Ex Vivo Ovine Model for Surgical and Microsurgical Training on Parotidectomy and Facial Nerve Reanimation: Proposal of Structured Training Program
Conclusion This proposal of training program on the ex vivo ovine model for the acquisition of skills needed in head and neck surgery proved to be feasible, effective, repeatable, and cheap. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - November 23, 2020 Category: Surgery Authors: Ghirelli, Michael Federici, Gaia Melchiorri, Claudio Malagoli, Andrea Presutti, Livio Fernandez, Ignacio Javier Tags: Original Article Source Type: research

Comment on Assessing the Influence of Attending Surgeon Continuity on Free Flap Outcomes Following Unplanned Returns to the Operating Room
J Reconstr Microsurg DOI: 10.1055/s-0040-1721121 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - November 23, 2020 Category: Surgery Authors: Marlborough, Fergal Berner, Juan Enrique Ahmed, Omar A. Ragbir, Maniram Tags: Letter to the Editor Source Type: research

A Structured, Microsurgical Training Curriculum Improves the Outcome in Lower Extremity Reconstruction Free Flap Residency Training: The Ludwigshafen Concept
J Reconstr Microsurg DOI: 10.1055/s-0040-1720960 Background Risk stratification, economic pressure, and a flat learning curve make the realization and development of proper microsurgical skills and competences a challenging task in the daily clinical practice. In previous studies, we were able to show that microsurgical procedures, e.g., free flaps and replantations, are safe training procedures and teachable in daily clinical practice in view of certain issues of risk stratification. The present study aims to evaluate further improvements in terms of safety and complication rates for free flaps as a training proce...
Source: Journal of Reconstructive Microsurgery - November 19, 2020 Category: Surgery Authors: Boecker, Arne Kornmann, Jonas Xiong, Lingyun Harhaus, Leila Aman, Martin Koepple, Christoph Fischer, Sebastian Will, Patrick A. Kneser, Ulrich Hirche, Christoph Tags: Original Article Source Type: research

Microsurgical Reconstruction of the Nose: The Aesthetic Approach to Total Defects
Conclusion Microvascular tissue transfer plays a key role in full-thickness nasal defects restoration. Comparing the two groups, both the RFF and ALT are effective and reliable options in lining reconstruction, although with different indications. Expanded forehead flap, combined to free cartilage graft, is our gold standard to provide external skin coverage to rebuild the nasal framework. According to our current approach, accurate preoperative planning, supported by modern technologic tools, multistage reconstruction, and ancillary procedures are useful to accomplish satisfactory functional and aesthetic outcomes. [...
Source: Journal of Reconstructive Microsurgery - November 17, 2020 Category: Surgery Authors: Pinto, Valentina Antoniazzi, Elisa Contedini, Federico Pignatti, Marco Pizzigallo, Angelo Marchetti, Claudio Cipriani, Riccardo Tags: Original Article Source Type: research

The Benefits of the Supercharged Ileocolic Flap in Patients Who Underwent Total Esophagectomy and Gastrectomy
Conclusion The supercharged ileocolic flap is a robust option for total esophageal replacement when the stomach is not available and the retrosternal route is the safest for transposition. The functional outcomes are excellent, with acceptable morbidity and a good life expectancy, either in cancer and noncancer patients. Supercharging the flap is recommended. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - November 17, 2020 Category: Surgery Authors: Marchi, Filippo Kang, Shih Ching Cheong, David Chon Fok Hung, Shao Yu Wang, Szu Han Chiu, Ting Han Chen, Yu Ting Tsao, Chung Kan Tags: Original Article Source Type: research

Reconstruction of Extensive Composite Parotid Region Oncologic Defects with Immediate Facial Nerve Reconstruction Using a Chimeric Scapulodorsal Vascularized Nerve Free Flap
Conclusion This is largest series presented in literature on primary FN reconstruction utilizing a vascularized nerve graft. We believe that the chimeric SDVN flap should be highly considered for these cases due to its versatility. The surgeon is able to use single donor site available soft and hard tissues components along with a vascular motor nerve graft, which offers a great length and number of distal branches, and easily matches with the extracranial FN trunk and its peripheral ramifications. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of content...
Source: Journal of Reconstructive Microsurgery - November 3, 2020 Category: Surgery Authors: Mangialardi, Maria L. Honart, Jean-Fracois Qassemyar, Quentin Guyon, Alice Li, Sean S. Benmoussa, Nadia Beldarida, Vincent Temam, St éphane Kolb, Fr édéric Tags: Original Article Source Type: research

