bluuebunny/crossref_metadata_2025_split huggingface dataset:
Major mandibular reconstruction with vascularized bone grafts: Indications and selection of donor tissue
Authors: Chen Yueh‐Bih Tang , Chen Hung‐Chi , Hahn Liang‐Hiunn 
Published: March 2007

AbstractFree vascularized bones have been shown by many specialists to exhibit specific capabilities of reconstructing a major mandibular defect and can solve problems that may be insoluble by other methods. Nevertheless, absolute indications for using vascularized bone for major mandibular reconstructions have not been sufficiently well delineated to convince people of always considering vascularized bone for major mandibular reconstructions as a first option. Based on our experience with 55 major mandibular reconstructions, we might delineate the absolute indications for using free vascularized bone for major mandibular reconstructions explicitly: (1) osteoradionecrosis of mandible or on irradiated tissue bed; (2) hemimandibular reconstruction with a free end facing the glenoid fossa; (3) long segment mandibular defect, especially across the symphysis; (4) inadequate skin or mucosal lining; (5) defects demanding sandwich reconstruction; (6) inability to obtain secure immobilization on the reconstructed unit; (7) failure of reconstruction by other methods; (8) near total mandibular reconstruction. Selection of donor tissue should be according to (1) the amount of tissue deficiencies, (2) composition of the defect, (3) design and placement of the flap, (4) irradiation on the recipient site or not, (5) which vessels to be used, (6) which flap has the appropriate vessel length (7) skin color and texture of the donor tissue, (8) how many osteotomies required to simulate the curvature of the resected mandible (9) speed of bony union, (10) feasibility of future osseointegration. We have used three kinds of vascularized bones (iliac bone, fibula, scapula). lliac bone was most frequently used, and has always been our first choice, since it can carry good quality bone, a large skin flap, and ample soft tissue. The fibula has the merit of being less bulky and good for simultaneous intraoral lining, but the contour is more rigid and the bony height is insufficient. The scapula bone is rarely used at present because of its relative inconvenience. © 1994 Wiley‐Liss, Inc.
Fibula osteoseptocutaneous flap for mandible reconstruction
Authors: Yim Kenneth K. , Wei Fu‐Chan 
Published: March 2007

AbstractThe fibula free flap has become an established flap for mandible reconstruction when vascularized bone is desirable. Recreating mandibular contour, providing soft tissue coverage, and restoring masticatory function are equally important in mandible reconstruction, and these can be provided by the fibula osteoseptocutaneous flap. This article is a summary of the anatomy, indications, and operative technique of the fibula osteoseptocutaneous flap accumulated from 49 consecutive mandible reconstructions. © 1994 Wiley‐Liss, Inc.
The place of the iliac crest in vascularized oromandibular reconstruction
Authors: Boyd J. Brian 
Published: March 2007

AbstractThe iliac crest is reevaluated with respect to the rapid evolution of vascularized mandibular reconstruction. With more flaps to choose from, indications for the crest have become more specific—playing to the strengths of this particular transfer. Ideally, defects should exclude soft tissue and occupy lateral segments of the mandibular arch—up to and including a complete hemimandible. The composite flap is capable of reconstructing external skin with ease, but the color match leaves something to be desired. Mucosal defects are less well handled. The flap can replace soft tissue bulk as well as mandibular height following through‐and‐through excisions in the region of the chin. Where donor site cosmesis is of paramount importance, the iliac crest is simply the best flap available. © 1994 Wiley‐Liss, Inc.
Vascularized metatarsal transfer in mandibular reconstruction
Authors: Macleod A. M. 
Published: March 2007

AbstractAdequate reconstruction of the mandible when associated with a mucosal deficit requires an osteocutaneous component in which the skin is closely associated with the bone. A curve in the bony framework to simulate the curvature of the mandible is required when the defect is in the anterior segment. The second metatarsal and toe osteocutaneous flap can provide such a mandibular mucosal replacement and has been used successfully for eighteen years. © 1994 Wiley‐Liss, Inc.
The greater omentum transplantation model in the rat
Authors: Zhang Feng , Lineaweaver William C. , Kao Samuel , Newlin Leonard , Buncke Harry J. 
Published: March 2007

