bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascularized periosteal bone graft from the supracondylar region of the femur
Authors: Doi Kazuteru , Sakai Kazuhiro 
Published: March 2007

AbstractFree, vascularized thin corticoperiosteal grafts and small pe‐riosteal bone grafts harvested from the supracondylar region of the femur are described. These grafts are nourished from the articular branch of the descending genicular artery and vein. Thin corticoperiosteal grafts consist of periosteum with a thin layer of outer cortical bone and include the cambium layer, which has a better osteogenic capacity. This graft is elastic and readily conforms to the recipient bed configuration. Thin corticoperiosteal grafts were used to treat 11 patients with fracture non‐union of an upper extremity that had no massive bone defects. Early, rapid union occurred in all patients except three: one in which the anastomosed vessel became obstructed and two in which the internal fixation of the fracture was unsecured. The small bone grafts consist of periosteum, full thickness cortex, and the underlying cancellous bone. This graft can be successfully harvested without disturbing the vascularity, unlike the currently used vascularized bone grafts. This graft was used to treat three patients with avascular necrosis of the body of the talus and could prevent the necrotic talus body from progressive collapse in patients in early stages of the disease. One patient with an infectious bone defect of the first metatarsal bone was successfully treated by vascularized bone graft with an accompanying skin flap. © 1994 Wiley‐Liss, Inc.
Replantation of amputated facial tissues with microvascular anastomosis
Authors: Jeng Seng‐Feng , Wei Fu‐Chan , Noordhoff M. Samuel 
Published: March 2007

AbstractA challenge to the microsurgeon is perfecting the technique of replantation of small pieces of facial tissue, mainly because of the extremely small size of the arteries as well as a lack of suitable veins for drainage. In the past 4 years, we have had seven cases of facial amputations, which included one scalp, two nasal tips, two ears, one lower lip, and one eyebrow. All of these patients were replanted/revascularized by microvascular anastomosis. Only two of the cases had suitable veins for anastomosis. Alternative techniques used for improving venous outflow were arterio‐venous fistula, chemical leeches, and pin pricks. Four of the cases were completely successful, two cases had partial loss of the replant, and one case failed due to absence of venous drainage. In facial amputation, an aggressive microsurgical attempt will result in more tissue surviving and a better cosmetic outcome than in any other reconstructive procedures. © 1994 Wiley‐Liss, Inc.
Study of microvascular polyester prosthesis in rat carotid arteries
Authors: Wang Min‐Sheng , Chen Zheng‐Rong , Chen Zhong‐Wei 
Published: March 2007

AbstractThe implantation of a microvascular polyester prosthesis (MPP) (internal diameter 1 mm, length 10 mm) in the carotid arteries was studied in 48 Sprague‐Dawley rats. The left carotid artery was resected to 7 mm in length and replaced with MPP by means of sleeve anastomoses. Postoperatively the patency was monitored with Doppler ultrasound at 24 and 72 hr, and at 1, 2, 3, 4, 8, and 12 weeks and was confirmed either by direct inspection intraoperatively or by angiography at the time of removal. At each monitoring time, all the throm‐bosed and some selected patent grafts were removed and prepared for scanning electron microscopy (SEM) study. The early patency rate was 100% within 24 hr, and the cumulative long‐term patency rate was 77.1% at 12 weeks. Rapid and complete endothelial lining (EL) restoration was demonstrated 3 weeks after operation, which provided a smooth and nonthrombogenic surface, and contributed to the long‐term patency. Ten of the 11 failed grafts occurred within 3 weeks, that is, before EL, due to thrombosis. These observations indicate that MPP can be successfully used as arterial conduits in rats, and an enhanced patency rate may be expected with the use of anticoagulants or endothelial cell seeding for prevention of early thrombosis. © 1994 Wiley‐Liss, Inc.
Technical considerations in two‐stage functioning free muscle transplantation reconstruction of both flexor and extensor functions of the forearm
Authors: Chuang David Chwei‐Chin , Strauch Robert J. , Wei Fu‐Chan 
Published: March 2007