The False Positive Rate of Transcutaneous Tissue Oximetry Alarms in Microvascular Breast Reconstruction Rises after 24 Hours
Conclusion The transcutaneous tissue oximetry false positive rate significantly rises after 24 hours. The benefit may not outweigh the concerns, labor, and effort that results from alarms after postoperative day 1. We recommend considering discontinuing this monitoring after 24 hours. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - October 31, 2020 Category: Surgery Authors: Tran, Phu C. DeBrock, Will Lester, Mary E. Hartman, Brett C. Socas, Juan Hassanein, Aladdin H. Tags: Original Article Source Type: research

Characteristics of the Superficial Circumflex Iliac Artery Perforator Flap in a Western Population and a Practice Approach for Free Flap Reconstruction
J Reconstr Microsurg DOI: 10.1055/s-0040-1719051 Background There has been increasing interest in the superficial circumflex iliac artery perforator (SCIP) flap as a source of thin, pliable soft tissue combined with a favorable donor site. Despite several clinical series from Asia, barriers to adoption include reluctance to perform submillimeter “supermicrosurgery” and the effect of body habitus on flap feasibility. The purpose of this study is to distinguish vascular anatomic characteristics of the SCIP flap in a North American population. Methods Computed tomography angiography was examined in...
Source: Journal of Reconstructive Microsurgery - October 31, 2020 Category: Surgery Authors: Messa, Charles A. Carney, Martin J. Tantillo, Kristopher Othman, Sammy Moores, Craig Mirzabeigi, Michael N. Weissler, Jason M. Cook, Tessa Kovach, Stephen J. Tags: Original Article Source Type: research

A Comparative Analysis of Outcomes of Free Nipple Areolar Grafting in Autologous Breast Reconstruction
Conclusion Nipple reconstruction can successfully be performed in microvascular breast reconstruction using free grafts. Although partial graft hypopigmentation is common, smaller areas of graft loss or depigmentation are anticipated and do not affect aesthetic outcomes. The use of free NAC grafts may allow additional patients to use their own nipples as part of their microvascular reconstruction and avoid secondary NAC reconstruction procedures. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  | ...
Source: Journal of Reconstructive Microsurgery - October 31, 2020 Category: Surgery Authors: Egan, Katie G. Lai, Eric Holding, Julie Butterworth, James Tags: Original Article Source Type: research

Effects of VEGF on Prefabricated Vascularized Bone Allografts in Rats
Conclusion These results suggest that VEGF-containing HAp/Col effectively stimulates angiogenesis and bone formation, but not bone resorption, in prefabricated vascularized bone allografts. This method could therefore become a useful tool for treating large bone defects. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - October 14, 2020 Category: Surgery Authors: Tobiume, Sachiko Kaji, Yoshio Nakamura, Osamu Yamaguchi, Konosuke Oka, Kunihiko Yamamoto, Tetsuji Tags: Original Article Source Type: research

Improving Outcomes in Anterolateral Thigh Flap Donor-Site Reconstruction Using Propeller Flaps: A Retrospective Comparative Study with Skin Grafting
Conclusion In high-tension ALT donor-site closure, the propeller perforator flap should always be considered to avoid split-thickness skin graft with related functional and aesthetic poor results. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - October 14, 2020 Category: Surgery Authors: Pagliara, Domenico Mangialardi, Maria Lucia Vitagliano, Stefano Pino, Valentina Salgarello, Marzia Tags: Original Article Source Type: research

When is the Critical Time for Soft Tissue Reconstruction of Open Tibia Fracture Patients?
J Reconstr Microsurg DOI: 10.1055/s-0040-1717151 Background The timing of soft tissue reconstruction for soft-tissue defect in patients with open fractures in the lower extremity is known to be critical for successful outcomes. However, medical advances, including development of dressing materials and refinement in the microsurgical techniques, might have undergone modifications in this “critical period.” There have been no studies on the role of timing on reconstructive outcomes. Thus, we have analyzed the effect of reconstruction timing on optimal surgical outcomes and complication rates in a single t...
Source: Journal of Reconstructive Microsurgery - October 14, 2020 Category: Surgery Authors: Lee, Seung Yeol Seong, Ik Hyun Park, Bo Young Tags: Original Article Source Type: research

Risk Factors for Neuropathic Pain Following Major Upper Extremity Amputation
Conclusion In patients with an upper extremity amputation proximal to the elbow or for trauma, there is an increased risk of developing neuropathic pain. In these patients, primary TMR/RPNI should be considered and this warrants a multidisciplinary approach involving general trauma surgeons, orthopaedic surgeons, plastic surgeons, and vascular surgeons. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - October 14, 2020 Category: Surgery Authors: Lans, Jonathan Hoftiezer, Yannick Lozano-Calder ón, Santiago A. Heng, Marilyn Valerio, Ian L. Eberlin, Kyle R. Tags: Original Article Source Type: research

