Cost and Outcome of Osteocutaneous Free-Tissue Transfer versus Pedicled Soft-Tissue Reconstruction for Composite Mandibular Defects

1996 ◽  
Vol 97 (6) ◽  
pp. 1167-1178 ◽  
Author(s):  
Andres Talesnik ◽  
Bernard Markowitz ◽  
Thomas Calcaterra ◽  
Christina Ahn ◽  
William Shaw
Keyword(s):  
Soft Tissue ◽  
Free Tissue Transfer ◽  
Soft Tissue Reconstruction ◽  
Tissue Transfer ◽  
Tissue Reconstruction

scholarly journals Maximizing Outcomes While Minimizing Morbidity: An Illustrated Case Review of Elbow Soft Tissue Reconstruction

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Adrian Ooi ◽  
Jonathan Ng ◽  
Christopher Chui ◽  
Terence Goh ◽  
Bien Keem Tan
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
Free Tissue Transfer ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Flap Reconstruction ◽  
Case Review ◽  
Tissue Transfer ◽  
Tissue Reconstruction ◽  
Elbow Reconstruction

Background. Injuries to the elbow have led to consequences varying from significant limitation in function to loss of the entire upper limb. Soft tissue reconstruction with durable and pliable coverage balanced with the ability to mobilize the joint early to optimize rehabilitation outcomes is paramount. Methods. Methods of flap reconstruction have evolved from local and pedicled flaps to perforator-based flaps and free tissue transfer. Here we performed a review of 20 patients who have undergone flap reconstruction of the elbow at our institution. Discussion. 20 consecutive patients were identified and included in this study. Flap types include local (n=5), regional pedicled (n=7), and free (n=8) flaps. The average size of defect was 138 cm2 (range 36–420 cm2). There were no flap failures in our series, and, at follow-up, the average range of movement of elbow flexion was 100°. Results. While the pedicled latissimus dorsi flap is the workhorse for elbow soft tissue coverage, advancements in microvascular knowledge and surgery have brought about great benefit, with the use of perforator flaps and free tissue transfer for wound coverage. Conclusion. We present here our case series on elbow reconstruction and an abbreviated algorithm on flap choice, highlighting our decision making process in the selection of safe flap choice for soft tissue elbow reconstruction.

Combined Single-Stage Osseous and Soft Tissue Reconstruction of the Tibia With the Ilizarov Method and Tissue Transfer

2008 ◽  
Vol 22 (3) ◽  
pp. 183-189 ◽  
Author(s):  
Michael D McKee ◽  
Daniel J Yoo ◽  
Rad Zdero ◽  
Marc Dupere ◽  
Lisa Wild ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Single Stage ◽  
Ilizarov Method ◽  
Soft Tissue Reconstruction ◽  
Tissue Transfer ◽  
Tissue Reconstruction

Free Tissue Transfer of the Rectus Abdominis Myoperitoneal Flap for Oral Reconstruction in a Dog

2001 ◽  
Vol 18 (4) ◽  
pp. 187-192 ◽  
Author(s):  
Otto I. Lanz
Keyword(s):  
Surgical Techniques ◽  
Free Tissue Transfer ◽  
Rectus Abdominis ◽  
Soft Tissue Reconstruction ◽  
Intact Male ◽  
Oronasal Fistula ◽  
Primary Wound Closure ◽  
Tissue Transfer ◽  
Tissue Reconstruction ◽  
Oral Reconstruction

A five-month-old intact/male Boxer dog was presented 5-days following bite wound trauma to the maxillary region resulting in an oronasal fistula extending from the maxillary canine teeth to the soft palate. Multiple surgical procedures using local, buccal mucosal flaps failed to repair the oronasal fistula. Free tissue transfer of the rectus abdominis myoperitoneal flap using microvascular surgical techniques was successful in providing soft tissue reconstruction of the hard palate area. Complications of these surgical techniques included muscle contraction and subsequent muzzle distortion. Small, refractory oronasal fistulae at the perimeter of the myoperitoneal flap were repaired by primary wound closure.

