scholarly journals Pedicled Cervical Lymphoadipose Tissue for Volume Reconstruction after Superficial Parotidectomy

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Kyle P. Davis ◽  
Amy L. Fraser ◽  
Elizabeth O. Shay ◽  
Michael W. Sim
Keyword(s):  
Donor Site ◽  
Muscle Flap ◽  
Free Flaps ◽  
Fat Grafting ◽  
Fat Graft ◽  
Superficial Parotidectomy ◽  
Pedicled Flaps ◽  
Facial Contour ◽  
Reconstructive Option ◽  
Level I

Volume restoration is often required after parotidectomy due to the resultant facial contour deformity. Common procedures include local pedicled flaps, such as the sternocleidomastoid muscle flap, fat grafting, and even autologous free flaps, for more extensive defects. Local pedicled flaps have the advantage of a single surgical site, which spares the patient the added morbidity of a separate fat graft donor site, while simultaneously reducing the operative time. We report two cases of a novel reconstructive option using pedicled level I and II cervical lymphoadipose tissue for volume restoration after superficial parotidectomy. This reconstruction would be useful for patients with benign parotid lesions and inferior parotid defects. In addition, with maintained blood supply to this tissue, it would likely provide sustained bulk over time.

scholarly journals Fat graft – the natural choice for reconstructive, regenerative and aesthetic surgery

2017 ◽  
Vol 5 (2) ◽  
pp. 113-117
Author(s):  
Samir Ibrahim ◽  
Joanna Rybacka-Mossakowska ◽  
Sławomir Michalak
Keyword(s):  
Stem Cells ◽  
Donor Site ◽  
Aesthetic Surgery ◽  
Fat Grafting ◽  
Fat Graft ◽  
Clinical Effects ◽  
Adipose Derived Stem Cells ◽  
Safe Alternative ◽  
Natural Choice ◽  
Reconstructive Operations

AbstractThe search for appropriate filler, which can be used for aesthetic and reconstructive operations is currently one of challenges for plastic surgery. The application of absorbable and permanent artificial fillers may cause adverse events. Thus, autologous fat grafting can be a safe alternative. Moreover, fat tissue is rich in adipose-derived stem cells (ASC), which can be successfully used for regenerative procedures. The paper reviews reports on fat grafting procedures, which indicate risks and their possible prophylactic.Adipose tissue is a much more prolific source of ASCs than bone marrow. Basically, ASC are characterized by a spectrum of markers: CD11b-CD45-CD13+CD73+CD90+, which can be widened by CD36+CD-106-CD10+CD26+CD49d+CD49e+CD3-D49f -PODXL- to improve phenotyping. It is suggested to use at least two negative markers and two positive markers during the same phenotyping analysis. Fat transfer requires appropriate approach, planning and technique to make it clinically successful.Fat grafting fulfills the expectations for ideal injectable agent, which can be used for aesthetic and reconstructive surgery. To improve the survival of fat graft, careful decisions on donor site, local anesthetic administration, liposuction method, processing and placement methods need to be made. Moreover, fat is the source of adipose-derived stem cells which can be used for regenerative procedures. A proper transformation and identification of those cells is required to improve clinical effects.

scholarly journals Bilateral Breast Reconstruction With Profunda Artery Perforator Flaps and Immediate Implant Augmentation

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Carrie K Chu ◽  
Michael DeFazio ◽  
Rene D Largo ◽  
Merrick Ross
Keyword(s):  
Breast Reconstruction ◽  
Brca2 Mutation ◽  
Donor Site ◽  
Free Flaps ◽  
Fat Grafting ◽  
Silicone Implants ◽  
Level Of Evidence ◽  
Immediate Reconstruction ◽  
Immediate Implant ◽  
Artery Perforator

