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Usefulness of Pulsed Wave Doppler Ultrasonography for Evaluating Recipient Vessels of Free Flap Reconstruction in Patients With Severe Extremity Trauma: A Preliminary Report 脉冲波多普勒超声对评估重度肢体创伤患者游离皮瓣重建受体血管的价值:初步报告
IF 1.5 3区 医学
Microsurgery Pub Date : 2025-02-12 DOI: 10.1002/micr.70030
Shunsuke Sato, Satoshi Hatashita, Takuya Nikaido, Michiyuki Hakozaki, Takuya Kameda, Yoichi Kaneuchi, Yoshifumi Kawamae, Masayuki Ito, Yoshihiro Matsumoto
{"title":"Usefulness of Pulsed Wave Doppler Ultrasonography for Evaluating Recipient Vessels of Free Flap Reconstruction in Patients With Severe Extremity Trauma: A Preliminary Report","authors":"Shunsuke Sato,&nbsp;Satoshi Hatashita,&nbsp;Takuya Nikaido,&nbsp;Michiyuki Hakozaki,&nbsp;Takuya Kameda,&nbsp;Yoichi Kaneuchi,&nbsp;Yoshifumi Kawamae,&nbsp;Masayuki Ito,&nbsp;Yoshihiro Matsumoto","doi":"10.1002/micr.70030","DOIUrl":"https://doi.org/10.1002/micr.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In cases of severe extremity trauma treated with the ‘internal fixation for fractures and flap’ technique, successful soft tissue reconstruction requires selecting recipient vessels that avoid the zone of injury. Pulsed wave Doppler ultrasonography has been proposed as a useful tool for the preoperative evaluation of recipient vessels in plastic surgeries. This report aimed to present the preliminary experience of pulsed wave Doppler ultrasonography in traumatic disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This report included 14 free flaps from 13 patients with severe extremity trauma. The flaps included nine free latissimus dorsi flaps (two combined with serratus anterior flaps) and five free anterolateral thigh flaps. The recipient vessels included the posterior tibial artery (<i>n</i> = 8), anterior tibial artery (<i>n</i> = 2), perforator of the hypoplastic posterior tibial artery (<i>n</i> = 1), brachial artery (<i>n</i> = 1), radial artery (<i>n</i> = 1), and the ulnar artery (<i>n</i> = 1). Preoperative pulsed Doppler ultrasonography was used to evaluate the recipient vessels and the vascular anastomosis site was determined based on the modified waveform classification and maximum flow velocity (<i>V</i><sub>max</sub>), as described by Ogino et al. The following variables were analyzed: modified vascular waveform classification at the anastomosis site, <i>V</i><sub>max</sub>, presence of posttraumatic vessel disease, and flap survival rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The modified vascular waveform classification at the anastomotic site was D-1a in seven cases, D-1b in four cases, and D-2 in three cases, with an average <i>V</i><sub>max</sub> of 27.4 cm/s (range: 16.2–40.0 cm/s). Post-traumatic vessel disease was not observed in any of the cases. The flap survival rate was 100%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pulsed wave Doppler ultrasonography is a valuable tool for the preoperative evaluation of recipient vessels in free flap reconstruction for severe extremity trauma. Its use can help ensure the optimal selection of recipient vessels, contributing to high flap survival rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comment on “Effects of Preoperative Hemoglobin on Microsurgical Reconstruction and Perioperative Blood Transfusion Requirement: A Meta-Analysis and Systematic Review of the Literature” 《术前血红蛋白对显微外科重建及围手术期输血需求的影响:文献荟萃分析及系统综述》评论
IF 1.5 3区 医学
Microsurgery Pub Date : 2025-02-12 DOI: 10.1002/micr.70032
Mehrab Neyazi, Rachana Mehta, Shubham Kumar, Ranjana Sah