Occlusion and Functional Outcomes after Complete Temporomandibular Joint Resection with Soft Tissue Reconstruction

2020 ◽  
Vol 162 (4) ◽  
pp. 589-592
Author(s):  
Jake J. Lee ◽  
Daniel P. Lander ◽  
Ryan S. Jackson ◽  
Joseph Zenga ◽  
Patrik Pipkorn
Keyword(s):  
Soft Tissue ◽  
Temporomandibular Joint ◽  
Functional Outcomes ◽  
Free Tissue Transfer ◽  
Feeding Tube ◽  
Soft Tissue Reconstruction ◽  
Intermaxillary Fixation ◽  
Occlusal Contact ◽  
Tissue Reconstruction ◽  
Interincisor Distance

Reconstructive outcomes after complete temporomandibular joint (TMJ) resection, including the condyle and glenoid fossa bone, are poorly defined in the literature. We described our technique and reviewed occlusion and functional outcomes of 6 consecutive patients undergoing complete TMJ resection and reconstruction with anterolateral thigh free tissue transfer and intermaxillary fixation with elastic bands for 6 to 8 weeks. At median follow-up of 14 months, median Mandibular Function Impairment Questionnaire score was 32 (range, 4-38), indicating mild to moderate impairment. Subjective occlusion was normal in 4 of 6 patients. Premature occlusal contact was seen in 2 of 6 patients. Maximal interincisor distance and horizontal mandibular shift with jaw abduction ranged from 29 to 40 mm and 5 to 8 mm, respectively. Four of 6 tolerated regular diets while 2 adhered to mechanical soft diets; no patients were feeding tube dependent. Soft tissue–only reconstruction after complete TMJ resection resulted in good subjective and objective occlusion in 4 of 6 patients and no cases of severe functional impairment.

Neurotized Free Tissue Transfer for Foot Reconstruction: A Systematic Review

2019 ◽  
Vol 36 (01) ◽  
pp. 032-040 ◽  
Author(s):  
Jacob R. Rinkinen ◽  
Shawn Diamond ◽  
Jonathan Lans ◽  
Curtis L. Cetrulo ◽  
Kyle R. Eberlin
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Activities Of Daily Living ◽  
Free Flap ◽  
Daily Living ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Ulcer Formation ◽  
Soft Tissue Reconstruction ◽  
Tissue Transfer

Background Soft tissue reconstruction of the foot represents a complex reconstructive challenge given the unique anatomical properties of the glabrous plantar skin. For large soft tissue defects and/or complex injuries, free tissue transfer is often the optimal reconstructive modality. The decision to pursue a neurotized free flap remains controversial and an area of debate. Given the trend toward increasing use of neurotized free flaps, we performed a systematic review to determine if nerve coaptation is a beneficial adjunct to free tissue transfer. Methods A systematic search of the English literature using PubMed and Web of Science was performed. Studies were identified between 1985 and 2018. Manuscripts were eligible if they contained original clinical outcomes research of patients who underwent free tissue transfer to the foot or heel with neurotization. Results A total of 189 studies were identified with initial screening and 19 studies were included in our analysis. A total of 175 patients underwent free flap reconstruction to the foot; of these, 107 patients had a nerve coaptation performed. Patients who underwent neurotization had improved sensory characteristics (two-point discrimination, light touch, and pain sensation), quicker return to ambulation and activities of daily living, and decreased ulcer formation compared with those who did not. Overall complications were infrequent, with ulceration being the most common. Conclusion Neurotized free flaps appear to have an overall decreased rate of ulceration, improved sensory discrimination, and quicker return to ambulation/activities of daily living in comparison to nonneurotized free flaps. However, when examining free anterolateral thigh (ALT) and free medial plantar artery (MPA) fasciocutaneous flaps, durability (i.e., frequency of ulcer formation) and functionality (ambulation and return to activities of daily living) do not appear to be significantly different between neurotized and nonneurotized flaps.

scholarly journals Contemporary reconstruction after complex facial trauma

2020 ◽  
Vol 8 ◽  
Author(s):  
Matthew R Zeiderman ◽  
Lee L Q Pu
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
Free Tissue Transfer ◽  
Facial Trauma ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Reconstruction Process ◽  
Optimal Outcomes ◽  
Reconstructive Process ◽  
Tissue Reconstruction

