperative period priority journal radical mastectomy skin defect tongue carcinoma very elderly LA - English M3 - Article N1 - L615490239 2017-04-25 2017-04-27 PY - 2017 SN - 1536-5964 0025-7974 ST - Using a pedicle pectoralis major musculocutaneous flap in head and neck reconstruction after modified radical mastectomy T2 - Medicine (United States) TI - Using a pedicle pectoralis major musculocutaneous flap in head and neck reconstruction after modified radical mastectomy UR - https://www.embase.com/search/results?subaction=viewrecord&id=L615490239&from=export http://dx.doi.org/10.1097/MD.0000000000006313 VL - 96 ID - 5775 ER - TY - JOUR AB - Background: Seromas are the most common complication of latissimus dorsi flap breast reconstruction. Electrocautery for flap elevation can cause seromas and injure the lymph or vessels of the surrounding tissues. Positive effects of the LigaSure Small Jaw (Medtronic [formerly Covidien], Minneapolis, MN, USA) sealing device were examined. Methods: Forty-three latissimus dorsi flap breast reconstruction patients were included. Twenty-three underwent surgery with electrocautery and 21 underwent surgery with LigaSure. The seroma formation rate, total drain volume, drainage indwelling periods at the breast site and donor site, operative time, and hospital stay duration were retrospectively compared. Associations between patient characteristics and these variables were analyzed. Results: Seroma incidence rates were 9/23 (39.1%) and 3/21 (14.3%) for the control and experimental groups. One control group patient underwent surgical treatment; the rest underwent conservative treatment. A significant difference in latissimus dorsi flap elevation time was found between the control and experimental groups (105.6 minutes and 77.1 minutes; p = .026). A significant difference in the drainage indwelling periods of the latissimus dorsi donor site was found (13.1 days and 11 days; p = .006). Excised breast mass weight, latissimus dorsi flap weight, breast drain total volume/indwelling period, and latissimus dorsi drain volume/indwelling period showed statistically significant associations. Radiation and chemotherapy were not significantly associated with any variables. Conclusion: The LigaSure device for latissimus dorsi flap breast reconstruction can reduce seromas, operative time, and hospital stay. It is a reliable and useful surgical sealing device that does not cause injury to the surrounding tissues. AU - Lee, J. S. AU - Kim, D. G. AU - Lee, J. W. AU - Choi, K. Y. AU - Chung, H. Y. AU - Cho, B. C. AU - Yang, J. D. DB - Medline DO - 10.1080/2000656X.2019.1612753 IS - 5 KW - back muscle breast reconstruction case control study devices female hemostasis human length of stay mastectomy middle aged operation duration postoperative complication retrospective study seroma surgical flaps transplantation LA - English M3 - Article N1 - L627710611 2020-09-24 PY - 2019 SN - 2000-6764 SP - 295-300 ST - Usefulness of the LigaSure™ small jaw sealing device for breast reconstruction with a latissimus dorsi flap T2 - Journal of plastic surgery and hand surgery TI - Usefulness of the LigaSure™ small jaw sealing device for breast reconstruction with a latissimus dorsi flap UR - https://www.embase.com/search/results?subaction=viewrecord&id=L627710611&from=export http://dx.doi.org/10.1080/2000656X.2019.1612753 VL - 53 ID - 4963 ER - TY - JOUR AB - BACKGROUND: The final stage of breast reconstruction after mastectomy for breast cancer is nipple reconstruction. However, a consistent and reliable method resulting in the most ideal aesthetic results has yet to be clarified. This study analysed the long-term outcomes of nipple reconstruction using Rapiplug. METHODS: Forty-one patients who underwent immediate breast reconstruction after mastectomy between January 2014 and February 2017 were enrolled. Nipple reconstruction was performed with C-V flap and Hammond flap, and hat-shaped Rapiplug was implanted at the flap core. Nipple projection and width were measured and nipple reduction rates were calculated immediately after and at 3, 6, and 12 months after surgery. Patient satisfaction was surveyed at the 12-month follow-up and compared with patient characteristics and other variables. RESULTS: Forty-one nipple reconstructions were performed in 41 patients. Most post-operative adverse events were resolved with conservative management, and revision was performed in only one case. The mean nipple projections were 8.9 ± 1.8, 7 ± 1.8, 5.6 ± 1.6 and 4.9 ± 1.6 mm immediately, and 3, 6 and 12 months after surgery, respectively, and the mean reduction rate of nipple size with reference to the size immediately after surgery was 22.2%, 37.2% and 44.7% at 3, 6 and 12 months after surgery, respectively. Patient satisfaction was 82.9% in overall outcome, and 85.3% of projection was good or excellent. CONCLUSION: Rapiplug can improve the long-term preservation of nipple projection after nipple reconstruction and is considered to be consistent and reliable with good aesthetic outcomes and no severe complications. AD - Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea. AN - 29423974 AU - Lee, J. S. AU - Kwon, J. H. AU - Lee, J. W. AU - Choi, K. Y. AU - Chung, H. Y. AU - Cho, B. C. AU - Yang, J. D. DA - Mar DO - 10.1111/ans.14410 DP - NLM ET - 2018/02/10 IS - 3 KW - Adult Breast Neoplasms/*surgery Esthetics/psychology Female Follow-Up Studies Humans Mammaplasty/*methods/trends Mastectomy/adverse effects Middle Aged Nipples/*surgery Patient Satisfaction/statistics & numerical data Retrospective Studies Surgical Flaps/transplantation Surgical Instruments/adverse effects/*trends Surveys and Questionnaires Treatment Outcome *C-V flap *Hammond flap *Rapiplug *nipple projection *nipple reconstruction LA - eng N1 - 1445-2197 Lee, Joon Seok Kwon, Joon Hyun Lee, Jeong Woo Choi, Kang Young Chung, Ho Yun Cho, Byung Chae Yang, Jung Dug Orcid: 0000-0002-9121-3604 Kyungpook National University Hospital/International Comparative Study Journal Article Research Support, Non-U.S. Gov't Australia ANZ J Surg. 2019 Mar;89(3):E71-E75. doi: 10.1111/ans.14410. Epub 2018 Feb 8. PY - 2019 SN - 1445-1433 SP - E71-e75 ST - Usefulness of Rapiplug in nipple reconstruction to improve nipple projection T2 - ANZ J Surg TI - Usefulness of Rapiplug in nipple reconstruction to improve nipple projection VL - 89 ID - 9798 ER - TY - JOUR AB - Background The emergence of breast-conserving surgery combined with radiotherapy as the treatment of choice for early stage breast cancer has resulted in greater focus on oncoplastic breast surgery. The use of perforator flaps has particularly gained in reputation for its effectiveness in the reconstruction of partial breast defects in Korean women. Herein, we present our experience with the use of thoracodorsal artery perforator (TDAP) and lateral intercostal artery perforator (LICAP) flaps. Methods This study included 33 patients who underwent breast reconstruction using TDAP or LICAP flaps at our hospital from January 2011 to December 2014. Data from patient medical records, and patient satisfaction surveys, which were conducted 12 months postoperatively, were retrospectively evaluated. Results TDAP and LICAP flap-based reconstructions were performed in 14 and 19 patients, respectively. Five patients developed complications that required additional intervention. Overall patient satisfaction was observed to be excellent in 15 (46%) patients, and good in 12 (36%). Conclusions Based on our experience, oncoplastic breast surgery using TDAP or LICAP flap is an effective remodeling technique for small-to-moderate breast defects in Korean women with smaller breasts. AD - [Kim, Jae Bong; Kim, Dong Kyu; Lee, Jeong Woo; Choi, Kang Young; Chung, Ho Yun; Cho, Byung Chae; Yang, Jung Dug] Kyungpook Natl Univ, Sch Med, Dept Plast & Reconstruct Surg, 130 Dongdeok Ro, Daegu 41944, South Korea. [Park, Ho Yong; Lee, Jee Yeon] Kyungpook Natl Univ, Sch Med, Dept Surg, Daegu, South Korea. Yang, JD (corresponding author), Kyungpook Natl Univ, Sch Med, Dept Plast & Reconstruct Surg, 130 Dongdeok Ro, Daegu 41944, South Korea. lambyang@knu.ac.kr AN - WOS:000425280500005 AU - Kim, J. B. AU - Kim, D. K. AU - Lee, J. W. AU - Choi, K. Y. AU - Chung, H. Y. AU - Cho, B. C. AU - Park, H. Y. AU - Lee, J. Y. AU - Yang, J. D. DA - Jan DO - 10.5999/aps.2017.01200 IS - 1 J2 - Arch. Plast. Surg.-APS KW - Intercostal artery perforator flap Oncoplastic breast surgery Thoracodorsal artery perforator flap Latissimus dorsi flap Breast reconstruction surgical techniques follow-up cancer mastectomy implant Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: FW4JU Times Cited: 7 Cited Reference Count: 18 Kim, Jae Bong Kim, Dong Kyu Lee, Jeong Woo Choi, Kang Young Chung, Ho Yun Cho, Byung Chae Park, Ho Yong Lee, Jee Yeon Yang, Jung Dug Yang, Jung dug/R-7806-2019 Lee, Jeong Woo/0000-0003-4903-6066 7 0 4 Korean soc plastic & reconstructive surgery Seoul 2234-6171 PY - 2018 SN - 2234-6163 SP - 29-36 ST - The usefulness of pedicled perforator flap in partial breast reconstruction after breast conserving surgery in Korean women T2 - Archives of Plastic Surgery-Aps TI - The usefulness of pedicled perforator flap in partial breast reconstruction after breast conserving surgery in Korean women UR - ://WOS:000425280500005 VL - 45 ID - 1683 ER - TY - JOUR AB - Background In Korean women, many of whom have small to moderate-sized breasts, it is difficult to cover a partial breast defect using oncoplastic volume displacement techniques after removal of an adequate volume of tissue during oncologic surgery. In such cases, oncoplastic volume replacement techniques are more useful. Methods From January 2007 to December 2011, 104 women underwent a total of 107 breastconserving surgeries with various kinds of oncoplastic volume replacement techniques. We used latissimus dorsi (LD) myocutaneous flap for cases in which the resection mass was greater than 150 g. In case with a resection mass less than 150 g, we used regional flaps such as a lateral thoracodorsal flap, a thoracoepigastric flap, or perforator flaps such as an intercostal artery perforator (ICAP) flap or a thoracodorsal artery perforator (TDAP) flap. Results The mean age was 46.1 years, and the average follow-up interval was 10.3 months. The patients underwent oncoplastic volume replacement techniques with a lateral thoracodorsal flap (n = 9), thoracoepigastric flap (n = 7), ICAP flap (n = 25), TDAP flap (n = 12), and LD flap (n= 54). There was one case of congestion in an LD flap, and two cases of fat necrosis in an ICAP flap. Most of the patients were satisfied with the cosmetic results. Conclusions Oncoplastic volume replacement techniques can be reliable and useful for the correction of breast deformity after breast-conserving surgery, especially in patients with small to moderate-sized breasts. AD - [Yang, Jung Dug; Kim, Min Chul; Lee, Jeong Woo; Cho, Young Kyoo; Choi, Kang Young; Chung, Ho Yun; Cho, Byung Chae] Kyungpook Natl Univ, Sch Med, Dept Plast & Reconstruct Surg, 130 Dongdeok Ro, Daegu 700421, South Korea. [Park, Ho Yong] Kyungpook Natl Univ, Sch Med, Dept Surg, Daegu, South Korea. Yang, JD (corresponding author), Kyungpook Natl Univ, Sch Med, Dept Plast & Reconstruct Surg, 130 Dongdeok Ro, Daegu 700421, South Korea. lambyang@paran.com AN - WOS:000219247100010 AU - Yang, J. D. AU - Kim, M. C. AU - Lee, J. W. AU - Cho, Y. K. AU - Choi, K. Y. AU - Chung, H. Y. AU - Cho, B. C. AU - Park, H. Y. DA - Sep DO - 10.5999/aps.2012.39.5.489 IS - 5 J2 - Arch. Plast. Surg.-APS KW - Breast neoplasms Mammaplasty Surgical flaps Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: V4T4M Times Cited: 23 Cited Reference Count: 15 Yang, Jung Dug Kim, Min Chul Lee, Jeong Woo Cho, Young Kyoo Choi, Kang Young Chung, Ho Yun Cho, Byung Chae Park, Ho Yong Yang, Jung dug/R-7806-2019 Lee, Jeong Woo/0000-0003-4903-6066 Kyungpook National University Research Fund This research was supported by Kyungpook National University Research Fund, 2012. 23 0 Korean soc plastic & reconstructive surgery Seoul 2234-6171 PY - 2012 SN - 2234-6163 SP - 489-496 ST - Usefulness of Oncoplastic Volume Replacement Techniques after Breast Conserving Surgery in Small to Moderate-sized Breasts T2 - Archives of Plastic Surgery-Aps TI - Usefulness of Oncoplastic Volume Replacement Techniques after Breast Conserving Surgery in Small to Moderate-sized Breasts UR - ://WOS:000219247100010 VL - 39 ID - 2710 ER - TY - JOUR AB - Background: Mammary reconstruction after surgery for breast cancer can be performed with free abdominal flaps such as DIEP (deep inferior epigastric perforator), TRAM (transverse rectus abdominis musculocutaneus) y SIEA (superficial inferior epigastric artery). Aim: To report our experience with the use of magnetic resonance angiography to plan mammary reconstruction. Material and Methods: The superficial epigastric vascular axis and the connections between the superficial and deep axis were explored with magnetic resonance angiography in 25 patients aged 32 to 63 years. Dominant perforating arteries (those with the greater caliber and predominant distribution through adipose tissue), were localized. Their intramuscular trajectory and that of the deep epigastric artery were also studied. The findings of magnetic resonance were compared with those of intraoperative Doppler ultrasound examination dissection during operation. Results: There was a 100% concordance between magnetic resonance findings and those of intraoperative Doppler. However in two patients a perforating artery with an adequate caliber was missed with magnetic resonance. Conclusions: Magnetic resonance angiography is useful in the planning of mammary reconstruction with epigastric flaps. AD - [Polanco M, Diego; Fernandez-Canamaque R, Jose; Ortega C, Isabel] Hosp Univ Getafe, Serv Cirugia Plast, Madrid, Spain. [Castillo G, Ernesto] Hosp Univ Getafe, Serv Radiol, Madrid, Spain. Polanco, D (corresponding author), Carretera Toledo 12500,CP 28905, Madrid, Spain. dpolanco@puc.cl AN - WOS:000282258200004 AU - Polanco, D. AU - Fernandez-Canamaque, J. AU - Ortega, I. AU - Castillo, E. DA - Oct IS - 5 J2 - Rev. Chil. Cir. KW - MR-Angiography free flaps breast reconstruction perforator flap doppler sonography diep flaps tram anatomy muscle Surgery LA - Spanish M3 - Article N1 - ISI Document Delivery No.: 655OB Times Cited: 0 Cited Reference Count: 13 Polanco M, Diego Fernandez-Canamaque R, Jose Ortega C, Isabel Castillo G, Ernesto 1 0 Soc cirujanos chile Santiago PY - 2010 SN - 0379-3893 SP - 449-453 ST - Usefulness of magnetic resonance angiography in the preoperative study for breast reconstruction using epigastric flaps T2 - Revista Chilena De Cirugia TI - Usefulness of magnetic resonance angiography in the preoperative study for breast reconstruction using epigastric flaps UR - ://WOS:000282258200004 VL - 62 ID - 3049 ER - TY - JOUR AB - Background: Women with small- to moderate-sized breasts present a specific challenge to performing oncoplastic volume-displacement techniques for reconstructing breast defects after breast-conserving surgery (BCS). In such cases, the lateral thoracic wall region serves as a versatile reconstruction donor site. Therefore, in the present study, we aimed to investigate the effectiveness and feasibility of employing lateral thoracic adipofascial (LTA) flaps to reconstruct breast defects following BCS.Patients and Methods: A total of 58 female patients who underwent BCS between February 2016 and April 2017 were analyzed. Of these, 33 patients were reconstructed with LTA flaps, and the other 25 patients received BCS only and were assigned as the control group. All patients were followed up, and we assessed surgery-related complications, breast appearance, and disease recurrence.Results: The mean weight of the resected breast tissue was 65.9 g (range, 35-100 g). The mean volume of LTA flaps was 309.5 cm3 (range, 112.6-588 cm3). This oncoplastic technique was performed with minimal complications in all patients. Two patients exhibited partial adipose liquefaction (6.1%), and 2 patients manifested wound infections.Conclusions: The LTA flaps were reliable and useful for reconstructing breast defects after BCS when the resected volume was confined to between 50 and 100 g, particularly in patients with small- to moderate-sized breasts. This is optimal for patients with lesions located in the upper-outer quadrant. AD - Department of Breast Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China Department of General Surgery, Yingshang County Hospital, Anhui, China AN - 141284785. Language: English. Entry Date: 20200708. Revision Date: 20200930. Publication Type: journal article. Journal Subset: Biomedical AU - Shikai, Hong AU - Shengying, Wang AU - Jianjun, Liu AU - Zehao, Qiang AU - Xucai, Zheng AU - Gongpu, Chen AU - Hong, Shikai AU - Wang, Shengying AU - Liu, Jianjun AU - Qiang, Zehao AU - Zheng, Xucai AU - Chen, Gongpu DB - cin20 DO - 10.1016/j.clbc.2019.04.009 DP - EBSCOhost IS - 5 KW - Breast -- Surgery Lumpectomy -- Methods Breast Reconstruction -- Methods Breast Neoplasms -- Surgery Fascia -- Transplantation Surgical Flaps -- Statistics and Numerical Data Adipose Tissue -- Transplantation Breast Neoplasms -- Pathology Breast -- Pathology Thorax -- Transplantation Prospective Studies Female Middle Age Case Control Studies Adult Retrospective Design Prognosis N1 - Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA. NLM UID: 100898731. PMID: NLM31204289. PY - 2019 SN - 1526-8209 SP - 370-376 ST - Usefulness of Lateral Thoracic Adipofascial Flaps After Breast-conserving Surgery in Small-to Moderate-sized Breasts T2 - Clinical Breast Cancer TI - Usefulness of Lateral Thoracic Adipofascial Flaps After Breast-conserving Surgery in Small-to Moderate-sized Breasts UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=141284785&site=ehost-live&scope=site VL - 19 ID - 585 ER - TY - JOUR AB - CASE 1: A 59-year-old female patient with left inflammatory breast cancer (HER2 type) T4N1M0, stage III B. Although a partial response (PR) was observed after chemotherapy, an increase of the tumor was confirmed, and thus she underwent pectoralis-conserving mastectomy and immediate reconstruction with a rectus abdominis flap. After the surgery, the patient continued to undergo radiotherapy and administration of trastuzumab. At present, after 1 year and 3 months, she is alive with no recurrence. CASE 2: A 67-year-old female patient with left inflammatory breast cancer (triple negative) T4N2M0, stage III B. Since a variety of chemotherapeutics were ineffective, she underwent mastectomy with pectoralis resection and immediate reconstruction with a rectus abdominis flap to control pain/bleeding caused by the increased tumor. Although radiotherapy and chemotherapy were performed after the surgery, lung and hepatic metastases were developed 6 months after the surgery, and she died in the 10th month after the surgery. CONCLUSION: In mastectomy for inflammatory breast cancer, an immediate reconstruction with a muscle cutaneous flap enabled unhesitating mastectomy in a wide area, and thus we consider this will be a useful technique. AD - Dept. of Surgical Oncology, Osaka City University Graduate School of Medicine. AN - 22202317 AU - Aomatsu, N. AU - Kawajiri, H. AU - Takashima, T. AU - Morisaki, T. AU - Hirakawa, T. AU - Fukuoka, T. AU - Kashiwagi, S. AU - Nakamura, M. AU - Onoda, N. AU - Ishikawa, T. AU - Hirakawa, K. DA - Nov DP - NLM ET - 2011/12/29 IS - 12 KW - Aged Female Humans Inflammatory Breast Neoplasms/pathology/*surgery Mastectomy Middle Aged Neoplasm Staging *Reconstructive Surgical Procedures *Surgical Flaps LA - jpn N1 - Aomatsu, Naoki Kawajiri, Hidemi Takashima, Tsutomu Morisaki, Tamami Hirakawa, Toshiki Fukuoka, Tatsunari Kashiwagi, Shinichiro Nakamura, Masanori Onoda, Naoyoshi Ishikawa, Tetsuro Hirakawa, Kosei Case Reports English Abstract Journal Article Japan Gan To Kagaku Ryoho. 2011 Nov;38(12):2165-7. PY - 2011 SN - 0385-0684 (Print) 0385-0684 SP - 2165-7 ST - [Usefulness of immediate reconstruction after mastectomy for inflammatory breast cancer with muscle cutaneous flap] T2 - Gan To Kagaku Ryoho TI - [Usefulness of immediate reconstruction after mastectomy for inflammatory breast cancer with muscle cutaneous flap] VL - 38 ID - 13557 ER - TY - JOUR AB - In breast-conservative therapy (BCT), it is difficult to repair defects in the inferior portion of the breast. We performed an immediate reconstruction using an inframammary adipofascial flap after breast conservation in 4 patients with breast cancer in the inferior portion of their breasts and evaluated the usefulness of the procedure. A skin incision is made at the inframammary line. Immediately following BCT, a tongue-shaped flap of the fat and the anterior sheath of the rectus abdominis muscle are pulled up and inserted to reconstruct the breast mound. The cosmetic outcomes of all patients were good, and this surgical procedure can be easily performed by general surgeons without the need of assistance by plastic surgeons. We believe this to be a useful surgical modality for the reconstruction of BCT in the inferior portion breast cancer. AN - RN205035290 AU - Ogawa, T. AU - Hanamura, N. AU - Yamashita, M. AU - Ri, Y. AU - Kuriyama, N. AU - Isaji, S. CN - 617 RD1 0838.500000 LA - English N1 - Monthly: 9-14 issues per year United States Elsevier Science B.V., Amsterdam. PY - 2007 SN - 0002-9610 SP - 514 - 518 ST - Usefulness of breast-volume replacement using an inframammary adipofascial flap after breast-conservation therapy T2 - American Journal of Surgery TI - Usefulness of breast-volume replacement using an inframammary adipofascial flap after breast-conservation therapy VL - 193, NUMB 4 ID - 186 ER - TY - JOUR AB - Background Breast-conserving surgery is widely accepted as an appropriate method in breast cancer, and the lateral thoracodorsal flap provides a simple, reliable technique, especially when a mass is located in the lateral breast. This study describes the usefulness of a lateral thoracodorsal flap after breast conserving surgery in laterally located breast cancer. Methods From September 2008 to February 2013, a lateral thoracodorsal flap was used in 20 patients with laterally located breast cancer treated at our institution. The technique involves a local medially based, wedge shaped, fasciocutaneous transposition flap from the lateral region of the thoracic area. Overall satisfaction and aesthetic satisfaction surveys were conducted with the patients during a 6-month postoperative follow-up period. Aesthetic results in terms of breast shape and symmetry were evaluated by plastic surgeons. Results The average specimen weight was 76.8 g. The locations of the masses were the upper lateral quadrant (n = 15), the lower lateral quadrant (n = 2), and the central lateral area (n = 3). Complications developed in four of the cases, partial flap necrosis in one, wound dehiscence in one, and fat necrosis in two. The majority of the patients were satisfied with their cosmetic outcomes. Conclusions Partial breast reconstruction using a lateral thoracodorsal flap is well matched with breast color and texture, and the surgery is less aggressive than other techniques with few complications. Therefore, the lateral thoracodorsal flap can be a useful, reliable technique in correcting breast deformity after breast conserving surgery, especially in laterally located breast cancer. AD - [Yang, Jung Dug; Ryu, Dong Wan; Lee, Jeong Woo; Choi, Kang Young; Chung, Ho Yun; Cho, Byung Chae] Kyungpook Natl Univ, Grad Sch Med, Dept Plast & Reconstruct Surg, 130 Dongdeok Ro, Daegu 700421, South Korea. [Park, Ho Yong] Kyungpook Natl Univ, Grad Sch Med, Dept Surg, Daegu, South Korea. [Byun, Jin Suk] BS Aesthet Clin, Daegu, South Korea. Yang, JD (corresponding author), Kyungpook Natl Univ, Grad Sch Med, Dept Plast & Reconstruct Surg, 130 Dongdeok Ro, Daegu 700421, South Korea. lambyang@daum.net AN - WOS:000219260700013 AU - Yang, J. D. AU - Ryu, D. W. AU - Lee, J. W. AU - Choi, K. Y. AU - Chung, H. Y. AU - Cho, B. C. AU - Park, H. Y. AU - Byun, J. S. DA - Jul DO - 10.5999/aps.2013.40.4.367 IS - 4 J2 - Arch. Plast. Surg.-APS KW - Mammaplasty Surgical flaps Mastectomy Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: V4T9S Times Cited: 4 Cited Reference Count: 17 Yang, Jung Dug Ryu, Dong Wan Lee, Jeong Woo Choi, Kang Young Chung, Ho Yun Cho, Byung Chae Park, Ho Yong Byun, Jin Suk Yang, Jung dug/R-7806-2019 Lee, Jeong Woo/0000-0003-4903-6066 Kyungpook National University Research Fund This research was supported by Kyungpook National University Research Fund, 2012. 5 0 1 Korean soc plastic & reconstructive surgery Seoul 2234-6171 PY - 2013 SN - 2234-6163 SP - 367-373 ST - Usefulness of a Lateral Thoracodorsal Flap after Breast Conserving Surgery in Laterally Located Breast Cancer T2 - Archives of Plastic Surgery-Aps TI - Usefulness of a Lateral Thoracodorsal Flap after Breast Conserving Surgery in Laterally Located Breast Cancer UR - ://WOS:000219260700013 VL - 40 ID - 2572 ER - TY - JOUR AD - [Sallam, I.] NCI Cairo Univ, MISR Canc Ctr, Surg Oncol, Breast Unit, Giza, Egypt. [Amira, G.] NCI Cairo Univ, MISR Canc Ctr, Surg Oncol, Giza, Egypt. [Sherif, A.; Sherif, M.] MISR Int Hosp, Plast & Reconstruct Surg, Al Jizah, Egypt. [Wrmzyar, S. J.] Erbil Univ Hosp, Breast Unit, Erbil, Iraq. AN - WOS:000461694000288 AU - Sallam, I. AU - Amira, G. AU - Sherif, A. AU - Wrmzyar, S. J. AU - Sherif, M. DA - Mar DO - 10.1016/s0960-9776(19)30366-2 J2 - Breast KW - Oncology Obstetrics & Gynecology LA - English M3 - Meeting Abstract N1 - ISI Document Delivery No.: HP5CN Times Cited: 0 Cited Reference Count: 0 Sallam, I. Amira, G. Sherif, A. Wrmzyar, S. J. Sherif, M. Sallam, Ibrahim/0000-0002-9486-498X 0 Churchill livingstone Edinburgh 1532-3080 1 PY - 2019 SN - 0960-9776 SP - S107-S108 ST - The usefulness and feasibility of lateral intercostal artery perforator flap reconstruction in breast conserving surgery as an optimal choice for immediate partial breast reconstruction T2 - Breast TI - The usefulness and feasibility of lateral intercostal artery perforator flap reconstruction in breast conserving surgery as an optimal choice for immediate partial breast reconstruction UR - ://WOS:000461694000288 VL - 44 ID - 1432 ER - TY - JOUR AD - Memorial Hermann Hospital; Houston, Texas (Boutros) University of Texas Medical Branch; Galveston, Texas (Wijay). AN - 20885221 AU - Boutros, S. AU - Wijay, N. DA - Oct DO - 10.1097/PRS.0b013e3181ea92e7 DP - NLM ET - 2010/10/05 IS - 4 KW - Breast Neoplasms/*radiotherapy/surgery Epigastric Arteries Esthetics Female Humans Mammaplasty/*methods Mastectomy/methods Middle Aged Skin/radiation effects Surgical Flaps/*blood supply Transplantation, Autologous Treatment Outcome Wound Healing/physiology LA - eng N1 - 1529-4242 Boutros, Sean Wijay, Nandhika Case Reports Journal Article United States Plast Reconstr Surg. 2010 Oct;126(4):197e-199e. doi: 10.1097/PRS.0b013e3181ea92e7. PY - 2010 SN - 0032-1052 SP - 197e-199e ST - The use of Z-plasty during delayed autologous breast reconstruction for the improvement of aesthetic outcome T2 - Plast Reconstr Surg TI - The use of Z-plasty during delayed autologous breast reconstruction for the improvement of aesthetic outcome VL - 126 ID - 10361 ER - TY - JOUR AD - Mersin Univ, Sch Med, Dept Plast & Reconstruct Surg, Mersin, Turkey. Mersin Univ, Sch Med, Dept Gen Surg, Mersin, Turkey. Demirkan, F (corresponding author), GMK Bulvari, 521-33 Yenisehir, TR-33040 Mersin, Turkey. feritdemirkan@superonline.com AN - WOS:000236376900003 AU - Demirkan, F. AU - Gurbuz, O. AU - Tutuncu, N. AU - Akca, T. AU - Aydin, S. DA - Apr DO - 10.1097/01.sap.0000202145.44913.10 IS - 4 J2 - Ann. Plast. Surg. KW - DIEP flap breast reconstruction Wise pattern symmetrization skin-sparing mastectomy breast reconstruction tram satisfaction Surgery LA - English M3 - Article; Proceedings Paper N1 - ISI Document Delivery No.: 026XP Times Cited: 2 Cited Reference Count: 26 Demirkan, F Gurbuz, O Tutuncu, N Akca, T Aydin, S 16th Annual Meeting of the European-Association-of-Plastic-Surgeons May 26-28, 2005 Marseilles, FRANCE European Assoc Plast Surg 2 0 1 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2006 SN - 0148-7043 SP - 359-363 ST - Use of Wise pattern for achieving symmetry in one stage in immediate reconstructions with deep inferior epigastric artery perforator flap T2 - Annals of Plastic Surgery TI - Use of Wise pattern for achieving symmetry in one stage in immediate reconstructions with deep inferior epigastric artery perforator flap UR - ://WOS:000236376900003 VL - 56 ID - 3641 ER - TY - JOUR AB - Nipple sparing mastectomy with free tissue transfer for breast reconstruction offers excellent aesthetic outcomes but poses a challenge in monitoring the buried flap. Venous anastomotic flow couplers directly monitor buried flaps without the need for monitoring skin paddles. In a two year period we used the Synovis GEM™ flow coupler on 24 DIEP flaps. In our practice, flow couplers are effective in monitoring buried free flaps for breast reconstruction. The avoidance of a second procedure to remove a skin paddle improves patient experience and nullifies the additional flow coupler cost. One patient needed return to theatre when a Doppler wire became dislodged early in the series. There were no other issues with flap monitoring and no flap failures. We offer our tips to optimise flow coupler use. AD - S.L. Chadwick, Department of Plastic Surgery, Wythenshawe Hospital, Manchester University NHS Foundation Trust, United Kingdom, United Kingdom AU - Chadwick, S. L. AU - Khaw, R. AU - Duncan, J. AU - Wilson, S. W. AU - Highton, L. AU - O'Ceallaigh, S. DB - Embase DO - 10.1016/j.jpra.2019.09.002 KW - anastomotic device Synovis GEM adult artery thrombosis article breast cancer breast reconstruction controlled study cost benefit analysis cost control cost effectiveness analysis deep inferior epigastric perforator flap esthetics free tissue graft human mastectomy nipple-sparing mastectomy patient monitoring perforator flap pulse wave retrospective study risk reduction vein anastomosis vein thrombosis LA - English M3 - Article N1 - L2004319220 2019-12-24 2019-12-31 PY - 2020 SN - 2352-5878 SP - 50-54 ST - The use of venous anastomotic flow couplers to monitor buried free DIEP flap reconstructions following nipple-sparing mastectomy T2 - JPRAS Open TI - The use of venous anastomotic flow couplers to monitor buried free DIEP flap reconstructions following nipple-sparing mastectomy UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004319220&from=export http://dx.doi.org/10.1016/j.jpra.2019.09.002 VL - 23 ID - 4808 ER - TY - JOUR AB - INTRODUCTION: The effect of vasopressors on flaps remains controversial in the literature. Often, surgeons avoid vasopressors with the thought that vasoconstriction reduces flap perfusion resulting in flap loss. METHODS: A retrospective review was performed on patients who required chest wall reconstruction from 1998 to 2013. Patients were identified through the use of Current Procedural Terminology codes. The data collected included demographics, indications for surgery, prior debridement, preoperative albumin levels, and perioperative vasopressor use. Outcomes measures included flap survival, flap complications, reoperation rates, intensive care unit length of stay, and mortality. RESULTS: Of the 1220 patient records reviewed, 88 had chest reconstruction by a plastic surgeon. Twenty-one patient records were excluded due to incomplete data. One patient experienced complete flap loss; these data were excluded from statistical analysis. Fifty patients received perioperative vasopressors whereas 15 did not. There was no significant difference in flap survival or loss between groups who received perioperative vasopressors and those who did not receive vasopressors. Age, intensive care unit length of stay, flap complications, and reoperation rates were significantly higher in those with partial flap survival. CONCLUSIONS: Perioperative vasopressor use does not adversely affect the outcome of pedicled flaps for chest wall reconstruction. Further research is warranted to review the effects of vasopressor dose and type on pedicled flaps. AU - Kite, A. C. AU - Nigro, L. C. AU - Feldman, M. J. AU - Pozez, A. L. DB - Medline DO - 10.1097/SAP.0000000000001108 IS - 3 KW - adult breast reconstruction female follow up graft survival human male middle aged postoperative complication retrospective study skeletal muscle statistics and numerical data surgical flaps thorax tumor thorax wall LA - English M3 - Article N1 - L622349432 2018-06-01 PY - 2017 SN - 1536-3708 SP - e11-e14 ST - The Use of Vasopressors in Pedicled Flaps for Chest Wall Reconstruction T2 - Annals of plastic surgery TI - The Use of Vasopressors in Pedicled Flaps for Chest Wall Reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622349432&from=export http://dx.doi.org/10.1097/SAP.0000000000001108 VL - 79 ID - 5653 ER - TY - JOUR AB - AbstractBackground External oblique myocutaneous flap (EOMF) has been used successfully for many years in reconstructive plastic surgery, its function is mainly concentrated in the restoration of chest wall defects following breast cancer resection. However, for the lower abdominal wall or groin defects after malignant tumor resection, reconstruction with EOMF is little reported. In this study, we report our experience with EOMF downward transposition to repair the defects. Methods 12 patients with malignant diseases in the lower abdominal wall or groin underwent aggressive tumor resection, the defects were reconstructed immediately with EOMF. Patient characteristics, details of operation and postoperative complications were described. Results 12 patients received radical resection, the defect size ranged from 140 to 588-cm2. Ipsilateral or bilateral EOMF was utilized to repair the defects. The EOMF had good quality skin and soft tissue to cover the defects, postoperatively, four patients developed seroma, two patients had distal tip necrosis, but no serious complications occurred, the wound of donor site healed well, no abdominal hernia was found. Conclusion Our study provides a new and alternative approach to reconstruct large defects with EOMF downward transposition after malignant tumor resection in the lower abdominal wall or groin. J. Surg. Oncol. 2014; 110:930-934. 2014 Wiley Periodicals, Inc. AN - RN362958312 AU - Zhang, R. AU - Wang, C. AU - Chen, Y. AU - Zheng, B. AU - Shi, Y. CN - 616.994 RD651 5067.380000 LA - English N1 - Fortnightly: 15-30 issues per year United States John Wiley & Sons, Ltd PY - 2014 SN - 0022-4790 SP - 930 - 934 ST - The use of unilateral or bilateral external oblique myocutaneous flap in the reconstruction of lower abdominal wall or groin defects after malignant tumor resection T2 - Journal of Surgical Oncology TI - The use of unilateral or bilateral external oblique myocutaneous flap in the reconstruction of lower abdominal wall or groin defects after malignant tumor resection VL - 110, NUMB 8 ID - 220 ER - TY - JOUR AB - In the studied series of 167 free transfer two microsurgical flaps in one stage surgery were used in six cases. Two times latissimus + fibula in extensive defects of the tibia and soft tissues of the shin, two times forearm + forearm in isolated defects of the feet, in one case TRAMF + TRAMF for the reconstruction of both breasts and in one case of reconstruction of the penis and the urethra in a transsexual female to male. in this case three flaps were used - pedunculated rectus abdominis muscle and LAF for the reconstruction of the urethra and a sensitive flap from the forearm for the cover of both preceding flaps. The healing of all flaps was satisfactory and individual case records are described in detail and discussed. AD - J. Vesely, Institute for Traumatology, Brno, Italy AU - Vesely, J. AU - Prochazka, V. AU - Valka, J. AU - Mirazek, T. AU - Santi, P. AU - Bertino, P. DB - Embase Medline IS - 4 KW - article breast reconstruction female fibula forearm free tissue graft human latissimus dorsi flap male microsurgery penis plastic surgery rectus abdominis muscle soft tissue surgical technique transsexualism urethroplasty LA - English M3 - Article N1 - L25073373 1995-03-14 PY - 1994 SN - 0323-0414 SP - 99-103 ST - Use of two microsurgical flaps in one stage reconstructive surgery T2 - Acta Chirurgiae Plasticae TI - Use of two microsurgical flaps in one stage reconstructive surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L25073373&from=export VL - 36 ID - 8827 ER - TY - JOUR AU - Bidhendi Yarandi, R. DB - Medline DO - 10.1097/PRS.0000000000006029 IS - 4 KW - breast reconstruction breast tumor human mastectomy surgical flaps LA - English M3 - Letter N1 - L629470369 2020-01-31 PY - 2019 SN - 1529-4242 SP - 704e-705e ST - The Use of Tumescent Technique in Mastectomy and Related Complications: A Meta-Analysis T2 - Plastic and reconstructive surgery TI - The Use of Tumescent Technique in Mastectomy and Related Complications: A Meta-Analysis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629470369&from=export http://dx.doi.org/10.1097/PRS.0000000000006029 VL - 144 ID - 4970 ER - TY - JOUR AD - Department of Surgery, Brigham and Women's Hospital, Faulkner Hospital, Boston, MA, USA. ychun@partners.org AN - 104823436. Language: English. Entry Date: 20110311. Revision Date: 20200708. Publication Type: Journal Article AU - Chun, Y. S. AU - Verma, K. AU - Rosen, H. AU - Lipsitz, S. R. AU - Breuing, K. AU - Guo, L. AU - Golshan, M. AU - Grigorian, N. AU - Eriksson, E. DB - cin20 DO - 10.1016/j.amjsurg.2009.12.011 DP - EBSCOhost IS - 2 KW - Ischemia -- Etiology Breast Reconstruction -- Methods Mastectomy -- Adverse Effects Mastectomy -- Methods Skin -- Blood Supply Surgical Flaps Adult Age Factors Body Mass Index Comorbidity Female Human Logistic Regression Breast Reconstruction -- Adverse Effects Medical Records Middle Age Necrosis -- Etiology Necrosis -- Surgery Odds Ratio Radiotherapy, Adjuvant -- Adverse Effects Retrospective Design Risk Factors Smoking Time Factors Treatment Outcomes N1 - research. Journal Subset: Biomedical; USA. NLM UID: 0370473. PMID: NLM20409522. PY - 2011 SN - 0002-9610 SP - 160-165 ST - Use of tumescent mastectomy technique as a risk factor for native breast skin flap necrosis following immediate breast reconstruction T2 - American Journal of Surgery TI - Use of tumescent mastectomy technique as a risk factor for native breast skin flap necrosis following immediate breast reconstruction UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104823436&site=ehost-live&scope=site VL - 201 ID - 832 ER - TY - JOUR AB - Background: Use of the thoracodorsal artery perforator (TDAP) flap in combination with alloplastic devices has been proven to be a safe method of breast reconstruction. However, preoperative irradiation increases the complication rate and thus some consider preoperative radiotherapy a relative contraindication to alloplastic alone reconstruction. We evaluated the longterm outcomes of patients with preoperative radiotherapy who had delayed alloplastic reconstruction with a TDAP flap. Methods: A retrospective analysis of a prospectively maintained database was performed to identify patients who had received a Latissimus Dorsi (LD), a Muscle Sparing Latissimus Dorsi (MSLD), or a TDAP flap plus a tissue expander or implant between 2005 and 2012. Information regarding patients' primary diagnosis, radiation history, prior breast reconstructions, and complications was collected and analyzed. Results: Sixteen patients who had a total of 16 breast reconstructions with an LD (6) or TDAP/MSLD1 flap (10). Demographic data, device type, co-morbidities and complications were analyzed. The rate of capsular contracture and size asymmetry were higher in the LD group, but there was no difference noted for major complications. Minor complications were also similar between the 2 groups. Conclusions: Patients who underwent irradiation before TDAP flap did not have a higher complication rate when compared with patients who had a full LD flap following radiation. By integrating well-vascularized, nonradiated tissue of a TDAP flap in reconstruction, overall complication rate may be minimized and the results are comparable to the generally accepted method of utilizing the entire latissimus dorsi muscle. AD - [Bank, Jonathan; Song, David H.] Univ Chicago, Med Ctr, Dept Surg, Sect Plast & Reconstruct Surg, 5841 South Maryland Ave, Chicago, IL 60637 USA. [Ledbetter, Kelly] Univ Washington, Dept Surg, Div Plast Surg, Seattle, WA 98195 USA. Song, DH (corresponding author), Univ Chicago, Med Ctr, Dept Surg, Sect Plast & Reconstruct Surg, 5841 South Maryland Ave, Chicago, IL 60637 USA. songd@uchicago.edu AN - WOS:000219031400001 AU - Bank, J. AU - Ledbetter, K. AU - Song, D. H. C7 - e140 DA - May DO - 10.1097/gox.0000000000000085 IS - 5 J2 - Prs-Glob. Open KW - tissue expansion cancer patients women risk complications chemotherapy radiotherapy mastectomy Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: V4L1N Times Cited: 7 Cited Reference Count: 19 Bank, Jonathan Ledbetter, Kelly Song, David H. NCATS NIH HHSUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Advancing Translational Sciences (NCATS) [UL1 TR000430] Funding Source: Medline; NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCESUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Advancing Translational Sciences (NCATS) [UL1TR000430] Funding Source: NIH RePORTER 7 0 1 Lippincott williams & wilkins Philadelphia PY - 2014 SN - 2169-7574 SP - 6 ST - Use of Thoracodorsal Artery Perforator Flaps to Enhance Outcomes in Alloplastic Breast Reconstruction T2 - Plastic and Reconstructive Surgery-Global Open TI - Use of Thoracodorsal Artery Perforator Flaps to Enhance Outcomes in Alloplastic Breast Reconstruction UR - ://WOS:000219031400001 VL - 2 ID - 2428 ER - TY - JOUR AB - Omental flap was introduced for breast reconstruction after mastectomy either alone or as an adjunct to prosthetic reconstruction. Laparoscopically harvested omental flap was used successfully for this issue. Most of reports had described its use after partial mastectomy, skin or nipple areola sparing mastectomies. In this case, we used the thoracodorsal artery perforator (Tdap) flap as a cover for the omental flap in a patient who underwent modified radical mastectomy. Modified radical mastectomy was done in the usual fashion. The descending branch of the thoracodorsal vessel was traced till its main perforator in an antegrade fashion. Then, the supplied skin island flap was created and rotated to cover the laparoscopically harvested omental flap that was delivered after its mobilization through a small epigastric wound from underneath the inner aspect of the lower mastectomy flap. The overall operative time was around 150 min. No blood transfusion was required. Pain score was around 6–7 in the early postoperative hours. No major complications were encountered, and the patient was discharged at the third postoperative day. The overall esthetic score was expressed as “good.” To our knowledge, this is the first time to report usage of laparoscopically harvested omental flap after modified radical mastectomy with skin coverage by the thoracodorsal artery perforator (Tdap) flap. One criticism that may arise is the dual flap reconstruction; however, this method still as an alternative to the myocutaneous flaps with a reasonable operative time and minimal donor site and overall morbidities with good esthetic outcome. Modified radical mastectomy can be safely and efficiently reconstructed using a laparoscopically harvested omental flap with a cutaneous coverage using the thoracodorsal artery perforator (Tdap) flap. AD - A. Khater, Department of Surgical Oncology, Mansoura Oncology center (OCMU), Faculty of Medicine, Mansoura University, Gomhoria Street, Mansoura, Egypt AU - Khater, A. AU - Abdelwahab, K. AU - El din Sedky, A. H. AU - Gaballa, K. DB - Embase DO - 10.1007/s13193-020-01039-0 KW - paclitaxel trastuzumab adjuvant radiotherapy adult appendectomy article body mass breast calcification breast carcinoma breast tumor cancer chemotherapy cancer staging case report clinical article Doppler flowmetry female greater omentum human human tissue hysterectomy laparoscopic surgery mammography middle aged modified radical mastectomy needle biopsy omental flap open surgery operation duration postoperative pain postoperative period priority journal skin island flap thoracodorsal artery thoracodorsal artery perforator flap uterus myoma wound healing LA - English M3 - Article N1 - L2004089771 2020-01-24 2020-11-09 PY - 2020 SN - 0976-6952 0975-7651 SP - 52-55 ST - Use of Thoracodorsal Artery Perforator (Tdap) Flap to Cover a Laparoscopically Harvested Omental Flap After Modified Radical Mastectomy; a Case Report T2 - Indian Journal of Surgical Oncology TI - Use of Thoracodorsal Artery Perforator (Tdap) Flap to Cover a Laparoscopically Harvested Omental Flap After Modified Radical Mastectomy; a Case Report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004089771&from=export http://dx.doi.org/10.1007/s13193-020-01039-0 VL - 11 ID - 4643 ER - TY - JOUR AB - Introduction: Methods allowing one to locate the position of a cutaneous perforator do not allow one to determine the boundaries of the vascularized skin. In clinical practice this causes complications in the form of marginal necrosis of the flap. Aim: To examine the usefulness of thermography to assess the extent of vascularization of the skin and subcutaneous tissue by a single perforator. Material and methods: Thirty-one male rats were used. Using dynamic thermography the perforators on the abdominal skin were located. Afterwards the flap was prepared on a randomly chosen perforator. After 24 h the extent of vascularization of the skin by a single perforator was examined. Results: In 22.5% of cases the number of perforators marked in the thermography was equal to the number of perforators marked intraoperatively, in 64.5% it was lower and in 13% higher. The use of thermography has shown that basing the flap vascularization on the perforator with low efficiency resulted in statistically more frequent occurrence of ischemia and partial necrosis of the flap (p = 0.024). Partial necrosis of the flap occurred in 12 of 31 cases, always in the area in which during the preoperative thermography no perforators were found. The areas of necrosis occurred irrespectively of the distance from the supplying vessel. Conclusions: When designing the shape of the flap, the distribution of all perforators must be considered. The perforators need to be included in the area of prepared tissues because their location indicates the area with a more efficient network of vessels. AD - [Czapla, Norbert; Lokaj, Mark; Prowans, Piotr] Pomeranian Med Univ, Clin Plast Endocrine & Gen Surg, PL-70010 Police, Poland. [Falkowski, Aleksander] Pomeranian Med Univ, Dept Intervent Radiol, Szczecin, Poland. Czapla, N (corresponding author), Pomeranian Med Univ, Clin Plast Endocrine & Gen Surg, 2 Siedlecka St, PL-70010 Police, Poland. norbertczapla@gmail.com AN - WOS:000342712700003 AU - Czapla, N. AU - Lokaj, M. AU - Falkowski, A. AU - Prowans, P. DO - 10.5114/wiitm.2014.44056 IS - 3 J2 - Videosurgery Miniinvasive Tec. KW - thermography perforator flap dynamic infrared thermography diep flap vascular anatomy breast reconstruction vessels delay perforasome selection dirt Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: AQ3SB Times Cited: 1 Cited Reference Count: 31 Czapla, Norbert Lokaj, Mark Falkowski, Aleksander Prowans, Piotr Czapla, Norbert/AAE-1082-2021; Prowans, Piotr/AAD-9169-2021; Prowans, Piotr/B-5495-2015; Lokaj, Marek/B-7495-2015; Czapla, Norbert/B-4862-2015 Prowans, Piotr/0000-0002-6102-364X; Czapla, Norbert/0000-0002-3967-6927; Falkowski, Aleksander/0000-0002-3926-5546 1 0 4 Termedia publishing house ltd Poznan 2299-0054 PY - 2014 SN - 1895-4588 SP - 319-328 ST - The use of thermography to design tissue flaps - experimental studies on animals T2 - Videosurgery and Other Miniinvasive Techniques TI - The use of thermography to design tissue flaps - experimental studies on animals UR - ://WOS:000342712700003 VL - 9 ID - 2478 ER - TY - GEN AN - NCT03340623 AU - Hospital, Brugmann University DA - November 1 KW - Mammary Reconstruction N1 - No Results Available Device: Venous coupler Rate of venous thrombosis|Surgery duration|Anastomosis duration|Age|Body mass index|Tabagism|Co-morbidity : diabetes|Co-morbidity : cardio-vascular disease|Co-morbidity : medical history of venous thrombosis|Immediate of differed reconstruction|Unilateral or Bilateral DIEP|Medical complications (yes/no)|Type of cancer treatment Female 40 Other Observational Model: Cohort|Time Perspective: Retrospective CHUB-venous coupler May 28, 2018 PB - https://ClinicalTrials.gov/show/NCT03340623 PY - 2017 ST - Use of the Venous Coupler in Breast Reconstruction by Means of a Deep Inferior Epigastric Perforator: Reduction of Surgery Length and Venous Thromboses ? TI - Use of the Venous Coupler in Breast Reconstruction by Means of a Deep Inferior Epigastric Perforator: Reduction of Surgery Length and Venous Thromboses ? ID - 491 ER - TY - JOUR AB - We report our initial experience using the vascular closure staple clip applier (a nonpenetrating titanium clip applied in an interrupted, everting fashion) for microvascular anastomosis in free-flap surgery. In total, 153 anastomoses were performed in 87 free flaps (174 potential anastomoses) using the vascular closure stapler between October of 1997 and June of 1999. In 66 flaps, both the arterial and venous anastomosis were performed with the clip applier, whereas in 21 flaps only the venous anastomosis was performed using the clips. A total of 146 anastomoses were performed in an end-to-end fashion, and seven were performed end-to-side. Of the 87 flaps there were 53 TRAM flaps, seven bilateral TRAM, five latissimus dorsi, four gastrocnemius, three rectus abdominis, two radial forearm, two fibula, and four Rubens fat- pad flaps. Seventy flaps were used for breast reconstruction, seven flaps for lower limb reconstruction, four flaps for head and neck reconstruction, and six flaps for chest wall/trunk reconstruction. There were no postoperative anastomotic complications of bleeding, thrombosis, or need for revision (100 percent patency rate), with a significantly reduced time for completion of anastomoses. The clip applier is a safe, reliable method for performing microvascular anastomoses, allowing reduced operating time and possible cost savings in free-flap surgery. AD - D. Pennington, 1204/135 Macquarie Street, Sydney, NSW 2000, Australia AU - Cope, C. AU - Lee, K. AU - Stern, H. AU - Pennington, D. DB - Embase Medline DO - 10.1097/00006534-200007000-00020 IS - 1 KW - article clip free tissue graft human major clinical study microvascular surgery priority journal surgical technique treatment indication LA - English M3 - Article N1 - L30429630 2000-07-16 PY - 2000 SN - 0032-1052 SP - 107-110 ST - Use of the vascular closure staple clip applier for microvascular anastomosis in free-flap surgery T2 - Plastic and Reconstructive Surgery TI - Use of the vascular closure staple clip applier for microvascular anastomosis in free-flap surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L30429630&from=export http://dx.doi.org/10.1097/00006534-200007000-00020 VL - 106 ID - 8518 ER - TY - JOUR AB - Approximately ten years after abdominoplasty, transverse rectus abdominis musculocutaneous (TRAM) flaps were utilized for breast reconstruction in two patients. Both had considerable excess lower abdominal tissue that they wanted removed. We assumed that a new perforating system had developed that might support the lower abdominal skin even though all the original perforators would have been sacrificed at the time of the abdominoplasty. The two patients had successful breast reconstructions performed utilizing bipedicle TRAM flaps with full survival of the flaps. However, we do not recommend the general use of TRAM flaps after abdominoplasty. AD - ST JOSEPH HOSP,PLAST SURG SERV,HOUSTON,TX. AN - WOS:A1995RZ94700013 AU - Sozer, S. O. AU - Cronin, E. D. AU - Biggs, T. M. AU - Gallegos, M. L. DA - Oct DO - 10.1097/00000637-199510000-00013 IS - 4 J2 - Ann. Plast. Surg. KW - blood-flow tram flap breast reconstruction island flap doppler Surgery LA - English M3 - Note N1 - ISI Document Delivery No.: RZ947 Times Cited: 20 Cited Reference Count: 17 Sozer, so cronin, ed biggs, tm gallegos, ml 20 0 Little brown co Boston PY - 1995 SN - 0148-7043 SP - 409-412 ST - THE USE OF THE TRANSVERSE RECTUS-ABDOMINIS MUSCULOCUTANEOUS FLAP AFTER ABDOMINOPLASTY T2 - Annals of Plastic Surgery TI - THE USE OF THE TRANSVERSE RECTUS-ABDOMINIS MUSCULOCUTANEOUS FLAP AFTER ABDOMINOPLASTY UR - ://WOS:A1995RZ94700013 VL - 35 ID - 4291 ER - TY - JOUR AB - The muscolocutaneous flaps present a peculiar anatomical structure and a rich vascularization, permitting the removal of a considerable quantity of tissue, copiously vital and trophic, able to provide a valid defense against local infection and to exert a sort of revitalizing action in the receiving site. The employment of these flaps constitutes the most appropriate choice for the revascularization of ischemic, infected, dystrophic and irradiated areas, and to repair pathologic cavities or to cover alloplastic implants used for the reconstruction of defects of the chest skeleton. The Authors describe an exemplary case of recurrence of breast cancer involving the sternal-costal plane. After the removal of the tumor with exposition of the pleural cavity and of the lungs, the defect is covered with a fragment of nonabsorbable mesh material and with the repositioning of a transverse rectus abdominis myocutaneous (TRAM) flap. The TRAM flap that owes its principle renown in the use of breast reconstruction after mastectomy, provides a large quantity of tissue to the receiving site, while leaving minimal tissue at the donor site. This could represent a fit choice in the repair of ample loss of substance of the anterior chest wall, above all in the medial and inferior portions. AD - Istituto di Chirurgia Plastica Ricostruttiva, Universita degli Studi, Torino AU - Datta, G. AU - Capello, L. AU - Bocchiotti, G. DB - Embase IS - SUPPL. KW - abdominal wall musculature adult breast carcinoma case report conference paper female human myocutaneous flap cancer recurrence thorax wall defect LA - Italian M3 - Conference Paper N1 - L21305849 1991-11-13 PY - 1991 SN - 0390-2221 SP - 256-264 ST - The use of the transverse rectus abdominis myocutaneous (tram) flap for the reconstruction of the anterior chest wall in a case of recurrence of breast cancer T2 - Rivista Italiana di Chirurgia Plastica TI - The use of the transverse rectus abdominis myocutaneous (tram) flap for the reconstruction of the anterior chest wall in a case of recurrence of breast cancer UR - https://www.embase.com/search/results?subaction=viewrecord&id=L21305849&from=export VL - 23 ID - 8934 ER - TY - JOUR AB - Approximately ten years after abdominoplasty, transverse rectus abdominis musculocutaneous (TRAM) flaps