AbstractDissections of the rat omentum were performed to study the feasibility of rat omental free transfer. The right epiploic vessels were found to be adequate for anastomosis in transfer. Twelve omental free flaps were transferred to the groin, with 100% survival of flaps in the 10 animals that survived the operation. The artery and vein averaged 0.3 and 0.4 mm in diameter, respectively. The average pedicle length was 5 mm, and the average flap weight was 136.9 mg. This omental transplant offers a new experimental means of studying lymphedema, neovascularization, and tissue revascularization. © 1994 Wiley‐Liss, Inc.
Successful heterotopic heart transplantation in rat
Authors: Schmid Christof , Binder Jochen , Heemann Uwe , Tilney Nicholas L. 
Published: March 2007

AbstractHeterotopic heart transplantation in rats has become a substantial tool for numerous investigations. This report describes a surgical technique of infrarenal heterotopic heart transplantation with a prodigious surgical success rate which was developed over many years of practice. Difficulties arising from anatomic variations are depicted and alternative approaches are discussed. © 1994 Wiley‐Liss, Inc.
Postoperative results of vascularized double fibula grafts for femoral pseudoarthrosis with large bony defect
Authors: Tomita Yoshitsugu , Murota Kagehisa , Takahashi Fumito , Moriyama Masatoshi , Beppu Moroe 
Published: March 2007

AbstractIn open femoral bone fractures osteomyelitis may develop as a complication. Many difficulties are experienced in the treatment of those fractures because an extended bone defect may be formed after repeated operations, and then amputation of the femoral bone becomes necessary. Since 1981 the present authors have performed the vascularized double fibula grafts in the treatment of 18 patients with successful results. With this grafting method, both vascularized double fibula grafts are collected at the same time, one as an intramedullary graft and the other as an onlay graft.The most important point in carrying out grafting by this method is to prepare the recipient bone bed adequately. In many cases, it is necessary to carry out the primary operation to curette the focus, and resect necrotic tissues and sequestrated bone before the vascularized double fibula grafts, and then grafting is performed as a second operation after infection has been controlled following the initial operation. Although differences in time required for recovery cannot be eliminated completely, it becomes possible for 16 out of 18 patients to walk without the use of a brace and crutches within 13 months on average. © 1994 Wiley‐Liss, Inc.
A modified free gracilis flap in the rat
Authors: Yeh Lih‐Seng , Hou Sheng‐Mou , Lin An‐Chung , Lin Jinn 
Published: March 2007

AbstractWe present in this paper the use of a combined neurovas‐cularized flap of gracilis muscle and inguinal skin in the rat with the femoral vessels and obturator nerve serving as the pedicles. The epigastric, saphenous, and muscular branch vessels arising from the femoral vessels were preserved, and a portion of adductor magnus muscle was included in the flap to protect the delicate muscle vessels at their origins. The inguinal skin and muscle flap both had independent blood supplies, thus, separate assessment of muscle and skin rejection was possible in the single transplanted “packet.” The muscle flap with the reconnected motor nerve regained contractile ability upon nerve stimulation within 30 days after the iso‐transplantation. The results suggest that the modified gracilis myocutaneous flap provides an ideal model for transplantation research. © 1994 Wiley‐Liss, Inc.
Pattern assembly—an aid to flap design during oral microsurgical reconstruction
Authors: Grime Peter David , Wei Fu‐Chan 
Published: March 2007

AbstractSurgical ablation of tumors within the oral cavity results in a three‐dimensional defect and a potential puzzle for the reconstructive surgeon. Although a myriad of papers discussing the relative advantages and disadvantages of various methods of reconstruction are readily available for consultation, very few publications have provided the surgeon with a guide either to visualization of the defect or to how to reconstruct a three‐dimensional defect with an essentially two‐dimensional flap. Our intention is not to provide the answer for every oral reconstructive problem—after all, no two patients are alike—but we will demonstrate that an appreciation of the defect in three‐dimensions, together with an understanding of oral function, provides a template for flap design and inset. This is achieved by simplifying the complex anatomical shape of the oral cavity into a geometric form from which a series of simple, easily recognisable shapes can be derived and assembled as necessary into a pattern that reproduces the defect, providing a template for flap design and inset. © 1994 Wiley‐Liss, Inc.
Fibula osteoseptocutaneous free flap in maxillary reconstruction
Authors: Yim Kenneth K. , Wei Fu‐Chan 
Published: March 2007