Abstract Complex facial trauma requires complex repair and solutions. This process is challenging for the surgeon who seeks to manage the expectations of the patient and family while achieving the best possible result. Historically, the use of pedicled flaps, and then free tissue transfer, were the primary techniques utilized. Advancements in soft-tissue reconstruction, such as perforator flaps and pre-expanded and prefabricated flaps, allow refinement of the soft-tissue reconstruction process to create the best initial soft-tissue coverage. The advent of contemporary technologies, such as virtual surgical planning, stereolithography and customized implants and plates, facilitates a tailored approach to the patient’s reconstructive needs for precise bony reconstruction. When surgical and technological techniques are combined in complementary multistage reconstructions, better reconstructive and aesthetic outcomes are achievable than ever before. In this review, the authors present a summary of the management of complex facial trauma based on the senior author’s broad experience. Initial management and contemporary reconstructive techniques and technology to provide optimal outcomes are reviewed. A case series of complex facial traumas and their reconstructive process is also presented to demonstrate how complementary staged procedures can yield an optimal result. We believe the reconstructive surgeon managing complex facial trauma should strive to incorporate contemporary technologies and techniques into their armamentarium to provide the best patient care.

Indications for immediate tissue transfer for soft tissue reconstruction in visceral pelvic surgery

Surgery ◽  
2001 ◽  
Vol 130 (3) ◽  
pp. 463-469 ◽  
Author(s):  
Andrew K.M. Khoo ◽  
John M. Skibber ◽  
Ayman Sameh Nabawi ◽  
Ali Gurlek ◽  
Adel A. Youssef ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Pelvic Surgery ◽  
Soft Tissue Reconstruction ◽  
Tissue Transfer ◽  
Tissue Reconstruction

Pediatric Microsurgery in the Reconstruction of Complex Posttraumatic Foot and Ankle Defects: A Long-Term Follow-Up with a Comprehensive Review of the Literature

2020 ◽  
Author(s):  
Amr Elbatawy ◽  
Mohammed Elgammal ◽  
Tarek Zayid ◽  
Abdelnaser Hamdy ◽  
Mohamed Osama Ouf ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Adult Population ◽  
Free Tissue Transfer ◽  
Anterior Tibial Artery ◽  
Soft Tissue Reconstruction ◽  
Complication Rates ◽  
Foot And Ankle ◽  
Review Of The Literature ◽  
Tissue Transfer

Abstract Background Lower limb reconstruction is a well-recognized challenge to the trauma or plastic surgeon. Although techniques and outcomes in the adult population are well documented, they are less so in the pediatric population. Here, we present our experience in the management of posttraumatic foot and ankle defects with free tissue transfer in children. Methods We performed a retrospective analysis of 40 pediatric patients between the ages of 3 and 16 from 2008 to 2016 who underwent foot and ankle soft tissue reconstruction. Any patient who underwent reconstruction for any reason other than trauma was excluded. Data were collected on operative time, free tissue transfer type, use of vein grafts, length of hospital stay, and postoperative morbidity. Also, a comprehensive systematic literature review was completed according to the PRISMA protocol for all previous reports of foot and ankle reconstruction in the young age group with free tissue transfer. Results Of our 40 patients, 23 were males and 12 females, free tissue transfer was used to reconstruct primarily the dorsum (71%), heel (11%), medial (9%), and lateral (3%) aspect of the foot. The anterior tibial artery was the predominant recipient vessel for anastomosis (77%). Mean inpatient stay was 9 days and our complication rate was 20%, primarily of superficial infection treated with antibiotic therapy. The review of the literature articles is completely analyzed in detail. Conclusion The need for durable coverage of exposed joints, tendons, fractures, or hardware makes the free flap particularly well suited to trauma reconstruction of the foot and ankle. The lack of underlying vascular disease in this patient group allows for low complication rates. Our study evidences the safety and positive long-term outcomes of free tissue transfer for the reconstruction of huge sized-soft tissue defects of the foot and ankle in children.

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