were utilized for breast reconstruction in two patients. Both had considerable excess lower abdominal tissue that they wanted removed. We assumed that a now perforating system had developed that might support the lower abdominal skin even though all the original perforators would have been sacrificed at the time of the abdominoplasty. The two patients had successful breast reconstructions performed utilizing bipedicle TRAM flaps with full survival of the flaps. However, we do not recommend the general use of TRAM flaps after abdominoplasty. AD - E.D. Cronin, Cohen and Cronin Clinic, 1315 Calhoun 920, Houston, TX 77002, United States AU - Sozer, S. O. AU - Cronin, E. D. AU - Biggs, T. M. AU - Gallegos, M. L. DB - Embase Medline DO - 10.1097/00000637-199510000-00013 IS - 4 KW - abdominoplasty adult aged angiography article breast reconstruction breast surgery case report female fibrocystic breast disease human myocutaneous flap preoperative evaluation priority journal prosthesis complication rectus abdominis muscle silicone prosthesis subcutaneous mastectomy survival rate treatment outcome LA - English M3 - Article N1 - L25306930 1995-10-31 PY - 1995 SN - 0148-7043 SP - 409-412 ST - The use of the transverse rectus abdominis musculocutaneous flap after abdominoplasty T2 - Annals of Plastic Surgery TI - The use of the transverse rectus abdominis musculocutaneous flap after abdominoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L25306930&from=export http://dx.doi.org/10.1097/00000637-199510000-00013 VL - 35 ID - 8783 ER - TY - JOUR AD - VASCONEZ, HC (corresponding author), KENTUCKY CLIN,DIV PLAST SURG,SUITE K454,740 S LIMESTONE,LEXINGTON,KY 40536, USA. AN - WOS:A1995QD63200016 AU - Vasconez, H. C. AU - Holley, D. T. DA - Jan IS - 1 J2 - Clin. Plast. Surg. KW - Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: QD632 Times Cited: 7 Cited Reference Count: 0 Vasconez, hc holley, dt 7 0 W b saunders co Philadelphia PY - 1995 SN - 0094-1298 SP - 153-166 ST - USE OF THE TRAM AND LATISSIMUS-DORSI FLAPS IN AUTOGENOUS BREAST RECONSTRUCTION T2 - Clinics in Plastic Surgery TI - USE OF THE TRAM AND LATISSIMUS-DORSI FLAPS IN AUTOGENOUS BREAST RECONSTRUCTION UR - ://WOS:A1995QD63200016 VL - 22 ID - 4318 ER - TY - JOUR AB - Breast cancer has reached near epidemic proportions in this country. It is a devastating blow to the patient and her family. Refinements in breast reconstruction have aided greatly in alleviating this harsh attack on the patient's well being and femininity. Many modalities have been used in the past to achieve breast reconstruction but the use of autogenous tissue and immediate reconstruction have permitted the plastic surgeon the opportunity to regain the normal shape of the breast and at times even obtain an improved aesthetic result. We are still not able to obtain a reconstructed breast that has normal sensation and erogenous stimulation. Patients, however, are demanding more and more of their surgeons as they try to better adapt to their conditions. It is hoped that with the advent of new health care reform these patients will not be deprived of the meaningful advances that have been made to date in this field. To paraphrase a saying attributed to Tagliacozzi: 'Our objective is not merely to stamp out disease but it is also to buoy the spirit of the afflicted.' AD - H.C. Vasconez, Division of Plastic Surgery, Kentucky Clinic, 740 South Limestone, Lexington, KY 40536-0284, United States AU - Vasconez, H. C. AU - Holley, D. T. DB - Embase Medline IS - 1 KW - arm edema autograft blood autotransfusion brachial plexus injury breast cancer breast reconstruction breast surgery cancer surgery clinical article female human latissimus dorsi flap mastectomy myocutaneous flap patient selection plastic surgery postoperative complication rectus abdominis muscle review surgical technique treatment outcome treatment planning wound infection LA - English M3 - Review N1 - L25043721 1995-02-17 PY - 1995 SN - 0094-1298 SP - 153-166 ST - Use of the tram and latissimus dorsi flaps in autogenous breast reconstruction T2 - Clinics in Plastic Surgery TI - Use of the tram and latissimus dorsi flaps in autogenous breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L25043721&from=export VL - 22 ID - 8817 ER - TY - JOUR AB - The latissimus dorsi (LD) musculocutaneous flap with implant has been widely used for breast reconstruction. This technique, which is safe and reliable, results in the sacrifice of the largest muscle in the body with high seroma incidence in the donor site. The thoracodorsal artery perforator (TDAP) flap spares the LD muscle. However, the TDAP has never been used together with implant for breast reconstruction. We present our strategies in sparing the LD muscle by using the TDAP flap with an implant beneath. The perforator was always mapped preoperatively. The TDAP flap was designed with the perforator located at the proximal part. Modifications to the flap should be done when multiple small perforators are found or when the perforator enters the subcutaneous tissue in the middle of the flap. A small segment of the muscle is included in the flap behind the perforator (LD-muscle sparing TDAP type I) to protect perforator compression by the implant. In very thin patients, a larger segment of the LD is needed to cover the implant (LD muscle-sparing TDAP type II). In both situations, the rest of the LD muscle is spared with its motor innervation. We present 4 patients who underwent a TDAP flap with implant for breast reconstruction. The flaps were transferred successfully. No seroma formation occurred. Combining a TDAP flap with an implant is feasible. Perforator mapping with correct flap design is the keystone in this technique. Reducing donor site morbidity and seroma rate are the ultimate goals of this technique. The TDAP flap should be modified to an LD muscle-sparing version in any case of unfavorable anatomic or clinical situations. © 2008 by Lippincott Williams & Wilkins. AD - M. Hamdi, Plastic Surgery Department, Gent University Hospital, Gent, Belgium AU - Hamdi, M. AU - Salgarello, M. AU - Liliana, B. A. AU - Van Landuyt, K. DB - Embase Medline DO - 10.1097/SAP.0b013e318158fd7b IS - 2 KW - adult article body mass breast endoprosthesis breast reconstruction case report female human outcome assessment patient information patient satisfaction plastic surgery priority journal surgical technique thoracodorsal artery thoracodorsal artery perforator flap treatment outcome LA - English M3 - Article N1 - L354941338 2009-08-25 PY - 2008 SN - 0148-7043 SP - 143-146 ST - Use of the Thoracodorsal Artery Perforator (TDAP) flap with implant in breast reconstruction T2 - Annals of Plastic Surgery TI - Use of the Thoracodorsal Artery Perforator (TDAP) flap with implant in breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L354941338&from=export http://dx.doi.org/10.1097/SAP.0b013e318158fd7b VL - 61 ID - 7841 ER - TY - JOUR AB - Latissimus dorsi (LD) myocutaneous flap breast reconstruction with a tissue expander/implant is a post-mastectomy option often used as a salvage procedure for a failed tissue expander (TE). The patient is traditionally placed in the lateral decubitus position for flap dissection and is re-prepped and re-draped in the supine position for placement of the tissue expander. A new generation of anatomically-shaped, tabbed tissue expanders are increasingly being used in place of traditional untabbed expanders. The innovative suture tabs allow for more predictable and controlled expander placement while the patient is in the lateral decubitus position, eliminating the need to reposition the patient intraoperatively. The objective of this study was to evaluate the use of tabbed tissue expanders in latissimus dorsi breast reconstruction, with respect to total operative time, complication rates, and aesthetic outcomes. The outcomes of 34 LD breast reconstruction procedures with tissue expanders were evaluated. Eight patients received tabbed tissue expanders with no position change, while 26 patients underwent an intraoperative position change. Demographic information, total operative time, and follow-up complication data were collected. Aesthetic outcomes were evaluated by three blinded individuals using a validated scoring scale. The mean operative time for procedures with no position change was 107 minutes. The mean operative time for position change cohort was 207 minutes. There was no statistical difference in complication rates or aesthetic outcomes between the two groups. In conclusion, tabbed tissue expanders decrease operative time by eliminating the need for an intraoperative position change without influencing complication rates while maintaining equivalent aesthetic outcomes. © 2013 Informa Healthcare. AD - J.Y.S. Kim, Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg, School of Medicine, 675 N. Saint Clair Street, Chicago, IL 60611, United States AU - Gust, M. J. AU - Nguyen, K. T. AU - Hirsch, E. M. AU - Connor, C. M. AU - Davila, A. AU - Rawlani, V. AU - Kim, J. Y. S. DB - Medline DO - 10.3109/2000656X.2012.730051 IS - 2 KW - adult aged article breast reconstruction devices equipment design esthetics evaluation study female follow up human mastectomy methodology middle aged patient satisfaction retrospective study surgical flaps tissue expander tissue expansion treatment outcome LA - English M3 - Article N1 - L368585833 2013-06-17 PY - 2013 SN - 2000-656X SP - 126-129 ST - Use of the tabbed expander in latissimus dorsi breast reconstruction T2 - Journal of Plastic Surgery and Hand Surgery TI - Use of the tabbed expander in latissimus dorsi breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L368585833&from=export http://dx.doi.org/10.3109/2000656X.2012.730051 VL - 47 ID - 6850 ER - TY - JOUR AD - J. Higginson, Institute of Head and Neck Studies and Education, University of Birmingham, United Kingdom AU - Higginson, J. AU - McMillan, K. AU - Mustafa, E. M. AU - Grew, N. DB - Embase Medline DO - 10.1016/j.bjoms.2018.07.001 IS - 8 KW - adult anterolateral thigh flap artery anastomosis article breast reconstruction cancer surgery case report clinical article deep inferior epigastric perforator flap external jugular vein full thickness skin graft human intensive care unit internal jugular vein male maxilla cancer Medline middle aged orbital exenteration osteocutaneous flap postoperative period rectus abdominis muscle saphenous vein sarcoma scapular flap Scopus transverse rectus abdominis musculocutaneous flap vein anastomosis vein graft LA - English M3 - Article N1 - L2000972812 2018-07-27 2018-10-11 PY - 2018 SN - 1532-1940 0266-4356 SP - 761-762 ST - Use of the superficial inferior epigastric vein as an unusual interpositional vein graft T2 - British Journal of Oral and Maxillofacial Surgery TI - Use of the superficial inferior epigastric vein as an unusual interpositional vein graft UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2000972812&from=export http://dx.doi.org/10.1016/j.bjoms.2018.07.001 VL - 56 ID - 5277 ER - TY - JOUR AD - Department of Plastic and Reconstructive Surgery (Salgarello, Visconti) Breast Unit; Catholic University of "Sacro Cuore"; University Hospital "A. Gemelli"; Rome, Italy (Barone-Adesi). AN - 21285834 AU - Salgarello, M. AU - Visconti, G. AU - Barone-Adesi, L. DA - Feb DO - 10.1097/PRS.0b013e318200aff6 DP - NLM ET - 2011/02/03 IS - 2 KW - Breast Implantation/*methods Breast Implants Breast Neoplasms/surgery Fascia Female Humans Mastectomy Pectoralis Muscles *Surgical Flaps Tissue Expansion/*methods LA - eng N1 - 1529-4242 Salgarello, Marzia Visconti, Giuseppe Barone-Adesi, Liliana Comment Letter United States Plast Reconstr Surg. 2011 Feb;127(2):1010-1011. doi: 10.1097/PRS.0b013e318200aff6. PY - 2011 SN - 0032-1052 SP - 1010-1011 ST - Use of the subpectoral fascia flap for expander coverage in postmastectomy breast reconstruction T2 - Plast Reconstr Surg TI - Use of the subpectoral fascia flap for expander coverage in postmastectomy breast reconstruction VL - 127 ID - 11451 ER - TY - CHAP AB - This paper shows results of the static thermography for intraoperative and postoperative imaging of TRAM flap perfusion. The results were compared with the clinical examination of flap perfusion. The study was conducted on a group of 38 female patients who underwent breast reconstruction. AD - [Kolacz, Sz.; Jankau, J.] Med Univ Gdansk, Dept Plast Surg, Ul Debinki 7, PL-80211 Gdansk, Poland. Gdansk Univ Technol, Dept Biomed Engn, 80-233,Ul Narutowicza, Gdansk, Poland. Kolacz, S (corresponding author), Med Univ Gdansk, Dept Plast Surg, Ul Debinki 7, PL-80211 Gdansk, Poland. skolacz@gmail.com; matmod@biomed.eti.pg.gda.pl AN - WOS:000399006500059 AU - Kolacz, S. AU - Moderhak, M. AU - Jankau, J. AU - Qirt Conf, Org Comm CY - Quebec DO - 10.21611/qirt.2016.060 LA - English N1 - ISI Document Delivery No.: BH2KH Times Cited: 0 Cited Reference Count: 7 Kolacz, Sz. Moderhak, M. Jankau, J. Proceedings Paper 13th Quantitative Infrared Thermography Conference (QIRT) Jul 04-08, 2016 Gdansk Univ Technol, Fac Elect Telecommunicat & Informat, Gdansk, POLAND QIRT Comm, Gdansk Univ Technol, EC Test Syst Sp z o o, Automat Technol, InfraTec GmbH Infrarotsensorik & Messtechnik, FLIR Syst Inc, TELOPS Statutory Funds of Electronics, Telecommunications and Informatics Faculty, Gdansk University of Technology This work has been partially supported by Statutory Funds of Electronics, Telecommunications and Informatics Faculty, Gdansk University of Technology Univ laval, dept genie electrique & genie informatique, 1065 ave medecine, quebec, quebec g1v 0a6, canada 2371-4085 PB - Qirt Council PY - 2016 SP - 411-417 ST - The use of the static thermography in monitoring flap perfusion in breast reconstruction with TRAM flap T2 - 13th Quantitative Infrared Thermography Conference T3 - Quantitative Infrared Thermography TI - The use of the static thermography in monitoring flap perfusion in breast reconstruction with TRAM flap UR - ://WOS:000399006500059 ID - 2107 ER - TY - JOUR AD - B.-K. Tan, Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Academia, 20 College Road, Singapore AU - Hwee, J. AU - Tan, B. K. AU - Hattori, Y. DB - Embase DO - 10.5999/aps.2019.01851 IS - 3 KW - ankle prosthesis adult aged anastomosis anterolateral thigh flap blood vessel brachial artery breast reconstruction clavicle clavicle fracture cranioplasty degloving injury external jugular vein female fibula graft head and neck surgery human human tissue humerus internal mammary artery jugular vein latissimus dorsi flap male microsurgery middle aged muscle flap note open fracture osteomyelitis peripheral vein reconstructive surgery revascularization saphenous vein saphenous vein graft scalp segmentectomy skin graft split thickness skin graft sternoclavicular joint superior thyroid artery thoracodorsal artery thoracodorsal artery perforator flap thorax wall reconstruction tibia fracture transverse rectus abdominis musculocutaneous flap treatment outcome tuberculous osteomyelitis varicosis vasodilatation vein anastomosis venous congestion LA - English M3 - Note N1 - L2004417340 2020-05-29 2020-09-30 PY - 2020 SN - 2234-6171 2234-6163 SP - 282-286 ST - Use of the short saphenous vein graft in microsurgical reconstruction T2 - Archives of Plastic Surgery TI - Use of the short saphenous vein graft in microsurgical reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004417340&from=export http://dx.doi.org/10.5999/aps.2019.01851 VL - 47 ID - 4753 ER - TY - JOUR AB - Currently, the choice for recipient vessels in microvascular breast reconstruction is made between axillary and internal mammary regions. The authors report their experience with anastomosis to a new, unconventional, axillary recipient vessel, the serratus anterior muscle vascular pedicle. Among 340 deep inferior epigastric perforator (DIEP) flap breast reconstructions performed between 2004 and 2013, 11 were successfully revascularised to the serratus anterior (SA) pedicle: In three cases, complications led to a salvage procedure, while in eight cases, anastomosis to this recipient site was electively planned. The pedicle was constantly present, with calibre always comparable to that of flap's pedicle. At the mean 24-month follow-up, no recipient site complications were observed. The SA muscle pedicle resulted as a reliable choice in salvage procedures and a suitable option for recipient vessel selection in elective cases. (C) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - [Santanelli di Pompeo, Fabio; Longo, Benedetto; Laporta, Rosaria; Pagnoni, Marco; Cavalieri, Enrico] Univ Roma La Sapienza, Sch Med & Psychol, St Andrea Hosp, Plast Surg Unit, I-00185 Rome, Italy. Santanelli di Pompeo, F (corresponding author), Azienda Osped St Andrea UOD Chirurg Plast, Via Grottarossa 1035-1039, I-00189 Rome, Italy. fabio.santanelli@uniroma1.it AN - WOS:000333534000014 AU - Santanelli di Pompeo, F. AU - Longo, B. AU - Laporta, R. AU - Pagnoni, M. AU - Cavalieri, E. DA - Apr DO - 10.1016/j.bjps.2013.12.033 IS - 4 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - Diep flap Breast reconstruction Recipient vessels Serratus anterior vascular pedicle internal mammary vessels free tram thoracodorsal artery blood-flow perforator vein Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: AD8RT Times Cited: 2 Cited Reference Count: 28 Santanelli di Pompeo, Fabio Longo, Benedetto Laporta, Rosaria Pagnoni, Marco Cavalieri, Enrico Santanelli di Pompeo, Fabio/0000-0002-1217-3668; Longo, Benedetto/0000-0001-8671-0609 2 0 3 Elsevier sci ltd Oxford 1878-0539 PY - 2014 SN - 1748-6815 SP - 456-460 ST - The use of the serratus anterior muscle vascular pedicle as recipient site in DIEP flap transfer for breast reconstruction T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - The use of the serratus anterior muscle vascular pedicle as recipient site in DIEP flap transfer for breast reconstruction UR - ://WOS:000333534000014 VL - 67 ID - 2440 ER - TY - JOUR AB - BACKGROUND: Postmastectomy partial submuscular tissue expander placement can prevent the upper pole fullness commonly seen with complete submuscular prosthesis placement. The resultant inferior and lateral margins require coverage to prevent prosthesis exposure. The fascial layer overlying the serratus anterior muscle can be used as an alternative to previously defined techniques to provide composite lateral coverage. This method offers adequate coverage, prevents expander lateralization, and minimizes use of allogenic material. This study reports the anatomy, surgical procedure, clinical outcomes, and aesthetics following use of the serratus anterior fascial flap for lateral expander coverage in postmastectomy expander-based breast reconstruction. METHODS: Twenty-two patients (31 breasts) who underwent breast reconstruction with serratus fascia were included in a retrospective case-note analysis after approval by the institutional review board. Demographics, perioperative factors, postoperative complications, patient satisfaction, and aesthetics were recorded as relevant endpoints. Ten fresh cadaver hemichests were dissected, and the serratus fascia for each was measured for length and width. RESULTS: At a mean follow-up of 197 days (range, 71 to 370 days), seroma occurred in two breasts, wound infection occurred in one breast, partial mastectomy skin flap necrosis occurred in four breasts, and minor wound dehiscence occurred in one breast. There were no incidences of capsular contracture or hematoma. Four patients (five breasts) reported very mild tightness or banding in the lateral chest wall. The mean length of cadaver serratus fascia was 164.3 mm and the mean width was 122.8 mm. CONCLUSION: The serratus anterior fascia flap is a versatile and safe alternative for providing vascularized composite lateral prosthesis coverage in expander-based breast reconstruction. AD - Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern Medical Center. AN - 20335858 AU - Saint-Cyr, M. AU - Dauwe, P. AU - Wong, C. AU - Thakar, H. AU - Nagarkar, P. AU - Rohrich, R. J. DA - Apr DO - 10.1097/PRS.0b013e3181d17f61 DP - NLM ET - 2010/03/26 IS - 4 KW - Adult Aged Breast/anatomy & histology/surgery *Breast Implantation Fascia/anatomy & histology Fasciotomy Female Humans Mammaplasty/*methods Middle Aged *Patient Satisfaction Postoperative Complications Retrospective Studies *Surgical Flaps Surveys and Questionnaires *Tissue Expansion Devices LA - eng N1 - 1529-4242 Saint-Cyr, Michel Dauwe, Phillip Wong, Corrine Thakar, Hema Nagarkar, Purushottam Rohrich, Rod J Journal Article United States Plast Reconstr Surg. 2010 Apr;125(4):1057-1064. doi: 10.1097/PRS.0b013e3181d17f61. PY - 2010 SN - 0032-1052 SP - 1057-1064 ST - Use of the serratus anterior fascia flap for expander coverage in breast reconstruction T2 - Plast Reconstr Surg TI - Use of the serratus anterior fascia flap for expander coverage in breast reconstruction VL - 125 ID - 9791 ER - TY - JOUR AB - AimVenous congestion is a common cause of DIEP flap failure. When identified intraoperatively, an additional venous anastomosis can improve the venous outflow and prevent flap failure. The aim of this study was to assess if the retrograde limb of the internal mammary vein (IMV) could be considered a good recipient vessel to be used when persistent flap congestion is present, and a second venous anastomosis is required. Patients and methodsA retrospective study was conducted in 74 patients who had undergone DIEP flap breast reconstruction. Patients were classified into two groups: SVA (single venous anastomosis) and DVA (dual venous anastomosis). In the SVA group (n=38), the IMV antegrade limb was used for venous drainage. A single DIEV (Deep Inferior Epigastric Vein) was anastomosed to the superior arm of the IMV. In the DVA group (n=36), both the antegrade (superior) and retrograde (inferior) stumps of the IMV were used, connecting the larger DIEV to the antegrade IMV and the other DIEV or the SIEV (Superficial Inferior Epigastric Vein) to the IMV retrograde limb. ResultsNo venous congestion or flap loss was observed when two venous anastomoses were performed using both the IMV antegrade and retrograde limbs (P=0.3271). In the DVA group, no major complication occurred (P=0.0453). Operative explorations were significantly reduced in the DVA group (P=0.0242). ConclusionThese findings suggest that when an additional venous outflow is required, the use of the IMV retrograde limb may help to avoid flap venous congestion. (c) 2016 Wiley Periodicals, Inc. Microsurgery 36:447-452, 2016. AD - [La Padula, Simone; Hersant, Barbara; Noel, Warren; Niddam, Jeremy; Hermeziu, Oana; Bouhassira, Jonathan; Bosc, Romain; Meningaud, Jean Paul] UPEC, Dept Plast Surg, Henri Mondor Hosp, 51 Ave Marechal de Lattre de Tassigny, F-94000 Creteil, France. La Padula, S (corresponding author), UPEC, Dept Plast Surg, Henri Mondor Hosp, 51 Ave Marechal de Lattre de Tassigny, F-94000 Creteil, France. drsimonelapadula@gmail.com AN - WOS:000383598700001 AU - La Padula, S. AU - Hersant, B. AU - Noel, W. AU - Niddam, J. AU - Hermeziu, O. AU - Bouhassira, J. AU - Bosc, R. AU - Meningaud, J. P. DA - Sep DO - 10.1002/micr.30043 IS - 6 J2 - Microsurgery KW - epigastric perforator flap free-tissue-transfer free tram recipient vessels drainage superdrainage strategies arterial anatomy salvage Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: DW4FT Times Cited: 13 Cited Reference Count: 29 La Padula, Simone Hersant, Barbara Noel, Warren Niddam, Jeremy Hermeziu, Oana Bouhassira, Jonathan Bosc, Romain Meningaud, Jean Paul La padula, simone/0000-0003-3543-9024 13 0 1 Wiley-blackwell Hoboken 1098-2752 PY - 2016 SN - 0738-1085 SP - 447-452 ST - Use of the retrograde limb of the internal mammary vein to avoid venous congestion in DIEP flap breast reconstruction: Further evidences of a reliable and time-sparing procedure T2 - Microsurgery TI - Use of the retrograde limb of the internal mammary vein to avoid venous congestion in DIEP flap breast reconstruction: Further evidences of a reliable and time-sparing procedure UR - ://WOS:000383598700001 VL - 36 ID - 1963 ER - TY - JOUR AB - Breast augmentation is by far one of the most common aesthetic procedures currently performed by plastic surgeons. The plane of dissection for prosthesis placement is quite often partial submuscular. The rectus sternalis, an nomalous muscle, may interfere with the submuscular pocket dissection when an intraalveolar or submammary approach is used. The use of this muscle to cover the prosthesis in its most medial part is presented. AD - Belvedere Private Hospital, Knee Hill Abbeywood, London, SE2 0GD, UK. Mrumarkhan@aol.com AN - 17965818 AU - Khan, U. D. DA - Jan DO - 10.1007/s00266-007-9046-1 DP - NLM ET - 2007/10/30 IS - 1 KW - Adult Breast Implantation/*methods *Breast Implants Fasciotomy Female Humans Mammaplasty/*methods Pectoralis Muscles/*surgery *Silicone Gels Surgical Flaps Treatment Outcome LA - eng N1 - Khan, Umar Daraz Case Reports Journal Article Review United States Aesthetic Plast Surg. 2008 Jan;32(1):21-4. doi: 10.1007/s00266-007-9046-1. PY - 2008 SN - 0364-216X (Print) 0364-216x SP - 21-4 ST - Use of the rectus sternalis in augmentation mammoplasty: case report and literature search T2 - Aesthetic Plast Surg TI - Use of the rectus sternalis in augmentation mammoplasty: case report and literature search VL - 32 ID - 12726 ER - TY - JOUR AN - 2411187 AU - Bricout, N. AU - Banzet, P. DP - NLM ET - 1985/01/01 IS - 2 KW - Breast/*surgery Breast Neoplasms/surgery Female Humans Surgery, Plastic *Surgical Flaps LA - fre N1 - Bricout, N Banzet, P English Abstract Journal Article France Ann Chir Plast Esthet. 1985;30(2):111-9. OP - Utilisation du lambeau myo-cutané de grand droit, abdominal inférieur, en reconstruction mammaire. PY - 1985 SN - 0294-1260 (Print) 0294-1260 SP - 111-9 ST - [Use of the lower rectus abdominis myocutaneous flap in breast reconstruction] T2 - Ann Chir Plast Esthet TI - [Use of the lower rectus abdominis myocutaneous flap in breast reconstruction] VL - 30 ID - 10677 ER - TY - JOUR AB - Early experience using a rhomboid flap to reconstruct the breast after partial mastectomy and axillary clearance of glands is encouraging. This operation has been used in 7 cases to reconstruct breasts after partial mastectomy and axillary clearance of glands and has given a good cosmetic result. AN - 4037638 AU - Gwynn, B. R. AU - Williams, C. R. C2 - PMC2497859 DA - Jul DP - NLM ET - 1985/07/01 IS - 4 KW - Adult Aged Axilla Breast Neoplasms/*surgery Female Humans Lymph Node Excision *Mastectomy Methods Middle Aged *Surgical Flaps LA - eng N1 - 1478-7083 Gwynn, B R Williams, C R Journal Article Ann R Coll Surg Engl. 1985 Jul;67(4):245-6. PY - 1985 SN - 0035-8843 (Print) 0035-8843 SP - 245-6 ST - Use of the Limberg flap to close breast wounds after partial mastectomy T2 - Ann R Coll Surg Engl TI - Use of the Limberg flap to close breast wounds after partial mastectomy VL - 67 ID - 13489 ER - TY - JOUR AN - 2425709 AU - Pousset, C. AU - Salmon, R. J. AU - Soussaline, M. AU - Guillet, J. L. AU - Durand, J. C. AU - Pilleron, J. P. DP - NLM ET - 1986/01/01 IS - 1 KW - Adult Aged Breast Neoplasms/radiotherapy/*surgery Female Humans Methods Middle Aged Neoplasm Recurrence, Local/*surgery *Surgical Flaps LA - fre N1 - Pousset, C Salmon, R J Soussaline, M Guillet, J L Durand, J C Pilleron, J P English Abstract Journal Article France Ann Chir Plast Esthet. 1986;31(1):82-5. OP - Utilisation du lambeau myo-cutané du grand dorsal pour les récidives du cancer du sein après irradiation. PY - 1986 SN - 0294-1260 (Print) 0294-1260 SP - 82-5 ST - [Use of the latissimus dorsi myocutaneous flap for recurrence in breast cancer after irradiation] T2 - Ann Chir Plast Esthet TI - [Use of the latissimus dorsi myocutaneous flap for recurrence in breast cancer after irradiation] VL - 31 ID - 13476 ER - TY - JOUR AB - Breast conservation surgery is now widely accepted as the treatment of choice in early breast cancer. Randomised controlled trials have shown comparable recurrence and survival rates following breast conservation when compared to mastectomy, with the perceived advantage that it should leave a cosmetically acceptable result without reconstruction. It is our experience that an adequate local excision may result in a poor cosmetic result with distortion of the nipple position, especially in women with small breasts. Between January 1994 and July 1996, we have performed 30 procedures, combining a wide local excision and axillary lymph node clearance for breast cancer with immediate reconstruction of the defect with a latissimus dorsi musculocutaneous flap. All patients had postoperative radiotherapy to the residual breast and, where appropriate, to the axilla. Adjuvant hormonal therapy or chemotherapy was prescribed where indicated. Patient's ages ranged from 36 to 72 years. All tumours were in the lateral, superior or inferior quadrants. The mean combined operating time was 120 min. Two patients required postoperative blood transfusion. Mean hospital stay was 8 days. Histology confirmed tumour clearance in all cases and six patients had axillary lymph node metastases. There were two cases of minor wound infection and six cases of seroma at the donor site. We conclude that breast cancers are ideally treated by a multidisciplinary team and that an immediate latissimus dorsi musculocutaneous flap may correct the deformities often seen after breast conservation surgery. AD - Department of Plastic and Reconstructive Surgery, Stoke Mandeville Hospital NHS Trust, Aylesbury, UK. AN - 10434887 AU - Kat, C. C. AU - Darcy, C. M. AU - O'Donoghue, J. M. AU - Taylor, A. R. AU - Regan, P. J. DA - Mar DO - 10.1054/bjps.1997.3035 DP - NLM ET - 1999/08/06 IS - 2 KW - Adult Aged Breast Neoplasms/*surgery Female Follow-Up Studies Humans Lymph Node Excision Mammaplasty/*methods Mastectomy, Segmental Middle Aged Muscle, Skeletal/*transplantation *Skin Transplantation *Surgical Flaps LA - eng N1 - Kat, C C Darcy, C M O'Donoghue, J M Taylor, A R Regan, P J Journal Article England Br J Plast Surg. 1999 Mar;52(2):99-103. doi: 10.1054/bjps.1997.3035. PY - 1999 SN - 0007-1226 (Print) 0007-1226 SP - 99-103 ST - The use of the latissimus dorsi musculocutaneous flap for immediate correction of the deformity resulting from breast conservation surgery T2 - Br J Plast Surg TI - The use of the latissimus dorsi musculocutaneous flap for immediate correction of the deformity resulting from breast conservation surgery VL - 52 ID - 11387 ER - TY - JOUR AB - The latissimus dorsi musculocutaneous flap was used to provide chest wall coverage in 40 patients following mastectomy to treat recurrent cancer in irradiated breasts. Although the axillary region had received 50 to 55 grays, the neurovascular pedicle was never jeopardized, thus assuring vascularisation of the flap. In two cases, a small area of skin necrosis in the upper inner border of the flap was observed. Complete healing occurred within weeks. The authors advocate this fast and simple surgical procedure when the quality of the skin and/or the extent of resection prevents primary closure. AD - Institut Curie, Paris, France. AN - 3345406 AU - Salmon, R. J. AU - Razaboni, R. AU - Soussaline, M. DA - Jan DO - 10.1016/0007-1226(88)90143-9 DP - NLM ET - 1988/01/01 IS - 1 KW - Breast Neoplasms/*radiotherapy/surgery Female Humans Mastectomy Neoplasm Recurrence, Local/*surgery *Surgical Flaps LA - eng N1 - Salmon, R J Razaboni, R Soussaline, M Journal Article England Br J Plast Surg. 1988 Jan;41(1):41-4. doi: 10.1016/0007-1226(88)90143-9. PY - 1988 SN - 0007-1226 (Print) 0007-1226 SP - 41-4 ST - The use of the latissimus dorsi musculocutaneous flap following recurrence of cancer in irradiated breasts T2 - Br J Plast Surg TI - The use of the latissimus dorsi musculocutaneous flap following recurrence of cancer in irradiated breasts VL - 41 ID - 13434 ER - TY - JOUR AN - 2618334 AU - Visnjić, M. AU - Stanković, M. DP - NLM ET - 1989/01/01 KW - Adult Breast Neoplasms/*surgery Female Humans Middle Aged Neoplasm Recurrence, Local/surgery *Surgical Flaps/methods LA - hrv N1 - Visnjić, M Stanković, M Journal Article Serbia Acta Chir Iugosl. 1989;36 Suppl 1:312-4. OP - Primena latissimus dorsi reznja u rekonstrukciji defekata posle hirurskog lecenja tumora dojke. PY - 1989 SN - 0354-950X (Print) 0354-950x SP - 312-4 ST - [Use of the latissimus dorsi flap in the reconstruction of defects after surgical treatment of breast tumors] T2 - Acta Chir Iugosl TI - [Use of the latissimus dorsi flap in the reconstruction of defects after surgical treatment of breast tumors] VL - 36 Suppl 1 ID - 13338 ER - TY - JOUR AN - 3661014 AU - Kostić, I. AU - Visnić, M. DP - NLM ET - 1986/01/01 IS - 2 KW - Breast/surgery Breast Neoplasms/pathology/*surgery Female Humans *Mastectomy Middle Aged *Surgical Flaps Wound Healing LA - hrv N1 - Kostić, I Visnić, M Case Reports English Abstract Journal Article Serbia Acta Chir Iugosl. 1986;33(2):209-15. OP - Mogućnosti primene latissimus dorsi reznja u rekonstrukciji defekata posle mastektomija zbog uznapredovalih i egzulcerisanih karcinoma dojke. PY - 1986 SN - 0354-950X (Print) 0354-950x SP - 209-15 ST - [Use of the latissimus dorsi flap in the reconstruction of defects after mastectomy in advanced and ulcerative breast carcinoma] T2 - Acta Chir Iugosl TI - [Use of the latissimus dorsi flap in the reconstruction of defects after mastectomy in advanced and ulcerative breast carcinoma] VL - 33 ID - 11008 ER - TY - JOUR AD - Countess of Chester Hospital, UK AN - 111973114. Language: English. Entry Date: 20160805. Revision Date: 20151229. Publication Type: Article. Supplement Title: Nov2015 Supplement 1. Journal Subset: Biomedical AU - Snashall, E. AU - Wadsworth, P. AU - Harding-MacKean, C. AU - Redmond, E. DB - cin20 DO - 10.1016/j.ijsu.2015.07.097 DP - EBSCOhost N1 - USA. NLM UID: 101228232. PY - 2015 SN - 1743-9191 SP - S30-S30 ST - Use of the latissimus dorsi flap in breast reconstruction: The patient perspective T2 - International Journal of Surgery TI - Use of the latissimus dorsi flap in breast reconstruction: The patient perspective UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=111973114&site=ehost-live&scope=site VL - 23 ID - 725 ER - TY - JOUR AB - The transverse rectus abdominis musculocutaneous (TRAM) flap is the most commonly used autogenous tissue flap for breast reconstruction. However, it may not provide sufficient volume in all patients to match the contralateral breast. Insufficient abdominal bulk or bilateral reconstructions limit the amount of tissue available for the TRAM flap. Partial flap loss from fat necrosis or radiation injury may result in contour deformities of the reconstructed breast. Additional soft-tissue augmentation and contouring may be necessary to produce adequate volume, contour, and symmetry. The authors present 7 patients who underwent latissimus dorsi flap reconstruction to correct volume and contour abnormalities that developed after TRAM flap breast reconstruction. Preservation of the serratus branch of the thoracodorsal vessels allows this flap to be used even after free TRAM flap reconstruction. AD - Univ Calif Los Angeles, Med Ctr, Div Plast & Reconstruct Surg, Los Angeles, CA 90024 USA. Karanas, YL (corresponding author), Stanford Univ, Med Ctr, Div Plast & Reconstruct Surg, NC-104, Stanford, CA 94305 USA. AN - WOS:000174841800001 AU - Karanas, Y. L. AU - Santoro, T. D. AU - Shaw, W. W. AU - Da Lio, A. L. DA - Apr DO - 10.1097/00000637-200204000-00001 IS - 4 J2 - Ann. Plast. Surg. KW - partial mastectomy defects surgical-correction classification deformities irradiation experience cancer repair Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 538YB Times Cited: 3 Cited Reference Count: 20 Karanas, YL Santoro, TD Shaw, WW Da Lio, AL 3 0 Lippincott williams & wilkins Philadelphia PY - 2002 SN - 0148-7043 SP - 343-347 ST - Use of the latissimus dorsi flap for recontouring and augmentation after TRAM flap breast reconstruction T2 - Annals of Plastic Surgery TI - Use of the latissimus dorsi flap for recontouring and augmentation after TRAM flap breast reconstruction UR - ://WOS:000174841800001 VL - 48 ID - 3954 ER - TY - JOUR AB - The use of an ipsilateral or a contralateral rectus abdominis muscle as a pedicle and comparison of their advantages and disadvantages in TRAM flap breast reconstruction have been reported in the literature. In our clinical experience with 22 pedicled TRAM flap breast reconstructions, the use of either an ipsilateral or contralateral pedicle was found to be equivocal regarding the flap viability and the aesthetic outcome. Thus, it seems better to decide their use according to the needs of an individual patient. In our series, the contralateral pedicled TRAM flap with a vertical flap inset was preferred in patients with a small opposite breast or in patients with infraclavicular tissue losses (four patients). The ipsilateral pedicled TRAM flap reconstruction with a horizontal flap inset was preferred in patients with a full and attractive opposite breast, unless they received adjuvant radiotherapy (six patients). In patients who received adjuvant radiotherapy the contralateral pedicle was used regardless of the inset model preferred (10 patients). Bilateral TRAM flap breast reconstruction was applied in one of our cases, which is not included in the three categories above mentioned. The aesthetic outcome was determined by analyzing a patient satisfaction questionnaire. Overall satisfaction was achieved in 17 patients. Four patients were dissatisfied. We think that choosing the correct flap inset model is one of the most important factors in achieving a satisfactory aesthetic outcome. Choosing the correct pedicle regarding the type of the flap inset model is equally important to facilitate technical ease during flap transposition and to improve flap survival. AD - Istanbul Univ, Fac Med, Dept Gen Surg, TR-34590 Capa, Turkey. Istanbul Univ, Fac Med, Dept Plast & Reconstruct Surg, TR-34590 Capa, Turkey. Ozkan, AC (corresponding author), Incirli Osmaniye Yolu,Goksu Apartmani 7-24, TR-34730 Istanbul, Turkey. aretmd@e-kolay.net AN - WOS:000181079800010 AU - Ozkan, A. C. AU - Cizmeci, O. AU - Aydin, H. AU - Ozden, B. C. AU - Tumerdem, B. AU - Emekli, U. AU - Asoglu, O. AU - Bozfakioglu, Y. DA - Nov-Dec DO - 10.1007/s00266-002-1495-y IS - 6 J2 - Aesthet. Plast. Surg. KW - TRAM flap ipsilateral pedicle contralateral pedicle Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 647EQ Times Cited: 8 Cited Reference Count: 13 Ozkan, AC Cizmeci, O Aydin, H Ozden, BC Tumerdem, B Emekli, U Asoglu, O Bozfakioglu, Y ozden, Burcu celet/AAL-7545-2021; Ozkan, Aret Cerci/AAC-2911-2020 ozden, Burcu celet/0000-0002-7156-0684; 10 0 Springer New york 1432-5241 PY - 2002 SN - 0364-216X SP - 451-456 ST - The use of the ipsilateral versus contralateral pedicle and vertical versus horizontal flap inset models in TRAM flap breast reconstruction: The aesthetic outcome T2 - Aesthetic Plastic Surgery TI - The use of the ipsilateral versus contralateral pedicle and vertical versus horizontal flap inset models in TRAM flap breast reconstruction: The aesthetic outcome UR - ://WOS:000181079800010 VL - 26 ID - 3921 ER - TY - JOUR AB - Chest wall ablative surgery often requires autologous tissue transfer to reconstruct the resulting defect. The female breast is commonly of a suitable size to provide anteromedial chest wall coverage as a pedicled dermoglandular flap. In anterolateral defects the latissimus dorsi or serratus anterior flaps are often the preferred choice, in the absence of which free tissue transfer is an alternative technique. However these options may not always be available or suitable. A 90-year-old female presented with a large chest wall mass in keeping with recurrence of oesophageal squamous cell carcinoma in the thoracotomy scar following a previous oesophagectomy. The latissimus dorsi and serratus anterior muscles were transected during the previous thoracotomy. Following complete resection, the ipsilateral breast was used as a rotational dermoglandular flap to provide coverage over the exposed ribs. The use of breast as a local flap is an alternative option in anterolateral chest wall reconstruction. AN - RN281519407 AU - Taghizadeh, R. AU - Rampaul, R. S. AU - O’Donoghue, J. M. CN - 617.95 TP 5040.695800 LA - English N1 - United Kingdom ELSEVIER SCIENCE B.V.AMSTERDAM PY - 2010 SN - 1748-6815 SP - e779 - e781 ST - Use of the ipsilateral breast in anterolateral chest wall reconstruction T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Use of the ipsilateral breast in anterolateral chest wall reconstruction VL - 63, NUMB 11 ID - 201 ER - TY - JOUR AD - Department of Plastic Surgery, Queen Victoria Hospital, West Sussex, United Kingdom. AN - 17415272 AU - Snelling, A. P. AU - Mosahebi, A. AU - Pereira, J. AU - Smith, R. W. DA - Apr 15 DO - 10.1097/01.prs.0000256486.52463.93 DP - NLM ET - 2007/04/07 IS - 5 KW - Adult Breast Diseases/etiology Cicatrix/etiology Contracture/etiology Female Humans Mammaplasty/*methods Mammary Arteries/*surgery Middle Aged Postoperative Complications/etiology Surgical Flaps/*blood supply LA - eng N1 - 1529-4242 Snelling, Andrew P Mosahebi, Afshin Pereira, John Smith, Roger W Case Reports Letter United States Plast Reconstr Surg. 2007 Apr 15;119(5):1626-1627. doi: 10.1097/01.prs.0000256486.52463.93. PY - 2007 SN - 0032-1052 SP - 1626-1627 ST - Use of the internal mammary vessels in breast reconstruction: a cautionary note T2 - Plast Reconstr Surg TI - Use of the internal mammary vessels in breast reconstruction: a cautionary note VL - 119 ID - 12698 ER - TY - JOUR AD - [Fernandes, Rui] Univ Florida, Coll Med, Dept Surg,Div Surg Oncol, Div Oral Maxillofacial Surg,Sect Head Neck Surg, Jacksonville, FL 32209 USA. Fernandes, R (corresponding author), Univ Florida, Coll Med, Dept Surg,Div Surg Oncol, Div Oral Maxillofacial Surg,Sect Head Neck Surg, 653-1 W 8th St,Jackson Ville, Jacksonville, FL 32209 USA. rui.fernandes@jax.ufl.edu AN - WOS:000289123800049 AU - Pirgousis, P. AU - Fernandes, R. DA - Apr DO - 10.1016/j.joms.2010.04.021 IS - 4 J2 - J. Oral Maxillofac. Surg. KW - composite tissue-transplantation microvascular free flaps breast reconstruction laryngectomy head Dentistry, Oral Surgery & Medicine LA - English M3 - Article N1 - ISI Document Delivery No.: 744VR Times Cited: 5 Cited Reference Count: 19 Pirgousis, Phil Fernandes, Rui 6 0 W b saunders co-elsevier inc Philadelphia 1531-5053 PY - 2011 SN - 0278-2391 SP - 1225-1228 ST - Use of the Internal Mammary Artery Perforator Flap for Repair of Pharyngocutaneous Fistulas in the Vessel-Depleted Neck T2 - Journal of Oral and Maxillofacial Surgery TI - Use of the Internal Mammary Artery Perforator Flap for Repair of Pharyngocutaneous Fistulas in the Vessel-Depleted Neck UR - ://WOS:000289123800049 VL - 69 ID - 2932 ER - TY - JOUR AB - The infusion pain pump has been a valuable addition to postoperative pain management in plastic and reconstructive surgery. Concerns have been raised regarding the potential ischemic or infectious complications of placing a catheter beneath the operative site for infusion of local anesthesia (+/- epinephrine). The purpose of this review is to document our experience with this form of postoperative pain control in plastic surgical procedures. Thirty-six consecutive transverse rectus abdominis muscle (TRAM) flap breast reconstruction patients were reviewed and included in the series (16 left, 10 right, and 10 bilateral). The average age was 52 years, and 4 patients had a simultaneous symmetry procedure. The cohort was divided into those with a postoperative pain pump versus those without a pain pump. Data points queried included type, route, and amount of narcotic administered per day in the postoperative period, as well as complications. All patients received patient-controlled analgesia (PCA) morphine, n = 34; meperidine (Demerol, Sanofi-Synthelabo), n = 1; hydromorphone hydrochloride (Dilaudid, Abbott Pharmaceutical) n = 1. The pain pump was used in 16 patients bupivacaine (Marcaine, AstraZeneca, n = 16). It was typically infused starting postoperatively at a rate of 4 mL/d and discontinued on postoperative day 2. Supplemental intravenous narcotics were required in 12% (n = 2/16) of patients with a pain pump versus 35% (n = 7/20) in those patients without a pain pump. There were no significant differences in the average number of days the PCA was used (1.8 days with a pain pump versus 2.2 without), and patients with the pain pump started postoperative medications slightly earlier (1.8 versus 2.0 days). PCA requirements were significantly lower in those patients with the pain pump. The average days to discharge for patients with a pain pump were 3.4 compared with 4.7 days in those patients without the pain pump. There were no differences in donor-site or breast complications. The postoperative pain pump has been useful in reducing the intravenous narcotic requirements and length of stay in patients following TRAM flap breast reconstruction. There were no flap, donor-site, or implant complications related to the presence of the catheter. Cost-effectiveness and patient satisfaction data would be interesting. AD - Emory Div Plastic Surg, Atlanta, GA 30308 USA. Losken, A (corresponding author), Emory Div Plastic Surg, 550 Peachtree St,Suite 84300, Atlanta, GA 30308 USA. albert_losken@emoryhealthcare.org AN - WOS:000228840400006 AU - Losken, A. AU - Parris, J. J. AU - Douglas, T. D. AU - Codner, M. A. DA - May DO - 10.1097/01.sap.0000155277.74482.4c IS - 5 J2 - Ann. Plast. Surg. KW - breast TRAM reconstruction pain pump analgesia postoperative pain surgery analgesia Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 922LW Times Cited: 36 Cited Reference Count: 12 Losken, A Parris, JJ Douglas, TD Codner, MA 36 0 1 Lippincott williams & wilkins Philadelphia PY - 2005 SN - 0148-7043 SP - 479-482 ST - Use of the infusion pain pump following transverse rectus abdominis muscle flap breast reconstruction T2 - Annals of Plastic Surgery TI - Use of the infusion pain pump following transverse rectus abdominis muscle flap breast reconstruction UR - ://WOS:000228840400006 VL - 54 ID - 3717 ER - TY - JOUR AB - In this article, the authors discuss the advances in monitoring free tissue transfers, with a focus on the implantable Doppler system. Authors address indications and techniques for implanting the Doppler system, in addition to presenting a framework to assess the reliability and potential benefits of the implantable Doppler device. © 2011 Elsevier Inc. AD - B.W. Chang, Plastic and Reconstructive Surgery at Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202, United States AU - Bedri, M. I. AU - Chang, B. W. DB - Embase Medline DO - 10.1016/j.cps.2011.03.016 IS - 2 KW - blood vessel shunt breast reconstruction Doppler flowmetry false positive result free tissue graft graft salvage human reliability review sensitivity and specificity surgical technique LA - English M3 - Review N1 - L361809507 2011-05-31 2011-06-27 PY - 2011 SN - 0094-1298 1558-0504 SP - 309-312 ST - Use of the Implantable Doppler in Free Tissue Breast Reconstruction T2 - Clinics in Plastic Surgery TI - Use of the Implantable Doppler in Free Tissue Breast Reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L361809507&from=export http://dx.doi.org/10.1016/j.cps.2011.03.016 VL - 38 ID - 7373 ER - TY - JOUR AB - A case of a female patient with postradiation defect of the whole thickness of the chest wall is presented. Radiotherapy was used in breast cancer. Chest wall defect was closed with pedicled graft of gastrocolic omentum covered with free sin grafts. AN - 2798207 AU - Nagadowska, M. AU - Luboiński, G. DA - Jan 9-16 DP - NLM ET - 1989/01/09 IS - 2-3 KW - Aged Breast Neoplasms/*radiotherapy Cobalt Radioisotopes/*adverse effects/therapeutic use Female Humans *Omentum Osteoradionecrosis/etiology/*surgery Radiation Injuries/*surgery Ribs/*radiation effects/surgery *Surgical Flaps LA - pol N1 - Nagadowska, M Luboiński, G Case Reports English Abstract Journal Article Poland Pol Tyg Lek. 1989 Jan 9-16;44(2-3):53-4. OP - Wykorzystanie sieci wiekszej w leczeniu popromiennej martwicy całej grubości ściany klatki piersiowej. PY - 1989 SN - 0032-3756 (Print) 0032-3756 SP - 53-4 ST - [Use of the greater omentum in the treatment of post-radiation necrosis of the whole thickness of the chest wall] T2 - Pol Tyg Lek TI - [Use of the greater omentum in the treatment of post-radiation necrosis of the whole thickness of the chest wall] VL - 44 ID - 13815 ER - TY - JOUR AB - The extended V-Y latissimus dorsi myocutaneous flap described by Micali and Carramaschi provides an innovative method of closing large anterior chest defects after resection of breast cancer. The technique provides robust chest wall coverage that is able to withstand immediate postoperative radiotherapy. The aim of this article is to confirm the usefulness of the flap's design and describe modifications to the technique. The modifications to technique include: a curvilinear design that recruited more skin for closure in patients with wounds extending laterally or superiorly, routine transposition of latissimus dorsi insertion inferio-medially onto the chest wall to maximize pedicle reach, and the use of small split skin grafts or delayed primary closure if there was tension in closing. Twelve patients who underwent resection of locally advanced breast cancer had immediate chest wall reconstruction with the extended V-Y latissimus dorsi musculocutaneous flap. The V to Y design of the flap's cutaneous island allowed primary closure of chest wound and donor defect. There were no instances of chest wound dehiscence. The chest wounds healed, allowing patients to undergo adjuvant radiotherapy in a mean time interval of 6 weeks after surgery. AD - Department of Plastic Surgery, Singapore General Hospital, Singapore. AN - 16863813 AU - Woo, E. AU - Tan, B. K. AU - Koong, H. N. AU - Yeo, A. AU - Chan, M. Y. AU - Song, C. DA - Aug DO - 10.1016/j.athoracsur.2005.07.030 DP - NLM ET - 2006/07/26 IS - 2 KW - Adult Aged Breast Neoplasms/*surgery Female Humans Mammaplasty/*methods Middle Aged *Surgical Flaps Thoracic Wall/*surgery LA - eng N1 - 1552-6259 Woo, Evan Tan, Bien-Keem Koong, Heng Nung Yeo, Allen Chan, Mun Yew Patrick Song, Colin Journal Article Netherlands Ann Thorac Surg. 2006 Aug;82(2):752-5. doi: 10.1016/j.athoracsur.2005.07.030. PY - 2006 SN - 0003-4975 SP - 752-5 ST - Use of the extended V-Y latissimus dorsi myocutaneous flap for chest wall reconstruction in locally advanced breast cancer T2 - Ann Thorac Surg TI - Use of the extended V-Y latissimus dorsi myocutaneous flap for chest wall reconstruction in locally advanced breast cancer VL - 82 ID - 10742 ER - TY - JOUR AB - Perforator flaps are one of the most complex currently known forms of tissue reconstruction. Their discovery base based on the knowledge of many generations of scientists. The DIEP flap is used in clinical situations where there is need to reconstruct a large tissue volume. Owing to the similarity of tissue structure and skin colour, it is a flap of choice in breast reconstruction with native tissues. It has large dimensions size and a considerable volume. Its peduncle is characterised by a large diameter and significant length of vessels. Anatomical variation is low and possible to assess preoperatively. It is for these reasons that the DIEP flap is counted among the flaps of the highest clinical use. With careful planning, application of meticulous surgical technique and utilisation of the operating team's experience, the complication rate is relatively low. The current reality of medical procedure pricing makes it impossible not to mention the costs. DIEP flap breast reconstruction is apparently expensive. Breast reconstruction with implants is associated with lower initial costs, but often requires additional procedures spread over time (e.g. implant replacement, plastic surgery of the other breast), which makes the costs difficult to estimate. Costs incurred by a facility performing DIEP flap reconstruction are currently not reflected in the pricing of this procedure by the Polish National Health Fund (NFZ), which is another factor affecting the number of such surgeries performed in Poland. AU - Ulatowski, Ł AU - Kaniewska, A. DB - Medline DO - 10.1515/pjs-2015-0091 IS - 9 KW - breast endoprosthesis breast reconstruction economics human patient satisfaction standards surgical flaps transplantation LA - English M3 - Review N1 - L614630350 2017-03-07 PY - 2015 SN - 2299-2847 SP - 472-481 ST - The Use Of The Diep Flap In The Modern Reconstructive Surgery T2 - Polski przeglad chirurgiczny TI - The Use Of The Diep Flap In The Modern Reconstructive Surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L614630350&from=export http://dx.doi.org/10.1515/pjs-2015-0091 VL - 87 ID - 6193 ER - TY - JOUR AB - Introduction: The use of abdominal flaps is recognized as a very advantageous approach for breast reconstruction with gradual refinements leading from the pedicled transverse rectus abdominis musculocutaneous flap to the criterion standard deep inferior epigastric perforator (DIEP) flap and its several variations. A systematic review with meta-analysis attempts to investigate the safety of the bipedicled DIEP flap for unilateral breast reconstruction. Methods: The literature search used "PubMed" database, and a relevant study conducted at the Queen Victoria Hospital was also included. The extraction of data included study type, follow-up, patients' age, body mass index, preexisting abdominal scars, timing of reconstruction, operating time, flap inset, pedicles' configuration, flap failure, revision, and complication rates. Proportions were pooled with Freeman-Tukey arcsine transformation, and meta-regression was performed to evaluate whether complication rates were modified by different variables. Results: Fourteen eligible articles provided an overall sample of 486 flaps, with a median follow-up of 18.5 months. In most cases, immediate reconstruction with undivided flap was performed, with equal use of extraflap and intraflap pedicles' configuration. Only 4 cases of flap failure (0.82%) were documented, with 18% overall complications and 3% fat necrosis rate. The forest plot showed significant between-study heterogeneity, and meta-regression revealed marginal positive association between older patient and complication rate. Conclusions: Bipedicled DIEP flap for unilateral breast reconstruction is a technique that maintains the complications rate relatively low in challenging postmastectomy cases. Further comparative studies are needed to substantiate the findings of this study. AD - [Christopoulos, Georgios; Vlachogiorgos, Apostolos; Ghanem, Ali M.] Queen Mary Univ London, Blizard Inst, London, England. [Christopoulos, Georgios; Mackey, Simon P.] Queen Victoria Hosp, Plast Surg Dept, E Grinstead, England. [Sergentanis, Theodoros N.] Natl & Kapodistrian Univ Athens, Dept Hyg Epidemiol & Med Stat, Sch Med, Athens, Greece. Christopoulos, G (corresponding author), Flat 102,Ensign House,Juniper Dr, London SW18 