AbstractWe report on two patients with severe injuries of the forearm who were reconstructed using functioning free muscle transplantation (FFMT) for individual replacement of flexor and extensor function. In both cases a two‐stage procedure was performed: The extensor reconstruction preceded the flexor reconstruction by 4–6 months. The extensor digitorum communis and flexor digitorum profundus were successfully reconstructed in both cases using bilateral gracilis FFMT. In one case the flexor pollicis longus and extensor pollicis lon‐gus were also reconstructed using the adductor longus in addition to the gracilis. Clinical follow‐up was a minimum of 2 years. Both patients achieved wrist control, excellent finger flexion, and metacarpophalangeal joint extension. One patient also had good interphalangeal finger extension, but the other developed a persistent claw deformity due to the lack of recovery of ulnar nerve function. Performing the extensor reconstruction prior to the flexor reconstruction theoretically allows a more rapid return of function and a shorter rehabilitation period than using the converse sequence. © 1994 Wiley‐Liss, Inc.
Phalloplasty for female transsexuals with sensate free forearm flap
Authors: Fang Rong‐Hwang , Lin Jin‐Teh , Ma Shiuh 
Published: March 2007

AbstractOne of the primary goals of phalloplasty on female to male transsexuals is to void while standing. However, achieving competence of the neourethra, sensation, and rigidity of the neophallus still present a challenge. Over a 5 year period (1988–1993), 56 phalloplasties using sensate free forearm flaps were performed for 56 primary female transsexuals. The urethrocutaneous fistula rate was 38/56 and one flap totally necrosed. However, when the flap was prefabricated with a tubed graft of vaginal mucosa for the 28 cases (the later part of the series), there were less complications and a lower fistula rate within this portion of the neourethra. Although the whole procedure was time consuming, it was worthwhile and patient satisfaction was high. © 1994 Wiley‐Liss, Inc.
In vivo analysis of microvascular reperfusion injury in striated muscle and skin
Authors: Menger Michael D. , Vollmar Brigitte 
Published: March 2007

AbstractThe use of intravital fluorescence microscopy in the models of the hamster dorsal skin fold chamber and the ear of the hairless mouse allows for the quantitative analysis of post‐ischemic microvascular reperfusion injury in striated muscle and skin. Prolonged periods of ischemia (4 hours in striated muscle and 6 hours in skin) are associated with (1) perfusion failure of nutritive capillaries at the onset of reperfusion (no‐reflow) and (2) activation, accumulation and microvascular adherence of white blood cells, formation of reactive oxygen metabolites and release of potent mediators (leukotrienes, platelet‐activating factor) with the consequence of increased microvascular permeability due to the loss of endothelial integrity, interstitial edema and cell damage (reflow‐paradox). Prophylactic and/or therapeutic regimens may, therefore, include improvement of capillary perfusion by hemodilution, and inhibition of leukocyte adherence, radical formation and mediator release by appropriate counteracting compounds, including anti‐oxidants, antibodies directed against adhesion molecules, leukotriene synthesis inhibitors and platelet‐activating factor receptor antagonists. © 1994 Wiley‐Liss, Inc.
Direct visualization and measurements of wound neovascularization: Application in microsurgery research
Authors: Kjolseth Dorthe , Kim Michael K. , Andresen Louise H. , Morsing Annie , Frank Johannes M. , Schuschke Dale , Anderson Gary L. , Banis Joseph C. , Tobin Gordon R. , Weiner Leonard J. , Hjortdal Vibeke E. , Barker John H. 
Published: March 2007

AbstractNeovascularization or angiogenesis is an essential yet poorly understood component of the healing process. In wound healing research, there is a lack of models enabling quantitative and continuous measurements of wound neovascul‐arization. The hairless mouse ear wound model permits quantitative measurements of wound epithelialization and neovascularization continuously throughout the healing process. On the ears of male homozygous (hr/hr) hairless mice, standardized circular full thickness dermal wounds are produced; then, using vital microscopy, these two processes are directly viewed and measured at day 0 and every third day thereafter until these are complete. This model system and its application to clinically relevant situations are reviewed. © 1994 Wiley‐Liss, Inc.
Microcirculatory consequences of microvascular surgery
Authors: O'Shaughnessy Michael , Gu Jin‐Mei , Wyllie Frances , Acland Robert D. , Anderson Gary L. , Banis Joseph C. , Barker John H. 
Published: March 2007

