Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

The combined use of a pedicled superficial inferior epigastric artery flap and a groin flap for reconstruction of a dorsal and volar hand blast injury.

ABSTRACT: A hand blast injury case causing a large through-and-through composite tissue loss is presented. This injury resulted in a dorsal and a palmar hand defect with segmental bone loss. Soft tissue coverage of both dorsal and palmar wounds was achieved by two separate pedicle flaps with pedicles closely arising from the femoral artery: a superficial inferior epigastric artery (SIEA) flap and a groin flap. Simultaneously, a large iliac corticocancellous bone graft was harvested from the same incision to be used for the wrist fusion procedure. This approach uses two separate pedicled flaps with robust independent blood supply to cover simultaneously a dorsal and a volar hand wound. A large through-and-through hand defect can be reconstructed readily with this approach, and it is associated with much less perioperative morbidity compared to free composite tissue transfer options. The dissection of both the groin flap and the SIEA flap is straightforward and can be easily performed by a single surgeon. The combined use of these two flaps allows stable coverage of sizable dorsal and palmar wounds of the hand.

SUBMITTER: Choi JY

PROVIDER: S-EPMC2584222 | biostudies-other | 2008 Dec

REPOSITORIES: biostudies-other

ACCESS DATA

Json Xml

Similar Datasets

Hatchet flap and rotation flap for distal dorsal finger defect reconstruction.

Project description: Not available

| S-EPMC5053009 | biostudies-literature

A Bilobed Pedicled Groin Flap for Reconstruction of Forearm Skin Defects following Replantation.

Project description:The versatility of a pedicled groin flap can be further increased by raising it in a bilobed fashion. This allows the flap to cover both the volar and dorsal surfaces of a hand or forearm defect. A 48-year-old man sustained an avulsion amputation of his right forearm by a rolling machine in a workplace accident. Replantation of the right forearm was performed, and the postoperative course was uneventful. Unfortunately, the wound healing was complicated by circumferential marginal skin necrosis, which was confined to the distal forearm. A bilobed pedicled groin flap was performed for the wound coverage because reconstruction with a free flap would be very risky as the vessels were avulsed from the proximal part of the forearm. A good functional recovery of the hand and fingers was noted at 12 months' follow-up. The advantages of a bilobed pedicle groin flap are that it allows coverage of both the volar and dorsal surfaces at one setting and primary closure of the donor site is possible. Furthermore, a long tube-shaped pedicle in this flap can reduce the patient discomfort and prevent finger stiffness by allowing a range of motion exercise. In conclusion, the bilobed pedicled groin flap is a useful option to cover soft tissue defects involving both the volar and dorsal surfaces over the mid- to distal forearm, especially when the free flap is contraindicated.

| S-EPMC7253286 | biostudies-literature

Fertility-sparing Scrotal Reconstruction with a Superficial Circumflex Iliac Perforator Flap

Project description:Summary: It is believed that skin flaps should not be used to reconstruct large scrotal defects because thick flaps increase testicular temperature and decrease fertility, and those skin grafts should be used to reconstruct large scrotal defects. We report a case of extensive scrotal defect reconstructed with bilateral superficial circumflex iliac perforator (SCIP) flaps in which spermatogenesis improved postoperatively over time. A 44-year-old man underwent reconstruction of an extensive scrotal defect caused by Fournier gangrene, and bilateral SCIP flaps were used for the reconstruction. In the third postoperative month, his semen volume and sperm count after centrifugation were 1.5 mL and eight, respectively. Based on these semen findings, fertility specialists diagnosed the patient with extremely low fertility. In the ninth postoperative month, the semen volume was 2.2 mL, sperm density was 2.7 × 106/mL, sperm motility was 64%, and normal sperm morphology was 54%, indicating significant improvement. Based on the sperm findings, fertility specialists considered the patient capable of causing pregnancy. There have been no reports of preservation of spermatogenesis after scrotal reconstruction with a thinned perforator flap. In the postoperative period, we observed improvement of spermatogenesis, which suggests that scrotal reconstruction with an SCIP flap may be effective for improving both cosmetic appearance and fertility.

| S-EPMC10208698 | biostudies-literature

Superficial temporal artery flap for reconstruction of complex facial defects: A new algorithm.

