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At least 199 records · Page 11Linked to original sources

PubMed1989

[Reconstruction of the breast after radical mastectomy in cancer. Reconstruction of the breast volume].

After underlining the serious psychological consequences of radical mastectomy for carcinoma and the importance of breast reconstruction for the patient's complete recovery, the paper briefly reviews the main reconstruction techniques employed in restoring breast volume which is essentially achieved by inserting an artificial prosthesis below a myocutaneous skin flap often taken from the great dorsal. Some mention is also made of recently developed alternative techniques.

Breast↗

PubMed1989

[Reconstruction of the breast after radical mastectomy in cancer. Reconstruction of the areola-nipple complex and the symmetry of the 2 breasts].

After pointing out the need for reconstruction of the nipple-areola complex and the restoration of symmetry between the two breasts after radical mastectomy for cancer, the paper briefly examines the techniques currently available for the achievement of these "finishing touches" that usually take longer then the primary and fundamental breast reconstruction.

Breast↗

PubMed1989

[Bilio-duodenal jejunum interposition as a technical alternative to Roux-Y reconstruction following reconstruction of cancer of the fork of the hepatic duct].

The inability to predict preoperatively whether resection will result in tumorfree or at least tumorinfiltrated margins, represents one essential problem in surgical treatment of central bile duct carcinoma. In a certain number of cases the operation ends with a tumorinfiltrated biliodigestive anastomosis usually performed in a Roux-en-Y-technique. In those cases early tumor recurrence is predictable, but any follow-up and treatment by endoscopic methods (laser resection, pigtail drainage) are inhibited by the long jejunal limb of the Roux-en-Y-reconstruction. Therefore we changed our operative procedure in patients with central bile duct carcinomas performing the reconstruction of intestinal bile drainage by a cholangio-duodenal interposition of a 25 cm jejunal segment. This technique now allows endoscopic reintervention in cases of recurrent tumors or benign strictures of the anastomosis which is demonstrated.

Anastomosis, Roux-en-Y↗

PubMedDate not supplied

Reconstruction of the chest wall after full thickness resection: a comparison between myocutaneous flap and acrylic resin plate as reconstructive techniques.

Thirty-three patients with chest wall malignancies underwent full thickness resection of the chest wall and immediate reconstruction of the defects with either synthetic materials (acrylic resin plate, 16 patients) or with myocutaneous flaps (rectus abdominis flaps, 17 patients). Although the acrylic resin plate proved to be excellent for maintaining stability of the chest wall, five patients suffered from local skin necrosis, requiring skin grafting, and four suffered from persistent foreign body reactions, necessitating ultimate removal of the plate. The patients receiving myocutaneous flap repair had excellent wound healing, acceptable rigidity of their chest wall, and no foreign body reactions throughout the follow-up period. The 50% post-operative survival time for the entire series was 29 months, suggesting that the procedure in an effective treatment modality for breast cancer involving the chest wall. Reconstruction with a myocutaneous flap is indicated as long as the chest wall defect is not too extensive.

Acrylic Resins↗

PubMed1993

[Forum: reconstruction of the traumatic thumb. Toe as a donor site for reconstruction of the thumb].

One method of reconstruction of the thumb consists of microsurgical transfer of a toe. After a brief anatomical and technical review, the authors describe the various possibilities of thumb reconstruction using toe transfer: transfer of the 2nd toe, transfer of the great toe, partial toe transfers. Traumatic amputations must be distinguished from congenital amputations in terms of the indications for toe transfers. The indication for toe transfer in a case of traumatic amputation may be based on the level of amputation.

Amputation, Traumatic↗

PubMed1993

[Forum: reconstruction of the traumatic thumb. Esthetics and post-traumatic reconstruction of the thumb].

The authors deal with the aesthetic problems of traumatic thumb reconstructions from two complementary points of view: surgical and psychoanalytical. From the surgical point of view, they discuss the aesthetic factors of repair ("aesthetics equals function") in the hand and in the donor site. The features of a "good" reconstructed thumb are recalled, together with the ways of achieving this result, taking into account several imperatives related to the various techniques: the residual scar, the proportions of the thumb (length and diameter) and the appearance of the nail. The morphological sequelae at the principal donor sites (hand, forearm and foot) are also evaluated. Although sacrifice of the great toe is not longer justified, that of the second toe should be weighted up against the limited sequelae of "custom-made" great toe flaps. In the second, psychoanalytical approach to the aesthetic problem, the deep motivations underlying the patient's request are examined. In order to satisfy the patient's demand, it is essential to clearly define the indications and contraindications related to the patient's psychological make-up, the importance of the aesthetic role of his or her hand and the psychological impact of both the initial trauma and the secondary sequelae of surgery, bearing in mind that psychological factors change with time, just as the body image also varies continuously. Finally, the dual, surgical and psychoanalytical approach should allow the surgeon to satisfy the hand injury patient's functional and aesthetic demands under the best possible conditions.

Amputation, Traumatic↗

PubMed1996

[Chest wall reconstruction, relation between reconstruction method and infection].

