We present a case of a failed bipedicled (unilateral rectus flap with superior epigastric pedicle preserved and inferior epigastric vessels anastomosed to the thoracodorsal trunk as the second pedicle) transverse rectus abdominis muscle flap that had compromised the dominant pedicle of the latissimus dorsi ...
PubMed
Recurrent poststernotomy mediastinitis has significant morbidity and mortality. Reconstructive treatment begins with pectoral muscle or omental flaps. When these options are unavailable or inadequate, surgeons resort to internal mammary artery-based vertical rectus abdominis muscle flap. If the ...
The transverse rectus abdominis muscle flap is widely used in free microvascular tissue transfer for breast reconstruction following mastectomy. Flap survival may be compromised by failure at the microsurgical anastomosis due to both venous and arterial thrombosis. It is unclear, whether hereditary thrombophilia ...
An alcoholic 50-year-old male patient with a history of schizophrenia sustained stab wounds into both ventricles and left lung, and survived following an emergency department thoracotomy. The EDT wound, however became infected requiring serial debridements of soft tissue, rib cartilage and sternum. Regional flap options such as pectoralis major and latissimus dorsi ...
PubMed Central
Harvesting the rectus abdominis myocutaneous flap results in defects in both the rectus abdominis muscle and the anterior rectus sheath, which may be circumvented by dissecting a perforator flap (DIEP flap) instead. However, the latter is associated with a reduction in the ...
The goal of reconstruction of the skull base is to repair dural defects with a watertight seal and separate it from the nasopharynx and the exterior environment with well vascularised tissue. This prevents cerebro-spinal fluid leakage and secondary contamination leading to the potentially life threatening complications of meningitis or extradural abscess. Following large composite resections, ...
Ventral hernia formation is a common complication of rectus abdominis musculocutaneous flap harvest. The site and extent of harvest of the flap are known contributing factors. Therefore, an accurate location of the arcuate line of Douglas, which marks the lower extent of the posterior wall of the rectus sheath, may be relevant before ...
With improved detection and genetic screening for breast cancer, increasing numbers of patients are choosing mastectomy and immediate breast reconstruction. Advances in breast reconstruction and mastectomy techniques over the last 25 years have increased expectations for breast reconstruction. The purpose of this review is to describe the role of the pedicled transverse rectus ...
Extremely large chest wall defects may result following salvage oncological surgery. Typically these defects involve a large skin defect combined with a variable resected area of underlying muscle and ribs. In situations where the skin defect is very large the use of a large latissimus dorsi flap may require skin grafting to the donor site if a ...
Breast reconstruction using the lower abdominal free superficial inferior epigastric artery (SIEA) flap has the potential to virtually eliminate abdominal donor-site morbidity because the rectus abdominis fascia and muscle are not incised or excised. However, despite its advantages, the free SIEA flap for breast ...
The pedicled transverse rectus abdominis myocutaneous (TRAM) flap remains a popular choice for patients requesting breast reconstruction. Criticism of all techniques that harvest the rectus abdominis muscle centre on abdominal wall weakness.[Dulin WA, Avila RA, Verheyden CN, Grossman L. Evaluation of abdominal wall ...
Empyema continues to be an uncommon, frustrating, and potentially lethal complication of pneumonectomy. Between 1990 and 1994 we treated 16 cases of recalcitrant postpneumonectomy (partial or total) empyema with combinations of pulse lavage, sharp debridement, muscle flaps, myodermal flaps, and thoracoplasty. We performed 11 pectoralis ...
Tumors of the gluteal region are rare. Defects from resection often can be closed primarily. Some patients require local flaps such as a gluteus maximus V-Y advancement flap. Such flaps typically result in some muscle dysfunction. In addition, the use of local irradiated tissue may lead to wound complications and ...
Different reconstruction techniques of the anterior and middle skull base as consequence of a defect after surgical treatment of neoplastic pathologies are described in the literature. The aim of the present study is to present our experience regarding the use of microvascular free flaps for reconstruction of the anterior or middle skull base after large defects caused by ...
To determine the best method for preserving abdominal-wall integrity after TRAM flap breast reconstruction, the records of 130 patients followed for at least 6 months (mean 18 months) were examined. Three strategies for management of the abdominal-wall repair were compared. In the first group (72 patients), the entire width of the rectus abdominis ...
During recent years, clinical research on the donor site morbidity after free or pedicled transverse rectus abdominis myocutaneous (TRAM) flap surgery has been focusing on the reduced flexion capacity of the abdominal wall. However, the rectus abdominis muscles have close interactions with their synergists and ...
Free TRAM flap breast reconstruction was performed in 23 patients from july 1993 through november 1995 at the Saint-Louis Hospital in Paris. The surgical team was composed of eight different surgeons. In all cases a delayed breast reconstruction procedure was performed. All patients in this series had previously received radiation therapy and 82.6% patients presented with ...
Although abdominal perforator flaps based on a cutaneous branch of the deep inferior epigastric artery (DIEP flaps) have many advantages, preparing these flaps is technically difficult and requires great skill, especially as the portion of the artery running under the anterior rectus abdominis sheath must be ...
Coverage of large defects of the soft tissue of the groin present a challenging problem. Exposure of the femoral vessels or prosthetic grafts requires urgent coverage with well vascularized tissue. The medial and lateral femoral circumflex arteries supply the gracilis, sartorius, vastus lateralis, rectus femoris and tensor fascia lata muscles, permitting the use of these ...
... Title : ACTION OF PYRIDINE-2-ALDOXIME METHOCHLORIDE (PAM) ON THE RECTUS ABDOMINIS MUSCLE OF THE FROG,. ...
DTIC Science & Technology
The authors retrospectively reviewed the computerized records of 71 women undergoing 80 deep inferior epigastric perforator (DIEP) flap reconstructions after mastectomy over a 1-year period. There were 33 normal, 26 overweight, and 12 obese patients. No statistically significant difference in flap complications was found between groups. Overall fat ...
An experimental study was planned to examine whether the blood supply of muscle would be maintained by reverse flow from the cutaneous arteriolar microcirculatory system via the musculocutaneous perforators. A flap model containing both muscle and skin based on the inferior superficial epigastric vessels was designed with the blood ...
Preoperative Doppler ultrasonography for planning free perforator flaps is widely established to identify preoperatively perforators. The method allows one to localise the penetrating point of the perforator through the abdominal fascia. By this means it is not possible to see the intramuscular course or the position of the perforator in relation to the inferior epigastric ...
Wide, complex defects of the scalp caused by various insults always represent reconstructive challenges for surgeons. Our study group consisted of 18 patients (14 males and 4 females) with a mean age of 40.2 years. Nineteen free-tissue transfers were used to reconstruct the scalp defects. The selected cases included 8 latissimus dorsi muscle flaps, 3 ...
