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Alok Misra

Publications and source records attributed to Alok Misra.

7 recordsLinked to original sources
PubMed2006

A comparison of postoperative pain between DIEP and extended latissimus dorsi flaps in breast reconstruction.

BACKGROUND: The senior author (A.P.) has performed 70 consecutive breast reconstructions over 3 years using the free deep inferior epigastric perforator (DIEP) and pedicled extended latissimus dorsi flaps. This study set out to compare these two methods of reconstruction by looking at postoperative morphine requirements and lengths of stay in hospital. METHODS: Patient notes were retrospectively reviewed and the total morphine used by patient-controlled analgesia was measured. RESULTS: The mean morphine per kilogram required by patients who had DIEP flaps (0.21 mg/kg; n = 22) was significantly less than the amount required by patients who had extended latissimus dorsi flaps (0.47 mg/kg; n = 48; p < 0.001). An observed trend also revealed that DIEP flap patients remained in hospital for less time compared with extended latissimus dorsi flap patients, although the difference was not significant (p > 0.01). CONCLUSIONS: This study shows that DIEP flap patients require less postoperative morphine and therefore might experience less pain than extended latissimus dorsi flap patients. DIEP flap patients may also leave the hospital sooner.

Female↗
PubMed2005

Fasciocutaneous flaps based on fascial feeder and perforator vessels for defects in the patellar and peripatellar regions.

BACKGROUND: Soft-tissue reconstruction in the patellar and peripatellar regions is a challenging problem. Restoring the original thin, pliable, and tough skin properties is a necessary demand, if appearance and knee function are not to be compromised. Local tissue provides the closest match to the original, but limited availability can restrict the reach of conventional local flaps and, more often than not, produce donor sites that need coverage of their own. METHODS: A retrospective study was performed over a 7-year period (from 1995 to September of 2002) using local fasciocutaneous flaps, based on fascial feeder and perforator vessels, to reconstruct a variety of patellar and peripatellar defects. Fifteen patients with a mean age of 62 years (range, 18 to 86 years) were reviewed. RESULTS: Early complications were minimal, with only one patient (wound dehiscence) requiring a further procedure. All patients achieved a good final outcome. CONCLUSIONS: The authors found the fascial feeder- and perforator-based local fasciocutaneous flap in the patellar and peripatellar regions to be a simple and reproducible technique to perform. By islanding local flaps on perforator/fascial feeder vessels, greater mobility is achievable, when compared with conventional flaps. Combining local fascial feeder- and perforator-based flaps with V-Y advancement minimizes donor-site complications. On this basis, well-matched local tissue can be used for reconstruction in the patellar and peripatellar areas, with minimal compromise to either appearance or function or both.

Adolescent↗