AbstractAlthough free tissue transfer success has been greatly improved by developments in operating microscopes, microsutures, microinstruments, and technique, free flap and replant failure remain a significant problem under certain adverse circumstances. The nature of these failures is often multifactorial and remains poorly understood. A greater understanding of the processes involved would provide the potential for greater pharmacological control of any adverse conditions prevailing and would thus offer the prospect of more effective adjunctive therapy in the presence of such adverse conditions. Research endeavors in this area have been hindered by the absence of good research models. The isolated rat cremaster muscle model is a recently developed model that simulates the conditions of free tissue transfer. Using this model, both thrombus formation and numerous microcirculatory parameters can be measured. The microcir‐culatory parameters studied to date include the formation of thromboembolism, capillary perfusion, vessel diameters, red blood cell velocity, leukocyte‐endothelium interaction, and microvascular leakage. The isolated rat cremaster muscle model addresses many of the shortcomings of earlier research models and offers the promise of answering at least some of the many unanswered questions relating to free flap and replant failure. © 1994 Wiley‐Liss, Inc.
Clinical use of the 3m 2.5 mm mechanical microcoupling device in free tissue transfer
Authors: Sasson Homayoun Nazarian , Stofman Guy M. , Berman Peter 
Published: March 2007

AbstractThe long‐term patency of the 2.5 mm mechanical microvascular anastomotic device (the Unilink system) was evaluated in 10 cases of free flap transfer in nine patients between July 1991 and July 1993. Flap survival indicated adequate patency to time of healing. All cases were considered critical end‐to‐end venous anastomoses, without a parallel conventional microvascular hand‐sewn anastomosis associated with the coupling device. The types of flaps used were seven rectus abdominous and one each of serratus anterior and lateral arm muscles and a free jejunum.There were no postoperative complications requiring reexploration. The 2.5 mm device had a rate of 100% flap take with complete healing at an average of 15 months postoper‐atively. Selected Doppler flow studies depicted the coupler device in vivo with duplex scan verification of venous patency.The 2.5 mm coupler is a versatile anastomotic device for vessels with a diameter of 2.4–3.2 mm. This expands the applicability of the UNILINK system for use in larger diameter vessels. © 1994 Wiley‐Liss, Inc.
Long‐term follow‐up of coverage of weight bearing surface of the foot with free muscular flap in a pediatric population
Authors: Harris Patrick G. , Letrosne Eric , Caouette‐Laberge Louise , Egerszegi E. Patricia 
Published: March 2007

AbstractBetween 1985 and 1991, 13 muscular free flaps with split thickness skin grafts (10 latissimus dorsi, 2 rectus abdominis, and 1 gracilis) were done in 12 patients to cover the weight bearing surface of the foot. Four open wounds were closed primarily and nine unstable scars were replaced with a free flap.A retrospective analysis shows that over the short term the flaps provided a complete coverage of wounds, with a 100% survival of flaps, and permitted normal weight bearing ambulation starting at 1 month postoperatively. Long‐term results show deep pressure sensation but no light touch sensation. All patients are able to wear normal shoes. Six patients (seven flaps) required further surgery to close subsequent wounds on the flaps: Three hypertrophic scars with recurrent ulcerations needed scar revisions, one child presented a fistula through the flap due to underlying osteomyelitis, and one patient presented a friction wound on the lateral malleolus requiring thinning of the flap. Two flaps presented an area of pressure necrosis through the full thickness of the flap and had to be replaced with another free flap (fasciocutaneous sensate flap) over the heel area.In conclusion, it seems that in the pediatric population, skin‐grafted muscular coverage of the weight bearing surface of the foot is a good alternative, even if more problems with hypertrophic scarring around the grafts have been found than in the adult population. In two cases, the flaps had to be replaced because of pressure necrosis over the calcaneus. Long‐term follow‐up of the sensate fasciocutaneous flaps will be needed to find out if they provide a better alternative for foot coverage. © 1994 Wiley‐Liss, Inc.
Fingertip replantation: Pre‐osteosynthesis vein graft technique
Authors: Ikeda Kazuo , Morikawa Seiji , Hashimoto Fumio , Tomita Katsuro 
Published: March 2007