Intraoperative Real-Time Visualization of the Lymphatic Vessels Using Microscope-Integrated Laser Tomography
J Reconstr Microsurg DOI: 10.1055/s-0040-1718549 Background Detection and selection of the lymphatic vessels are important for maximizing therapeutic efficacy of lymphaticovenular anastomosis (LVA). Some imaging modalities have been reported to be useful for intraoperative identification of the lymphatic vessels, but they have limitations. In this article, we present new capabilities of intraoperative laser tomography, which was used to evaluate the lumen of the lymphatic vessel and to validate the patency of anastomosis. Patients and Methods Fifty-two patients with upper extremity lymphedema secondary to b...
Source: Journal of Reconstructive Microsurgery - October 14, 2020 Category: Surgery Authors: Hayashi, Akitatsu Yoshimatsu, Hidehiko Visconti, Giuseppe Sujarittanakarn, Sasithorn Giacalone, Guido Hayashi, Nobuko Yamamoto, Takumi Yang, Johnson Chia-Shen Hong, Joon Pio Tags: Original Article Source Type: research

The Double Stitch Everting Technique in the End-to-Side Microvascular Anastomosis: Validation of the Technique Using a Randomized N-of-1 Trial
J Reconstr Microsurg DOI: 10.1055/s-0040-1718548 Background The double stitch everting (DSE) technique, in which time is won by leaving the needle inside the vessel wall in-between stitching, is a modification of the end-to-side (ETS) anastomosis in the interest of reducing anastomosis time. This ensures proper wall eversion, intima-to-intima contact, and improved suture symmetry. Materials and Methods We designed an N-of-1 randomized trial with each microsurgeon as their own control. We included 10 microsurgeons of different levels of experience who were then asked to perform classic and DSE ETS anastomose...
Source: Journal of Reconstructive Microsurgery - October 14, 2020 Category: Surgery Authors: Dindelegan, George C. Dammers, Ruben Oradan, Alex V. Vinasi, Ramona C. Dindelegan, Maximilian Volovici, Victor Tags: Original Article Source Type: research

Preoperative Tracing of Lateral Femoral Cutaneous Nerve with Sonography for Sensory Anterolateral Thigh Free Flap Reconstruction
J Reconstr Microsurg DOI: 10.1055/s-0040-1718395 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - October 14, 2020 Category: Surgery Authors: Walczak, Dominik A. Grajek, Maciej Migacz, Ewa Kukwa, Wojciech Krakowczyk, Łukasz Tags: Letter to the Editor Source Type: research

Vascularized Genitofemoral Nerve Flap Based on the Deep Branch of the Superficial Circumflex Iliac Artery
J Reconstr Microsurg DOI: 10.1055/s-0040-1718367 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - October 14, 2020 Category: Surgery Authors: Hashimoto, Hiroki Kageyama, Takashi Sakai, Hayahito Tsukuura, Reiko Tags: Letter to the Editor Source Type: research

A Head-to-Head Comparison of the Medial Sural Artery Perforator versus Radial Forearm Flap for Tongue Reconstruction
J Reconstr Microsurg DOI: 10.1055/s-0040-1718551 Background For tongue reconstruction, the radial forearm flap (RFF) is commonly used. In the last decade, the medial sural artery perforator (MSAP) flap has been successfully used with reportedly superior donor-site outcomes. Our study is the first to compare the RFF and MSAP for reconstruction of partial glossectomy defects (
Source: Journal of Reconstructive Microsurgery - October 8, 2020 Category: Surgery Authors: Ng, Marcus J.M. Goh, Cindy S.L. Tan, Ngian Chye Song, David H. Ooi, Adrian S.H. Tags: Original Article Source Type: research

Prevalence and Utilization of Obturator Artery Anatomic Variant in Autologous Breast Reconstruction
Conclusion Utilization of this anatomic variant in stacked or dual-pedicled autologous breast reconstruction results in antegrade IMA perfusion of both primary and secondary flaps, as well as improved size match compared with other anastomotic options. Knowledge of the vascular anatomy and variations in the inferior epigastric system is crucial to both preventing complications and optimizing flap planning and outcome. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Jour...
Source: Journal of Reconstructive Microsurgery - October 8, 2020 Category: Surgery Authors: Mu ñoz, Katherine D. Reuter Powers, Jeremy M. Zhang, Shuhao Kale, Santosh S. Tags: Original Article Source Type: research