{"title":"Comment on “Effects of Preoperative Hemoglobin on Microsurgical Reconstruction and Perioperative Blood Transfusion Requirement: A Meta-Analysis and Systematic Review of the Literature”","authors":"Mehrab Neyazi,&nbsp;Rachana Mehta,&nbsp;Shubham Kumar,&nbsp;Ranjana Sah","doi":"10.1002/micr.70032","DOIUrl":"https://doi.org/10.1002/micr.70032","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors Associated With Claw Toe Deformity Following Vascularized Fibula Flap Harvesting: A Retrospective Analysis of Potential Risk Factors and Preventive Strategies 带血管的腓骨皮瓣切除后爪趾畸形的相关因素:潜在危险因素和预防策略的回顾性分析
IF 1.5 3区 医学
Microsurgery Pub Date : 2025-02-11 DOI: 10.1002/micr.70031
Shigeki Ishibashi, Rikuo Shinomiya, Yuta Hayashi, Tsubasa Tashiro, Shogo Nagamatsu, Tomoaki Hamana, Toru Sunagawa, Nobuo Adachi
{"title":"Factors Associated With Claw Toe Deformity Following Vascularized Fibula Flap Harvesting: A Retrospective Analysis of Potential Risk Factors and Preventive Strategies","authors":"Shigeki Ishibashi,&nbsp;Rikuo Shinomiya,&nbsp;Yuta Hayashi,&nbsp;Tsubasa Tashiro,&nbsp;Shogo Nagamatsu,&nbsp;Tomoaki Hamana,&nbsp;Toru Sunagawa,&nbsp;Nobuo Adachi","doi":"10.1002/micr.70031","DOIUrl":"https://doi.org/10.1002/micr.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Claw toe deformity at the donor site is a complication following vascularized fibula flap surgery. Despite its potential to necessitate further surgery, the factors contributing to this complication are not well understood. Therefore, this study aimed to identify factors associated with this complication and propose potential preventive strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed 40 cases of vascularized fibula flap harvesting conducted between 2010 and 2022. The presence of claw toe deformity was evaluated, and various patient and surgical factors were analyzed. Postoperative magnetic resonance imaging (MRI) and intraoperative indocyanine green angiography images were also assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Claw toe deformity was observed in 25% of patients, with a significantly higher incidence among those undergoing primary wound closure (<i>p</i> = 0.018). Age (<i>p</i> = 0.595), body mass index (<i>p</i> = 0.482), smoking status (<i>p</i> = 0.157), diabetes (<i>p</i> = 0.556), peripheral arterial disease (<i>p</i> &gt; 0.999), preoperative chemotherapy (<i>p</i> = 0.715), operative time (<i>p</i> = 0.080), harvested fibula length (<i>p</i> = 0.981), skin paddle size (<i>p</i> = 0.695), and horizontal width of skin flap (<i>p</i> = 0.906) were not significantly associated with claw toe deformity. The cutoff values for primary wound closure were identified as a skin flap horizontal width of 3.5 cm and a horizontal width-to-circumference ratio of 10.4%. MRI revealed signal changes in the flexor hallucis longus on T2-weighted images in all six cases with claw toe deformity and in 6 of the 12 cases without deformity. Indocyanine green angiography revealed ischemia in the flexor hallucis longus in all six examined cases; however, four of these cases did not develop claw toe deformity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study emphasizes the importance of the wound closure method and skin flap size in primary closure for preventing claw toe deformity after vascularized fibula flap procedures. These findings may contribute to improved postoperative outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk Factors of Free Flap Outcomes After Head and Neck Cancer Surgery: A Multivariable Analysis From a Single Center Experience 头颈癌手术后游离皮瓣预后的危险因素:单中心经验的多变量分析
IF 1.5 3区 医学
Microsurgery Pub Date : 2025-02-08 DOI: 10.1002/micr.70023
Chia-Hsuan Tsai, Cristhiam Yang, Yao-Chang Liu, Chi-Ling Chen, Huang-Kai Kao