Abstract The smaller volume of the profunda artery perforator (PAP) flap relative to that of abdominal flaps limits the size of breast reconstruction that may be achieved. Immediate implant augmentation of abdominal free flaps has been performed, but immediate implant augmentation of PAP flaps has never been described. A 54-year-old woman with BRCA2 mutation, submuscular implants, and previous abdominoplasty presented for nipple-sparing mastectomies (NSM). Autologous tissue volume was inadequate to support reconstruction to the desired size. She wished to avoid serial expansion. Skin quality was unsuitable for direct-to-implant reconstruction. The patient underwent bilateral NSM. The previous implants were removed with capsule preservation. Bilateral PAP flaps were harvested and anastomosed to the internal mammary vessels. Moderate classic profile 170-mL smooth round silicone implants were placed into the existing capsule pockets with lateral capsulorraphy. There were no flap, implant, or infectious complications. Initial mastectomy skin and nipple ischemia completely resolved without necrosis. Donor site healing was uneventful. At 8 months, the reconstruction is supple and the implants remain well-positioned without rippling. One minor revision was performed for fat grafting and to correct lateral nipple deviation. PAP flap breast reconstruction with immediate implant augmentation is technically feasible. Advantages include improved prosthetic coverage, allowing for immediate reconstruction to a larger size with reduced concern regarding mastectomy skin necrosis and threat to the device, optimal implant camouflage, and improved substrate for secondary fat grafting if necessary. Level of Evidence: 5

scholarly journals Arthroscopic Synovectomy Combined with Autologous Fat Grafting in Early Stages of CMC Osteoarthritis of the Thumb

2017 ◽  
Vol 07 (02) ◽  
pp. 165-171 ◽  
Author(s):  
Robert Kemper ◽  
Johanna Wirth ◽  
Eva-Maria Baur
Keyword(s):  
Early Stage ◽  
Donor Site ◽  
Fat Grafting ◽  
Fat Graft ◽  
Pinch Strength ◽  
Arthroscopic Synovectomy ◽  
No Donor ◽  
Autologous Fat ◽  
Autologous Fat Graft ◽  
Cmc Joint

Background Minimal invasive treatments such as arthroscopic techniques may be adequate to restore the anatomy and functional integrity of the thumb CMC (carpometacarpal) joint. In this paper, we reported the interposition of autologous fat tissue in combination with arthroscopic synovectomy/debridement for early stage of the thumb CMC joint osteoarthritis. Patients and Methods Twelve patients with a mean age of 46 years with early radiological stages of thumb CMC joint osteoarthritis were included. Evaluation of outcome was measured prior and 3, 12, and 24 months after surgery including, Visual Analog Scale (VAS), QuickDASH, grip and pinch strength, range of motion (ROM), and patient satisfaction. Results Pain at rest (or with load) was reduced from preoperative 4,7 (8,7) to 2 (5,9) at 3 to 6 months; 1,4 (4,3) at 12 months; and 0,75 (2,7) at 2 years after the surgery. Initial preoperative QuickDASH value of 52 points reduced to 33 (17–65) at 6 months, 23 (2–70) at 12 months, and 20 (11–29) at 24 months after the surgery. Grip strength and thumb pinch with respect to the contralateral untreated thumb was reduced in the first 12 months but recovered subsequently. ROM was equal to the contralateral thumb. Three patients suffered from tendinitis and required surgical treatment. One patient indicated prolonged pain symptoms. No infections were noted and no donor-site morbidity or side effects were detected. Conclusion Arthroscopic synovectomy combined with autologous fat graft is a reliable surgical option for early thumb CMC joint osteoarthritis and that effect continues for more than 24 months.

The Role of Free Flaps in the Treatment of Persistent Scalp Osteomyelitis

2006 ◽  
Vol 59 (suppl_1) ◽  
pp. ONS-64-ONS-67 ◽  
Author(s):  
Willy D. Boeckx ◽  
René R.W.J. van der Hulst ◽  
Lloyd V. Nanhekhan ◽  
Francesca De Lorenzi
Keyword(s):  
Free Flap ◽  
Donor Site ◽  
Muscle Flap ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Surgical Debridement ◽  
Neurosurgical Procedures ◽  
Latissimus Dorsi Muscle Flap ◽  
Flap Transfer ◽  
Free Flap Transfer

