scholarly journals Propeller Flap: Surgical Option after Resection of Lower Limb Melanoma

2021 ◽  
Vol 7 (3) ◽  
pp. 1-5
Author(s):  
Roney Gonçalves Fechine Feitosa ◽  
Keyword(s):  
Lower Limb ◽  
Reverse Flow ◽  
Low Cost ◽  
Lower Limbs ◽  
Aesthetic Result ◽  
Propeller Flap ◽  
Aesthetic Results ◽  
Lower Limb Reconstruction ◽  
The Aesthetic ◽  
Surgical Option

Objective: To describe a series of cases of lower limb reconstruction using an axial reverse flow flap (propeller flap) after melanoma excision. Patients and methods: From August 2014 to December 2016, at the Plastic Surgery Service at UNIFESP, five patients with defects in the lower limbs after melanoma resection were reconstructed using propeller flap. In all cases, the perforating vessels were previously mapped using Doppler ultrasound. Results: The size of the defect ranged from 4 cm × 3 cm to 8 cm × 4.5 cm. One case had a 180º rotation. In all the others, a 90° rotation was sufficient. All patients had good aesthetic results. Conclusion: The propeller flap is a simple and low cost technique. It is indicated for reconstruction of the distal third of small and/or medium-sized lower limb. The aesthetic result is satisfactory with the thickness and color of the flap very similar to the excised area.

scholarly journals Investigation of the dynamical characteristics of the lower-limbs exoskeleton actuators

2018 ◽  
Vol 161 ◽  
pp. 03008 ◽  
Author(s):  
Andrey Yatsun ◽  
Andrey Karlov ◽  
Andrey Malchikov ◽  
Sergey Jatsun
Keyword(s):  
Control System ◽  
Experimental Determination ◽  
Lower Limb ◽  
Low Cost ◽  
Experimental Tests ◽  
Theoretical Modeling ◽  
Lower Limbs ◽  
Dynamical Characteristics ◽  
Powered Exoskeleton

Authors present results of the theoretical modeling and experimental tests of the low-cost DС- motors, used in lower limb powered exoskeleton. Actuators work in difficult regime and it is important to achieve desired parameters, even for not robust motors. Results give us information and methods and means of experimental determination of the main characteristics of the robot‘s actuators. It gives possibility to tune control system and the whole system to achieve optimal walking regime.

scholarly journals Systematization of the Incisions in Nipple-Sparing Mastectomy

2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Cammarota MC ◽  
Barcelos LDP ◽  
Dias RCS ◽  
de Aquino Filho TM ◽  
Neto AB ◽  
...  
Keyword(s):  
Breast Size ◽  
Excess Skin ◽  
Aesthetic Result ◽  
Nipple Areola Complex ◽  
Areola Complex ◽  
Aesthetic Results ◽  
The Aesthetic ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Introduction: Nipple-Sparing Mastectomy (NSM) is a consolidated technique that has been used for years with good aesthetic results. Its indication is usually limited by breast size, due to difficulty repositioning the Nipple-Areola Complex (NAC) and treating excess skin in large breasts. The challenge in these cases is to maximize the aesthetic result without increasing the risk of necrosis and other complications.

scholarly journals A Study of Clinical Applications of Perforator-Based Propeller Flaps in Leg Reconstructive Surgery: A Single-Center Experience of 40 Cases

2019 ◽  
Vol 19 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Shahab Faria Shahabuddin ◽  
Mohammed Fahud Khurram
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Soft Tissue Defect ◽  
Surgical Reconstruction ◽  
Flap Necrosis ◽  
Aesthetic Result ◽  
Propeller Flap ◽  
Degloving Injury ◽  
Group I ◽  
Group Ii

