3,909 results on '"Surgical flaps"'
Search Results
2. Weichteilplastik in der Akut- und Postakutsituation.
- Author
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Al Meklef, Rami, Rein, Susanne, and Kremer, Thomas
- Abstract
Copyright of Die Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2024
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3. Rekonstruktionsmöglichkeiten infektionsbedingter Defekte: Plastisch-chirurgisches Armamentarium.
- Author
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März, Vincent, Vogt, Peter M., and Schlottmann, Frederik
- Abstract
Copyright of Die Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2024
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4. Therapiestrategien bei frakturassoziierten Infektionen mit begleitendem Weichteilschaden.
- Author
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Alt, Volker, Rupp, Markus, Kerschbaum, Maximilian, Prantl, Lukas, and Geis, Sebastian
- Abstract
Copyright of Die Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2024
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5. [Total calcanectomy in osteomyelitis and soft tissue defect with complex secondary reconstruction of the hindfoot : Case report and literature comparison].
- Author
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Kolitsch D, Kobbe P, Langwald S, and Hückstädt M
- Subjects
- Female, Humans, Male, Middle Aged, Soft Tissue Injuries surgery, Surgical Flaps, Treatment Outcome, Calcaneus surgery, Calcaneus pathology, Osteomyelitis surgery, Plastic Surgery Procedures methods
- Abstract
The clinical picture and surgical treatment of implant-associated osteomyelitis of the calcaneus with soft tissue defect are presented based on this case study. Due to the fulminant infection, complete resection of the calcaneus and a two-stage complex reconstruction of the hindfoot were performed. As necrosis developed in the surgical access route, coverage with a free ALT flap became necessary., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: D. Kolitsch, P. Kobbe, S. Langwald und M. Hückstädt geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patient/-innen zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern/Vertreterinnen eine schriftliche Einwilligung vor., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2024
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6. [Rectovaginal fistulas : Differentiated diagnostics and treatment].
- Author
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Schwandner O
- Subjects
- Humans, Female, Magnetic Resonance Imaging methods, Tomography, X-Ray Computed methods, Surgical Flaps, Diagnosis, Differential, Endosonography methods, Crohn Disease surgery, Crohn Disease complications, Crohn Disease diagnosis, Rectovaginal Fistula surgery, Rectovaginal Fistula diagnosis, Rectovaginal Fistula etiology
- Abstract
Rectovaginal fistulas (RVF) represent less than 5% of anorectal fistulas. The classification of RVF is based on the localization (low vs. high) and the etiology. The most frequent causes of RVF are birth trauma, Crohn's disease, previous surgery and pelvic irradiation. In most cases a clinical diagnostic assessment is sufficient. Additionally, endosonography is a reliable tool to detect sphincter defects. Computed tomography (CT) and magnetic resonance imaging (MRI) are reserved for special situations (e.g., RVF related to anastomotic leakage, after pelvic irradiation or associated with complex perianal fistulizing Crohn's disease). The surgical treatment is primarily oriented to the localization and etiology. Surgical techniques range from local procedures (e.g., endorectal advancement flap repair, transvaginal or transperineal closure) up to more invasive tissue interposition (e.g., bulbocavernosus muscle fat tissue flap or transposition of the gracilis muscle). In "high" RVF transabdominal approaches such as coloanal anastomosis, pull through procedures or omental interposition are indicated. All surgical procedures show high recurrence rates. Several operations are mostly necessary and a stoma creation is often required., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: Gemäß den Richtlinien des Springer Medizin Verlags werden Autoren und Wissenschaftliche Leitung im Rahmen der Manuskripterstellung und Manuskriptfreigabe aufgefordert, eine vollständige Erklärung zu ihren finanziellen und nichtfinanziellen Interessen abzugeben. Autoren: O. Schwandner: A. Finanzielle Interessen: Takeda, Medtronic, AbbVie, Falk Foundation, med update (Honorar für Referententätigkeit, Reise- und Übernachtungskosten). – B. Nichtfinanzielle Interessen: Berufliche Tätigkeit: Leitender Arzt der Abteilung für Proktologie, Krankenhaus Barmherzige Brüder Regensburg | Mitgliedschaften in wissenschaftlichen Gesellschaften: Deutsche Gesellschaft für Chirurgie, Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie, Deutsche Gesellschaft für Koloproktologie, Vereinigung der Bayerischen Chirurgen, Deutsche Kontinenz Gesellschaft, American Society of Colon & Rectal Surgeons | Mitgliedschaft in Berufsverbänden: Berufsverband der Deutschen Coloproktologen | Position in wissenschaftlicher Fachgesellschaft: Mitglied des Vorstands der Deutschen Gesellschaft für Koloproktologie (Generalsekretär). Wissenschaftliche Leitung: Die vollständige Erklärung zum Interessenkonflikt der Wissenschaftlichen Leitung finden Sie am Kurs der zertifizierten Fortbildung auf www.springermedizin.de/cme . Der Verlag: erklärt, dass für die Publikation dieser CME-Fortbildung keine Sponsorengelder an den Verlag fließen. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2024
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7. [Long-Term Outcome of Digital Defect Reconstruction using Cross-Finger Flaps].