Project description:BACKGROUND:A variety of island flaps can be based on the superficial temporal artery with variable tissue composition. They can be used for defect reconstruction, cavity resurfacing, facial hair restoration, or contracture release. METHODS:Seventy-two patients underwent facial reconstruction using a superficial temporal artery island flap from October 2010 to October 2014. The defects had various etiologies, including trauma, burns, tumors, exposed hardware, and congenital causes. We classified the patients by indication into 5 groups: cavity resurfacing, contracture release, facial hair restoration, skin coverage, and combined. The demographic data of the patients, defect characteristics, operative procedures, postoperative results, and complications were retrospectively documented. The follow-up period ranged from 24 to 54 months. RESULTS:A total of 24 females and 48 males were included in this study. The mean age of the patients was 33.7±15.6 years. The flaps were used for contracture release in 13 cases, cavity resurfacing in 10 cases, skin coverage in 17 cases, facial hair restoration in 19 cases, and combined defects in 13 cases. No major complications were reported. Conclusion: Based on our experiences with the use of superficial temporal artery island flaps, we have developed a detailed approach for the optimal management of patients with composite facial defects. The aim of this article is to provide the reader with a systematic algorithm to use for such patients.

| S-EPMC5869424 | biostudies-literature

Reversed posterior interosseous flap: safe and easy method for hand reconstruction.

Project description:UnlabelledComplex hand trauma presents multifaceted problems for the surgeon. Soft tissue defects of the upper extremity must be carefully assessed to determine the most appropriate method of coverage of hand. In this article, the reversed posterior interosseous flap was used for coverage of the hand. The injured areas include: dorsum of the hand (10 cases), the wrist (3 cases) and the dorsal thumb (2 cases). All flaps survived completely and none exhibited venous compromise. All donor sites were skin grafted. The reversed posterior interosseous flap is a versatile option for coverage of moderate sized defects of the hand and is specifically indicated for coverage of injuries of the wrist, dorsal hand and dorsal thumb.Electronic supplementary materialThe online version of this article (doi:10.1007/s12593-011-0042-y) contains supplementary material, which is available to authorized users.

| S-EPMC3172356 | biostudies-literature

Extended inferior turbinate flap for endoscopic reconstruction of skull base defects.

Project description:Objective When the use of the nasoseptal flap for endoscopic skull base reconstruction has been precluded, the posterior pedicle inferior turbinate flap is a viable option for small midclival defects. Limitations of the inferior turbinate flap include its small surface area and limited arc of rotation. We describe a novel extended inferior turbinate flap that expands the reconstructive applications of this flap. Design Cadaveric anatomical study. Participants Cadaveric specimens. Main Outcome Measures Flap size, arc of rotation, and reconstructive applications were assessed. Results The average width of the flap was 5.46 ± 0.58 cm (7.32 ± 0.59 cm with septal mucosa). The average length of the flap was 5.01 ± 0.58 cm (5.28 ± 0.37 cm with septal mucosa). The average surface area of the flap was ∼ 27.26 ± 3.65 cm(2) (40.53 ± 6.45 cm(2) with septal mucosa). The extended inferior turbinate flap was sufficient to cover clival defects extending between the paraclival internal carotid arteries. The use of the flap in 22 cadavers and 5 clinical patients is described. Conclusion The extended inferior turbinate flap presents an additional option for reconstruction of skull base defects when the nasoseptal flap is unavailable.

| S-EPMC4108488 | biostudies-other

Predictors of Reoperations in Deep Inferior Epigastric Perforator Flap Breast Reconstruction.

Project description:The deep inferior epigastric perforator (DIEP) procedure is regarded a safe option for autologous breast reconstruction. Reoperations, however, may occur, and there is no consensus in the literature regarding the risk factors. The aim of this study was to identify factors associated with reoperations in DIEP procedure.A retrospective study of consecutive patients undergoing DIEP breast reconstruction 2007 to 2014 was performed and included a review of 433 medical charts. Surgical outcome was defined as any unanticipated reoperation requiring return to the operating room. Multivariate regression analysis was utilized to identify predictors of reoperation. The following factors were considered: age, body mass index, comorbidity, childbearing history, previous abdominal surgery, adjuvant therapy, reconstruction laterality and timing, flap and perforator characteristics, and number and size of veins.In total, 503 free flaps were performed in 433 patients, 363 (83.8%) unilateral and 70 (16.2%) bilateral procedures. Mean age was 51 years; 15.0% were obese; 13.4% had hypertension; 2.3% had diabetes; 42.6% received tamoxifen; 58.8% had preoperative radiotherapy; 45.6% had abdominal scars. Reoperation rate was 15.9% (80/503) and included flap failure, 2.0%; partial flap loss, 1.2%; arterial thrombosis, 2.0%; venous thrombosis, 0.8%; venous congestion, 1.2%; vein kinking, 0.6%. Other complications included bleeding, 2.2%; hematoma, 3.0%; fat necrosis, 2.8%, and infection, 0.2%. Factors negatively associated with reoperation were childbearing history (odds ratio [OR]: 3.18, P = 0.001) and dual venous drainage (OR: 1.91, P = 0.016); however, only childbearing remained significant in the multivariate analyses (OR: 4.56, P = 0.023).The history of childbearing was found to be protective against reoperation. Number of venous anastomoses may also affect reoperation incidence, and dual venous drainage could be beneficial in nulliparous patients.

| S-EPMC5010354 | biostudies-other

Bipedicled SIEA Flap with Deep Inferior Epigastric Artery and Vein Grafts for Breast Reconstruction.