Beyond the Tip of the Blade: An Investigation of Upper Extremity Machete Injuries in Honduras
This study aims to provide critical information to better prepare visiting surgeons and establishes a blueprint to improve microsurgical reconstruction. Methods A retrospective chart review was performed to identify patients with machete injuries to the upper extremity (UE) who presented to the Hospital Escuela Universitario (HEU) for treatment from 2015 to 2017. Additional microsurgical data was obtained by personal communication with members of the plastic surgery department at the HEU. Results Complete data was retrieved for 100 patients who presented to the HEU with a UE machete wound. The cohort was ma...
Source: Journal of Reconstructive Microsurgery - October 8, 2020 Category: Surgery Authors: Johnson, Anna Rose La ínez, Stephanie S. Santos, Herman J. Chen, Austin D. La ínez, Carlos Lin, Samuel J. Agag, Richard L. Lee, Bernard T. Tags: Original Article Source Type: research

Combined Tissue Transfer for Extensive Lower Limb Complex Defects: Flow-through Flaps, Chimera, and “Orochi” Flaps
J Reconstr Microsurg DOI: 10.1055/s-0040-1715814Perforator flaps can be raised anywhere in the body, with minimal donor-site deformity, and can be made into custom-made combined composite flaps, especially for severe complex defects such as osteomyelitis of the lower limbs. Here, we report on the representative application of the combined tissue transfers for complex leg defects. For a wide range of complex defects in the lower extremity, it is necessary to perform reliable revascularization by bypass or flow-through type or vein graft. At the same time, a chimeric or “Orochi” type combined transfer using a min...
Source: Journal of Reconstructive Microsurgery - October 6, 2020 Category: Surgery Authors: Koshima, Isao Tags: Review Article Source Type: research

Chronic Knee and Ankle Pain Treatment through Selective Microsurgical Approaches: A Minimally Invasive Option in the Treatment Algorithm for Refractory Lower Limb Pain
J Reconstr Microsurg DOI: 10.1055/s-0040-1717100 Background Injury or compression of a sensory nerve is an under-reported source of disabling pain in the lower limb. It is known that peripheral nerve microsurgeons can reconstruct and rewire injured nerves to relieve chronic pain but this option remains not completely understood and ignored by most orthopaedic surgeons, neurologists, and pain therapists. In this paper, we describe our experience with knee and ankle peripheral nerve surgery to improve the condition of patients suffering from chronic, posttraumatic lower limb pain. Patients and Methods Between...
Source: Journal of Reconstructive Microsurgery - October 6, 2020 Category: Surgery Authors: Pietramaggiori, Giorgio Sapino, Gianluca De Santis, Giorgio Bassetto, Franco Scherer, Saja Tags: Original Article Source Type: research

Optimizing the Chicken Wing Anatomy: Nomenclature Review and Description for Microsurgery and Supermicrosurgery Training
J Reconstr Microsurg DOI: 10.1055/s-0040-1718393 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 30, 2020 Category: Surgery Authors: Navia, Alfonso Tejos, Rodrigo Ya ñez, Ricardo Cuadra, Alvaro Dagnino, Bruno Tags: Review Article Source Type: research

Role of Ultrahigh Frequency Ultrasound in Evaluating Experimental Flaps
Conclusion Ultrahigh frequency ultrasound may be a valuable tool for postoperative flap assessment, while the chimeric flap can be moved freely in a sandwich position making it suitable for adding tissue substitutes within its components. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 30, 2020 Category: Surgery Authors: Morarasu, Stefan Ghetu, Nicolae Coman, Corneliu George Morarasu, Bianca Codrina Boicu, Daniel Spiridon, Irene Alexandra Gardikiotis, Ioannis Danciu, Mihai Pieptu, Dragos Tags: Original Article Source Type: research

The Evolution of the Free Fibula Flap for Head and Neck Reconstruction: 21 Years of Experience with 128 Flaps
Conclusion During this 21-year period, we performed several changes in our practice. This included the use of a three-dimensional (3D) prefabricated model of the mandible, a shift toward side-table osteotomies, increasing the rate of osteofascial flaps in contrast to osteocutaneous flaps and the use of an implantable Doppler. These changes, together with a learning curve of the surgical team, significantly improved our overall success rates. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  ...
Source: Journal of Reconstructive Microsurgery - September 29, 2020 Category: Surgery Authors: Fliss, Ehud Yanko, Ravit Bracha, Gal Teman, Roy Amir, Aharon Horowitz, Gilad Muhanna, Nidal Fliss, Dan M. Gur, Eyal Zaretski, Arik Tags: Original Article Source Type: research