1TR, England. gdchristopoulos@gmail.com; tsergentanis@yahoo.gr; avlachogiorgos@gmail.com; simonmackeyplastics@gmail.com; ali.m.ghanem@gmail.com AN - WOS:000608708900010 AU - Christopoulos, G. AU - Sergentanis, T. N. AU - Vlachogiorgos, A. AU - Mackey, S. P. AU - Ghanem, A. M. DA - Dec DO - 10.1097/sap.0000000000002456 IS - 6 J2 - Ann. Plast. Surg. KW - bipedicled DIEP DIEP flap double pedicle intraflap anastomosis abdominal flap breast reconstruction systematic review meta-analysis Surgery LA - English M3 - Review N1 - ISI Document Delivery No.: PT6FJ Times Cited: 0 Cited Reference Count: 59 Christopoulos, Georgios Sergentanis, Theodoros N. Vlachogiorgos, Apostolos Mackey, Simon P. Ghanem, Ali M. 0 4 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2020 SN - 0148-7043 SP - E66-E75 ST - The Use of the Bipedicled Deep Inferior Epigastric Perforator Flap for Unilateral Breast Reconstruction A Systematic Review and Meta-analysis T2 - Annals of Plastic Surgery TI - The Use of the Bipedicled Deep Inferior Epigastric Perforator Flap for Unilateral Breast Reconstruction A Systematic Review and Meta-analysis UR - ://WOS:000608708900010 VL - 85 ID - 1006 ER - TY - JOUR AB - The use of minimally invasive surgery continues to evolve in all fields of surgery with new developments in techniques and instrumentation. One instrument that has evolved and become useful in the field of plastic surgery is the balloon dissector. The purpose of this paper is to examine the role of the balloon dissector in minimally invasive aesthetic and reconstructive plastic surgery. We define the concept of the fascial cleft-the loose areolar space between fascial linings. In addition, the balloon dissector and its use is described. The optical cavity created by the balloon dissector device is discussed, along with the two techniques used to maintain the optical cavity, and manual retraction and carbon dioxide insufflation. The application of the balloon dissector in various regions of the body is discussed along with its use in free tissue transfers. Three patients are presented to illustrate the application of the balloon dissector. AD - L.S. Levin, Duke University Medical Center, Division of Plastic, PO Box 3974, Durham, NC 27710, United States AU - Ip, T. Y. AU - Aponte, R. AU - Koger, K. E. AU - German, G. AU - Zobrist, R. AU - Scott Levin, L. DB - Embase Medline DO - 10.1097/00000637-199803000-00002 IS - 3 KW - carbon dioxide adult article breast augmentation burn contracture case report child female free tissue graft human priority journal retractor soft tissue defect surgical anatomy surgical equipment LA - English M3 - Article N1 - L28106899 1998-04-14 PY - 1998 SN - 0148-7043 SP - 205-213 ST - Use of the balloon dissector in minimally invasive aesthetic and reconstructive surgery T2 - Annals of Plastic Surgery TI - Use of the balloon dissector in minimally invasive aesthetic and reconstructive surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L28106899&from=export http://dx.doi.org/10.1097/00000637-199803000-00002 VL - 40 ID - 8656 ER - TY - JOUR AB - INTRODUCTION: Oncologic reconstruction in obese patients can be challenging. Donor tissues, such as the rectus flap, can be excessively bulky and result in significant cosmetic and functional deformities. Although the use of the anterolateral thigh (ALT) flap as an alternative to the radial forearm flap has been extensively described, few studies have evaluated the use of the ALT flap as an alternative to the rectus flap. The purpose of this study was to evaluate our experience with the ALT flap in overweight or obese patients. METHODS: A retrospective review was conducted of all ALT flaps performed over a 2-year period at Memorial Sloan-Kettering Cancer Center. All patients with a body mass index (BMI) >25 kg/m were identified and evaluated. RESULTS: Twenty-seven patients underwent ALT flap reconstruction during the study period. Of these, 11 patients were overweight (BMI, 25.1-30 kg/m) or obese (BMI, >30 kg/m). Reconstructions were performed for a variety of oncologic defects, including head and neck (n = 7), extremity (n = 2), chest wall (n = 1), and abdominal wall (n = 1). Complications were, in general, mild and infrequent. One patient experienced a minor infection, 1 patient had partial flap loss, and 2 patients had partial skin graft loss at the donor site. There were no flap losses. CONCLUSIONS: The ALT flap is a safe and reliable flap for reconstruction of diverse defects in overweight or obese patients. Large flaps can be designed and tailored to the defect by harvesting variable amounts of skin, subcutaneous tissues, fascia, and muscle. The ALT flap may be a good alternative to the rectus flap in overweight or obese patients. Copyright © 2006 by Lippincott Williams & Wilkins. AD - B.J. Mehrara, 1275 York Avenue, New York, NY 10021, United States AU - Davidge, K. AU - Pusic, A. AU - Disa, J. J. AU - Mehrara, B. J. DB - Embase Medline DO - 10.1097/01.sap.0000210536.97696.1f IS - 5 KW - methacrylic acid methyl ester adult angiosarcoma anterolateral thigh flap body mass bone necrosis breast cancer cancer radiotherapy cancer surgery clinical article female free tissue graft head and neck cancer human male morbid obesity postoperative infection priority journal radiation necrosis rectus abdominis muscle retrospective study review sigmoid carcinoma skin graft soft tissue sarcoma treatment failure treatment outcome LA - English M3 - Review N1 - L43970238 2006-07-18 PY - 2006 SN - 0148-7043 SP - 536-539 ST - Use of the anterolateral thigh flap as an alternative to the rectus flap in obese and overweight patients T2 - Annals of Plastic Surgery TI - Use of the anterolateral thigh flap as an alternative to the rectus flap in obese and overweight patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L43970238&from=export http://dx.doi.org/10.1097/01.sap.0000210536.97696.1f VL - 56 ID - 8092 ER - TY - JOUR AB - The present study was conducted to evaluate the use of the transverse rectus abdominis myocutaneous (TRAM) flap in immediate autologous soft tissue coverage of the large wound defect that results from some oncological problems and would be impossible to dose by direct primary sutures. The study included patients with locally advanced breast cancer (LABC) (n = 24), post-mastectomy local recurrence (n = 10), post-mastectomy irradiation ulcer (n = 4), recurrent fibrosarcoma of the chest wall (n = 1), and a huge ulcerating malignant melanoma of the groin region (n = 1). All patients were female except for the patient with melanoma. Their ages ranged between 39-73 years with an average of 56.2 years. The lower TRAM flap was used in 24 patients and the middle in only six. Mesh re-inforcement of the abdominal wall was adopted in 14 patients (35%). The mean operating time was 2.5 h and the average postoperative hospital stay was 9.7 days (range, 7-12 days). Six patients (15%) had partial flap necrosis which healed after debridement and secondary sutures, and eight patients had wound sepsis (20%). No patient suffered from abdominal herniation, although four patients (10%) had an epigastric bulge postoperatively. During the 48.5 month follow-up period (range 36-56 months), three cases of local recurrence and four cases of distant metastases were encountered in the patients with LABC. Three of the latter died at 7, 11 and 12 months postoperatively. Based on these data, it may be concluded that the results of the TRAM flap for immediate coverage of the large post-extirpation defect in different oncological problems have been encouraging. No flaps were lost, no abdominal herniation was encountered, and overall complications were minimal. AD - Univ Alexandria, Fac Med, Dept Surg, Alexandria, Egypt. Sakr, MF (corresponding author), Univ Alexandria, Fac Med, Dept Surg, Alexandria, Egypt. AN - WOS:000171003700017 AU - Mohamed, S. A. AU - Sakr, M. F. AU - El-Hammadi, H. A. AU - Moussa, M. M. AU - El-Sharaky, M. M. DA - Oct-Dec IS - 4 J2 - Int. Surg. KW - TRAM flap breast cancer locally advanced local recurrence fibrosarcoma melanoma abdominal island flap breast reconstruction Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 472UQ Times Cited: 7 Cited Reference Count: 16 Mohamed, SA Sakr, MF El-Hammadi, HA Moussa, MM El-Sharaky, MM Sakr, Mahmoud/0000-0002-0176-6070 7 0 Int college of surgeons Chicago PY - 2000 SN - 0020-8868 SP - 347-352 ST - The use of the 'TRAM' flap in some oncological problems T2 - International Surgery TI - The use of the 'TRAM' flap in some oncological problems UR - ://WOS:000171003700017 VL - 85 ID - 4043 ER - TY - JOUR AD - Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. Morris, DJ (corresponding author), Beth Israel Deaconess Med Ctr, E Campus,ST-934,330 Brookline Ave, Boston, MA 02215 USA. AN - WOS:000072330700019 AU - Morris, D. J. DA - Mar IS - 3 J2 - Plast. Reconstr. Surg. KW - breast reconstruction strategies weakness Surgery LA - English M3 - Editorial Material N1 - ISI Document Delivery No.: ZA118 Times Cited: 0 Cited Reference Count: 4 Morris, DJ 0 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 1998 SN - 0032-1052 SP - 711-712 ST - Use of synthetic mesh for the entire abdominal wall after TRAM flap transfer - Discussion T2 - Plastic and Reconstructive Surgery TI - Use of synthetic mesh for the entire abdominal wall after TRAM flap transfer - Discussion UR - ://WOS:000072330700019 VL - 101 ID - 4196 ER - TY - JOUR AB - Abdominal wall competence is a major concern of all plastic surgeons using the TRAM flap for breast reconstruction. Low hernia rates and adequate abdominal stability are standard expectations in abdominal wall closure. Described here is this institution's experience with the use of a large piece of synthetic mesh as a supplementary reinforcement for the entire abdominal wall in an attempt to stabilize it and achieve a superior abdominal aesthetic result. Twenty-five consecutive patients had routine reinforcement,vith the extended mesh technique. Mean patient follow-up was 24 months with a minimum of 1 year. No hernia or mesh-related infection were encountered and only one patient had a lower abdominal bulge. We recommend the use of a large synthetic mesh for improved strength and aesthetic quality of the abdominal wall after TRAM flap breast reconstruction. AD - Rambam Med Ctr, Dept Plast & Reconstruct Surg, IL-31096 Haifa, Israel. Rambam Med Ctr, Dept Surg A, IL-31096 Haifa, Israel. Moscona, RA (corresponding author), Rambam Med Ctr, Dept Plast & Reconstruct Surg, IL-31096 Haifa, Israel. AN - WOS:000072330700018 AU - Moscona, R. A. AU - Ramon, Y. AU - Toledano, H. AU - Barzilay, G. DA - Mar DO - 10.1097/00006534-199803000-00018 IS - 3 J2 - Plast. Reconstr. Surg. KW - breast reconstruction pedicled tram marlex mesh strategies weakness Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: ZA118 Times Cited: 39 Cited Reference Count: 16 Moscona, RA Ramon, Y Toledano, H Barzilay, G 39 0 Lippincott williams & wilkins Philadelphia PY - 1998 SN - 0032-1052 SP - 706-710 ST - Use of synthetic mesh for the entire abdominal wall after TRAM flap transfer T2 - Plastic and Reconstructive Surgery TI - Use of synthetic mesh for the entire abdominal wall after TRAM flap transfer UR - ://WOS:000072330700018 VL - 101 ID - 4195 ER - TY - JOUR AB - Background: Use of drains has been advocated in order to prevent seroma and hematoma; however, specific recommendations vary widely. The goal is to perform a systematic analysis of published literature on the use of drains for breast reconstruction. Methods: The literature search was performed according to the PRISMA guidelines. The search included the Cochrane Library, Embase, and Pubmed databases using the terms "breast reconstruction" and "breast flap" combined with "drain", "seroma," and "seroma prevention". The references were appraised in two rounds, by two independent reviewers; studies were included/excluded based on relevance of title and subsequently by the content of their abstracts/manuscripts. Outcomes regarding seroma, infection rate, length of stay (LOS), drainage, reconstruction type and complications were analyzed. Results: Of 2252 studies identified via search, 64 were relevant and 21 met inclusion criteria. Most of the study designs were case series or retrospective cohort studies (Level of Evidence III or IV), with the exception of one prospective randomized-controlled trial. Seroma rate was given in 18 studies, infection rate in 11, and criteria for drain removal in 19. Reoperation rate was available in 7 and LOS in 18 studies. The majority of studies (13) agreed to remove the drain when the output was less than 30 ml/24 h. Drain output was reported in 11, and 20 reported drain type used. Conclusion: There is sparse literature available with which to make evidence-based guidelines. A standardized guideline for reporting drain use is crucial to providing a better understanding of complications in breast reconstruction related to surgical drains. (C) 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - [Scomacao, Isis; Cummins, Andi; Duraes, Eliana F. R.; Djohan, Risal] Cleveland Clin Fdn, Dept Plast & Reconstruct Surg, 60 Crile Bldg,9500 Euclid Ave, Cleveland, OH 44195 USA. [Roan, Esra] SOMAVAC Med Solut Inc, Memphis, TN USA. Scomacao, I (corresponding author), Cleveland Clin Fdn, Dept Plast & Reconstruct Surg, 60 Crile Bldg,9500 Euclid Ave, Cleveland, OH 44195 USA. isis.scomacao@gmail.com AN - WOS:000521042000004 AU - Scomacao, I. AU - Cummins, A. AU - Roan, E. AU - Duraes, E. F. R. AU - Djohan, R. DA - Apr DO - 10.1016/j.bjps.2019.11.019 IS - 4 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - Seroma Closed suction Suction Seroma prevention Breast reconstruction randomized clinical-trial closed-suction drains lymph-node dissection game abdominal drains seroma formation donor-site tissue expander tram flap postoperative seroma quilting suture Surgery LA - English M3 - Review N1 - ISI Document Delivery No.: KW3BJ Times Cited: 1 Cited Reference Count: 59 Scomacao, Isis Cummins, Andi Roan, Esra Duraes, Eliana F. R. Djohan, Risal scomacao, isis/AAF-4219-2019 1 Elsevier sci ltd Oxford 1878-0539 PY - 2020 SN - 1748-6815 SP - 651-662 ST - The use of surgical site drains in breast reconstruction: A systematic review T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - The use of surgical site drains in breast reconstruction: A systematic review UR - ://WOS:000521042000004 VL - 73 ID - 1203 ER - TY - JOUR AB - Background: The purpose of this study was to evaluate the feasibility of super-microsurgery (perforator-to-perforator anastomosis) in lower extremity reconstruction. Methods: From January of 2007 to February of 2008, a total of 42 patients were treated for soft-tissue defects of the lower extremity resulting from various causes. They were reconstructed with either anterolateral thigh perforator flaps (38 flaps) or upper medial thigh perforator flaps (four flaps) using the super-microsurgery technique. The region of the defect was located on the knee, including the upper third of the leg in 17 patients and the middle third of the leg in 25 patients. All of the flaps were anastomosed between the perforators in end-to-end fashion. Results: With the exception of one flap, all flaps survived without any complications. One flap was observed to have no flow after 24 hours and was deemed unsalvageable. The average time of operation was 3 hours 20 minutes. Ambulation was allowed within 7 days after surgery if bone status was feasible. Conclusions: The use of supermicrosurgery in lower extremity reconstruction allows an increase in selection of recipient pedicles. By using a perforator-to-perforator anastomosis approach, less time is consumed in securing the recipient vessel and elevating the flap, and the risk for major vessel injury is minimized and flap survival is acceptable. However, it requires a steep learning curve before the technique can be used comfortably. The supermicrosurgery technique is feasible and may be efficient in the hands of a skilled surgeon. (Plast. Reconstr. Surg. 123: 230, 2009.) AD - Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast Surg, Seoul, South Korea. Hong, JP (corresponding author), Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast Surg, Poongnap 2 Dong 388-1, Seoul, South Korea. joonphong@amc.seoul.kr AN - WOS:000262317700029 AU - Hong, J. P. DA - Jan DO - 10.1097/PRS.0b013e3181904dc4 IS - 1 J2 - Plast. Reconstr. Surg. KW - free tissue transfer breast reconstruction perforator flaps chronic osteomyelitis thigh tibia leg Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 392QQ Times Cited: 88 Cited Reference Count: 25 Hong, Joon Pio 94 0 4 Lippincott williams & wilkins Philadelphia PY - 2009 SN - 0032-1052 SP - 230-235 ST - The Use of Supermicrosurgery in Lower Extremity Reconstruction: The Next Step in Evolution T2 - Plastic and Reconstructive Surgery TI - The Use of Supermicrosurgery in Lower Extremity Reconstruction: The Next Step in Evolution UR - ://WOS:000262317700029 VL - 123 ID - 3354 ER - TY - JOUR AB - Background The low deep inferior epigastric perforator (DIEP) flap was first introduced in 2016 as it had aesthetic advantages over the conventional DIEP flap. With our experience of over 100 low DIEP flap procedures to date, we have conspicuously lowered complication rates and established more definitive criteria to select proper candidates. Methods We analyzed 103 patients who underwent breast reconstruction with the low DIEP flap at our hospital between May 2014 and June 2018. Demographics, patient selection criteria, flap specifics, surgical outcomes including postoperative complications, and the location of the abdominal scar and umbilicus were reviewed retrospectively. Results The mean patient age was 46.7 years, and the average body mass index was 23.7 kg/m (2) . A low DIEP with an average weight of 377 g was utilized within 6 hours 17 minutes in this cohort. There was no significant difference in the rate of venous congestion or fat necrosis compared with the conventional DIEP flap. The average distance from the pubic hairline to the abdominal scar was 0.6 cm and from the anterior superior iliac spine to the abdominal scar was -0.4 cm. The postoperative location of the umbilicus was 7.0 cm above the pubic hairline. Conclusion The low DIEP flap is not only a reliable option for a breast reconstruction but is an aesthetically superior approach with a lower abdominal scar and natural umbilicus. Patients may benefit from this technique if prudently selected by computed tomography (CT) angiography. A perforator that is larger than 1 mm in diameter and well enhanced on CT angiography from the division of the external iliac artery to the abdominal skin particularly in the intramuscular course should be selected. AD - [Cha, Han Gyu; Kang, Min Kyu; Han, Hyun Ho; Kim, Eun Key; Eom, Jin Sup] Univ Ulsan, Coll Med, Dept Plast Surg, Asan Med Ctr, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea. Eom, JS (corresponding author), Univ Ulsan, Coll Med, Dept Plast Surg, Asan Med Ctr, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea. jinsupp@amc.seoul.kr AN - WOS:000486036100010 AU - Cha, H. G. AU - Kang, M. K. AU - Han, H. H. AU - Kim, E. K. AU - Eom, J. S. DA - Oct DO - 10.1055/s-0039-1692168 IS - 8 J2 - J. Reconstr. Microsurg. KW - breast reconstruction DIEP flap donor-site scar satisfaction Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: IX9UO Times Cited: 0 Cited Reference Count: 9 Cha, Han Gyu Kang, Min Kyu Han, Hyun Ho Kim, Eun Key Eom, Jin Sup Cha, Hangyu/0000-0003-3059-1334 0 Thieme medical publ inc New york 1098-8947 PY - 2019 SN - 0743-684X SP - 622-629 ST - Use of Strict Patient Selection Criteria to Achieve Significant Surgical Outcomes from a Low DIEP Flap Breast Reconstruction T2 - Journal of Reconstructive Microsurgery TI - Use of Strict Patient Selection Criteria to Achieve Significant Surgical Outcomes from a Low DIEP Flap Breast Reconstruction UR - ://WOS:000486036100010 VL - 35 ID - 1319 ER - TY - JOUR AB - INTRODUCTION: Long-term follow-up of the use of skin sparing mastectomy (SSM) in the treatment of breast cancer is presented to determine the impact of local recurrence (LR) on survival. METHODS: 565 cases of breast cancer were treated by SSM and IBR from 1/1/1989-12/31/1998. The AJCC pathological staging was Stage 0 175 (31%), Stage I 135 (23.9%), Stage II 173 (30.6%), Stage III 54 (9.6%), Stage IV 8 (1.4%), recurrent 20 (3.5%). Forty-one patients received postoperative adjuvant radiation therapy. RESULTS: Thirty-one patients developed a LR during the follow-up including five who received adjuvant radiation. The distribution of LR stratified by cancer stage was Stage 0 1 (3.2%), Stage I 5 (16.1%), Stage II 17 (54.8%), Stage III 6 (19.4%), and recurrent 2 (6.5%). The overall LR was 5.5%. Isolated LRs were treated with surgical resection and radiation therapy if not previously administered. Twenty-four patients (77.4%) developed a systemic relapse and 7 (22.6%) patients remained free of recurrent disease at a mean follow-up of 78.1 months. The cancer stage of those remaining disease free was Stage 0 1, Stage I 4, and Stage II 2. CONCLUSIONS: LR of breast cancer after SSM is not always associated with systemic relapse. AD - Winship Cancer Institute, Emory University School of Medicine, Emory University, 1365B, Clifton Road, Atlanta, GA 30322, USA. grant_carlson@emory.org AN - 14998566 AU - Carlson, G. W. AU - Styblo, T. M. AU - Lyles, R. H. AU - Jones, G. AU - Murray, D. R. AU - Staley, C. A. AU - Wood, W. C. DA - Dec DO - 10.1016/j.suronc.2003.09.002 DP - NLM ET - 2004/03/05 IS - 4 KW - Adult Age Distribution Aged Biopsy, Needle Breast Neoplasms/*mortality/pathology/radiotherapy/*surgery Cohort Studies Dermatologic Surgical Procedures Disease-Free Survival Female Follow-Up Studies Humans Incidence Logistic Models Mammaplasty Mastectomy/*methods Middle Aged Multivariate Analysis Neoplasm Recurrence, Local/*epidemiology/pathology Neoplasm Staging Probability Radiotherapy, Adjuvant Retrospective Studies Risk Assessment Surgical Flaps Survival Analysis Treatment Outcome LA - eng N1 - Carlson, Grant W Styblo, Toncred M Lyles, Robert H Jones, Glyn Murray, Douglas R Staley, Charles A Wood, William C Journal Article Netherlands Surg Oncol. 2003 Dec;12(4):265-9. doi: 10.1016/j.suronc.2003.09.002. PY - 2003 SN - 0960-7404 (Print) 0960-7404 SP - 265-9 ST - The use of skin sparing mastectomy in the treatment of breast cancer: The Emory experience T2 - Surg Oncol TI - The use of skin sparing mastectomy in the treatment of breast cancer: The Emory experience VL - 12 ID - 13304 ER - TY - JOUR AB - Background: Breast reconstruction with autologous tissue following mastectomy for breast cancer has become the standard of care. Microvascular breast augmentation is an alternative for patients with failed breast prostheses, including painful capsular contractures or poor cosmetic outcomes. We present a series of 4 patients who underwent microvascular breast augmentation with cross-chest flap recipient vessels. Methods: We perform a bilateral DIEP flap reconstruction in an outpatient setting following a modified recovery protocol, focused on decreasing postoperative pain and narcotic requirements, allowing early ambulation and discharge. This includes harvest of the flap via abdominal microfascial incisions and rib-sparing vessel dissection. Cosmetic microvascular augmentation of the contralateral breast was performed via cross-chest flap recipient vessel anastomoses, where the pedicle was tunneled across the chest and anastomosed to the primary flap. Results: Four patients underwent flap-based breast augmentation with cross-chest recipient vessels. Two patients underwent immediate DIEP flap breast reconstruction of the affected side and contralateral flap-based augmentation, while 2 patients underwent bilateral breast augmentation with DIEP flaps for cosmetic purposes due to undesired cosmetic results following implant-based augmentations. No intraoperative complications were reported, and all patients were discharged within 23 hours without signs of flap compromise or need for operative take-backs. Mean follow-up was 23 weeks. Conclusions: The DIEP flap is recognized as an option for breast augmentation, although its limitations are several, including the pain and recovery associated with autologous tissue-based breast reconstruction. Enhanced recovery protocols help reduce this burden, making it more acceptable and feasible. AD - [Deramo, Paul] Univ Texas Hlth Sci Ctr Houston, Houston, TX 77030 USA. [Martinez, Carlos A.; Boutros, Sean G.] Houston Plast Craniofacial & Sinus Surg, 9230 Katy Freeway,Suite 600, Houston, TX 77055 USA. Boutros, SG (corresponding author), Houston Plast Craniofacial & Sinus Surg, 9230 Katy Freeway,Suite 600, Houston, TX 77055 USA. drseanboutros@drseanboutros.com AN - WOS:000562717200043 AU - Deramo, P. AU - Martinez, C. A. AU - Boutros, S. G. C7 - e2978 DA - Jul DO - 10.1097/gox.0000000000002978 IS - 7 J2 - Prs-Glob. Open KW - internal mammary vessels reconstruction Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: NE6NO Times Cited: 0 Cited Reference Count: 17 Deramo, Paul Martinez, Carlos A. Boutros, Sean G. 0 Lippincott williams & wilkins Philadelphia PY - 2020 SN - 2169-7574 SP - 5 ST - Use of Single-recipient Vessels for Cross-chest Abdominal Flap-based Breast Augmentation as an Outpatient T2 - Plastic and Reconstructive Surgery-Global Open TI - Use of Single-recipient Vessels for Cross-chest Abdominal Flap-based Breast Augmentation as an Outpatient UR - ://WOS:000562717200043 VL - 8 ID - 1114 ER - TY - JOUR AD - [Kosutic, Damir; Lambe, Gerard F.] Christie NHS Fdn Trust, Dept Plast & Reconstruct Surg, Manchester, Lancs, England. Kosutic, D (corresponding author), Christie NHS Fdn Trust, Wilmslow Rd, Manchester M20 4BX, Lancs, England. dkosutic@hotmail.com AN - WOS:000422776400016 AU - Kosutic, D. AU - Lambe, G. F. DA - Jan DO - 10.1002/micr.30269 IS - 1 J2 - Microsurgery KW - Surgery LA - English M3 - Letter N1 - ISI Document Delivery No.: FS9YP Times Cited: 2 Cited Reference Count: 5 Kosutic, Damir Lambe, Gerard F. 3 0 1 Wiley Hoboken 1098-2752 PY - 2018 SN - 0738-1085 SP - 120-121 ST - The use of single recipient internal mammary vessels for bilateral diep flap breast reconstruction in a recipient-vessel-depleted patient T2 - Microsurgery TI - The use of single recipient internal mammary vessels for bilateral diep flap breast reconstruction in a recipient-vessel-depleted patient UR - ://WOS:000422776400016 VL - 38 ID - 1700 ER - TY - JOUR AB - BACKGROUND: Tissue reinforcement with acellular dermal matrix (ADM) in implant-based breast reconstruction contributes to the coverage of the implant and avoids its direct exposure to skin incision, yet not without risk of infection. Our integrated technique makes use of the in situ serratus anterior fascia as a support of the implant following mastectomy, which serves the same purpose of ADM in terms of aesthetic outcomes, but minimizes the hazard of infective complications. METHODS: We retrospectively reviewed all the nipple-sparing mastectomies with direct-to-implant immediate reconstruction in Hong Kong Sanatorium and Hospital from 2012 to 2016. The authors made use of the serratus anterior fascial flap as inferolateral coverage for the subpectoral implant. Consequently, the implant would be completely covered by autologous tissues. RESULTS: Among the 51 women included, primary breast cancers account for 91.8% of our indications for these 61 procedures of integrated mastectomy and implant reconstruction. The remaining five (8.2%) were performed as contralateral prophylactic mastectomy. Almost three quarters of the patients had a bra cup size of B or below. After a mean follow-up of 28.9 months, there was no reported post-operative complication of skin flap or nipple-areolar complex necrosis, or infection or extrusion of the implant. CONCLUSIONS: Our series support that the serratus anterior fascial flap could provide autologous coverage in integrated mastectomy and implant breast reconstruction, especially in small- and medium-sized breasts. Appropriate patient selection, as well as meticulous surgical technique, is critical for its success. AU - Chan, Y. H. Y. AU - Yue, I. K. H. AU - Ho, C. M. AU - Cheung, P. S. Y. DB - Medline DO - 10.1007/s00268-019-05275-6 IS - 3 KW - adult adverse event breast endoprosthesis breast reconstruction breast tumor esthetics fascia female human mastectomy middle aged procedures retrospective study surgical flaps transplantation LA - English M3 - Article N1 - L629871900 2019-11-21 2021-01-06 PY - 2020 SN - 1432-2323 SP - 825-830 ST - The Use of Serratus Anterior Fascial Flap in Integrated Mastectomy and Implant Reconstruction T2 - World journal of surgery TI - The Use of Serratus Anterior Fascial Flap in Integrated Mastectomy and Implant Reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629871900&from=export http://dx.doi.org/10.1007/s00268-019-05275-6 VL - 44 ID - 4818 ER - TY - JOUR AB - BACKGROUND: This study aimed to evaluate the impact of semi-absorbable mesh on donor-site morbidity and patient-reported outcomes in deep inferior epigastric perforator (DIEP) flap breast reconstruction. METHODS: We conducted a retrospective cohort study of all patients who had DIEP flap breast reconstruction in our department from July 2007 to March 2019. Patients were invited to a comparative follow-up visit and grouped according to donor-site closure: primary fascial closure (the no-mesh group) and fascial reinforcement with semi-absorbable mesh in a subfascial position (the mesh group). The primary outcome of interest was donor-site morbidity, including bulging, hernia formation and rectus abdominis muscle strength. We also surveyed, surgical site complications and patient-reported outcomes using Patient and Observer Scar Assessment Scale v2.0 and BREAST-Q© version 2.0. RESULTS: A total of 191 patients had received DIEP flap breast reconstruction. Eighty-five patients (44.5%) with 108 DIEP flaps (53 patients in the mesh group and 32 patients in the no-mesh group) were included in the study. The mean BMI of the patients was significantly higher in the mesh group (mesh group, 26.9 vs. no-mesh group, 25.0, with p = 0.03). The incidence of hernia was significantly reduced in the mesh group (mesh group, 2.8% vs. no-mesh group, 13.5%, with p = 0.03). The incidence of bulging and the extent of rectus abdominis muscle strength were similar for both groups. Operative surgical site complications were reduced in the mesh group (mesh group, 7.5% vs. no-mesh group, 18.8%). There was no difference in patients' physical well-being and satisfaction with the donor site between groups. Patient-reported scar outcome was significantly better in the no-mesh group (p < 0.001). CONCLUSION: Our novel method of donor-site closure with semi-absorbable mesh in a subfascial position for reinforcement of the anterior rectus fascia on the DIEP donor site is safe. It has no negative impact on surgical site complications and patient-reported outcomes, while reducing the incidence of hernias on the donor-site in DIEP flap breast reconstruction. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . AU - Siegwart, L. C. AU - Sieber, L. AU - Fischer, S. AU - Diehm, Y. AU - Hirche, C. AU - Kneser, U. AU - Kotsougiani-Fischer, D. DB - Medline DO - 10.1007/s00266-020-02096-0 KW - adult article body mass breast reconstruction cohort analysis complication deep inferior epigastric perforator flap donor site evidence based medicine fascia female follow up hernia human major clinical study male morbidity muscle strength patient-reported outcome physical well-being rectus abdominis muscle reinforcement (psychology) retrospective study satisfaction scar LA - English M3 - Article in Press N1 - L634077794 2021-02-09 PY - 2021 SN - 1432-5241 ST - The Use of Semi-Absorbable Mesh and its Impact on Donor-Site Morbidity and Patient-Reported Outcomes in DIEP Flap Breast Reconstruction T2 - Aesthetic plastic surgery TI - The Use of Semi-Absorbable Mesh and its Impact on Donor-Site Morbidity and Patient-Reported Outcomes in DIEP Flap Breast Reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L634077794&from=export http://dx.doi.org/10.1007/s00266-020-02096-0 ID - 4501 ER - TY - JOUR AB - Background This study aimed to evaluate the impact of semi-absorbable mesh on donor-site morbidity and patient-reported outcomes in deep inferior epigastric perforator (DIEP) flap breast reconstruction. Methods We conducted a retrospective cohort study of all patients who had DIEP flap breast reconstruction in our department from July 2007 to March 2019. Patients were invited to a comparative follow-up visit and grouped according to donor-site closure: primary fascial closure (the no-mesh group) and fascial reinforcement with semi-absorbable mesh in a subfascial position (the mesh group). The primary outcome of interest was donor-site morbidity, including bulging, hernia formation and rectus abdominis muscle strength. We also surveyed, surgical site complications and patient-reported outcomes using Patient and Observer Scar Assessment Scale v2.0 and BREAST-Q(C) version 2.0. Results A total of 191 patients had received DIEP flap breast reconstruction. Eighty-five patients (44.5%) with 108 DIEP flaps (53 patients in the mesh group and 32 patients in the no-mesh group) were included in the study. The mean BMI of the patients was significantly higher in the mesh group (mesh group, 26.9 vs. no-mesh group, 25.0, with p = 0.03). The incidence of hernia was significantly reduced in the mesh group (mesh group, 2.8% vs. no-mesh group, 13.5%, with p = 0.03). The incidence of bulging and the extent of rectus abdominis muscle strength were similar for both groups. Operative surgical site complications were reduced in the mesh group (mesh group, 7.5% vs. no-mesh group, 18.8%). There was no difference in patients' physical well-being and satisfaction with the donor site between groups. Patient-reported scar outcome was significantly better in the no-mesh group (p < 0.001). Conclusion Our novel method of donor-site closure with semi-absorbable mesh in a subfascial position for reinforcement of the anterior rectus fascia on the DIEP donor site is safe. It has no negative impact on surgical site complications and patient-reported outcomes, while reducing the incidence of hernias on the donor-site in DIEP flap breast reconstruction. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. AD - [Siegwart, L. C.; Sieber, L.; Fischer, S.; Diehm, Y.; Hirche, C.; Kneser, U.; Kotsougiani-Fischer, D.] Heidelberg Univ, Burn Ctr, BG Trauma Ctr Ludwigshafen Hand & Plast Surg, Dept Hand Plast & Reconstruct Surg,Microsurg, Ludwig Guttmann Str 13, D-67071 Ludwigshafen, Germany. Kotsougiani-Fischer, D (corresponding author), Heidelberg Univ, Burn Ctr, BG Trauma Ctr Ludwigshafen Hand & Plast Surg, Dept Hand Plast & Reconstruct Surg,Microsurg, Ludwig Guttmann Str 13, D-67071 Ludwigshafen, Germany. dkotsougiani@googlemail.com AN - WOS:000609118700003 AU - Siegwart, L. C. AU - Sieber, L. AU - Fischer, S. AU - Diehm, Y. AU - Hirche, C. AU - Kneser, U. AU - Kotsougiani-Fischer, D. DO - 10.1007/s00266-020-02096-0 J2 - Aesthet. Plast. Surg. KW - DIEP Breast reconstruction Mesh Donor-site morbidity Hernia Surgery LA - English M3 - Article; Early Access N1 - ISI Document Delivery No.: PU2EG Times Cited: 1 Cited Reference Count: 35 Siegwart, L. C. Sieber, L. Fischer, S. Diehm, Y. Hirche, C. Kneser, U. Kotsougiani-Fischer, D. 1 0 Springer New york 1432-5241 SN - 0364-216X SP - 10 ST - The Use of Semi-Absorbable Mesh and its Impact on Donor-Site Morbidity and Patient-Reported Outcomes in DIEP Flap Breast Reconstruction T2 - Aesthetic Plastic Surgery TI - The Use of Semi-Absorbable Mesh and its Impact on Donor-Site Morbidity and Patient-Reported Outcomes in DIEP Flap Breast Reconstruction UR - ://WOS:000609118700003 ID - 989 ER - TY - JOUR AB - Purpose: To examine how often screening mammography depicts clinically occult malignancy in breast reconstruction with autologous myocutaneous flaps (AMFs). Materials and Methods: Between January 1, 2000, and July 15, 2015, the authors retrospectively identified 515 women who had undergone mammography of 618 AMFs and who had at least 1 year of clinical follow-up. Of the 618 AMFs, 485 (78.5%) were performed after mastectomy for cancer and 133 (21.5%) were performed after prophylactic mastectomy. Medical records were used to determine the frequency, histopathologic characteristics, presentation, time to recurrence, and detection modality of malignancy. Cancer detection rate (CDR), sensitivity, specificity, positive predictive value, and false-positive biopsy rate were calculated. Results: An average of 6.7 screening mammograms (range, 1-16) were obtained over 15.5 years. The frequency of local-regional recurrence (LRR) was 3.9% (20 of 515 women; 95% confidence interval [CI]: 2.2%, 5.6%); all LRRs were invasive, and none were detected in the breast mound after prophylactic mastectomy. Of the 20 women with LRR, 13 (65%) were screened annually before the diagnosis. Seven of those 13 women (54%) had clinically occult LRR, and mammography depicted five. Five of the six clinically evident recurrences (83%) were interval cancers. The median time between reconstruction and first recurrence was 4.4 years (range, 0.8-16.2 years). The CDR per AMF was 1.5 per 1000 screening mammograms (five of 3358; 95% CI: 0.18, 2.8) after mastectomy for cancer and 0 of 1000 examinations (0 of 805 mammograms; 95% CI: 0, 5) after prophylactic mastectomy. Sensitivity, specificity, positive predictive value, and false-positive biopsy rate were 42% (five of 12), 99.4% (4125 of 4151), 16% (five of 31), and 0.6% (26 of 4151), respectively. Conclusion: The CDR of screening mammography (1.5 per 1000 screening mammograms) of the AMF after mastectomy for cancer is comparable to that for one native breast of an age-matched woman. Screening mammography adds little value after prophylactic mastectomy. (c) RSNA, 2018 AD - [Noroozian, Mitra] Michigan Med Univ Michigan, Dept Radiol, 2910G Taubman Ctr,SPC 5326,1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA. Michigan Med Univ Michigan, Rogel Canc Ctr, 2910G Taubman Ctr,SPC 5326,1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA. Noroozian, M (corresponding author), Michigan Med Univ Michigan, Dept Radiol, 2910G Taubman Ctr,SPC 5326,1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA. smitran@med.umich.edu AN - WOS:000444990900007 AU - Noroozian, M. AU - Carlson, L. W. AU - Savage, J. L. AU - Jeffries, D. O. AU - Joe, A. I. AU - Neal, C. H. AU - Patterson, S. K. AU - Hadjiiski, L. M. AU - Helvie, M. A. DA - Oct DO - 10.1148/radiol.2018172783 IS - 1 J2 - Radiology KW - tram flap reconstruction skin-sparing mastectomy immediate reconstruction locoregional recurrence cancer carcinoma risk Radiology, Nuclear Medicine & Medical Imaging LA - English M3 - Article N1 - ISI Document Delivery No.: GU1BV Times Cited: 12 Cited Reference Count: 21 Noroozian, Mitra Carlson, Leah W. Savage, Julia L. Jeffries, Deborah O. Joe, Annette I. Neal, Colleen H. Patterson, Stephanie K. Hadjiiski, Lubomir M. Helvie, Mark A. 12 0 1 Radiological soc north america Oak brook PY - 2018 SN - 0033-8419 SP - 39-48 ST - Use of Screening Mammography to Detect Occult Malignancy in Autologous Breast Reconstructions: A 15-year Experience T2 - Radiology TI - Use of Screening Mammography to Detect Occult Malignancy in Autologous Breast Reconstructions: A 15-year Experience UR - ://WOS:000444990900007 VL - 289 ID - 1533 ER - TY - JOUR AB - It has been postulated that the abdominal skin may have either predominantly deep or superficial venous drainage. This may account for complications arising from autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEAP) flap. In this study, we evaluate the use of the retrograde limb of the internal mammary vein (IMV) as a second recipient vein in reconstructions with the DIEAP flap. In Part A, 10 IMVs were harvested from 5 fresh cadavers and the flow of methylene blue through the retrograde limb and the presence of valves were evaluated under a stereoscopic microscope.In Part B, the clinical outcomes of 38 patients who underwent single or bilateral autologous breast reconstruction using the DIEAP flap technique between January 2007 and March 2011 were reviewed. A total of 48 flaps were evaluated: 31 with single vein anastomosis and 17 with 2-vein anastomosis. In Part A, no valves were identified in the IMVs. In all 10 cadaver IMVs, there was free flow of methylene blue in both antegrade (superior) and retrograde (inferior) directions.In Part B, a retrospective analysis of the 2 patient outcomes was performed. Outcomes assessed included total flap loss, partial flap necrosis, fat necrosis, wound infection, wound dehiscence, and hematoma. Results were compared using a 2-tailed Fisher exact test with a critical P value of 0.05. No statistically significant differences between groups were identified. The retrograde limb of the IMV seems to be a safe alternate recipient vein in DIEAP and muscle sparing free TRAM autologous breast reconstruction. This study does not identify a significant reduction in overall fat necrosis or overall complications when using the 2 venous repair techniques versus the simple venous repair technique. AD - A. Al-Dhamin AU - Al-Dhamin, A. AU - Bissell, M. B. AU - Prasad, V. AU - Morris, S. F. DB - Medline IS - 3 KW - anastomosis article blood flow breast breast reconstruction case control study comparative study epigastric artery female follow up graft survival human methodology microsurgery pathology perforator flap physiology vascularization vein LA - English M3 - Article N1 - L373971184 2014-10-21 PY - 2014 SN - 1536-3708 SP - 281-284 ST - The use of retrograde limb of internal mammary vein in autologous breast reconstruction with DIEAP flap: anatomical and clinical study T2 - Annals of plastic surgery TI - The use of retrograde limb of internal mammary vein in autologous breast reconstruction with DIEAP flap: anatomical and clinical study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L373971184&from=export VL - 72 ID - 6557 ER - TY - JOUR AB - Background It has been postulated that the abdominal skin may have either predominantly deep or superficial venous drainage. This may account for complications arising from autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEAP) flap. In this study, we evaluate the use of the retrograde limb of the internal mammary vein (IMV) as a second recipient vein in reconstructions with the DIEAP flap. Methods In Part A, 10 IMVs were harvested from 5 fresh cadavers and the flow of methylene blue through the retrograde limb and the presence of valves were evaluated under a stereoscopic microscope. In Part B, the clinical outcomes of 38 patients who underwent single or bilateral autologous breast reconstruction using the DIEAP flap technique between January 2007 and March 2011 were reviewed. A total of 48 flaps were evaluated: 31 with single vein anastomosis and 17 with 2-vein anastomosis. Results In Part A, no valves were identified in the IMVs. In all 10 cadaver IMVs, there was free flow of methylene blue in both antegrade (superior) and retrograde (inferior) directions. In Part B, a retrospective analysis of the 2 patient outcomes was performed. Outcomes assessed included total flap loss, partial flap necrosis, fat necrosis, wound infection, wound dehiscence, and hematoma. Results were compared using a 2-tailed Fisher exact test with a critical P value of 0.05. No statistically significant differences between groups were identified. Conclusions The retrograde limb of the IMV seems to be a safe alternate recipient vein in DIEAP and muscle sparing free TRAM autologous breast reconstruction. This study does not identify a significant reduction in overall fat necrosis or overall complications when using the 2 venous repair techniques versus the simple venous repair technique. AD - [Al-Dhamin, Ammar; Bissell, Mary Beth; Prasad, Vani; Morris, Steven F.] Dalhousie Univ, Dept Surg, Halifax, NS B3H3A7, Canada. Morris, SF (corresponding author), Dalhousie Univ, Dept Surg, 4443-1796 Summer St, Halifax, NS B3H3A7, Canada. sfmorris@dal.ca AN - WOS:000334767500006 AU - Al-Dhamin, A. AU - Bissell, M. B. AU - Prasad, V. AU - Morris, S. F. DA - Mar DO - 10.1097/SAP.0b013e3182605674 IS - 3 J2 - Ann. Plast. Surg. KW - breast reconstruction DIEAP flaps internal mammary vein valves retrograde microsurgery recipient vessels epigastric perforator flap free tram flap venous superdrainage outflow option donor site arterial vessels anatomy Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: AF5QH Times Cited: 16 Cited Reference Count: 29 Al-Dhamin, Ammar Bissell, Mary Beth Prasad, Vani Morris, Steven F. 16 0 2 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2014 SN - 0148-7043 SP - 281-284 ST - The Use of Retrograde Limb of Internal Mammary Vein in Autologous Breast Reconstruction With DIEAP Flap T2 - Annals of Plastic Surgery TI - The Use of Retrograde Limb of Internal Mammary Vein in Autologous Breast Reconstruction With DIEAP Flap UR - ://WOS:000334767500006 VL - 72 ID - 2443 ER - TY - JOUR AN - RN191017893 AU - Glasberg, S. B. AU - D Amico, R. A. CN - 617.95 RD 6528.924000 LA - English N1 - Irregular: Frequency variable United States WILLIAMS & WILKINS PY - 2006 SN - 0032-1052 SP - 8 - 15 ST - Use of Regenerative Human Acellular Tissue (AlloDerm) to Reconstruct the Abdominal Wall following Pedicle TRAM Flap Breast Reconstruction Surgery T2 - Plastic and Reconstructive Surgery TI - Use of Regenerative Human Acellular Tissue (AlloDerm) to Reconstruct the Abdominal Wall following Pedicle TRAM Flap Breast Reconstruction Surgery VL - 118, NUMB 1 ID - 185 ER - TY - JOUR AN - RN205097362 AU - Chang, D. W. CN - 618.19 RC280 2277.494080 LA - English N1 - Quarterly: 4 issues per year United Kingdom ELSEVIER SCIENCE B.V. AMSTERDAM PY - 2007 SN - 1043-321X SP - 101 - 102 ST - Use of Regenerative Human Acellular Tissue (AlloDerm) to Reconstruct the Abdominal Wall Following Pedicle TRAM Flap Breast Reconstruction Surgery T2 - Breast Diseases TI - Use of Regenerative Human Acellular Tissue (AlloDerm) to Reconstruct the Abdominal Wall Following Pedicle TRAM Flap Breast Reconstruction Surgery VL - 18, NUMB 1 ID - 187 ER - TY - JOUR AB - INTRODUCTION: Outcome measures of breast reconstruction have used panel assessment of photographs. This provides limited information to the assessor as these images are static.. The aim of this study was to assess whether the use of digital video was a valid assessment tool and to compare its use against photography. METHODS: 35 patients post‐reconstruction underwent photography, digital video capture and completed Breast Cancer Treatment Outcomes Scale (BCTOS) questionnaires. The photographs/video clips were randomised and shown to a 21 member panel. Opinions on aesthetic aspects of the reconstruction were assessed using the BCTOS and Harris scale. Panel inter‐rater agreement and patient‐panel correlation was assessed using Kendall's Coefficient of Concordance and Spearman's rank correlation tests respectively. RESULTS: There was a "moderate" degree of inter‐rater agreement amongst panel members in all categories. Greater agreement occurred using video footage to assess overall cosmesis (0.548 vs 0.507) and shape (0.505 vs 0.486). Video showed a greater degree of correlation with patient self‐assessment scores in comparison to photography (0.311 vs 0.281). CONCLUSION: Video footage coupled with panel assessment is a valid method of assessing post‐operative outcomes of breast reconstruction and appears superior to still photographs in terms of inter‐rater agreement and correlation with patient self‐assessment. AN - CN-01022205 AU - Gilmour, A. AU - Mackay, I. R. AU - Young, D. AU - Hill, M. E. AU - Brown, L. AU - Malyon, A. D. DO - 10.1016/j.bjps.2014.05.036 IS - 10 KW - *breast reconstruction *videorecording Article Computer Systems Computer system Controlled clinical trial Controlled study Digital video Female Human Humans Mammaplasty Patient Satisfaction Photography Randomized controlled trial Reproducibility Reproducibility of Results Subjective assessment Surgical Flaps Treatment Outcome Video Recording M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2014 SP - 1357‐1363 ST - The use of real-time digital video in the assessment of post-operative outcomes of breast reconstruction T2 - Journal of plastic, reconstructive & aesthetic surgery TI - The use of real-time digital video in the assessment of post-operative outcomes of breast reconstruction UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01022205/full VL - 67 ID - 104 ER - TY - JOUR AB - Operations will be performed by one of two plastic surgeons who perform this surgery in a similar manner. The entire unilateral rectus abdominis muscle will be harvested with fascial‐sparing as part of the pedicled TRAM flap. The flap will be shaped and sutured to the chest site, and the abdominal fascial defect will be closed primarily, followed by a polypropylene mesh overlay. Two 10 mm Jackson‐Pratt (JP) drains will be placed in the flap wound, and two JPs will be placed in the abdominal wound. Immediately after transfer of the extubated patient to the recovery room bed, study devices will be placed on the reconstructed breast and abdominal donor sites, and activated. In the treatment arm, the PEMF signal is automatically delivered every two hours for fifteen minutes while the patient is in the hospital. AN - CN-02041776 AU - Nct PY - 2010 ST - Use of Pulsed Electromagnetic Fields (PEMF) After Breast Reconstruction Surgery T2 - https://clinicaltrials.gov/show/NCT01262599 TI - Use of Pulsed Electromagnetic Fields (PEMF) After Breast Reconstruction Surgery UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02041776/full ID - 99 ER - TY - JOUR AB - BACKGROUND: A prior study in patients undergoing breast surgery with and without the use of paravertebral blocks (PVB) found no significant difference in patient length of stay (LOS). However, patients undergoing bilateral procedures and those undergoing immediate reconstructions were excluded. We sought to determine if the use of PVB in patients undergoing unilateral or bilateral mastectomy plus immediate reconstruction decreases patient LOS. METHODS: We undertook a retrospective review of patients who had mastectomies with immediate reconstructions with and without the use of preoperative PVB. Outcomes including LOS, postoperative nausea and vomiting, and time to oral narcotics were compared between groups. RESULTS: Mean LOS for the PVB group was 42 h. This was significantly less than the mean LOS of 47 h for the nonblock group (p = .0015). The significantly lower LOS for the PVB group was true for patients undergoing bilateral procedures (p = .045), unilateral procedures (p = .0031), tissue expander placement (p = .0114), and immediate implant placement (p = .037). Mean time to conversion to oral narcotics was significantly shorter in the PVB group (15 h) compared with the nonblock group (20 h) (p < .001). The incidence of postoperative nausea in the PVB group (42.8 %) was also significantly less than in the nonblock group (54.7 %) (p = .031). CONCLUSIONS: The routine use of preoperative PVB in patients undergoing mastectomy plus immediate reconstruction significantly decreased patient LOS. In addition to improved pain control from the block itself, quicker conversion to oral narcotics because of less postoperative nausea likely contributed to a decreased LOS. AD - Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA. scoopey@partners.org AN - 23064793 AU - Coopey, S. B. AU - Specht, M. C. AU - Warren, L. AU - Smith, B. L. AU - Winograd, J. M. AU - Fleischmann, K. DA - Apr DO - 10.1245/s10434-012-2678-7 DP - NLM ET - 2012/10/16 IS - 4 KW - Adult Aged Breast Neoplasms/*surgery Female Follow-Up Studies Humans Length of Stay Lymph Node Excision *Mammaplasty *Mastectomy Middle Aged Neoplasm Staging *Nerve Block Pain, Postoperative/*prevention & control Preoperative Care Prognosis Prospective Studies Retrospective Studies Sentinel Lymph Node Biopsy Surgical Flaps Young Adult LA - eng N1 - 1534-4681 Coopey, Suzanne B Specht, Michelle C Warren, Lisa Smith, Barbara L Winograd, Jonathan M Fleischmann, Katharine Journal Article United States Ann Surg Oncol. 