Skull-base surgery is associated with a high risk of cerebrospinal fluid (CSF) leak, infection, and functional and aesthetic deformity. Appropriate reconstruction of cranial-base defects following surgery helps to prevent these complications. Between March 1998 and May 2000, 28 patients (age: 1-68 years) underwent reconstruction of the anterior and middle cranial fossae. The indications for ...
This article reports a case of re-elevating a prior vertical rectus abdominis musculocutaneous flap as a deep inferior epigastric artery perforator-based propeller flap to cover a recurrent chest wall defect. This case demonstrates that a conventional musculocutaneous flap tissue with a preserved perforator can be ...
IntroductionBreast reconstruction with autologous tissue transfer is now a standard operation, but abnormalities of the abdominal wall contour represent a complication which has led surgeons to invent techniques to minimize the morbidity of the donor site.Case presentationWe report the case of a woman who had bilateral transverse rectus abdominis myocutaneous ...
This article details the experiences of United States military reconstructive surgeons in the soft tissue management of war wounds of the foot and ankle resulting from the conflicts in Iraq and Afghanistan. War wounds from this conflict are commonly caused by blast and fragmentation, and are characteristically extensive, heterogeneous, and severe. Multiple serial d�bridement episodes are ...
Breast reconstruction with transverse rectus abdominis muscle (TRAM) flap raises two contradictory questions: the vascular safety of the flap and the late abdominal wall sequellae. In order to analyse these sequellae, 71 patients with TRAM flap breast reconstruction at the Institut Curie had a ...
In 15 patients chest walls were excised because of recurrent breast cancer, radiation ulcer, or rib tumor. In most cases the full-thickness defect of the chest wall was about 10 x 10 cm. Reconstruction was performed using only a rectus abdominis musculocutaneous flap. No patient developed circulation problems in the flap or severe ...
Energy Citations Database
Abdominal wall function is a major concern for plastic surgeons performing breast reconstruction with TRAM flaps. The deep inferior epigastric perforator (DIEP) free flap spares the whole rectus abdominis muscle, includes skin and fat only, and therefore, preserves adequate abdominal wall competence. Between ...
Barraquer-Simons syndrome, a disorder of unknown etiology, is characterized by a cephalothoracic lipodystrophy. We present 2 patients treated with a bilateral free transverse rectus abdominis myocutaneous (TRAM) flap to restore facial contour. Our technique of using a muscle component to fill the cheek defect was based on our ...
Bilateral prophylactic mastectomy without reconstruction is not accepted by the majority of patients. Successful reconstruction is therefore a mandatory condition for prophylactic mastectomy. Of the many options for autologous breast reconstruction, the deep inferior epigastric perforator (DIEP) flap best meets requirements for bilateral reconstruction in selected patients. ...
SUMMARYDesmoid tumor is a rare, benign fibroblastic tumor that is characterized by highly aggressive local invasiveness.The authors report the case of a 35 year old male who presented with a 20 cm para-umbilical tumor invading the right rectus abdominis muscle. This required a wide excision of the abdominal wall. The resulting defect was closed with a ...
Inadequate blood supply of pedicle flaps results in partial necrosis, and prolonged ischemia during free-tissue transfer can result in partial or complete flap necrosis. Recent research in the field of cardiovascular surgery has shown that ischemic preconditioning (repeated brief episodes of coronary artery occlusion followed by reperfusion) improves ...
In the patient with a radiation ulcer of the chest wall, the first question is whether the lesion contains persistent or recurrent cancer. It is also important to determine whether any other local problems such as mediastinal abscess may interfere with the reconstruction. Whether or not cancer is present, all nonviable tissue must be removed. If cancer is not present, and a partial thickness of ...
... TRANSMISSION. I. EFFECTS OF 2-PAM AND EA 1814 ON THE FROG RECTUS ABDOMINIS MUSCLE PREPARATION. Corporate ...
Rectus abdominis muscle strains are common and debilitating injuries among competitive tennis players. Eccentric overload, followed by forced contraction of the non?dominant rectus abdominis during the cocking phase of the service motion is the accepted injury mechanism. A tennis?specific rehabilitation program emphasising eccentrics ...
Full-thickness chest wall resection is performed for complete removal of primary and secondary malignant chest wall tumors. Large defects of the chest wall after resection must be repaired to maintain adequate ventilation, to protect important intrathoracic structures, and to preserve cosmetic integrity. Various materials have been utilized over the years to replace the rigid chest wall. At ...
The authors report the successful repair of large lower abdominal hernia defects after transverse rectus abdominis muscle (TRAM) flap breast reconstruction in 11 patients using a technique of intraperitoneal application of synthetic polypropylene (Prolene) mesh anchored to the peritoneal surface of the abdominal wall tissues. Five of ...
Microvascular free tissue transfer in head and neck reconstruction requires suitable recipient vessels which are frequently compromised by prior surgery or radiotherapy to the neck. This article details a new technique of arterial free flap pedicle anastomosis to the internal carotid artery in a vessel-depleted neck. A 63-year-old female was referred because of recurrence of ...
Prelamination is sometimes required for reconstruction of specialized organs. The purpose of this study was to create a chimeric flap model in dogs for prelamination. The anatomy of the deep and superficial caudal epigastric vessels, which supply the rectus abdominis muscle and superficial ventral fascia, respectively, were measured in ...
The author carried out 50 free flaps in 49 patients during 10 year consulting practice in orthopaedic departments in the regional hospital in Otwock. 43 flaps were transplanted to lower extremities and 7 to upper. Extensive bone defects (bd), requiring reconstruction of shafts especially in case of tibiae predominated. The recipient sites of free tissue ...
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. ...
A very rare condition of osteoma cutis was presented by a patient who required an unusual solution to an unusual problem. Multiple surgical procedures were performed during the treatment of the disease, thereby prohibiting the use of more common regional or distant flaps to achieve successful mandibular reconstruction. Microvascular tissue transfer was also not feasible ...
Major complications of radiation directed to the breast, axilla, and mediastinum were treated in 54 patients from 1974 to 1983. A classification of these complications facilitates both an understanding of the pattern of injury and the development of a treatment plan. Classification: I. Breast necrosis; II. Radionecrosis and Chest Wall Ulceration; III. Accelerated Coronary Atherosclerosis with ...
Cantrell syndrome is a very rare congenital anomaly with up to five features: a midline, upper abdominal wall abnormality, lower sternal defect, anterior diaphragmatic defect, diaphragmatic pericardial defect, and congenital abnormalities of the heart. This report describes our experience of performing a reconstruction of a chest wall defect in a Cantrell syndrome case with herniation of the ...
OBJECTIVE: Patients with and without radiation treatment before their breast reconstruction were compared to study the relationship of radiation to flap-related complications. SUMMARY BACKGROUND DATA: The transverse rectus abdominis muscle (TRAM) flap for breast reconstruction involves a a vascular pedicle and ...
