Comparison of Phasix, polypropylene, and primary closure of the abdominal donor site after bilateral free flap breast reconstruction: Long‐term evaluation of abdominal hernia and bulge formation

Microsurgery ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 434-439
Author(s):  
Deborah Yu ◽  
Anika T. Patel ◽  
Kristie Rossi ◽  
Neil S. Topham ◽  
Eric I. Chang
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Primary Closure ◽  
Donor Site ◽  
Abdominal Hernia ◽  
Term Evaluation ◽  
Bulge Formation

Safety of a Modified Lipoabdominoplasty Technique for Donor-Site Closure in Abdominal-Based Free Flap Breast Reconstruction

2021 ◽  
Author(s):  
Dimitra Kotsougiani-Fischer ◽  
Laura Sieber ◽  
Sebastian Fischer ◽  
Christoph Hirche ◽  
Spyridoula Maraka ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Donor Site

LONG-TERM DONOR-SITE MORBIDITY IN COMPOSITE ANTEROLATERAL THIGH FREE FLAP FOR COMPLEX DEFECT OF LOWER LEG AND FOOT RECONSTRUCTION

2020 ◽  
pp. 85-91
Author(s):  
Phuc Le Hong ◽  
Son Tran Thiet ◽  
Thuy Nguyen Xuan
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Free Flap ◽  
Donor Site ◽  
Lower Extremities ◽  
Lower Leg ◽  
Donor Site Morbidity ◽  
Thigh Circumference ◽  
Anterolateral Thigh

Background: In recent years, the composite anterolateral thigh free flap with tensor fasciae latae or vastus lateralis has been a new-applied type of flap that can provide very good reconstruction materials in complex defects of lower leg and foot. The study purpose is to evaluate the systematically complications of donor site, related factors to results of the donor area, in order to apply the result to improve the treatment, which have not been much reported in literature. Materials and Methods: Systematic donor site morbilidy evaluation in a prospective, uncontrolled clinical descriptive study of 33 composite anterolateral thigh free flaps in various forms to reconstruct anatomical structures or to resconstruct deep defects combined with covering the surfaces for complex soft tissue defects in lower extremities for 32 patients due to different causes in lower leg and foot area from 2014-2019 at Hue University of Medicine and Pharmacy. Examining and evaluating aesthetic and functional result of donor-site 3 months and 6 months up to 2 year after surgery; evaluating the correlation between the width and the type of the flaps and donor site closure methods. Result: In 33 composite flaps used, flap width to thigh circumference less than 20% in 27 cases (81.8%), more than 20% in 6 cases (18.20% ); There were 28 cases in which the donor site was directly closed, 5 cases required skin graft; All direct closed cases had flap width/ thigh circumference index below 20%; On the contrary, in cases having this index greater than 20%, the donor site required skin graft with p < 0.01. There are 11/33 (33.33%) of cases reported complications in donor site ; lateral thigh paresthesia is the most complicated complication with 8/33 cases (24.24%), followed by bad scarring 3/33 cases (9.09%). Conclusion: Long term follow up donor site morbility after composite anterior thigh free flap present 11/33 cases (33.33%): mostly complications of the donor site are thigh paresthesia with 8/33 cases (24.24%), and bad scarring 3/33 cases (9,09%), which improve time by time. Keywords: Composite anterior thigh free flap, lower extremities soft tissue defect, donor site morbidity

Assessing the Influence of Failed Implant Reconstruction on Patient Satisfaction and Decision Regret after Salvage Free-Flap Breast Reconstruction

2021 ◽  
Author(s):  
Ronnie L. Shammas ◽  
Amanda R. Sergesketter ◽  
Mahsa Taskindoust ◽  
Sonali Biswas ◽  
Scott T. Hollenbeck ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Breast Reconstruction ◽  
Free Flap ◽  
Well Being ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Decision Regret ◽  
History Of ◽  
Implant Reconstruction

Abstract Background Free-flap breast reconstruction after failed implant reconstruction is associated with improved patient outcomes. How the level of satisfaction achieved compares between patients with and without previously failed implant reconstruction remains unknown. The aim of this study was to assess the influence of prior failed implant-based reconstruction on long-term patient-reported outcomes after free-flap breast reconstruction. Methods All patients undergoing free-flap breast reconstruction between 2015 and 2019 were identified. Patient satisfaction using the BREAST-Q and decisional regret using the Decision Regret Scale were compared between patients with and without a history of implant breast reconstruction. Results Overall, 207 patients were contacted and 131 completed the BREAST-Q and Decision Regret Scale. A total of 23 patients had a history of failed implant-based reconstruction requiring free-flap-flap salvage, most commonly due to infection (39.1%), chronic pain (34.8%), capsular contracture (26%), and implant malposition (26.1%). Following definitive free-flap reconstruction, patients with prior failed implant reconstruction had significantly lower BREAST-Q scores for satisfaction with breast (61.2 ± 16.7 vs. 70.4 ± 18.7; p = 0.04) and sexual well-being (38.5 ± 18.2 vs. 52.8 ± 24.7; p = 0.01) and reported higher decision regret (19.1 ± 18.6 vs. 9.6 ± 15.6, respectively). There were no significant differences for psychosocial well-being (p = 0.67), physical well-being (chest; p = 0.27), and physical well-being (abdomen; p = 0.91). Conclusion A history of failed implant-based reconstruction is associated with reduced satisfaction and increased decision regret with the final reconstructive outcome. This data underscores the importance of appropriate patient selection at the initial consultation, and informed preoperative counseling regarding long-term outcomes in patients presenting for free-flap reconstruction after a failed implant-based reconstruction.

