Donor site morbidity of free jejunal flap reconstruction of the oropharyngeal cavity

1999 ◽  
Vol 22 (8) ◽  
pp. 376-378 ◽  
Author(s):  
J. Zacherl ◽  
K. Wild ◽  
G. V. Nehrer-Tairych ◽  
M. Öckher ◽  
T. Rath ◽  
...  
2021 ◽  
pp. 000313482110111
Author(s):  
Olivia M. DeLozier ◽  
Zachary E. Stiles ◽  
David Shibata ◽  
Jeremiah L. Deneve ◽  
Justin Monroe ◽  
...  

Background Gracilis flap reconstruction (GFR) following abdominoperineal resection (APR) or proctocolectomy (PC) can reduce pelvic wound complications but has not been adequately assessed in the setting of immunosuppression, fistulous disease, and neoadjuvant chemoradiation. Methods Patients undergoing APR/PC with GFR were retrospectively analyzed with regard to perioperative characteristics, and morbidity was assessed. Results Patients underwent GFR for rectal cancer ( n = 28), anal cancer ( n = 3), inflammatory bowel disease ( n = 13), or benign fistulizing disease ( n = 1). 22.2% were chronically immunosuppressed, and 66.7% underwent preoperative chemoradiation. Twenty (44.4%) patients had minor wound complications, all treated nonoperatively. Nine patients had major complications with 4 patients requiring reoperation. The 4 threatened flaps were unilateral, and all were salvaged. Donor site morbidity was minimal. Patients with major complications were older (56 vs. 71 years, P = .030), and less likely to have pelvic drains ( P = .018). Conclusion In high-risk perineal wounds, GFR offers durable reconstruction with acceptably low morbidity.


2015 ◽  
Vol 135 (1) ◽  
pp. 226e-227e ◽  
Author(s):  
Jon Peter Ver Halen ◽  
Nathan Stoikes ◽  
David Webb ◽  
Ben Powell ◽  
Guy Voeller

2020 ◽  
Vol 45 (1) ◽  
pp. 132-140
Author(s):  
Vera S. Schellerer ◽  
Lenka Bartholomé ◽  
Melanie C. Langheinrich ◽  
Robert Grützmann ◽  
Raymund E. Horch ◽  
...  

Abstract Background Management of donor site closure after harvesting a vertical rectus abdominis myocutaneous (VRAM) flap is discussed heterogeneously in the literature. We aim to analyze the postoperative complications of the donor site depending on the closure technique. Methods During a 12-year period (2003–2015), 192 patients in our department received transpelvic VRAM flap reconstruction. Prospectively collected data were analyzed retrospectively. Results 182 patients received a VRAM flap reconstruction for malignant, 10 patients for benign disease. The median age of patients was 62 years. 117 patients (61%) received a reconstruction of donor site by Vypro® mesh, 46 patients (24%) by Vicryl® mesh, 23 patients (12%) by direct closure and 6 patients (3%) by combination of different meshes. 32 patients (17%) developed in total 34 postoperative complications at the donor site. 22 complications (11%) were treated conservatively, 12 (6%) surgically. 17 patients (9%) developed incisional hernia during follow-up, with highest incidence in the Vicryl® group (n = 8; 17%) and lowest in the Vypro® group (n = 7; 6%). Postoperative parastomal hernias were found in 30 patients (16%) including three patients with simultaneous hernia around an urostomy and a colostomy. The highest incidence of parastomal hernia was found in patients receiving primary closure of the donor site (n = 6; 26%), the lowest incidence in the Vypro® group (n = 16; 14%). Conclusion The use of Vypro® mesh for donor site closure appears to be associated with a low postoperative incidence of complications and can therefore be recommended as a preferred technique.


2013 ◽  
Vol 39 (5) ◽  
pp. 499-504 ◽  
Author(s):  
R. M. Fakin ◽  
A. Biraima ◽  
H. Klein ◽  
P. Giovanoli ◽  
M. Calcagni

Fingertip injuries often result in fingernail defects. Reconstruction of this structure is important for adequate functional and aesthetic results. This study evaluates the eponychial flap reconstruction technique in 45 fingertip amputations with loss of more than half the fingernail. In 33 cases the procedure was performed in combination with a palmar island flap for pulp reconstruction. Average follow up was 5 months. All eponychial flaps healed uneventfully. In 44 cases, the pulp volume was restored without nail growth disturbance. Five complications (9%) were observed (pain, soft nail, and nail deformity). Only one hook nail deformity required reoperation. All patients were satisfied with the aesthetic and functional outcome. We found eponychial flap fingernail reconstruction effective even for injuries proximal to the lunula and have extended the indication for this technique to very proximal fingernail defects. Eponychial flap reconstruction is a simple, safe, and time-effective technique without donor site morbidity. Simultaneous reconstruction of dorsal and palmar injuries should both be performed primarily resulting in the restoration of a satisfying fingertip.


2014 ◽  
Vol 30 (08) ◽  
pp. 515-522 ◽  
Author(s):  
Miguel Medina ◽  
Harry Salinas ◽  
Kyle Eberlin ◽  
Daniel Driscoll ◽  
John Kwon ◽  
...  

Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 621-626 ◽  
Author(s):  
Hyuma A. Leland ◽  
Beina Azadgoli ◽  
Daniel J. Gould ◽  
Mitchel Seruya

Background: The purpose of this study was to systematically review outcomes following intercostal nerve (ICN) transfer for restoration of elbow flexion, with a focus on identifying the optimal number of nerve transfers. Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify studies describing ICN transfers to the musculocutaneous nerve (MCN) for traumatic brachial plexus injuries in patients 16 years or older. Demographics were recorded, including age, time to operation, and level of brachial plexus injury. Muscle strength was scored based upon the British Medical Research Council scale. Results: Twelve studies met inclusion criteria for a total of 196 patients. Either 2 (n = 113), 3 (n = 69), or 4 (n = 11) ICNs were transferred to the MCN in each patient. The groups were similar with regard to patient demographics. Elbow flexion ≥M3 was achieved in 71.3% (95% confidence interval [CI], 61.1%-79.7%) of patients with 2 ICNs, 67.7% (95% CI, 55.3%-78.0%) of patients with 3 ICNs, and 77.0% (95% CI, 44.9%-93.2%) of patients with 4 ICNs ( P = .79). Elbow flexion ≥M4 was achieved in 51.1% (95% CI, 37.4%-64.6%) of patients with 2 ICNs, 42.1% (95% CI, 29.5%-55.9%) of patients with 3 ICNs, and 48.4% (95% CI, 19.2%-78.8%) of patients with 4 ICNs ( P = .66). Conclusions: Previous reports have described 2.5 times increased morbidity with each additional ICN harvest. Based on the equivalent strength of elbow flexion irrespective of the number of nerves transferred, 2 ICNs are recommended to the MCN to avoid further donor-site morbidity.


Sign in / Sign up

Export Citation Format

Share Document