The transversus abdominis plane (TAP) block acts on the nerves localised in the anterior abdominal wall muscles. We evaluated the efficacy on post-bariatric (PB) patients undergoing body-contouring abdominoplasty. We retrospectively evaluated PB patients undergoing abdominoplasty with flank liposuction and compared results to a matched group of TAP ...
Reestablishing anterior rectus fascial integrity remains a clinical challenge after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. The main concerns include herniation and bulging due to abdominal weakness. Mesh-assisted closure of the fascial defect has improved bulging and herniation rates but infection, extrusion, and ...
The patient is a man in his sixties. A hard tumor that fixed to right iliac bone as big as an adult fist could be palpated in the ileocecal region. He complained a cramp and pain in the right thigh. Computed tomography of the abdomen after the administration of contrast material showed an irregular shape tumor that highly invaded through right iliac muscle, and it widely ...
Necrosis in TRAM (transverse rectus abdominis myocutaneous) still occurs in flap breast reconstruction. Blood flow may be improved by vascular endothelial growth factor (VEGF), an endogenous protein that stimulates neovascularization. Experimental studies of gene therapy with plasmid vector expressing human VEGF (hVEGF) presented inadequate results. Low ...
The objective of the present study was the evaluation of MRI of the breast in the follow-up of patients who had undergone autogenous tissue breast reconstruction using either a latissimus-dorsi muscle flap or a transverse rectus abdominis myocutaneous (TRAM) flap as correlated with patients' clinical, conventional ...
In 36 patients the first experience of performance of one-stage mammarial glands reconstruction is presented, using tissues of their own after conduction of mastectomy for the mammarial gland cancer. In 27 women patients the transposition or free microvascular transplantation of lower musculocutaneous flap basing on m. Rectus abdominis (transverse rectus ...
In an attempt to decrease donor-site morbidity for rectus abdominis muscle harvest during free tissue transfer, we developed a technique of minimally invasive harvest. The da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) was used in two cadavers for dissection and harvest of four rectus abdominis ...
The abdominal wall function of 57 patients who have undergone TRAM flap breast reconstructions using the whole rectus muscle, on one side (33 patients) or both (24 patients), was evaluated 6 months to 2 years after surgery. The defect was repaired with a Teflon mesh buried in the rectus sheath. There was a perfect tolerance to the mesh, and no hernia or ...
Sensitivity of slow fibers of mixed muscles of Testudo horsfieldi and Agama caucasica to cholinomimetic drugs were investigated by the cumulative concentration -- action curve method. These muscles, like the rectus abdominis muscle of frogs, are most sens...
National Technical Information Service (NTIS)
We report a case of dedifferentiated chondrosarcoma of the chest wall. After resection, the chest wall defect was reconstructed using polypropylene mesh and a transverse rectus abdominis myocutaneous flap. A 61-year-old woman presented with a 16-year history of a slow-growing mass underneath the right chest wall. After percutaneous biopsy, preoperative ...
Infection in a peripheral vascular prosthesis continues to be a serious complication in arterial reconstructive surgery and threatens the patient with loss of either limb or life. Infection rates at major centers are now low, ranging from 1 to 6 percent; however, limb loss and mortality rates for this complication range from 25 to 75 percent depending on the location of the graft and the extent of ...
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 ...
The objective of the study is to compare the long term outcomes of two common techniques of post-mastectomy breast reconstruction: tissue expansion/breast implants and transverse rectus abdominis musculocutaneous (TRAM) flaps. This four year prospective s...
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 ...
A case of a 32-year-old motorcyclist, who sustained an open comminuted fracture of the left tibia and subsequently developed spontaneous cecal perforation following successful fixation of the fracture and reconstruction of the soft tissue defect with a rectus abdominis free flap, is reported. Although benign cecal perforation has been described in patients ...
Prevention of hernia or bulge of the abdominal wall after TRAM breast reconstruction has been a challenge for the reconstruction surgeon. Different techniques have been described to avoid this complication. The use of anterior rectus abdominis sheath (ARAS) for the repair of various abdominal wall hernias has been well described in the literature and is the basis of the ...
... reproducing the biological flapping motion of the wings of the moth, Manduca sexta (hawkmoth) by artificially stimulating the flight muscles for Micro ...
An accurate preoperative evaluation of the vascular anatomy of the abdominal wall is essential in deep inferior epigastric perforator (DIEP) flap reconstruction. We present our experience of using computed tomographic angiography (CTA) of the abdomen as part of our standard preoperative assessment of abdominal-based breast reconstruction. One hundred consecutive cases were ...
Technical advances in myocutaneous flap preparation have resulted in primary reconstruction now being generally indicated for malignant tumors extensively infiltrating the pelvic cavity and perineum. Pelvic tumor resection can dramatically improve the health-related quality of life (QOL) of patients with locally recurrent rectal cancer complicated by infection and pain. ...
Breast conserving surgery for breast cancer has led to an increased interest in reconstruction following mastectomy. The transverse rectus abdominis myocutaneous flap has been proven to give good results in terms of restoration of body symmetry with near normal contour and consistency. Furthermore, immediate reconstruction has the advantage of a single ...
An alternative treatment for low rectal cancer is the extended posterior perineal approach with reconstruction of the pelvic floor (cylindrical technique). Pelvic floor defects often require flap reconstruction using gracilis flaps, vertical rectus abdominis myocutaneous flaps or local fasciocutaneous ...
The present study reviews 215 male patients suffering high velocity-high energy injuries of the lower leg or foot caused by war weapons such as missiles, gunshots, and land mines. They were treated in the Department of Plastic and Reconstructive Surgery at Gulhane Military Medical Academy (Ankara, Turkey) between November 1993-January 2001. Severe soft-tissue defects requiring ...
PURPOSE:: Limb salvage in bone sarcomas requires resection and joint and soft-tissue reconstruction. Suboptimal coverage can lead to prosthesis infection, subsequent hardware exposure, or loss with eventual amputation. In the pediatric sarcoma population, it is essential to not only have viable soft-tissue coverage but one that minimizes donor site morbidity and maximizes function and growth over ...
BACKGROUND:: Performing a sacrectomy from an exclusively posterior approach allows for the en bloc resection of tumors without the morbidity of a laparotomy. However, the reconstruction of the resultant extensive soft-tissue defects is challenging, as a vertical rectus abdominis myocutaneous flap is not harvested. OBJECTIVE:: We report the largest series ...
The volume occupied by the extracellular space has been investigated in six types of voluntary muscles: sartorius (frog), semitendinosus (frog), tibialis anticus longus (frog), iliofibularis (frog), rectus abdominis (frog), and diaphragm (rat). With the a...
Abdominal wall herniation is a relatively rare but well recognized complication that is known to occur following TRAM flap mobilization. Herein is presented a novel means to approach such a hernia, using the minimally invasive surgical approach to repair the defect with a piece of prosthetic material. PMID:9774021
Previous studies have described compound flaps based on the subscapular system for a variety of reconstructive needs. Most commonly, the combination includes the fasciocutaneous parascapular flap with the latissimus dorsi muscle flap used in the reconstruction of extensive lower extremity wounds. Indications for ...
