scholarly journals Volar Resurfacing of the Thumb with a Superficial Circumflex Iliac Artery Perforator Flap after Hydrofluoric Acid Burn

2018 ◽  
Vol 10 (03) ◽  
pp. 162-165 ◽  
Author(s):  
Johanna Riesel ◽  
Aviram Giladi ◽  
Matthew Iorio
Keyword(s):  
Soft Tissue ◽  
Iliac Artery ◽  
Hydrofluoric Acid ◽  
Tissue Injury ◽  
Donor Site ◽  
Soft Tissue Injury ◽  
Perforator Flap ◽  
Metacarpophalangeal Joint ◽  
Donor Site Morbidity ◽  
Artery Perforator

AbstractA right-hand-dominant 55-year-old male automotive mechanic presented 24 hours following a hydrofluoric acid burn to the volar left thumb. Despite the severity of soft tissue injury, the neurovascular bundles were intact. Although a free toe-pulp flap is often described to cover volar digit defects, the resultant 6- × 4-cm full-thickness injury of the thumb was too large to be adequately covered by a toe-pulp flap or other commonly used local flaps from the ipsilateral hand. The authors used a superficial circumflex iliac artery perforator (SCIP) flap to reconstruct the volar surface of the thumb from the tip to the metacarpophalangeal joint. They used an arterial anastomosis with the princeps pollicis artery so that the anastomosis was well outside the zone of injury. The patient recovered from the procedure without event and was discharged home on postoperative day 5. At his 2-week postoperative visit, protective sensation with diminished light touch was intact. The authors conclude that the SCIP flap is a technically challenging but versatile, thin flap with minimal donor site morbidity that can be used to resurface the volar aspect of the thumb. The SCIP flap is a valuable resource for the hand surgeon confronted with larger soft tissue defects of the hand.

scholarly journals Do-It-Yourself Preoperative High-Resolution Ultrasound-Guided Flap Design of the Superficial Circumflex Iliac Artery Perforator Flap (SCIP)

2021 ◽  
Vol 10 (11) ◽  
pp. 2427
Author(s):  
Daniel Schiltz ◽  
Jasmin Lenhard ◽  
Silvan Klein ◽  
Alexandra Anker ◽  
Daniel Lonic ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Duplex Sonography ◽  
Flap Design ◽  
Do It Yourself ◽  
Tissue Flap ◽  
Simplified Procedure ◽  
Artery Perforator

The superficial circumflex iliac artery perforator (SCIP) flap is a well-documented, thin, free tissue flap with a minimal donor site morbidity, and has the potential to become the new method for resurfacing moderate-size skin defects. The aim of this study is to describe an easy, reliable, systematic, and standardized approach for preoperative SCIP flap design and perforator characterization, using color-coded duplex sonography (CCDS). A list of customized settings and a straightforward algorithm are presented, which are easily applied by an operator with minimal experience. Specific settings for SCIP flap perforator evaluation were investigated and tested on 12 patients. Deep and superficial superficial circumflex iliac artery (SCIA) branches, along with their corresponding perforators and cutaneous veins, were marked individually with a permanent marker and the anatomy was verified intraoperatively. From this, a simplified procedure for preoperative flap design of the SCIP flap was developed. Branches could be localized and evaluated in all patients. A preoperative structured procedure for ultrasonically guided flap design of the SCIP flap is described. A 100% correlation between the number and emergence points of the branches detected by preoperative CCDS mapping and the intraoperative anatomy was found.

scholarly journals Most British Surgeons Would Consider Using a Tissue-Engineered Anterior Cruciate Ligament: A Questionnaire Study

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Sarah Rathbone ◽  
Nicola Maffulli ◽  
Sarah H. Cartmell
Keyword(s):  
Anterior Cruciate Ligament ◽  
Mechanical Performance ◽  
Tissue Injury ◽  
Cruciate Ligament ◽  
Donor Site ◽  
Soft Tissue Injury ◽  
Donor Site Morbidity ◽  
Online Questionnaire ◽  
Common Problems ◽  
Anterior Cruciate

Donor site morbidity, poor graft site integration, and incorrect mechanical performance are all common problems associated with autografts for anterior cruciate ligament (ACL) reconstructions. A tissue-engineered (TE) ligament has the potential to overcome these problems. We produced an online questionnaire relating to tissue engineering of the ACL to obtain input from practising clinicians who currently manage these injuries. 300 British orthopaedic surgeons specialising in knee surgery and soft tissue injury were invited to participate. 86% of surgeons would consider using a TE ACL if it were an option, provided that it showed biological and mechanical success, if it significantly improved the patient satisfaction (63%) or shortened surgical time (62%). 76% felt that using a TE ACL would be more appropriate than a patellar tendon, hamstring, or quadriceps autograft. Overall, most surgeons would be prepared to use a TE ACL if it were an improvement over the current techniques.