{"title":"Risk Factors of Free Flap Outcomes After Head and Neck Cancer Surgery: A Multivariable Analysis From a Single Center Experience","authors":"Chia-Hsuan Tsai,&nbsp;Cristhiam Yang,&nbsp;Yao-Chang Liu,&nbsp;Chi-Ling Chen,&nbsp;Huang-Kai Kao","doi":"10.1002/micr.70023","DOIUrl":"https://doi.org/10.1002/micr.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Risk factors for unfavorable outcomes, such as surgical site infection (SSI) and flap loss, following free flap reconstruction in patients with head and neck cancer are repeatedly reported without a definitive conclusion. Institutional reviews and meta-analyses each have their advantages and limitations. Although this study is without a definitive answer to these questions, it contributes to the literature by identifying potential influencing factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center cohort study included 596 patients who underwent head and neck reconstruction between 2015 and 2017. Patients were initially divided into two groups based on the presence or absence of SSI, and a similar comparison was made for flap loss. Data were further analyzed using univariate and multivariate logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall SSI rate was 18.29%, with the age of patients (65–74 years, adjusted OR 2.41, <i>p</i> &lt; 0.001; &gt; 74 years, adjusted OR 3.53, <i>p</i> &lt; 0.001) and segmental mandibulectomy (adjusted OR 1.81, <i>p</i> = 0.035) as independent risk factors. The overall flap failure rate was 4.4%, with medial sural flap (adjusted OR 6.89; <i>p</i> = 0.025) and prolonged operative time per hour (adjusted OR 1.38; <i>p</i> &lt; 0.001) identified as significant influencing factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Age should not be the sole determinant for excluding patients for free tissue transfer, though it may elevate the SSI rate. Special attention is potentially needed during postoperative care for patients who received segmental mandibulectomy, medial sural flap, or experienced prolonged operative time. Identifying these risk factors can assist surgeons in optimizing flap outcomes before head and neck reconstruction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Usefulness of Dorsal Scapular Artery Perforator Flap for Donor Site Closure After Harvesting Latissimus Dorsi Flap/Thoracodorsal Artery Perforator Flap: A Report of Three Cases 肩胛背动脉穿支瓣在背阔肌瓣/胸背动脉穿支瓣切除后供区闭合中的应用(附3例报告)
IF 1.5 3区 医学
Microsurgery Pub Date : 2025-02-06 DOI: 10.1002/micr.70033
Se Yeon Park, Kyeong-Tae Lee
{"title":"Usefulness of Dorsal Scapular Artery Perforator Flap for Donor Site Closure After Harvesting Latissimus Dorsi Flap/Thoracodorsal Artery Perforator Flap: A Report of Three Cases","authors":"Se Yeon Park,&nbsp;Kyeong-Tae Lee","doi":"10.1002/micr.70033","DOIUrl":"https://doi.org/10.1002/micr.70033","url":null,"abstract":"<div>\u0000 \u0000 <p>Reducing donor-site morbidity is crucial in free-flap reconstruction, with the primary goals of achieving dermis-to-dermis closure and avoiding skin grafts. Although latissimus dorsi (LD) myocutaneous and thoracodorsal artery perforator (TDAP) flaps usually allow primary closure, larger flap harvests may require skin grafts, potentially leading to undesirable outcomes. In such situations, local flap transfer can be considered for donor-site closure, yet there are few reports on this. This report aims to present cases where a dorsal scapular artery perforator (DSAP) rotational flap was used to close donor defects following large TDAP/LD flap harvests. The first case involved a 16-year-old girl who required a below-knee amputation due to an acute thrombotic event, leaving a 20 × 20 cm<sup>2</sup>-sized stump defect. Bilateral LD myocutaneous flaps were harvested, with the right donor site closed primarily, while a 20 × 9 cm<sup>2</sup>-sized defect remained on the left. A 22 × 9 cm<sup>2</sup>-sized DSAP flap, based on three perforators, was rotated to close the defect, showing excellent outcomes at 12 months. In the second and third cases, 75- and 78-year-old male patients with scalp angiosarcoma underwent wide excision and reconstruction with TDAP flaps, leaving 14 × 6 cm<sup>2</sup> and 14 × 7 cm<sup>2</sup>-sized donor defects. DSAP flaps, 15 × 7 cm<sup>2</sup> and 15 × 8 cm<sup>2</sup> in size, were rotated based on nearby perforators to close these areas. Both patients showed no morbidities at postoperative 8 and 2 months, respectively. When primary closure of the donor site is challenging after harvesting large TDAP /LD flaps, a DSAP rotational flap can provide a valuable option for minimizing donor-site morbidity.