BACKGROUND: Closure of donor-site defects from large cutaneous flap harvesting often faces significant morbidity, which limits the utility of workhorse flaps in large-soft-tissue defect reconstruction. To overcome this limitation, we introduced the concept of a second 'buddy' flap to reconstruct the donor-site defect. METHODS: Between ...
A comparison was made of the plastic methods for residual bone cavities--that of ground autogenous muscle and that of pedunculated muscle flap. The influence (or effect) of implanted tissue on the processes of biological sanitation of the walls of bone ca...
The purpose of this study was to modify the classic bilateral V-Y advancement flap procedure to decrease the tension in its closure and to break the midline vertical scar by interdigitating the flaps. After debridement of a pressure sore, the V-Y flaps were marked on both sides of the wound. Skin incisions were carried down to the ...
... involves a great loss of tissue, a full thickness graft, a flap of skin with underlying muscle ...
MedlinePLUS
Previous descriptions of the thoracolumbar spinal nerves innervating the anterior abdominal wall have been inconsistent. With modern surgical and anesthetic techniques that involve or may damage these nerves, an improved understanding of the precise course and variability of this anatomy has become increasingly important. The course of the nerves of the anterior abdominal is described based on a ...
This study investigated the effects of age and inactivity due to being chronically bedridden on atrophy of trunk muscles. The subjects comprised 33 young women (young group) and 41 elderly women who resided in nursing homes or chronic care institutions. The elderly subjects were divided into two groups: independent elderly group who were able to perform activities of daily ...
Knee reconstruction with endoprosthesis after tumor resection is accepted as superior when compared with the other methods. But sometimes soft tissue reconstruction would be a challenging problem in this way of treatment. Five patients who were operated for tumor resection in this location, followed by reconstruction were presented with their one-year post operative results. Four latissimus dorsi ...
As is not unusual with technological advances of any kind that invariably grab all the headlines, many previous standards of care, often without due consideration, are arbitrarily spurned as pass�. Advocates of muscle perforator flaps vehemently insist this is now the ideal soft-tissue flap, in lieu of the traditional ...
BACKGROUND: In our own experience over the last 15�years, the primary transpelvic vertical rectus abdominis myocutaneous (VRAM) flap is a reliable tool to prevent perineal wound complications after cylindrical excision in radical anorectal tumor surgery. To minimize the operative trauma in such patients, we performed a laparoscopic abdominoperineal ...
Examined the relative electromyographic (EMG) activity of upper and lower rectus abdominis (LRA) and external oblique (EOA) muscles during five abdominal strengthening exercises. Isometric and dynamic EMG data indicated that abdominal strengthening exercises activated various abdominal muscle groups. For the LRA and EOA ...
ERIC Educational Resources Information Center
This study was designed to assess the effects of environmental factors on experimental muscle flap temperature and to critically evaluate temperature as a modality for assessing vascular patency. A brief overview of the physiology of tissue heat transfer is presented. The right vertebral head of the biceps femoris muscle was used in ...
Objective To investigate associations between deep abdominal muscle activation and long-term pain outcome in chronic non-specific low back pain (LBP). Methods Recruitment of transversus abdominis and obliquus internus abdominis during the abdominal drawing-in manoeuvre was recorded by B-mode ultrasound and anticipatory onset of deep ...
Microvascular flap surgery is a common technique in reconstructive surgery. The wide indications and variable patients provide challenge also for anesthesiologist. Both hypotension and hypoperfusion can be harmful to the flap. Hypotensive patients are treated with fluid resuscitation and vasopressors (e.g., norepinephrine), if needed. As vasoconstrictors, ...
Two cases of successful reconstruction of massive defects around the knee with multiple-island combined flaps based on the subscapular axis are reported. Both defects resulted from aggressive debridement for acute osteomyelitis after open fixation of high-energy fractures around the knee. In Case 1, a four-island combined flap consisting of the scapular ...
The unipedicled TRAM flap is an useful alternative to breast reconstruction after mastectomy in patients who refuse mammary implants. There is however the risk of unpredictable partial skin necrosis even after rigorous surgical procedures. Certain authors have proposed color flow doppler assessment before reconstructive surgery better to identify the vascular network and ...
Experience with 100 consecutive chest wall reconstructions during the past 7 years was reviewed. There were 52 female and 48 male patients with ages ranging from 13 to 78 years (average 53). Of the 100 patients, 42 had tumors of the chest wall, 19 had radiation necrosis, 24 had infected median sternotomies , and 15 had combinations of the three. Seventy-six patients underwent skeletal resection of ...
Following unilateral iliac artery injection of radiopaque Microfil in cadavers, coronal sections of the anterior abdominal wall at 1-cm intervals were obtained employing computerized axial tomography of the intact specimen as well as xerography of frozen slices. Because they avoid the distortion and disruption of the vasculature induced by anatomical dissection, these studies clearly indicate that ...
A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus ...
Propeller perforator flaps supplied by branches from the transverse cervical artery allow transport of skin from the back region to supraclavicular defects. This article describes a soft tissue defect following resection of melanoma metastasis that was successfully reconstructed using a propeller flap based on a perforator originating from the anterior ...
In hypopharyngeal carcinoma, even partial laryngopharyngectomy, results in functional disorders involving swallowing and speaking. We reconstructed partial defects following partial laryngopharyngectomy using a combined flap of a hyoid bone flap and radial forearm free flap. Before ablative surgery, we prepared an ipsilateral hyoid ...
The purpose of this study was to investigate sensory recovery in 33 patients who underwent conventional mastectomy, skin-sparing mastectomy, or nipple-sparing mastectomy with immediate breast reconstruction using abdominal flaps. Reconstructions included a pedicled transverse (28 cases) or vertical (five cases) rectus abdominis musculocutaneous ...
In defect reconstruction following radical oncologic resection of malignant chest wall tumors, adequate soft-tissue reconstruction must be achieved along with function, stability, integrity, and aesthetics of the chest wall. The purpose of this retrospective analysis was to evaluate the oncoplastic concept following radical resection of malignant chest wall infiltration with an interdisciplinary ...
The gracilis muscle is a Class II muscle that is often used in free tissue transfer. The muscle has multiple secondary pedicles, of which the first one is the most consistent in terms of position and calibre. Each pedicle can support a segment of the muscle thus yielding multiple small flaps ...
Two cases with extensive posterior peritoneal defects after high sacral amputation for sacral chordoma are presented. An adipomuscular flap as a modification of the conventional gluteus maximus muscle flap was designed to obliterate an extensive residual posterior peritoneal dead space. The deep adipose tissue beneath the superficial ...
In this report, the authors describe the application of a muscle-sparing technique to harvest a myocutaneous latissimus dorsi muscle flap, including only a tiny lateral muscle segment but carrying a large skin paddle, with the advantage of leaving intact innervation and function of the remaining latissimus dorsi ...