Soft tissue management in lower limb poses a considerable challenge to a reconstructive plastic surgeon. Perforator-based propeller flaps can cover large wounds without sacrificing a major vascular axis and allows reconstruction using nearby similar tissues, thereby following the principle of replace like with like. This study was undertaken with the objective to look for the results of propeller flap in lower limb reconstruction and how the results can be improved. This was a retrospective study on 40 patients who underwent the reconstruction of soft tissue defects of lower limb with propeller flap. All the relevant data were collected and analyzed. Patients with soft tissue defect anywhere in the leg were included, but patients who had history of degloving injury, peripheral vascular disease, and diabetes mellitus were excluded. All these patients were divided in 2 groups according to the angle of rotation of propeller flap. Group I had 20 patients in which the flap was rotated by 150° to 180°. Group II had 20 patients, and the flap was rotated by 90° to 150°. Postoperatively, the first 2 cases in Group I showed total flap congestion and had complete necrosis, which were debrided and an alternate method was used to reconstruct. Thereafter, no patient had total flap necrosis. Minor complications were seen in 3 patients who showed transient venous congestion of the flap. Group II had no flap necrosis except for mild dehiscence, which was managed by secondary suturing. In most cases, the aesthetic result was acceptable and patients were completely satisfied. When parameters of the defect are suitable for treatment with a propeller-based local flap, this technique may be considered as the first option for surgical reconstruction. Proper planning, location of perforator with preoperative and intraoperative audio Doppler, and use of magnification would make this procedure more successful and definitely decrease the use of long-duration microvascular surgery.

scholarly journals Vein-Supercharged Peroneal Artery Perforator Propeller Flap for Achilles Soft Tissue Coverage

1970 ◽  
Vol 2 (2) ◽  
Author(s):  
Parintosa Atmodiwirjo ◽  
Laureen Supit
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Tissue Expansion ◽  
Soft Tissue Defect ◽  
Peroneal Artery ◽  
Soft Tissue Coverage ◽  
Aesthetic Result ◽  
Propeller Flap ◽  
Split Thickness Skin Grafting ◽  
Artery Perforator

Background: Wounds on the distal third of the lower extremity are reconstructively challenging, as there is lack of spare local tissue to design local flaps from. The perceived alternative is to perform free flaps to cover for these defects. Drawbacks include the need for specific training to perform microsurgery, longer time required, and the probable bulkiness when donor is obtained from certain areas. The perforator propeller flap is a local island fasciocutaneous flap, designed with 2 blades of skin island of unequal length extending from each side of the perforator. As the flap is rotated, the longer blade will cover the defect. Patient and Method: A case of soft tissue defect on the achilles is reported, with successful defect closure by utilizing a peronal artery perforator based fasciocutaneous propeller flap with 180 degree rotation and vein supercharge to facilitate backflow. Secondary defect required split-thickness skin grafting. Result: After surgery, muscles of the lower limb started to swell and get compromised. We removed some stitches to allow soft tissue expansion underneath the flap. after the release, flap perfusion improved. Stitches were left open for 3 days, then closure of flap edges by placing gradual traction sutures which were tightened daily. By the 7th day, flap edges was re-approximated and the skin grafts took well. Summary: The ability of the propeller flap to rotate makes this flap highly useful and versatile for the reconstruction of distal lower limb defects. Flap dimension can be enhanced when distal part of the flap is supercharged to neighboring recipient vessels. Another advantage is the close vicinity of donor, giving better aesthetic result.6

Long-term aesthetic outcome of fingertip reconstruction in complete syndactyly release

2012 ◽  
Vol 38 (3) ◽  
pp. 281-287 ◽  
Author(s):  
K. Bulic
Keyword(s):  
Nail Plate ◽  
Skin Grafts ◽  
Full Thickness ◽  
Aesthetic Outcome ◽  
Aesthetic Result ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Grade Scale ◽  
Aesthetic Results ◽  
The Aesthetic