2013 Apr;20(4):1282-6. doi: 10.1245/s10434-012-2678-7. Epub 2012 Oct 14. PY - 2013 SN - 1068-9265 SP - 1282-6 ST - Use of preoperative paravertebral block decreases length of stay in patients undergoing mastectomy plus immediate reconstruction T2 - Ann Surg Oncol TI - Use of preoperative paravertebral block decreases length of stay in patients undergoing mastectomy plus immediate reconstruction VL - 20 ID - 12875 ER - TY - JOUR AB - Background: Aesthetic breast augmentation can be fraught with postoperative complications, particularly capsular contracture (CC), skin surface irregularities, and implant or inframammary fold malposition. Similar complications have been addressed successfully in reconstructive breast surgery with acellular dermal matrix (ADM) products.Objective: The authors present their initial experience with porcine ADM (PADM) in aesthetic breast augmentation.Methods: Retrospective chart review was performed for 93 consecutive patients (179 breasts) who underwent revisionary cosmetic breast augmentation with or without mastopexy between May 2009 and September 2012. Porcine ADM (Strattice; Lifecell Corp, Branchburg, New Jersey) was placed bilaterally in 74 patients and unilaterally in 19 patients. All patients were operated upon by 1 surgeon (J.N.P.). Product use description and complications were recorded, including infection, extrusion, CC, and implant malposition.Results: Average follow-up was 12 months (range, 1-39 months). There were 2 major complications (1.6% of breasts): an infection in 1 breast that required implant explantation approximately 2 weeks postoperatively and an extrusion that required PADM removal. Two additional patients had high-riding implants resulting from folded PADM that required revision; both cases were corrected by excising the folded PADM segment. Seven other patients required office procedures to correct minor imperfections. Two CC recurrences were suspected (1 patient) in the 76 breasts that underwent capsulectomy and PADM placement.Conclusions: Porcine ADM demonstrated great utility as an adjunct in revisionary cosmetic breast surgery. The product helped to provide good aesthetic outcomes with low complication rates. Prospective, randomized trials may prove helpful in defining the role of PADM further in these challenging cases. AD - Dr Pozner is an adjunct clinical faculty member in the Department of Plastic Surgery at Cleveland Clinic Florida, Weston, Florida. AN - 104189133. Language: English. Entry Date: 20131108. Revision Date: 20200708. Publication Type: journal article AU - Pozner, Jason N. AU - White, Jeremy B. AU - Newman, Martin I. DB - cin20 DO - 10.1177/1090820X13491279 DP - EBSCOhost IS - 5 KW - Breast Implants -- Adverse Effects Breast Reconstruction -- Adverse Effects Surgery, Reconstructive -- Methods Dermis Adult Aged Animals Prospective Studies Esthetics Female Graft Survival Human Foreign-Body Reaction -- Surgery Breast Reconstruction -- Methods Middle Age Postoperative Complications -- Diagnosis Postoperative Complications -- Surgery Reoperation -- Methods Retrospective Design Risk Assessment Surgical Flaps Swine Treatment Outcomes Young Adult N1 - research. Journal Subset: Biomedical; Mexico & Central/South America; Peer Reviewed. Special Interest: Perioperative Care. NLM UID: 9707469. PMID: NLM23813397. PY - 2013 SN - 1090-820X SP - 681-690 ST - Use of porcine acellular dermal matrix in revisionary cosmetic breast augmentation T2 - Aesthetic Surgery Journal TI - Use of porcine acellular dermal matrix in revisionary cosmetic breast augmentation UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104189133&site=ehost-live&scope=site VL - 33 ID - 770 ER - TY - JOUR AD - [Otterburn, David; Losken, Albert] Emory Div Plast & Reconstruct Surg, Atlanta, GA 30308 USA. Losken, A (corresponding author), Emory Div Plast & Reconstruct Surg, 550 Peachtree St,Suite 84300, Atlanta, GA 30308 USA. albert_losken@emoryhealthcare.org AN - WOS:000265669200068 AU - Otterburn, D. AU - Losken, A. DA - Feb DO - 10.1097/PRS.0b013e31819597d4 IS - 2 J2 - Plast. Reconstr. Surg. KW - breast reconstruction repair Surgery LA - English M3 - Letter N1 - ISI Document Delivery No.: 440AE Times Cited: 9 Cited Reference Count: 9 Otterburn, David Losken, Albert 9 0 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2009 SN - 0032-1052 SP - E74-E76 ST - The Use of Porcine Acellular Dermal Material for TRAM Flap Donor-Site Closure T2 - Plastic and Reconstructive Surgery TI - The Use of Porcine Acellular Dermal Material for TRAM Flap Donor-Site Closure UR - ://WOS:000265669200068 VL - 123 ID - 3328 ER - TY - JOUR AB - PURPOSE: Nipple-areola reconstruction represents an important step for final mammary reconstruction. Many techniques have been described. The drawback is the progressive nipple projection loss with time from 50% to over 70% of the initial projection. In this report, we evaluated the effect of injectable poly-lactic acid (PLLA) to improve projection of reconstructed nipples. RESULTS: We selected 12 patients with a residual nipple projection between 0.1 and 2 mm. The patients were injected locally inside the nipple with 0.5 ml of PLLA (dilution 1:4) every 4 weeks for 4 times. At the study end, patients were satisfied with results. No adverse effects were observed. After one year, an increase of nipple projection ranging from 0.5 to 3.5 mm was obtained with an average increase of 2.3 mm (282%) and this variation was statistically significant (p < 0.0001). CONCLUSION: The use of injectable PLLA is a simple and effective procedure to improve projection of reconstructed nipple. AD - Department of Plastic and Reconstructive Surgery, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy. lucadessy@hotmail.it AN - 21195620 AU - Dessy, L. A. AU - Troccola, A. AU - Ranno, R. L. AU - Maruccia, M. AU - Alfano, C. AU - Onesti, M. G. DA - Jun DO - 10.1016/j.breast.2010.11.010 DP - NLM ET - 2011/01/05 IS - 3 KW - *Absorbable Implants Adult Drug Administration Schedule Female Humans Injections, Subcutaneous *Lactic Acid Mammaplasty/*methods Middle Aged Nipples/*surgery Polyesters *Polymers Prospective Studies Surgical Flaps LA - eng N1 - 1532-3080 Dessy, L A Troccola, A Ranno, R L M Maruccia, M Alfano, C Onesti, M G Clinical Trial Journal Article Netherlands Breast. 2011 Jun;20(3):220-4. doi: 10.1016/j.breast.2010.11.010. Epub 2010 Dec 30. PY - 2011 SN - 0960-9776 SP - 220-4 ST - The use of poly-lactic acid to improve projection of reconstructed nipple T2 - Breast TI - The use of poly-lactic acid to improve projection of reconstructed nipple VL - 20 ID - 10895 ER - TY - JOUR AB - Background: The plasmakinetic cautery is a surgical dissection instrument that combines scalpel-like cutting precision with electrocautery-like haemostasis properties, and operates at lower temperatures (40-170 degrees C) than conventional electrocautery (200-350 degrees C). The aim of this study is to evaluate the clinical benefits of using plasmakinetic cautery in abdominal free flap dissection for breast reconstruction. Methods: Forty women undergoing abdominal-based microsurgical breast reconstruction (DIEP/MSTRAM) were randomized to plasmakinetic cautery (n=20) or conventional electrocautery (n=20) for dissection of the abdominal free flap. Total abdominal wound drainage volume/duration, operation time and complications such as seroma and haematoma were examined. Results: Age, body mass index, type of reconstruction and abdominal flap weight were similar in both groups. Mean abdominal drainage volume was (279 +/- 262) mL in conventional electrocautery group and (294 +/- 265) mL in plasmakinetic cautery group (P=0.853). Plasmakinetic cautery group mean drainage duration (4.3 +/- 2.2 days) was no difference compared to conventional diathermy group (3.8 +/- 2.0 days, P=0.501). Mean operation time in the conventional electrocautery group and plasmakinetic cautery group was 157 +/- 50 vs. 174 +/- 70 min respectively (P=0.195). There was more seroma detected in the conventional electrocautery group compared to plasmakinetic cautery group at days 7, 14 and 42 post-operation, but this was not statically significant. 2 haematomas in conventional diathermy group and I haematoms in the plasmakinetic cautery group required evacuation. Conclusions: This study demonstrates that there are no significant differences between the use of plasmakinetic cautery and conventional electrocautery for abdominal free flap dissection. AD - [Chow, Whitney T. H.; Oni, Georgette; Ramakrishnan, Venkat V.; Griffiths, Mat] Mid Essex Hosp Serv NHS Trust, Broomfield Hosp, St Andrews Ctr Plast Surg & Burns, Chelmsford, Essex, England. Chow, WTH (corresponding author), Mid Essex Hosp Serv NHS Trust, Broomfield Hosp, St Andrews Ctr Plast Surg & Burns, Chelmsford, Essex, England. chowwhitney@yahoo.com AN - WOS:000472011300006 AU - Chow, W. T. H. AU - Oni, G. AU - Ramakrishnan, V. V. AU - Griffiths, M. DA - Jun DO - 10.21037/gs.2018.12.04 IS - 3 J2 - Gland Surg. KW - Breast reconstruction plasmakinetic cautery peak plasmablade abdominal flap dissection breast reconstruction complications seroma inferior epigastric perforator peak plasmablade diep flap complications seroma abdominoplasty electrosurgery ultrasound patient Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: ID9ML Times Cited: 0 Cited Reference Count: 29 Chow, Whitney T. H. Oni, Georgette Ramakrishnan, Venkat V. Griffiths, Mat 0 Ame publ co Shatin 2227-8575 PY - 2019 SN - 2227-684X SP - 242-248 ST - The use of plasmakinetic cautery compared to conventional electrocautery for dissection of abdominal free flap for breast reconstruction: single-centre, randomized controlled study T2 - Gland Surgery TI - The use of plasmakinetic cautery compared to conventional electrocautery for dissection of abdominal free flap for breast reconstruction: single-centre, randomized controlled study UR - ://WOS:000472011300006 VL - 8 ID - 1374 ER - TY - JOUR AB - A perforator-based fasciocutaneous flap is an alternative type of flap for pressure sore reconstruction. The aim of the present study was to determine whether a single-perforator-based flap or a multiple-perforator-based flap is better for pressure sore reconstruction. We reviewed the general data and postoperative complications in patients who received single-perforator-based or multiple-perforator-based fasciocutaneous flaps for pressure sore reconstruction between July 2009 and July 2012. No differences in general data, comorbidities, wound locations, flap sizes (73.9 vs. 67.0 cm(2), P = 0.455), and operative times were noted between the single-perforator-based and multiple-perforator-based flap groups. The flap rotation arc was larger in the single-perforator-based flap group than in the multiple-perforator-based flap group; however, the difference in the rotation arc was not significant (99.2A degrees vs. 55.5A degrees, respectively; P = 0.199). Two patients had total flap necrosis and one had partial flap necrosis in the single-perforator-based flap group. None of flap necrosis was noted in the multiple-perforator-based flap group; however, no significant differences in major complications were noted between the two groups. All donor sites underwent primary closure. This is the first clinical patient-matched research that considered the number of perforators and the rotation arc in applying perforator-based fasciocutaneous flaps in wound reconstruction. The results showed that the number of perforators is not the determinant factor of surgical outcome of the use of perforator-based fasciocutaneous flaps in pressure sore reconstruction. Thus, whether a single- or a multiple-perforator-based fasciocutaneous flap is used for flap perfusion does not jeopardize the operation. These results emphasize the reliability and convenience of using freestyle design of perforator-based flaps for pressure sore reconstruction. The design and clinical utility of the flaps have the advantage of being versatile. AD - [Lin, Chih-Hsun; Ma, Hsu] Taipei Vet Gen Hosp, Div Plast Surg, Dept Surg, 19F,201,Sec 2,Linong St, Taipei 112, Taiwan. [Lin, Chih-Hsun; Ma, Hsu] Natl Yang Ming Univ, Taipei, Taiwan. Lin, CH (corresponding author), Taipei Vet Gen Hosp, Div Plast Surg, Dept Surg, 19F,201,Sec 2,Linong St, Taipei 112, Taiwan.; Lin, CH (corresponding author), Natl Yang Ming Univ, Taipei, Taiwan. linchihhsun640305@gmail.com AN - WOS:000379523000015 AU - Lin, C. H. AU - Ma, H. DA - Aug DO - 10.1007/s00266-016-0662-5 IS - 4 J2 - Aesthet. Plast. Surg. KW - Perforator Perforasome Pressure sore Fasciocutaneous flap indocyanine green angiography soft-tissue defects y advancement flap breast reconstruction propeller flaps island flap computed-tomography forearm flap rat model free tram Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: DQ9IG Times Cited: 2 Cited Reference Count: 55 Lin, Chih-Hsun Ma, Hsu 3 0 7 Springer New york 1432-5241 PY - 2016 SN - 0364-216X SP - 540-548 ST - Use of Perforator-Based Fasciocutaneous Flaps for Pressure Sore Reconstruction: Single-Perforator-Based Versus Multiple-Perforator-Based Flaps T2 - Aesthetic Plastic Surgery TI - Use of Perforator-Based Fasciocutaneous Flaps for Pressure Sore Reconstruction: Single-Perforator-Based Versus Multiple-Perforator-Based Flaps UR - ://WOS:000379523000015 VL - 40 ID - 1978 ER - TY - JOUR AB - Over the last few years autologous breast reconstruction has become an important issue in the field of oncological surgery. At present, among the many different techniques, microvascular free flaps are recognized as a golden standard for postmastectomy reconstruction. Recently the use of flaps based on deep inferior epigastric and superior gluteal perforators is becoming more frequent and is commonly used for both uni- and bilateral breast restoration. Nevertheless, the choice between different microvascular reconstructive methods is still a matter of discussion. Basing upon our own experience with 76 free flaps we present three cases of different microvascluar techniques for bilateral breast reconstruction. We present and discuss the technical details regarding planning and together with the postoperative results and a quality of life analysis. AD - A. Maciejewski, Klinika Chirurgii Onkologicznej I Rekonstrukcyjnej, Centrum Onkologii - Instytut Im. Marii Skłodowskiej-Curie Oddział W Gliwicach, ul. Wybrzeze Armii Krajowej 15, 44-101 Gliwice, Poland AU - Maciejewski, A. AU - Dobrut, M. AU - Szumniak, R. AU - Wierzgoń, J. AU - Półtorak, S. AU - Grajek, M. DB - Embase IS - 4 KW - article breast cancer breast reconstruction gold standard human mastectomy perforator flap postoperative period quality of life surgical technique LA - Polish M3 - Article N1 - L355459833 2009-12-25 PY - 2009 SN - 0029-540X SP - 274-279 ST - The use of perforator free flaps (DIEP, SGAP) in bilateral breast reconstruction after different types of mastectomy. Cases presentation T2 - Nowotwory TI - The use of perforator free flaps (DIEP, SGAP) in bilateral breast reconstruction after different types of mastectomy. Cases presentation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355459833&from=export VL - 59 ID - 7625 ER - TY - BOOK A2 - Germann, G. AB - The convincing principle of the perforator flaps revolutionized breast reconstruction in the early 90's by the introduction of the DIEP-Flap by Allen(1) in 1992 and the S-GAP Flap(2) in 1993. The meticulous dissection of the perforator through the muscle reduces the harvesting defect to a minimum without muscle sacrifice. This offers an acceptable harvesting defect with no risk for herniation, abdominal wall weakness(3) nor reduced muscle strength and prolonged hospital stay(4). Besides these well known standard advantages of the perforator flaps we arc describing four further major advantages: a long pedicle, a large flap, a long-time soft and pliable tissue transplantation and a high tolerance for secondary revisions i.e. liposuction, Z-plastics or flap thinning. Therefore, it is a logical conclusion to use this advantage in comparison to conventional musculocutaneous flaps and to expand the indication for perforator flaps. We arc presenting a series of posttraumatic and postoncologic reconstructive options of the head, face, upper and lower extremities. AD - Univ Hosp Aachen, Dept Plast & Reconstruct Surg, Handsurg Burn Unit, Aachen, Germany. Heitland, A (corresponding author), Univ Hosp Aachen, Dept Plast & Reconstruct Surg, Handsurg Burn Unit, Aachen, Germany. AN - WOS:000184079700041 AU - Heitland, A. AU - Noah, E. M. AU - Allen, R. AU - Pallua, N. CY - 40128 Bologna LA - English N1 - ISI Document Delivery No.: BX04W Times Cited: 0 Cited Reference Count: 4 Heitland, A Noah, EM Allen, R Pallua, N Proceedings Paper 2nd Congress of the World-Society-for-Reconstructive-Microsurgery Jun 11-14, 2003 Heidelberg, germany World Soc Reconstruct Microsurg Via maserati 5, 40128 bologna, 00000, italy PB - Medimond S R L PY - 2003 SN - 88-323-3134-9 SP - 185-189 ST - The use of perforator flaps in huge postoncotic and posttraumatic defects - Considerable new indications for the DIEP-flap? T2 - Proceedings of the Ii Congress of the World Society for Reconstructive Microsurgery TI - The use of perforator flaps in huge postoncotic and posttraumatic defects - Considerable new indications for the DIEP-flap? UR - ://WOS:000184079700041 ID - 3918 ER - TY - JOUR AB - Introduction Breast cancer is the most frequent neoplasia affecting women worldwide. After mastectomy for breast cancer, autologous tissue breast reconstruction offers better long-term results. The use of abdominal free flaps has shown to be an adequate option. Aim We report a series of cases of deep inferior epigastric perforator flap (DIEP flap) and superficial inferior epigastric artery flap reconstructions. Patients and methods We describe 21 patients with breast reconstruction using DIEP flap and 3 cases of SIEA flap in CLC between 2007 and 2012. Results 24 patients underwent the procedure with an age range of 48 to 60 years; 18 patients underwent a unilateral reconstruction and 3 patients bilateral reconstructions with DIEP flaps; 3 patients underwent unilateral breast reconstruction with SIEA flap. Mean operative time was 6,5 h and mean hospitalization was 6 days. In one bilateral reconstruction the left flap was lost, which required a second free flap reconstruction. Discussion In our experience, microvascular breast reconstruction using perforator flaps has a low morbidity. As described in the literature, this is a valid alternative in selected patients. AD - J.A. Conejero, Departamento de Cirugía Plástica, Clínica Las Condes (CLC), Santiago, Chile AU - Conejero, J. A. AU - Benítez S, S. AU - Guridi G, R. AU - Arriagada I, C. DB - Embase DO - 10.1016/j.rchic.2016.05.005 IS - 6 KW - abdomen adult breast reconstruction case study clinical article deep inferior epigastric perforator flap hospitalization human middle aged morbidity perforator flap superficial inferior epigastric artery flap LA - English Spanish M3 - Article N1 - L613930820 2017-01-09 PY - 2016 SN - 0718-4026 0379-3893 SP - 440-445 ST - Use of perforator flaps from the lower abdomen (DIEP and SIEA) for breast reconstruction T2 - Revista Chilena de Cirugia TI - Use of perforator flaps from the lower abdomen (DIEP and SIEA) for breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613930820&from=export http://dx.doi.org/10.1016/j.rchic.2016.05.005 VL - 68 ID - 5882 ER - TY - JOUR AB - Background: Despite advances in reconstruction techniques, sacral defects continue to challenge surgeons. The perforator flap preserves the entire contralateral side as a future flap donor site and the gluteal muscle itself on the ipsilateral side to minimize donor-site morbidity. Materials and Methods: Between April 2003 and March 2013, data obtained from 60 patients with sacral defects reconstructed with perforator flaps were retrospectively analyzed. Results: We analyzed the sacral defects reconstructed with three different perforator flaps into the following groups: group 1, 30 patients with superior gluteal artery perforator flaps, (average flap size was 83.8 cm(2)); Group 2, 19 patients with parasacral perforator flaps (average flap size was 94.2 cm(2)); and Group 3, 11 patients with inferior gluteal artery perforator flaps (average flap size was 85.8 cm(2)). The overall flap survival rate was 93.3% (56/60). Conclusion: Perforator flaps are a reliable option for soft-tissue defect reconstruction as they provide a sufficient amount of tissue to cover large sacral defects. We recommend perforator flaps as a viable alternative in the management of sacral defects that cannot be reconstructed with primary closure or local fasciocutaneous flaps. AD - [Chiao, Hao-Yu; Chou, Chang-Yi; Tzeng, Yuan-Sheng; Chen, Shyi-Gen; Lin, Chin-Ta] Triserv Gen Hosp, Natl Def Med Ctr, Div Plast & Reconstruct Surg, Dept Surg, Taipei, Taiwan. [Chang, Shun-Cheng] Taipei Med Univ, Shuang Ho Hosp, Div Plast & Reconstruct Surg, Hyperbar Oxygen Therapy Ctr,Dept Surg, Taipei, Taiwan. Lin, CT (corresponding author), Triserv Gen Hosp, Natl Def Med Ctr, Div Plast & Reconstruct Surg, Dept Surg, Taipei, Taiwan. arrondakimo@yahoo.com.tw AN - WOS:000442747000002 AU - Chiao, H. Y. AU - Chang, S. C. AU - Chou, C. Y. AU - Tzeng, Y. S. AU - Chen, S. G. AU - Lin, C. T. DA - Jul-Aug DO - 10.4103/fjs.fjs_71_17 IS - 4 J2 - Formos. J. Surg. KW - Perforator flap pressure ulcer reconstruction sacral defect inferior gluteal artery y advancement flap pressure sores breast reconstruction superior coverage repair surgery Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: GR6HB Times Cited: 0 Cited Reference Count: 24 Chiao, Hao-Yu Chang, Shun-Cheng Chou, Chang-Yi Tzeng, Yuan-Sheng Chen, Shyi-Gen Lin, Chin-Ta Tzeng, Yuan-sheng/AAD-8843-2020 Tzeng, Yuan-sheng/0000-0002-8440-2351 Civilian Administration Division of Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan [TSGH-C106-165] This work was supported by the Civilian Administration Division of Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (TSGH-C106-165). 0 Wolters kluwer medknow publications Mumbai 2213-5413 PY - 2018 SN - 1682-606X SP - 142-147 ST - The use of perforator flaps for the reconstruction of sacral defects: Ten-year experience T2 - Formosan Journal of Surgery TI - The use of perforator flaps for the reconstruction of sacral defects: Ten-year experience UR - ://WOS:000442747000002 VL - 51 ID - 1582 ER - TY - JOUR AB - Coverage of the skin and soft tissue defects after mastectomy may constitute a significant problem. Although there are several options, none of them is ideal. Pedicled transverse rectus abdominis musculocutaneous flap (TRAM) has been criticized for its high complication rate of flap necrosis and fat necrosis. In this study we analysed the results of pedicled contra lateral TRAM flap used in 13 patients with breast cancer in whom primary closure of skin defects was impossible. Only one patient developed partial flap necrosis, none developed complete necrosis or fat necrosis. The results of this study were favourably influenced by good selection criteria, measures against hypothermia, conservative policy of blood transfusion. Excision of fat deep to Scarpa's fascia in zone 3 is thought to be essential in preventing partial flap necrosis and fat necrosis. In conclusion, pedicled contra lateral TRAM flap is a reliable method for coverage of large mastectomy skin and soft tissue defects. AD - J.K. Al Masad, Jordan University Hospital, P.O. Box 13046, Amman 11942, Jordan AU - Al Masad, J. K. DB - Embase IS - 1 KW - adult aged article breast cancer clinical article female human myocutaneous flap plastic surgery priority journal LA - English M3 - Article N1 - L26132427 1996-05-14 PY - 1996 SN - 0392-9078 SP - 59-65 ST - The use of pedicled transverse rectus abdominis myocutaneous (TRAM) flap to cover large post-mastectomy defects T2 - Journal of Experimental and Clinical Cancer Research TI - The use of pedicled transverse rectus abdominis myocutaneous (TRAM) flap to cover large post-mastectomy defects UR - https://www.embase.com/search/results?subaction=viewrecord&id=L26132427&from=export VL - 15 ID - 8763 ER - TY - JOUR AB - The predicled TRAM flap based on superior epigastric artery is very safe and reliable flap which provides sufficient autologous tissue for natural breast reconstruction. Depending on quantity of abdominal tissue used for the reconstruction, the breast can be sufficiently large and ptotic to achieve symmetry in a single operative procedure. The importance of appropriate patient selection should never be underestimated, especially in risky patients like heavy smokers, those with previous vascular diseases or heavy scarring of the abdominal wall, where delayed procedure is strongly indicated. Adequate patient selection, preoperative management, monitoring of the flap and routine postoperative care with oxygenation, together with the selection of proven surgical technique is the key for the safety of the procedure and reduced patient morbidity. AD - M.M. Colić, Clinic for Burns, Plastic and Reconstructive Surgery, Belgrade University School of Med., Bul. Kralja Aleksandra 280, 11000 Belgrade, Yugoslavia AU - Colić, M. M. AU - Colić, M. M. DB - Embase Medline IS - 1 KW - oxygen abdomen abdominal wall article breast reconstruction breast surgery controlled study epigastric artery female high risk patient human human tissue monitoring morbidity muscle flap oxygenation patient selection postoperative care preoperative evaluation rectus abdominis muscle reliability safety scar formation smoking surgical technique vascular lesion LA - English M3 - Article N1 - L32421952 2001-05-21 PY - 2001 SN - 0001-5423 SP - 7-10 ST - The use of pedicled tram flap for delayed breast reconstruction T2 - Acta Chirurgiae Plasticae TI - The use of pedicled tram flap for delayed breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L32421952&from=export VL - 43 ID - 8464 ER - TY - BOOK A2 - Abe, O. A2 - Inokuchi, K. A2 - Takasaki, K. AB - The pedicled TRAM flap based on superior epigastric artery is very safe and reliable flap which provides sufficient autologous tissue for natural breast reconstruction. Depending on quantity of abdominal tissue used for the reconstruction, the breast can be sufficiently large and ptotic to achieve symmetry in a single operative procedure. The importance of appropriate patient selection should never be underestimated, especially in risky patients like heavy smokers, those with previous vascular deseases or heavy scarring of the abdominal wall, where delayed procedure is strongly indicated. Adequate patient selection, preoperative management, monitoring of the flap and routine postoperative care with oxygenation, together with the selection of proven surgical technique is the key for the safety of the procedure and reduced patient morbidity. AD - Colic, M (corresponding author), UNIV BELGRADE, CLIN BURNS PLAST & RECONSTRUCT SURG, KARNEGIJEVA 4, BELGRADE, SERBIA. AN - WOS:A1996BH12F00295 AU - Colic, M. CY - 40128 Bologna LA - English N1 - ISI Document Delivery No.: BH12F Times Cited: 0 Cited Reference Count: 0 Colic, M Proceedings Paper XXXth Biennial Congress of the International-College-of-Surgeons Nov 25-29, 1996 Kyoto, japan Int Coll Surgeons, Int Coll Surgeons, Japanese Sect, Sci Council Japan, Japan Surg Soc Via maserati 5, 40128 bologna, 00000, italy PB - Medimond S R L PY - 1996 SN - 88-323-1125-9 SP - 1629-1635 ST - The use of pedicled TRAM flap for delayed breast reconstruction T2 - Xxx World Congress of the International College of Surgeons, Vols 1-2 TI - The use of pedicled TRAM flap for delayed breast reconstruction UR - ://WOS:A1996BH12F00295 ID - 4279 ER - TY - JOUR AB - Background In recent years, pedicled perforator flaps have revolutionized plastic surgery by reducing donor site morbidity and ensuring larger and deeper reconstructions with local pedicled cutaneous flaps. The aim of the study was to make a systematic review of perforator pedicled propeller flaps (PPPFs) in chest reconstruction. Methods Pubmed and Cochrane databases were searched from 1989 to October 2016 for articles describing the use of PPPFs in chest reconstruction. The preferred reporting items for systematic reviews and meta analyses statement was used in the selection process. The review was registered on international prospective register of systematic reviews. Furthermore, operative technique, indications and complications were searched. Results Twenty-four articles were selected (174 patients and 182 flaps). Oncological surgery was the first etiology (34.5%), followed by infections (11.5%), chest keloid scars (6.23%), malformations (4.6%), burns (3.4%), chronic ulcers (2.3%), Verneuil disease (1.8%), and acute wounds (1.8%). The arc of rotation was between 90 degrees and 120 degrees in 24.2%. The mean surface of flaps was 127.45 123.11 cm(2). Dissection was subfascial in 78.5% of the cases. Complications were found in 9.9% of patients and included mainly wound dehiscence (4.4%) and hematoma/seroma (2.2%). One case of total necrosis (0.5%) and 2 cases of partial necrosis (1.1%) were found. Conclusions The possibility of numerous pedicles makes it possible for PPPFs to offset most areas of wall chest defects. Furthermore, this surgical technique is reliable and reproducible, with lower donor site morbidity than that in the case of muscular flaps, which are classically used in this location. AD - [Florczak, Anne-Sophie; Rousseau, Pascal] Univ Hosp, Dept Plast Reconstruct & Aesthet Surg, Angers, France. [Chaput, Benoit] Hop Rangueil, Dept Plast Reconstruct & Aesthet Surg, Toulouse, France. [Chaput, Benoit] Hop Rangueil, CNRS, STROMAlab, UPS,EFS,INSERM,UMR5273,U1031, Toulouse, France. [Herlin, Christian] CHRU Montpellier, Dept Plast & Reconstruct Surg, Burns Unit, Montpellier, France. [Watier, Eric; Bertheuil, Nicolas] Univ Rennes 1, South Hosp, Dept Plast Reconstruct & Aesthet Surg, Rennes, France. [Bertheuil, Nicolas] Rennes Univ Hosp, SITI Lab, Rennes, France. Florczak, AS (corresponding author), Univ Hosp, Plast & Reconstruct Surg, Rue Larrey, F-49000 Angers, France. annsomafl@hotmail.com AN - WOS:000445207900023 AU - Florczak, A. S. AU - Chaput, B. AU - Herlin, C. AU - Rousseau, P. AU - Watier, E. AU - Bertheuil, N. DA - Oct DO - 10.1097/sap.0000000000001466 IS - 4 J2 - Ann. Plast. Surg. KW - chest reconstruction propeller flap perforator flap complications soft-tissue defects propeller flap breast reconstruction trunk reconstruction clinical-application wall reconstruction myocutaneous flap resection complications management Surgery LA - English M3 - Review N1 - ISI Document Delivery No.: GU3VK Times Cited: 6 Cited Reference Count: 59 Florczak, Anne-Sophie Chaput, Benoit Herlin, Christian Rousseau, Pascal Watier, Eric Bertheuil, Nicolas CHAPUT, benoit/0000-0002-8567-3479 6 0 1 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2018 SN - 0148-7043 SP - 487-494 ST - The Use of Pedicled Perforator Flaps in Chest Reconstruction: A Systematic Review of Outcomes and Reliability T2 - Annals of Plastic Surgery TI - The Use of Pedicled Perforator Flaps in Chest Reconstruction: A Systematic Review of Outcomes and Reliability UR - ://WOS:000445207900023 VL - 81 ID - 1527 ER - TY - JOUR AD - Melbourne Institute of Plastic Surgery, Department of Anatomy, Monash University,Melbourne, Australia. ram_silfen@hotmail.com AN - 16641711 AU - Silfen, R. AU - Ritz, M. AU - Southwick, G. DA - Apr 15 DO - 10.1097/01.prs.0000206316.15410.8e DP - NLM ET - 2006/04/28 IS - 5 KW - Humans Male Mammaplasty/*methods Middle Aged Nipples/surgery *Surgical Flaps Tattooing LA - eng N1 - 1529-4242 Silfen, Ram Ritz, Morris Southwick, Graeme Case Reports Journal Article United States Plast Reconstr Surg. 2006 Apr 15;117(5):1447-51; discussion 1452-4. doi: 10.1097/01.prs.0000206316.15410.8e. PY - 2006 SN - 0032-1052 SP - 1447-51; discussion 1452-4 ST - Use of pedicled local flaps for male chest augmentation and reshaping T2 - Plast Reconstr Surg TI - Use of pedicled local flaps for male chest augmentation and reshaping VL - 117 ID - 10077 ER - TY - JOUR AN - 13088309 AU - Maliniac, J. W. DA - Aug DO - 10.1097/00006534-195308000-00003 DP - NLM ET - 1953/08/01 IS - 2 KW - Breast/*surgery Female Humans *Mammaplasty *Mastectomy *Surgical Flaps *BREAST/surgery LA - eng N1 - Maliniac, j w Journal Article United States Plast Reconstr Surg (1946). 1953 Aug;12(2):110-5. doi: 10.1097/00006534-195308000-00003. PY - 1953 SN - 1075-1270 (Print) 1075-1270 SP - 110-5 ST - Use of pedicle dermofat flap in mammaplasty T2 - Plast Reconstr Surg (1946) TI - Use of pedicle dermofat flap in mammaplasty VL - 12 ID - 9647 ER - TY - JOUR AB - A technique is described in which the pectoralis minor muscle is rotated as a muscle pedicle flap to be used in immediate reconstruction of the breast. The advantages of this procedure are that it provides additional muscle coverage over the prosthesis as well as preventing lateral displacement. Seven patients have undergone this technique with excellent results. AN - 4034775 AU - Manstein, C. H. AU - Manstein, G. AU - Somers, R. G. AU - Barwick, W. J. DA - Oct DO - 10.1097/00006534-198510000-00015 DP - NLM ET - 1985/10/01 IS - 4 KW - Breast Neoplasms/*surgery Carcinoma/*surgery Female Humans Pectoralis Muscles/anatomy & histology/*transplantation Prostheses and Implants Surgery, Plastic Surgical Flaps LA - eng N1 - Manstein, C H Manstein, G Somers, R G Barwick, W J Journal Article United States Plast Reconstr Surg. 1985 Oct;76(4):566-9. doi: 10.1097/00006534-198510000-00015. PY - 1985 SN - 0032-1052 (Print) 0032-1052 SP - 566-9 ST - Use of pectoralis minor muscle in immediate reconstruction of the breast T2 - Plast Reconstr Surg TI - Use of pectoralis minor muscle in immediate reconstruction of the breast VL - 76 ID - 13596 ER - TY - JOUR AB - Treatment of breast cancer has undergone a major change with breast conservation surgery (consisting of lumpectomy and axillary dissection or sentilel lymph node biopsy) and forms a major proportion of the total number of surgeries. To give an aesthetically pleasing breast after surgery has been a challenge and various techniques to fill the breast defect or to reconstruct the partial mastectomy defect are already in practice like local wedge closure, local tissue rearrangement, local advancement flap, thoracodorsal perforator flap, latissmus dorsi flap, silicone implant, reduction mammoplasty, etc. In this article we present the use of pectoralis major muscle with or without pectoralis minor muscle as an innovation, to fill the lumpectomy defects in the upper quadrants of the breast. Ten patients with breast cancer in whom the cancer was between 2 and 4 cm were identified for the study, the prerequisite being that the tumor should be present in the upper quadrants of the breast. Patients with severe ptosis (grade 3) were excluded from the study. After lumpectomy was carried out, using the same incision, pectoralis major muscle flap was harvested based on thoraco-acromian pedicle, rolled over like a ball and used to fill the defect. Pectoralis minor muscle flap was supplemented in 2 patients where additional volume was required. All patients received standard protocol for breast cancer. The postoperative cosmesis was judged by 3 independent judges using visual analogue scale at the end of 9 months. The average tumor size was 2.86 cm. Out of 10 patients in whom it was done, good cosmesis was achieved in 9. The average visual analogue scale score was 87.8. The average operative time was 126 minutes and the hospital stay was 3.5 days. No patient had any flap necrosis. One patient had minor wound infection. None of the patients had positive surgical margin for malignancy. The technique, advantages, limitation, and further scope of this innovation have been dealt in the article. In our opinion this would be a very important armamentarium for the plastic surgeons involved in breast reconstruction. AD - [Manaswi, Anshuman] Bombay Hosp & Med Res Ctr, Dept Plast Surg, Bombay, Maharashtra, India. [Mehrotra, Neelu] Jawaharlal Nehru Canc Hosp & Res Ctr, Dept Surg, Bhopal, India. Manaswi, A (corresponding author), A-403 Krishna Palace,Thakur Complex, Bombay 400101, Maharashtra, India. dramanaswi@yahoo.com AN - WOS:000279246300007 AU - Manaswi, A. AU - Mehrotra, N. DA - Jul DO - 10.1097/SAP.0b013e3181bba07c IS - 1 J2 - Ann. Plast. Surg. KW - pectoralis major pectoralis minor lumpectomy breast reconstruction immediate reconstruction conserving therapy latissimus-dorsi surgery mastectomy algorithm defects Surgery LA - English M3 - Article; Proceedings Paper N1 - ISI Document Delivery No.: 616YB Times Cited: 7 Cited Reference Count: 13 Manaswi, Anshuman Mehrotra, Neelu 9th Asian-Pacific Congress of the International Confederation of Plastic, Reconstructive and Aesthetic Surgery 2005 Bombay, INDIA 7 0 Lippincott williams & wilkins Philadelphia PY - 2010 SN - 0148-7043 SP - 23-27 ST - Use of Pectoralis Major With or Without Pectoralis Minor Muscle Flap to Fill Lumpectomy in the Breast T2 - Annals of Plastic Surgery TI - Use of Pectoralis Major With or Without Pectoralis Minor Muscle Flap to Fill Lumpectomy in the Breast UR - ://WOS:000279246300007 VL - 65 ID - 3071 ER - TY - JOUR AB - Background: The National Surgical Quality Improvement Program (NSQIP) and the Tracking Operations and Outcomes for Plastic Surgeons (TOPS) registries gather outcomes for plastic surgery procedures. The NSQIP collects hospital data using trained nurses, and the TOPS relies on self-reported data. We endeavored to compare the TOPS and NSQIP data sets with respect to cohort characteristics and outcomes to better understand the strengths and weakness of each registry as afforded by their distinct data collection methods. Study Design: The 2008 to 2011 TOPS and NSQIP databases were queried for breast reductions and breast reconstructions. Propensity score matching identified similar cohorts from the TOPS and NSQIP databases. Shared 30-day surgical and medical complications rates were compared across matched cohorts. Results: The TOPS captured a significantly greater number of wound dehiscence occurrences (4.77%-5.47% vs 0.69%-1.17%, all P < 0.001), as well as more reconstructive failures after prosthetic reconstruction (2.82% vs 0.26%, P < 0.001). Medical complications were greater in NSQIP (P < 0.05). Other complication rates did not differ across any procedure (all P > 0.05). Conclusions: The TOPS and NSQIP capture significantly different patient populations, with TOPS' self-reported data allowing for the inclusion of private practices. This self-reporting limits TOPS' ability to identify medical complications; surgical complications and readmissions, however, were not underreported. Many surgical complications are captured by TOPS at a higher rate due to its broader definitions, and others are not captured by NSQIP at all. The TOPS and NSQIP provide complementary information with different strengths and weakness that together can guide evidence-based decision making in plastic surgery. AD - [Khavanin, Nima; Mlodinow, Alexei S.; Mayer, Kristen E.; Kim, John Y. S.] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA. [Gutowski, Karol A.] Ohio State Univ, Dept Plast Surg, Columbus, OH 43210 USA. [Hume, Keith M.; Simmons, Christopher J.] Amer Soc Plast Surg, Chicago, IL USA. [Weiss, Michael; Murphy, Robert X., Jr.] Lehigh Valley Hlth Network, Allentown, PA USA. Kim, JYS (corresponding author), Northwestern Univ, Feinberg Sch Med, Div Plast & Reconstruct Surg, 675 North St Clair St,Galter Suite 19-250, Chicago, IL 60611 USA. jokim@nmh.org AN - WOS:000348146100005 AU - Khavanin, N. AU - Gutowski, K. A. AU - Hume, K. M. AU - Simmons, C. J. AU - Mlodinow, A. S. AU - Weiss, M. AU - Mayer, K. E. AU - Murphy, R. X. AU - Kim, J. Y. S. DA - Feb DO - 10.1097/sap.0000000000000383 IS - 2 J2 - Ann. Plast. Surg. KW - breast surgery patient registry NSQIP TOPS breast reduction breast reconstruction TRAM latissimus free flap tissue expander free tram flap american-college complication rates reconstruction nsqip Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: AZ3SD Times Cited: 18 Cited Reference Count: 27 Khavanin, Nima Gutowski, Karol A. Hume, Keith M. Simmons, Christopher J. Mlodinow, Alexei S. Weiss, Michael Mayer, Kristen E. Murphy, Robert X., Jr. Kim, John Y. S. Mlodinow, Alexei/0000-0002-4700-9462 Musculoskeletal Transplant Foundation John Y.S. Kim receives research funding and is on the advisory board for the Musculoskeletal Transplant Foundation. Keith M. Hume and Christopher J. Simmons are employed by the American Society of Plastic Surgeons (ASPS). Robert X. Murphy, Jr, is the current president of the ASPS. All other authors have no relevant relationships to disclose. 18 0 2 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2015 SN - 0148-7043 SP - 157-162 ST - The Use of Patient Registries in Breast Surgery A Comparison of the Tracking Operations and Outcomes for Plastic Surgeons and National Surgical Quality Improvement Program Data Sets T2 - Annals of Plastic Surgery TI - The Use of Patient Registries in Breast Surgery A Comparison of the Tracking Operations and Outcomes for Plastic Surgeons and National Surgical Quality Improvement Program Data Sets UR - ://WOS:000348146100005 VL - 74 ID - 2304 ER - TY - JOUR AB - Abstract: The application of oncoplastic techniques to breast conservation therapy (BCT) is thought to improve cosmetic results with some documented oncologic advantages in certain patients. Although present data highlight the oncologic safety of this approach, the role of oncoplastic surgery specific to ductal carcinoma in situ (DCIS) has not been elucidated. In this study, all women in the Emory Healthcare system between January 1991 and June 2006 with biopsy-proven DCIS who underwent lumpectomies combined with simultaneous reduction mammaplasties or mastopexies were identified. Medical records, including office notes, operative and pathology reports were analyzed. Parameters included age, BMI, histologic grade (low, intermediate, high) and type (comedo versus non-comedo) of DCIS, margin status, locoregional recurrence, specimen weight, postoperative complications, and overall outcomes. Pedicle design and contralateral breast pathology were also analyzed. Twenty-eight women were included in the study with an average age of 47. Therapeutic mammaplasty was the definitive procedure for 18 (64%) of these patients. Ten patients (36%) required reoperations: nine for positive margins and one for residual microcalcifications (stereo biopsy DCIS). Overall, seven patients (25%) required completion mastectomy with reconstruction (transverse rectus abdominus myocutaneous flap: n = 3, latissimus flap: n = 4), whereas three patients (11%) underwent re-excisions with confirmation of negative margins. All ten women who required completion mastectomy or re-excisions exhibited either intermediate or high-grade, comedo DCIS. Overall, 50% (6/12) of women diagnosed with high-grade comedo DCIS required completion mastectomy with reconstruction after initial therapeutic mammaplasty. The final positive-margin rate for women diagnosed with intermediate-grade, comedo necrosis was 43% (3/7). The women in this failed group that required reoperations were overall younger (mean: 45.6; median: 43) than those in which oncoplastic surgery was the definitive procedure (mean: 57.8; median: 57). There were no significant differences between the failed and successful groups in terms of biopsy weight (failed: 253 g, successful: 237 g), type of excision (e.g., wire-localized), location of tumor, reduction type (e.g., superior medial), or postoperative complications. There was one case of locoregional recurrence of DCIS 7 months after the initial operation. All 28 patients had no evidence of disease at an average follow-up of 2.7 years. This study suggests that although oncoplastic reduction techniques are a reasonable approach for women with DCIS, stricter patient selection and improved confirmation of negative margins will minimize the need for either re-excisions or completion mastectomy and reconstruction. AN - RN267381214 AU - Song, H. M. AU - Styblo, T. M. AU - Carlson, G. W. AU - Losken, A. CN - 618.19 RC280 2277.494100 LA - English N1 - Bi-monthly: 5-8 issues per year United States Blackwell Publishing Ltd PY - 2010 SN - 1075-122X SP - 141 - 146 ST - The Use of Oncoplastic Reduction Techniques to Reconstruct Partial Mastectomy Defects in Women with Ductal Carcinoma In Situ T2 - Breast Journal TI - The Use of Oncoplastic Reduction Techniques to Reconstruct Partial Mastectomy Defects in Women with Ductal Carcinoma In Situ VL - 16, NUMB 2 ID - 202 ER - TY - JOUR AB - BACKGROUND: The extended latissimus dorsi (LD) flap has become a preferred method of breast reconstruction. However, donor site seroma is the most common complication of LD flap reconstruction. The purpose of this study was to investigate the effectiveness of OK-432 on postoperative drainage and seroma formation in the site of the LD myocutaneous flap donor site. METHODS: A retrospective study was conducted on 49 patients who underwent immediate breast reconstruction with extended LD flaps between July 2008 and September 2013. The patients received either OK-432 (OK-432 group, n = 24) or not (control group, n = 25) in the extended LD donor site. Outcome measures were obtained from the incidence and volume of postoperative seroma, total volume of back drains, the total drainage, indwelling period of drainage, and frequency of aspiration. RESULTS: There were no statistically significant differences between the two groups in terms of age, body mass index, and flap size. The incidence of seroma was 41.7% in the OK-432 group and 72% in the control group (P = 0.032). There were also significant reductions in volume of postoperative seroma (P = 0.021), total drainage volume (P < 0.001), total volume of back drains (P < 0.001), indwelling period of drainage (P = 0.004), and frequency of aspiration (P = 0.008). CONCLUSIONS: The use of OK-432 is a feasible option for the reduction or prevention of seroma formation at the donor site in patients undergoing immediate breast reconstruction using a LD myocutaneous flap for breast cancer. AD - Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China; Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China. Electronic address: lancetyang@126.com. Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China. Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China. Electronic address: docpanyf@126.com. AN - 25201573 AU - Yang, Y. AU - Chen, Y. AU - Qu, J. AU - Zhang, X. AU - Pan, Y. DA - Jan DO - 10.1016/j.jss.2014.08.010 DP - NLM ET - 2014/09/10 IS - 1 KW - Adult Antineoplastic Agents/administration & dosage Drainage/methods Female Humans Mammaplasty/*adverse effects/*methods Middle Aged Picibanil/*administration & dosage Retrospective Studies Seroma/*etiology/*prevention & control Superficial Back Muscles/surgery *Surgical Flaps Treatment Outcome Breast reconstruction Latissimus dorsi Ok-432 Seroma LA - eng N1 - 1095-8673 Yang, Yinlong Chen, Yizuo Qu, Jinmiao Zhang, Xiaohua Pan, Yifei Journal Article United States J Surg Res. 2015 Jan;193(1):492-6. doi: 10.1016/j.jss.2014.08.010. Epub 2014 Aug 12. PY - 2015 SN - 0022-4804 SP - 492-6 ST - The use of OK-432 to prevent seroma in extended latissimus dorsi flap donor site after breast reconstruction T2 - J Surg Res TI - The use of OK-432 to prevent seroma in extended latissimus dorsi flap donor site after breast reconstruction VL - 193 ID - 13090 ER - TY - JOUR AD - Plastic Surgery Department, Royal London Hospital, London E1 1BB, UK. Electronic address: lillicooper@doctors.org.uk. Plastic Surgery Department, Royal London Hospital, London E1 1BB, UK. AN - 25150933 AU - Cooper, L. AU - Payne, C. DA - Dec DO - 10.1016/j.bjps.2014.07.041 DP - NLM ET - 2014/08/26 IS - 12 KW - Fascia/*transplantation Female Humans Mammaplasty Middle Aged Reconstructive Surgical Procedures/*methods *Skin Transplantation Sternotomy/adverse effects *Surgical Flaps Surgical Wound Dehiscence/etiology/*surgery LA - eng N1 - 1878-0539 Cooper, Lilli Payne, Caroline Case Reports Letter Netherlands J Plast Reconstr Aesthet Surg. 2014 Dec;67(12):1762-3. doi: 10.1016/j.bjps.2014.07.041. Epub 2014 Aug 6. PY - 2014 SN - 1748-6815 SP - 1762-3 ST - The use of novel inferomedial fasciocutaneous breast flaps to reconstruct a sternal dehiscence with concomitant soft tissue loss T2 - J Plast Reconstr Aesthet Surg TI - The use of novel inferomedial fasciocutaneous breast flaps to reconstruct a sternal dehiscence with concomitant soft tissue loss VL - 67 ID - 13460 ER - TY - JOUR AB - Background: Delayed breast reconstructions (DBR) are preferred for high risk/locally advanced breast cancer (LABC) patients ( pts) who require postmastectomy radiotherapy (PMRT) due to superior cosmetic and lower complication rates. However, the use of neoadjuvant radiotherapy (NART) prior to surgery allows for definitive oncological surgery to be performed with an immediate ABR in a single operation [Sequence Reversal (SR)]. The aim of this study is to review the acute post-surgical complications of pts who underwent NART. Methods: This is a multi-institutional prospective review of 82 pts who underwent NART with 83 evaluable breasts. All pts had chemotherapy, followed by NART to the breast, supraclavicular fossa and level 3 axilla with or without coverage of remaining regional nodes. Approximately 6-7 weeks after completing NART, pts underwent definitive surgery and ABR. Acute post surgical toxicities (within 6 weeks of surgery) were graded using the Clavien-Dindo classification. Wound infection and dehiscence, mastectomy skin necrosis, flap necrosis, hematoma, anastomotic thrombosis were assessed for the breast and donor sites. Patient co-morbidities, smoking history, body mass index (BMI) and reconstruction type were assessed for its impact on surgical complications. Results: There were 62 clinically staged pts [63 evaluable breasts (cStage 2A-3C)] and 20 pathologically staged pts (pStage 2A-3C) with a median age of 49.2 years. All pts completed their NART with minimal toxicity and no break in radiotherapy delivery. 79 pts had a skin-sparing mastectomy (SSM) and 4 pts had a modified radical mastectomy. ABR with a DIEP flap was performed in the majority of pts (70). The average length of hospitalisation was 6.2 days. The risk of developing any breast complications was 25% (21/83), comparable to non NART ABR series of 16-60%. There were 6 significant grade 3 complications seen in 4 pts, with 3 occurring in 1 patient. She developed a wound infection, followed by anastomotic thrombosis and subsequent hematoma, all requiring surgical intervention. One patient developed flap necrosis requiring surgical debridement and VAC dressings. One patient developed mastectomy skin necrosis requiring skin grafting, but had a history of hypertension, hyperlipidaemia and diabetes. No patients developed any grade 4 or 5 toxicities. No patients developed DVT or PE. No flap losses were seen. The risk of developing any donor site complication was 19.3% (16/83) with only 6% (5/83) developing grade 3 complications (all abdominal wound dehiscence). A BMI of >30 was associated with an increased risk of abdominal wound dehiscence (3/12 vs 2/64 for BMI < 30). Conclusion: This review demonstrated that NART is a safe technique, which has not lead to an increase in surgical complication rates. SR can achieve a shorter, simpler reconstructive journey for patients. AD - M. Chao, GenesisCare, Radiation Oncology Victoria, Melbourne, Australia AU - Chao, M. AU - Foroudi, F. AU - Jassal, S. AU - Hyett, A. AU - Neoh, D. AU - Bevington, E. AU - Stoney, D. AU - Zantuck, N. AU - Law, M. AU - Foley, C. AU - Guerrieri, M. AU - Grinsell, D. AU - Loh, S. W. AU - Chew, G. AU - Yu, V. AU - Cokelek, M. AU - Taylor, K. AU - Cheng, M. AU - Chipman, M. AU - Baker, C. DB - Embase KW - abdominal injury adult advanced cancer axilla body mass breast cancer breast reconstruction cancer patient cancer radiotherapy cancer surgery chemotherapy classification comorbidity complication conference abstract debridement deep inferior epigastric perforator flap diabetes mellitus donor site female graft failure graft necrosis hematoma human hyperlipidemia hypertension major clinical study middle aged modified radical mastectomy multicenter study neoadjuvant therapy peroperative complication prospective study radiotherapy skin transplantation smoking surgery thrombosis toxicity wound infection LA - English M3 - Conference Abstract N1 - L621733487 2018-04-24 PY - 2018 SN - 1879-0852 SP - S65 ST - The use of neoadjuvant radiotherapy in high risk or locally advanced breast cancer patients prior to definitive surgery with mastectomy and autologous breast reconstruction does not impact on post operative surgical complications T2 - European Journal of Cancer TI - The use of neoadjuvant radiotherapy in high risk or locally advanced breast cancer patients prior to definitive surgery with mastectomy and autologous breast reconstruction does not impact on post operative surgical complications UR - https://www.embase.com/search/results?subaction=viewrecord&id=L621733487&from=export VL - 92 ID - 5437 ER - TY - JOUR AB - Background: The long-term stability of the breast shape, once it is achieved, should be included among the principal concerns of aesthetic mammaplasty. This goal presents a particular challenge to the surgeon treating a patient who is concerned with breast lift but also wants to preserve or even increase cup size.Objective: This report details the use of a lower myofascial supportive flap (MFF) to prevent secondary breast ptosis in various clinical situations.Methods: The conceptual approach was to use the MFF to reconstruct or make up for deficiencies of the superficial fascial system collagen network, which in this surgeon's view plays a key role in determining breast position and shape. The MFF flap was raised in the region of the pectoralis major and adjacent muscles based at the inframammary fold (IMF) level and sutured near the lower areola border, with the goal of recreating the IMF, stabilizing the nipple-fold distance, and providing long-term support to counteract the effects of gravity through the creation of a "balcony" flap within which the lower breast pole rests. The procedure was performed in various clinical situations, including primary mastopexy, secondary mastopexy to correct for "bottoming out" after previous surgery, mastopexy with augmentation, implant exchange plus mastopexy, and simple primary augmentation.Results: The use of the MFF provided an aesthetic breast shape while maintaining upper-pole fullness. Morbidity was highest among patients who underwent primary or secondary mastopexy and lowest among those who underwent simple primary augmentation. However, in the latter group, morbidity was notably higher than in patients who underwent simple primary augmentation without the use of the MFF.Conclusions: The MFF technique can provide better long-standing breast support than other procedures aimed at preventing or minimizing secondary breast ptosis. It is indicated most clearly for patients who are unwilling to give up breast volume for improved breast shape and who are unhappy with the results of previous standard mastopexy or augmentation. It is less useful in patients undergoing primary breast lift. Limitations include increased duration of surgery and increased trauma. AD - National Medico-Surgical Center, Moscow, Russia AN - 106580063. Language: English. Entry Date: 20050211. Revision Date: 20161117. Publication Type: journal article AU - Borovikov, A. AU - Borovikov, Alexei DB - cin20 DO - 10.1016/j.asj.2004.04.002 DP - EBSCOhost IS - 4 KW - Breast Reconstruction -- Methods Surgery, Operative -- Methods N1 - pictorial; tables/charts. Journal Subset: Biomedical; Mexico & Central/South America; Peer Reviewed. NLM UID: 9707469. PMID: NLM19336176. PY - 2004 SN - 1090-820X SP - 331-341 ST - Use of myofascial flaps in aesthetic breast surgery T2 - Aesthetic Surgery Journal TI - Use of myofascial flaps in aesthetic breast surgery UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106580063&site=ehost-live&scope=site VL - 24 ID - 905 ER - TY - JOUR AB - This is a study of the use of myocutaneous flaps by general surgeons in a district general hospital over a 5 year period, and shows that such work can be satisfactorily performed by general surgeons. AD - Kent and Canterbury Hospital, UK. AN - 2616400 AU - Allan, S. M. AU - Williams, C. R. AU - Heddle, R. M. AU - Jackson, D. B. AU - Collins, R. E. C2 - PMC2429810 DA - Oct DO - 10.1136/pgmj.65.768.738 DP - NLM ET - 1989/10/01 IS - 768 KW - Adult Aged Aged, 80 and over Breast/surgery Breast Neoplasms/surgery Carcinoma/surgery Evaluation Studies as Topic Female Humans Male Middle Aged Neoplasm Recurrence, Local/surgery Pressure Ulcer/surgery Reoperation Retrospective Studies *Surgical Flaps/adverse effects Tracheoesophageal Fistula/surgery LA - eng N1 - 1469-0756 Allan, S M Williams, C R Heddle, R M Jackson, D B Collins, R E Case Reports Journal Article Postgrad Med J. 1989 Oct;65(768):738-40. doi: 10.1136/pgmj.65.768.738. PY - 1989 SN - 0032-5473 (Print) 0032-5473 SP - 738-40 ST - The use of myocutaneous flaps by general surgeons T2 - Postgrad Med J TI - The use of myocutaneous flaps by general surgeons VL - 65 ID - 10709 ER - TY - JOUR AB - Perforator selection is of paramount importance when performing a Deep Inferior Epigastric Perforator flap. Technological advancements within imaging modalities have proved invaluable in preoperative planning and intraoperative assessment. Computed tomographic angiography remains the gold standard for preoperative perforator mapping, while color ultrasound Doppler is considered more reliable for determining vessel caliber. Intraoperatively, an imaging modality that provides sequential, real-time assessment of various perforators' supply to the flap would provide helpful insight to determine which perforator will optimize flap viability, especially of the most distal, lateral margins. Multispectral imaging, a variant of near infrared imaging, has emerged as an alternative method to assess tissue viability in the operating room as well as postoperatively. Unlike Spy technology, which is invasive and cost ineffective, the Snapshot(NIR) (KD203) is a handheld multispectral imaging device utilizing NIR to measure the oxygenation of the hemoglobin in the area to calculate the tissue oxygen content (StO2) displayed in a color image. The following case of a 46-year-old woman undergoing tertiary breast reconstruction for treatment of progressive grade 2 capsular contracture illustrates the utility and ease of KD203 application to intra-operative perforator determination in deep inferior epigastric perforator flap assessment. AD - [Rammos, Charalambos K.; Jones, Glyn E.; Taege, Sara M.; Lemaster, Chelsey M.] Univ Illinois, Coll Med, Dept Plast & Reconstruct Surg, Peoria, IL 61656 USA. Taege, SM (corresponding author), 624 NE Glen Oak Ave, Peoria, IL 61603 USA. staege2@uic.edu AN - WOS:000598231600031 AU - Rammos, C. K. AU - Jones, G. E. AU - Taege, S. M. AU - Lemaster, C. M. C7 - e3245 DA - Nov DO - 10.1097/gox.0000000000003245 IS - 11 J2 - Prs-Glob. Open KW - Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: PE2XK Times Cited: 0 Cited Reference Count: 10 Rammos, Charalambos K. Jones, Glyn E. Taege, Sara M. Lemaster, Chelsey M. Research Open Access Publishing (ROAAP) Fund of the University of Illinois at Chicago The authors acknowledge the Research Open Access Publishing (ROAAP) Fund of the University of Illinois at Chicago for financial support towards the open access publishing fee for this article. 