D W Chang

..However, the difficulties in achieving reliable long-term healing with allograft reconstruction have led us to use vascularized fibula transfer to enhance healing...

..The authors present an innovative method for pelvic ring reconstruction using a vascularized double-strut fibular bone flap that provides a stable pelvis and recovery of normal or near-normal gait...

..Currently, microsurgical variations of lymphatic bypass, in which excess lymph trapped within the lymphedematous limb is redirected into other lymphatic basins or into the venous circulation, have gained popularity...

..The purpose of this prospective study was to provide a preliminary analysis of lymphaticovenular bypass for the treatment of upper limb lymphedema in breast cancer patients...

..Most patients are able to resume oral feeding once the fistula is closed...

..In conclusion, the extended latissimus dorsi flap is a reliable method for total autologous breast reconstruction in most patients and should be considered more often as a primary choice for breast reconstruction...

..In conclusion, autologous sural nerve grafting after non-nerve-sparing radical prostatectomy is an effective means of preserving spontaneous erectile activity after the operation while maximizing cancer control potential...

..operated on and/or irradiated axilla lead to a higher incidence of lymphedema? In patients who have developed lymphedema following mastectomy, does delayed breast reconstruction with autologous flap reduce the severity of the lymphedema?..

..A retrospective study of 134 consecutive cases in 92 patients who underwent soft tissue reconstruction of the spinal region following tumor removal...

..The goal of the authors' study was to determine whether an autologous tissue flap, when combined with an implant for breast reconstruction, reduces the incidence of implant-related complications in previously irradiated breasts...

..The likelihood of tumor recurrence, extent of excision required, and need for postoperative radiation, as well as psychosocial and financial considerations, may affect whether immediate or delayed reconstruction is appropriate...

..Using an ovine rib model, the authors studied whether the addition of a vascularized periosteum or bone flap improved healing compared with a segmental allograft alone...

..The purpose of this study was to assess the effectiveness of free tissue transfer for treatment of advanced mandibular osteoradionecrosis (ORN) in head and neck cancer patients...

..Patients who are morbidly obese are at very high risk of failure and complications and should avoid any type of TRAM flap breast reconstruction...

..The subtotal thigh flap is a well-vascularized thick flap that provides a firm support for the abdominal viscera and is a large flap that can be used to close even a high lumbar defect...

..The best result is obtained when similar methods and tissues are used on both sides...

..In this review, current methods of reconstruction following sarcoma resection are discussed, and advances are highlighted...

..With proper patient selection, successful cranial base reconstruction can be performed with either local or free flaps with a low incidence of complications...

..Semin. Surg. Oncol. 19:211-217, 2000...

..Smoking-related complications were significantly reduced when the reconstruction was delayed or when the patient stopped smoking at least 4 weeks before surgery...

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..There were 21 DIEP flaps and 24 free TRAM flaps in the series. In this series, there was no significant difference between the cost of DIEP and free TRAM flap breast reconstruction...

..These findings indicate that, in patients who are candidates for free TRAM flap breast reconstruction and need postmastectomy radiation therapy, reconstruction should be delayed until radiation therapy is complete...

..3 percent. In select patients with advanced upper extremity sarcoma undergoing limb salvage, microvascular flap reconstruction can provide reliable, safe coverage with reasonable preservation of function...

..It was concluded that the use of the DIEP flap does reduce the patient requirement for postoperative pain medication and therefore presumably reduces postoperative pain. It may also slightly shorten hospital stay...

..The allograft provides bone stock and early stability, while the addition of the vascularized bone flap substantially facilitates the host-allograft union...

..When the defects are larger and in irradiated beds, free tissue transfer has emerged as the most reliable method to bolster the dural repair...

..The purpose of this study was to describe the authors' rib-sparing technique for accessing the internal mammary vessels that is efficient and reliable and limits chest wall morbidity...

..However, it is not known whether they are as reliable as the internal mammary vessels or whether their use would result in increased recipient-site complications...

..The purpose of this study was to evaluate outcomes in breast reconstruction combining lower abdominal flaps with implants and to compare the impact of timing of implant placement on complication and revision rates...

..Our results stressed the importance of taking a polygenic approach to evaluate the cumulative and interaction effects of genetic variations in the prediction of cancer risk and prognosis...

..Our goal was to determine the impact of reconstructive microsurgery on the treatment of advanced oral cavity cancers...

..Thus, it seems that free flaps help facilitate limb salvage and that they may preserve meaningful limb function in patients who undergo resection of soft-tissue malignancies of the foot...

..New developments in breast cancer diagnosis and treatment necessitate a team approach, with increased communication between the breast surgeon and the plastic surgeon in planning surgery for these patients...

..Nonrandomized studies of unilateral nerve-sparing (UNS) radical prostatectomy (RP) have reported improved recovery of erectile function if the sacrificed cavernous nerve is reconstructed with a sural nerve graft (SNG)...

..The purpose of this study was to analyze the causes of flap compromise and failure in head and neck free flap reconstruction...

..The ultimate goal is the development of a comprehensive risk prediction model which integrates genetic, environment, and person risk factors to benefit disease diagnosis, prevention, and treatment...

..This review of surgical procedures for the treatment of postmastectomy lymphedema focuses on microsurgical lymphovenous shunt operations and discusses current issues in surgical treatment and the need for uniform treatment standards...

..There were no other associated features in this patient to warn of the vascular variant. Reconstructive surgeons should be aware of possible variations in the vascular anatomy of this flap...

..The purpose of this study was to determine the outcomes of this new prophylactic approach to managing complex spine wounds...

..For these large defects that require a free flap, the distal portions of these limbs can be harvested as fillet flaps and represent the "spare parts" concept of surgical reconstruction...

..Thus, the authors advocate using the most expeditious and reliable flap based on the vascular anatomy of the DIEP system...

..Tissue flaps may be needed to provide vascularized tissue over alloplastic materials used to stabilize the chest wall, to cover vital structures of the chest cavity, to fill dead space, and to improve cosmesis...

..The purpose of this study was to address questions concerning the functional outcome following mandibular reconstruction with vascularized fibula flap in skeletally immature children..

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..It was concluded that age alone should not determine the type of breast reconstruction and that autogenous tissue breast reconstruction can be a safe successful alternative for women 65 years of age or older...

..In some cases, the TRAM flap tissue across the midline scar can be used reliably for breast reconstruction...

..CONCLUSIONS: For soft tissue sarcoma of the upper extremity, limb salvage with good functional outcome is possible with a judicious approach to reconstruction...

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..Over the years, the authors' preferred recipient vessels for microvascular autologous breast reconstruction have changed from the thoracodorsal to the internal mammary vessels...

..All four patients underwent modified radical mastectomy. The role of mammography, surgical options, specimen evaluation, and practical guidelines are discussed...

..A new minimal incision technique of sural nerve harvesting that is simple and quick, causes minimal donor site morbidity, and preserves the integrity of the nerve is described...

..Surgical defects are often large and cause significant functional, aesthetic, and psychological issues. The authors present their experience with reconstruction of the anterior and lateral skull base in the pediatric population...

..The authors performed a rigorous, quantitative, histomorphometric comparison of bone prefabrication in a large-animal model comparing graft implanted against muscle fascia and periosteum...

..This ovine model may serve as a useful tool to develop clinical osseous tissue-engineering strategies...