Use of Indocyanine Green Imaging for Perforator Identification in Preexpanded Brachial Artery Perforator Flaps

2020 ◽  
Vol 36 (05) ◽  
pp. 650-658
Author(s):  
Tinglu Han ◽  
Nima Khavanin ◽  
Mengqing Zang ◽  
Shan Zhu ◽  
Bo Chen ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Head And Neck ◽  
Brachial Artery ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Icg Angiography ◽  
Flap Design ◽  
Flap Elevation ◽  
Artery Perforator

AbstractThe tissues of the medial arm as a donor site for perforator flap design have several advantages. However, they are relatively underused with limited reports, partly due to unreliable perforator anatomy. Therefore, we aimed to review our preliminary experience using indocyanine green (ICG) angiography to design and elevate preexpanded pedicled brachial artery perforator (BAP) flaps for regional reconstruction. All patients underwent soft tissue reconstructions using a preexpanded BAP flap in two or three stages. ICG angiography was used to localize perforators during both expander insertion and flap elevation. The pedicle was divided at the third stage 3 weeks following flap elevation for head and neck cases. Sixteen patients underwent reconstructions of the head and neck (n = 13) or shoulder/trunk (n = 3) using 14 perforator-plus and 2 propeller BAP flaps. In total, 50 perforators were identified using ICG imaging, all of which were appreciable during both expander placement and flap elevation. Thirty-five perforators were directly visualized during flap elevation, and an additional 15 perforators were not explored but incorporated into the flap. All flaps survived without necrosis, and the donor sites healed uneventfully without complications. The medial arm provides thin and pliable skin for the resurfacing of regional defects with relatively minimal donor-site morbidity. With the assistance of ICG angiography, perforators of the brachial artery can be reliably identified, facilitating the preexpansion and elevation of pedicled BAP flaps for use in head–neck and trunk reconstruction.

Minimally invasive soft tissue reconstruction with free peroneal artery perforator flap

2016 ◽  
Vol 2 (8) ◽  
Author(s):  
Kenji Kawamura ◽  
Hiroshi Yajima ◽  
Shohei Omokawa ◽  
Takamasa Shimizu ◽  
Naoki Maegawa ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Donor Site ◽  
Perforator Flap ◽  
Peroneal Artery ◽  
Soft Tissue Reconstruction ◽  
Perforator Flaps ◽  
Major Vessel ◽  
Tissue Reconstruction ◽  
Artery Perforator

<p> </p><p><span style="font-family: Times New Roman;"> The development of a concept of perforator flap has dramatically changed the soft tissue reconstructive surgery. The surgery with perforator flaps enables to minimize donor-site morbidity by preserving important tissues including the muscle and the major vessel. The peroneal artery perforator flap is one of perforator flaps that can be harvested from the lower leg. The peroneal artery perforator flap has been widely used as a local flap for soft tissue reconstruction in the lower extremity; however, the free peroneal artery perforator flap transfer has been little reported. Utilities of the free peroneal artery perforator flap for soft tissue reconstruction of the extremities are reported, and minimally invasive flap surgery with perforator flaps is reviewed.</span></p><p> </p>

Time and Speed of Vascular Pedicle Dissection in Deep Inferior Epigastric Artery Perforator Flap Elevation

2017 ◽  
Vol 33 (08) ◽  
pp. 557-562
Author(s):  
Ji Yim ◽  
Yeon Lee ◽  
Young Kim ◽  
Eun Kim ◽  
Taik Lee ◽  
...  
Keyword(s):  
Free Flap ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Vascular Pedicle ◽  
Inferior Epigastric Artery ◽  
Epigastric Artery ◽  
Deep Inferior Epigastric Artery ◽  
Time Required ◽  
Artery Perforator

Background Breast reconstruction using deep inferior epigastric artery perforator (DIEP) free flap is widely used because of the advantages of minimizing donor-site morbidity, but it requires technical competency in vascular dissection. This study evaluated the influence of patient factors and vascular status on the time and speed of dissection of the vascular pedicle. Methods DIEP free flap procedures were performed in 49 patients assigned to immediate or delayed reconstruction groups. Factors that significantly influenced the time required and the speed of dissection were evaluated. Results The average total dissection time was 55.9 minutes (34.5 minutes for the intramuscular dissection and 21.4 minutes for the submuscular dissection). The dissection speed for the total vascular pedicle was 2.65 cm/10 minutes (1.71 cm/10 minutes for the intramuscular dissection and 4.30 cm/10 minutes for the submuscular dissection). The presence of a Pfannenstiel scar, length of the vascular pedicle in the intramuscular area, and the number of microclips used significantly correlated with the total dissection time. Conclusion The length of the intramuscular pedicle, number of microclips used, and presence of a Pfannenstiel scar significantly correlated with the total dissection time of the vascular pedicle. An assessment prior to the surgery can reduce the time of operation and make it easier to elevate the flap.

scholarly journals Our early experience in immediate total breast reconstruction with deep inferior epigastric artery perforator flap

2019 ◽  
Vol 6 (12) ◽  
pp. 4444
Author(s):  
Thyagaraj . ◽  
Ashrith Iyanahally ◽  
B. G. Tilak ◽  
M. E. Sham ◽  
Ganesh .
Keyword(s):  
Donor Site ◽  
Perforator Flap ◽  
Breast Cancer Diagnosis ◽  
Donor Site Morbidity ◽  
Diep Flap ◽  
Inferior Epigastric Artery ◽  
Aesthetic Result ◽  
Epigastric Artery ◽  
Deep Inferior Epigastric Artery ◽  
Artery Perforator

Background: As the breast cancer diagnosis has increased over recent years, patient have become more informative regarding treatment and reconstructive options, hence the expectation of the results will be very high. Reconstruction of breast with best result and less donor site morbidity is the target.Methods: A total of 20 cases were studied between January 2018 to January 2019 at our hospital to assess the outcome of deep inferior epigastric artery perforator (DIEP) flap for immediate breast reconstruction.Results: A total of twenty DIEP flaps were performed. Mean time required for flap harvest was 125 minutes, and time taken for flap inset was 110 minutes. There was no flap loss in any of the twenty cases. Two patients had fat necrosis. All patients were satisfied with aesthetic outcome.Conclusions: DIEP flap has good aesthetic result with less donor site morbidity.

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