Considering the poor long term results with the bladder neck suspensions, the poor results with the retropubic approach in obese or intrinsic sphincter deficiency and the complexity of the classical retropubic sling procedure, a simple vaginal sling urethropexy approach was developed. The vaginal mucosa is opened at 12 o'clock under the urethra. Dissection of the endopelvic fascia is undertaken. ...
BACKGROUND:: Postoperative abdominoplasty seromas are a problem. While drains are still commonly used during the initial postoperative period, this paper has demonstrated that the combination of an extended incision, suction undermining and progressive tension sutures can produce superior results without the need for suction drains. METHODS:: A retrospective review of 113 consecutive ...
Adequate soft tissue coverage is imperative after any interventions performed to maximize or preserve hand function. Although this can most simply be achieved by primary closure or a skin graft if possible, often a vascularized flap will be preferable, especially if a later secondary procedure is planned. Even moderately sized skin deficits of the upper extremity, and ...
Reconstruction for defects around the ankle continues to be challenging. Repairs have been effected with the dorsalis pedis flap, the medial plantar flap, and with reverse-flow island flaps using the anterior and posterior tibial systems and the peroneal system. However, sacrifice of the major vessels of the lower leg and wide and long ...
BACKGROUND: Recently, the supraclavicular artery island flap has gained popularity as a regional flap for head and neck reconstruction. During clinical follow-up, some patients report referred sensation to the shoulder when there is contact with the flap skin island surface. The authors examine the anatomical origin/characteristics of ...
The use of non-traditional exercise devices such as the Ab Lounge� has been promoted as being as effective as the traditional abdominal crunch in strengthening the abdominal musculature. Evidence for this is lacking, however. The purpose of this study was to compare the degree of activation of the upper and lower rectus abdominis using electromyography (EMG) during a ...
The deep inferior epigastric artery (DIEA) distributes musculocutaneous perforators in a uniform pattern that comprises "medial row" versus "lateral row" perforators, with these two rows having anatomical and functional differences. This pattern of two perforator rows is distributed from the DIEA regardless of the number of major DIEA trunks, with there variably being one to four major trunks. As ...
To assess the results of surgical resection and chest wall reconstruction we reviewed our experience with the complete chest wall reconstruction after en bloc excisions according to an original algorithm based on the location of the thoracic defect. The 14 reconstructions were performed by the senior author. We found 5 central, 6 lateral and 3 borders locations. In the central locations with a ...
Reconstruction with the latissimus dorsi muscle flap, combined with the serratus anterior fascia flap, was performed to cover two large and separate palmar and dorsal forearm skin defects in a patient, whose hand had been replanted 20 days earlier after traumatic amputation at the distal forearm level. As a result, a total forearm ...
A latissimus dorsi muscle flap was used to simultaneously resurface the dorsal index, middle, and ring fingers of a 10-year-old child who had sustained a severe abrasion burn from a go-kart injury. Rather than performing multiple individual flaps, or a single flap in which a secondary division procedure would have ...
BackgroundA Swiss ball is often incorporated into trunk strengthening programs for injury rehabilitation and performance conditioning. It is often assumed that the use of a Swiss ball increases trunk muscle activity. The aim of this study was to determine whether the addition of a Swiss ball to trunk bridging exercises influences trunk muscle ...
A combined tongue flap and V-Y advanced flap were used for reconstruction of the lower lip after radical excision of squamous cell carcinoma. This V-Y advancement flap is useful because the procedure does not require any difficult technique, and preservation of the orbicularis oris muscle and the branch of the ...
We have reviewed all the cases of flap reconstruction following resection of a gynaecological malignancy at the Royal Marsden Hospital over 12 years from 1993 until 2005. Forty-six patients were identified who required 53 flaps. The predominant site of the primary tumour was vulva, accounting for 83% of the cases, with cervix, ovary, vagina and endometrium ...
Background:The tenuous blood supply of traditional flaps for wound cover combined with collateral damage by sacrifice of functional muscle, truncal vessels, or nerves has been the bane of reconstructive procedures. The concept of perforator plus flaps employs dual vascular supply to flaps. By safeguarding ...
Various common locations of pressure sores require specific considerations. The most commonly used flap for the treatment of trochanteric ulcers is the tensor fascia lata (TFL) flap. According to our experience with the original flap, excessive tension and eventual suture separation at the confluence of the donor site ...
The lateral thigh flap based on the second and third perforator of profunda femoris vessel has not become very popular. We describe a technique of flow-through pedicle for this flap. The flow-through technique makes this flap very simple to transfer. The flap was used successfully in 6 cases for reconstruction for ...
Various reports describe surgical techniques for closing a meningomyelocele defect. We have used a combination flap consisting of a vertical bipedicled flap and V-Y advancement flap and used this technique in the successful repair of 11 meningomyelocele defects. The vertical bipedicled flap enhances the blood ...
PurposeTo determine the volume and degree of asymmetry of the rectus abdominis muscle (RA) in professional soccer players.MethodsThe volume of the RA was determined using magnetic resonance imaging (MRI) in 15 professional male soccer players and 6 non-active male control subjects.ResultsSoccer players had 26% greater RA volume than controls (P<0.05), ...
In rectus abdominis myocutaneous island flaps (3.0 x 1.5 cm) of 86 rats (Uje: WIST) transcutaneous oxygen tension measurements (tcPO2) were made by a Universal-PO2-Meter MO 10.1 (PRACITRONIC, Dresden, GDR) for monitoring flap viability following blood flow insufficiency produced experimentally. This insufficiency was induced by ...
BACKGROUND:: Selective embolization of the inferior epigastric arteries can serve as a method for transverse rectus abdominis musculocutaneous (TRAM) flap delay. The purpose of this study was to determine whether delay by selective arterial embolization is comparable to traditionally surgically delayed TRAM flaps as reported in the ...
This study compared the deep inferior epigastric perforator (DIEP) flap and the free transverse rectus abdominis myocutaneous (TRAM) flap in postmastectomy reconstruction using a cost-effectiveness analysis. A decision analytic model was used. Medical costs associated with the two techniques were estimated from the Ontario Ministry of ...
The use of a combination musculocutaneous free flap, consisting of a latissimus dorsi flap and a serratus anterior flap, for reconstruction of a large scalp and cranium defect is described. The recipient artery, the superficial temporal artery (STA), was anastomosed to the flap artery, without sacrificing blood ...
Reconstruction of the distal foot, especially of the toe has always been a challenging problem. Various methods have been tried with variable success rates and limitations. Presented here is a series of four cases, where distally based flaps were used. Two of them were Extensor Digitorum Brevis (EDB) muscle flaps and the other two were ...