DIEP and Muscle Sparing Breast Free Flap

2019 ◽  
pp. 781-794
Author(s):  
Maurice Y. Nahabedian
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Donor Site ◽  
The Other ◽  
No Donor ◽  
Technical Aspects ◽  
Body Habitus ◽  
Deep Inferior Epigastric Perforator ◽  
Muscle Sparing

The deep inferior epigastric perforator (DIEP) and muscle-sparing (MS) free transverse rectus abdominis musculocutaneous (TRAM) flaps are arguably the most common flaps used for autologous breast reconstruction. The benefit of these flaps is that very little to no donor site muscle is harvested. The decision to use one or the other is occasionally made preoperatively based on body habitus but often intraoperatively based on the quality of the perforating vessels. The technical aspects of the operation are similar except for the actual dissection around the perforating vessels. Studies have demonstrated no significant differences in outcome when comparing the DIEP and MS free TRAM flaps.

Comprehensive Analysis of Donor-Site Morbidity in Abdominally Based Free Flap Breast Reconstruction

2013 ◽  
Vol 132 (6) ◽  
pp. 1383-1391 ◽  
Author(s):  
Edward I. Chang ◽  
Eric I. Chang ◽  
Miguel A. Soto-Miranda ◽  
Hong Zhang ◽  
Naveed Nosrati ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Comprehensive Analysis

scholarly journals Long-term evaluation of autologous lamellar corneal grafts for the treatment of deep corneal ulcer in four dogs: a case report

2019 ◽  
Vol 64 (No. 02) ◽  
pp. 84-91
Author(s):  
SY Kim ◽  
JY Kim ◽  
SW Jeong
Keyword(s):  
Case Report ◽  
Corneal Ulcer ◽  
Donor Site ◽  
Ultrasound Biomicroscopy ◽  
Corneal Graft ◽  
Corneal Ulcers ◽  
Term Evaluation ◽  
The Aesthetic

Autologous lamellar corneal grafts were performed on four dogs with two deep corneal ulcers and two corneal perforations to achieve better visual and aesthetic outcomes. The donor corneal graft was harvested from the relatively normal corneal region of the affected eye and used to cover the corneal defect. At the two-year follow-up examination, ultrasound biomicroscopy was performed to confirm the thickness and endothelial continuity of the transplanted grafts and donor site of the cornea. The evaluations revealed that the dogs had healed without incident and that their vision had been maintained. Furthermore, the owners were satisfied with the aesthetic outcomes in all cases. Our findings show that autologous lamellar corneal grafts are useful and effective in treating canine corneal ulcers and perforations.

Predicting and Managing Donor-Site Wound Complications in Abdominally Based Free Flap Breast Reconstruction

2015 ◽  
Vol 135 (1) ◽  
pp. 14-23 ◽  
Author(s):  
Michael N. Mirzabeigi ◽  
Anthony J. Wilson ◽  
John P. Fischer ◽  
Marten Basta ◽  
Suhail Kanchwala ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Donor Site ◽  
Wound Complications

The proximal first dorsal metacarpal artery free flap for reconstruction of complex digital defects

2012 ◽  
Vol 38 (4) ◽  
pp. 399-404 ◽  
Author(s):  
P. Hyza ◽  
T. Kubek ◽  
J. Vesely ◽  
L. Drazan ◽  
U. Choudry
Keyword(s):  
Patient Satisfaction ◽  
Surgical Technique ◽  
Free Flap ◽  
Primary Closure ◽  
Donor Site ◽  
Free Flaps ◽  
Outcome Data ◽  
Patient Demographics ◽  
Dorsal Metacarpal Artery ◽  
First Dorsal Metacarpal Artery

We describe our experience and outcome with the ‘Proximal first dorsal metacarpal artery free flap’. Ten consecutive cases utilizing the proximal first dorsal metacarpal artery free flap for complex digital defects were studied. Surgical technique, patient demographics, and flap outcome data were collected. Patient satisfaction was analysed using a questionnaire. All defects healed successfully with no loss of free flaps. The short-pedicle proximal first dorsal metacarpal artery free flap enables primary closure of the donor site up to 2 cm of width (in nine of the ten donor sites). The flap is a reliable and versatile alternative in selected cases of complex digital injuries.

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