An aesthetically pleasing fingertip is an important but often under evaluated goal in syndactyly release. We assessed the aesthetic fingertip outcome in 26 patients with complete syndactylies, with a total of 84 separated digits, using a four-grade scale based on the quality of the lateral nail fold, nail plate definition, symmetry and pulp fullness. Fingertips with complete simple syndactylies released with the use of full-thickness skin grafts achieved a significantly better aesthetic result then fingertips with complete complex syndactylies released with the use of Buck-Gramcko pulp flaps. Fingertips involved in complex syndactylies achieved significantly better aesthetic results when reconstructed using Buck-Gramcko flaps in comparison with those reconstructed with full-thickness skin grafts. We recommend the use of Buck-Gramcko flaps in complete complex syndactylies, while reserve the traditional zig-zag and full-thickness skin graft closure for cases of complete simple syndactylies. We also propose a grading system for the aesthetic outcome of the fingertip following syndactyly release.

The Propeller Flap for Traumatic Distal Lower-Limb Reconstruction

2020 ◽  
Vol 102 (6) ◽  
pp. 510-518 ◽  
Author(s):  
Ioana Lese ◽  
Adriaan O. Grobbelaar ◽  
Dan Sabau ◽  
Alexandru V. Georgescu ◽  
Mihai A. Constantinescu ◽  
...  
Keyword(s):  
Lower Limb ◽  
Limb Reconstruction ◽  
Propeller Flap ◽  
Lower Limb Reconstruction

scholarly journals Functional Results of Transverse Extended Incision in Cervical Neck Dissection

2020 ◽  
Author(s):  
Carlos Miguel Chiesa-Estomba ◽  
Jon Alexander Sistiaga-Suarez ◽  
Izaskun Thomas-Arrizabalaga ◽  
Jose Angel González-García ◽  
Ekhiñe Larruscain ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Functional Results ◽  
Transverse Incision ◽  
Aesthetic Result ◽  
Subjective Satisfaction ◽  
Cervical Incision ◽  
Aesthetic Results ◽  
Surgical Field ◽  
The Aesthetic ◽  
Made In

Abstract Introduction Multiple incisions have been described for the surgical approach of cervical neck nodes. All of these descriptions are associated with better or worse exposure of the surgical field as well as with different functional and aesthetic results, which are not always satisfactory. Objective Compare the transverse cervical incision with the classic incision in J or U. Methods This is a retrospective study of 47 patients who required cervical neck dissection between June 15, 2016 and June 15, 2017.A transversal incision was made in these surgeries, and their results were then compared with those of a group of 57 patients treated between January 1, 2010 and January 1, 2012, in whose cases an incision in J or U was made. Results Regarding the incision type, complications were present in 4 (8.5%) cases in the transversal incision group, and in 7 (12.2%) patients of the group of traditional incisions in J or U, without statistical differences (p = 0.078). The only variables associated with complications of healing in the two groups was body mass index (BMI) < 18.5. The patients showed subjective satisfaction with the aesthetic result of the transverse incision, with an average of 7.51 vs 6.20 in the J or U incision. Conclusion The transverse incision represents a safe, aesthetic, and oncologically adequate option, associated with a lower cicatricial retraction rate, without significant complication rate and allowing adequate exposure of the surgical field, similar to the obtained with the classic incision in J or U.

scholarly journals Prospective randomized study comparing clinical, functional, and aesthetic results of minipterional and classic pterional craniotomies

2015 ◽  
Vol 122 (5) ◽  
pp. 1012-1019 ◽  
Author(s):  
Leonardo C. Welling ◽  
Eberval G. Figueiredo ◽  
Hung T. Wen ◽  
Marcos Q. T. Gomes ◽  
Edson Bor-Seng-Shu ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Randomized Study ◽  
Surgical Techniques ◽  
Prospective Randomized Study ◽  
Anterior Circulation ◽  
Temporal Muscle ◽  
Aesthetic Result ◽  
Aesthetic Results ◽  
The Aesthetic ◽  
Anterior Circulation Aneurysms