The combined dorsalis pedis cutaneous, extensor hallucis and digitorum brevis muscle conjoined free flap is useful for a moderate or subtotal defect of the full-thickness lip when local or regional flaps are not applicable. This method can restore good oral competence, adequate oral aperture allowing dental hygiene, and an ability to ...
Spinal manipulative therapy (SMT) is common in the management of low back pain (LBP) and has been associated with changes in muscle activity, but evidence is conflicting. This study investigated the effect of SMT on trunk muscle activity in postural tasks in people with and without LBP. In 20 subjects (10 with LBP and 10 controls), EMG recordings were made ...
BackgroundAn important variability of contractile and metabolic properties between muscles has been highlighted. In the literature, the majority of studies on beef sensorial quality concerns M. longissimus thoracis. M. rectus abdominis (RA) is easy to sample without huge carcass depreciation and may appear as an alternative to M. longissimus thoracis for ...
In this article, we review our experience during the past 9 years with 205 consecutive thoracic wall reconstructions. The 100 female and 105 male patients ranged in age from 12 to 85 years (mean, 53.4 years). One hundred fourteen patients had thoracic wall tumors, 56 had radiation necrosis, 56 had infected median sternotomy wounds, and 8 had costochondritis. Twenty-nine of these patients had ...
Immediate breast reconstruction has become a standard of care following mastectomy for cancer, largely due to improved esthetic and psychologic outcomes achieved with this technique. However, the current historical standards--transverse rectus abdominis myocutaneous flap reconstruction and expander--implant surgery-still have limitations as regards patient ...
Our experience with 500 consecutive chest-wall reconstructions over the past 18 years is reviewed. Of the 500 patients, 286 were male and 214 were female. Their ages ranged from 1 day to 85 years (average 55 years). Among the patients, 275 had chest-wall tumors, 142 had infected median sternotomies, 119 had radiation necrosis, and 121 had combinations of the three. Skeletal resection of the chest ...
Four patients diagnosed with sacral chordoma underwent reconstruction with the gluteus maximus flap using an approach based on available muscle remnants and their residual blood supply. The entire unilateral gluteus maximus muscle was turned over to fill the defect in 2 patients. The flap was based on 1 or 2 ...
Closure of fascia after transverse rectus abdominis myocutaneous (TRAM) flap has usually been performed with direct closure or synthetic material. The dermal autograft removed from zone IV of the flap is an alternative to reinforce fascial closure. Record of the patients who had been undergone breast and head and neck reconstruction by ...
Breast cancer is a common cancer among women. The transverse rectus abdominis myocutaneous (TRAM) flap is a popular option because not only does it provide a breast with satisfactory bulk composed of autogenous tissue but it also provides an abdominal dermolipectomy to the patient. Fat necrosis remains a common problem following TRAM ...
This study aimed at evaluating various reconstructive procedures for chest wall radionecrosis after breast carcinoma therapy. Four different techniques were performed between 1973 and 1992 in 120 patients: latissimus dorsi musculocutaneous flap (LDF; n = 81); transposed omentum and split-thickness skin graft (TGO; n = 20); fasciocutaneous flap (FCF; n = ...
This combined anatomic and clinical study illustrates the first experiences of an osteomyocutaneous flap from the medial femoral condyle for reconstruction of composite tissue defects. We analyzed the anatomic consistency and the vascular distribution of this flap and showed that muscle tissue can easily be added as a composite ...
Devastating hand and forearm injuries almost exclusively need free flap transfer if reconstruction is attempted. Early active and passive motion is only possible with aggressive, early, and comprehensive reconstruction. Despite recent advances in compound flaps, in selected cases it might be wise to harvest several smaller flaps and ...
PurposeTo determine the volume and degree of asymmetry of the musculus rectus abdominis (RA) in professional tennis players.MethodsThe volume of the RA was determined using magnetic resonance imaging (MRI) in 8 professional male tennis players and 6 non-active male control subjects.ResultsTennis players had 58% greater RA volume than controls (P?=?0.01), due to hypertrophy of ...
Revascularization, one of the major components of bone healing, was examined in an experimental model. The radioactive microsphere technique demonstrated that after 4 weeks beneath a musculocutaneous flap, isolated bone segments had significant blood flow, whereas bone beneath a cutaneous flap did not. The muscle ...
BackgroundAlthough multiple strategies for autologous breast reconstruction exist, a vertical midline scar in the abdominal wall as a result of previous laparatomy or abdominoplasty represents a major surgical challenge. To date, little research has been conducted on the regeneration potential of the abdominal wall�s superficial vascular, perforator and choke vessel system after surgery using a ...
Introduction and aim. Management of complicated wounds after tumor extipiration of pelvic and proximal lower limb musculoskeletal sarcoma represents an essential component in the outcome of these patients. The authors present modified vertical rectus abdominis musculocutaneous (VRAM) flap techniques to reconstruct extensive defects after debridment of ...
The deep inferior epigastric artery perforated rectus abdominis (DIEAP-ra) free flap is a modification of the classic myocutaneous DIEA free flap in which only fasciocutaneous tissue is harvested based on the paraumbilical perforators of the medial row. The aim of this retrospective study is to describe our experience with this ...
1. Surface EMG recordings were made from left and right homologous muscle pairs in healthy adults. During each recording session subjects were requested to maintain a weak isometric contraction of both the left and right muscle. 2. Cross-correlation analysis of the two multiunit EMG recordings from each pair of muscles was performed. ...
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 ...
The transverse rectus abdominis myocutaneous (TRAM) flap can create a good breast shape, however, the patchwork-like scar obviously shows that the breast has been reconstructed. To reconstruct a breast without the patchwork-like appearance, we used a two-stage procedure using a tissue expander before transplanting a de-epithelialised TRAM ...
This study compares the outcome of Singapore flap, vertical rectus abdominis musculocutaneous flap (VRAM), and gracilis musculocutaneous flap vaginal reconstruction. A retrospective review of 99 consecutive patients with complete vaginal defects was conducted at the Mayo Clinic from January 1988 to October 2001. ...
In view of the good results of breast reconstruction with the transverse rectus abdominis myocutaneous (TRAM) flap, we used this method in 48 patients, but we observed abdominal complications, which are difficult to accept for cosmetic surgery. Hartrampf, one of pioneers of this technique, reports a very low complication, rate by closing the abdominal wall ...
A new extended external oblique musculocutaneous flap utilized in the reconstruction of chest-wall defects is described. The flap is drawn as a V-Y rotation flap on the ipsilateral abdominal wall. It is laterally based, and its pedicle coincides with the five lowest costal insertions of the external oblique. The ...
The posterior calf region is a useful donor site for skin or composite flaps including muscle and/or nerves. We reported the first clinical use of the lateral gastrocnemius perforating artery flap including a vascularized sural nerve in 2003. This flap was elevated based on a perforator arising from the lateral ...
An investigation was conducted assessing the possibility and feasibility of reproducing the biological flapping motion of the wings of the moth, Manduca sexta (hawkmoth) by artificially stimulating the flight muscles for Micro Air Vehicle research. Electr...