0 1 Lippincott williams & wilkins Philadelphia PY - 2020 SN - 2169-7574 SP - 4 ST - The Use of Multispectral Imaging in DIEP Free Flap Perforator Selection: A Case Study T2 - Plastic and Reconstructive Surgery-Global Open TI - The Use of Multispectral Imaging in DIEP Free Flap Perforator Selection: A Case Study UR - ://WOS:000598231600031 VL - 8 ID - 1024 ER - TY - JOUR AB - Introduction: Repair of recurrent abdominal hernias is a surgical challenge. These patients usually present to the plastic surgeon as a last resort for treatment. Such recalcitrant hernias cause enormous morbidity and constitute a financial burden to any health service. It is important to explore novel and potentially effective repair methods. We report on a technique using overlay prolene mesh fixed to bone by Mitek anchors. Methods: All patients who had Mitek bone anchor fixation of synthetic mesh, to repair recurrent iatrogenic abdominal hernias between 2003 and 2010 by one surgeon (C. M. M.), were retrospectively reviewed. The indications, operative details, and clinical outcomes were documented. Results: A total of 7 patients (6 females, 1 male) aged 35 to 60 (average 53) years were included in the study. The causes of herniation were previous surgical incisions (3) and abdominal flap harvests (4). They had had a median of 3 hernia repairs before referral to plastic surgery. The operations lasted for a mean of 6 hours (range, 3-10(1/2) hr). There were no major intra- and postoperative problems although 1 patient requested removal of 2 of his 8 Mitek anchors because of persistent localized pain and tenderness. After a mean follow-up of 24 months (range, 4-34), only 1 patient developed a recurrent lower abdominal bulge. Conclusion: Our single operator series demonstrated that Mitek bone anchor fixation of prosthetic mesh reinforcement of abdominal wall hernia repair is an effective treatment technique associated with a low morbidity. This method of recalcitrant hernia repair may be a useful addition to the armamentarium of the plastic surgeon. AD - [Malata, Charles M.] Cambridge Univ Hosp NHS Fdn Trust, Addenbrookes Hosp, Dept Plast & Reconstruct Surg, Cambridge CB2 2QQ, England. [Ali, Ali A.] Univ Cambridge, Sch Clin Med, Cambridge, England. [Ali, Ali A.] Univ Cambridge, Peterhouse Coll, Cambridge, England. Malata, CM (corresponding author), Cambridge Univ Hosp NHS Fdn Trust, Addenbrookes Hosp, Dept Plast & Reconstruct Surg, Box 186,Hills Rd, Cambridge CB2 2QQ, England. cmalata@hotmail.com AN - WOS:000305485200015 AU - Ali, A. A. AU - Malata, C. M. DA - Jul DO - 10.1097/SAP.0b013e31822128c6 IS - 1 J2 - Ann. Plast. Surg. KW - Mitek bone anchors TRAM flap-induced hernias recurrent incisional hernias prolene mesh fixation iatrogenic hernias TRAM flap harvest postmassive weight loss body contouring surgery Fleur-de-lys abdominoplasty flap breast reconstruction diep flap free tram experience Surgery LA - English M3 - Article; Proceedings Paper N1 - ISI Document Delivery No.: 961RJ Times Cited: 8 Cited Reference Count: 17 Ali, Ali A. Malata, Charles M. 46th Meeting of the European-Society-for-Surgical-Research (ESSR) May 25-28, 2011 Aachen, GERMANY European Soc Surg Res (ESSR) Malata, Charles/0000-0002-0070-0838 10 0 2 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2012 SN - 0148-7043 SP - 59-63 ST - The Use of Mitek Bone Anchors for Synthetic Mesh Fixation to Repair Recalcitrant Abdominal Hernias T2 - Annals of Plastic Surgery TI - The Use of Mitek Bone Anchors for Synthetic Mesh Fixation to Repair Recalcitrant Abdominal Hernias UR - ://WOS:000305485200015 VL - 69 ID - 2736 ER - TY - JOUR AB - Abdominal wall complications of TRAM flap breast reconstruction are well described. Synthetic mesh abdominal reinforcement is believed to decrease the incidence of these complications. An innovative technique with commonly available suture anchors has been used in a case of recurrent abdominal laxity after a TRAM flap. Osseous fixation of synthetic mesh with the Mitek GII suture anchor will undoubtedly be used more widely in abdominal wall reconstruction. AD - L.A. Hoffman, Department of Plastic Surgery, New York Hospital, 535 E. 68th St., New York, NY 10021, United States AU - Francis, K. R. AU - Hoffman, L. A. AU - Cornell, C. AU - Cortese, A. DB - Embase Medline IS - 2 KW - abdominal wall closure adult article breast reconstruction case report female human myocutaneous flap plastic surgery priority journal rectus abdominis muscle surgical technique LA - English M3 - Article N1 - L24044204 1994-02-16 PY - 1994 SN - 0032-1052 SP - 419-421 ST - The use of Mitek anchors to secure mesh in abdominal wall reconstruction T2 - Plastic and Reconstructive Surgery TI - The use of Mitek anchors to secure mesh in abdominal wall reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L24044204&from=export VL - 93 ID - 8869 ER - TY - JOUR AB - Background: During breast reconstruction using the transverse rectus abdominis myocutaneous (TRAM) flap, the use of mesh for abdominal donor-site closure provides for a technology that potentially offers clinical benefit yet incurs an added cost. The authors' goal was to determine whether it is cost effective to use mesh during abdominal donor-site closure when performing a TRAM flap for breast reconstruction. Methods: A literature review was conducted to identify and collect published hernia and bulge rates at abdominal TRAM flap donor sites closed either primarily or with mesh. A decision tree analysis was performed. Outcome probabilities, costs of complications, and expert utility estimates were populated into the decision tree model to evaluate the cost-utility of using mesh in TRAM abdominal donor-site closure. One-way sensitivity analyses were performed to verify the robustness of the results. Results: The authors' literature review resulted in 10 articles describing 1195 patients who had TRAM abdominal donor-site closure primarily and 696 patients who had donor-site closure performed with mesh. Pooled hernia/bulge complication rates for these two groups were 7.87 percent and 4.45 percent, respectively. The use of mesh was more clinically effective based on total quality-adjusted life-years gained of 30.53 compared with 30.41 when performing primary fascial closure alone. The incremental additional cost incurred by the mesh arm when running the decision tree model was $693.14. This difference in cost, divided by the difference in clinical efficacy (0.12), results in an incremental cost-utility ratio value of $5776.17 per quality-adjusted life-year gained when using mesh, making it cost effective (when using a willingness-to-pay threshold of $50,000). One-way sensitivity analysis revealed the following: (1) using mesh was a cost-effective option, provided that the price of mesh was less than or equal to $5970; (2) mesh was cost effective when its use led to a hernia/bulge rate less than or equal to 7.25 percent; and (3) primary facial closure was cost effective when its use led to a hernia/bulge rate less than or equal to 4.75 percent. Conclusion: The use of mesh when repairing the abdominal donor site during a pedicled or free TRAM flap breast reconstruction is cost effective compared with primary fascial closure alone. AD - [Chatterjee, Abhishek; Ramkumar, Dipak B.; Dawli, Tamara B.; Nigriny, John F.; Stotland, Mitchell A.; Ridgway, Emily B.] Dartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA. Chatterjee, A (corresponding author), Dartmouth Hitchcock Med Ctr, 1 Med Ctr Dr, Lebanon, NH 03756 USA. ac14terminat@yahoo.com AN - WOS:000350754700042 AU - Chatterjee, A. AU - Ramkumar, D. B. AU - Dawli, T. B. AU - Nigriny, J. F. AU - Stotland, M. A. AU - Ridgway, E. B. DA - Mar DO - 10.1097/prs.0000000000000957 IS - 3 J2 - Plast. Reconstr. Surg. KW - acellular dermal matrix pedicled tram flap decision-analysis economic evaluations plastic-surgery synthetic mesh wall hernia primer repair Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: CD0IO Times Cited: 17 Cited Reference Count: 37 Chatterjee, Abhishek Ramkumar, Dipak B. Dawli, Tamara B. Nigriny, John F. Stotland, Mitchell A. Ridgway, Emily B. 17 0 4 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2015 SN - 0032-1052 SP - 682-689 ST - The Use of Mesh versus Primary Fascial Closure of the Abdominal Donor Site When Using a Transverse Rectus Abdominis Myocutaneous Flap for Breast Reconstruction: A Cost-Utility Analysis T2 - Plastic and Reconstructive Surgery TI - The Use of Mesh versus Primary Fascial Closure of the Abdominal Donor Site When Using a Transverse Rectus Abdominis Myocutaneous Flap for Breast Reconstruction: A Cost-Utility Analysis UR - ://WOS:000350754700042 VL - 135 ID - 2290 ER - TY - JOUR AB - The maintenance of adequate projection is one of the most important aspects in nipple reconstruction. A total of 17 nipples were reconstructed using the modified top hat flap technique with lyophilized allogeneic costal cartilage, and patients were followed up for 1 year. Projection at 6 months and 1 year was compared with the immediate postoperative result, as well as with the results of nipples reconstructed without cartilage. After 6 months and 1 year, there were significant reductions in projection, with the average losses of 51.7% and 57.7%, respectively. There were no significant differences between groups with or without cartilage. These findings show that nipples reconstructed with lyophilized allogeneic cartilage beneath the modified top hat flap showed no benefit compared with nipples reconstructed without cartilage. AD - Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. AN - 21178755 AU - Kim, E. K. AU - Lee, T. J. DA - Feb DO - 10.1097/SAP.0b013e3181ee73e8 DP - NLM ET - 2010/12/24 IS - 2 KW - Cartilage/*transplantation Follow-Up Studies Freeze Drying Humans Mammaplasty/*methods Nipples/*surgery Ribs *Surgical Flaps LA - eng N1 - 1536-3708 Kim, Eun Key Lee, Taik Jong Journal Article United States Ann Plast Surg. 2011 Feb;66(2):128-30. doi: 10.1097/SAP.0b013e3181ee73e8. PY - 2011 SN - 0148-7043 SP - 128-30 ST - Use of lyophilized allogeneic costal cartilage: is it effective to maintain the projection of the reconstructed nipple? T2 - Ann Plast Surg TI - Use of lyophilized allogeneic costal cartilage: is it effective to maintain the projection of the reconstructed nipple? VL - 66 ID - 10913 ER - TY - JOUR AB - Abdominal-based free flaps are commonly used for breast reconstruction, and the internal mammary or thoracodorsal vessels are typically used as recipient sites. Conversely, free tissue transfer is less commonly used for chest wall reconstruction in the setting of chest wall recurrence, in part, because of a paucity of recipient vessels. Here, we describe a case of a 68-year-old female smoker with metastatic breast cancer, who presented with a chest wall recurrence. There was a large area of chronic ulceration with foul smelling drainage, in addition to radiation-induced tissue injury, and palliative resection was performed. The area was reconstructed with a free transverse rectus abdominis myocutaneous flap using lumbar perforators as recipient vessels, because conventional recipient sites were unavailable because of scarring from radiation and residual tumor. This case demonstrates that uncommon recipient vessels such as lumbar perforators may allow for successful palliative chest wall reconstruction. We hypothesize that the tumor burden, previous surgeries, and radiation may have rendered the recipient field relatively ischemic, thereby inducing hypertrophy of the lumbar perforators, similar to a delay phenomenon. AD - [Sillah, Nyama M.; Shah, Jinesh; Fukudome, Eugene; Lin, Samuel J.] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Div Plast Surg, 110 Francis St,Suite 5A, Boston, MA 02215 USA. Lin, SJ (corresponding author), Harvard Med Sch, Beth Israel Deaconess Med Ctr, Div Plast Surg, 110 Francis St,Suite 5A, Boston, MA 02215 USA. sjlin@bidmc.harvard.edu AN - WOS:000388167200015 AU - Sillah, N. M. AU - Shah, J. AU - Fukudome, E. AU - Lin, S. J. C7 - e642 DA - Mar DO - 10.1097/gox.0000000000000540 IS - 3 J2 - Prs-Glob. Open KW - flap breast reconstruction tram flap delay phenomenon Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: EC5IF Times Cited: 0 Cited Reference Count: 9 Sillah, Nyama M. Shah, Jinesh Fukudome, Eugene Lin, Samuel J. Lin, Samuel/P-6158-2019; Chen, Austin D/N-3879-2017 0 1 Lippincott williams & wilkins Philadelphia PY - 2016 SN - 2169-7574 SP - 4 ST - Use of Lumbar Perforator Recipient Vessels for Salvage Chest Wall Reconstruction: A Case Report T2 - Plastic and Reconstructive Surgery-Global Open TI - Use of Lumbar Perforator Recipient Vessels for Salvage Chest Wall Reconstruction: A Case Report UR - ://WOS:000388167200015 VL - 4 ID - 2066 ER - TY - JOUR AB - Background Historically, conventional musculocutaneous flaps have been commonly used for reconstruction after soft tissue sarcoma resection, and the use of lower abdominal perforator flaps has not been popular. This report examined the current role of lower abdominal perforator flaps in sarcoma treatment. Methods We reviewed the outcomes of 14 patients (mean age: 46.3 years, range: 18-79 years) who underwent immediate reconstruction with a deep inferior epigastric artery perforator (DIEP) flap or a superficial inferior epigastric artery (SIEA) flap after sarcoma resection. The defects ranged in size from 7 x 6 cm(2) to 25 x 22 cm(2) (mean: 16.5 x 12.1 cm(2)). An oblique design was used for pedicled DIEP flaps and a transverse design for free DIEP flaps. Results Free SIEA flaps were used in six patients, pedicled DIEP flaps in five, and free DIEP flaps in three. The flaps ranged in size from 13 x 8 cm(2) to 36 x 12.5 cm(2) (mean: 23.1 x 9.2 cm(2)). All DIEP flaps except one were harvested based on one dominant perforator. All flaps survived without vascular compromise. Surgical site infection and seroma occurred at the recipient site in one patient each. No donor-site complications occurred. Conclusions Lower abdominal perforator flaps can serve as a versatile donor site for reconstruction after sarcoma resection. AD - [Miyamoto, Shimpei; Arikawa, Masaki; Kagaya, Yu] Natl Canc Ctr, Div Plast & Reconstruct Surg, Tokyo, Japan. Miyamoto, S (corresponding author), Natl Canc Ctr, Div Plast & Reconstruct Surg, Chuo Ku, 5-1-1 Tsukiji, Tokyo 1040045, Japan. miyamos-tky@umin.ac.jp AN - WOS:000502396300001 AU - Miyamoto, S. AU - Arikawa, M. AU - Kagaya, Y. DA - Mar DO - 10.1002/micr.30539 IS - 3 J2 - Microsurgery KW - donor site morbidity breast reconstruction myocutaneous flap diep flap tram versatility angiosome defect thigh siea Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: KU5TM Times Cited: 3 Cited Reference Count: 30 Miyamoto, Shimpei Arikawa, Masaki Kagaya, Yu , Shimpei/0000-0003-4367-6927 3 1 Wiley Hoboken 1098-2752 PY - 2020 SN - 0738-1085 SP - 353-360 ST - The use of lower abdominal perforator flaps in soft-tissue reconstruction after sarcoma resection T2 - Microsurgery TI - The use of lower abdominal perforator flaps in soft-tissue reconstruction after sarcoma resection UR - ://WOS:000502396300001 VL - 40 ID - 1265 ER - TY - JOUR AB - Local perforator flaps are used as immediate volume replacement techniques in breast conserving surgery. Here, we describe a case series of local perforator flaps used in the delayed setting to correct defects following previous breast surgery, including previous breast conservation surgery or mastectomy with reconstruction. All cases were performed in a tertiary referral breast unit between 2014 and 2020. Cases were identified using a prospectively maintained database. Indications, type of perforator flap used, immediate post-operative complications, and longer term outcomes were recorded. Fifteen cases were identified: 8 following previous breast conserving surgery and radiotherapy, 6 following mastectomy and reconstruction, and 1 for developmental breast asymmetry following childhood radiotherapy. Indications included volume deficit, contour defect, asymmetry, and capsular contracture. One patient a major complication requiring return to theater due to implant-related infection. There were no flap losses. Longer term, 2 patients underwent lipomodeling to further augment breast volume as part of a planned, staged revision. One patient subsequently elected to have bilateral breast implant exchange to increase volume. Our series shows the versatility of local perforator flaps in the correction of complex breast defects that can occur following previous breast surgery. Delayed local perforator flaps are associated with low morbidity, and further revision surgery is not commonly required. AD - [Quinn, Edel Marie; O'Ceallaigh, Siobhan; Highton, Lyndsey; Murphy, John] Manchester Univ NHS Fdn Trust, Wythenshawe Hosp, Nightingale Breast Ctr, Dept Oncoplast Breast Surg, Manchester, Lancs, England. Quinn, EM (corresponding author), Wythenshawe Hosp, Nightingale Breast Ctr, Southmoor Rd, Manchester M23 9LT, Lancs, England. edelquinn@rcsi.ie AN - WOS:000607727900016 AU - Quinn, E. M. AU - O'Ceallaigh, S. AU - Highton, L. AU - Murphy, J. C7 - e3263 DA - Dec DO - 10.1097/gox.0000000000003263 IS - 12 J2 - Prs-Glob. Open KW - Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: PS1ZI Times Cited: 0 Cited Reference Count: 16 Quinn, Edel Marie O'Ceallaigh, Siobhan Highton, Lyndsey Murphy, John 0 Lippincott williams & wilkins Philadelphia PY - 2020 SN - 2169-7574 SP - 5 ST - The Use of Local Perforator Flaps in Delayed or Secondary Breast Reconstruction T2 - Plastic and Reconstructive Surgery-Global Open TI - The Use of Local Perforator Flaps in Delayed or Secondary Breast Reconstruction UR - ://WOS:000607727900016 VL - 8 ID - 1008 ER - TY - JOUR AB - Free transverse abdominis myocutaneous flap (TRAM) reconstruction is regarded as a major operation involving significant blood loss and a long operating time. Infiltration of a local anaesthetic with adrenaline has been used to reduce blood loss in reduction mammoplasty with good results. In this study, 80-100 ml 0.5% lidocaine with adrenaline (1:100,000) was infiltrated preoperatively in 13 TRAM reconstruction patients (study group). Infiltration was subcutaneous to the lower abdomen, the mastectomy scar and the other breast (if operated on). In the control group (15 patients), there was no such infiltration. The groups were similar to each other in patient and oncological characteristics. Perioperative blood loss was significantly lower in the study group (382 ml) than in the control group (987 ml). The operating time was also significantly shorter in the study group (142 min) than in the control group (188 min). There were no systemic side effects of lidocaine or adrenaline, nor where there were any flap losses, skin necroses or wound infections calling for revision in either group. © Springer-Verlag 2002. AD - C.K. Hellevuo, Jyväskylä Central Hospital, Jyväskylä, Finland AU - Hellevuo, C. K. AU - Salmi, A. AU - Muuronen, E. AU - Autio, V. DB - Embase DO - 10.1007/s00238-002-0363-y IS - 5 KW - epinephrine lidocaine adult article bleeding breast reconstruction clinical article controlled study human mastectomy myocutaneous flap operation duration peroperative complication preoperative care priority journal retrospective study skin necrosis surgical infection LA - English M3 - Article N1 - L40834331 2005-07-20 PY - 2002 SN - 0930-343X SP - 243-246 ST - The use of lidocaine with adrenaline reduces blood loss and operating time in free TRAM breast reconstruction T2 - European Journal of Plastic Surgery TI - The use of lidocaine with adrenaline reduces blood loss and operating time in free TRAM breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L40834331&from=export http://dx.doi.org/10.1007/s00238-002-0363-y VL - 25 ID - 8370 ER - TY - JOUR AB - Breast conserving surgery has been reserved for patients with favorable proportion between tumor dimensions and breast size. Introduction of local flaps from the lateral thoracic region has widened the indications for breast conserving surgery, by allowing surgeons to perform wider excisions, thus yet be able to ensure tumor-free surgical margins and a good aesthetic result. We have used lateral intercostal perforator flaps and flaps harvested on the lateral thoracic artery and lateral thoracic artery axial flap in patients with small breasts and an unfavorable tumor to breast size proportion. From May 2015 to October 2016, 19 patients with breast tumors have been treated with BCS and immediate volume replacement reconstruction by pedicle perforator flaps from the lateral thoracic region. In 15 patients lateral intercostal artery perforator flaps or lateral thoracic artery perforator flaps were used after quadrantectomy or wide local excision, in 3 patients as volume replacement after mastectomy and in 1 patient after mastectomy following previous augmentation mammoplasty. In all patients, good breast symmetry was achieved, with no major complications. Fibrosis of the flap and residual breast parenchyma, with volume reduction were noticed after postoperative radiotherapy in thin patients or flaps with little subcutaneous fat. Perforator flaps from the lateral thoracic region should become the gold standard for reconstructions after breast conserving surgery involving less than 20% of the breast volume or after mastectomy in patients with small breasts. The operating procedure is safe, quick and allows sparing of the latissimus dorsi muscle and thus minimal donor site morbidity, as well as an excellent aesthetic result. AN - 30939877 AU - Martellani, L. AU - Manara, M. AU - Renzi, N. AU - Papa, G. AU - Ramella, V. AU - Arnež, Z. DA - Winter DP - NLM ET - 2019/04/04 IS - 1 KW - Breast/pathology/surgery Breast Neoplasms/pathology/*surgery Female Humans Mammaplasty/*methods *Mastectomy, Segmental Organ Size Perforator Flap/*blood supply Tumor Burden Licap Ltap breast reconstruction perforator flaps LA - eng N1 - Martellani, L Manara, M Renzi, N Papa, G Ramella, V Arnež, Z Journal Article Czech Republic Acta Chir Plast. 2019 Winter;60(1):4-8. OP - Použití licap a ltap laloků pro rekonstrukci prsu. PY - 2019 SN - 0001-5423 (Print) 0001-5423 SP - 4-8 ST - Use of licap and ltap flaps for breast reconstruction T2 - Acta Chir Plast TI - Use of licap and ltap flaps for breast reconstruction VL - 60 ID - 8997 ER - TY - JOUR AB - The musculocutaneous flap of the latissimus dorsi was used 11 times pediculated and 9 times free. It allows the reconstruction in one stage of considerable losses of substance in the trunk and the limbs. In the reconstruction of the upper limb, this pedicled flap makes it possible to cover the brachial canal, but not the elbow. When it is free this flap may be so tailored as to be both 'motor' (dissection out of the nerve of the latissimus dorsi) and 'sensory' (dissection of the sensory cutaneous branches of T 5). AD - SOS Main, Hop. Boucicaut, 75730 Paris Cedex 15 AU - Mitz, V. AU - Staub, S. AU - Vilain, R. DB - Embase Medline IS - 1 KW - arm breast breast reconstruction free tissue graft latissimus dorsi muscle major clinical study microvascular surgery muscle myocutaneous flap therapy LA - French N1 - L11097791 1981-07-02 PY - 1981 SN - 0003-3960 SP - 44-51 ST - The use of latissimus musculocutaneous flaps is easy and reliable T2 - Annales de Chirurgie Plastique TI - The use of latissimus musculocutaneous flaps is easy and reliable UR - https://www.embase.com/search/results?subaction=viewrecord&id=L11097791&from=export VL - 26 ID - 8987 ER - TY - JOUR AB - BACKGROUND: Immediate reconstruction with autogenous tissue is one of the options for reconstruction following breast-conservation surgery for breast cancers in major centres with ready availability of appropriate skills. Immediate correction of volume deficit by latissimus dorsi miniflap (LDMF) in addition has cosmetic appeal by filling the defect without extra skin incision. METHODS: Data was collected retrospectively from clinical records of 51 patients who underwent LDMF procedures in a district general hospital between June 2000 and December 2004, and the results were analysed. Postal questionnaire survey was done to assess the level of subjective satisfaction of the cosmetic outcome. RESULTS: Wide local excision and axillary-node sampling/clearance along with immediate reconstruction with a LDMF (involving a musculo-subcutaneous flap without skin) were performed in all patients. Patients' median age was 50 years. Sixty-five percent of the tumours were in the upper-outer quadrant, median weight of the specimen was 217.5 g (31-510 g), median clearance margin was 5 mm (0-15 mm) and median pathological size of the tumour was 20 mm (8-60 mm). Four patients required mastectomy later, whereas 1 patient had flap necrosis. At a median follow-up of 33 months, there has been no recurrence. Eighty-six percent of the patients who responded to the postal survey were satisfied with the cosmetic outcome. CONCLUSION: Immediate LDMF reconstruction is an acceptable way of correcting deformity after breast-conservation surgery. We demonstrate by our experience that it is a viable option for breast cancer in small district hospitals/ breast units. AD - Department of Surgery, Bassetlaw Hospital, Worksop, Nottinghamshire, UK. AN - 17180559 AU - Navin, C. AU - Agrawal, A. AU - Kolar, K. M. DA - Jan DO - 10.1007/s00268-006-0396-7 DP - NLM ET - 2006/12/21 IS - 1 KW - Adult Aged Breast Neoplasms/*surgery Carcinoma, Ductal, Breast/*surgery Female Hospitals, District Humans Mammaplasty/economics/*methods *Mastectomy, Segmental Middle Aged Patient Satisfaction *Surgical Flaps LA - eng N1 - Navin, C Agrawal, A Kolar, K M Journal Article United States World J Surg. 2007 Jan;31(1):46-50. doi: 10.1007/s00268-006-0396-7. PY - 2007 SN - 0364-2313 (Print) 0364-2313 SP - 46-50 ST - The use of latissimus dorsi miniflap for reconstruction following breast-conserving surgery: experience of a small breast unit in a district hospital T2 - World J Surg TI - The use of latissimus dorsi miniflap for reconstruction following breast-conserving surgery: experience of a small breast unit in a district hospital VL - 31 ID - 10873 ER - TY - JOUR AB - Laser-assisted indocyanine green angiography allows surgeons to determine intraoperative flap perfusion and achieve the best outcomes in breast reconstruction. This study stratified outcomes based on a meta-analysis of complications including longitudinal trials comparing the clinical assessment of skin flaps during breast reconstruction. Nine studies met inclusion criteria and reported outcomes of interest (n = 2256). The risk of flap necrosis and the necessity of reoperation was statistically significantly higher in the control group. AD - Biophotonics Applied Health Sciences Post-graduate Program, Universidade Nove de Julho, São Paulo, Brazil. Department of Plastic and Reconstructive Surgery, Hospital Santa Paula, São Paulo, Brazil. Department of Surgical Oncology, Hospital Santa Paula, São Paulo, Brazil. AN - 31773735 AU - da Silva Neto, E. AU - Figueiredo, P. H. M. AU - Moro, M. G. AU - de Oliveira, A. P. L. AU - Assumpção, C. B. AU - Perina, A. L. F. AU - da Costa, F. P. P. AU - Faria, E. P. AU - de Oliveira, A. C. V. AU - Prates, R. A. DA - Apr DO - 10.1002/jso.25782 DP - NLM ET - 2019/11/28 IS - 5 KW - *Coloring Agents Female *Fluorescein Angiography Humans *Indocyanine Green Lasers Mammaplasty/*methods Surgical Flaps/*blood supply breast cancer nipple-sparing mastectomy photodynamic diagnosis skin necrosis skin-sparing mastectomy LA - eng N1 - 1096-9098 da Silva Neto, Edgard Figueiredo, Pedro H M Orcid: 0000-0002-7507-662x Moro, Marcella G de Oliveira, Ana P L Assumpção, Carolina B Perina, André L F da Costa, Fábio P P Faria, Eduardo P de Oliveira, André C V Prates, Renato A Journal Article Meta-Analysis Systematic Review United States J Surg Oncol. 2020 Apr;121(5):759-765. doi: 10.1002/jso.25782. Epub 2019 Nov 26. PY - 2020 SN - 0022-4790 SP - 759-765 ST - Use of laser-assisted indocyanine green angiography in breast reconstruction: Systematic review and meta-analysis T2 - J Surg Oncol TI - Use of laser-assisted indocyanine green angiography in breast reconstruction: Systematic review and meta-analysis VL - 121 ID - 11895 ER - TY - JOUR AB - The posteromedial thigh (PMT) flap has been described for breast reconstruction in vertical fashion (vPMT). However, it might not incorporate enough soft tissue for reconstruction of a medium size breast. Here, we present a case utilizing the free inverted-L posteromedial thigh (L-PMT) flap for autologous reconstruction of the breast. A 65-year-old woman with a body max index (BMI) of 24.5 kg/m(2) underwent nipple sparring mastectomy and received immediate unilateral breast reconstruction. The flap was raised based on the first medial perforator of the profunda femoris artery (PFA). The internal mammary artery and vein were dissected as recipient vessels. The flap size was 25 cm x 25 cm. The mastectomy specimen and weight of the flap was 260 g and 310 g, respectively. The flap survived completely after surgery. The donor site was primarily closed with minimal morbidities. Follow-up observations were conducted from 1 to 6 months. The patient was satisfied with the reconstruction. The free L-PMT flap may be suitable for breast reconstruction in women with moderate breast size. The inverted-L pattern of the PMT flap allows the surgeon to include a bigger quantity of flap soft tissue enabling a more anatomical shape of the breast and represents an alternative design that may be used for autologous breast reconstruction in selected patients. AD - [Scaglioni, Mario F.; Eder, Maximilian; Giovanoli, Pietro] Univ Hosp Zurich, Dept Plast & Hand Surg, Ramistr 100, CH-8091 Zurich, Switzerland. [Eder, Maximilian] Breast Ctr Zurich, Zurich, Switzerland. Scaglioni, MF (corresponding author), Univ Hosp Zurich, Dept Plast & Hand Surg, Ramistr 100, CH-8091 Zurich, Switzerland. mario.scaglioni@gmail.com AN - WOS:000439824400016 AU - Scaglioni, M. F. AU - Eder, M. AU - Giovanoli, P. DA - Jul DO - 10.1002/micr.30187 IS - 5 J2 - Microsurgery KW - artery perforator flap option lift Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: GO2RN Times Cited: 3 Cited Reference Count: 17 Scaglioni, Mario F. Eder, Maximilian Giovanoli, Pietro 3 0 2 Wiley Hoboken 1098-2752 PY - 2018 SN - 0738-1085 SP - 558-562 ST - The use of inverted-L posteromedial thigh (L-PMT) flap for autologous breast reconstruction: A case report T2 - Microsurgery TI - The use of inverted-L posteromedial thigh (L-PMT) flap for autologous breast reconstruction: A case report UR - ://WOS:000439824400016 VL - 38 ID - 1581 ER - TY - JOUR AB - Breast reconstruction is a cosmetically critical procedure for women and it must be undertaken to balance the shape, size, and position of the breast with the other breast. Since the first introduction of the free abdominoplasty flap in 1979, the transverse rectus abdominis musculocutaneous (TRAM) flap technique has been a widely accepted method of breast reconstruction after mastectomy. In breast reconstruction with a free flap, the selection of suitable recipient vessels is the critical decision to be made by the surgeon. The most common recipient vessel for free flap breast reconstruction is the axillary system. However, when used as a recipient, the axillary system may limit flap movement and flexibility in breast shaping. The use of the internal mammary vessels as a recipient site attains ideal breast symmetry. However, the technique requires partial rib resection and eliminates the opportunity for a potential coronary artery bypass graft, which requires the internal mammary artery. Based on these considerations, the selection of suitable recipient vessels constitutes an important requirement for successful free tissue transfer. The authors have performed breast reconstruction with the TRAM flap anastomosed to the internal mammary perforator vessel and conclude that these perforators could be useful as recipient vessels, especially in the case of immediate breast reconstruction with the free TRAM flap. AD - Ajou Univ, Sch Med, Dept Plast & Reconstruct Surg, Suwon 442721, South Korea. Park, MC (corresponding author), Ajou Univ, Sch Med, Dept Plast & Reconstruct Surg, Suwon 442721, South Korea. AN - WOS:000180925500005 AU - Park, M. C. AU - Lee, J. H. AU - Chung, J. H. AU - Lee, S. H. DA - Feb DO - 10.1097/01.Sap.0000037272.55380.94 IS - 2 J2 - Ann. Plast. Surg. KW - flap site Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 644NW Times Cited: 34 Cited Reference Count: 17 Park, MC Lee, JH Chung, JH Lee, SH 34 0 1 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2003 SN - 0148-7043 SP - 132-137 ST - Use of internal mammary vessel perforator as a recipient vessel for free TRAM breast reconstruction T2 - Annals of Plastic Surgery TI - Use of internal mammary vessel perforator as a recipient vessel for free TRAM breast reconstruction UR - ://WOS:000180925500005 VL - 50 ID - 3898 ER - TY - JOUR AB - Perforator-based flaps have in recent years become the mainstay of autologous breast reconstruction practice. Imaging modalities ranging from Doppler ultrasound to CT angiography demonstrate varying utility in the preoperative identification and localisation of perforators. Despite these available radiological investigations, finding and quantitatively assessing perforators remain a time-consuming and tedious process that is often complicated by a number of factors including variable anatomy prior surgery and body habitus. Thermographic imaging shows promise as a novel modality for preoperative localisation of perforator vessels. This review summarises the currently available evidence for its application in perforator mapping for abdominal-based autologous breast reconstruction. We discuss the development of the technology over the years, its current use, its advantages and how it may impact on reconstructive breast surgery. AD - O. Hennessy, Department of Plastic Surgery, Galway University Hospital, Galway, Ireland AU - Hennessy, O. AU - Potter, S. M. DB - Embase DO - 10.1016/j.jpra.2019.11.006 KW - breast reconstruction computed tomographic angiography deep inferior epigastric perforator flap Doppler flowmetry free tissue graft human patient history of surgery preoperative evaluation quantitative analysis radiology review systematic review thermography LA - English M3 - Review N1 - L2004824976 2020-02-05 PY - 2020 SN - 2352-5878 SP - 60-70 ST - Use of infrared thermography for the assessment of free flap perforators in autologous breast reconstruction: A systematic review T2 - JPRAS Open TI - Use of infrared thermography for the assessment of free flap perforators in autologous breast reconstruction: A systematic review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004824976&from=export http://dx.doi.org/10.1016/j.jpra.2019.11.006 VL - 23 ID - 4811 ER - TY - JOUR AB - BACKGROUND: Indocyanine green angiography (ICGA) reduces ischemic complications by assessing mastectomy flap perfusion intraoperatively. However, outcomes of ICGA can be surgeon-dependent due to its relative novelty. We aimed to determine whether patient outcomes improved with the adoption of ICGA over time. METHODS: We conducted a single-institution retrospective study of mastectomy patients between March 2012 (date of ICGA introduction) and October 2016. We included patients who underwent immediate expander-based reconstruction with intraoperative ICGA, followed by second-stage permanent implant placement. Patients were chronologically sorted into 3 groups, of 45 patients each, based on the date of ICGA. Complications and reconstruction wait times (time between initial expander placement and subsequent final reconstruction) amongst the 3 groups were evaluated. Using the Cochran-Armitage test for trend, we tested the change in median adjusted expander fill volumes (expander fill volume in milliliter per gram of breast removed) over time. RESULTS: We identified 135 patients. Rates of ischemic complications significantly decreased (Group 1, 36%; Group 2, 22%; Group 3, 11%; p = 0.03), despite significantly increasing median adjusted expander fill volumes (Group 1, 0.46 mL/g; Group 2, 0.63 mL/g; Group 3, 0.76 mL/g; p = 0.003) over time. The rates of unexpected returns to the operating room across the 3 groups were not significantly different. The median reconstruction wait time was significantly reduced in the later groups (Group 1, 146 days; Group 2, 122 days; Group 3, 87 days; p = 0.01). CONCLUSIONS: Outcomes for mastectomy with immediate expander-based reconstruction were found to improve with increasing case volume after implementation of ICGA. AD - Department of Surgery, University of Minnesota, 420 Delaware Street SE, MMC 195, Minneapolis, MN 55455, United States. Department of Surgery, University of Minnesota, 420 Delaware Street SE, MMC 195, Minneapolis, MN 55455, United States. Electronic address: jhui@umn.edu. AN - 30642794 AU - Diep, G. K. AU - Marmor, S. AU - Kizy, S. AU - Huang, J. L. AU - Jensen, E. H. AU - Portschy, P. AU - Cunningham, B. AU - Choudry, U. AU - Tuttle, T. M. AU - Hui, J. Y. C. DA - Apr DO - 10.1016/j.bjps.2018.12.037 DP - NLM ET - 2019/01/16 IS - 4 KW - Angiography/*methods *Coloring Agents Female Humans *Indocyanine Green Mammaplasty/adverse effects/*methods *Mastectomy Middle Aged Radiography, Interventional/methods Retrospective Studies Surgical Flaps/*blood supply Treatment Outcome Breast reconstruction Indocyanine green angiography Mastectomy LA - eng N1 - 1878-0539 Diep, Gustave K Marmor, Schelomo Kizy, Scott Huang, Jing Li Jensen, Eric H Portschy, Pamela Cunningham, Bruce Choudry, Umar Tuttle, Todd M Hui, Jane Yuet Ching Journal Article Netherlands J Plast Reconstr Aesthet Surg. 2019 Apr;72(4):548-554. doi: 10.1016/j.bjps.2018.12.037. Epub 2019 Jan 7. PY - 2019 SN - 1748-6815 SP - 548-554 ST - The use of indocyanine green angiography in postmastectomy reconstruction: Do outcomes improve over time? T2 - J Plast Reconstr Aesthet Surg TI - The use of indocyanine green angiography in postmastectomy reconstruction: Do outcomes improve over time? VL - 72 ID - 12170 ER - TY - JOUR AU - Struk, S. AU - Honart, J. F. AU - Qassemyar, Q. AU - Leymarie, N. AU - Sarfati, B. AU - Alkhashnam, H. AU - Mazouni, C. AU - Rimareix, F. AU - Kolb, F. DB - Medline DO - 10.1016/j.anplas.2017.09.008 IS - 1 KW - coloring agent indocyanine green breast reconstruction breast tumor diagnostic imaging female fluorescence angiography human lymphedema mastectomy partial mastectomy pathology procedures sentinel lymph node biopsy surgical flaps transplantation treatment outcome LA - French M3 - Review N1 - L624473165 2018-10-25 PY - 2018 SN - 1768-319X SP - 54-61 ST - Use of indocyanine green angiography in oncological and reconstructive breast surgery T2 - Annales de chirurgie plastique et esthetique TI - Use of indocyanine green angiography in oncological and reconstructive breast surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L624473165&from=export http://dx.doi.org/10.1016/j.anplas.2017.09.008 VL - 63 ID - 5516 ER - TY - JOUR AB - Introduction: Mastectomy skin flap necrosis represents a significant complication of breast reconstructive procedures and is reported to occur in 30%-52% of patients undergoing breast reconstruction. Early identification of ischemia and early initiation of hyperbaric oxygen (HBO2) therapy can mitigate the effects of ischemia and rescue otherwise non-viable breast flap tissue. Methods: We retrospectively examined the outcomes of HBO2 therapy in eight breasts with compromised mastectomy skin flaps between September 2015 and January 2017. Indocyanine green angiography (ICGA) was used to assess perfusion intraoperatively and post-HBO2 administration. Results: Seven patients were referred for HBO2 within 24 hours of mastectomy. One patient failed to improve despite starting hyperbaric treatment within 24 hours. All other patients manifested successful healing of their mastectomy skin flaps with acceptable cosmesis after 10 HBO2 treatments. The mean relative perfusion of the at-risk area was 13.8% (±3.7%) pre-HBO2 and 101.6% (±37.3%) post-HBO2. The average area at-risk pre-HBO2 was 17.1 cm2 and reduced to zero post-HBO2. Relative perfusion values after HBO2 were found to be 6.8 (±3.4) times greater than those measured prior to HBO2. Conclusions: A short course of HBO2 may be sufficient to successfully rescue at risk post-mastectomy breast flaps. ICGA is a useful adjunct for evaluating post-mastectomy breast flap perfusion before and after HBO2 therapy. AU - Rajpal, N. AU - Walters, E. T. AU - Elmarsafi, T. AU - Pittman, T. A. AU - Johnson-Arbor, K. K. DB - Medline IS - 4 KW - coloring agent indocyanine green adult adverse event aged angiography breast reconstruction breast tumor female human hyperbaric oxygen therapy ischemia mastectomy middle aged necrosis pathology postoperative complication procedures retrospective study salvage therapy surgical flaps vascularization wound healing LA - English M3 - Article N1 - L629368269 2019-09-24 2019-11-18 PY - 2019 SN - 1066-2936 SP - 461-465 ST - Use of hyperbaric oxygen therapy for tissue ischemia after breast reconstruction T2 - Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc TI - Use of hyperbaric oxygen therapy for tissue ischemia after breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629368269&from=export VL - 46 ID - 5062 ER - TY - JOUR AB - The authors consider 12 cases of breast-reconstruction after mastectomy, made with the Holmstrom's flap, to verify the validity and the real utility of this way of reconstruction. It has been made a follow-up of 4 years, to verify, in course of time, the characteristics of the reconstructed breasts. All the patients have been operated in a general surgery department. The Holmstrom's flap has been prevalently used in patients, during immediate reconstruction. The breast reconstruction, made with this fascio-cutaneous transposition flap, requires the use of prosthesis. The operating time has a very short duration. The breast reconstruction, made with this method, requires a very short staying in hospital. The nipple-areola complex reconstruction has been made in a second time, few months later. The patients have been examined periodically, to verify, immediately, the result of the flap and, later, the quality of the new breast's shape and the occurrence of capsular contracture. The results achieved with this reconstructive method are a good shape and ptosys as to confer great naturalness to the new breast. The authors conclude that, even if they use the TRAM-flap as first choice in breast-reconstruction, the Holmstrom's flap is a reconstructive technique of great utility in immediate breast reconstruction, that is able to give very good aesthetic results. AD - M. Ferri, Via Cassia 929, 00189 Roma, Italy AU - Bertucci, D. AU - Ferri, M. AU - Grimaldi, M. AU - Giudiceandrea, F. AU - Cervelli, V. DB - Embase Medline IS - 10 KW - article breast prosthesis breast reconstruction clinical article esthetic surgery fasciocutaneous flap female human length of stay mastectomy skin transposition flap surgical technique LA - Italian M3 - Article N1 - L27519286 1997-12-19 PY - 1997 SN - 0026-4733 SP - 1267-1270 ST - Use of Holmstrom's flap in breast reconstruction T2 - Minerva Chirurgica TI - Use of Holmstrom's flap in breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L27519286&from=export VL - 52 ID - 8684 ER - TY - GEN AN - NCT01587248 AU - University, Aga Khan DA - March KW - Breast Cancer|Modified Radical Mastectomy N1 - No Results Available Device: Harmonic|Procedure: electrocautery Duration of drains (days)|Operative time|Drain Volume|Overall complications|Pain Female Phase 3 152 Other Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Single (Participant)|Primary Purpose: Prevention 1519-Sur-ERC-10 August 2011 PB - https://ClinicalTrials.gov/show/NCT01587248 PY - 2010 ST - hmrm TI - Use of Harmonic in Breast Surgery ID - 509 ER - TY - JOUR AB - Learning objectives: The purpose of this study was to identify if the use of Glyceryl Trinitrate (GTN) enabled better visualization of deep inferior epigastric perforator (DIEP) vessels and their characteristics. The objective was to determine if the number of perforators seen on CT increased with GTN and establish if it provided a true representation of the vessel dimensions. This would allow the most suitable perforator to be selected for surgery. Furthermore, did it improve vessel selection for the DIEP flap, resulting in a better outcome for the patient. Background: CT is the gold standard for DIEP flap planning (Keys et al.) as it has been proven to be the most accurate way to map the intramuscular course of the DIEP vessels (Malhotra et al., Minqiang et al.). Studies have shown that patients who had the preoperative DIEP CT scan, resulted in significantly reduced operating times and postoperative complications, as up to 82% of perforators used by the surgeons were planned from the CT (Keys et al., Minqiany et al., Karunarity et al.). These studies further identified that the planned perforators that weren't used were due predominantly to the lack of adequate information provided by the preoperative CT. The use of GTN in CT imaging has previously solely been used for coronary angiograms for its ability to dilate these vessels to better visualise and assess for abnormalities. GTN could be further utilized in other CT angiograms such as looking at the DIEP vessels to more accurately assess their size, location, course and length, all important factors when determining if a perforator is suitable for use in a DIEP flap breast reconstruction. Imaging findings: Since introducing 300 mg sublingual of GTN for the DIEP CT angiograms the number of perforators identified has increased by 40%. This has also meant that every scan has demonstrated at least 1 suitable perforator that could be used for the DIEP flap, as the vessels are more accurately characterized with GTN. Previously, without GTN there have been several failed scans where no suitable perforator was seen. Conclusion: GTN has proven to be advantageous for preoperative planning for DIEP flap breast reconstructions. It has not only increased the number of perforators seen on the preoperative CT but it also gave more accurate information in regards to the DIEP vessel's characteristics thus providing the surgeon with an improved preoperative plan. This allows for the most suitable perforator being selected for the DIEP flap and reducing the chances of complications occurring. Furthermore, there have been no complications with the administration of GTN to date. AD - A. Crook, Fiona Stanley Hospital, Perth, WA, Australia AU - Crook, A. AU - Wood, C. AU - Ho, K. DB - Embase DO - 10.1111/1754-9485.2-12656 KW - glyceryl trinitrate adult breast reconstruction complication congenital malformation deep inferior epigastric perforator flap drug therapy gold standard human learning operation duration outcome assessment postoperative complication surgeon surgery x-ray computed tomography LA - English M3 - Conference Abstract N1 - L618976779 2017-11-01 PY - 2017 SN - 1754-9485 SP - 115 ST - The use of GTN in pre-operative CT planning for DIEP breast reconstructions T2 - Journal of Medical Imaging and Radiation Oncology TI - The use of GTN in pre-operative CT planning for DIEP breast reconstructions UR - https://www.embase.com/search/results?subaction=viewrecord&id=L618976779&from=export http://dx.doi.org/10.1111/1754-9485.2-12656 VL - 61 ID - 5621 ER - TY - JOUR AB - The deep inferior epigastric perforator (DIEP) flap only contains blood vessels without any muscle tissue, so donor site morbidity is greatly reduced. However, the flaps reduced blood supply limits its use to Zone II and Zone IV. If unilateral modified mastectomy is performed, Zone I and III should be used instead of Zone I and II. Unlike Zone II of the free TRAM flap, Zone II of the DIEP flap has a tendency for fat necrosis. Another difficulty in DIEP flap elevation is the wide range of anatomical variation present in the perforators themselves. Indeed, in some patients the perforators are prohibitively small, in which instance the authors convert the procedure to a fascia sparing free TRAM flap (attaching a small amount of the muscle around the vessels and excluding the fascia) or a standard free TRAM flap. That is the key to a safe and successful breast reconstruction when using the abdominal tissue. AD - K. Nohira, Soshundo Plastic Surgery, Sapporo 060-0061, Japan AU - Nohira, K. AU - Shintomi, Y. AU - Yajima, K. AU - Yamamoto, Y. AU - Sugihara, T. DB - Embase IS - 2 KW - abdominoplasty adult article breast reconstruction case report epigastric artery fascia fat necrosis female free tissue graft human mastectomy myocutaneous flap rectus abdominis muscle LA - Japanese M3 - Article N1 - L32244627 2001-04-10 PY - 2001 SN - 0021-5228 SP - 121-127 ST - Use of free DIEP flap for breast reconstruction T2 - Japanese Journal of Plastic and Reconstructive Surgery TI - Use of free DIEP flap for breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L32244627&from=export VL - 44 ID - 8475 ER - TY - JOUR AB - Background: The skin sparing mastectomy continues to allow improvement in the esthetic outcome after immediate autologous breast reconstruction. However, native skin flap necrosis does occur and can sigificantly jeopardize the result. The purpose of this series was to evaluate objectively the utility of fluorescein dye as a tool to assist with evaluation of eventual flap viability or flap necrosis. Methods: Fifty consecutive periareolar mastectomy flaps were evaluated after autologous reconstruction. Patient demographics and risk factors were queried. The mastectomy skin flaps were evaluated clinically for viability and managed appropriately. Flap inset was performed. Intravenous fluorescein dye was then given, and areas of nonfluorescence were marked (size and location documented). Photodocumentation was performed intraoperatively and 1 week postoperatively. Areas of skin survival and skin necrosis were documented, and comparisons were made. Results: The type of reconstructions included TRAM flap (n = 3 1), and latissimus dorsi with expander (n = 19), with an average age of 50 years (range: 38-68 years). Patient demographics included previous radiation therapy (n = 5), smoking history (n = 14), hypertension (n = 13), and previous breast scars (n = 16). Skin fluorescence corresponded with flap survival (n = 48/50), giving a positive predictive value of 96%. Two flaps (1 patient) had some skin necrosis despite full fluorescence; however, she was eventually diagnosed with hepatitis C. vasculitis. Of the 21 flaps with areas of nonfluorescence, skin necrosis was present in 5 of 21, a negative predictive value of 25%. The majority of areas of nonfluorescence were less than 4 cm(2) and had full flap survival (n = 16/21). Two flaps with nonfluorescence of <4 cm(2) and previous radiation therapy had skin necrosis. All flaps with areas >4 cm(2) had skin necrosis, unless proximally located on the skin flaps. Conclusions: Fluorescein dye is a sensitive test for determining native mastectomy skin flap viability after autologous reconstruction; however, viability is underpredicted. Location on the skin flaps, size of nonfluorescence, as well as history of radiation therapy should be taken into consideration. Areas of nonfluorescence <4 cm(2) typically survive, except in the irradiated breast. Any area of nonfluorescence >4 cm(2) typically does not survive, except when located more proximally on the flap. AD - [Losken, Albert; Schaefer, Timothy G.; Carlson, Grant W.] Emory Div Plast & Reconstruct Surg, Atlanta, GA 30308 USA. [Styblo, Toncred M.] Emory Div Surg Oncol, Atlanta, GA USA. Losken, A (corresponding author), Emory Div Plast & Reconstruct Surg, 550 Peachtree St,Suite 84300, Atlanta, GA 30308 USA. Albert_losken@emoryhealthcare.org AN - WOS:000257081300006 AU - Losken, A. AU - Styblo, T. M. AU - Schaefer, T. G. AU - Carlson, G. W. DA - Jul DO - 10.1097/SAP.0b013e318156621d IS - 1 J2 - Ann. Plast. Surg. KW - skin sparing mastectomy flap viability fluorescein dye autologous reconstruction local recurrence perfusion Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 318HD Times Cited: 48 Cited Reference Count: 24 Losken, Albert Styblo, Toncred M. Schaefer, Timothy G. Carlson, Grant W. 50 0 Lippincott williams & wilkins Philadelphia PY - 2008 SN - 0148-7043 SP - 24-29 ST - The use of fluorescein dye as a predictor of mastectomy skin flap viability following autologous tissue reconstruction T2 - Annals of Plastic Surgery TI - The use of fluorescein dye as a predictor of mastectomy skin flap viability following autologous tissue reconstruction UR - ://WOS:000257081300006 VL - 61 ID - 3403 ER - TY - JOUR AB - BACKGROUND: Breast plastic surgery is a rapidly evolving field of medicine. The modern view of surgical trends reflects the desire to minimize complications and introduce advanced technologies. These always will be priorities for surgeons. Reconstructive surgery, a branch of plastic surgery focusing on restoration of lost functional and aesthetic component, seeks to enhance psychological rehabilitation and improves the quality of life, as well as aesthetic recovery. OBJECTIVE: This review addresses the action of fibrin agents and their effect on the quality of surgical hemostasis. DISCUSSION AND CONCLUSION: The fundamental goals for the surgeon are to perform a minimally traumatic intervention and to prevent any form of complication. Achieving complete hemostasis is an intraoperative necessity. Timely prevention of bleeding and hemorrhagic phenomena can affect not only the outcome of the operation, but also the incidence of postoperative complications. Topics include the integrity of microvascular anastomoses, tissue adhesion, and the incidence of seromas and hematomas associated with fibrin glue usage. The literature on fibrin adhesives with respect to prevention of postoperative complications, and the effectiveness with active drainage also are analyzed. AD - I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya str., Moscow 119991,Russian Federation. Department of Normal and Topographic Anatomy, Faculty of Fundamental Medicine, M.V. Lomonosov Moscow State University (MSU), 31-5 Lomonosovsky Prospekt, 117192 Moscow, Russian Federation. Department of Clinical Sciences, Faculty of Health Sciences, University of Tolima, Ibagué -730001,Colombia. Department of Biological Sciences, Salem University, 223 West Main Street Salem, WV 26426,United States. Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka 142432, Russian Federation. GALLY International Research Institute, 7733 Louis Pasteur Drive, #330, San Antonio, TX 78229, United States. Research Institute of Human Morphology, 3 Tsyurupy Street, Moscow, 117418, Russian Federation. AN - 31721704 AU - Chen, K. AU - Sinelnikov, M. Y. AU - Nikolenko, V. N. AU - Reshetov, I. V. AU - Cao, Y. AU - Li, Z. AU - Kochurova, E. V. AU - Nikolenko, S. N. AU - Avila-Rodríguez, M. AU - Somasundaram, S. G. AU - Kirkland, C. E. AU - Aliev, G. DO - 10.2174/1568026619666191112101448 DP - NLM ET - 2019/11/14 IS - 32 KW - Breast/*surgery Breast Neoplasms/*surgery Female *Fibrin Tissue Adhesive/pharmacology Hemostatics/pharmacology Humans *Reconstructive Surgical Procedures Surgical Flaps Aesthetics Breast Fibrin glue Fibrinogen Plastic surgery Reconstruction. LA - eng N1 - 1873-4294 Chen, Kuo Sinelnikov, Mikhail Y Nikolenko, Vladimir N Reshetov, Igor V Cao, Yu Li, Zhi Kochurova, Ekaterina V Nikolenko, Svetlana N Avila-Rodríguez, Marco Somasundaram, Siva G Kirkland, Cecil E Aliev, Gjumrakch Journal Article Review United Arab Emirates Curr Top Med Chem. 2019;19(32):2985-2990. doi: 10.2174/1568026619666191112101448. PY - 2019 SN - 1568-0266 SP - 2985-2990 ST - The Use of Fibrin-based Tissue Adhesives for Breast in Reconstructive and Plastic Surgery T2 - Curr Top Med Chem TI - The Use of Fibrin-based Tissue Adhesives for Breast in Reconstructive and Plastic Surgery VL - 19 ID - 11293 ER - TY - JOUR AB - BACKGROUND: The reconstruction of a large postmastectomy chest wall defect for patients with stage III/IV breast cancer is a challenge for plastic surgeons. In this study, we present the application of an extended transverse rectus abdominis myocutaneous (TRAM) flap to easily and safely reconstruct these defects. PATIENTS AND METHODS: A retrospective review from November 1997 to November 2016 revealed that 65 patients with stage III/IV breast cancer immediately underwent postmastectomy TRAM flap reconstruction. In total, 16 patients were enrolled in this study based on the inclusion criteria of a postmastectomy chest skin defect size of greater than or equal to 100 cm and a TRAM flap size of greater than or equal to 80% of the lower abdominal area for reconstruction. RESULTS: Eleven (68.9%) and 5 patients (31.3%) were diagnosed with stage III and stage IV breast cancer, respectively. The chest wall skin defects ranged from 135 to 440 cm. All flap areas exceeded 80% of the lower abdominal area. Overall, 100% of the harvested flaps were used in 3 patients, and only 1 patient had marginal necrosis in zone IV. No total flap loss was observed. The average length of hospital stay was 5.8 days, and the mean follow-up duration was 46.6 months (range, 4.5-117.7 months). On a Likert scale, the mean follow-up satisfaction score of 10 patients was 4.7. CONCLUSIONS: Even when the flap area exceeded 80% of the lower abdominal area, the extended TRAM flap proved an effective and viable method for the immediate reconstruction of extensive postmastectomy chest wall skin defects, resulting in few minor complications and high follow-up satisfaction scores. AU - Lin, Y. N. AU - Ou-Yang, F. AU - Hsieh, M. C. AU - Lee, S. S. AU - Huang, S. H. AU - Chuang, C. H. AU - Chang, C. H. AU - Kuo, Y. R. AU - Hou, M. F. AU - Lin, S. D. DB - Medline DO - 10.1097/SAP.0000000000002188 IS - 1S Suppl 1 KW - adult advanced cancer article breast cancer cancer patient cancer staging cancer surgery complication female follow up graft failure hospitalization human Likert scale major clinical study mastectomy necrosis retrospective study satisfaction skin defect surgery thorax wall defect transverse rectus abdominis musculocutaneous flap LA - English M3 - Article N1 - L630062376 2019-12-12 PY - 2020 SN - 1536-3708 SP - S34-S39 ST - Use of Extended Pedicled Transverse Rectus Abdominis Myocutaneous Flap for Extensive Chest Wall Defect Reconstruction After Mastectomy for Locally Advanced Breast Cancer T2 - Annals of plastic surgery TI - Use of Extended Pedicled Transverse Rectus Abdominis Myocutaneous Flap for Extensive Chest Wall Defect Reconstruction After Mastectomy for Locally Advanced Breast Cancer UR - https://www.embase.com/search/results?subaction=viewrecord&id=L630062376&from=export http://dx.doi.org/10.1097/SAP.0000000000002188 VL - 84 ID - 4890 ER - TY - JOUR AD - University of Washington Medical Center Division of Plastic Surgery Box 356410 1959 NE Pacific Street Seattle, WA 98195-6410, USA. AN - 20816511 AU - Neligan, P. C. DA - Oct DO - 10.1016/j.cps.2010.07.002 DP - NLM ET - 2010/09/08 IS - 4 KW - Breast Diseases/*surgery *Epigastric Arteries Female Humans Mammaplasty/*methods Mastectomy Surgical Flaps/*blood supply LA - eng N1 - 1558-0504 Neligan, Peter C Introductory Journal Article United States Clin Plast Surg. 2010 Oct;37(4):xi. doi: 10.1016/j.cps.2010.07.002. PY - 2010 SN - 0094-1298 SP - xi ST - The use of DIEAP flaps in postmastectomy breast reconstruction is a case in point. Preface T2 - Clin Plast Surg TI - The use of DIEAP flaps in postmastectomy breast reconstruction is a case in point. Preface VL - 37 ID - 11949 ER - TY - JOUR AB - BACKGROUND: A deepithelialized flap is used in almost all surgical fields, particularly in plastic, reconstructive, and aesthetic surgery. This article describes several operating techniques using deepithelialized flaps that in specific cases can improve silicone breast implant coverage. METHODS: All the patients underwent surgery in our department. The operations described are subcutaneous mastectomies with immediate reconstruction using silicone implants, mastopexy with immediate augmentation using silicone implants in a patient with very thin skin, and reaugmentation with mastopexy and reimplantation of silicone implants in a patient with very thin skin and extremely thin pectoral muscles. In all the described operations, we used a superolaterally based deepithelialized flap from the lower part of the breast that we fixed to the thoracic wall to cover the inferior part of the implant. RESULTS: The authors have extensive experience using this flap in such specific cases. To date, they have performed more than 30 operations using this technique. Each patient was followed for 2-7 years, and the findings show excellent postoperative results. None of the patients had implant extrusions, flap extrusions, or infections. The long-term cosmetic results were outstanding. CONCLUSION: The use of deepithelialized flaps in patients with very thin skin or pectoral muscles is a safe and easy way to improve implant coverage and prevent implant extrusion. This technique provides an alternative surgical option that can be beneficial in certain mammary cases. AD - Department of Plastic Surgery, 1st Medical Faculty of Charles University in Prague, University Hospital Bulovka, Prague 8, 180 00, Czech Republic. mestak@gmail.com AN - 21607536 AU - Mestak, J. AU - Sukop, A. AU - Mestak, O. DA - Dec DO - 10.1007/s00266-011-9745-5 DP - NLM ET - 2011/05/25 IS - 6 KW - Female Humans Mammaplasty/*methods *Surgical Flaps Treatment Outcome LA - eng N1 - 1432-5241 Mestak, Jan Sukop, Andrej Mestak, Ondrej Journal Article Research Support, Non-U.S. Gov't United States Aesthetic Plast Surg. 2011 Dec;35(6):1106-11. doi: 10.1007/s00266-011-9745-5. Epub 2011 May 24. PY - 2011 SN - 0364-216x SP - 1106-11 ST - Use of deepithelialized flap in mammoplasties: simple method with excellent results T2 - Aesthetic Plast Surg TI - Use of deepithelialized flap in mammoplasties: simple method with excellent results VL - 35 ID - 12331 ER - TY - JOUR AB - Background: Decision analysis allows clinicians to compare different strategies in the context of uncertainty, through explicit and quantitative measures such as quality of life outcomes and costing data. This is especially important in breast reconstruction, where multiple strategies can be offered to patients. This systematic review aims to appraise and review the different decision analytic models used in breast reconstruction. Methods: A search of English articles in PubMed, Ovid, and Embase databases was performed. All articles regardless of date of publishing were considered. Two reviewers independently assessed each article, based on strict inclusion criteria. Results: Out of 442 articles identified, 27 fit within the inclusion criteria. These were then grouped according to aspects of breast reconstruction, with implant-based reconstruction (n = 13) being the most commonly reported. Decision analysis (n = 19) and/or economic analyses (n = 27) were employed to discuss reconstructive options. The most common outcome was cost (n = 27). The decision analysis models compared and contrasted surgical strategies, management options, and novel adjuncts. Conclusions: Decision analysis in breast reconstruction is growing exponentially. The most common model used was a simple decision tree. Models published were of high quality but could be improved with a more in-depth sensitivity analysis. It is essential for surgeons to familiarize themselves with the concept of decision analysis to better tackle complicated decisions, due to its intrinsic advantage of being able to weigh risks and benefits of multiple strategies while using probabilistic models. AD - [Bouhadana, Gabriel] McGill Univ, Fac Med, Montreal, PQ, Canada. [Safran, Tyler; Al-Halabi, Becher; Davison, Peter G.] McGill Univ, Div Plast & Reconstruct Surg, Montreal, PQ, Canada. Safran, T (corresponding author), McGill Univ, Montreal Gen Hosp, Hlth Ctr, Div Plast & Reconstruct Surg, 1650 Cedar Ave, Montreal, PQ H3G 1A4, Canada. tyler.safran@mail.mcgill.ca AN - WOS:000533878900062 AU - Bouhadana, G. AU - Safran, T. AU - Al-Halabi, B. AU - Davison, P. G. C7 - e2786 DA - Apr DO - 10.1097/gox.0000000000002786 IS - 4 J2 - Prs-Glob. Open KW - cost-effectiveness analysis acellular dermal matrix epigastric perforator flap tram flap postmastectomy reconstruction implant reconstruction utility analysis single-stage medical literature plastic-surgery Surgery LA - English M3 - Review N1 - ISI Document Delivery No.: LO8MD Times Cited: 0 Cited Reference Count: 50 Bouhadana, Gabriel Safran, Tyler Al-Halabi, Becher Davison, Peter G. Alhalabi, Becher/0000-0001-9690-8977 0 Lippincott williams & wilkins Philadelphia PY - 2020 SN - 2169-7574 SP - 17 ST - Use of Decision Analysis and Economic Evaluation in Breast Reconstruction: A Systematic Review T2 - Plastic and Reconstructive Surgery-Global Open TI - Use of Decision Analysis and Economic Evaluation in Breast Reconstruction: A Systematic Review UR - ://WOS:000533878900062 VL - 8 ID - 1183 ER - TY - JOUR AB - Since anatomical variations and pathological changes are well recognised in the arterial vessels of the lower leg there is general agreement that some form of pre-operative radiological imaging of the vascular system should be carried out prior to microsurgical fibula flap harvesting. Although there is some controversy as to which modality is best, in the main imaging concentrates on providing information solely on the course and patency of the three main arterial components. Since recent literature has demonstrated the value of computed tomographic (CT) angiography in the planning of breast reconstruction with deep inferior epigastric artery perforator flaps we investigated whether this modality would be beneficial in evaluating the perforating vessels supplying the cutaneous elements of the fibula flap. 15 patients were prospectively evaluated with fine-cut lower limb CT angiography. In all cases the dominant perforators could be reliably identified and their course to the skin plotted. Measurements taken from fixed bony points permitted this detail to be transferred to the operative site. Ultimately the presence and course of the perforator vessels was confirmed to have been accurately determined by pre-operativeCTangiography at operation. AD - C. Kerawala, Royal Marsden Hospital, London, United Kingdom AU - Kerawala, C. AU - Cascarini, L. AU - Bisase, B. DB - Embase DO - 10.1016/j.bjoms.2011.03.140 KW - computed tomographic angiography harvest fibula graft maxillofacial surgery artery imaging microsurgery human anatomical variation deep inferior epigastric perforator flap cardiovascular system harvesting planning breast reconstruction patient leg skin lower leg LA - English M3 - Conference Abstract N1 - L70481136 2011-08-02 PY - 2011 SN - 0266-4356 SP - S73 ST - The use of CT angiography in the identification of peroneal artery perforators prior to fibula flap harvest T2 - British Journal of Oral and Maxillofacial Surgery TI - The use of CT angiography in the identification of peroneal artery perforators prior to fibula flap harvest UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70481136&from=export http://dx.doi.org/10.1016/j.bjoms.2011.03.140 VL - 49 ID - 7341 ER - TY - JOUR AB - BACKGROUND: Unsuccessful breast reconstruction management represents a complex challenge for the plastic surgeon. Although these events rarely occur, many patients are not suitable candidates for conventional flaps, because of either previous donor-site surgery or lack of sufficient tissue. METHODS: In this study, a contralateral free latissimus dorsi musculocutaneous flap (CL-LDMF) was planned for correction of major lesions in the anterior chest wall. Twelve patients underwent secondary/tertiary breast reconstruction with CL-LDMF with a customized shape (horizontal, oblique, or "fleur-de-lis") depending on the amount of tissue necessary. The technique was indicated in patients with large thoracic defects who lacked a donor site and had undergone previous unsuccessful pedicled LDMF. RESULTS: The mean follow-up time was 42.5 months (range: 18-72 months). Five local complications occurred in four of the 12 patients. Dorsal dehiscence was observed in one, local wound infection in one, small partial CL-LDMF necrosis in one, and dorsal seroma in one patient. All cases of complications were limited and treated with a conservative approach except for one implant extrusion 4 months after reconstruction. No total flap loss was reported. All patients achieved a satisfactory thoracic and breast reconstruction. CONCLUSION: The results of this study demonstrate that free CL-LDMF is a reliable technique and should be considered in selected cases of tertiary reconstructions. The majority of complications were immediate, minor, and comparable to other reconstructive techniques. We believe that in selected patients, especially those who do not have available donor-site areas, free CL-LDMF is advantageous and should be part of the armamentarium of all plastic surgeons who deal with tertiary breast reconstructions. AD - Division of Plastic Surgery, Cancer Institute of São Paulo, University of São Paulo School of Medicine, São Paulo, Brazil; Division of Plastic Surgery, Hospital Sírio-Libanês, São Paulo, Brazil. Electronic address: munhozalex@uol.com.br. Division of Plastic Surgery, Cancer Institute of São Paulo, University of São Paulo School of Medicine, São Paulo, Brazil. Breast Division, Cancer Institute of São Paulo, University of São Paulo School of Medicine, São Paulo, Brazil. Division of Plastic Surgery, University of São Paulo School of Medicine, São Paulo, Brazil. AN - 26947672 AU - Munhoz, A. M. AU - Montag, E. AU - Arruda, E. G. AU - Okada, A. AU - Fonseca, A. AU - Filassi, J. R. AU - Gemperli, R. DA - Aug DO - 10.1016/j.bjps.2016.01.019 DP - NLM ET - 2016/03/08 IS - 8 KW - Adult Aged Breast Neoplasms/pathology/radiotherapy/*surgery Female Humans Mammaplasty/adverse effects/*methods Middle Aged *Myocutaneous Flap Postoperative Complications/*surgery Reoperation Retrospective Studies Superficial Back Muscles Treatment Failure Young Adult Breast cancer Breast reconstruction Complication Latissimus dorsi myocutaneous flap Microsurgery Total failure LA - eng N1 - 1878-0539 Munhoz, Alexandre Mendonça Montag, Eduardo Arruda, Eduardo Gustavo Okada, Alberto Fonseca, Alexandre Filassi, José Roberto Gemperli, Rolf Journal Article Netherlands J Plast Reconstr Aesthet Surg. 2016 Aug;69(8):1087-91. doi: 10.1016/j.bjps.2016.01.019. Epub 2016 Feb 3. PY - 2016 SN - 1748-6815 SP - 1087-91 ST - The use of contralateral free extended latissimus dorsi myocutaneous flap for a tertiary failed breast reconstruction: Is it still an option? T2 - J Plast Reconstr Aesthet Surg TI - The use of contralateral free extended latissimus dorsi myocutaneous flap for a tertiary failed breast reconstruction: Is it still an option? VL - 69 ID - 9497 ER - TY - JOUR AB - Background: Estimation of the volume of abdominal tissue is desirable when planning autologous abdominal based breast reconstruction. However, this can be difficult clinically. The aim of this study was to develop a simple, yet reliable method of calculating the deep inferior epigastric artery perforator flap weight using the routine preoperative computed tomography angiogram (CTA) scan. Methods: Our mathematical formula is based on the shape of a DIEP flap resembling that of an isosceles triangular prism. Thus its volume can be calculated with a standard mathematical formula. Using bony landmarks three measurements were acquired from the CTA scan to calculate the flap weight. This was then compared to the actual flap weight harvested in both a retrospective feasibility and prospective study. Results: In the retrospective group 17 DIEP flaps in 17 patients were analyzed. Average predicted flap weight was 667 g (range 293-1254). The average actual flap weight was 657 g (range 300-1290) giving an average percentage error of 6.8% (p-value for weight difference 0.53). In the prospective group 15 DIEP flaps in 15 patients were analyzed. Average predicted flap weight was 618 g (range 320-925). The average actual flap weight was 624 g (range 356-970) giving an average percentage error of 6.38% (p-value for weight difference 0.57). Conclusions: This formula is a quick, reliable and accurate way of estimating the volume of abdominal tissue using the preoperative CTA scan. (C) 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - [Nanidis, Theodore G.] Chelsea & Westminster Hosp, Dept Plast Reconstruct & Burns Surg, London SW10 9NH, England. [Ridha, Hyder; Jallali, Navid] Imperial Coll Healthcare NHS Trust, Dept Plast & Reconstruct Surg, London W6 8RF, England. Nanidis, TG (corresponding author), Chelsea & Westminster Hosp, Dept Plast Reconstruct & Burns Surg, 369 Fulham Rd, London SW10 9NH, England. t.nanidis@yahoo.co.uk AN - WOS:000342361100015 AU - Nanidis, T. G. AU - Ridha, H. AU - Jallali, N. DA - Oct DO - 10.1016/j.bjps.2014.05.049 IS - 10 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - DIEP Breast reconstruction CTA Volume calculation Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: AP8WW Times Cited: 9 Cited Reference Count: 4 Nanidis, Theodore G. Ridha, Hyder Jallali, Navid 9 0 1 Elsevier sci ltd Oxford 1878-0539 PY - 2014 SN - 1748-6815 SP - 1352-1356 ST - The use of computed tomography for the estimation of DIEP flap weights in breast reconstruction: A simple mathematical formula T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - The use of computed tomography for the estimation of DIEP flap weights in breast reconstruction: A simple mathematical formula UR - ://WOS:000342361100015 VL - 67 ID - 2361 ER - TY - JOUR AB - The success of microvascular reconstruction depends on many factors. Although many factors cannot be dictated by a surgeon, the success of anastomosis can be maximized by honing skill with performing anastomoses. However, size discrepancy of vessels remains a common challenge, given the lack of an ideal technique. In this study, the authors introduce their experience in using composite deep inferior epigastric arterial and venous grafts to overcome the vessel size and pedicle length discrepancy in lateral thigh and superficial inferior epigastric artery (SIEA) flaps. Of the 1095 flaps performed, the authors identified a total of 12 flaps (one lateral thigh flap and 11 SIEA flaps) on nine patients for breast reconstruction. The authors used deep inferior epigastric vessels to act as interposition grafts between the internal mammary artery and flap pedicle. For the SIEA flaps, the authors anastomosed the SIEA system to the deep inferior epigastric arterial system, checked the viability of the flap, and then transferred the flap to the internal mammary artery and flap pedicle. For the SIEA flaps, the authors anastomosed the SIEA system to the deep inferior epigastric arterial system, checked the viability of the flap, and then transferred the flap to the internal mammary artery system in three patients. In the last five patients, the authors anastomosed the deep inferior epigastric vessels to the internal mammary artery system first, and then transferred the SIEA flap. For the lateral thigh flap, the authors anastomosed grafts to the internal mammary artery system first as well. There were no flap losses or fat necrosis. Although the authors' outcomes are limited to only breast reconstruction, they believe this method could be expanded to different types of reconstruction, especially reconstruction of the head and neck. AD - [Teotia, Sumeet S.] Univ Texas Southwestern Med Ctr Dallas, Dept Plast Surg, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. Temple Univ, Div Plast & Reconstruct Surg, Philadelphia, PA 19122 USA. Teotia, SS (corresponding author), Univ Texas Southwestern Med Ctr Dallas, Dept Plast Surg, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. sumeet.teotia@utsouthwestern.edu AN - WOS:000451341600061 AU - Cho, M. J. AU - Haddock, N. T. AU - Gassman, A. A. AU - Teotia, S. S. DA - Oct DO - 10.1097/prs.0000000000004730 IS - 4 J2 - Plast. Reconstr. Surg. KW - end-to-end perforator flap experience diameter mismatch siea Surgery LA - English M3 - Editorial Material N1 - ISI Document Delivery No.: HB8LR Times Cited: 1 Cited Reference Count: 21 Cho, Min-Jeong Haddock, Nicholas T. Gassman, Andrew A. Teotia, Sumeet S. Cho, Min-Jeong/U-5363-2019 Haddock, Nicholas/0000-0003-4649-6147 1 0 Lippincott williams & wilkins Philadelphia 1529-4242 PY - 2018 SN - 0032-1052 SP - 867-870 ST - Use of Composite Arterial and Venous Grafts in Microsurgical Breast Reconstruction: Technical Challenges and Lessons Learned T2 - Plastic and Reconstructive Surgery TI - Use of Composite Arterial and Venous Grafts in Microsurgical Breast Reconstruction: Technical Challenges and Lessons Learned UR - ://WOS:000451341600061 VL - 142 ID - 1532 ER - TY - JOUR AB - Introduction: Currently, there is no validated PROMS instrument for partial breast reconstruction with chest wall perforator flap (CWPF), which spares the latissimus dorsi (LD) muscle. CWPF expands options for breast conserving therapy (BCT) in high tumour: breast ratio. Methods: The Breast-Q™ provides a Q-score that ranges between 0-100, with 100 being the highest score in both patient satisfaction and Quality of Life (QOL) domains. Eight patients completed a combination of post-operative BCT and post-operative LD flap modules of Breast-Q™. Results: Mean post-operative Q-scores derived from eight responses were: - Satisfaction with: breast=88.5, radiated breast=92, patient care, surgeon and staff>90 - QoL domain: physical well-being=82.9, psychosocial wellbeing =92.4, sexual well-being=77.7 - Back appearance=91.1, shoulder and back function=82.9. The mean pre-operative extent of tumors (including two multi-focal) was 38.4 (18-76)mm and post-operative 9.5 (0-50)mm. One pathological complete response was in G3 triple-negative tumour with non-concentric imaging response following neo-adjuvant chemotherapy. Others included two G2 ILC, two NST and three High-Grade DCIS. Seven patients would have needed mastectomy or would have had significant defect/deformity without CWPF. Conclusions: CWPF clearly avoided mastectomy or deformity following BCT with excellent post-operative patient-reported satisfaction with breast and chest/back wound. A future pre-operative BCT Q-score (under development by the Breast-Q team) could provide a useful comparison. Although limited by small numbers, this initial data provides useful new insights into this logical combination of Q-score modules. It could be tested in either a larger cohort or serve as a framework for the development of a new Breast-Q in CWPF. AD - A. Agrawal, Cambridge University Hospitals, Cambridge, United Kingdom AU - Agrawal, A. AU - Mirshekar-Syahkal, B. DB - Embase DO - 10.1016/j.ejso.2016.02.155 IS - 5 KW - breast reconstruction clinical article deformity female human imaging intraductal carcinoma latissimus dorsi flap mastectomy neoadjuvant therapy patient care patient satisfaction perforator flap physical well-being quality of life shoulder staff surgeon surgery thorax wall wound LA - English M3 - Conference Abstract N1 - L614540541 2017-02-28 PY - 2016 SN - 1532-2157 SP - S39 ST - Use of combination of modules of BREAST-Q in partial breast reconstruction with lateral chest wall perforator flap T2 - European Journal of Surgical Oncology TI - Use of combination of modules of BREAST-Q in partial breast reconstruction with lateral chest wall perforator flap UR - https://www.embase.com/search/results?subaction=viewrecord&id=L614540541&from=export http://dx.doi.org/10.1016/j.ejso.2016.02.155 VL - 42 ID - 6009 ER - TY - JOUR AB - The use of the circumflex scapular pedicle as a recipient vessel for breast reconstruction in a series of 40 consecutive cases in 37 patients is reported. There were 3 bilateral reconstructions and 84 unilateral reconstructions. Twenty-one cases were immediate reconstructions, and 19 cases were secondary reconstructions. The diameter of the artery varied from 1.5 mm to 3 mm and systematically matched with the diameter of the epigastric artery. The artery was a branch of the subscapular system in 82.5 percent of cases (33 of 40). In 17.5 percent of cases (7 of 40), the artery was a direct branch of the axillary artery. The length of available pedicle between the axillary vessel and the distal part where it can be divided (on its division between scapular and parascapular artery) was of 76 ± 13 mm for the artery and 72 ± 12 mm for the vein. The vein was unique in 77.5 percent of cases. The diameter was similar to the artery diameter when unique. There was a dual venous system in 21 of 40 cases (52.5 percent) but in 15 cases (37.5 percent), one of the two veins was dominant. In the seven cases for which the veins were dual and of equivalent diameter, the epigastric veins were also dual and allowed a second anastomosis. Clinically, the anastomosis was always possible on the artery. In one case of reconstruction after Halstedt mastectomy, no vein could be found, because all the veins had been ligated previously. One venous thrombosis (2.5 percent) and one arterial thrombosis were experienced. Both were treated by revised anastomoses and did not compromise late results. The circumflex scapular pedicle is a reliable and simple recipient site for breast reconstruction. It allows a unique site of dissection in immediate reconstruction and avoids division of the thoracodorsal pedicle. The technique is now used exclusively at this institution. AD - L.A. Lantieri, Service de Chirurgie Plastique, Hopital Henri Mondor, 94000 Creteil, France AU - Lantieri, L. A. AU - Mitrofanoff, M. AU - Rimareix, F. AU - Gaston, E. AU - Raulo, Y. AU - Baruch, J. P. DB - Embase Medline DO - 10.1097/00006534-199912000-00015 IS - 7 KW - artery anastomosis artery diameter article axillary artery axillary vein breast reconstruction clinical article dissection donor site epigastric artery free tissue graft human mastectomy pedicled skin flap priority journal recipient scapula surgical technique LA - English M3 - Article N1 - L29565989 1999-12-15 PY - 1999 SN - 0032-1052 SP - 2049-2053 ST - Use of circumflex scapular vessels as a recipient pedicle for autologous breast reconstruction: A report of 40 consecutive cases T2 - Plastic and Reconstructive Surgery TI - Use of circumflex scapular vessels as a recipient pedicle for autologous breast reconstruction: A report of 40 consecutive cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L29565989&from=export http://dx.doi.org/10.1097/00006534-199912000-00015 VL - 104 ID - 8552 ER - TY - JOUR AB - Numerous studies have shown that the final stage in breast reconstruction, creation of the nipple-areolar complex, correlates highly with patient satisfaction and acceptance of body image. There are many different techniques, including nipple sharing, free-composite grafts, and local "pull-out" flaps, all of which are vulnerable to an unpredictable degree of loss of projection and possible need for reoperation. This leads to problems with symmetry and overbuilding the initial reconstruction with wider-based, larger flaps, which may cause breast-contour changes. We have used calcium hydroxylapatite (Radiesse, Bioform Inc., Franksville, WI) following nipple-areolar reconstruction to maintain or restore projection in selected breast-reconstruction patients. Approximately 0.4-1 mL of calcium hydroxylapatite was injected subdermally using a 27-gauge needle in 6 selected patients. All patients tolerated the office procedure well without the need for local anesthesia. We report initial short-term success, with 100% patient satisfaction, minimal loss of projection, and no complications. Semipermanent injectable soft-tissue fillers such as calcium hydroxylapatite may be useful in selected patients as a simple solution to the difficult problem of the lack of nipple projection following reconstruction. AD - Georgetown University Medical Center, Washington, DC 20037, USA. AN - 15985787 AU - Evans, K. K. AU - Rasko, Y. AU - Lenert, J. AU - Olding, M. DA - Jul DO - 10.1097/01.sap.0000168370.81333.97 DP - NLM ET - 2005/06/30 IS - 1 KW - Biocompatible Materials Breast Implants Durapatite/*therapeutic use Female Humans Injections Mammaplasty/*methods Microspheres Middle Aged Nipples/*surgery Pilot Projects Surgical Flaps Tissue Expansion Treatment Failure Treatment Outcome LA - eng N1 - Evans, Karen Kim Rasko, Yvonne Lenert, Joanne Olding, Michael Journal Article United States Ann Plast Surg. 2005 Jul;55(1):25-9; discussion 29. doi: 10.1097/01.sap.0000168370.81333.97. PY - 2005 SN - 0148-7043 (Print) 0148-7043 SP - 25-9; discussion 29 ST - The use of calcium hydroxylapatite for nipple projection after failed nipple-areolar reconstruction: early results T2 - Ann Plast Surg TI - The use of calcium hydroxylapatite for nipple projection after failed nipple-areolar reconstruction: early results VL - 55 ID - 11259 ER - TY - JOUR AD - H. Van Dam, Department of Plastic Surgery, Royal London Hospital, Whitechapel, London E1 1BB, United Kingdom AU - Van Dam, H. AU - Nduka, C. AU - Carver, N. C1 - botox(Allergan,United States) C2 - Allergan(United States) DB - Embase Medline DO - 10.1097/01.PRS.0000123612.77138.25 IS - 7 KW - botulinum toxin A adult breast carcinoma breast reconstruction breast surgery cancer radiotherapy case report diagnostic procedure female Food and Drug Administration histopathology human letter mastectomy muscle spasm muscle twitch myocutaneous flap pedicled skin flap priority journal rectus abdominis muscle strabismus transverse rectus abdominis musculocutaneous flap treatment indication botox LA - English M3 - Letter N1 - L39201763 2004-09-26 PY - 2004 SN - 0032-1052 SP - 2224 ST - The use of botulinum toxin in treating a twitching tram flap [11] T2 - Plastic and Reconstructive Surgery TI - The use of botulinum toxin in treating a twitching tram flap [11] UR - https://www.embase.com/search/results?subaction=viewrecord&id=L39201763&from=export http://dx.doi.org/10.1097/01.PRS.0000123612.77138.25 VL - 113 ID - 8256 ER - TY - JOUR AB - Background: Autologous abdominal tissue transfer is a well-established method of breast reconstruction. The deep inferior epigastric perforator (DIEP) flap has the additional benefit of minimal donor site morbidity as it spares the muscle and fascia. Conventional DIEP flaps may not provide adequate volume in cases where the patient is thin, has midline abdominal scars, and/or has a large volume of tissue to replace. One solution is to use a bipedicled DIEP flap, incorporating all the available abdominal tissue. Bipedicled DIEP flaps have been described in a number of different configurations. The literature appears to favor intra-flap anastomosis, with a minimal exposition of two recipient vessels. It has been demonstrated that both the antegrade internal mammary artery (aIMA) and retrograde internal mammary artery (rIMA) are adequate recipient vessels. Here, the authors present a single-center experience with bipedicled DIEP flaps to both the aIMA and rIMA, showing their feasibility and safety. Methods: A retrospective review of patients who underwent unilateral breast reconstruction using bipedicled DIEP flaps was performed to assess outcomes. Results: A total of 20 patients who underwent unilateral breast reconstruction using a bipedicled DIEP flap were selected for this study. All of them were previously diagnosed with cancer. There were zero flap failure and zero instance of abdominal hernia or issue with abdominal wall functionality following the surgeries. Conclusions: The series of surgeries described in this study resulted in successful breast reconstruction in 20 women using a bipedicled DIEP flap. The results show that this approach allows for reconstruction in places where a conventional DIEP does not provide adequate volume, achieved safely, and does not increase morbidity. The bipedicled DIEP flap is a viable option for large-volume autologous breast reconstruction, providing ample tissue for successful reconstruction while also allowing for shorter recovery and limited donor site morbidity. (C) 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - [Rosa, Jonatan Hernandez; Sherif, Rami D.; Torina, Philip J.; Harmaty, Marco A.] Icahn Sch Med Mt Sinai, 1 Gustave L Levy Pl, New York, NY 10029 USA. Sherif, RD (corresponding author), 5 East 98th St,14th Floor,Suite B,Box 1259, New York, NY 10029 USA. rami.sherif@icahn.mssm.edu AN - WOS:000390537800008 AU - Rosa, J. H. AU - Sherif, R. D. AU - Torina, P. J. AU - Harmaty, M. A. DA - Jan DO - 10.1016/j.bjps.2016.09.010 IS - 1 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - Breast reconstruction DIEP Bi-pedicle Flap reconstruction Microsurgery tram flaps diep flap experience superior systems Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: EF7VQ Times Cited: 10 Cited Reference Count: 19 Rosa, Jonatan Hernandez Sherif, Rami D. Torina, Philip J. Harmaty, Marco A. 10 0 Elsevier sci ltd Oxford 1878-0539 PY - 2017 SN - 1748-6815 SP - 47-53 ST - Use of both antegrade and retrograde internal mammary vessels in the bipedicled deep inferior epigastric perforator flap for unilateral breast reconstruction T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Use of both antegrade and retrograde internal mammary vessels in the bipedicled deep inferior epigastric perforator flap for unilateral breast reconstruction UR - ://WOS:000390537800008 VL - 70 ID - 1920 ER - TY - JOUR AU - Macdonald, C. R. AU - Reeve, W. AU - Hazari, A. DB - Embase Medline DO - 10.1016/j.bjps.2013.12.005 IS - 5 KW - hemoglobin blood transfusion breast reconstruction cost benefit analysis deep inferior epigastric perforator flap erythrocyte transfusion free tissue graft gold standard human letter major clinical study priority journal risk assessment thrombocyte transfusion LA - English M3 - Letter N1 - L52927959 2013-12-26 2014-04-25 PY - 2014 SN - 1878-0539 1748-6815 SP - 732-733 ST - The use of blood products in free flap based breast reconstruction: A cost and safety analysis T2 - Journal of Plastic, Reconstructive and Aesthetic Surgery TI - The use of blood products in free flap based breast reconstruction: A cost and safety analysis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52927959&from=export http://dx.doi.org/10.1016/j.bjps.2013.12.005 VL - 67 ID - 6575 ER - TY - JOUR AB - As surgeons we are under increasing pressure to improve efficiency and cost saving without negatively impacting on the quality and safety of our patient's care. Published rates of red cell transfusion in free flap based breast reconstruction range widely (18-80%). We felt that our transfusion rates were low enough that routinely cross matching blood was likely to be a poor use of resources. We retrospectively reviewed a year of free flap based breast reconstruction activity at a regional centre. There had been 141 free flaps performed on 130 patients. One patient received an elective pre-operative platelet transfusion and five patients received red cell transfusions (5/130, 3.8%). Two patients received blood intra-operatively whilst the rest received red cells over days 1 to 4 post-op. None of the patients had abnormal antibodies and all could have safely received universal donor (O negative) blood. 124 patients had blood needlessly cross matched at significant expense. The patients that did require transfusion could either have received universal donor blood or have safelywaited for blood to be cross matched.We would encourage other departments to review their practice as a potential area for improving cost efficiency without any additional increase in risk. AD - C. Macdonald, Queen Victoria Hospital, East Grinstead, United Kingdom AU - Macdonald, C. AU - Reeve, W. AU - Hazari, A. DB - Embase DO - 10.1016/j.ijsu.2013.06.518 IS - 8 KW - antibody blood free tissue graft breast reconstruction safety surgeon human patient transfusion erythrocyte donor cost control risk thrombocyte transfusion patient care LA - English M3 - Conference Abstract N1 - L71272045 2013-12-31 PY - 2013 SN - 1743-9191 SP - 683 ST - The use of blood products in free flap based breast reconstruction - A cost and safety analysis T2 - International Journal of Surgery TI - The use of blood products in free flap based breast reconstruction - A cost and safety analysis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71272045&from=export http://dx.doi.org/10.1016/j.ijsu.2013.06.518 VL - 11 ID - 6686 ER - TY - JOUR AN - WOS:000342231800021 AU - Jones, C. AU - Lidder, S. AU - Jevani, A. DA - Aug IS - 3 J2 - Scott. Med. J. KW - General & Internal Medicine LA - English M3 - Meeting Abstract N1 - ISI Document Delivery No.: AP7BE Times Cited: 0 Cited Reference Count: 0 Jones, C. Lidder, S. Jevani, A. 0 Sage publications ltd London 2045-6441 PY - 2014 SN - 0036-9330 SP - E28-E28 ST - The use of bilateral free superior gluteal artery perforator flaps for immediate unilateral breast reconstruction T2 - Scottish Medical Journal TI - The use of bilateral free superior gluteal artery perforator flaps for immediate unilateral breast reconstruction UR - ://WOS:000342231800021 VL - 59 ID - 2383 ER - TY - JOUR AB - Background: The deep inferior epigastric perforator (DIEP) flap is currently the flap of choice for autologous breast reconstruction. When the amount of tissue transferred needs to be maximised, a bi-pedicled DIEP flap allows harvesting the entire lower abdomen. Methods: A retrospective analysis was conducted including patients who had unilateral breast reconstruction with bi-pedicled DIEP flaps between January 2013 and December 2017. Demographic information, operation notes and post-operative course were reviewed. Mann-Whitney-Wilcoxon and Fischer’s exact tests were used to look for a statistically significant association between complications and intra-operative modalities. Results: Forty-four cases were reviewed. Half of these patients underwent delayed breast reconstructions, 40.9% underwent immediate reconstructions and 10% were salvage cases. The majority of the cases (52.3%) had an initial anastomosis of the secondary pedicle to either a side branch (38.6%) or the superior continuity (13.6%) of the primary pedicle (intra-flap anastomosis). Twenty-seven percent of the intra-flap arterial anastomoses were performed using vessel couplers. The remaining 47.7% of the cohort had anastomoses of both pedicles to the internal mammary (IM) vessels anterogradely and retrogradely. There were no flap failures. The cases in which both pedicles were anastomosed with IM vessels had an overall higher complications rate, but were not related to flap failures or anastomotic issues. Intra-flap anastomosis on the other hand is a reliable alternative including the possibility of vessel coupler application to smaller arteries of this approach. Conclusions: In our experience, bi-pedicled DIEP flaps are a safe alternative for unilateral breast reconstruction when the amount of harvested tissue needs to be maximised. Level of evidence: Level III, therapeutic study. AD - G. Christopoulos, The Blizard Institute, Queen Mary University of London, London, United Kingdom AU - Christopoulos, G. AU - Berner, J. E. AU - Sergentanis, T. N. AU - Blackburn, A. AU - Mackey, S. P. DB - Embase DO - 10.1007/s00238-020-01742-9 KW - adult artery anastomosis article breast reconstruction case report clinical article complication deep inferior epigastric perforator flap demography female graft failure human human tissue male mammary gland retrospective study LA - English M3 - Article in Press N1 - L2006725603 2020-09-22 PY - 2020 SN - 1435-0130 0930-343X ST - The use of bi-pedicled DIEP flap for unilateral breast reconstruction: a 5-year retrospective study T2 - European Journal of Plastic Surgery TI - The use of bi-pedicled DIEP flap for unilateral breast reconstruction: a 5-year retrospective study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2006725603&from=export http://dx.doi.org/10.1007/s00238-020-01742-9 ID - 4863 ER - TY - JOUR AB - Background The deep inferior epigastric perforator (DIEP) flap is currently the flap of choice for autologous breast reconstruction. When the amount of tissue transferred needs to be maximised, a bi-pedicled DIEP flap allows harvesting the entire lower abdomen. Methods A retrospective analysis was conducted including patients who had unilateral breast reconstruction with bi-pedicled DIEP flaps between January 2013 and December 2017. Demographic information, operation notes and post-operative course were reviewed. Mann-Whitney-Wilcoxon and Fischer's exact tests were used to look for a statistically significant association between complications and intra-operative modalities. Results Forty-four cases were reviewed. Half of these patients underwent delayed breast reconstructions, 40.9% underwent immediate reconstructions and 10% were salvage cases. The majority of the cases (52.3%) had an initial anastomosis of the secondary pedicle to either a side branch (38.6%) or the superior continuity (13.6%) of the primary pedicle (intra-flap anastomosis). Twenty-seven percent of the intra-flap arterial anastomoses were performed using vessel couplers. The remaining 47.7% of the cohort had anastomoses of both pedicles to the internal mammary (IM) vessels anterogradely and retrogradely. There were no flap failures. The cases in which both pedicles were anastomosed with IM vessels had an overall higher complications rate, but were not related to flap failures or anastomotic issues. Intra-flap anastomosis on the other hand is a reliable alternative including the possibility of vessel coupler application to smaller arteries of this approach. Conclusions In our experience, bi-pedicled DIEP flaps are a safe alternative for unilateral breast reconstruction when the amount of harvested tissue needs to be maximised. Level of evidence: Level III, therapeutic study. AD - [Christopoulos, Georgios; Berner, Juan Enrique; Blackburn, Adam; Mackey, Simon P.] Queen Victoria Hosp, Dept Plast Surg, E Grinstead, England. [Christopoulos, Georgios] Queen Mary Univ London, Blizard Inst, London, England. [Berner, Juan Enrique] Univ Oxford, Kellogg Coll, Oxford, England. [Sergentanis, Theodoros N.] Natl & Kapodistrian Univ Athens, Dept Hyg Epidemiol & Med Stat, Sch Med, Athens, Greece. Christopoulos, G (corresponding author), Queen Victoria Hosp, Dept Plast Surg, E Grinstead, England.; Christopoulos, G (corresponding author), Queen Mary Univ London, Blizard Inst, London, England. gdchristopoulos@gmail.com AN - WOS:000570816300001 AU - Christopoulos, G. AU - Berner, J. E. AU - Sergentanis, T. N. AU - Blackburn, A. AU - Mackey, S. P. DO - 10.1007/s00238-020-01742-9 J2 - Eur. J. Plast. Surg. KW - Bi-pedicled DIEP Double pedicle Intra-flap anastomosis DIEP flap Breast reconstruction epigastric perforator flap vascular anatomy tissue transfer anastomosis morbidity couplers scars head Surgery LA - English M3 - Article; Early Access N1 - ISI Document Delivery No.: NQ4EK Times Cited: 0 Cited Reference Count: 41 Christopoulos, Georgios Berner, Juan Enrique Sergentanis, Theodoros N. Blackburn, Adam Mackey, Simon P. Berner, Juan/AAI-1244-2021 Berner, Juan/0000-0003-2178-5161 0 1 Springer New york 1435-0130 SN - 0930-343X SP - 8 ST - The use of bi-pedicled DIEP flap for unilateral breast reconstruction: a 5-year retrospective study T2 - European Journal of Plastic Surgery TI - The use of bi-pedicled DIEP flap for unilateral breast reconstruction: a 5-year retrospective study UR - ://WOS:000570816300001 ID - 1058 ER - TY - JOUR AU - Morrison, S. D. AU - Massie, J. P. AU - Kneib, C. J. AU - Massenburg, B. B. AU - Impastato, K. AU - Said, H. K. AU - Cederna, P. S. DB - Medline DO - 10.1097/PRS.0000000000006363 IS - 1 KW - autotransplantation breast reconstruction female human male physiology procedures sex reassignment sexual characteristics subcutaneous fat surgical flaps thorax transgender transplantation treatment outcome LA - English M3 - Letter N1 - L629697886 2019-11-01 PY - 2020 SN - 1529-4242 SP - 228e-229e ST - The Use of Autologous Tissue for Chest Feminization in Gender-Affirming Surgery T2 - Plastic and reconstructive surgery TI - The Use of Autologous Tissue for Chest Feminization in Gender-Affirming Surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629697886&from=export http://dx.doi.org/10.1097/PRS.0000000000006363 VL - 145 ID - 4889 ER - TY - JOUR AB - The purpose of this study was to evaluate a new technique of harvesting and preparing autologous platelet gel and autologous fibrin glue (body glue) and to evaluate their effectiveness in stopping capillary bleeding in the surgical flaps of patients undergoing cosmetic surgery. A convenience sample of 20 patients ranging from 25 to 76 years of age undergoing cosmetic surgery involving the creation of a surgical flap were included in the study. The types of surgical procedures included face lifts, breast augmentations, breast reductions, and neck lifts. Platelet-poor and platelet-rich plasma were prepared during the procedure from autologous blood using a compact, tabletop, automated autologous platelet concentrate system (SmartPReP, Harvest Autologous Hemobiologics, Norwell, Mass.). The platelet-poor and platelet-rich plasma were combined with a thrombin-calcium chloride solution to produce autologous fibrin glue and autologous platelet gel, respectively. Capillary bed bleeding was present in all cases and effectively sealed within 3 minutes following the application of platelet gel and fibrin glue. The technique for making the solution and for evaluating its effectiveness in achieving and maintaining hemostasis during cosmetic surgical procedures is described. Autologous platelet gel and fibrin glue prepared by the automated concentrate system are compared with autotransfusor-prepared platelet gel and Tisseel (Baxter Healthcare Corp.), a commercially prepared fibrin sealant preparation. AD - D. Man, 851 Meadows Road, Boca Raton, FL 33486, United States AU - Man, D. AU - Plosker, H. AU - Winland-Brown, J. E. C1 - tisseel(Baxter,United States) C2 - Baxter(United States) DB - Embase Medline DO - 10.1097/00006534-200101000-00037 IS - 1 KW - fibrin glue thrombocyte concentrate adult aged article bleeding breast augmentation breast reduction clinical article cost effectiveness analysis esthetic surgery female hemostasis human male priority journal rhytidoplasty skin flap thrombocyte rich plasma tisseel LA - English M3 - Article N1 - L32039261 2001-01-22 PY - 2001 SN - 0032-1052 SP - 229-236 ST - The use of autologous platelet-rich plasma (platelet gel) and autologous platelet-poor plasma (fibrin glue) in cosmetic surgery T2 - Plastic and Reconstructive Surgery TI - The use of autologous platelet-rich plasma (platelet gel) and autologous platelet-poor plasma (fibrin glue) in cosmetic surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L32039261&from=export http://dx.doi.org/10.1097/00006534-200101000-00037 VL - 107 ID - 8488 ER - TY - JOUR AB - INTRODUCTION: Seromas and drains are major sources of morbidity associated with latissimus dorsi breast reconstruction. Our goal was to look at an autologous platelet‐leukocyte‐enriched plasma spray and to assess its efficacy in reducing drain burden and seroma formation. METHODS: We performed a single surgeon, patient‐controlled, blinded study on bilateral latissimus dorsi breast reconstruction patients in which we applied autologous platelet‐leukocyte‐enriched plasma to one side and measured drain amounts, time to drain removal, and seroma rate. RESULTS: Twelve patients were included in this study. The average age was 41.1 years, and the average body mass index was 21.6 kg/m. Average volume of drain output showed neither difference (789 mL spray side vs. 790 mL control side) nor average time to drain removal (11.83 days spray side vs. 11.5 days control side). There were 2 complications reported: 1 hematoma (8.33%) and 1 seroma (8.33%) that required aspiration in a postoperative visit. CONCLUSIONS: It appears after 12 patients that there is no demonstrable difference regarding drain output, time to drain removal, or seroma incidence between the study and the control group. We feel a larger study population would add power and confirm these findings. AN - CN-00903307 AU - Harper, J. G. AU - Elliott, L. F. AU - Bergey, P. DO - 10.1097/SAP.0b013e31823d2af0 IS - 5 KW - Adult Drainage Exudates and Transudates Female Humans Leukocytes Mammaplasty [*methods] Platelet‐Rich Plasma Postoperative Complications [*prevention & control] Prospective Studies Seroma [etiology, *prevention & control] Single‐Blind Method Surgical Flaps Treatment Outcome Wound Healing M3 - Journal Article; Randomized Controlled Trial PY - 2012 SP - 429‐431 ST - The use of autologous platelet-leukocyte-enriched plasma to minimize drain burden and prevent seroma formation in latissimus dorsi breast reconstruction T2 - Annals of plastic surgery TI - The use of autologous platelet-leukocyte-enriched plasma to minimize drain burden and prevent seroma formation in latissimus dorsi breast reconstruction UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00903307/full VL - 68 ID - 59 ER - TY - JOUR AB - Concern exists that plastic surgeons are performing fewer autologous and microsurgical breast reconstructions, despite superior long-term outcomes. The authors describe the proportion of U.S. plastic surgeons performing these procedures and evaluate motivating factors and perceived barriers. A random national sample of American Society of Plastic Surgeons members was surveyed (n = 325; response rate, 76 percent). Surgeon and practice characteristics were assessed, and two multiple logistic regression models were created to evaluate factors associated with (1) high-volume autologous providers and (2) microsurgical providers. Qualitative assessments of motivating factors and barriers to microsurgery were also performed. Fewer than one-fifth of plastic surgeons perform autologous procedures for more than 50 percent of their breast cancer patients, and only one-quarter perform any microsurgical breast reconstruction. Independent predictors of a high-volume autologous practice include involvement with resident education (odds ratio, 2.57; 95 percent CI, 1.26 to 5.24) and a microsurgical fellowship (odds ratio, 2.09; 95 percent CI, 1.04 to 4.27). Predictors of microsurgical breast reconstruction include involvement with resident education (odds ratio, 6.8; 95 percent CI, 3.32 to 13.91), microsurgical fellowship (odds ratio, 2.4; 95 percent CI, 1.16 to 4.95), and high breast reconstruction volume (odds ratio, 6.68; 95 percent CI, 1.76 to 25.27). The primary motivator for microsurgery is superior outcomes, and the primary deterrents are time and reimbursement. The proportion of U.S. plastic surgeons with a high-volume autologous or microsurgical breast reconstruction practice is low. Involvement with resident education appears to facilitate both, whereas time constraints and reimbursement are primary deterrents. Future efforts should focus on improving the feasibility and accessibility of all types of breast reconstruction. AD - A.R. Kulkarni, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA. AU - Kulkarni, A. R. AU - Sears, E. D. AU - Atisha, D. M. AU - Alderman, A. K. DB - Medline IS - 3 KW - adult article breast reconstruction breast tumor clinical practice economics education female health care delivery health care survey human male mastectomy medical education methodology microsurgery middle aged motivation reimbursement statistical model statistics surgical flaps time United States utilization review LA - English M3 - Article N1 - L563004261 2014-01-13 PY - 2013 SN - 1529-4242 SP - 534-541 ST - Use of autologous and microsurgical breast reconstruction by U.S. plastic surgeons T2 - Plastic and reconstructive surgery TI - Use of autologous and microsurgical breast reconstruction by U.S. plastic surgeons UR - https://www.embase.com/search/results?subaction=viewrecord&id=L563004261&from=export VL - 132 ID - 6730 ER - TY - JOUR AD - Rabin Med Ctr, Dept Plast & Reconstruct Surg, IL-49100 Petah Tiqwa, Israel. Amir, A (corresponding author), Rabin Med Ctr, Dept Plast & Reconstruct Surg, Beilinson Campus, IL-49100 Petah Tiqwa, Israel. AN - WOS:000079107900048 AU - Amir, A. AU - Silfen, R. AU - Hauben, D. J. DA - Apr DO - 10.1097/00006534-199904040-00050 IS - 4 J2 - Plast. Reconstr. Surg. KW - Surgery LA - English M3 - Letter N1 - ISI Document Delivery No.: 175RC Times Cited: 10 Cited Reference Count: 3 Amir, A Silfen, R Hauben, DJ 10 0 Lippincott williams & wilkins Philadelphia PY - 1999 SN - 0032-1052 SP - 1329-1329 ST - Use of Archimedes' law for measuring the volume of the TRAM flap in immediate breast reconstruction T2 - Plastic and Reconstructive Surgery TI - Use of Archimedes' law for measuring the volume of the TRAM flap in immediate breast reconstruction UR - ://WOS:000079107900048 VL - 103 ID - 4112 ER - TY - JOUR AB - Thorek's technique, first described in 1922 for breast reductions, has been progressively replaced by techniques using a dermoglandular pedicle. This first technique is still performed today in cases of major hypertrophy. But the major disadvantage is the tendency for the breast to be too flat post-reduction. We tried to correct this problem by preserving an inferior dermoglandular flap rolled into a cone shape before positioning it within the bulk of the breast, thus giving a better projection. The authors present a series of 21 patients operated by this technique with a median follow-up of two years. The preliminary results are encouraging and we think that this procedure is a treatment of choice in cases of gigantomastia. AD - Service de Chirurgie Plastique Reconstructrice et Esthétique et Chirurgie de la Main, Centre Hospitalier du Luxembourg. AN - 10427830 AU - Neuprez, A. AU - Haykal, S. AU - Calteux, N. DA - Jun DP - NLM ET - 1999/07/31 IS - 3 KW - Adult Breast/*transplantation Female Humans Mammaplasty/*methods Nipples/surgery Reconstructive Surgical Procedures/*methods *Surgical Flaps LA - fre N1 - Neuprez, A Haykal, S Calteux, N Case Reports English Abstract Journal Article France Ann Chir Plast Esthet. 