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Case of Ala Reconstruction With an Extended Pedicle Helical Rim Flap 扩展蒂螺旋缘皮瓣重建鼻翼1例。
IF 1.5 3区 医学
Microsurgery Pub Date : 2025-01-29 DOI: 10.1002/micr.70027
Filipa Poleri, Jorge Correia-Pinto, Larissa Lanzaro, Rui Casimiro, Carolina Chaves, Horácio Zenha, Horácio Costa
{"title":"A Case of Ala Reconstruction With an Extended Pedicle Helical Rim Flap","authors":"Filipa Poleri,&nbsp;Jorge Correia-Pinto,&nbsp;Larissa Lanzaro,&nbsp;Rui Casimiro,&nbsp;Carolina Chaves,&nbsp;Horácio Zenha,&nbsp;Horácio Costa","doi":"10.1002/micr.70027","DOIUrl":"10.1002/micr.70027","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arterial End-To-Side Anastomosis as a Salvage Maneuver in DIEP-Flap Breast Reconstruction 动脉端侧吻合在diep -皮瓣乳房再造术中的应用。
IF 1.5 3区 医学
Microsurgery Pub Date : 2025-01-29 DOI: 10.1002/micr.70028
E. Schouppe, Dariush Nikkhah
{"title":"Arterial End-To-Side Anastomosis as a Salvage Maneuver in DIEP-Flap Breast Reconstruction","authors":"E. Schouppe,&nbsp;Dariush Nikkhah","doi":"10.1002/micr.70028","DOIUrl":"10.1002/micr.70028","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Microsurgical Reconstruction of Complex Scalp Defects With Vastus Lateralis Free Flap 股外侧游离皮瓣显微外科重建复杂头皮缺损。
IF 1.5 3区 医学
Microsurgery Pub Date : 2025-01-29 DOI: 10.1002/micr.70025
Giovanni Zabbia, Emanuele Cammarata, Mara Franza, Francesca Toia, Greta Tondini, Francesca Graziano, Domenico Gerardo Iacopino, Adriana Cordova
{"title":"Microsurgical Reconstruction of Complex Scalp Defects With Vastus Lateralis Free Flap","authors":"Giovanni Zabbia,&nbsp;Emanuele Cammarata,&nbsp;Mara Franza,&nbsp;Francesca Toia,&nbsp;Greta Tondini,&nbsp;Francesca Graziano,&nbsp;Domenico Gerardo Iacopino,&nbsp;Adriana Cordova","doi":"10.1002/micr.70025","DOIUrl":"10.1002/micr.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Scalp reconstruction is a challenging field for plastic surgeons. In case of large or complex defects, microsurgical-free flaps are usually required. Reconstructive failure can result in high morbidity and in some cases be life-threatening.</p>\u0000 \u0000 <p>In this article, we present our experience in the reconstruction of complex scalp defects with the use of a vastus lateralis (VL) free flap.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>From July 2013 to July 2023, we retrospectively analyzed patients who underwent soft tissue reconstruction of the scalp with a VL-free flap at the authors' institution. The patient's demographic, clinical and surgical characteristics, and postoperative complications were recorded and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty patients were included. The mean age was 67.3 years. Seventeen patients were male, while 13 were female. In 56.7% of patients, defects resulted from cancer resection. In four patients, the defect was limited to the soft tissues while a multi-layer defect with bone and/or dura involvement was present in 26 patients. Soft tissue reconstruction was always achieved with a VL-free flap (<i>n</i> = 30). In 28 cases, a skin-grafted muscular flap was used. The most used recipient vessels were the superior thyroid vessels (<i>n</i> = 18). Complications occurred in six patients (20%): two cases of total flap loss