Abstract OBJECTIVE: To evaluate the efficacy of the combination of an extensive surgical debridement and simultaneous free flap repair in case of troublesome cranial osteomyelitis. METHODS: Five patients with persistent, frontal bone osteomyelitis were treated with surgical debridement of the infected bone and reconstruction with a free flap. In all patients, osteomyelitis occurred after neurosurgical procedures and lasted from 1 to 7 years. A latissimus dorsi muscle flap with a split skin graft has been performed. RESULTS: No flap failure occurred and donor site morbidity was negligible. No signs of osteomyelitis or soft tissue infection were observed during the mean follow-up period of 3.2 years. Furthermore, the contour of the cranium could be preserved without a need for bone grafts or implants. CONCLUSION: In our experience, the combination of an extensive surgical debridement and a free flap transfer is demonstrated to be an effective treatment for “chronic” osteomyelitis of the cranium.

Myocutaneous Gracilis Free Flaps in Microsurgical Breast Reconstruction: A Systematic Review Comparing Variations of the Upper Gracilis Flap

2017 ◽  
Vol 33 (09) ◽  
pp. 630-635 ◽  
Author(s):  
Vicky Kang ◽  
Emilie Robinson ◽  
Eric Barker ◽  
Anuja Antony
Keyword(s):  
Systematic Review ◽  
Breast Reconstruction ◽  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Fat Grafting ◽  
Complication Rates ◽  
Implant Placement ◽  
Pubmed Database ◽  
Low Incidence

Background The transverse upper gracilis (TUG) flap has gained increasing acceptance as a reliable option for breast reconstruction, specifically in patients without adequate abdominal tissue. Three major flap designs of the upper gracilis flap have been proposed to balance volume needs with flap vascularity. A systematic review was performed to identify outcomes of the major gracilis flaps: TUG, vertical-transverse upper gracilis (V-TUG), and longitudinal gracilis myocutaneous (LGM) flaps. This study is the first and only systematic review to date reviewing the variations of the upper gracilis flap in microsurgical breast reconstruction. Methods A systematic review of the literature was conducted using PubMed database from 1966 through 2015. Inclusion and exclusion criteria were applied. Outcomes assessed included total flap volumes, additional breast procedures to achieve intended breast volume, and complication rates. Results A total of 485 gracilis-type flaps were performed in 335 patients. V-TUG flaps provided the largest mean flap weights and did not require additional lipofilling or implant placement, whereas the majority of TUG flaps (50.6%) required additional fat grafting or implant placements. All flap types demonstrated a low incidence of donor-site morbidity. Overall flap loss rate was low; TUG flaps reported 2.3% total and 2.0% partial flap losses, while V-TUG and LGM flaps reported no flap losses. Conclusion This review found V-TUG yielded highest mean flap weights and did not require additional breast augmentation procedures as compared with the TUG. Also, the V-TUG was a safer donor-site option with fewer flap and donor-site morbidities.

scholarly journals Autologous cartilage and fibrin sealant may be superior to conventional fat grafting in preventing physeal bone bridge formation – a pilot study in porcines

2020 ◽  
Vol 14 (5) ◽  
pp. 459-465
Author(s):  
Ahmed A. Abood ◽  
Bjarne Møller-Madsen ◽  
Juan Manuel Shiguetomi-Medina ◽  
Hans Stødkilde-Jørgensen ◽  
Casper Foldager ◽  
...  
Keyword(s):  
Articular Surface ◽  
Donor Site ◽  
Current Treatment ◽  
Fat Grafting ◽  
Fat Graft ◽  
Level Of Evidence ◽  
Bone Bridge ◽  
Magnetic Resonance Imaging Mri ◽  
Paired Design ◽  
Made In