1999 Jun;44(3):231-7. OP - Utilisation d'un lambeau dermo-glandulaire inférieur dans la technique de Thorek. A propos de 21 cas. PY - 1999 SN - 0294-1260 (Print) 0294-1260 SP - 231-7 ST - [The use of an inferior dermo-glandular flap in Thorek's technique, based on a series of 21 cases] T2 - Ann Chir Plast Esthet TI - [The use of an inferior dermo-glandular flap in Thorek's technique, based on a series of 21 cases] VL - 44 ID - 9557 ER - TY - JOUR AN - 7294669 AU - Zelnik, J. N. AU - Pearl, R. M. AU - Johnson, D. DA - Sep DP - NLM ET - 1981/09/01 IS - 3 KW - Breast/blood supply/*surgery Female Humans Nipples/blood supply/surgery Surgery, Plastic/methods *Surgical Flaps LA - eng N1 - Zelnik, J N Pearl, R M Johnson, D Journal Article United States Ann Plast Surg. 1981 Sep;7(3):204-6. PY - 1981 SN - 0148-7043 (Print) 0148-7043 SP - 204-6 ST - Use of an axial flap for reduction mammaplasty T2 - Ann Plast Surg TI - Use of an axial flap for reduction mammaplasty VL - 7 ID - 12743 ER - TY - JOUR AB - Abdominoplasty techniques are commonly used in aesthetic surgery and in reconstructive procedures e for example, in DIEP (deep inferior epigastric perforator) flap breast reconstruction. The inferior skin apron is extremely rarely used as an advancement flap for local reconstruction of pelvico-perineal defects. We report a unique pair of cases in which abdominoplasty flap advancement was performed in combination with bilateral gracilis myocutaneous flaps following massive pelvico-perineal tissue excision for penile cancer recurrence in two men in their seventies. There is currently no mention in the existing literature regarding the flap's use in such a deep defect or in combination with gracilis flaps. The patients' distorted and scarred anatomy from previous operations and radiotherapy (combined with a very large pelvic defect and excess abdominal girth) called for the adoption of this novel approach which ultimately resulted in two very different outcomes. AD - M. Little, Whittington Hospital, London, United Kingdom AU - Little, M. AU - Wormald, J. AU - Singh, M. AU - Ayres, B. AU - Soldin, M. DB - Embase KW - abdominal circumference abdominoplasty adoption adult anatomy cancer recurrence cancer surgery case report drug combination excision gracilis flap human human tissue male penis cancer perineum radiotherapy LA - English M3 - Conference Abstract N1 - L619900124 2017-12-26 PY - 2017 SN - 1743-9159 SP - S67 ST - The use of an abdominoplasty advancement flap to aid closure of large pelvico-perineal defects T2 - International Journal of Surgery TI - The use of an abdominoplasty advancement flap to aid closure of large pelvico-perineal defects UR - https://www.embase.com/search/results?subaction=viewrecord&id=L619900124&from=export VL - 47 ID - 5600 ER - TY - JOUR AB - BACKGROUND: The objective of this study was to demonstrate the use of the authors' technique to improve long-term maintenance of nipple projection by using AlloDerm (LifeCell Corp., Branchburg, N.J.) as a central core in nipple reconstruction. METHODS: The nipple reconstruction technique involved the use of a modified star dermal flap pattern measuring 5 cm in length and 1.0 to 1.5 cm in width, depending on the amount of desired projection to match the opposite nipple. Then, a 1.5 × 4.5-cm piece of AlloDerm was placed into the core of the newly reconstructed nipple and sutured closed. After the incisions were closed, an ocular eye bubble protector was used to prevent compressive forces on the newly reconstructed nipple, and strict postoperative use of this protector was maintained for 6 weeks. RESULTS: A total of 30 nipple reconstructions were performed [14 transverse rectus abdominis musculocutaneous (TRAM) flaps and 16 tissue-expanded breast mounds]. Caliper measurements of nipple projection were recorded at the time of surgery and at 3, 6, and 12 months postoperatively. Twelve-month average maintenance of nipple projection was 56 percent for the TRAM flap group and 47 percent for the tissue-expanded group. There were no infections or associated complications. CONCLUSIONS: The authors' results demonstrate that the use of a modified star dermal flap pattern with the placement of an AlloDerm graft core is a safe, easily performed, and reproducible technique for improving the long-term maintenance of projection in reconstructed nipples. ©2007American Society of Plastic Surgeons. AD - C.E. Garramone, Aesthetic Plastic Surgery Institute, P.A., 220 S.W. 84th Avenue, Plantation, FL 33324, United States AU - Garramone, C. E. AU - Lam, B. DB - Embase Medline DO - 10.1097/01.prs.0000258831.38615.80 IS - 6 KW - article breast reconstruction clinical article compression dermis human infection nipple postoperative care postoperative complication priority journal safety skin flap surgical technique suture technique tissue expansion transverse rectus abdominis musculocutaneous flap LA - English M3 - Article N1 - L46632044 2007-05-01 PY - 2007 SN - 0032-1052 SP - 1663-1668 ST - Use of AlloDerm in primary nipple reconstruction to improve long-term nipple projection T2 - Plastic and Reconstructive Surgery TI - Use of AlloDerm in primary nipple reconstruction to improve long-term nipple projection UR - https://www.embase.com/search/results?subaction=viewrecord&id=L46632044&from=export http://dx.doi.org/10.1097/01.prs.0000258831.38615.80 VL - 119 ID - 7990 ER - TY - JOUR AB - The article focuses on a research related to clinical and patient-reported outcomes in the use of acellular dermal matrix versus latissimus dorsi flap for breast reconstruction. Topics discussed include comparing patient-reported and clinical outcomes for latissimus dorsi (LD) and acellular dermal matrix (ADM) reconstruction; recording patient demographics, operative time, and length of in-hospital stay, and importance of considering psychological needs and expectations of patients. AD - Department of Surgery, Dorset County Hospital, Dorset UK National Cancer Institute, Cairo University, Cairo Egypt Department of Surgery, Yeovil District Hospital, Somerset UK AN - 119458168. Language: English. Entry Date: 20161118. Revision Date: 20190517. Publication Type: Article AU - Youssef, Mina M. G. AU - Pucher, Philip H. AU - Kennedy, Katy AU - Osborne, Caroline AU - Graja, Tomasz DB - cin20 DO - 10.1111/tbj.12664 DP - EBSCOhost IS - 6 KW - Breast Reconstruction -- Methods Patient Satisfaction Treatment Outcomes Latissimus Dorsi Muscles -- Surgery Surgical Flaps Human Female Inpatients Academic Medical Centers -- United Kingdom United Kingdom Questionnaires Descriptive Statistics Data Analysis Software P-Value Mann-Whitney U Test Comparative Studies Postoperative Complications Adult Middle Age Aged N1 - letter; questionnaire/scale; research; tables/charts. Journal Subset: Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Peer Reviewed; USA. Instrumentation: Modified EORTC Patient Satisfaction Questionnaire (EORTC IN-PATSAT32). NLM UID: 9505539. PY - 2016 SN - 1075-122X SP - 702-704 ST - Use of Acellular Dermal Matrix versus Latissimus Dorsi Flap for Breast Reconstruction: Clinical and Patient-Reported Outcomes T2 - Breast Journal TI - Use of Acellular Dermal Matrix versus Latissimus Dorsi Flap for Breast Reconstruction: Clinical and Patient-Reported Outcomes UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=119458168&site=ehost-live&scope=site VL - 22 ID - 698 ER - TY - JOUR AD - Medical University of South Carolina College of Medicine; Charleston, S.C. (Uflacker) Department of Plastic Surgery; University of Texas Southwestern Medical Center; Dallas, Texas (Janis). AN - 20595842 AU - Uflacker, A. B. AU - Janis, J. E. DA - Jul DO - 10.1097/PRS.0b013e3181dab369 DP - NLM ET - 2010/07/03 IS - 1 KW - Adult *Biocompatible Materials Breast Neoplasms/*surgery Carcinoma/*surgery *Collagen Female Follow-Up Studies Humans Mastectomy/*adverse effects/methods Pectoralis Muscles/surgery Postoperative Complications/*surgery Sternum Surgical Flaps Thoracic Wall/*surgery LA - eng N1 - 1529-4242 Uflacker, Andre B Janis, Jeffrey E Case Reports Letter United States Plast Reconstr Surg. 2010 Jul;126(1):34e-36e. doi: 10.1097/PRS.0b013e3181dab369. PY - 2010 SN - 0032-1052 SP - 34e-36e ST - The use of acellular dermal matrix in the correction of visible parasternal deformities after breast reconstruction T2 - Plast Reconstr Surg TI - The use of acellular dermal matrix in the correction of visible parasternal deformities after breast reconstruction VL - 126 ID - 13697 ER - TY - JOUR AB - Generally, a partial breast defect can be covered with surrounding breast tissue. However, when the tumor is located in the upper central and inner quadrant, simple closure with breast tissue is insufficient because rotation of breast tissue is difficult in this location. We introduce a surgical technique using an absorbable Interceed(®) pouch with double-layer skin closure for a remnant defect. A total of 43 patients with breast cancer underwent conventional breast-conserving surgery, following which an Interceed(®) pouch with double-layer skin closure was applied for a remnant defect of the breast. Patients assessed their own cosmetic outcomes based on a four-point scoring system. The mean age of the patients and their mean body mass index were 51.2 years and 23.1 kg/m(2) , respectively. Cosmetic outcomes were self-reported to be excellent in 13 cases (30.2%), good in 26 cases (60.5%), fair in three cases (7.0%), and poor in one case (2.3%). Postoperative complications occurred in two cases (4.6%). In conclusion, a use of an absorbable Interceed(®) pouch with double-layer skin closure is a simple, feasible, ancillary surgical technique to correct an upper central and inner quadrant breast defect without significant complications. AD - Department of surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. AN - 24890770 AU - Lee, J. AU - Bae, Y. DA - Jul-Aug DO - 10.1111/tbj.12281 DP - NLM ET - 2014/06/04 IS - 4 KW - Adult Aged Breast Neoplasms/pathology/*surgery Cellulose, Oxidized/*therapeutic use Female Humans Mammaplasty/methods Mammary Glands, Human/pathology/surgery Mastectomy, Segmental/*methods Middle Aged Self Report Surgery, Plastic/methods Surgical Flaps Treatment Outcome breast neoplasm prosthesis reconstruction LA - eng N1 - 1524-4741 Lee, Jeeyeon Bae, Youngtae Clinical Trial Journal Article United States Breast J. 2014 Jul-Aug;20(4):414-9. doi: 10.1111/tbj.12281. Epub 2014 Jun 2. PY - 2014 SN - 1075-122x SP - 414-9 ST - The use of absorbable interceed(®) pouch with double-layer skin closure for partial defect of breast T2 - Breast J TI - The use of absorbable interceed(®) pouch with double-layer skin closure for partial defect of breast VL - 20 ID - 9330 ER - TY - JOUR AB - This study is designed to evaluate the effect of abdominal quilting sutures on the incidence of abdominal seroma formation in patients undergoing pedicled transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction. It is theorized that the use of such sutures during closure of abdominal flaps will collapse dead space, thus preventing abdominal seroma formation. A total of 71 consecutive patients undergoing pedicled TRAM flap breast reconstruction were randomly assigned to receive abdominal quilting sutures or to undergo a standard abdominal closure. Primary outcome measures included: daily drain output for the first 3 postoperative days, time to drain removal, and seroma formation. Drain output per day decreased with the use of abdominal quilting sutures; however, the time to drain removal was not significantly affected. Most importantly, there was no significant decrease in the incidence of seroma formation with the use of abdominal quilting sutures in this series. AN - CN-00521233 AU - McCarthy, C. AU - Lennox, P. AU - Germann, E. AU - Clugston, P. DO - 10.1097/01.sap.0000151465.10356.dd IS - 4 KW - *breast reconstruction *myocutaneous flap *rectus abdominis muscle *seroma/pc [Prevention] Abdomen Abdominal Muscles [*transplantation] Article Body Mass Index Clinical trial Controlled clinical trial Controlled study Drain Female Human Humans Incidence Intermethod comparison Major clinical study Mastectomy Middle Aged Postoperative Complications Postoperative period Preoperative Care Priority journal Randomized controlled trial Reconstructive Surgical Procedures [*methods] Seroma [etiology, *prevention & control] Surgical Flaps Suture Sutures Suturing method M3 - Clinical Trial; Journal Article; Randomized Controlled Trial PY - 2005 SP - 361‐364 ST - Use of abdominal quilting sutures for seroma prevention in TRAM flap reconstruction: a prospective, controlled trial T2 - Annals of plastic surgery TI - Use of abdominal quilting sutures for seroma prevention in TRAM flap reconstruction: a prospective, controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00521233/full VL - 54 ID - 34 ER - TY - JOUR AB - Introducrion: The mammary reconstruction pursues the obtainment of a breast with shape, volume and consistency similar to the normal breast. It can be achieved by using the own patient's tissues and/or alloplastic implants. The most appropriate technique is choosed after the assessment of the general conditions, age, anatomy, remnant tissues and expectations. Materials and Methods: The lower abdominal region offers a multitude of flaps for breast reconstruction. The TRAM flap procedure uses skin, fat and muscle from the lower abdominal wall. It can be pedicle, leaving the flap attached to its original blood supply (perforators of the Superior Epigastric vessels) and tunnelling it under the skin to the breast area, or free, requiring the use of microsurgery to connect the vascular supply to the internal mammary or toracodorsal vessels. The DIEP flap only requires the removal of skin and fat. No muscle is sacrificed. The blood supply comes from the perforator arteries of the deep inferior epigastric vessels. The flap is connected to the patient's chest using microsurgery. Results: The TRAM flap procedure allows to shape a soft and natural breast with results that mimic a “tummy tuck” procedure. The DIEP flap has significantly fewer abdominal complications and side-effects (pain, bulging, hernia, strength loss) because the majority of the abdominal muscle is spared. Conclusions: Breast reconstruction is fundamental for the acceptance of mastectomy, improving the patient's self image and confidence. The abdominal area is an ideal donor site for mammary reconstruction. An adequate planning and patient selection can achieve the best results choosing the most adequate technique. AD - L. Canta, Cattedra di Chirurgia Plastica, Ricostruttiva ed Estetica, Università degli Studi di Napoli Federico II, Italy AU - Canta, L. AU - Moio, M. AU - Molea, G. DB - Embase DO - 10.1159/000321283 IS - 3-4 KW - breast reconstruction society surgeon human breast procedures patient skin tissues transverse rectus abdominis musculocutaneous flap vascularization deep inferior epigastric perforator flap microsurgery muscle patient selection planning self concept mastectomy abdominal wall musculature abdominal wall hernia pain side effect donor site thorax artery general condition allograft LA - English M3 - Conference Abstract N1 - L70979797 2013-02-05 PY - 2010 SN - 0014-312X SP - 186 ST - The use of abdominal flaps for breast reconstruction T2 - European Surgical Research TI - The use of abdominal flaps for breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70979797&from=export http://dx.doi.org/10.1159/000321283 VL - 45 ID - 7434 ER - TY - JOUR AB - Background The use of various latissimus dorsi (LD) flap types in combination with implants is a safe and reliable 1-stage breast reconstruction method. However, 1 or more positional changes are generally required during the procedure. We designed a vertical skin paddle that was centered along the midaxillary line and harvested the required LD muscle amount based on the thoracodorsal artery descending branch, thereby completing flap elevation, inset, and donor-site closure in the supine position following skin-sparing mastectomy. Methods Between July 2017 and September 2017, we enrolled patients who underwent breast reconstruction using the vertical muscle-sparing LD (ms-LD) flap with an implant. The vertical ms-LD flap was selected when the nipple-areolar complex could not be spared or when adjuvant radiation therapy was anticipated. Results Eleven patients were enrolled in the study. All patients underwent skin-sparing mastectomy (with excision of the nipple-areolar complex for oncological reason). The mean mastectomy specimen weight was 402.3 g. The average flap length and width were 15.2 and 5.5 cm, respectively. The mean implant size was 290 mL. The average operative time was 112 minutes. All surgical procedures were performed in the supine position, and the flap reached the most medial part of the breast without any tension in all cases. The mean follow-up length was 87 days, and no complications such as infection, partial flap loss, or donor-site seroma were observed. Conclusions Vertical ms-LD flaps can be harvested and utilized in direct-to-implant reconstructions when a skin paddle (or banking) is required, or when acellular dermal matrix use is precluded, or when additional soft tissue coverage is mandatory in high-risk patients not requiring intraoperative position changes. This technique can shorten the operation time and may reduce donor-site morbidity and associated complications. AD - [Lee, Hyung Chul] Korea Univ, Coll Med, Anam Hosp, Dept Plast Surg, Seoul, South Korea. [Han, Hyun Ho; Kim, Eun Key] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast Surg, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea. Kim, EK (corresponding author), Univ Ulsan, Coll Med, Asan Med Ctr, Dept Plast Surg, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea. nicekek@korea.com AN - WOS:000439309700007 AU - Lee, H. C. AU - Han, H. H. AU - Kim, E. K. DA - Aug DO - 10.1097/sap.0000000000001489 IS - 2 J2 - Ann. Plast. Surg. KW - breast reconstruction direct-to-implant reconstruction muscle-sparing LD artery perforator flap donor site Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: GN7IT Times Cited: 2 Cited Reference Count: 10 Lee, Hyung Chul Han, Hyun Ho Kim, Eun Key 2 0 Lippincott williams & wilkins Philadelphia 1536-3708 PY - 2018 SN - 0148-7043 SP - 152-155 ST - Use of a Vertical Muscle-Sparing Latissimus Dorsi Flap in Implant-Based Breast Reconstruction Without Position Change T2 - Annals of Plastic Surgery TI - Use of a Vertical Muscle-Sparing Latissimus Dorsi Flap in Implant-Based Breast Reconstruction Without Position Change UR - ://WOS:000439309700007 VL - 81 ID - 1560 ER - TY - JOUR AB - This case reports the use of a tissue expander to facilitate the surgical closure of a decubitus ulcer in a spinal cord injured quadriplegic. The patient is a 42-year-old man with chronic nonhealing of a right ischial pressure ulcer. It had required a flap rotation and partial ischiectomy in the remote past that had been problem-free for many years. The patient subsequently required the placement of a new flap, but insufficient tissue was available to close the wound with the hip in 90 degrees of flexion. Closing the wound with the hip in extension merely led to breakdown when the hip was put in the 90 degrees of flexion required for the sitting position. The problem was solved by using a tissue expander to increase the available soft tissue. A tissue expander was inserted and gradually expanded over a period of weeks by injecting it with fluid. It was then removed, and the expanded tissue that had grown over it allowed closure of the wound without tension on the tissues with the hip in flexion. The patient subsequently returned to the sitting position and his work as a computer programmer. Tissue expanders are commonly used in breast reconstruction, but have found many other uses in plastic surgery over the last decade. It is felt that tissue expansion techniques should not be the primary surgery treatment of decubitus ulcers, but can be used in difficult cases like this one to provide additional tissue. AD - Department of Physical Medicine and Rehabilitation, Providence Hospital Cincinnati, OH 45239. AN - 2930642 AU - Braddom, R. L. AU - Leadbetter, M. G. DA - Apr DO - 10.1097/00002060-198904000-00005 DP - NLM ET - 1989/04/01 IS - 2 KW - Adult Buttocks/surgery Humans Male Pressure Ulcer/etiology/*surgery/therapy Quadriplegia/complications Surgery, Plastic/*methods *Surgical Flaps LA - eng N1 - Braddom, R L Leadbetter, M G Case Reports Journal Article United States Am J Phys Med Rehabil. 1989 Apr;68(2):70-2. doi: 10.1097/00002060-198904000-00005. PY - 1989 SN - 0894-9115 (Print) 0894-9115 SP - 70-2 ST - The use of a tissue expander to enlarge a graft for surgical treatment of a pressure ulcer in a quadriplegic. Case report T2 - Am J Phys Med Rehabil TI - The use of a tissue expander to enlarge a graft for surgical treatment of a pressure ulcer in a quadriplegic. Case report VL - 68 ID - 13935 ER - TY - JOUR AB - Background: The significant variation in the vascular anatomy of the abdominal wall makes preoperative imaging essential when raising a deep inferior epigastric artery perforator (DIEP) flap due to the potential for maximizing operative success, reducing intraoperative error and minimizing operative complications. Computerized models and virtual reality applications are being used to facilitate teaching and preoperative evaluation in a number of other complex anatomical regions. The variability in perforator anatomy makes DIEP flap surgery a suitable candidate for application of such technology. In this context, a study was undertaken to determine the feasibility of computed tomography angiography (CTA)-guided VirSSPA three-dimensional (3D) software for virtual reality navigation in DIEP flap surgery and to compare findings with operative measurements. Materials and Methods: We recruited 12 consecutive patients planned for an elective DIEP flap for breast reconstruction. Each patient underwent preoperative imaging of the anterior abdominal wall vasculature with both conventional CTA and VirSSPA 3D reconstruction. Imaging findings were compared with operative findings. Results: In all cases, the major perforators were accurately localized using both methods. 3D reconstruction of the abdominal wall with VirSSPA demonstrated a significant good correlation with perforator location compared with operative findings, showing an average error rate of 0.23 cm (95% CI, 0.17-0.30). Conclusion: In short, the main advantage of VirSSPA, when used in conjunction with an image assessment such as CTA, is to provide additional and potentially more accurate data over conventional CTA with regard to the site of the best perforators and its course through the muscle. © 2010 Elsevier Inc. All rights reserved. AD - P. Gacto-Sánchez, Plastic and Reconstructive Surgery Department, University Hospitals Virgen del Rocío, Sevilla, Spain AU - Gacto-Sánchez, P. AU - Sicilia-Castro, D. AU - Gómez-Cía, T. AU - Lagares, A. AU - Collell, T. AU - Suárez, C. AU - Parra, C. AU - Infante-Cossío, P. AU - De La Higuera, J. M. DB - Embase Medline DO - 10.1016/j.jss.2009.01.025 IS - 1 KW - abdominal wall angiography article breast reconstruction clinical article clinical trial computer assisted tomography software deep inferior epigastric perforator flap feasibility study female human intermethod comparison priority journal three dimensional computer program vascularization LA - English M3 - Article N1 - L50519266 2010-06-16 2010-06-28 PY - 2010 SN - 0022-4804 1095-8673 SP - 140-147 ST - Use of a Three-Dimensional Virtual Reality Model for Preoperative Imaging in DIEP Flap Breast Reconstruction1 T2 - Journal of Surgical Research TI - Use of a Three-Dimensional Virtual Reality Model for Preoperative Imaging in DIEP Flap Breast Reconstruction1 UR - https://www.embase.com/search/results?subaction=viewrecord&id=L50519266&from=export http://dx.doi.org/10.1016/j.jss.2009.01.025 VL - 162 ID - 7519 ER - TY - JOUR AB - Background. The significant variation in the vascular anatomy of the abdominal wall makes preoperative imaging essential when raising a deep inferior epigastric artery perforator (DIEP) flap due to the potential for maximizing operative success, reducing intraoperative error and minimizing operative complications. Computerized models and virtual reality applications are being used to facilitate teaching and preoperative evaluation in a number of other complex anatomical regions. The variability in perforator anatomy makes DIEP flap surgery a suitable candidate for application of such technology. In this context, a study was undertaken to determine the feasibility of computed tomography angiography (CTA)-guided VirSSPA three-dimensional (3D) software for virtual reality navigation in DEEP flap surgery and to compare findings with operative measurements. Materials and Methods. We recruited 12 consecutive patients planned for an elective DIEP flap for breast reconstruction. Each patient underwent preoperative imaging of the anterior abdominal wall vasculature with both conventional CTA and VirSSPA 3D reconstruction. Imaging findings were compared with operative findings. Results. In all cases, the major perforators were accurately localized using both methods. 3D reconstruction of the abdominal wall with VirSSPA demonstrated a significant good correlation with perforator location compared with operative findings, showing an average error rate of 0.23 cm (95% CI, 0.17-0.30). Conclusion. In short, the main advantage of VirSSPA, when used in conjunction with an image assessment such as CTA, is to provide additional and potentially more accurate data over conventional CTA with regard to the site of the best perforators and its course through the muscle. (C) 2010 Elsevier Inc. All rights reserved. AD - [Gacto-Sanchez, Purificacion; Sicilia-Castro, Domingo; Gomez-Cia, Tomas; Lagares, Araceli; Collell, Teresa; Infante-Cossio, Pedro] Univ Hosp Virgen del Rocio, Dept Plast & Reconstruct Surg, Seville 41013, Spain. [Suarez, Cristina; Parra, Carlos; Maria De La Higuera, Jose] Univ Hosp Virgen del Rocio, Technol Dev & Invest Grp, Project Direct, Seville 41013, Spain. Gacto-Sanchez, P (corresponding author), Univ Hosp Virgen del Rocio, Dept Plast & Reconstruct Surg, Ave Manuel Siurot S-N, Seville 41013, Spain. purigacto@gmail.com AN - WOS:000279071500022 AU - Gacto-Sanchez, P. AU - Sicilia-Castro, D. AU - Gomez-Cia, T. AU - Lagares, A. AU - Collell, T. AU - Suarez, C. AU - Parra, C. AU - Infante-Cossio, P. AU - De La Higuera, J. M. DA - Jul DO - 10.1016/j.jss.2009.01.025 IS - 1 J2 - J. Surg. Res. KW - computer assisted surgery reconstructive surgical procedures microsurgery perforator flaps ct angiography doppler sonography experience Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 614PF Times Cited: 19 Cited Reference Count: 21 Gacto-Sanchez, Purificacion Sicilia-Castro, Domingo Gomez-Cia, Tomas Lagares, Araceli Collell, Teresa Suarez, Cristina Parra, Carlos Infante-Cossio, Pedro Maria De La Higuera, Jose IBIS, ECONOMIA SALUD/I-5156-2016; Infante-Cossio, Pedro/F-4451-2019; Calderon, Carlos Luis Parra/C-9315-2015; IBIS, PLANIFICACION/I-3334-2016; Suarez-Mejias, Cristina/C-9347-2015 Infante-Cossio, Pedro/0000-0002-2770-8573; Calderon, Carlos Luis Parra/0000-0003-2609-575X; Suarez-Mejias, Cristina/0000-0002-3190-4665 Andalusian Department of Health, Spain The modular software programming tools used in this study were developed at Alcala Innova and Reina Mercedes Foundation in collaboration with the University of Sevilla, Spain. The VirSSPA project is being developed and financed by the Andalusian Department of Health, Spain. 21 0 7 Academic press inc elsevier science San diego 1095-8673 PY - 2010 SN - 0022-4804 SP - 140-147 ST - Use of a Three-Dimensional Virtual Reality Model for Preoperative Imaging in DIEP Flap Breast Reconstruction T2 - Journal of Surgical Research TI - Use of a Three-Dimensional Virtual Reality Model for Preoperative Imaging in DIEP Flap Breast Reconstruction UR - ://WOS:000279071500022 VL - 162 ID - 3081 ER - TY - JOUR AB - Reconstruction of the inframammary fold (IMF) during breast reconstruction is vital in achieving good aesthetic outcomes and avoiding further corrective surgery. The IMF is usually reconstructed by comparing with the other side and estimating its correct position. The IMF template can be used to accurately and consistently mark the position of the IMF relative to the contralateral side thus aiding accurate reconstruction without the need to estimate. © 2011 British Association of Plastic. AD - A. Sadri, Royal Free Hospital, Pond Street, London, NW3 2QG, United Kingdom AU - Akhavani, M. AU - Sadri, A. AU - Ovens, L. AU - Floyd, D. DB - Embase Medline DO - 10.1016/j.bjps.2011.04.022 IS - 10 KW - article breast reconstruction deep inferior epigastric perforator flap human inframammary fold mastectomy priority journal skinfold surgical technique suture technique treatment outcome LA - English M3 - Article N1 - L51453449 2011-06-02 2011-09-27 PY - 2011 SN - 1748-6815 1878-0539 SP - e259-e261 ST - The use of a template to accurately position the inframammary fold in breast reconstruction T2 - Journal of Plastic, Reconstructive and Aesthetic Surgery TI - The use of a template to accurately position the inframammary fold in breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L51453449&from=export http://dx.doi.org/10.1016/j.bjps.2011.04.022 VL - 64 ID - 7266 ER - TY - JOUR AB - A method of breast reconstruction after mastectomy, using wide undermining of the chest and abdominal skin and advancement of the latter upward to create a pocket, is described. A double-lumen silicone prosthesis is inserted to create the mound, and various methods for nipple-areolar construction are described. The method has been in use for 20 years, and it has been quite satisfactory when the deficiency in the chest wall cover is not too large. AN - 384431 AU - Lewis, J. R., Jr. DA - Oct DO - 10.1097/00006534-197910000-00008 DP - NLM ET - 1979/10/01 IS - 4 KW - Breast/*surgery Female Humans *Mastectomy Nipples/surgery Prostheses and Implants Skin Transplantation Surgery, Plastic/*methods *Surgical Flaps Transplantation, Autologous LA - eng N1 - Lewis, J R Jr Journal Article United States Plast Reconstr Surg. 1979 Oct;64(4):491-7. doi: 10.1097/00006534-197910000-00008. PY - 1979 SN - 0032-1052 (Print) 0032-1052 SP - 491-7 ST - Use of a sliding flap from the abdomen to provide cover in breast reconstructions T2 - Plast Reconstr Surg TI - Use of a sliding flap from the abdomen to provide cover in breast reconstructions VL - 64 ID - 12909 ER - TY - JOUR AN - 12711989 AU - Mukherjee, R. P. DA - May DO - 10.1097/01.Prs.0000057066.53356.78 DP - NLM ET - 2003/04/25 IS - 6 KW - Breast Implantation/*methods Breast Implants Female Humans *Mastectomy Middle Aged Surgical Flaps Tissue Expansion LA - eng N1 - Mukherjee, Rama P Comment Letter United States Plast Reconstr Surg. 2003 May;111(6):2113-4. doi: 10.1097/01.PRS.0000057066.53356.78. PY - 2003 SN - 0032-1052 (Print) 0032-1052 SP - 2113-4 ST - Use of a skin-sparing reduction pattern to create a combination skin-muscle flap pocket in immediate breast reconstruction T2 - Plast Reconstr Surg TI - Use of a skin-sparing reduction pattern to create a combination skin-muscle flap pocket in immediate breast reconstruction VL - 111 ID - 12988 ER - TY - JOUR AD - handandplastic@usxchange.net AN - 12087255 AU - Hammond, D. C. AU - Capraro, P. A. AU - Ozolins, E. B. AU - Arnold, J. F. DA - Jul DO - 10.1097/00006534-200207000-00035 DP - NLM ET - 2002/06/28 IS - 1 KW - Breast Implants Female Humans Mammaplasty/*methods Mastectomy/*methods Outcome and Process Assessment, Health Care Reoperation *Surgical Flaps *Tissue Expansion Devices LA - eng N1 - Hammond, Dennis C Capraro, Philippe A Ozolins, Ellen B Arnold, Jame F Comparative Study Journal Article United States Plast Reconstr Surg. 2002 Jul;110(1):206-11. doi: 10.1097/00006534-200207000-00035. PY - 2002 SN - 0032-1052 (Print) 0032-1052 SP - 206-11 ST - Use of a skin-sparing reduction pattern to create a combination skin-muscle flap pocket in immediate breast reconstruction T2 - Plast Reconstr Surg TI - Use of a skin-sparing reduction pattern to create a combination skin-muscle flap pocket in immediate breast reconstruction VL - 110 ID - 10049 ER - TY - JOUR AD - A.A. Zeltzer AU - Zeltzer, A. A. AU - Andrades, P. AU - Hamdi, M. AU - Blondeel, P. N. AU - Van Landuyt, K. DB - Medline IS - 6 KW - adult anastomosis article breast breast reconstruction female free tissue graft human mammary artery middle aged thrombosis vascularization LA - English M3 - Article N1 - L362295916 2011-08-15 PY - 2011 SN - 1529-4242 SP - 153e-4e ST - The use of a single set of internal mammary recipient vessels in bilateral free flap breast reconstruction T2 - Plastic and reconstructive surgery TI - The use of a single set of internal mammary recipient vessels in bilateral free flap breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L362295916&from=export VL - 127 ID - 7332 ER - TY - JOUR AN - 18656435 AU - Salgarello, M. AU - Cervelli, D. AU - Barone-Adesi, L. DA - Nov DO - 10.1016/j.bjps.2008.02.033 DP - NLM ET - 2008/07/29 IS - 11 KW - Female Humans Mammaplasty/*instrumentation Nipples/*surgery *Protective Devices Silicones Surgical Flaps LA - eng N1 - 1878-0539 Salgarello, Marzia Cervelli, Daniele Barone-Adesi, Liliana Letter Netherlands J Plast Reconstr Aesthet Surg. 2008 Nov;61(11):1396-8. doi: 10.1016/j.bjps.2008.02.033. Epub 2008 Jul 24. PY - 2008 SN - 1748-6815 SP - 1396-8 ST - The use of a silicone nipple shield as protective device in nipple reconstruction T2 - J Plast Reconstr Aesthet Surg TI - The use of a silicone nipple shield as protective device in nipple reconstruction VL - 61 ID - 10145 ER - TY - JOUR AB - BACKGROUND: In patients with a thin soft tissue breast envelope, lower pole implant palpability is a postoperative sequela that concerns patients. Anatomically, the lower aspect of the breast near the inframammary fold lacks sufficient soft tissue to cover the breast implant after augmentation. METHODS: A transareolar incision was made, and subcutaneous dissection was performed. The dissection first proceeded caudally to the lower aspect to the breast parenchyma. The dissection then changed direction and moved cephalad to the mid breast or nipple region. The fatty tissue and pectoralis muscle fascia were cut transversely at this level, and the dissection was reversed caudally in a subfascial plane to the new inframammary fold region. This maneuver created a retromammary adipofascial flap. RESULTS: A total of 368 breast augmentations were performed in 184 patients. Breast implants were inserted in the subfascial plane in 40 patients (21.7%) and in the subpectoral-subfascial plane in 144 patients (78.3%). A total of 368 breast implants were inserted, including 140 smooth cohesive silicone implants (38.0%), 2 textured round implants (0.5%), and 226 anatomic-type implants (61.5%). A cadaveric dissection revealed that a retromammary adipofascial flap measuring 3-4 mm in thickness can be acquired. Capsular contracture occurred in six breasts (1.7%). CONCLUSIONS: During breast augmentation, an inferiorly based retromammary adipofascial flap can be created to help cover the lower pole of the breast from implant palpability. This is helpful especially in patients with thin skin, hypoplastic breasts, or constricted breasts. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . AD - Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA, USA. Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, Seoul, Korea. Apgugeong Avenue Plastic Surgery Clinic, Seil Bldg 6 fl., 11, Nonhyeon-ro 171-gil, Gangnam-gu, Seoul, 06030, Korea. prspklee@yahoo.com. AN - 30132110 AU - Han, H. H. AU - Kim, K. K. AU - Lee, K. H. AU - Kim, I. B. AU - Lee, P. K. DA - Dec DO - 10.1007/s00266-018-1215-x DP - NLM ET - 2018/08/23 IS - 6 KW - Adipose Tissue/*transplantation Adult Breast/anatomy & histology/pathology Breast Implantation/*methods *Breast Implants Cadaver Cohort Studies Dissection Esthetics Fascia/transplantation Female Graft Survival Humans Mammaplasty/*methods Myocutaneous Flap/*transplantation *Patient Satisfaction Pectoralis Muscles/surgery Retrospective Studies Risk Assessment Treatment Outcome Wound Healing/physiology Autologous caudal breast augmentation Caudal breast padding Retromammary adipofascial flap Thin soft tissue LA - eng N1 - 1432-5241 Han, Hyun Ho Kim, Kenneth K Lee, Kee Hoon Kim, In-Beom Lee, Paik Kwon Journal Article United States Aesthetic Plast Surg. 2018 Dec;42(6):1447-1456. doi: 10.1007/s00266-018-1215-x. Epub 2018 Aug 21. PY - 2018 SN - 0364-216x SP - 1447-1456 ST - The Use of a Retromammary Adipofascial Flap in Breast Augmentation for Patients with Thin Soft Tissue T2 - Aesthetic Plast Surg TI - The Use of a Retromammary Adipofascial Flap in Breast Augmentation for Patients with Thin Soft Tissue VL - 42 ID - 11105 ER - TY - JOUR AB - To use the entire muscle for breast reconstruction with the latissimus dorsi musculocutaneous flap, the location of the skin ellipse on the back is planned with a cloth pattern. The technique as used in two patients is described and illustrated. AN - 7208681 AU - Ruetschi, M. S. AU - LeWinn, L. R. AU - Chaglassian, T. A. DA - Oct DO - 10.1097/00006534-198010000-00030 DP - NLM ET - 1980/10/01 IS - 4 KW - Adult Back Breast/*surgery Breast Neoplasms/surgery Female Humans *Mastectomy Middle Aged Surgery, Plastic/*methods *Surgical Flaps LA - eng N1 - Ruetschi, M S LeWinn, L R Chaglassian, T A Journal Article United States Plast Reconstr Surg. 1980 Oct;66(4):635-41. doi: 10.1097/00006534-198010000-00030. PY - 1980 SN - 0032-1052 (Print) 0032-1052 SP - 635-41 ST - The use of a preoperative pattern in chest wall reconstruction with the latissimus dorsi musculocutaneous flap T2 - Plast Reconstr Surg TI - The use of a preoperative pattern in chest wall reconstruction with the latissimus dorsi musculocutaneous flap VL - 66 ID - 11078 ER - TY - JOUR AB - Large abdominal wall soft tissue defects are traditionally reconstructed using loco-regional flaps and/or tissue expanders. Pedicled perforator flaps offer similar tissue coverage with minimal donor site morbidity and do not require microsurgical skills. The deep inferior epigastric perforator (DIEP) flap has become increasingly popular for breast reconstruction and offers abundant soft tissue while permitting primary donor site closure. To minimize operative sessions, recovery time, donor site morbidity, and avoid microsurgery, we combined tissue expansion with a "propeller" flap design and report this first case of a pre-expanded pedicled perforator flap based on the DIEP to address a large abdominal wall defect due to a burn injury. (C) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - [Cheng, Angela; Saint-Cyr, Michel] Univ Texas SW Med Ctr Dallas, Dept Plast Surg, Dallas, TX 75390 USA. [Cheng, Angela] Emory Univ Hosp, Div Plast Surg, Atlanta, GA 30322 USA. [Saint-Cyr, Michel] Mayo Clin, Div Plast Surg, Rochester, MN 55905 USA. Saint-Cyr, M (corresponding author), Mayo Clin, Div Plast Surg, 200 1st St SW, Rochester, MN 55905 USA. SaintCyr.Michel@mayo.edu AN - WOS:000319114200024 AU - Cheng, A. AU - Saint-Cyr, M. DA - Jun DO - 10.1016/j.bjps.2012.09.017 IS - 6 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - DIEP flap Propeller flap Abdominal defect Deep inferior Epigastric artery perforator flap Burn tissue expansion reconstruction Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 146TJ Times Cited: 10 Cited Reference Count: 14 Cheng, Angela Saint-Cyr, Michel Dr. Saint-Cyr Dr. Saint-Cyr is a paid consultant for LifeCell. 14 0 4 Elsevier sci ltd Oxford 1878-0539 PY - 2013 SN - 1748-6815 SP - 851-854 ST - Use of a pre-expanded "propeller" deep inferior epigastric perforator (DIEP) flap for a large abdominal wall defect T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Use of a pre-expanded "propeller" deep inferior epigastric perforator (DIEP) flap for a large abdominal wall defect UR - ://WOS:000319114200024 VL - 66 ID - 2580 ER - TY - JOUR AB - Background and Aims: Fat-grafting is an established technique that is increasingly being used to correct contour and volume deficit after breast reconstructive surgery. The authors set out to assess the feasibility of using high frequency ultrasound intra-operatively to guide fat-grafting in patients with previous breast reconstructive surgery. Material and Methods: Three patients who required fatgrafting for breast asymmetries and contour irregularities were included in this study. One patient had had previous failed Deep Inferior Epigastric Perforator (DIEP) reconstruction, one had tethered scarring and volume deficit post DIEP reconstruction, the third required fat grafting over a previous implant based reconstruction. The Sonosite SNerve™ portable ultrasound machine (SonoSite ltd, Herts, UK) was used intra-operatively by the surgeon to guide safe fat placement. Results: The portable ultrasound machine allowed direct visualization of important structures intraoperatively. Ribs, pleura and the breast implant were easily identifiable and permitted injection of fat graft into the correct tissue plane. No patient suffered any complication. Conclusions: Ultrasound guided fat-grafting allows direct visualization not only of the injection cannula and fat graft in real time, but also the underlying anatomy/anatomical planes in a non invasive, safe manner. This study supports the feasibility of surgeon-performed ultrasound as an adjunct to fat-grafting for reconstructive breast surgery. AD - K. Mason, St Andrews Centre for Plastic Surgery and Burns, Broomfield Hospital, Essex, United Kingdom AU - Mason, K. AU - Oni, G. AU - Theodorakopoulou, E. AU - Khan, L. AU - Chow, W. AU - Griffiths, M. DB - Embase DO - 10.1159/381839 KW - breast European society surgery ultrasound human patient machine surgeon plastic surgery injection implant cannula scar formation breast endoprosthesis pleura rib tissues United Kingdom breast surgery deep inferior epigastric perforator flap LA - English M3 - Conference Abstract N1 - L71958136 2015-07-28 PY - 2015 SN - 0014-312X SP - 12-13 ST - The use of a portable ultrasound to guide fat-grafting for breast asymmetry T2 - European Surgical Research TI - The use of a portable ultrasound to guide fat-grafting for breast asymmetry UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71958136&from=export http://dx.doi.org/10.1159/381839 VL - 55 ID - 6238 ER - TY - JOUR AB - The extended latissimus dorsi flap (LD) is used in breast reconstruction since the 70's. LD flap is often used in corrective surgery in cases of unsatisfactory cosmetic results after breast-conserving therapy. In our department LD flap has several uses. In addition to free microvascular flaps-which applies in breast reconstructive surgery is routine, there are clinical situations where the use of pedicled LD flap is justified. The main indications for its use are: the inability to apply microvascular flap, the general condition (diabetes, advanced atherosclerosis), smoking, previous surgery of abdominal wall, abdominal obesity, patient preferences. Approximately 30% of patients after breast reconstruction require corrective procedures. Group which uses extended LD flap account for 24 patients. In 16 cases it was used for elective breast reconstruction. In the remaining eight cases it was used in the corrective procedures symmetry and shape of the previously reconstructed breast. Based on our own experience it can be concluded that the LD flap with an alternative to microvascular techniques. Complication rate when using the LD flap is relatively low and includes: seroma and slight motor disability of the shoulder girdle. AD - A. MacIejewski, Department of Oncological and Reconstructive Surgery, Center of Oncology, Division in Gliwice, Poland AU - MacIejewski, A. AU - Ulczok, R. AU - Dobrut, M. AU - Szumniak, R. AU - Półtorak, S. DB - Medline DO - 10.2478/v10035-012-0062-8 IS - 7 KW - adult article breast reconstruction breast tumor case report female follow up human mastectomy methodology middle aged patient satisfaction surgical flaps tissue expansion treatment outcome LA - English M3 - Article N1 - L365616497 2013-02-07 PY - 2012 SN - 0032-373X SP - 367-370 ST - The use of a pedunculated, extended latissimus dorsi flap in primary and secondary breast reconstruction procedures-case report T2 - Polski Przeglad Chirurgiczny/ Polish Journal of Surgery TI - The use of a pedunculated, extended latissimus dorsi flap in primary and secondary breast reconstruction procedures-case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L365616497&from=export http://dx.doi.org/10.2478/v10035-012-0062-8 VL - 84 ID - 7105 ER - TY - JOUR AB - The extended latissimus dorsi flap (LD) is used in breast reconstruction since the 70's. LD flap is often used in corrective surgery in cases of unsatisfactory cosmetic results after breast-conserving therapy. In our department LD flap has several uses. In addition to free microvascular flaps - which applies in breast reconstructive surgery is routine, there are clinical situations where the use of pedicled LD flap is justified. The main indications for its use are: the inability to apply microvascular flap, the general condition (diabetes, advanced atherosclerosis), smoking, previous surgery of abdominal wall, abdominal obesity, patient preferences. Approximately 30% of patients after breast reconstruction require corrective procedures. Group which uses extended LD flap account for 24 patients. In 16 cases it was used for elective breast reconstruction. In the remaining eight cases it was used in the corrective procedures symmetry and shape of the previously reconstructed breast. Based on our own experience it can be concluded that the LD flap with an alternative to microvascular techniques. Complication rate when using the LD flap is relatively low and includes: seroma and slight motor disability of the shoulder girdle. AD - Department of Oncological and Reconstructive Surgery, Center of Oncology, M. Skłodowska-Curie Institute, Division in Gliwice. AN - 22935460 AU - Maciejewski, A. AU - Ulczok, R. AU - Dobrut, M. AU - Szumniak, R. AU - Półtorak, S. DA - Jul DO - 10.2478/v10035-012-0062-8 DP - NLM ET - 2012/09/01 IS - 7 KW - Adult Breast Neoplasms/*surgery Female Follow-Up Studies Humans Mammaplasty/*methods Mastectomy Middle Aged *Patient Satisfaction *Surgical Flaps *Tissue Expansion Treatment Outcome LA - eng N1 - 2299-2847 Maciejewski, Adam Ulczok, Rafał Dobrut, Mirosław Szumniak, Ryszard Półtorak, Stanisław Case Reports Journal Article Poland Pol Przegl Chir. 2012 Jul;84(7):367-70. doi: 10.2478/v10035-012-0062-8. PY - 2012 SN - 0032-373x SP - 367-70 ST - The use of a pedunculated, extended latissimus dorsi flap in primary and secondary breast reconstruction procedures--case report T2 - Pol Przegl Chir TI - The use of a pedunculated, extended latissimus dorsi flap in primary and secondary breast reconstruction procedures--case report VL - 84 ID - 11001 ER - TY - JOUR AB - Internal mammary vessels are commonly used in microvascular breast reconstruction. Most surgeons resect a portion of the rib to expose these vessels. This resection can lead to contour abnormalities in the chest wall that are difficult to correct. In addition, exposure of these vessels deep in the wound can be problematic. The purpose of this study was to evaluate our experience with a pectoralis major flap designed to improve exposure and fill in the defect created by rib resection. All consecutive patients who underwent autologous breast reconstruction using the internal mammary vessels as recipient vessels between 2000 and 2005 were identified. All procedures were performed by a single surgeon. In each case, a superiorly based flap within the pectoralis major muscle spanning the bottom of the second rib to the top of the fourth costal cartilage was raised. This "L"-shaped flap was reflected and a portion of the third rib cartilage was excised. At the conclusion of the microsurgical anastomosis the pectoralis major flap was repaired and used to cover the defect created by rib resection. Patient demographic, operative details, and postoperative complications were obtained from a prospectively maintained clinical database. Deformity around sternal border was evaluated from the patients' photographs. There were 99 autologous reconstructions in 90 patients. In 71 cases the internal mammary artery/vein were used as recipient vessels. There were no cases of microvascular thrombosis or flap loss. A portion of the third rib was excised in all patients who underwent microsurgical anastomoses to the internal mammary vessels. In 3 patients a portion of both the second and third ribs was removed because of branching of the internal mammary vein proximal to the level of the third rib. A contour deformity was noted in 4 patients (4.4%) after a mean follow-up of 27 months. Of the 4 patients with contour deformity, 2 had a portion of both the third and second costal cartilage removed because of venous branching above the level of the third rib cartilage. The modified pectoralis major L-shaped flap is a useful technique for safe and clear exposure of the internal mammary vessels. In addition, the use of this flap to cover the segment of resected rib cartilage can decrease the contour deformities associated with rib resection as compared with reported rates in the literature. Resection of multiple rib segments, though unavoidable at times because of anatomic considerations, may be associated with an increased rate of postoperative contour deformities. © 2008 by Lippincott Williams & Wilkins. AD - B. J. Mehrara, FACS, 1275 York Avenue, New York, NY, 10021 AU - Mosahebi, A. AU - Da Lio, A. AU - Mehrara, B. J. DB - Embase Medline DO - 10.1097/SAP.0b013e318151f9fa IS - 1 KW - adult anastomosis article breast reconstruction clinical evaluation controlled study demography experience female follow up free tissue graft human major clinical study mammary artery microvascular surgery muscle flap pectoralis major muscle photography postoperative complication priority journal rib cartilage rib resection surgeon LA - English M3 - Article N1 - L354616887 2009-06-11 PY - 2008 SN - 0148-7043 SP - 30-34 ST - The use of a pectoralis major flap to improve internal mammary vessels exposure and reduce contour deformity in microvascular free flap breast reconstruction T2 - Annals of Plastic Surgery TI - The use of a pectoralis major flap to improve internal mammary vessels exposure and reduce contour deformity in microvascular free flap breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L354616887&from=export http://dx.doi.org/10.1097/SAP.0b013e318151f9fa VL - 61 ID - 7855 ER - TY - JOUR AB - Locally advanced breast cancer has a poor prognosis. Skin infiltration, ulceration and invasion of the chest wall, in the absence of distant metastases, worsen dramatically the quality of life. The Authors report 4 cases of one time wide resection and reconstruction using a pedicled myocutaneous flap of latissimus dorsi. This technique allowed good and rapid palliation of local symptoms. AN - 2484643 AU - Sorrentino, P. AU - Baccaglini, U. AU - Castoro, C. AU - Borelli, P. AU - Pavei, P. AU - Nosadini, A. AU - Iuliani, M. AU - Tremolada, C. AU - Mazzoleni, F. AU - Peracchia, A. DA - Nov DP - NLM ET - 1989/11/01 IS - 11 KW - Aged Breast/pathology Breast Neoplasms/pathology/*surgery Carcinoma/pathology/*surgery Female Humans Mastectomy, Radical Neoplasm Invasiveness Palliative Care Prognosis *Surgical Flaps LA - ita N1 - Sorrentino, P Baccaglini, U Castoro, C Borelli, P Pavei, P Nosadini, A Iuliani, M Tremolada, C Mazzoleni, F Peracchia, A Case Reports English Abstract Journal Article Italy G Chir. 1989 Nov;10(11):670-3. OP - L'uso del lembo miocutaneo di gran dorsale nel carcinoma mammario localmente avanzato. PY - 1989 SN - 0391-9005 (Print) 0391-9005 SP - 670-3 ST - [Use of a latissimus dorsi myocutaneous flap in locally advanced breast cancer] T2 - G Chir TI - [Use of a latissimus dorsi myocutaneous flap in locally advanced breast cancer] VL - 10 ID - 11657 ER - TY - JOUR AD - Instituto Dante Pazzanese de Cardiologia, São Paulo, SP. anger@uol.com.br AN - 15608988 AU - Anger, J. AU - Farsky, P. S. AU - Amato, V. L. AU - Abboud, C. S. AU - Almeida, A. F. AU - Arnoni, R. T. AU - Dinkhuysen, J. J. AU - Paulista, P. P. DA - Dec DO - 10.1590/s0066-782x2004001900008 DP - NLM ET - 2004/12/21 KW - Breast/surgery Female Humans Reoperation Sternum/*surgery *Surgical Flaps Surgical Wound Dehiscence/*surgery Surgical Wound Infection/*surgery LA - por N1 - Anger, Jaime Farsky, Pedro Silvio Amato, Vivian Lerner Abboud, Cely Saad Almeida, Antonio Flávio Sanches de Arnoni, Renato T Dinkhuysen, Jarbas Jackson Paulista, Paulo P Journal Article Brazil Arq Bras Cardiol. 