We have operated 52 cases of chest wall resection in these 20 years. Twenty five cases in it were reconstructed by unabsorbable artificial materials such as Marlex mesh, Gore-Tex sheet and some others (Group 1). Eleven cases were covered with the net knitted by absorbable threads or muscle flaps (Group 2). Resting 16 cases have not received any definitive renovations (Group 3). Group 1 has suffered from such severe postoperative complications as acute empyema (8%) and chronic empyema (8%). Few cases in Group 2 has had infectious complication and ventilatory disturbance. Rate of postoperative vital capacity in Group 3 was the lowest value among three groups, though they had the smallest chest wall defects. We obtained following conclusions from this study. Every chest wall defect should be repaired by some way even if the defect were small. Chest wall defect in compromised host should be repaired by absorbable artificial material and muscle flap. Unabsorbable artificial materials are now indispensable for the reconstruction of large chest wall defect, however we must fully take care of postoperative infections in cases of its use.

Biocompatible Materials↗

PubMed1995

[3-dimensional reconstruction for planning surgical reconstruction of tumors in the single kidney].

Organ-sparing renal surgery for renal cell carcinoma has greatly increased in importance over the last few years owing to the widespread application of ultrasound examination. When a normal contralateral kidney is present the indications for organ-sparing surgery are very strict. Our patient presented with a large tumour in a single kidney and, though fully informed about all the risks involved, insisted upon an organ-sparing operation. In planning and execution of the operation we were much assisted by the use of a three-dimensional reconstruction made from the CT scan carried out preoperatively, because this showed the exact position and size of the tumour. We report on the course of the patient's illness and present a simple three-dimensional reconstruction technique.

Carcinoma, Renal Cell↗

PubMed1997

Conceptual considerations in head & neck reconstruction. Defect analysis and options for reconstruction.

This article reviews the authors' approach to the management of facial defects based on extensive experience in facial reconstruction. The article describes basic principles of wound healing with attention to healing by secondary intention and its role in facial reconstruction. Detailed consideration is provided for various options of repair of facial defects including primary closure, grafting, and local flap techniques.

Head and Neck Neoplasms↗

PubMed1997

Reconstruction of a medial tibial plateau defect using a "pillar" bone graft--a report of two knee reconstructions.

A technique of reconstructing a large tibial plateau defect has been described using a solid bone graft as a pillar to hold up the tibial component of a total knee replacement. The advantage of using a solid bone graft is that there is good initial structural support for the tibial component. This enables early mobilisation. This method has worked well in the two knees reported. Other methods of reconstructing a tibial plateau defect are discussed.

Aged↗

PubMed1998

[Reconstruction of incisional hernias with defined tensiometrically controlled tension--a possibility for anatomically correct reconstruction of the abdominal wall].

The repair of incisional hernias of the abdominal wall is characterized by high rates of recurrence if arbitrary tension is applied. A rationale for selecting the appropriate reconstruction technique as defined by intraoperative tension measurements has proven effective and successful. Here, the inlay/onlay technique tolerates up to 3.5 kilopounds (kp). Our results show that using this technique, complete reconstruction is possible in 65% of cases with a recurrence rate of 2.3%.

Cicatrix↗

PubMed2003

Application of continuous-wave EPR spectral-spatial image reconstruction techniques for in vivo oxymetry: comparison of projection reconstruction and constant-time modalities.

In this study we report the application of continuous-wave (CW) electron paramagnetic resonance (EPR) constant-time spectral spatial imaging (CTSSI) for in vivo oxymetry. 2D and 3D SSI studies of a phantom and live mice were carried out using projection reconstruction (PR) and constant-time (CT) modalities using a CW-EPR spectrometer/imager operating at 300 MHz frequency. Distortion of line shape, which is inherent in the PR method, was minimized by the CTSSI modality. It was also found that CTSSI offers improved noise reduction, restores a smoother line shape, and gives high convergence of estimated values. Spatial resolution was also improved by CTSSI, although fundamental spectral line-width broadening was observed. Although additional corrections are required for accurate estimations of spectral line width, CTSSI was able to demonstrate distinct differences in oxygen tension between a tumor and the normal legs of a C3H mouse. The PR method, on the other hand, was unable to make such a distinction unequivocally with the triarylmethyl spin probes. CTSSI promises to be a more suitable method for quantitative in vivo oxymetric studies using radiofrequency EPR imaging (EPRI).

Animals↗

PubMed1987

Latissimus dorsi and rectus abdominis breast reconstruction postmastectomy: musculocutaneous breast reconstruction.

The female breast is one of the most important physical expressions of femininity. Removal of this sexual organ can induce severe psychological effects. In our service the final decision for breast reconstruction is always made by the patient. We have done this operation on 115 patients: 43 with the latissimus dorsi technique (LDT) and 72 with the rectus abdominis technique (RAT). At present we prefer the RAT, done simultaneously with mastectomy or delayed, since the breasts obtained with it have in general a very natural and harmonious appearance.

Breast↗

PubMed2006

One-stage posterior cruciate ligament inlay reconstruction combining anterior cruciate ligament reconstruction following knee dislocation.