AbstractThe skin paddle in the fibula osteoseptocutaneous flap is thin, soft, and pliable, and it can be used for external skin coverage and intraoral linings. The flexibility of the fibula in three‐dimensional positioning after multiple osteotomies is desirable in complex spatial skeletal reconstruction. The fibula osteoseptocutaneous flap is suitable for one‐stage reconstruction of composite maxillary defects. The unique characteristics of the fibula osteoseptocutaneous flap and its application in the one‐stage composite maxillary defect are discussed. © 1994 Wiley‐Liss, Inc.
Selection of recipient vessels for free flaps to the distal leg and foot following trauma
Authors: Chen Hung‐Chi , Chuang Chwei‐Chin , Chen Samuel , Hsu Weng‐Ming , Wei Fu‐Chan 
Published: March 2007

AbstractThe recipient vessels are of prime importance in free flap transfers to the lower limbs. To determine the incidence and pattern of vascular trauma, a study was carried out in 126 patients who had Gustillo Type III open fractures of the distal legs and feet that required free flaps for wound coverage.In comparison with the posterior tibial artery, the anterior tibial artery has a much higher incidence of injury with more extensive damage. It can be injured at a more proximal level than estimated from gross inspection during surgery. This should be borne in mind when the anterior tibial artery is selected as the recipient artery in order to prevent reexploration and failure of the flaps. However, the posterior tibial artery is much less vulnerable to damage in most injuries and is more reliable as the recipient artery. In this series there was no problem in finding proper recipient veins in the legs. A general principle is proposed for selecting recipient vessels in crushed legs, with a warning against the pitfalls that have been encountered. © 1994 Wiley‐Liss, Inc.
In vivo microscopy of microcirculatory injury in skeletal muscle following ischemia/reperfusion
Authors: Pemberton Mark , Anderson Gary , Barker John 
Published: March 2007

AbstractWhile the sequence of biochemical and cellular events in the pathogenesis of ischemia/reperfusion injury is increasingly well understood, the way that these processes interact at the level of microcirculation to promote a distinctive reperfusion injury is less well defined. It is becoming clear, however, that these processes are initiated at the level of microcirculation, and that microcirculatory damage may precede actual tissue injury. Such damage causes microvascular no‐reflow, which in turn effectively prolongs the time of tissue ischemia and extends tissue injury. Recently, microcirculatory models have been adapted for study of the microvascular effects of ischemia/reperfusion. We have used a new in vivo mouse cremaster muscle model to study, by direct and quantitative measurement, the acute microvascular changes involved in ischemia/reperfusion. Previously described changes in capillary perfusion and venular leukocyte adhesion were observed in this model following reperfusion after prolonged ischemia (4–6 hours). We have further characterized an intense reactive vasoconstriction or vasospasm that occurs after prolonged ischemia; this vessel reaction may represent an important overlooked cause of no‐reflow following ischemia/reperfusion. This article summarizes our work in the context of other available methods that have been used to define the microvascular changes of ischemia/reperfusion. © 1994 Wiley‐Liss, Inc.
Microcirculation research, angiogenesis, and microsurgery
Authors: Frank Johannes M. , Kaneko Shino , Joels Charles , Tobin Gordon R. , Banis Joseph C. , Barker John H. 
Published: March 2007