and two cases of infection of the cranioplasty materials requiring their removal. In two cases patients died within 48 h. All patients were satisfied with the aesthetic and functional results at 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the case of complex scalp defects, the gold standard is reconstruction through microsurgical flaps that provide well-vascularized tissue and allow to cover large defects, reducing the incidence of infections and ensuring good brain protection even without cranioplasty. In our experience, VL-free flap represents a valid option, providing a low donor site morbidity, the possibility of a two-team approach, and a low complication rate.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Double-Barreled Vascularized Fibula Free Flap in Pediatric Tibial Bone Defect Reconstruction: A 20-Year Monocentric Experience 双管带血管腓骨游离皮瓣在小儿胫骨骨缺损重建中的应用:20年单中心经验。
IF 1.5 3区 医学
Microsurgery Pub Date : 2025-01-27 DOI: 10.1002/micr.70024
François Thuau, Antoine Hamel, Franck Duteille
{"title":"Double-Barreled Vascularized Fibula Free Flap in Pediatric Tibial Bone Defect Reconstruction: A 20-Year Monocentric Experience","authors":"François Thuau,&nbsp;Antoine Hamel,&nbsp;Franck Duteille","doi":"10.1002/micr.70024","DOIUrl":"10.1002/micr.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Reconstructing large bone defects for lower limb salvage in the pediatric population remains challenging due to complex oncological or septic issues, limited surgical options, and lengthy procedures prone to complications. The vascularized double-barreled fibula free flap is pivotal for reconstructing large bones. In this article, we report our experience with this technique in the surgical management of pediatric tibial bone defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of patients under 18 years of age who underwent tibial reconstruction using a double-barreled fibula free flap at our center between 2004 and 2023. Collected data included demographic information, operative details, time to bone consolidation and full weight-bearing, and functional outcomes using the Musculoskeletal Tumor Society (MSTS) score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight patients (5 females, 3 males) with a mean age of 12.5 years (range 5–17) were included. The average tibial defect length was 11.2 cm (range 7–14 cm), affecting the proximal tibia in 4 cases (50%), the middle third in 3 cases (37.5%), and the distal third in 1 case (12.5%). Reconstruction followed oncologic resection in 7 patients (87.5%) and addressed congenital pseudarthrosis in 1 patient (12.5%).</p>\u0000 \u0000 <p>One patient died of sarcoma. Six patients (75%) achieved full weight-bearing within a median of 7 months (range 6–16) and a bone consolidation at 9 months in median (range 6–18). One reconstruction (12.5%) failed due to septic pseudarthrosis leading to a below-knee amputation. The mean MSTS score was 81.65 (range 63.3–100).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study is the first to focus on pediatric tibial reconstructions using the double-barreled vascularized fibula free flap. It highlights the technique's reliability for reconstructing tibial defects, particularly in intermediate-sized cases (7–14 cm). This single-stage procedure minimizes stress fracture risk, enables earlier weight-bearing, and is an alternative to the Capanna technique without requiring an allograft.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current Practices and Evidence of Aspirin Usage in Microvascular Surgery: A Systematic Review and Meta-Analysis 微血管手术中阿司匹林使用的现行实践和证据:系统回顾和荟萃分析。
IF 1.5 3区 医学
Microsurgery Pub Date : 2025-01-27 DOI: 10.1002/micr.70029
Faraaz Azam, Cyril Awaida, Anca Dogaroiu, Andrei Odobescu
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