AbstractSince 1985 we have been performing replantation of amputated fingertips using a pre‐osteosynthesis vein graft technique. First, we locate an artery and vein at the distal part of the fingertip and perform a vein graft. After this, we perform osteosynthesis. Since there is sufficient vessel length, the anastomosis technique becomes easier than with the method previously used. In our department, between 1985 and 1990 we performed 11 Zone I replantations. Ten fingers survived and one failed. There were good results in seven cases and three had fair results. The pre‐osteosynthesis vein graft technique is a reliable technique for amputated fingertip replantation. © 1994 Wiley‐Liss, Inc.
Distal phalanx microsurgical replantation
Authors: Malizos Konstantinos N. , Beris Alexandros E. , Kabani Chalid T. , Korobilias Anastasios B. , Mavrodontidis Alexandros N. , Soucacos Panayotis N. 
Published: March 2007

AbstractReplantation of a completely amputated part of the distal phalanx, which has a very small vessel size, has been reported by several authors with a varying rate of success. Drainage through venous anastomosis is not always possible. In 12 completely amputated fingers, at the level of, or more distal to, the distal interphalangeal joint, we attempted microsurgical replantation with a successful outcome in ten cases. Seven digits had one or two veins anastomosed. In five digits, an adequate size vein was not found, and the drainage was accomplished with provoked bleeding which was maintained for the 3 postoperative days at the expense of blood transfusion. In all successful cases the patients returned to their occupation in a mean of 9 weeks with very good or excellent functional results. © 1994 Wiley‐Liss, Inc.
Transpositional microsurgery in multiple digital amputations
Authors: Soucacos Panayotis N. , Beris Alexandros E. , Malizos Konstantinos N. , Vlastou Catherine , Soucacos Panayotis K. , Georgoulis Anastasios D. 
Published: March 2007

AbstractIn 34 of the 62 patients treated for complete multiple digital amputations, the severed part was not replanted in its anatomical position, but in the place of the most useful stump. This procedure is defined as transpositional digital microsurgery and refers to the transposition and replantation of any digit to another stump which plays a more significant role in the function of the hand. Twenty‐eight patients had transposition of a digit, while six patients underwent thumb transposition. All except six of the transposed digits survived, while all of the thumbs survived the surgical procedure. The cosmetic appearance of the hand with a transposed digit or thumb was acceptable to the patients. Two‐point discrimination was assessed to be 10–14 mm for the transposed digits, and the functional ability of the transplanted digit was comparable to digits which were replanted in their anatomical position. In conclusion, transpositional digital microsurgery remains a useful alternative for the treatment of multiple digit amputations, particularly in patients with severely damaged non‐replantable amputated parts. © 1994 Wiley‐Liss, Inc.
Vascularised bone grafts in the treatment of long bone defects
Authors: Xenakis Theodore H. , Malizos Konstantinos N. , Beris Alexandros E. , Vekris Marios , Georgoulis Anastasios D. , Soucacos Panayotis N. 
Published: March 2007

AbstractReconstruction of large bony defects of long bones was performed using vascularised fibular grafts in four patients at the Department of Orthopaedic Surgery of the University of Ioannina Medical School. Indications for grafting procedures in this small series had been the loss of bone due to the extensive resection of avascular and necrotic bone from septic pseudoarthrosis in three patients and congenital pseudarthrosis secondary to neurofibromatosis in a child. Primary skeletal union with graft hypertrophy occurred in three of the patients. The fourth patient had an asymptomatic nonunion at the proximal end of the graft. The result in each patient was the presence of a well‐aligned limb that had normal or nearly normal motion and acceptable length. © 1994 Wiley‐Liss, Inc.
Use of the latissimus dorsi flap in head and neck reconstructive microsurgery
Authors: Papadopoulos Othon N. , Gamatsi Irene E. 
Published: March 2007

AbstractReconstructive surgery of the head and neck has particularly benefited from the rapid developments in microsurgery. Resection of tumours from the head and neck which are associated with serious physical and psychological problems, or which often require multiple reconstructive procedures, can now be performed as a single‐stage procedure with good oncological and functional results. The present series reports on the treatment of 12 primary or recurrent malignant tumours of the head and neck using the latissimus dorsi musculocutaneous free flap. Complications consisted of two venous thromboses which required revision of the anastomoses. The oncological and functional results were good, while the aesthetic outcome was fair. We conclude that the latissimus dorsi muscle or musculocutaneous free flap is the method of choice to repair wide defects of the head and neck following the resection of malignant tumours. © 1994 Wiley‐Liss, Inc.
Successful treatment of venous congestion in free skin flaps using medical leeches
Authors: Soucacos Panayotis N. , Beris Alexandros E. , Malizos Konstantinos N. , Xenakis Theodore A. , Georgoulis Anastosios 
Published: March 2007