Microsurgery Fellowship Website and Social Media Presence: Are Programs Optimizing Recruitment Strategy?
Conclusion As the field of microsurgery continues to grow, the need for effective recruitment and training of microsurgeons continues to be essential. Overall, we conclude that both the accessibility and quality of information available to applicants are limited, which is a missed opportunity for recruitment. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 28, 2020 Category: Surgery Authors: Atia, Andrew Langdell, Hannah C. Hollins, Andrew Shammas, Ronnie L. Glener, Adam Marks, Caitlin Lee, Bernard T. Phillips, Brett T. Tags: Original Article Source Type: research

Effects of Ischemic Preconditioning and C1 Esterase Inhibitor Administration following Ischemia-Reperfusion Injury in a Rat Skin Flap Model
Conclusion Intravenous administration of C1-Inh did not significantly modulate I/R-related damage in this experimental model, but further research is needed. On the other hand, IPC reduces tissue damage and improves neovascularization, confirming its potential protective effects in skin flaps following I/R injury. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 23, 2020 Category: Surgery Authors: Masa, Inmaculada Casado-S ánchez, César Crespo-Lora, Vicente Ballest ín, Alberto Tags: Original Article Source Type: research

Histological Assessment of Wallerian Degeneration of the Rat Tibial Nerve Following Crush and Transection Injuries
Conclusion The ABC method of histological assessment is a consistent and reliable method that will be useful to quantify the effects of different interventions on the WD process. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 23, 2020 Category: Surgery Authors: Kerns, James M. Walter, James S. Patetta, Michael J. Sood, Anshum Hussain, Awais K. Chung, Joyce J. Deshpande, Abhishek DesLaurier, Justin T. Dieter, Raymond A. Siemionow, Maria Seiler, Figen A. Amirouche, Farid M.L. Gonzalez, Mark H. Tags: Original Article Source Type: research

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps
Conclusion This study shows that systemic piracetam treatment provides protection against ischemia-reperfusion injury in musculocutaneous flaps and can offer a simple and inexpensive alternative to the preconditioning technique. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 23, 2020 Category: Surgery Authors: Demir öz, Anıl Dereba şınlıoğlu, Handan Ercan, Alp Arslan, Hakan Ayd ın, Övgü Ekmek çi, Hakan Balc ı Ekmekçi, Özlem Ayd ın, Yağmur Tags: Original Article Source Type: research

The Blue-Blood Porcine Chest Wall: A Novel Microsurgery Training Simulator for Internal Mammary Vessel Dissection and Anastomosis
Conclusion Overall, this novel model can provide inexpensive and realistic simulation of internal mammary vessel preparation and anastomosis. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 20, 2020 Category: Surgery Authors: Zeng, Weifeng Gunderson, Kirsten A. Sanchez, Ruston J. Albano, Nicholas J. Nkana, Zeeda H. Thadikonda, Kishan M. Dingle, Aaron M. Poore, Samuel O. Tags: Original Article Source Type: research

Mechanism of Peripheral Nerve Regeneration Using a Bio 3D Conduit Derived from Normal Human Dermal Fibroblasts
Conclusion Abundant ECM formation resulted in a stable tube-like structure of the Bio 3D conduit with high cell viability. NHDFs in the Bio 3D conduit have the potential to differentiate into SCs-like cells. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 20, 2020 Category: Surgery Authors: Yurie, Hirofumi Ikeguchi, Ryosuke Aoyama, Tomoki Ito, Akira Tanaka, Mai Noguchi, Takashi Oda, Hiroki Takeuchi, Hisataka Mitsuzawa, Sadaki Ando, Maki Yoshimoto, Koichi Akieda, Shizuka Nakayama, Koichi Matsuda, Shuichi Tags: Original Article Source Type: research

Bone Union Enhancement by bFGF-Containing HAp/Col in Prefabricated Vascularized Allo-Bone Grafts
Conclusion Osteogenic cells, osteoconductive scaffolds, growth factors, and mechanical environment are known to be important factors in the process of fracture healing. The PVAG developed herein contains osteogenic cells, osteoconductive scaffolds, and growth factors. In addition, the PVAG is rigidly fixed to the fracture site, providing a stable mechanical environment. Together, these four factors contributed to a good bone union. Furthermore, this method did not promote bone resorption. Thus, the addition of a vascular bundle and bFGF-containing HAp/Col makes it possible to create an ideal vascularized allo-bone gra...
Source: Journal of Reconstructive Microsurgery - September 20, 2020 Category: Surgery Authors: Yamaguchi, Konosuke Kaji, Yoshio Nakamura, Osamu Tobiume, Sachiko Nomura, Yumi Oka, Kunihiko Yamamoto, Tetsuji Tags: Original Article Source Type: research