Project description:A superficial inferior epigastric artery (SIEA) flap can be an alternative to a deep inferior epigastric artery perforator (DIEAP) flap in cases where SIEAs are relatively well developed. Although an SIEA flap is less invasive than a DIEAP flap, the pedicles of the former are anatomically shorter, making it more difficult to choose recipient vessels when bilateral SIEAs are necessary. A 45-year-old female diagnosed with cancer of the left breast underwent mastectomy (specimen weight: 750 g) and immediate two-stage breast reconstruction using a free abdominal flap with bilateral pedicles was planned. Preoperative computed tomographic angiography showed that the bilateral DIEAPs in the flap were less than one millimeter in diameter, whereas the bilateral SIEAs were well developed enough for us to opt for a double-pedicled stacked SIEA flap. After the double-pedicled SIEA flap was elevated, folded, and temporarily placed in the subcutaneous pocket, the pedicle length on one side was found to be insufficient. Therefore, portions of the right composite deep inferior epigastric artery (DIEA) and vein (DIEV) grafts (roughly 7 cm) were collected from a short fasciotomy and anastomosed to the peripheral ends of the right SIEA and SIEV, respectively. Following this, the left SIEA and SIEV were antegradely anastomosed to the internal mammary artery and vein (IMA/IMV), while the DIEA/DIEV grafts were retrogradely anastomosed to the IMA/IMV, respectively. We recommend the proactive use of this method, as pedicle extension using the DIEA/DIEV grafts enables a higher degree of freedom in unilateral breast reconstruction using bilateral SIEA flaps.

| S-EPMC9400944 | biostudies-literature

Superficial Circumflex Iliac Perforator-Osteocutaneous Flap for Reconstruction of Extensive Composite Defects in the Forefoot.

Project description:Although the great toe plays important roles in walking, loading, and maintaining balance when compared with other toes, there are few reports on great toe reconstruction, including the reconstruction of distal phalanx. This report aims to describe the use of a superficial circumflex iliac artery perforator (SCIP)-osteocutaneous flap for reconstructing a complex tissue defect of the great toe. A 62-year-old man presented with a crush injury to the forefoot. Because the great toe was severely crushed, the defect distal to the proximal phalanx of the great toe was reconstructed using a SCIP-osteocutaneous flap. The immediate postoperative course was uneventful; however, surgical revision was necessary. Signs of osseous union could be observed on radiographic images taken 2 months after the initial surgery. Twenty-four months after surgery, the patient could freely walk without resorption of the transferred bone. We demonstrated that SCIP-osteocutaneous flaps may be promising free flaps in complex tissue defect reconstruction of the great toe.

| S-EPMC7489706 | biostudies-literature

Survey of Surgeon-reported Postoperative Protocols for Deep Inferior Epigastric Perforator Flap in Breast Reconstruction.

Project description:BackgroundThe use of deep inferior epigastric perforator (DIEP) flaps is a well-established breast reconstruction technique.MethodsA 29-question survey was e-mailed to 3186 active American Society of Plastic Surgeons members, aiming to describe postoperative monitoring practice patterns among surgeons performing DIEP flaps.ResultsFrom 255 responses (8%), 79% performing DIEP surgery were analyzed. Among them, 34.8% practiced for more than 20 years, 34.3% for 10-20 years, and 30.9% for less than 10 years. Initial 24-hour post-DIEP monitoring: intensive care unit (39%) and floor (36%). Flap monitoring: external Doppler (71%), tissue oximetry (41%), and implantable Doppler (32%). Postoperative analgesia: acetaminophen (74%), non-steroidal anti-inflammatory drugs (69%), neuromodulators (52%), and opioids (4.4%) were administered on a scheduled basis. On postoperative day 1, 61% halt intravenous fluids, 67% allow ambulation, 70% remove Foley catheter, and 71% start diet. Most surgeons discharged patients from the hospital on postoperative day 3+. Regardless of experience, patients were commonly discharged on day 3. Half of the surgeons are in academic/nonacademic settings and discharge on/after day 3.ConclusionsThis study reveals significant heterogeneity among the practice patterns of DIEP surgeons. In light of these findings, it is recommended that a task force be convened to establish standardized monitoring protocols for DIEP flaps. Such protocols have the potential to reduce both the length of hospital stays and overall care costs all while ensuring optimal pain management and vigilant flap monitoring.

| S-EPMC10653572 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data