The authors compared two methods of determining the extent of skeletal muscle injury. The first method used nitroblue tetrazolium dye (NBT) to distinguish between live and injured muscles. The muscle flap was sectioned transversely into 1 mm thick segment...
The symmetry of, and physical characteristics influencing, the thickness of the lateral abdominal muscles at rest and during abdominal exercises were examined in 57 healthy subjects (20 men, 37 women; aged 22�62 years). M-mode ultrasound images were recorded from the abdominal muscles at rest and during abdominal hollowing exercises in hook-lying. The ...
The use of dynamic myoplasty to restore function to failing organs is an exciting new application of skeletal muscle flaps. A complication of large flap elevation that can compromise flap function is ischemia-induced necrosis; one approach to minimizing this is to pretreat tissues with ischemic preconditioning. The ...
A skin and fascia flap from the medial thigh is proposed for vaginal and perineal reconstruction. Dissection, vascular injection, and radiographs of 20 fresh cadaver limbs uniformly demonstrated the presence of a communicating suprafascial vascular plexus in the medial thigh. Three to four nonaxial vessels were consistently found to enter the proximal plexus from within 5 cm ...
The vascular effects of isoxsuprine, diazoxide, and isoproterenol were studied in arterial buttock flaps and latissimus dorsi myocutaneous flaps in pigs. Capillary blood flow to the skin and muscles of these flaps was measured by the radioactive microsphere (15-mu diameter) technique 6 hours postoperatively under ...
Acute low back pain (LBP) is associated with differential changes in motor coordination of deep and superficial trunk muscles. Whether this is related to differential changes in excitability of descending corticomotor inputs remains unclear and was investigated in nine healthy individuals. Fine-wire i.m. electrodes were inserted bilaterally into deep (transversus ...
Perforator flaps have been successfully used for reconstruction of pressure sores. Although V-Y advancement flaps approximate debrided wound edges, perforator-based propeller flaps allow rotation of healthy tissue into the defect. Perforator-based propeller flaps were planned in 13 patients. Seven pressure sores ...
Two patients developed an epidural abscess in the posterior cranial fossa following tumor dissection from the occipital region of the head and underwent surgical treatment. After debridement of necrotic and infectious tissues inside the abscess was performed, the empty cavity was filled and the tissue defect was reconstructed by using a trapezius muscle ...
The authors describe a modification of the classic gluteal bilateral V-Y advancement flap for sacral defect closure. After initial debridement, the V-Y design is marked on both sides of the defect. The incision is carried down to the fascia of the underlying gluteus maximus muscle. The upper and lower arms of the flaps are elevated and ...
In the years 1983-1997, 252 female to male transsexuals were treated in the Department of Plastic Surgery of University Medical School in ?�d?. In 209 patients surgical penis construction was performed. The paper presents operative techniques and results of penis construction with the use of four kinds of flaps: a bipedicled abdominal tube flap, a single ...
When reconstructing the thoracic wall, non-adaptation of the suture line is a critical concern, especially when artificial implants are used. Therefore, a reliable and safe flap is required. Based on an anatomical study of cadavers, we decided to dissect the pectoralis major musculo-cutaneous flap into two parts, on the surface and beneath the ...
Facial defect after an extended total maxillectomy is one of the most difficult deformities to reconstruct aesthetically, because the defect is not only large but also three-dimensional. Although free-flap reconstruction is useful, the patchwork-like scar, bad colour match and poor texture match are major problems. The contracture and displacement of the reconstructed eyelids ...
Free tissue transplantation is nowadays regarded as an established method in reconstructive surgery - even in infants. Adequate diameters of vessels for microsurgical anastomosis have been shown in numerous studies. Especially the latissimus dorsi muscle seems to be ideal as a standard flap in this age group. The main disadvantage of this ...
The anal sphincter insufficiency stage III, caused by inborn developmental disorders and traumatic affection of its vast portions, may be successfully eliminated using plasty performance with application of a long flap of muscle gluteus maximus. Various ants of the operation were applied in 29 patients. Electrostimulation of muscles ...
Consistent branching of the thoracodorsal vessels to the latissimus dorsi makes it possible to split the muscle into independent branched units. The use of the lateral split latissimus dorsi muscle flap to protect the bronchial stump in case of bronchus at risk of insufficiency is described. PMID:19101334
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 ...
The relative importance of oxygen in relation to resistance to infection was assessed in 24 mongrel dogs. Rectus abdominis musculocutaneous (MC) and corresponding cutaneous random pattern (RP) flaps based at the level of the xiphoid were elevated, replaced, and sutured. Immediately after the surgical procedure, 0.1 ml saline containing 10(8) Staphylococcus ...
Flexion contracture of the elbow is a common sequela of burn injury. Numerous methods have been suggested for release, including grafting, Z-plasty, Y-V flaps, local or distant fasciocutaneous flaps, muscle or myocutaneous flaps, free flaps, tissue expanders and non-surgical orthotics. In this ...
Scrotal skin has unique cosmetic and functional features that make its reconstruction difficult. Coverage of the testicles and constituting a good cosmetic appearance are major expectations from a successful reconstruction. Usually flaps are the choice for scrotal reconstruction, but every single flap has its own characteristics. In our series, between ...
The perforator-based flaps in the sacral and ischial region is designed according to the localization of perforators that penetrate the gluteus maximus muscle, reach the intra-fascial and supra-fascial planes with the overlying skin forming a rich vascular plexus. The perforator-based flaps described in this article are highly ...
The authors have utilized six pectoralis major myocutaneous flaps in attempts to salvage extensive necrotic wounds of the pharynx and neck. The flap was employed in the following situations: massive necrosis of the entire neck skin with both carotid artery systems exposed, radiation necrosis of the neck skin with exposure of carotid artery, dehiscence of ...
17 local muscle flaps were used to cover soft tissue defects in 13 open fractures (1 degree to 4 degrees) of the lower limb and in four patients with chronic ostitis associated with instable scar forming. The Musculus soleus was used in 16 cases exclusively or in combination with the Musculus gastrocnemius (three times), Musculus hallucis longus (one time) ...
The anterolateral thigh flap (ALTF) has been in wide clinical use for the last two decades, its major disadvantage has been its variable anatomy. We are presenting a case in which no substantial perforators were found to be arising from either the lateral septum of thigh or Vastus Laterlis muscle. In this case, instead of raising another ...
INTRODUCTION: Spigelian hernia is an uncommon abdominal wall hernia occurring through the linea semilunaris located near the lateral border of the rectus abdominis muscle. CASE REPORT: We report an extremely rare case of incarcerated Meckel's diverticulum within a Spigelian hernia diagnosed by multidetector computed tomography. PMID:21800227
The goal of the study was to assess whether endothelin-1 levels are increased in tissue and plasma in free flaps. To assess this hypothesis, blood samples were taken from the general circulation before and after reperfusion and from the flap after reperfusion in 20 patients undergoing breast reconstruction with free transverse rectus ...