Purpose The article compares physeal recovery after insertion of autologous cartilage and a conventional fat graft in a standardized porcine physeal gap model. Presence of a bone bridge was the primary outcome. Methods Ten porcines in two groups of five were included in a paired design. A standardized physeal gap in the distal femur was made in all animals. One group (n = 5) was randomized for deposition of autologous cartilage and a Tisseel® or Tisseel® alone. The autologous cartilage was harvested from the femoral articular surface. The other group was randomized for fat grafting or no grafts at all. All animals were housed for 14 weeks. Magnetic resonance imaging (MRI) was performed at 14 weeks prior to euthanasia. The physis was harvested for histology. Results MRI – Three bone bridges were seen in the fat grafted gaps. All empty gaps formed a bone bridge. No gaps filled with autologous cartilage and Tisseel® resulted in bone bridges. One gap filled with Tisseel® only caused a bone bridge. Histology – The cartilage grafted gaps recovered with physeal-like cartilaginous tissue in histological analysis. Conclusions Fat grafts seems ineffective in preventing bone bridges. The use of autologous cartilage may be superior to the current treatment. However, donor site complications were not investigated. The study serves as a proof of concept study and requires further investigation. Level of evidence III

scholarly journals Free adipose tissue (FAT) graft pooling for severe dead space management

2020 ◽  
Vol 14 (3) ◽  
pp. 293-296
Author(s):  
Gustavo Souza ◽  
Robinson Pires ◽  
Egídio Santana Junior ◽  
Lydia Ferreira ◽  
Richard Yoon ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flaps ◽  
Fat Grafting ◽  
Fat Graft ◽  
Soft Tissue Reconstruction ◽  
Salvage Procedure ◽  
Level Of Evidence ◽  
Space Management ◽  
Extremity Trauma ◽  
Tissue Reconstruction

Complex lower extremity trauma with large soft tissue defects requires early wound coverage to reduce the risk of complications. In particular circumstances, however, local or free flaps may be contraindicated due to local or systemic issues. This study presents a helpful and effective salvage procedure for soft tissue reconstruction that uses autologous fat grafting combined with negative pressure wound therapy. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Treatment of Linear Scleroderma (en Coup de Sabre) With Dermal Fat Grafting

2015 ◽  
Vol 20 (3) ◽  
pp. 269-271 ◽  
Author(s):  
Ensar Zafer Barin ◽  
Hakan Cinal ◽  
Mehmet Akif Cakmak ◽  
Onder Tan
Keyword(s):  
Donor Site ◽  
Cost Effective ◽  
Late Complications ◽  
Fat Grafting ◽  
Fat Graft ◽  
Localized Scleroderma ◽  
Aesthetic Result ◽  
Linear Scleroderma ◽  
Depressed Scar ◽  
Effective Option

Background: Linear scleroderma, also known as “ en coup de sabre,” is a subtype of localized scleroderma that warrants aesthetic correction because it appears on the forehead region in children. Objective: To report dermal fat grafting as a novel and effective surgical treatment option in linear scleroderma. Methods: Under local anesthesia, a dermal fat graft was successfully placed into a subcutaneous pocket that was prepared underneath the depressed scar. The donor site was closed primarily. Results: No early or late complications developed postoperatively. After 1-year follow-up, the dermal fat graft was viable, the depressed scar was adequately augmented, and a good aesthetic result and patient satisfaction were obtained. Conclusion: We believe that dermal fat grafting is a cost-effective option and provides a long-lasting aesthetic outcome in the management of linear scleroderma.

Basic Techniques of Fat Grafting

2019 ◽  
pp. 131-136
Author(s):  
Shaili Gal ◽  
Lee L. Q. Pu
Keyword(s):  
Postoperative Care ◽  
Operative Technique ◽  
Donor Site ◽  
Fat Grafting ◽  
Fat Graft ◽  
Contour Deformity ◽  
Fat Grafts ◽  
Grafting Technique ◽  
Individualized Approach ◽  
Selection Of

In this chapter, the authors describe a standardized approach to fat grafting based on available scientific studies to obtain the best results for patients. Assessment of the defect and choosing the appropriate fat graft method is essential to achieving the desired result for different patients’ needs. Thus, fat grafting can be classified into small, large, and mega-volume fat grafting for an individualized approach. Once the indication for fat grafting is identified, the fat grafting technique can then be chosen based on the defect or contour deformity. Operative technique is detailed in terms of proper selection of donor site, proper harvest and processing of fat based on the fat grafting method chosen, along with proper placement of fat grafts and postoperative care.

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