AbstractAngiogenesis, the formation of new blood vessels, is essential to a variety of normal and pathologic processes such as wound healing and tumor growth. In microsurgery the development of new vessels between the transferred tissue and the recipient bed is critical to the final outcome of the reconstruction.Several experimental models have been previously developed to study angiogenesis and the effect that new substances have on regulating this process, but they lack the ability to make quantitative measurements. Therefore, we have developed an animal model using the homozygous (hr/hr) hairless mouse ear; by using intravital microscopy and computer‐assisted analysis, angiogenesis can be quantitatively measured. Using this model we showed that basic fibroblast growth factor and transforming growth factor beta significantly increased total vessel length by 32% and 63%, respectively, during 20 days following subcutaneous injection. In this paper the importance of angiogenesis research to reconstructive microsurgery is presented and discussed. © 1994 Wiley‐Liss, Inc.
Direct visualization and measurement of microsurgically induced thromboembolism
Authors: Andresen Dorthe M. , O'Shaughnessy Michael , Acland Robert D. , Anderson Gary L. , Schuscke Dale , Banis Joseph , Barker John H. 
Published: March 2007

AbstractA common cause of free flap and replant failure is thrombotic occlusion of the anastomosed pedicle vessel(s). Clinical observations and subsequent experimental studies showed that platelet emboli generated at the arterial anastomosis caused significant alterations in the downstream microcirculation. To study both the thrombogenic arterial (anastomosis) site and the downstream microcirculation, we developed an animal model (the isolated rat cremaster) in which we could directly view and quantitatively analyze thrombus formation and the appearance of emboli in the downstream microcirculation. Using this model we studied the effect that reducing blood flow across the arterial anastomotic site had on thrombus formation at the anastomotic site and the appearance of emboli in the downstream microcirculation. In 40 male Spra‐gue‐Dawley rats we found that reducing blood flow velocity to approximately half of normal during reperfusion nearly eliminated emboli appearing in the downstream microcirculation compared with controls, 43.9 ± 31.5 vs. 259.5 ± 117.8 emboli, respectively. We also found that the same low flow had no effect on thrombus size at the pedicle artery injury site yet significantly decreased the rate at which thrombus formation occurred (time to maximum thrombus size; low flow = 25.3 ± 8 minutes, normal flow = 6.6 ± 3 minutes). From these studies we conclude that reducing pedicle artery blood flow in our rat model during reperfusion can protect the downstream microcirculation from platelet emboli‐induced injury; however, the same reduction in flow does not affect thrombus formation in the pedicle artery. Further studies using direct observation/measurement techniques are needed for a better understanding of the mechanisms regulating free flap and replant failure. © 1994 Wiley‐Liss, Inc.
Microvascular response in the rabbit ear to total body cooling: A model for study of human digits
Authors: Pollock F. Edward , Smith Thomas L. , Koman L. Andrew 
Published: March 2007

AbstractConditions such as Raynaud's disease, cold intolerance following digit replantation, and reflex sympathetic dystrophy are all exacerbated by diminished blood flow in the digits. The rabbit ear, being similar to the human digit, is an excellent model for studying microvascular responses during thermoregulation and was used in this study of microcirculatory changes during total‐body cold stress. In eight rabbits a window was placed in one ear each, and the underlying vascular beds were photographed with the unanesthetized animal at room temperature (23°C) and in a cold room (6°C). Luminal arterial diameters constricted more than venular diameters during cold stress (39.6% vs. 16.5%, respectively, of the control diameters; P = 0.014). All responses were linear; the slopes of the regression lines were significantly different between arterioles and venules (P < 0.0001). This study suggests that decreased circulation in response to cold is due to decreases in the diameter and number of vessels available for perfusion, as predicted by the Poiseuille equation. © 1994 Wiley‐Liss, Inc.
A comparison of nerve grafting and tissue expansion techniques in the rat
Authors: Hall Gary D. , van Way Charles W. 
Published: March 2007

