Other authors have reported similar results.[8] The
reconstructed mandible in this case functions well, like other authors have reported in these complex reconstructions in children.[4, 5, 7, 8] As observed in other pathologies, like facial palsy, for example, children tend to have a higher ability to adapt and have better functional outcomes than adults. Once facial growth is complete, additional surgery may be necessary to improve the final aesthetic result and to allow the use of osteointegrated implants, the benefits and risks of which will have to be discussed with the patient and her parents. In summary, this case of mandibular selleck inhibitor reconstruction with fibular osteocutaneous free flap in an 8-month-old girl with a 12-year follow-up is, to our knowledge, the longest reported in such a young patient. “
“Background: An important element in Nivolumab concentration achieving high success rates with free flap surgery has been the use of different techniques for monitoring flaps postoperatively as a means to detecting vascular compromise. Successful monitoring of the vascular pedicle to a flap can potentiate rapid return to theater in the setting of compromise, with the potential to salvage the flap. There is little evidence that any technique
offers any advantage over clinical monitoring alone. Methods: A consecutive series of 547 patients from a single plastic surgical unit who underwent a fasciocutaneous free flap operation for breast reconstruction [deep inferior epigastric artery perforator (DIEP) flap, superficial inferior epigastric artery (SIEA) flap, or superior gluteal artery perforator (SGAP) flap] were included. A comparison was made between the first 426 consecutive patients in whom flap monitoring was performed using clinical monitoring alone and the subsequent 121 patients in whom monitoring was achieved with the Cook-Swartz implantable Doppler probe. Outcome measures
included flap salvage rate and false-positive rate. Results: There was a strong trend toward improved salvage rates with the implantable Doppler probe compared with clinical monitoring (80% vs. 66%, P = 0.48). When combined with the literature (meta-analysis), the data prove statistically significant (P < 0.01). There was no statistical BCKDHB difference between the groups for false-positive rates. Conclusion: Flap monitoring with the implantable Doppler probe can improve flap salvage rates without increasing the rate of false-positive takebacks. © 2009 Wiley-Liss, Inc. Microsurgery, 2010. “
“Supermicrosurgical lymphaticovenular anastomosis (LVA) has become a useful option for the treatment of compression-refractory lymphedema with its effectiveness and less invasiveness. It is important to make as many bypasses as possible for better treatment results of LVA operation. We report a secondary lymphedema case successfully treated using a modified lambda-shaped LVA.