The transverse rectus abdominis myocutaneous (TRAM) flap is ideal for postmastectomy reconstruction but is tenuous in morbidly obese patients. Because of their relatively high incidence of postoperative complications, morbidly obese patients are often not considered candidates for autogenous reconstruction. The midabdominal TRAM flap ...
Rehabilitation of major resections of the tongue has always posed a serious problem. This paper presents the feasibility and rational of rehabilitating partial glossectomies by the use of the pectoralis major myocutaneous flap and the fabrication of a "new tongue" by the use of this flap. The criteria for these techniques in benign and malignant tumors of ...
Management of patients with large or recurrent pressure ulcerations can be complicated by the lack of available local flap, whether already used or because adjacent lesions make such flap insufficient for complete coverage. In this article, the gracilis muscle was modified to cover large defects without help from its cutaneous ...
Background:Depressed scars in the neck pose a cosmetic problem. There is a need to fill the lost tissue volume defect between the surface and deeper tissues. It is preferable that the filling is done by autologous tissue which is available in substantial amount in the adjoining area. There should be no donor site morbidity. Platysma muscle flap meets these ...
An airscrew-type calculation is employed to determine the power output of birds' pectoral muscles in
NASA Technical Reports Server (NTRS)
1 With isotonic recording the percentage of muscle shortening as compared with the maximal possible shortening, and with isometric recording the percentage of developed tension were determined. In relatively 'thick' muscles, such as dorsal leech muscle, frog rectus abdominis or protractor pharynx of holothuria ...
The tumescent technique has been shown to be efficacious in reducing both operative and postoperative bleeding without significant deleterious side effects in suction lipectomy. In this study, the effects of the tumescent technique on postoperative complications in transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction are investigated. ...
Objective:To evaluate the suitability of microvascular flaps for the reconstruction of extensive full-thickness defects of the chest wall.Summary Background Data:Chest wall defects are conventionally reconstructed with pedicular musculocutaneous flaps or the omentum. Sometimes, however, these flaps have already been used, are not ...
Surgically delaying a unipedicled lower abdominal transverse rectus abdominis musculocutaneous (TRAM) flap has been shown to improve flow within the flap. This delay, however, also affects blood supply and drainage of the entire anterior abdominal wall. The purpose of this study was to compare the abdominal complications between ...
The transversus abdominis plane (TAP) block is an innovative regional anesthetic technique using local anesthetic that is gaining popularity in the analgesic management of human patients undergoing abdominal surgery. Needle placement in the TAP block is within the facial plane between the internal oblique and transversus abdominis ...
Transversus abdominis plane block provides postoperative analgesia following abdominal surgery by targeting thoracolumbar nerves between the internal oblique and transversus abdominis muscles. Posterior and subcostal approaches using ultrasound guidance have been described. However there have been inconsistent results in relation to ...
Recently, the roles of transabdominal muscles particularly TrA (transverse abdominis) muscle in spinal stability leading to treatment of low back pain have been suggested. Both in clinical setting and follow up studies, abdominal muscle thickness measurements need to be repeated at a later point in time to ...
The bilateral V-Y advancement flaps are used commonly in the closure of circular skin defects. We modified the standard bilateral V-Y advancement flap technique to reduce the tension along the closure, and used it in 10 patients between 1995 and 1997. In the presence of a circular defect, bilateral V-Y advancement flaps were marked on ...
Fifty-four hemophiliac patients underwent a total of 94 studies using computed tomography (CT), ultrasound, or both. Not only common bleeding sites such as the iliopsoas muscles but also several unusual sites were encountered: these included th iliac bone, bowel wall, mesentery, rectus abdominis muscle, retroperitoneum, bladder wall, ...
A modified pectoralis major myocutaneous flap was used to stabilize necrotic neck wounds rapidly in irradiated patients. The flap was a sandwich flap that included an overlying parasternal pectoral skin paddle for pharyngeal reconstruction, the pectoralis muscle for carotid protection, and a meshed skin graft ...
BACKGROUND: Reconstruction of complex urethral defects should provide lasting coverage, a patent tube for voiding, and a natural appearing contour with minimal morbidity to the donor and recipient sites. Many reports have emerged in the literature regarding complex urethral reconstruction through a variety of methods including anterolateral thigh flaps, radial artery forearm ...
Among the many bone and muscle flaps described in literature, several have stood the test of time and come forward as the preferred donor sites. Each has its own advantages and disadvantages. Yet another bone flap that has never been described in literature is introduced here. This is the vascularized femur bone ...
Lower extremity diabetic wounds have been a challenge to clinical surgeons because of the higher risk of limb ischemia, soft-tissue infection, and soft-tissue loss caused by the pathology of the disease. In the published data, the most commonly used reconstruction techniques include pedicled flaps, microsurgical muscle or musculocutaneous ...
PURPOSE:: Hip muscle weakness has been associated with altered lower extremity mechanics and the increased likelihood of receiving treatment for low back problems, though biomechanical injury mechanisms focused on the trunk have not been investigated. The purpose of this study was to compare lumbopelvic kinematic variables and muscle activation of the ...
The mode of action of a purified toxin from Naja naja naja (Indian cobra) venom was investigated in frog rectus abdominis muscle, chick biventer cervicis muscle, cat tibialis anterior muscle (close-arterial) and in both innervated and denervated rat diaphragm muscle preparations. The toxin ...
1. Junctional potentials were recorded with a micro-electrode inserted into muscle fibres of the rectus abdominis muscle of the frog. Large and small nerve fibres were stimulated separately, using a selective stimulation technique. In a few muscle fibres rectangular current pulses were applied through a second ...
The effects of aqueous (AEE), dialysable (DIF) and methanol (MEE) extracts of Portulaca oleracea stems and leaves were compared with those of dantrolene sodium and methoxyverapamil (D-600) with respect to inhibition of twitch tension on the rat phrenic nerve-hemidiaphragm and with respect to contracture induced by nicotinic agonists on the frog rectus abdominis preparations. ...
Effective stabilization of the sacroiliac joints (SIJ) is essential, since spinal loading is transferred via the SIJ to the coxal bones, and further to the legs. We performed a biomechanical analysis of SIJ stability in terms of reduced SIJ shear force in standing posture using a validated static 3-D simulation model. This model contained 100 muscle elements, 8 ligaments, and ...
We report the successful repair for tracheoinnominate fistula, in which the innominate artery was interposed with a synthetic graft and the pectoralis muscle was used as a seal against infection. We know of 10 other reported cases. PMID:20158425
We describe three surgical methods used to repair salivary fistulas in different situations that are seen after reconstruction of the pharyngoesophagus in patients with hypopharyngeal cancer. The principle of these methods is the same; a cervical skin flap next to the fistula is used as the internal lining and an anterior chest skin flap is rotated as an ...