2004 Dec;83 Spec No:43-5. doi: 10.1590/s0066-782x2004001900008. Epub 2004 Dec 13. OP - A utilização de retalho composto de pele e tecido mamário na reparação de área cruenta resultante da deiscência de esternotomia em cirurgia cardíaca. PY - 2004 SN - 0066-782X (Print) 0066-782x SP - 43-5 ST - [Use of a flap composed of skin and breast tissue for repairing a recalcitrant wound resulting from dehiscence of sternotomy in cardiac surgery] T2 - Arq Bras Cardiol TI - [Use of a flap composed of skin and breast tissue for repairing a recalcitrant wound resulting from dehiscence of sternotomy in cardiac surgery] VL - 83 Spec No ID - 11463 ER - TY - JOUR AB - The deep inferior epigastric artery perforator (DIEP) flap was originally developed by Koshima and Soeda to reduce donor site morbidity associated with the rectus abdominis myocutaneous flap. Therefore, this flap is often used in breast reconstruction instead of a conventional TRAM flap. We used this flap in two patients requiring hand and foot soft tissue repair and we believe that this flap is also useful in reconstruction of the extremities. However, flap harvest is technically challenging and the surgeon must be very careful in dissection of the perforator to preserve the muscle branches and intercostal nerves. AD - N. Ishikura, Dept. of Plastic and Reconstr. Surg., Kanazawa Medical University, Ishikawa 920-0265, Japan AU - Ishikura, N. AU - Heshiki, T. AU - Shimada, K. AU - Kawakami, S. DB - Embase IS - 2 KW - adult article breast reconstruction case report donor site epigastric artery foot injury hand injury human intercostal nerve male myocutaneous flap rectus abdominis muscle soft tissue injury LA - Japanese M3 - Article N1 - L32244625 2001-04-10 PY - 2001 SN - 0021-5228 SP - 103-108 ST - Use of a DIEP flap in reconstruction of the extremities T2 - Japanese Journal of Plastic and Reconstructive Surgery TI - Use of a DIEP flap in reconstruction of the extremities UR - https://www.embase.com/search/results?subaction=viewrecord&id=L32244625&from=export VL - 44 ID - 8474 ER - TY - JOUR AB - Breast radiotherapy during childhood may cause unpredictable outcomes in soft tissue growth and may be responsible for most iatrogenic-related breast hypoplasias. Poor local skin quality and subcutaneous atrophy poses a difficult problem for the use of alloplastic tissues. Clinical use of a deep inferior epigastric perforator flap (DIEP) in oncological breast surgery is a common practice; however few studies have described its application in benign situations and no previous report addressed this subject. The authors indicate the use of the DIEP flap to correct severe hypomastia after previous childhood radiotherapy for hemangioma treatment, followed by unsuccessful alloplastic tissue reconstruction. For selected patients the DIEP flap may constitute a new alternative for complications of radiotherapy treatment due to the possibility of large tissue transfer with minimal donor area morbidity. The quantity of flap tissue necessary to restore the breast mound, the perforator vessel size, and the quality of suitable recipient vessels should be carefully evaluated. However, the need for microsurgical training as well as the extended surgical time are the main limiting factors for the use of this flap. AD - Division of Plastic Surgery, University of Sao Paulo School of Medicine, Sao Paulo, Brazil. munhozalex@uol.com.br AN - 105856363. Language: English. Entry Date: 20080314. Revision Date: 20200708. Publication Type: Journal Article AU - Munhoz, A. M. AU - Duarte, G. G. AU - Fells, K. AU - Arruda, E. AU - Montag, E. AU - Aldrighi, C. AU - Aldrighi, J. M. AU - Ferreira, M. C. DB - cin20 DO - 10.1111/j.1524-4741.2006.00367.x DP - EBSCOhost IS - 1 KW - Arteries -- Transplantation Breast Reconstruction Breast -- Pathology Breast -- Surgery Radiotherapy -- Adverse Effects Surgical Flaps Abdominal Muscles -- Blood Supply Abdominal Muscles -- Transplantation Adult Breast Neoplasms -- Radiotherapy Breast -- Radiation Effects Female Hemangioma -- Radiotherapy Severity of Illness Indices Human N1 - case study; research. Journal Subset: Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Peer Reviewed; USA. NLM UID: 9505539. PMID: NLM17214798. PY - 2007 SN - 1075-122X SP - 76-82 ST - The use of a deep inferior epigastric perforator flap (DIEP) in a case of severe breast asymmetry secondary to radiation therapy during childhood T2 - Breast Journal TI - The use of a deep inferior epigastric perforator flap (DIEP) in a case of severe breast asymmetry secondary to radiation therapy during childhood UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105856363&site=ehost-live&scope=site VL - 13 ID - 889 ER - TY - JOUR AB - Background: Recently, the deep inferior epigastric perforator (DIEP) flap has become the gold standard for breast reconstruction, but it has some drawbacks such as abdominal bulging and hernia. To overcome these disadvantages, the superficial inferior epigastric artery perforator (SIEA) flap is used as an alternative option, but it has another problem, namely limited vascular territory and risk of vascular thrombosis. To solve these problems, we introduced our new technique, a combined SIEA and superficial circumflex iliac artery perforator (SCIP) based double pedicled abdominal flap. In this report, we present our experience of using this technique. Methods: The SIEA and SCIP based double pedicled abdominal flap was used in five patients who wanted to have unilateral breast reconstruction after a mastectomy due to breast cancer. The average age was 48.2 (range 38–56) years, and the average BMI was 24.4 (range 19.2–31.4). The SIEA and SCIP based double pedicled abdominal flap was designed as a modified DIEP flap, and all flaps were placed in the vertical setting. The flap pedicles had two different vascular supplies, SIEA and SCIA, and the drainage systems, SIEV and SCIV, anastomosed to the internal mammary artery and vein in all cases. Results: The harvested SIEA and SCIP based double pedicled abdominal flaps were a median volume of 925 g (range 452–1570 g) and average size of 491 cm2 (range 440–611 cm2). The average reconstructive time was 7:41 (range 6:31–9:17). In four out of the five cases, the SIEA and SCIA joined together to make a common pedicle artery trunk, and its average size was 1.08 mm. Four out of the five cases had a wide vascular territory crossing the abdominal midline as shown by ICG angiography. One case showed ICG fluorescence for the hemi-side of the abdominal flap. Postoperative course was uneventful, and there were no major perioperative complications, which need extra surgical procedures. Follow-up period averaged 273 days (range 194–312 days). Conclusion: The SIEA and SCIP based double pedicled abdominal flap showed viable flap territory across the midline in all cases. The SIEA and SCIP based double pedicled abdominal flap might be another ideal option for breast reconstruction, when appropriate SIEA and SCIA pedicles are identified, and an adequate ICG fluorescence is obtained for the size of flap needed. AD - T. Yano, Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital, Tokyo, Japan AU - Yano, T. AU - Yoshimatsu, H. AU - Karakawa, R. AU - Fuse, Y. AU - Kuramoto, Y. AU - Shibata, T. AU - Suesada, N. AU - Miyashita, H. DB - Embase Medline DO - 10.1002/micr.30727 KW - adult article body mass breast cancer breast reconstruction cancer patient cancer surgery clinical article complication deep inferior epigastric perforator flap female fluorescence follow up human iliac artery indocyanine green angiography internal mammary artery mastectomy middle aged peroperative complication surgery surgical technique trunk vein LA - English M3 - Article in Press N1 - L2010710254 2021-03-16 PY - 2021 SN - 1098-2752 0738-1085 ST - Use of a combined SIEA and SCIP based double pedicled abdominal flap for breast reconstruction T2 - Microsurgery TI - Use of a combined SIEA and SCIP based double pedicled abdominal flap for breast reconstruction UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2010710254&from=export http://dx.doi.org/10.1002/micr.30727 ID - 4522 ER - TY - JOUR AB - Background Recently, the deep inferior epigastric perforator (DIEP) flap has become the gold standard for breast reconstruction, but it has some drawbacks such as abdominal bulging and hernia. To overcome these disadvantages, the superficial inferior epigastric artery perforator (SIEA) flap is used as an alternative option, but it has another problem, namely limited vascular territory and risk of vascular thrombosis. To solve these problems, we introduced our new technique, a combined SIEA and superficial circumflex iliac artery perforator (SCIP) based double pedicled abdominal flap. In this report, we present our experience of using this technique. Methods The SIEA and SCIP based double pedicled abdominal flap was used in five patients who wanted to have unilateral breast reconstruction after a mastectomy due to breast cancer. The average age was 48.2 (range 38-56) years, and the average BMI was 24.4 (range 19.2-31.4). The SIEA and SCIP based double pedicled abdominal flap was designed as a modified DIEP flap, and all flaps were placed in the vertical setting. The flap pedicles had two different vascular supplies, SIEA and SCIA, and the drainage systems, SIEV and SCIV, anastomosed to the internal mammary artery and vein in all cases. Results The harvested SIEA and SCIP based double pedicled abdominal flaps were a median volume of 925 g (range 452-1570 g) and average size of 491 cm(2) (range 440-611 cm(2)). The average reconstructive time was 7:41 (range 6:31-9:17). In four out of the five cases, the SIEA and SCIA joined together to make a common pedicle artery trunk, and its average size was 1.08 mm. Four out of the five cases had a wide vascular territory crossing the abdominal midline as shown by ICG angiography. One case showed ICG fluorescence for the hemi-side of the abdominal flap. Postoperative course was uneventful, and there were no major perioperative complications, which need extra surgical procedures. Follow-up period averaged 273 days (range 194-312 days). Conclusion The SIEA and SCIP based double pedicled abdominal flap showed viable flap territory across the midline in all cases. The SIEA and SCIP based double pedicled abdominal flap might be another ideal option for breast reconstruction, when appropriate SIEA and SCIA pedicles are identified, and an adequate ICG fluorescence is obtained for the size of flap needed. AD - [Yano, Tomoyuki; Yoshimatsu, Hidehiko; Karakawa, Ryo; Fuse, Yuma; Kuramoto, Yukiko; Shibata, Tomoyoshi; Suesada, Nobuko; Miyashita, Hiroki] Canc Inst Hosp, Dept Plast & Reconstruct Surg, Tokyo, Japan. Yano, T (corresponding author), Canc Inst Hosp, Dept Plast & Reconstruct Surg, Koto Ku, 3-8-31 Ariake, Tokyo 1358550, Japan. yanoaprs@icloud.com AN - WOS:000625917500001 AU - Yano, T. AU - Yoshimatsu, H. AU - Karakawa, R. AU - Fuse, Y. AU - Kuramoto, Y. AU - Shibata, T. AU - Suesada, N. AU - Miyashita, H. DO - 10.1002/micr.30727 J2 - Microsurgery KW - Surgery LA - English M3 - Article; Early Access N1 - ISI Document Delivery No.: QS5CF Times Cited: 0 Cited Reference Count: 26 Yano, Tomoyuki Yoshimatsu, Hidehiko Karakawa, Ryo Fuse, Yuma Kuramoto, Yukiko Shibata, Tomoyoshi Suesada, Nobuko Miyashita, Hiroki Fuse, Yuma/0000-0002-1045-3068 0 Wiley Hoboken 1098-2752 SN - 0738-1085 SP - 8 ST - Use of a combined SIEA and SCIP based double pedicled abdominal flap for breast reconstruction T2 - Microsurgery TI - Use of a combined SIEA and SCIP based double pedicled abdominal flap for breast reconstruction UR - ://WOS:000625917500001 ID - 968 ER - TY - JOUR AB - Introduction: Lateral chest wall perforator flap (CWPF) provides a non-muscle parenchymal replacement option for partial breast reconstruction following breast conservation surgery (BCS) in high tumour:breast ratio excisions. Since this is the latest oncoplastic procedure in the armamentarium of breast-conserving surgery options, there is not yet a specific Breast-QO' module. Hence, a previous single centre pilot study explored a combination of two modules of Breast-Q (Abstract, ABS, 2016). This study combines pilot data from two University teaching hospitals. Methods: The Breast-Q provides a Q-score that ranges between 0 and 100, with 100 being the highest score in both patient satisfaction and Quality of Life (QOL) domains. Patients from two University teaching hospitals completed a combination of post-operative breast conservation therapy (BCT) module and post-operative LD flap module of Breast-Q. Results: Mean post-operative Q-scores derived from 36 available responses were as follows: • Satisfaction with: breast = 81.3, irradiated breast = 87.2, patient care, surgeon and staff > 95 • QoL domain: physical well-being = 76.4, psychosocial wellbeing = 82.1, sexual well-being = 60.4 • Back appearance = 90.5, shoulder and back function = 77.1 Conclusions: Where displacement option such as therapeutic mammoplasty (i.e. BCT with reduction) is not applicable, CWPF offers an alternative BCS option (often avoiding mastectomy) especially in smaller breasts with no or low-grade ptosis. Our two-centre cohort exploring patient-reported outcomes finds favourable patient satisfaction scores in this latest Oncoplastic procedure. Further, this study reinforces the feasibility of combination of two Q-score modules though needs validation in a larger multi-centre prospective study. AD - Z. Ang, Cambridge University, Cambridge, United Kingdom AU - Ang, Z. AU - Tenovici, A. AU - Roy, P. AU - Agrawal, A. DB - Embase DO - 10.1007/s10549-017-4585-x IS - 1 KW - adult breast reconstruction case report city clinical article cohort analysis conference abstract drug combination feasibility study female human male mastectomy multicenter study outcome assessment patient care patient satisfaction patient-reported outcome perforator flap physical well-being prospective study ptosis (eyelid) quality of life shoulder staff surgeon surgery teaching hospital thorax wall validation process LA - English M3 - Conference Abstract N1 - L620694733 2018-02-20 PY - 2018 SN - 0167-6806 SP - 371 ST - Use of a combination of modules of BREAST-Q in lateral chest wall flap partial breast reconstruction: A tale of two cities T2 - Breast Cancer Research and Treatment TI - Use of a combination of modules of BREAST-Q in lateral chest wall flap partial breast reconstruction: A tale of two cities UR - https://www.embase.com/search/results?subaction=viewrecord&id=L620694733&from=export http://dx.doi.org/10.1007/s10549-017-4585-x VL - 167 ID - 5537 ER - TY - JOUR AB - Aesthetically pleasing and symmetrical breasts are the goal of reconstructive breast surgery. Sometimes, however, multiple procedures are needed to improve a reconstructed breast's symmetry and appearance. In order to avoid additional corrective procedures, we have developed a new method that uses a reverse engineering technique to produce what we call a new breast replica cast (NBRC). The NBRC is a mould of the contralateral healthy breast, designed according to preoperative laser 3D images. During surgery, the mould is used to help shape the new breast. With this method, we are able to achieve breast symmetry in terms of volume, projection, contour, and position on the chest wall more accurately, more quickly, and more safely than before. AD - Department of Plastic, Reconstructive, Aesthetic Surgery and Burns, University Medical Centre Ljubljana, Zaloska 7, SI-1000 Ljubljana, Slovenia. AN - 21982542 AU - Ahcan, U. AU - Bracun, D. AU - Zivec, K. AU - Pavlic, R. AU - Butala, P. DA - Apr DO - 10.1016/j.breast.2011.09.009 DP - NLM ET - 2011/10/11 IS - 2 KW - Adult Breast/anatomy & histology/*surgery Breast Neoplasms/surgery Female Humans Imaging, Three-Dimensional/*methods Lasers Mammaplasty/*instrumentation/methods Middle Aged Models, Anatomic *Surgical Flaps LA - eng N1 - 1532-3080 Ahcan, Uros Bracun, Drago Zivec, Katarina Pavlic, Rok Butala, Peter Journal Article Netherlands Breast. 2012 Apr;21(2):183-9. doi: 10.1016/j.breast.2011.09.009. Epub 2011 Oct 7. PY - 2012 SN - 0960-9776 SP - 183-9 ST - The use of 3D laser imaging and a new breast replica cast as a method to optimize autologous breast reconstruction after mastectomy T2 - Breast TI - The use of 3D laser imaging and a new breast replica cast as a method to optimize autologous breast reconstruction after mastectomy VL - 21 ID - 9314 ER - TY - JOUR AB - Background and aim: Although the internal mammary vessels are, for many surgeons, the recipient vessels of choice in microvascular breast reconstruction, there continues to be some debate regarding their use. The reliability of these vessels, particularly the vein, has been called into question, with high rates of conversion to alternative vessels being reported. This study investigates the true usability rate of the internal mammary vessels in a large series of consecutive patients without preselection. Methods: A review of all patients who underwent microvascular breast reconstruction at the University Health Network between September 2007 and December 2013 was conducted, and the conversion rate to alternative vessels was determined. Results: A total of 759 microvascular breast reconstructions were performed in 515 patients. The internal mammary vessels were explored in all cases and found to be suitable for anastomosis in 756 of 759 reconstructions. Conversion to the thoracodorsal vessels was required in three reconstructions (0.4%) due to unusable internal mammary arteries. There was no significant increase in unusable vessels with timing or laterality of reconstruction or other factors such as smoking, vascular co-morbidities and adjuvant chemotherapy or radiotherapy. Total flap failure occurred in four reconstructions (0.5%), whereas partial flap loss occurred in five (0.6%). Conclusion: The internal mammary vessels can be safely and reliably used in almost all patients undergoing microsurgical breast reconstruction with low rates of microvascular complications. (C) 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. AD - [O'Neill, Anne C.; Hayward, Victoria; Zhong, Toni; Hofer, Stefan O. P.] Univ Toronto, Div Plast & Reconstruct Surg, Dept Surg & Surg Oncol, Univ Hlth Network, 200 Elizabeth St, Toronto, ON, Canada. O'Neill, AC (corresponding author), Univ Toronto, Div Plast & Reconstruct Surg, Dept Surg & Surg Oncol, Univ Hlth Network, 200 Elizabeth St, Toronto, ON, Canada. Anne.O'Neill@uhn.ca AN - WOS:000377698600006 AU - O'Neill, A. C. AU - Hayward, V. AU - Zhong, T. AU - Hofer, S. O. P. DA - Jul DO - 10.1016/j.bjps.2016.01.030 IS - 7 J2 - J. Plast. Reconstr. Aesthet. Surg. KW - Microvascular breast reconstruction Internal mammary vessels Recipient vessels Microsurgery free-tissue-transfer free tram flap thoracodorsal vessels vein artery perforator algorithm selection choice site Surgery LA - English M3 - Article; Proceedings Paper N1 - ISI Document Delivery No.: DO3RK Times Cited: 13 Cited Reference Count: 35 O'Neill, Anne C. Hayward, Victoria Zhong, Toni Hofer, Stefan O. P. Annual Meeting of the Canadian-Society-of-Plastic-Surgeons May 29, 2013 Calgary, CANADA Canadian Soc Plast Surg 14 0 1 Elsevier sci ltd Oxford 1878-0539 PY - 2016 SN - 1748-6815 SP - 907-911 ST - Usability of the internal mammary recipient vessels in microvascular breast reconstruction T2 - Journal of Plastic Reconstructive and Aesthetic Surgery TI - Usability of the internal mammary recipient vessels in microvascular breast reconstruction UR - ://WOS:000377698600006 VL - 69 ID - 1999 ER - TY - JOUR AB - Free tissue transfer is the autologous transplantation of composite tissue and its arterial and venous blood supply to a distant site. Free tissue transfers, also called free flaps, may include skin, fascia, muscle, or bone. Free flaps were once considered highly complex procedures; now they are frequently used as the reconstructive option of choice. While several variables must be considered when one plans a free tissue transfer, the most important consideration is the size and location of the defect created by the tumor resection. Free tissue transfer is a multistep procedure, including preparation of the recipient site, harvesting of the flap, and transfer and revascularization of the flap. For upper extremity reconstruction, the gracilis muscle flap has been particularly useful, as has the lateral arm fasciocutaneous flap. Semin. Surg. Oncol. 19:246-254, 2000. (C) 2000 Wiley-Liss, Inc. AD - Mayo Clin Scottsdale, Dept Surg, Scottsdale, AZ 85259 USA. Smith, AA (corresponding author), Mayo Clin Scottsdale, Dept Surg, 13400 E Shea Blvd, Scottsdale, AZ 85259 USA. smith.anthony@mayo.edu AN - WOS:000166195300006 AU - Willcox, T. M. AU - Smith, A. A. DA - Oct-Nov DO - 10.1002/1098-2388(200010/11)19:3<246::Aid-ssu6>3.0.Co;2-f IS - 3 J2 - Semin. Surg. Oncol. KW - reconstructive surgical procedures surgical flaps tissue transplantation upper extremity reconstruction soft-tissue coverage breast reconstruction muscle flaps radiation injuries arm avulsion anatomy defects Oncology Surgery LA - English M3 - Review N1 - ISI Document Delivery No.: 388RK Times Cited: 12 Cited Reference Count: 48 Willcox, TM Smith, AA 12 0 2 Wiley-liss Hoboken PY - 2000 SN - 8756-0437 SP - 246-254 ST - Upper limb free flap reconstruction after tumor resection T2 - Seminars in Surgical Oncology TI - Upper limb free flap reconstruction after tumor resection UR - ://WOS:000166195300006 VL - 19 ID - 4047 ER - TY - JOUR AB - A prospective clinical study was conducted to evaluate the impact of upper cervicothoracic sympathetic block (CTGB) on blood supply of the unipedicled transverse rectus abdominis musculocutaneous (TRAM) flap. The use of the technique is first reported herein, as a manipulation improving arterial blood flow within the flap in high‐risk patients, thus reducing postoperative morbidity. From March 2003 to September 2006, 28 heavy smokers, who underwent delayed breast reconstruction with unipedicled TRAM flap, were included in the study. Intraoperative upper cervicothoracic block (ganglia C5,6,7 and T1,2) was performed in 16 patients (group A), while 12 patients, who did not consent to have the blockade (group B), were the control. Clinical evaluation and thermographic monitoring of skin temperature, using the Thermacam A40 (FLIR systems, Wilsonville, OR), was used in all patients and determined the blood flow within the flap. All patients were monitored for early and late complications. In all group A patients, CTGB resulted in TRAM flap temperature increase within 9.5 to 16 min. Flap temperature elevation was found to be significantly higher (P < 0.001) and hospital stay was significantly shorter (P = 0.004) in group A patients. No CTGB or TRAM flap complications were recorded in group A patients. However, in group B, major fat necrosis occurred in 2 patients and partial (1/3) flap necrosis in 1 patient. Upper cervicothoracic sympathetic block is a reliable, safe, and useful technique for increasing blood flow within TRAM flaps in high‐risk patients, like heavy smokers, and it minimizes postoperative morbidity. AN - CN-00650713 AU - Tsoutsos, D. AU - Kakagia, D. AU - Gravvanis, A. AU - Iconomou, T. AU - Tsagkarakis, M. AU - Zogogiannis, I. AU - Dimitriou, V. DO - 10.1097/SAP.0b013e31815acb82 IS - 3 KW - Adult Analysis of Variance Autonomic Nerve Block Fat Necrosis [epidemiology, etiology] Humans Length of Stay Mammaplasty [*methods, statistics & numerical data] Middle Aged Prospective Studies Skin Temperature Smoking [epidemiology] Surgical Flaps [adverse effects, *blood supply] Thermography [economics] M3 - Controlled Clinical Trial; Journal Article PY - 2008 SP - 247‐251 ST - Upper cervicothoracic sympathetic block increases blood supply of unipedicled TRAM flap T2 - Annals of plastic surgery TI - Upper cervicothoracic sympathetic block increases blood supply of unipedicled TRAM flap UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00650713/full VL - 61 ID - 22 ER - TY - JOUR AB - Background. - After massive weight loss (MWL), female patients often develop upper trunk laxity and severe breast deformities. Usually several procedures are required to address upper body contouring issues. Objectives. - To achieve better breasts and improve upper body contour, the authors employed a combined approach, associating lateral chest wall perforator propeller flaps with an upper bodylift (UBL). Methods. - Between September 2015 and March 2017, nine post-bariatric patients underwent simultaneously an UBL and autologous augmentation breast reshaping with lateral chest wall perforator propeller flaps. The authors analyzed the clinical indications, results and complications of this procedure. Results. - Eighteen lateral perforator propeller flaps for autologous breast augmentationmastopexy associated with an UBL were performed successfully. Mean pre-MWL body mass index (BMI) was 54.3 +/- 10.9 kg/m(2), with a mean preoperative pre-UBL BMI of 28.7 +/- 3.6 kg/m(2). The average weight loss before surgery was 67.7 +/- 22.4 kg. The flaps were harvested on intercostal and/or lateral thoracic arteries. All donor sites had been closed primarily. Following the classification of Dindo and Clavien, four minor complications (I, II), and two major complications (IIIb), including two hematomas requiring reoperation, were reported. No flap necrosis occurred. Follow-up averaged 27.9 +/- 8.4 months. The patients' satisfaction with their improved breast shapes and chest wall contours was "good'', with an aesthetic outcome mean ranked 3.8 +/- 0.8 (out of 5). Conclusions. - After MWL, upper body deformities can be treated safely and reliably by a combined approach, associating an UBL and autologous lateral chest wall perforator flaps to provide more natural and durable breast shapes, as well as an upper circumferential reshaping. (C) 2019 Elsevier Masson SAS. All rights reserved. AD - [Isola, N.; Aillet, S.; Watier, E.; Bertheuil, N.] Univ Rennes 1, Hosp Sud, Dept Plast Reconstruct & Aesthet Surg, F-35200 Rennes, France. [Bertheuil, N.] Univ Rennes 1, INSERM U1236, F-35000 Rennes, France. [Bertheuil, N.] Rennes Univ Hosp, SITI Lab, F-35000 Rennes, France. [Chaput, B.] Hop Rangueil, INSERM U1031, CNRS, UPS,EFS,STROMA Lab,UMR5273, F-31100 Toulouse, France. [Chaput, B.] Hop Rangueil, Dept Plast Reconstruct & Aesthet Surg, 1 Ave Jean Poulhes, F-31059 Toulouse, France. [Herlin, C.] Montpellier Univ Hosp, Hop Lapeyronie, Dept Plast Surg & Burn Surg, F-34090 Montpellier, France. Bertheuil, N (corresponding author), South Hosp, Dept Plast Reconstruct & Aesthet Surg, 16 Blvd Bulgarie, F-35200 Rennes, France. nbertheuil@gmail.com AN - WOS:000515105200007 AU - Isola, N. AU - Herlin, C. AU - Chaput, B. AU - Aillet, S. AU - Watier, E. AU - Bertheuil, N. DA - Feb DO - 10.1016/j.anplas.2019.07.006 IS - 1 J2 - Ann. Chir. Plast. Esthet. KW - Massive weight loss Bariatric surgery Perforator flap Autologous breast augmention Mastopexy Upper body lift Breast reshaping autologous augmentation-mastopexy surgery classification reconstruction complications torsoplasty Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: KN8OQ Times Cited: 1 Cited Reference Count: 39 Isola, N. Herlin, C. Chaput, B. Aillet, S. Watier, E. Bertheuil, N. CHAPUT, benoit/0000-0002-8567-3479 1 0 Elsevier Bridgewater 1768-319x PY - 2020 SN - 0294-1260 SP - 44-53 ST - Upper body lift and breast reshaping with lateral chest wall perforator propeller flap following massive weight loss T2 - Annales De Chirurgie Plastique Esthetique TI - Upper body lift and breast reshaping with lateral chest wall perforator propeller flap following massive weight loss UR - ://WOS:000515105200007 VL - 65 ID - 1235 ER - TY - JOUR AB - We present a woman who, after a modified mastectomy, underwent a breast reconstruction with a tissue expander that soon afterward developed a Baker grade 4 capsular contracture. The result was improved with a capsulotomy and a deepithelialized upper arm fasciocutaneous flap, to give fullness to the lateral aspect of the breast. We think that the upper arm fasciocutaneous flap can be a good adjunct in breast reconstruction when lack of tissue in the lateral aspect of the breast or axilla jeopardizes the aesthetic results. AD - Burns and Plastic Center, Madrid Red Cross, Madrid, Spain. AN - 1952755 AU - DaMatta, A. AU - Arenas, C. DA - Sep DO - 10.1097/00000637-199109000-00014 DP - NLM ET - 1991/09/01 IS - 3 KW - Arm/*transplantation Esthetics Female Humans Mammaplasty/*methods/standards *Mastectomy, Modified Radical Middle Aged Surgical Flaps/*methods/standards Tissue Expansion LA - eng N1 - DaMatta, A Arenas, C Case Reports Journal Article United States Ann Plast Surg. 1991 Sep;27(3):278-80. doi: 10.1097/00000637-199109000-00014. PY - 1991 SN - 0148-7043 (Print) 0148-7043 SP - 278-80 ST - The upper arm fasciocutaneous flap in breast reconstruction T2 - Ann Plast Surg TI - The upper arm fasciocutaneous flap in breast reconstruction VL - 27 ID - 11489 ER - TY - JOUR AD - Department of Medical, Surgical and Health Sciences, Plastic and Reconstructive Surgery Unit, University of Trieste, Italy. Electronic address: chiarastoccomd@gmail.com. Department of Surgical Sciences, Plastic Surgery and Microsurgery Unit, University of Cagliari, Sardinia, Italy. Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, United Kingdom. AN - 29422398 AU - Stocco, C. AU - Figus, A. AU - Razzano, S. DA - Jun DO - 10.1016/j.bjps.2018.01.025 DP - NLM ET - 2018/02/10 IS - 6 KW - Female Humans *Mammaplasty Patient Satisfaction *Perforator Flap Quality of Life *Surveys and Questionnaires *Transplant Donor Site LA - eng N1 - 1878-0539 Stocco, Chiara Figus, Andrea Razzano, Sergio Letter Netherlands J Plast Reconstr Aesthet Surg. 2018 Jun;71(6):928-929. doi: 10.1016/j.bjps.2018.01.025. Epub 2018 Feb 13. PY - 2018 SN - 1748-6815 SP - 928-929 ST - Upgrading the BREAST-Q questionnaire with donor site evaluation after PAP flap breast reconstruction T2 - J Plast Reconstr Aesthet Surg TI - Upgrading the BREAST-Q questionnaire with donor site evaluation after PAP flap breast reconstruction VL - 71 ID - 13080 ER - TY - JOUR AB - BACKGROUND: Conservative treatment of lower pole breast cancer in small or medium sized breasts could be attended with poor cosmetic outcomes. The purpose of this study was to assess the results of the "Crescent" Oncoplastic technique in this indication. MATERIAL AND METHODS: Prospective study in 54 breast cancer patients undergoing the technique. RESULTS: Post-operative recovery was uneventful except 1 hematoma and 6 breast seromas. With a mean follow-up period of 45 months (range 27-64), no local recurrences was detected. Five patients had fat necrosis. Cosmetic results were assessed as being excellent (39%), good (35%), fair (20%) and mediocre (6%). CONCLUSION: We therefore advise this technique as a first step oncoplastic surgery technique for tumors situated near the inframammary fold. We also recommend the systematic check of the final cosmetic results in the standing position in order to obtain the best possible results. AD - Assistance Publique-Hôpitaux de Paris, Department of Gynecologic and Oncologic Surgery, Hôpital Européen George-Pompidou, 20 Rue Leblanc, 75015 Paris, France. AN - 22186353 AU - Aljarrah, A. AU - Nos, C. AU - Nasr, R. AU - Clough, K. B. AU - Bats, A. S. AU - Lecuru, F. DA - Aug DO - 10.1016/j.breast.2011.11.004 DP - NLM ET - 2011/12/22 IS - 4 KW - Adult Aged Breast Neoplasms/*surgery Carcinoma, Ductal, Breast/*surgery Carcinoma, Intraductal, Noninfiltrating/*surgery Female Follow-Up Studies Humans Mammaplasty/*methods *Mastectomy, Segmental Middle Aged Patient Satisfaction Postoperative Complications Prospective Studies *Surgical Flaps Treatment Outcome LA - eng N1 - 1532-3080 Aljarrah, Adil Nos, Claude Nasr, Rana Clough, Krishna B Bats, Anne-Sophie Lecuru, Fabrice Clinical Trial Journal Article Multicenter Study Netherlands Breast. 2012 Aug;21(4):475-9. doi: 10.1016/j.breast.2011.11.004. Epub 2011 Dec 18. PY - 2012 SN - 0960-9776 SP - 475-9 ST - Updated follow-up of patients treated with the oncoplastic "Crescent" technique for breast cancer T2 - Breast TI - Updated follow-up of patients treated with the oncoplastic "Crescent" technique for breast cancer VL - 21 ID - 12146 ER - TY - JOUR AB - The surgical management of breast cancer has undergone continuous and profound changes over the last three decades. For patients with early stage breast cancer, breast-conserving surgery followed by radiation therapy has been definitively validated as a safe alternative to radical mastectomy, with similar survival rates, better cosmetic outcomes and acceptable rates of local recurrence. Thanks to the improvements in diagnostic work-up, as well as the wider diffusion of screening programs and efforts in patient and physician education, tumors are more often detected at an early stage, furtherly facilitating the widespread use of breast conserving techniques. Breast-conserving surgery has been introduced also in the treatment of patients with locally advanced tumors after tumor downsizing with preoperative chemotherapy, with acceptable rates of ipsilateral breast tumor recurrence. When performing breast-conserving surgery all efforts should be made to ensure negative surgical margins in order minimize the risk of ipsilateral breast tumor recurrence as they are associated with worse distant-disease-free and breast cancer-specific survival rates. The recent introduction of "oncoplastic techniques'', that may allow more extensive excisions of the breast without compromising the cosmetic results, has furtherly increased the use of breast-conserving procedures. Mastectomy remains a valid surgical alternative in selected cases and is usually associated with immediate reconstructive procedures. Staging of the axilla has also gradually evolved toward less aggressive approaches with the adoption of sentinel node biopsy, but several controversies still remain about completion of axillary lymph node dissection in patients with a pathologic positivity in sentinel lymph node biopsy. The present work will highlight the benefits and unresolved issues of the different surgical treatment options in breast cancer and axillary treatment. AD - [Franceschini, Gianluca; Sanchez, Alejandro Martin; Di Leone, Alba; Magno, Stefano; Moschella, Francesca; Accetta, Cristina; Natale, Maria; Di Giorgio, Danilo; Scaldaferri, Assunta; D'Archi, Sabatino; Scardina, Lorenzo; Masetti, Riccardo] Univ Cattolica Sacro Cuore, Multidisciplinary Breast Ctr, I-00168 Rome, Italy. Franceschini, G (corresponding author), Univ Cattolica Sacro Cuore, Multidisciplinary Breast Ctr, Largo Agostino Gemelli 8, I-00168 Rome, Italy. franceschinigianluca@gmail.com AN - WOS:000356204500001 AU - Franceschini, G. AU - Sanchez, A. M. AU - Di Leone, A. AU - Magno, S. AU - Moschella, F. AU - Accetta, C. AU - Natale, M. AU - Di Giorgio, D. AU - Scaldaferri, A. AU - D'Archi, S. AU - Scardina, L. AU - Masetti, R. C7 - Pii s0003469x15023295 DA - Mar-Apr IS - 2 J2 - Ann. Ital. Chir. KW - Axillary treatment Breast Cancer Conservative surgery Mastectomy Sentinel node sentinel lymph-node nipple-sparing mastectomy 20-year follow-up axillary dissection conserving surgery american society tram flaps biopsy reconstruction carcinoma Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: CK4PA Times Cited: 17 Cited Reference Count: 57 Franceschini, Gianluca Sanchez, Alejandro Martin Di Leone, Alba Magno, Stefano Moschella, Francesca Accetta, Cristina Natale, Maria Di Giorgio, Danilo Scaldaferri, Assunta D'Archi, Sabatino Scardina, Lorenzo Masetti, Riccardo d'archi, sabatino/M-3451-2017; D'Archi, Sabatino/AAJ-9137-2021; Franceschini, Gianluca/C-5491-2016; Sanchez, Alejandro Martin/M-6703-2016 d'archi, sabatino/0000-0002-0223-9635; D'Archi, Sabatino/0000-0002-0223-9635; Franceschini, Gianluca/0000-0002-2950-3395; Sanchez, Alejandro Martin/0000-0002-4840-507X; MAGNO, STEFANO/0000-0002-3721-9693; Natale, Maria/0000-0001-5778-8941; MASETTI, Riccardo/0000-0002-7520-9111; Scardina, Lorenzo/0000-0002-5828-2851 17 0 3 Edizioni luigi pozzi Rome 2239-253x PY - 2015 SN - 0003-469X SP - 89-99 ST - Update on the surgical management of breast cancer T2 - Annali Italiani Di Chirurgia TI - Update on the surgical management of breast cancer UR - ://WOS:000356204500001 VL - 86 ID - 2282 ER - TY - JOUR AB - Oncoplastic surgery of the breast (OPS) has generated great excitement over the past years and has become an integrated component of the surgical treatment of breast cancer. Oncoplastic surgical procedures associate the best surgical oncologic principles to achieve wide tumor-free margins with the best principles of plastic surgery to optimize cosmetic outcomes. Thanks to oncoplastic techniques, the role of breast conserving surgery (BCS) has been extended to include a group of patients who would otherwise require mastectomy to achieve adeguate tumor clearance. As OPS continues to gain acceptance and diffusion, an optimal and systematic approach to these techniques is becoming increasingly necessary. This article has the aim to review the essential principles and techniques associated with oncoplastic surgery, based on the data acquired through an extensive search of the PUBMED and MEDLINE database for articles published using the key words "breast cancer oncoplastic surgery". This review analyzes possible the advantages", classifications, indications, and the criteria for a proper selection of oncoplastic techniques to facilitate one's ability to master these procedures and make OPS a safe and an effective procedure.Oncoplastic surgery of the breast (OPS) has generated great excitement over the past years and has become an integrated component of the surgical treatment of breast cancer. Oncoplastic surgical procedures associate the best surgical oncologic principles to achieve wide tumor-free margins with the best principles of plastic surgery to optimize cosmetic outcomes. Thanks to oncoplastic techniques, the role of breast conserving surgery (BCS) has been extended to include a group of patients who would otherwise require mastectomy to achieve adeguate tumor clearance. As OPS continues to gain acceptance and diffusion, an optimal and systematic approach to these techniques is becoming increasingly necessary. This article has the aim to review the essential principles and techniques associated with oncoplastic surgery, based on the data acquired through an extensive search of the PUBMED and MEDLINE database for articles published using the key words "breast cancer oncoplastic surgery". This review analyzes possible the advantages", classifications, indications, and the criteria for a proper selection of oncoplastic techniques to facilitate one's ability to master these procedures and make OPS a safe and an effective procedure. AD - Department of Surgery, Breast Unit, School of Medicine, Rome, Italy AU - Franceschini, G. AU - Terribile, D. AU - Magno, S. AU - Fabbri, C. AU - Accetta, C. AU - Di Leone, A. AU - Moschella, F. AU - Barbarino, R. AU - Scaldaferri, A. AU - D'Archi, S. AU - Carvelli, M. E. AU - Bove, S. AU - Masetti, R. DB - Embase Medline IS - 11 KW - article breast augmentation breast hypertrophy breast reduction breast surgery cancer localization cancer surgery follow up free tissue graft human intraductal carcinoma latissimus dorsi flap latissimus dorsi muscle Medline myocutaneous flap oncoplastic breast surgery partial mastectomy patient satisfaction perforator flap plastic surgeon skin incision thoracodorsal artery thoracodorsal artery perforator flap tumor volume wide excision work experience LA - English M3 - Article N1 - L369318193 2013-07-23 2013-07-25 PY - 2012 SN - 1128-3602 SP - 1530-1540 ST - Update on oncoplastic breast surgery T2 - European Review for Medical and Pharmacological Sciences TI - Update on oncoplastic breast surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L369318193&from=export VL - 16 ID - 6989 ER - TY - JOUR AB - Oncologic, reconstructive, and cosmetic breast surgery has evolved in the last 20 years. Familiarity with cutting-edge surgical techniques and their imaging characteristics is essential for radiologic interpretation and may help avert false-positive imaging findings. Novel surgical techniques include skin- and nipple-sparing mastectomies, autologous free flaps, autologous fat grafting, and nipple-areola-complex breast reconstruction. These techniques are illustrated and compared with conventional surgical techniques, including modified radical mastectomy and autologous pedicled flaps. The role of magnetic resonance (MR) imaging in surgical planning, evaluation for complications, and postsurgical cancer detection is described. Breast reconstruction and augmentation using silicone gel-filled implants is discussed in light of the Food and Drug Administration's recommendation for MR imaging screening for "silent" implant rupture 3 years after implantation and every 2 years thereafter. Recent developments in skin incision techniques for reduction mammoplasty are presented. The effects of postsurgical changes on the detection of breast cancer are discussed by type of surgery. AD - From the Department of Radiology, Breast Imaging Section, New York University School of Medicine, Langone Medical Center, 550 First Ave, New York, NY 10016. AN - 107793658. Language: English. Entry Date: 20150220. Revision Date: 20170411. Publication Type: journal article AU - Margolis, Nathaniel E. AU - Morley, Christopher AU - Lotfi, Philip AU - Shaylor, Sara D. AU - Palestrant, Sarah AU - Moy, Linda AU - Melsaether, Amy N. DB - cin20 DO - 10.1148/rg.343135059 DP - EBSCOhost IS - 3 KW - Breast -- Surgery Breast Neoplasms -- Radiography Mammography -- Methods Ultrasonography -- Methods Adipose Tissue -- Transplantation Breast Implants -- Adverse Effects Breast Neoplasms -- Surgery Female Magnetic Resonance Imaging Breast Reconstruction -- Methods Mastectomy -- Methods Neoplasm Recurrence, Local -- Radiography Postoperative Period Prosthesis Failure Sensitivity and Specificity Surgical Flaps N1 - review. Commentary: Heller Samantha L. Invited commentary. (RADIOGRAPHICS) 2014 May-Jun; 34 (3): 660-662. Journal Subset: Biomedical; Double Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA. Special Interest: Diagnostic Imaging. NLM UID: 8302501. PMID: NLM24819786. PY - 2014 SN - 0271-5333 SP - 642-660 ST - Update on imaging of the postsurgical breast T2 - RadioGraphics TI - Update on imaging of the postsurgical breast UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=107793658&site=ehost-live&scope=site VL - 34 ID - 748 ER - TY - JOUR AB - Oncologic, reconstructive, and cosmetic breast surgery has evolved in the last 20 years. Familiarity with cutting-edge surgical techniques and their imaging characteristics is essential for radiologic interpretation and may help avert false-positive imaging findings. Novel surgical techniques include skin- and nipple-sparing mastectomies, autologous free flaps, autologous fat grafting, and nipple-areola-complex breast reconstruction. These techniques are illustrated and compared with conventional surgical techniques, including modified radical mastectomy and autologous pedicled flaps. The role of magnetic resonance (MR) imaging in surgical planning, evaluation for complications, and postsurgical cancer detection is described. Breast reconstruction and augmentation using silicone gel-filled implants is discussed in light of the Food and Drug Administration's recommendation for MR imaging screening for "silent" implant rupture 3 years after implantation and every 2 years thereafter. Recent developments in skin incision techniques for reduction mammoplasty are presented. The effects of postsurgical changes on the detection of breast cancer are discussed by type of surgery. (C) RSNA, 2014. AD - [Margolis, Nathaniel E.; Morley, Christopher; Lotfi, Philip; Shaylor, Sara D.; Palestrant, Sarah; Moy, Linda; Melsaether, Amy N.] NYU, Sch Med, Langone Med Ctr, Dept Radiol,Breast Imaging Sect, New York, NY 10016 USA. Margolis, NE (corresponding author), NYU, Sch Med, Langone Med Ctr, Dept Radiol,Breast Imaging Sect, 550 1St Ave, New York, NY 10016 USA. nathaniel.margolis@nyumc.org AN - WOS:000341915200009 AU - Margolis, N. E. AU - Morley, C. AU - Lotfi, P. AU - Shaylor, S. D. AU - Palestrant, S. AU - Moy, L. AU - Melsaether, A. N. DA - May-Jun DO - 10.1148/rg.343135059 IS - 3 J2 - Radiographics KW - abdominis myocutaneous flap skin-sparing mastectomy autologous fat tram flap tumor recurrence conservation therapy mammographic changes reconstruction cancer augmentation Radiology, Nuclear Medicine & Medical Imaging LA - English M3 - Article N1 - ISI Document Delivery No.: AP2PH Times Cited: 20 Cited Reference Count: 76 Margolis, Nathaniel E. Morley, Christopher Lotfi, Philip Shaylor, Sara D. Palestrant, Sarah Moy, Linda Melsaether, Amy N. Moy, Linda/U-8018-2019 Moy, Linda/0000-0001-9564-9360 20 0 5 Radiological soc north america Oak brook PY - 2014 SN - 0271-5333 SP - 642-+ ST - Update on Imaging of the Post-surgical Breast T2 - Radiographics TI - Update on Imaging of the Post-surgical Breast UR - ://WOS:000341915200009 VL - 34 ID - 2421 ER - TY - JOUR AB - Breast reconstruction using autologous tissue is commonly accomplished using the transverse rectus abdominis myocutaneous (TRAM) flap. The establishment of microvascular surgery led to the development of the free TRAM flap because of its increased vascularity and decreased rectus abdominis sacrifice. The muscle-sparing free TRAM, DIEP, and SIEA flap techniques followed in an effort to decrease abdominal donor site morbidity by decreasing injury to the rectus abdominis muscle and fascia. Data have accumulated over the past decade that show that muscle- and fascia-sparing techniques, such as the use of DIEP flaps, result in measurably better postoperative abdominal strength. However, muscle-sparing techniques do not appear to decrease the risk of abdominal bulging or hernia, and there are no significant differences in patient-reported abdominal weakness or functional impairments. The SIEA flap is presented as a reemerging method that can virtually eliminate abdominal donor site morbidity. Sensory nerve coaptation to improve reconstructed breast sensation is also reviewed. AD - Department of Plastic and Reconstructive Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX. AN - 20574488 AU - Chevray, P. M. C2 - PMC2884730 DA - May DO - 10.1055/s-2004-829044 DP - NLM ET - 2004/05/01 IS - 2 KW - Breast reconstruction Diep Siea Tram flap LA - eng N1 - 1536-0067 Chevray, Pierre M Journal Article Semin Plast Surg. 2004 May;18(2):97-104. doi: 10.1055/s-2004-829044. PY - 2004 SN - 1535-2188 (Print) 1535-2188 SP - 97-104 ST - Update on Breast Reconstruction Using Free TRAM, DIEP, and SIEA Flaps T2 - Semin Plast Surg TI - Update on Breast Reconstruction Using Free TRAM, DIEP, and SIEA Flaps VL - 18 ID - 13889 ER - TY - JOUR AB - Breast reconstruction is considered as part of the breast cancer treatment when a mastectomy is required. Implants or expanders are the most frequent techniques used for the reconstructions. Expander provides usually a better symmetry. A contralateral mastoplasty often is required to improve the symmetry. The nipple areola complex, which can be preserved in certain conditions, is usually removed and can be reconstructed in a second stage under local anesthesia. In case of radical mastectomy and/or radiotherapy, a musculocutaneous flap, such as rectus abdominis or latissimus dorsi autologous flaps, is required. When microsurgical facilities are available, free or perforator flaps respecting the muscle are preferred to decrease the donor site complications. In situ carcinomas or prophylactic mastectomy can be reconstructed immediately as well as invasive carcinoma according to the recent literature. Locally advanced breast cancer can be reconstructed after complete oncologic treatment. Radiotherapy of the thoracic wall is proposed in case of lymph node metastases, raising the discussion about the technique choice and the timing of the reconstruction. Plastic surgery procedures can improve the cosmetic results of the conservative surgery, also extending its indications and reducing both mastectomy and reexcision rates. Oncoplasty techniques are becoming more and more sophisticated, requiring the skill of trained plastic surgeons. Numerous publications confirm the psychosocial benefit resulting from the breast reconstruction. AD - [Petit, Jean-Yves; Rietjens, Mario; Lohsiriwat, Visnu; Rey, Piercarlo; Garusi, Cristina; De Lorenzi, Francesca; Martella, Stefano; Manconi, Andrea; Barbieri, Benedetta] EIO, Plast & Reconstruct Surg Unit, I-20141 Milan, Italy. [Lohsiriwat, Visnu] Mahidol Univ, Siriraj Hosp, Fac Med, Bangkok 10700, Thailand. [Clough, Krishna B.] Inst Sein, Paris Breast Ctr, F-75116 Paris, France. Petit, JY (corresponding author), EIO, Plast & Reconstruct Surg Unit, Via Ripamonti 435, I-20141 Milan, Italy. jean.petit@ieo.it AN - WOS:000304880600005 AU - Petit, J. Y. AU - Rietjens, M. AU - Lohsiriwat, V. AU - Rey, P. AU - Garusi, C. AU - De Lorenzi, F. AU - Martella, S. AU - Manconi, A. AU - Barbieri, B. AU - Clough, K. B. DA - Jul DO - 10.1007/s00268-012-1486-3 IS - 7 J2 - World J.Surg. KW - skin-sparing mastectomy pedicled tram flap cancer-patients follow-up prophylactic mastectomy capsular contracture tissue expanders 2nd primary immediate implant Surgery LA - English M3 - Article N1 - ISI Document Delivery No.: 953OX Times Cited: 13 Cited Reference Count: 74 Petit, Jean-Yves Rietjens, Mario Lohsiriwat, Visnu Rey, Piercarlo Garusi, Cristina De Lorenzi, Francesca Martella, Stefano Manconi, Andrea Barbieri, Benedetta Clough, Krishna B. Rietjens, Mario/AAQ-6808-2020; Barbieri, Benedetta/AAM-7807-2020; de lorenzi, francesca/A-9364-2013; manconi, andrea/A-9354-2013 Barbieri, Benedetta/0000-0002-3597-3449; De Lorenzi, Francesca/0000-0001-6050-898X 17 0 15 Springer New york 1432-2323 PY - 2012 SN - 0364-2313 SP - 1486-1497 ST - Update on Breast Reconstruction Techniques and Indications T2 - World Journal of Surgery TI - Update on Breast Reconstruction Techniques and Indications UR - ://WOS:000304880600005 VL - 36 ID - 2744 ER - TY - JOUR AB - Purpose of review Presented is a brief overview of the current state of postmastectomy reconstruction. Recent findings Breast reconstruction has been shown to have a positive effect on the psychological well being of women with breast cancer. Numerous studies have demonstrated that reconstruction performed concurrently with mastectomy is oncologically safe. Nevertheless, although increasing numbers of women are choosing to undergo postmastectomy reconstruction, this trend is inconsistent across demographic subgroups. In addition, the paradigm of performing immediate reconstruction on all-comers is being challenged by increasing use of postoperative radiotherapy. It is now appreciated that the implications of performing reconstruction in the setting of radiotherapy are both profound and controversial. Finally, questions are being raised about the factors that influence the ultimate surgical goal, namely patient satisfaction. It is anticipated that future investigations using newly developed, patient-reported outcome measures will provide important information about outcomes following reconstruction, which in turn will facilitate the decision-making process for both patients and surgeons. Summary Recent refinements in surgical techniques and prosthetic technologies, development of novel tissue substitutes, and increasing use of adjuvant radiotherapy have led to changes in the practice of breast reconstruction following mastectomy. AD - [Reavey, Patrick; McCarthy, Colleen M.] Mem Sloan Kettering Canc Ctr, Dept Surg, Plast & Reconstruct Surg Serv, New York, NY 10021 USA. McCarthy, CM (corresponding author), Mem Sloan Kettering Canc Ctr, Dept Surg, Plast & Reconstruct Serv, 1275 York Ave, New York, NY 10021 USA. mccarthc@mskcc.org AN - WOS:000252839300012 AU - Reavey, P. AU - McCarthy, C. M. DA - Feb DO - 10.1097/GCO.0b013e3282f2329b IS - 1 J2 - Curr. Opin. Obstet. Gynecol. KW - autogenous tissue reconstruction postmastectomy reconstruction tissue expander/implant reconstruction surgeons 12-year experience pedicled tram flap patient satisfaction subcutaneous mastectomy implant reconstruction sparing mastectomy older women immediate postmastectomy complications Obstetrics & Gynecology LA - English M3 - Article N1 - ISI Document Delivery No.: 257ZX Times Cited: 23 Cited Reference Count: 51 Reavey, Patrick McCarthy, Colleen M. 23 0 1 Lippincott williams & wilkins Philadelphia 1473-656x PY - 2008 SN - 1040-872X SP - 61-67 ST - Update on breast reconstruction in breast cancer T2 - Current Opinion in Obstetrics & Gynecology TI - Update on breast reconstruction in breast cancer UR - ://WOS:000252839300012 VL - 20 ID - 3456 ER - TY - JOUR AB - We present the case of a 51 years-old patient, with the diagnosis of a giant borderline Phyllodes tumor. We present her clinical record, treatment and the follow-up care in the next two years and a half. We remark the importance of being conscious about health care. AD - M.J. Cancelo Hidalgo, Servicio de Obstetricia y Ginecología Hospital, Universitario de Guadalajara, Calle Donante de Sangre, s/n, Guadalajara, Mexico AU - Cancelo Hidalgo, M. J. AU - Martín Gómez, M. AU - Bustos Martínez, G. AU - García Llorente, M. AU - Barrera Coello, L. AU - Corniero Perea, M. DB - Embase DO - 10.20960/j.pog.00187 IS - 2 KW - adult article breast areola breast hemorrhage breast reconstruction breast tumor case report clinical article deep inferior epigastric perforator flap female histology human human tissue middle aged phyllodes tumor radical mastectomy tumor growth tumor volume LA - English M3 - Article N1 - L2002158978 2019-07-11 2019-07-16 PY - 2019 SN - 1578-1453 0304-5013 SP - 163-167 ST - Unusual size and reconstructive procedure in a phyllodes tumor T2 - Progresos de Obstetricia y Ginecologia TI - Unusual size and reconstructive procedure in a phyllodes tumor UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002158978&from=export http://dx.doi.org/10.20960/j.pog.00187 VL - 62 ID - 5140 ER - TY - JOUR AB - Liposuction is a simple and elegant way to treat fatty excess; it has been even used for the treatment of lipomas and some gynecomasties. The goal of this article is to present 2 patients with an unusual complication of this use: the liposuction of a malignant tumor. The first patient consulted following the liposuction of a "gynecomasty", which was in fact a breast cancer. The second was treated by liposuction for an ankle "lipoma"; it proved to be a liposarcoma. In order to avoid liposuction and dissemination of a malignant tumor, the pre-operative investigations have to search clinical peculiarities evoking the diagnosis: an unilateral "gynecomasty", irregular, hard or painless, in a 50-years-old patient, must incite the surgeon to perform a classical excision, just as a recurrent "lipoma", deeply located, voluminous or quickly extensive, situated on the limbs or in the humeroscapular area. Paraclinic investigations may be indicated; doubtful cases must be right away rejected for liposuction, and treated by a surgical excision with strict safety margins and complete anatomopathologic examination of the lesion. Liposuction has become a very useful technique for the plastic surgeon; however, we must not forget, despite of its many advantages the risk for dissemination of an unknown malignant tumor. Every surgeon must keep it in mind and prefer a surgical removal in atypical cases. AD - Service de chirurgie plastique et des brûlés, centre hospitalier St-Joseph St-Luc, 20, quai Claude-Bernard, 69007, Lyon, France. delphine.voulliaume@mageos.com AN - 12837640 AU -