AbstractThis study compares nerve repair following tissue expansion with nerve repair using an interposed graft in the rat. Group I had expansion conducted over 2 weeks at 40 mmHg. A 4 mm segment was excised from the lengthened nerve and repaired primarily. Group II had a 4 mm segment of nerve excised and then replaced as an interposition graft. Group III was sham‐operated controls. Thirteen weeks postoperatively, all animals were evaluated using walking track analysis. Thirty‐five rats finished the study: Eleven in group 1, 10 in group II, and 14 in group III. The Sciatic Functional Index (SFI) was calculated for each group as follows: group l, −57 ± 11 (mean ± standard deviation); group II, −59 ± 25; group III, −13 ± 6.5. The control group was significantly better than either experimental group (P < 0.01). The two experimental groups were not statistically different. Nerve repair following expansion allowed only one coaptation to be used. Functional results were the same as with interposition grafting. Repair by the expansion technique would eliminate the need to harvest a nerve graft, and the subsequent donor defect. © 1994 Wiley‐Liss, Inc.
Continuous rat intravenous infusion
Authors: Kononov Anatoly , Browne Earl Z. , Alexander Frederick , Porvasnik Stacy 
Published: March 2007

AbstractHypovolemic shock and ischemic injury to the graft commonly cause death in small animals after organ transplantation. A venous line must be readily available to replace fluids before fatal complications occur. To establish a venous line, researchers expose a vein by preliminary surgery. This time‐consuming procedure adds unnecessary trauma to the recipient and worsens the results. The possibility of long‐term fluid transfusion in small animals by serial injections at close intervals is quite limited.We describe a simple technique of continuous IV infusion by catheterization of the rat dorsal penile vein with a 24‐gauge, 3/4‐inch catheter. This easy‐to‐learn technique has permitted us to establish a venous line quickly without trauma in 148 rats while doing donor and recipient procedures for small bowel and ileocecal segment transplantation. The technique we describe has eliminated one of the most frequent causes of postoperative mortality after organ transplantation—hypovolemic shock. We would like to emphasize that other measures, including avoiding massive bleeding and reducing operative and warm ischemic time, are also very important in preventing this complication. The massive IV infusion alone may not totally eliminate hypovolemic shock if other factors are neglected. The use of this technique has allowed us to perform small bowel transplantation with 90% success. © 1994 Wiley‐Liss, Inc.
Bilateral thumb amputation
Authors: Soucacos Panayotis N. , Beris Alexandros E. , Malizos Konstantinos N. , Touliatos Alexandros S. 
Published: March 2007

AbstractSeventy‐one patients with thumb amputations, 45 complete and 26 incomplete nonviable, have been treated at the Microsurgical Unit of the Department of Orthopaedic Surgery at the University of Ioannina Medical School over the past 15 years. Of these thumb amputations, which included crush, avulsion, and guillotine injuries, three cases involved amputation of both thumbs. The three patients with complete bilateral thumb amputations are presented. Because of the importance of the thumb, microsurgical replantation efforts were made which proved successful for two of the patients. Replantation efforts in the third patient, who had severe crush injuries of both thumbs, were not successful. Bilateral thumb amputation is a serious and disabling injury. When replantation is attempted by a team of surgeons well trained in microsurgery, the final result can be impressive, with exceptionally good function of the replanted thumbs. © 1994 Wiley‐Liss, Inc.
Microsurgical treatment of ring avulsion injuries
Authors: Beris Alexandros E. , Soucacos Panayotis N. , Malizos Konstantinos N. , Xenakis Theodore A. 
Published: March 2007

AbstractFourteen patients with ring avulsion injuries were treated at the University of Ioannina from 1982 to 1991. One patient was classified as Urbaniak class II, and microsurgical repair produced good functional results. The remaining 13 patients had class III injuries. Six of these patients had class IIIa injuries, defined as skin avulsions at the level of the proximal phalanx, amputation at the distal interphalangeal joint with an intact flexor digitorum superficialis. Replantation was successful in four patients. Seven patients had class IIIb injuries, defined as skin avulsion and complete amputation at the level of the proximal phalanx, with severance of both flexor tendons. Replantation was successful in four patients, with compromised functional results in two. Primary surgical repair is the treatment of choice for class II and IIIa injuries which usually have rewarding results. Although there may be some functional compromise following replantation in class IIIb injuries in adults, we suggest that microsurgical replantation should also be attempted after the prognosis is clearly explained to the patient. © 1994 Wiley‐Liss, Inc.