Global ETD Search

1	Minimizing Donor-Site Morbidity Following Bilateral Pedicled TRAM Breast Reconstruction With the Double Mesh Fold Over Technique Bharti, Gaurav, Groves, Leslie, Sanger, Claire, Thompson, James, David, Lisa, Marks, Malcolm 01 May 2013 (has links) INTRODUCTION: Transverse rectus abdominus muscle flaps (TRAM) can result in significant abdominal wall donor-site morbidity. We present our experience with bilateral pedicle TRAM breast reconstruction using a double-layered polypropylene mesh fold over technique to repair the rectus fascia. METHODS: A retrospective study was performed that included patients with bilateral pedicle TRAM breast reconstruction and abdominal reconstruction using a double-layered polypropylene mesh fold over technique. RESULTS: Thirty-five patients met the study criteria with a mean age of 49 years old and mean follow-up of 7.4 years. There were no instances of abdominal hernia and only 2 cases (5.7%) of abdominal bulge. Other abdominal complications included partial umbilical necrosis (14.3%), seroma (11.4%), partial wound dehiscence (8.6%), abdominal weakness (5.7%), abdominal laxity (2.9%), and hematoma (2.9%). CONCLUSIONS: The TRAM flap is a reliable option for bilateral autologous breast reconstruction. Using the double mesh repair of the abdominal wall can reduce instances of an abdominal bulge and hernia. abdominal reconstruction anterior rectus fascia polypropylene mesh transverse rectus abdominus muscle flaps
2	Minimizing Donor-Site Morbidity Following Bilateral Pedicled TRAM Breast Reconstruction With the Double Mesh Fold Over Technique Bharti, Gaurav, Groves, Leslie, Sanger, Claire, Thompson, James, David, Lisa, Marks, Malcolm 01 May 2013 (has links) INTRODUCTION: Transverse rectus abdominus muscle flaps (TRAM) can result in significant abdominal wall donor-site morbidity. We present our experience with bilateral pedicle TRAM breast reconstruction using a double-layered polypropylene mesh fold over technique to repair the rectus fascia. METHODS: A retrospective study was performed that included patients with bilateral pedicle TRAM breast reconstruction and abdominal reconstruction using a double-layered polypropylene mesh fold over technique. RESULTS: Thirty-five patients met the study criteria with a mean age of 49 years old and mean follow-up of 7.4 years. There were no instances of abdominal hernia and only 2 cases (5.7%) of abdominal bulge. Other abdominal complications included partial umbilical necrosis (14.3%), seroma (11.4%), partial wound dehiscence (8.6%), abdominal weakness (5.7%), abdominal laxity (2.9%), and hematoma (2.9%). CONCLUSIONS: The TRAM flap is a reliable option for bilateral autologous breast reconstruction. Using the double mesh repair of the abdominal wall can reduce instances of an abdominal bulge and hernia. abdominal reconstruction anterior rectus fascia polypropylene mesh transverse rectus abdominus muscle flaps
3	Mechanisms that Jeopardize Skeletal Muscle Perfusion during Surgery Mak, Timothy 05 December 2013 (has links) We assessed potential mechanisms that may jeopardize skeletal muscle perfusion during surgery leading to adverse outcomes including muscle injury and flap hypoxia. In craniotomy patients, we observed an increase in serum lactate and creatine kinase and urine myoglobin; indicative of muscle damage. The early rise in lactate correlated with elevated BMI, suggesting that obesity caused tissue compression and muscle ischemia. In our rodent model, we investigated the effects of flap preparation and phenylephrine on muscle perfusion by assessing microvascular blood flow and tissue PO2. Phenylephrine reduced muscle blood flow by ~20%, yet increased PO2 by ~10% suggestive of decreased O2 metabolism. At baseline, muscle flap blood flow was reduced by ~50% while PO2 was severely reduced ~80% (~5 torr) suggesting that flap perfusion was attenuated and O2 metabolism was increased. Phenylephrine infusion further reduced muscle flap perfusion. These data demonstrate multiple mechanisms by which muscle perfusion is jeopardized during surgery. Muscle Perfusion Phenylephrine Serum Lactate Creatine Kinase Muscle Damage Muscle Flap Neurosurgery Free Tissue Transfer Rhabdomyolysis Craniotomy Rectus Abdominus Muscle Oxygen Body Mass Index Microvascular Blood Flow 0719
4	Mechanisms that Jeopardize Skeletal Muscle Perfusion during Surgery Mak, Timothy 05 December 2013 (has links) We assessed potential mechanisms that may jeopardize skeletal muscle perfusion during surgery leading to adverse outcomes including muscle injury and flap hypoxia. In craniotomy patients, we observed an increase in serum lactate and creatine kinase and urine myoglobin; indicative of muscle damage. The early rise in lactate correlated with elevated BMI, suggesting that obesity caused tissue compression and muscle ischemia. In our rodent model, we investigated the effects of flap preparation and phenylephrine on muscle perfusion by assessing microvascular blood flow and tissue PO2. Phenylephrine reduced muscle blood flow by ~20%, yet increased PO2 by ~10% suggestive of decreased O2 metabolism. At baseline, muscle flap blood flow was reduced by ~50% while PO2 was severely reduced ~80% (~5 torr) suggesting that flap perfusion was attenuated and O2 metabolism was increased. Phenylephrine infusion further reduced muscle flap perfusion. These data demonstrate multiple mechanisms by which muscle perfusion is jeopardized during surgery. Muscle Perfusion Phenylephrine Serum Lactate Creatine Kinase Muscle Damage Muscle Flap Neurosurgery Free Tissue Transfer Rhabdomyolysis Craniotomy Rectus Abdominus Muscle Oxygen Body Mass Index Microvascular Blood Flow 0719

1

Page generated in 0.038 seconds