AbstractOf 74 patients with extensive skin loss of the upper and lower extremities who were treated with free skin flaps, 20 patients presented with venous insufficiency within the immediate 6 to 12 hours following surgery. In 17 of these patients, the venous congestion after free tissue transfer was successfully treated with medical leeches. The remaining three skin flaps did not survive, despite leeching, as well as exploration and revision of the venous anastomoses. The results from this small number of patients with free skin tissue transfers are encouraging, suggesting that in the presence of venous congestion, the use of medicinal leeches is a desirable modality of treatment. © 1994 Wiley‐Liss, Inc.
Microsurgical reconstruction of large nerve defects using autologous nerve grafts
Authors: Daoutis Nicholas K. , Gerostathopoulos Nicholas E. , Efstathopoulos Demetrios G. , Misitizis Diamantis P. , Bouchlis George N. , Anagnostou Stratos K. 
Published: March 2007

AbstractBetween 1986 and 1993, 643 patients with peripheral nerve trauma were treated in our clinic. Primary neurorraphy was performed in 431 of these patients and nerve grafting in 212 patients. We present the functional results after nerve grafting in 93 patients with large nerve defects who were followed for more than 2 years. Evaluation of function was based on the Medical Research Council (MRC) classification for motor and sensory recovery. Factors affecting functional outcome, such as age of the patient, denervation time, length of the defect, and level of the injury were noted. Good results according to the MRC classification were obtained in the majority of cases, although function remained less than that of the uninjured side. © 1994 Wiley‐Liss, Inc.
Nerve grafting in peripheral nerve microsurgery of the upper extremity
Authors: Kalomiri Domna E. , Soucacos Panayotis N. , Beris Alexandros E. 
Published: March 2007

AbstractThe use of microsurgical techniques is essential in peripheral nerve surgery, in which dissection at the fascicular level is required. Magnification with an operating microscope allows for an accurate evaluation of the severity of the trauma to the nerve tissue and permits atraumatic interfascicular dissection. Fascicular or interfascicular dissection and repair with the use of nerve grafts was carried out in 220 peripheral nerve lesions of the upper extremity. Our results of nerve‐grafting in the upper extremity (median, ulnar, and radial‐nerves) indicate an inverse association between the age of the patient and the delay between injury and grafting. In addition, we found that nerve grafting without tension produces superior results over simple neurorrhaphy under tension and permits better axonal growth and nerve recovery. © 1994 Wiley‐Liss, Inc.
Combined transsylvian‐subtemporal exposure of cerebral aneurysms involving the basilar apex
Authors: Kopitnik Thomas A. , Batjer H. Hunt , Samson Duke S. 
Published: March 2007

AbstractThe surgical repair of cerebral aneurysms involving the apex of the basilar artery continues to undergo refinement and evolution. The inherent difficulty in accessing the basilar apex as well as the complexities of the microanatomy render this area a notoriously hazardous and technically challenging region in which to perform microsurgical clipping of cerebral aneurysms. Several operative approaches have been described and are constantly undergoing a state of evolution in the hopes of optimizing the exposure of the distal basilar artery and minimizing the inherent risks of surgery. The consistent decline in operative morbidity has paralleled improved understanding of the microvascular anatomy, both in this region and along the various corridors of approach. No single operative approach is universally superior, considering the wide variability of individual patient anatomy and vascular configurations. Each approach has strengths, weaknesses, and potential complications that must be considered in the thought process of planning an operative attack on a basilar apex aneurysm. Intimate familiarity with the microvasculature and the microsurgical anatomy of the region is an imperative prerequisite for the application of any surgical approach to this region. This paper outlines a detailed review of the microsurgical anatomy that is pertinent to microsurgery of aneurysms in this region, and describes an approach referred to as the combined transsylvian‐subtemporal approach. We have found this operative approach particularly useful in aneurysm surgery of the basilar apex but do not mean to imply that this single approach is suitable for all surgeons or all patients. This paper is designed to discuss an approach and microanatomic understanding that we find useful in the surgical treatment of aneurysms involving the basilar apex. © 1994 Wiley‐Liss, Inc.