Knee dislocation is a rare but severe injury that involves damage to the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral or medial ligamentous structures, and other soft tissues or bony structures surrounding the knee joint. No consensus exists regarding the best treatment method. This work presents a method of 1-stage ACL and PCL reconstruction in which a contralateral quadriceps tendon-bone autograft with tibial inlay technique is used for the PCL and contralateral hamstring tendon autograft with suspension fixation is used for the ACL. After harvesting grafts, the patient is put in the lateral decubitus position. Under arthroscopy, the femoral tunnel for the anterolateral bundle of the PCL is created using an 8-mm reamer via a prepositioned guide pin. Next, the tibial tunnel of the ACL is created with an appropriate diameter cannulated reamer. Directed by the femoral guide instrument with a 7-mm offset, a guide pin is positioned retrograde through the tibial tunnel. A reamer is then used to create a 35-mm long closed-ended femoral tunnel for the ACL. A posterior arthrotomy for the PCL inlay technique is performed. After capsulotomy, a unicortical window is created at the footprint of the PCL and the inlay graft is fixed using a 3.5mm-cancellous screw and washer. The PCL graft is then passed into the femoral tunnel. The ACL graft is passed in a retrograde fashion using the Beath pin. The ACL graft is fixed by tying with a washer on the femoral side and by tying with a screw on the tibial side. The PCL graft is then fixed on the femoral side.

Anterior Cruciate Ligament↗

PubMed2006

Use of Palacos R-40 with gentamicin to reconstruct temporal defects after maxillofacial reconstructions with temporalis flaps.

The temporalis muscle flap is a useful flap for the reconstruction of oral ablative defects. A complication of its use that was overlooked was the crater-like defect created when the muscle is stripped from its attachment on the temporal fossa. The cold-cure acrylic we use is Palacos R-40 with Gentamicin (Heraeus Kulzer GmbH). This material is radio-opaque, rapidly setting and contains gentamicin. We present a total of 41 cases over an 11-year period (1994-2005). We have a 97.6% (n = 40) success rate. Infection developed in only one case, which leads to the removal of the acrylic implant. The use of Palacos R-40 with Gentamicin is easy to use, it can be custom-moulded to fit and fill the defect any of shape and size. It has minimal complications and high success rate with acceptable results to the patients.

Anti-Bacterial Agents↗

PubMed1999

Reconstruction of perianal skin defect using a V-Y advancement of bilateral gluteus maximus musculocutaneous flaps: reconstruction considering anal cleft and anal function.

In order to preserve the anal function after ano-perianal skin excision for malignancy, we have reconstructed a deep, symmetrical natal cleft using a V-Y advancement of bilateral gluteus maximus musculocutaneous flaps thinned medially and sutured to the ooccyx, anococcygeal ligament and the central tendon of the perineum. This technique was applied in three cases of Bowen's disease and two cases of Paget's disease. In all five cases, postoperative anal functions such as comfortable defecation and sensation, were well preserved, the perianal skin and underwear stayed clean, and there was no disturbance of walking or exercise.

Aged↗

PubMed1981

Isokinetic thigh muscle strength after ligament reconstruction in the knee joint: results from a 5-10 year follow-up after reconstructions of the anterior cruciate ligament in the knee joint.

We evaluated the thigh muscle strength using an isokinetic dynamometer in 80 patients 5 to 10 years following anterior cruciate ligament reconstruction. Patients with good results also had good muscle function, both of their flexor and their extensor muscles. Patients with poor results demonstrated reduced muscle strength in both their hamstrings and their quadriceps. Patients with fair functional results demonstrated reduced strength of their extensor muscles compared to their normal leg. However, strength in their operated leg's flexor muscles was unchanged compared to their normal leg. This may be due to the fact that strong hamstring muscles can compensate for some instability of the anterior cruciate ligament.

Adolescent↗

PubMed2001

No bone ingrowth into the tibia tunnel in anterior cruciate ligament-reconstructed patients: a 1-year prospective quantified CT study of 10 patients reconstructed with an autologous bone-patellar tendon-bone graft.

10 patients with major instability symptoms due to an acute anterior cruciate ligament injury were operated on with a bone-patellar tendon-bone reconstruction. Tibial condyle bone mineral density (BMD), bone ingrowth and changes in diameter in the tibia bone tunnel were studied with quantified computed tomography (QCT) postoperatively and after 1, 3, 6 and 12 months. We found no sign of bone ingrowth in the form of increased bone mineral density (BMD) in the bone tunnels in any of the patients. The tunnel diameter increased in all patients during the first postoperative months. After 1 year, 5 patients had a smaller diameter than at the first postoperative examination, 2 had the same diameter as immediately after surgery and 2 patients had a larger diameter. A sclerotic zone developed in all patients along the perimeter of the tunnel during the 3-6 months of follow-up. The BMD in the tibial condyle decreased at 3 months; it then increased, but between 6 and 12 months, it levelled out and was slightly lower than postoperatively. In conclusion, we found no growth of bone into the tunnel and tendinous part of the graft during the first postoperative year.

Adult↗