After studying this article, the participant should be able to: 1. Describe different useful flaps. 2. Identify pitfalls of specific flaps. 3. Incorporate tips that facilitate flap use.
We have a ...wide selection of flaps to choose from for any given reconstruction. This article describes the use of different flaps that the author has found useful in his practice. Some of these flaps are mainstream, whereas others are not. The article does not suggest that these are the only flaps that one should use, nor does it go into great detail on the dissection of each flap except where the author has identified pitfalls or where he can offer tips and tricks that facilitate use of these flaps. Flaps are described from head to toe.
Lymphedema: Surgical and Medical Therapy Chang, David W; Masia, Jaume; Garza, Ramon ...
Plastic and reconstructive surgery (1963),
2016-September, Letnik:
138, Številka:
3S Current Concepts in Wound Healing: Update 2016
Journal Article
Recenzirano
BACKGROUND:Secondary lymphedema is a dreaded complication that sometimes occurs after treatment of malignancies. Management of lymphedema has historically focused on conservative measures, including ...physical therapy and compression garments. More recently, surgery has been used for the treatment of secondary lymphedema.
METHODS:This article represents the experience and treatment approaches of 5 surgeons experienced in lymphatic surgery and includes a literature review in support of the techniques and algorithms presented.
RESULTS:This review provides the reader with current thoughts and practices by experienced clinicians who routinely treat lymphedema patients.
CONCLUSION:The medical and surgical treatments of lymphedema are safe and effective techniques to improve symptoms and improve quality of life in properly selected patients.
Head and neck reconstruction Neligan, Peter C
Plastic and reconstructive surgery (1963)
131, Številka:
2
Journal Article
Recenzirano
After reading this article, the participant should be able to: 1. Discuss the principles behind the choice of reconstructive techniques for all major head and neck regions. 2. Differentiate between ...the optimal choices for reconstruction of the different mandibulectomy defects. 3. List the requirements for successful reconstruction of the skull base. 4. Further study new and evolving head and neck reconstruction techniques and options.
Management of head and neck cancer has undergone many significant changes during the past two decades. This article gives an overview of the major areas in the head and neck, highlighting current practice and more recent trends in reconstruction choices. Further detail is given in the related videos. The five attached videos depict individual techniques of mandibular reconstruction, showing the technique of fibular dissection and osteotomy: endoscopic skull base reconstruction through a transpterygoid/lateral canthotomy approach, scalp reconstruction using a latissimus dorsi free flap and skin graft, maxillary reconstruction using the deep circumflex iliac artery iliac crest and internal oblique flap, and pharyngoesophageal reconstruction using an anterolateral thigh flap.
Current Concepts in the Surgical Management of Lymphedema Kung, Theodore A; Champaneria, Manish C; Maki, Jeffrey H ...
Plastic and reconstructive surgery (1963),
2017-April, 2017-Apr, 2017-04-00, 20170401, Letnik:
139, Številka:
4
Journal Article
Recenzirano
LEARNING OBJECTIVES:After studying this article, the participant should be able to1. Discuss the key points in diagnosing lymphedema. 2. Understand the imaging modalities that facilitate diagnosis ...and surgical planning. 3. Appreciate the indications for both physiologic and ablative procedures. 4. Recognize the potential role of lymphaticovenular anastomosis and vascularized lymph node transfer in the treatment of patients with lymphedema.
SUMMARY:Lymphedema is an incurable disease caused by insufficient lymphatic drainage leading to abnormal accumulation of interstitial fluid within the soft tissues. Although this condition may result from a primary structural defect of the lymphatic system, most cases in developed countries are secondary to iatrogenic causes. The diagnosis of lymphedema can be made readily by performing a clinical history and physical examination and may be confirmed by imaging studies such as lymphoscintigraphy, magnetic resonance lymphangiography, or indocyanine green lymphangiography. Nonsurgical treatment continues to be the mainstay of lymphedema management. However, advances in microsurgical techniques have revolutionized surgical options for treating lymphedema, and emerging evidence suggests that reconstructive methods may be performed to restore lymphatic flow. Procedures such as lymphaticovenular anastomosis and vascularized lymph node transfer can potentially offer a more permanent solution to chronic lymphedema, and initial studies have demonstrated promising results.
The goal of this consensus conference, sponsored by the American Association of Plastic Surgeons, was to perform a systematic review and meta-analysis of controlled trials to examine both the ...benefits and risks of surgical treatment and surgical prevention of upper and lower extremity lymphedema.
The panel met in Boston for a 3-day, face-to-face meeting in July of 2017. After an exhaustive review of the existing literature, the authors created consensus recommendations using the Grading of Recommendations, Assessment, Development and Evaluation criteria. Important directions for future research were also identified.
There is evidence to support that lymphovenous anastomosis can be effective in reducing severity of lymphedema (grade 1C). There is evidence to support that vascular lymph node transplantation can be effective in reducing severity of lymphedema (grade 1B). Currently, there is no consensus on which procedure (lymphovenous bypass versus vascular lymph node transplantation) is more effective (grade 2C). A few studies show that prophylactic lymphovenous bypass in patients undergoing extremity lymphadenectomy may reduce the incidence of lymphedema (grade 1B). More studies with longer follow-up are required to confirm this benefit. Debulking procedures such as liposuction are effective in addressing a nonfluid component such as fat involving lymphedema (grade 1C). There is a role for liposuction combined with physiologic procedures although the timing of each procedure is currently unresolved (grade 1C).
Many studies seem to support some efficacy of lymphovenous bypass and vascular lymph node transplantation. Many studies show the important role of lymphedema therapy and other procedures such as liposuction and debulking. The management of lymphedema is a challenging field with many promising advances. However, many questions remain unanswered.
PDF
