J J Disa

..The results of this study have eliminated the routine use of low-molecular-weight dextran prophylaxis at our institution in an effort to reduce morbidity in head and neck microsurgical reconstruction...

..In this experience, the best results were seen after TRAM (pedicled or free) flap reconstruction...

..Microvascular reconstruction of pharyngeal defects is highly successful with few postoperative complications. With appropriate flap selection, functional outcome can be optimized...

....

....

..This study demonstrates that the use of tissue expanders in breast reconstruction is reliable, with the vast majority of patients completing the expansion process...

..An algorithm for mandible reconstruction with microvascular osseous flaps is presented. Semin. Surg. Oncol. 19:226-234, 2000...

..The most common local complications are stricture and fistula formation. A history of preoperative radiation therapy increases the risk of local complications...

..To enhance earlier identification of flap compromise in buried free flaps, alternative monitoring techniques such as implantable Doppler probes or exteriorization of flap segments are recommended...

..The authors evaluated the risks and benefits of nipple- or areola-sparing mastectomy with breast reconstruction...

..The ilium is recommended only when other options are unavailable. Thoughtful flap selection and design should supplant the need for multiple, simultaneous free flaps and vein grafting in most cases...

..In this series, good to excellent aesthetic results were achieved in the majority of patients with minimal associated complications...

..Thus, smokers who undergo postmastectomy expander/implant reconstruction should be informed of the increased risk of surgical complications and should be counseled on smoking cessation...

..The purpose of this study was to review the authors' experience with a large number of microvascular complications over an 11-year period...

..Removal of the entire TRAM flap was only necessary in the setting of multifocal recurrence or involvement of the flap pedicle with disease. The risk of local recurrence was not increased following complete skin-sparing mastectomy...

..The purpose of this study was to evaluate the incidence of postoperative adverse events and identify significant predictors of complications in acellular human dermis tissue expander breast reconstruction...

..In this series the free forearm, fibula, rectus, and jejunum flaps have become the workhorse donor sites for the vast majority of defects...

..The free tissue transfer should ideally not be incorporated into these structures. Most patients with even the largest resections can be restored to fairly good function by following this algorithm. Semin. Surg. Oncol. 19:218-225, 2000...

..Reconstruction can offer most patients successful swallowing while minimizing complications...

..We attempt to review the impact of breast reconstruction on the incidence and detection of locoregional recurrence and discuss treatment options...

..The authors review the experience at a single institution of hand reconstruction following sarcoma resection based on prospectively collected data...

..These data support the conclusion that immediate, bilateral breast reconstruction using tissue expansion and implants is an acceptable option for the subset of patients who may undergo unilateral, postexchange radiotherapy...

..The exact mechanisms of this association are unknown and warrant additional investigation...

..Mantle irradiation did not appear to compromise the prosthetic breast reconstruction. Tissue expander/implant breast reconstruction should remain a viable option in this category of irradiated patients...

..The authors review their experience with intraoperative heparin therapy, specifically addressing the risks of hematoma, pedicle thrombosis, and flap loss rate...

..The ease of flap elevation and minimal donor site morbidity make it a useful, single-stage reconstructive option in these difficult wounds...

..Current techniques used for scalp reconstruction after surgical ablation are the subject of this review...

..We evaluated the risks and benefits of nipple-sparing mastectomy in a multiinstitutional experience in the settings of risk-reducing surgery and breast cancer treatment...

..The authors report their experience with thumb reconstruction following wide excision of bone and soft-tissue tumors of the thumb...

..The objective of the current study was to identify predictors of patient satisfaction with breast appearance, including implant type, in a large sample of women who underwent breast reconstruction surgery using implants...

..This article explores the oncologic and reconstructive issues relevant to women desiring cosmetic breast implants and women with breast cancer who have undergone prior cosmetic breast augmentation...

..This study evaluates the rate of microvascular thrombosis in patients undergoing free-tissue transfer treated with or without antiplatelet agents...

..The purpose of this study was to evaluate the influence of prosthetic reconstruction on the incidence, detection, and management of locoregional recurrence following mastectomy for invasive breast cancer...

..It does not, however, appear to increase the risk of postoperative complications...

..This study evaluated the impact of clinical risk factors to predict complications following postmastectomy expander/implant reconstruction...