OBJECT The object of this study was to compare the clinical, functional, and aesthetic results of 2 surgical techniques, pterional (PT) and minipterional (MPT) craniotomies, for microsurgical clipping of anterior circulation aneurysms. METHODS Fifty-eight patients with ruptured and unruptured anterior circulation aneurysms were enrolled into a prospective randomized study. The first group included 28 patients who underwent the MPT technique, and the second group comprised 30 patients who underwent the classic PT craniotomy. To evaluate the aesthetic effects, patients were asked to grade on a rule from 0 to 100 the best and the worst aesthetic result. Photographs were also taken, assessed by 2 independent observers, and classified as showing excellent, good, regular, or poor aesthetic results. Furthermore, quantitative radiological assessment (percentage reduction in thickness and volumetric analysis) of the temporal muscle, subcutaneous tissue, and skin was performed. Functional outcomes were compared using the modified Rankin Scale (mRS). Frontal facial palsy, postoperative hemorrhage, cerebrospinal fistula, hydrocephalus, and mortality were also analyzed. RESULTS Demographic and preoperative characteristics were similar in both groups. Satisfaction in terms of aesthetic result was observed in 19 patients (79%) in the MPT group and 13 (52%) in the PT group (p = 0.07). The mean score on the aesthetic rule was 27 in the MPT group and 45.8 in the PT group (p = 0.03). Two independent observers analyzed the patient photos, and the kappa coefficient for the aesthetic results was 0.73. According to these observers, excellent and good results were seen in 21 patients (87%) in the MPT and 12 (48%) in the PT groups. The degree of temporal muscle, subcutaneous tissue, and skin atrophy was 14.9% in the MPT group and 24.3% in the PT group (p = 0.01). Measurements of the temporal muscle revealed 12.7% atrophy in the MPT group and 22% atrophy in the PT group (p = 0.005). The volumetric reduction was 14.6% in the MPT and 24.5% in the PT groups (p = 0.012). Mortality and mRS score were similar in both groups at the 6-month evaluation (p = 0.99). CONCLUSIONS Minipterional craniotomy provides clinical results similar to those of the PT technique. Moreover, it provides better cosmetic results. It can be used safely and effectively to surgically treat aneurysms of the anterior circulation instead of the PT approach.

Free Flaps in Complex Lower Limb Reconstruction - 2-Year Experience

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
Horácio Zenha ◽  
Carla Diogo ◽  
Sara Ramos ◽  
Susana Pinheiro ◽  
Ricardo Carvalho ◽  
...  
Keyword(s):  
Lower Limb ◽  
Free Flaps ◽  
Limb Reconstruction ◽  
Lower Limb Reconstruction

Design of a Human Knee Reeducation Mechanism

2019 ◽  
Vol 11 (1) ◽  
pp. 42-53
Author(s):  
Allaoua Brahmia ◽  
Ridha Kelaiaia
Keyword(s):  
Lower Limb ◽  
Mechanical Design ◽  
Kinematic Chain ◽  
Lower Limbs ◽  
Kinematic Structure ◽  
Robotic Device ◽  
Human Knee ◽  
Kinematic Study ◽  
Rehabilitation Exercise ◽  
New Machine

Abstract To establish an exercise in open muscular chain rehabilitation (OMC), it is necessary to choose the type of kinematic chain of the mechanical / biomechanical system that constitutes the lower limbs in interaction with the robotic device. Indeed, it’s accepted in biomechanics that a rehabilitation exercise in OMC of the lower limb is performed with a fixed hip and a free foot. Based on these findings, a kinematic structure of a new machine, named Reeduc-Knee, is proposed, and a mechanical design is carried out. The contribution of this work is not limited to the mechanical design of the Reeduc-Knee system. Indeed, to define the minimum parameterizing defining the configuration of the device relative to an absolute reference, a geometric and kinematic study is presented.

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