A Meta-Analysis of Autologous Microsurgical Breast Reconstruction and Timing of Adjuvant Radiation Therapy
Conclusion Immediate free flap breast reconstruction is associated with superior flap survival compared with delayed reconstruction. Rates of complications are largely comparable, and rates of revision surgeries are equivalent. The differences in long-term aesthetic outcomes are not, however, clearly assessed by the available literature. Even in the face of PMRT, immediate free flap breast reconstruction is an effective approach. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (...
Source: Journal of Reconstructive Microsurgery - September 20, 2020 Category: Surgery Authors: Heiman, Adee J. Gabbireddy, Sairisheel R. Kotamarti, Vasanth S. Ricci, Joseph A. Tags: Original Article Source Type: research

Delayed Distally Based Prophylactic Lymphaticovenular Anastomosis: Improved Functionality, Feasibility, and Oncologic Safety?
J Reconstr Microsurg DOI: 10.1055/s-0040-1716743 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 20, 2020 Category: Surgery Authors: Chen, Wei F. Knackstedt, Rebecca Tags: Letter to the Editor Source Type: research

Propeller Flaps for Reconstruction around the Foot and Ankle
J Reconstr Microsurg DOI: 10.1055/s-0040-1715656The propeller flap challenges conventional wisdom for the safe raising of flaps. Its unique design is based on a belief that a sizeable fasciocutaneous flap can be perfused by only a single perforator. What is more remarkable is the concept that this cleanly dissected pedicle can continue to safely perfuse the flap even when it is twisted 180 degrees. Clearly, meticulous technique is essential and the key points in raising this flap and its versatility for reconstruction of defects around the foot and ankle are discussed in this article. [...] Thieme Medical Publishers 333 Se...
Source: Journal of Reconstructive Microsurgery - September 17, 2020 Category: Surgery Authors: Teo, Tiew Chong Tags: Review Article Source Type: research

A Retrospective Study of an Updated and Traditional Surgical Approach of the Distally Based Sural Flap
Conclusion The modifications applied to the harvesting of the DBSF have achieved higher survival rate, lower dehiscence rate, and shorter hospital stay time in comparison with traditional approach in our retrospective study. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 16, 2020 Category: Surgery Authors: Xu, Heng Cao, Xuexin Kiu-Huen, Sally Zhu, Zhu Chen, Jun Chi, Zhenglin Zhang, Yixin Tags: Original Article Source Type: research

Adverse Events Associated with Implantable Dopplers during Microvascular Surgery
Conclusion This study demonstrates a variety of ID-related malfunctions. One-third of device malfunctions were associated with patient complications, and false-positive Doppler signal loss contributed substantially to the requirement of surgical re-exploration. These are important considerations for surgical teams utilizing IDs in free tissue transfer procedures. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - September 16, 2020 Category: Surgery Authors: Pier, Matthew M. Pasick, Luke J. Benito, Daniel A. Saini, Prashant Patel, Sahil Joshi, Arjun S. Goodman, Joseph F. Thakkar, Punam Tags: Original Article Source Type: research

The Benefits of Expert Instruction in Microsurgery Courses
This study aims to determine the importance of an expert instructor to guide students through procedures. We compared student proficiency across two microsurgery courses: one with (Columbia University, United States [CU] cohort) and one without a dedicated microsurgery instructor (University of Thessaloniki, Greece [UT] cohort). Methods Students were divided into two cohorts of 22 students (UT cohort) and 25 students (CU cohort). Student progress was evaluated by examining patency (lift-up and milking tests), anastomotic timing, and quality (Anastomosis Lapse Index [ALI]) of end-to-end arterial and venous anastomos...
Source: Journal of Reconstructive Microsurgery - September 7, 2020 Category: Surgery Authors: Paladino, Joseph Gasteratos, Konstantinos Akelina, Yelena Marshall, Brittany Papazoglou, Lysimachos G. Strauch, Robert J. Tags: Original Article Source Type: research

In Pursuit of the “Perforator” in the Perforator Skin Flap
J Reconstr Microsurg DOI: 10.1055/s-0040-1716387Another congress of the World Society for Reconstructive Microsurgery (WSRM) this past year in Bologna was magnificent not just for the presentation of so many keynote lectures by the giants of our field nor the novel and innovative ideas shown by those who will someday follow in those footsteps, but by making all of us realize how many capable microsurgeons there are now practically everywhere in this world, doing incredibly important surgical management of challenges that previously were unmet and resulted in sheer devastation for so many of our patients. How much we are th...
Source: Journal of Reconstructive Microsurgery - September 5, 2020 Category: Surgery Authors: Taylor, G. Ian Hallock, Geoffrey G. Tags: Review Article Source Type: research