....

....

....

..Preoperative gastrostomy tube placement is not necessary in most patients unless severe preoperative nutritional compromise is present...

..It has a low incidence of complications, low morbidity, and is easy to perform with a high success rate...

..Flap selection is determined on the basis of the type of defect. Using this algorithm, immediate vaginal reconstruction with pedicled regional flaps can be performed with minimal patient morbidity and few surgical complications...

..The purpose of this investigation was to evaluate the effect of drains on complications, including infection, seroma, and hematoma formation, in patients undergoing exchange of a temporary expander for a permanent breast implant...

..Based on this single institutional experience over a decade, an algorithm to chest wall reconstruction is provided...

..These results confirm that this technique is both efficacious and cost-effective...

..Individualizing selection of a reconstructive technique for each patient will be the predominant factor in achieving a reconstructive success...

..When possible, appropriate prophylaxis against VTE in cancer patients under going head and neck reconstruction is recommended...

..In every case, regardless of the technique chosen, the surgeon seeks to reconstruct a nipple areola complex that is esthetically pleasing in its color, symmetry, position on the breast mound, and projection...

..The objective of this report is to describe indications and outcomes for these patients...

..Large flaps can be designed and tailored to the defect by harvesting variable amounts of skin, subcutaneous tissues, fascia, and muscle. The ALT flap may be a good alternative to the rectus flap in overweight or obese patients...

..Local scalp flaps with skin grafts, and free tissue transfer remain the mainstay of reconstruction in most instances...

..The purpose of this study was, therefore, to review our experience with the management of postoperative salivary fistulas...

..This study evaluates the authors' institutional experience with immediate postoperative complications following DIEP and free/muscle-sparing TRAM flaps...

..Acceptable surgical candidates demonstrate resolution of acute radiation changes, no evidence of late radiation changes, and appropriate thickness of the mastectomy skin flaps...

..This study examined a single institution's experience with the pedicled latissimus dorsi flap in reconstructing large shoulder defects after oncologic resection...

..Limb reconstruction has traditionally involved allografting. The authors evaluated reconstruction of extremity long bone defects after tumor resection using fibula free flaps...

..The impact of radiation changes on alloplastic and autologous breast reconstruction is unpredictable. This article reviews the pathophysiology of radiation changes and the alterations to the reconstructive process...

..Good to excellent aesthetic results can be expected in most patients...

..In this procedure highly vascularized tissue is used to increase healing, accelerate clearance of bacteria, and fill any dead space...

..Complication rates for patients reconstructed with free-tissue transfer techniques is similar to those patients reconstructed by conventional techniques, despite an increase in complexity of resection in this group...

..01]). CONCLUSIONS: Laparoscopic RRSO is safe and feasible in patients who have undergone a prior TRAM flap reconstruction...

..Pedicled or microvascular transfer of well-vascularized muscle can be used to wrap the allograft and minimize devastating wound complications potentially leading to loss of allograft and limb...

..Because of concern of potential under-dosing in these patients, we examined the dosimetric effects of the Magna-Site (Santa Barbara, CA) metallic port that is present in certain TEs...

..However, available published data show that NSM can be safely performed for breast cancer treatment in carefully selected cases. Further studies and longer follow-up are necessary to refine selection criteria for NSM...

..Postoperative radiation therapy is therefore not a contraindication to secondary revision. However, these procedures should be delayed for several months after the acute effects of radiation have resolved...

..004). Adults were more likely to develop pain than instability. CONCLUSIONS: Our series suggests that children with an age-length sum <16 should be considered for prophylactic tibiofibular synostosis creation...

..Reexpansion was successful in patients without prior radiotherapy. Secondary reconstruction with autologous tissue is appropriate when there is a history of radiotherapy...

..Minor skin graft loss resulting from postoperative radiotherapy can usually be treated conservatively without the need for additional surgery...

..Finally, removal of closed suction drainage tubes should be deferred until after the brachytherapy catheters are removed to minimize complications resulting from catheter dislodgement...

..This review discusses several benign and premalignant neoplasms frequently encountered by the plastic surgeon. The emphasis is on clinical presentation, histopathologic correlation, and management approach...

..Early/late complications and functional problems after anterior cranial base resections are uncommon when free tissue transfer is used concomitantly...