Intraoperative Microvascular Complications in Autologous Breast Reconstruction: The Effects of Resident Training on Microsurgical Outcomes
We present our experience with autologous reconstruction (deep inferior epigastric perforators, profunda artery perforator, lumbar artery perforator, bipedicled, and stacked) where a supervised trainee completed the microvascular anastomosis. Methods Retrospective chart review was performed on 413 flaps (190 patients) with microvascular anastomoses performed by postgraduate year (PGY)-4, PGY-5, PGY-6, PGY-7 (microsurgery fellow), or attending physician (AP). Comorbidities, intra-operative complications, revisions, operative time, ischemia time, return to operating room (OR), and flap losses were compared between tr...
Source: Journal of Reconstructive Microsurgery - September 5, 2020 Category: Surgery Authors: Teotia, Sumeet S. Dickey, Ryan M. Liu, Yulun Jayaraman, Avinash P. Haddock, Nicholas T. Tags: Original Article Source Type: research

Impact of Blood Transfusion in Free Flap Breast Reconstruction Using Propensity Score Matching
J Reconstr Microsurg DOI: 10.1055/s-0040-1716388 Background Microvascular thrombosis has been associated with cytokine release and inflammatory syndromes which can occur as a result of blood transfusions. This phenomenon could potentially lead to complications in breast free flap reconstruction. The aim of this study was to evaluate the impact of perioperative blood transfusion in free flap breast reconstruction using large population analysis. Methods The American College of Surgeons National Quality Improvement Program database was queried for delayed free flap breast reconstructions performed in 2016. Th...
Source: Journal of Reconstructive Microsurgery - September 5, 2020 Category: Surgery Authors: Karamanos, Efstathios Shah, Amita R. Kim, Julie N. Wang, Howard T. Tags: Original Article Source Type: research

Fat-Augmented Latissimus Dorsi versus Deep Inferior Epigastric Perforator Flap: Comparative Study in Delayed Autologous Breast Reconstruction
J Reconstr Microsurg DOI: 10.1055/s-0040-1716348 Background The use of autologous tissues is considered the mainstay for delayed breast reconstruction. Aside the free abdominal flaps, which are most commonly used, the fat-augmented latissimus-dorsi (FALD) flap has been recently shown a reliable alternative option for pure autologous breast reconstruction. In this retrospective study, we aim to compare outcomes of autologous breast reconstructions using the extended FALD and deep inferior epigastric perforator flap (DIEP) flap, with an emphasis on patients' characteristics, demographic data, complications, and patie...
Source: Journal of Reconstructive Microsurgery - September 5, 2020 Category: Surgery Authors: Demiri, Efterpi C. Tsimponis, Antonios Pagkalos, Anastasios Georgiadou, Eleni Goula, Olga-Christina Spyropoulou, Georgia-Alexandra Dionyssiou, Dimitrios Tags: Original Article Source Type: research

Breaking Down Silos: Collaboration in Head and Neck Reconstruction Research
Conclusion Collaboration among head and neck reconstruction research at the US institutions is low compared with the potential. Specialties focus on different research subtopics, and therefore can benefit from working together. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - August 31, 2020 Category: Surgery Authors: Silva, Amanda K. Rodriguez, Eduardo D. Jacobson, Adam S. Levine, Jamie P. Tags: Original Article Source Type: research

The Ideal Microsurgery Fellowship: A Survey of Fellows and Fellowship Directors
This study surveys fellowship directors (FD) and recent microsurgery fellows (MFs), graduates, to describe the ideal microsurgery fellowship program. Methods A 15-item questionnaire was sent to 38 FDs and 90 recent microsurgery fellowship graduates. This questionnaire addressed program attributes, case volumes and compositions, ideal experiences, and time allocation to different fellowship experiences. Data were analyzed using descriptive statistics, t-tests, and Chi-squared tests. Results The FD and MF surveys had a response rate of 47 and 49%, respectively. Both MF and FD agreed that exposure to microsurg...
Source: Journal of Reconstructive Microsurgery - August 31, 2020 Category: Surgery Authors: Reghunathan, Meera Zaldana-Flynn, Michelle Rose, John Crisera, Christopher A. Reid, Chris M. Tags: Original Article Source Type: research

Different Hydraulic Constructs to Optimize the Venous Drainage of DIEP Flaps in Breast Reconstruction: Decisional Algorithm and Review of the Literature
Conclusion Several alternatives for venous anastomosis in superdrainage are available. We propose an algorithm to simplify the choice. The use of the ipsilateral SIEV to be connected to a vein of the chest appears to be advantageous. The anatomical position that allows the easiest anastomosis dictates which chest vein to favor. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)
Source: Journal of Reconstructive Microsurgery - August 31, 2020 Category: Surgery Authors: Pignatti, Marco Pinto, Valentina Giorgini, Federico A. Lozano Miralles, Maria Elisa D'Arpa, Salvatore Cipriani, Riccardo De Santis, Giorgio Tags: Original Article Source Type: research

Anatomical Study and Clinical Application of Ulnar Artery Proximal Perforator Flaps
Conclusion The free ulnar artery proximal perforator flap can be harvested in two different manners for the same skin island of the forearm. When possible, harvesting it form the PURA allows lengthening of the pedicle. In our experience, this flap presents many advantages such as thinness and hairlessness; it allows preservation of the ulnar neurovascular bundle with an acceptable donor site morbidity. Level of evidence: IV. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Sourc...
Source: Journal of Reconstructive Microsurgery - August 31, 2020 Category: Surgery Authors: Cherubino, Mario Bolletta, Alberto Baroni, Tommaso Di Taranto, Giuseppe Losco, Luigi Rubino, Corrado Valdatta, Luigi Tags: Original Article Source Type: research

The Role of Cadaver-Based Flap Course in Microsurgical Education and Practice Patterns of Attendees: A Survey Study
J Reconstr Microsurg DOI: 10.1055/s-0040-1716320 Background In 2017, our institution initiated a cadaver laboratory-based course dedicated to teaching reconstructive microsurgery indications, preoperative planning, and flap dissection. The goals of this study are to describe the demographics and experience of participants/instructors and to evaluate the learning objectives and effectiveness of the course. Methods Penn Flap Course (PFC) participants were sent an anonymous survey at the inaugural PFC 2017. Then, in 2019, both instructors and participants were sent a more comprehensive survey. Surveys included...
Source: Journal of Reconstructive Microsurgery - August 31, 2020 Category: Surgery Authors: Azoury, Sa ïd C. Othman, Sammy Colen, David L. Broach, Robyn B. Lin, Ines Zenn, Michael R. Kovach, Stephen J. Levin, L. Scott Tags: Original Article Source Type: research

Anatomy, Exposure, and Preparation of Recipient Vessels in Microsurgical Head and Neck Reconstruction
J Reconstr Microsurg DOI: 10.1055/s-0040-1715644Successful microvascular reconstruction of head and neck defects requires the ability to safely identify, isolate, and utilize recipient vessels. To date, however, a comprehensive review of the anatomy and techniques relevant to the available anatomic regions has not been undertaken. This review covers the relevant clinical anatomy of the anterior triangle, posterior triangle, submandibular region, intraoral region, preauricular region, chest, and arm, taking particular care to highlight the structures that are crucial to identify while performing each dissection. Finally, a ...
Source: Journal of Reconstructive Microsurgery - August 29, 2020 Category: Surgery Authors: Xu, Hope Jazayeri, Leila Matros, Evan Henderson, Peter W. Tags: Review Article Source Type: research

A Cadaveric Anatomical and Histological Study of Recipient Intercostal Nerve Selection for Sensory Reinnervation in Autologous Breast Reconstruction
This study aimed to evaluate the optimum ACB recipient site level for sensory nerve coaptation in ABR. Methods Twelve hemi-chests were dissected from six fresh cadaveric females. Costal cartilages were removed and the anterior cutaneous intercostal nerve (ACB) and the lateral (subcutaneous) division of the anterior cutaneous branch (LACB) of the intercostal nerve were exposed. Anatomical measurements were recorded, and nerve samples were evaluated histologically with carbonic anhydrase staining to differentiate sensory fascicles. Assessment of fascicular diameter, axonal counts, and fascicular area were compared. ...
Source: Journal of Reconstructive Microsurgery - August 29, 2020 Category: Surgery Authors: Mohan, Anita T. Suchyta, Marissa Vyas, Krishna S. Lachman, Nirusha Mardini, Samir Saint-Cyr, Michael Tags: Original Article Source Type: research

Impact of Intraoperative Hypothermia on Microsurgical Free Flap Reconstructions
This study evaluates the effects of hypothermia on outcomes of free flap reconstructions. Methods Within 7 years, 602 patients underwent 668 microvascular free flap reconstructions. The cases were divided into two groups regarding the minimal core body temperature during free flap surgery: hypothermia (HT;
Source: Journal of Reconstructive Microsurgery - August 29, 2020 Category: Surgery Authors: Moellhoff, Nicholas Broer, Peter Niclas Heidekrueger, Paul I. Ninkovic, Milomir Ehrl, Denis Tags: Original Article Source Type: research