- Author
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Mulica M, Yasmin M, Cai A, Arkudas A, Müller-Seubert W, and Horch RE
- Subjects
- Humans, Female, Male, Middle Aged, Adult, Aged, Follow-Up Studies, Plastic Surgery Procedures methods, Postoperative Complications surgery, Postoperative Complications etiology, Patient Satisfaction, Fingers surgery, Aged, 80 and over, Amputation, Traumatic surgery, Finger Injuries surgery, Range of Motion, Articular physiology, Surgical Flaps
- Abstract
Introduction: Although multiple advances have been made in finger defect reconstruction, cross-finger flaps remain an important reconstructive tool. However, data on long-term results are scarce in the literature. This study aimed to assess the clinical and subjective long-term outcomes of patients who underwent cross-finger flap reconstruction for palmar digital and fingertip defects., Patients and Methods: Between January 2003 and July 2022, 35 patients (31 male, 4 female, mean age: 59.0 years±20.1) were screened and included in the study. The data were obtained through a clinical examination, a Quick-DASH score and a self-designed questionnaire. Clinical outcomes were assessed by evaluating the range of motion (ROM) of the reconstructed finger and the donor finger compared with the contralateral uninjured hand. In addition to ROM, a static two-point separation test was performed to assess the sensory function of the reconstructed finger. The follow-up period was between 1 year and 19 years (mean: 12.6 years±6.1)., Results: There was no significant difference in terms of ROM between the reconstructed finger and the donor finger compared with the contralateral uninjured hand. All patients reported normal discrimination between sharp and blunt objects. However, there was a significant difference in two-point discrimination between the reconstructed finger and the healthy contralateral finger (p<0.05). The average Quick-DASH score was 5.1 points. Satisfaction with the functional outcome in terms of mobility and load-bearing capacity of the cross-finger flap averaged 8.1 out of 10 points. Satisfaction with the aesthetic outcome of the reconstructed finger averaged 7.7 out of 10 points. In 4 cases, persistent pain was reported when the reconstructed finger was under stress. No cases of pain at rest were reported., Conclusion: In the long run, cross-finger flaps are a safe and effective reconstructive procedure for covering defects in palmar injuries of the finger and fingertip amputation. They represent a simple, reliable, long-lasting reconstructive technique. The necessary temporary iatrogenic syndactyly does not lead to long-term limitations in the range of motion., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)
- Published
- 2024
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8. [Fasciocutaneous bridge flap to cover defects on the lower leg after compartment syndrome with a complication-prone course : An "almost" forgotten safe flap procedure].
- Author
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Borger A, Karge T, Babeluk R, Zak L, Semmler L, Hajdu S, and Radtke C
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- Humans, Male, Adult, Tibial Fractures surgery, Tibial Fractures complications, Surgical Flaps adverse effects, Soft Tissue Injuries surgery, Soft Tissue Injuries etiology, Treatment Outcome, Skin Transplantation methods, Leg Injuries surgery, Plastic Surgery Procedures methods, Reoperation, Compartment Syndromes surgery, Compartment Syndromes etiology
- Abstract
This article reports on a complicated case of a soft tissue defect with challenging soft tissue coverage on the lower leg. After a lower leg fracture and treatment with a tibial nail, a 29-year-old man developed compartment syndrome due to massive secondary bleeding with a lesion of the common peroneal nerve and muscle necrosis around the fibular muscles. The initial coverage with split skin showed no tendency to heal, so the patient was admitted to this hospital with a soft tissue defect of approximately 25 cm × 10 cm on the lateral lower leg with an exposed tibia over a length of 15 cm. The primary attempt was coverage with a split-thickness skin graft after secondary granulation; however, due to the previously damaged vascular supply, the wound demonstrated a delayed incomplete healing over 8 months. In addition, X‑ray imaging revealed a nonunion and a resulting screw fracture of the two distal locking screws. The indications for revision surgery to treat the fracture and change the implant were fulfilled. In the same procedure, the residual cutaneous defects were closed. Given the previously complication-prone course and a difficult local blood flow situation, the choice of reconstruction procedures was limited. A bridge flap of the medial lower leg was performed in an interdisciplinary approach. The lifting defect was covered with split-thickness skin. In this way, the wound was finally adequately covered after 1 year., (© 2024. The Author(s).)
- Published
- 2024
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9. [Modified gluteus maximus transfer for hip abductor deficiency].
- Author
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Zimmerer A, Nonnemacher L, Fischer M, Gebhardt S, Hofer A, Reichert J, and Wassilew G
- Subjects
- Humans, Male, Female, Middle Aged, Treatment Outcome, Aged, Adult, Surgical Flaps, Plastic Surgery Procedures methods, Buttocks surgery, Hip Contracture surgery, Hip Joint surgery, Muscular Atrophy surgery, Muscle, Skeletal surgery
- Abstract
Objective: Transfer of the gluteus maximus with refixation at the greater trochanter for treatment of abductor deficiency., Indications: Symptomatic abductor deficiency with atrophy and fatty degeneration of the gluteal muscles > 50% (grade 3 by quartile) with good strength of the gluteus maximus., Contraindications: Low atrophy or fatty degeneration of less than 50% of the gluteal muscles, limited strength of the gluteus maximus, infection., Surgical Technique: First, the fascia lata is incised dorsally to the tensor fascia latae muscle, with the incision extending approximately 1.5 cm proximal to the iliac crest. A second incision divides the gluteus maximus muscle longitudinally along the muscle fibers and continues towards the fascia lata distal to the greater trochanter. These incisions result in a triangular muscle flap, which is elevated and divided into anterior and posterior portions. The posterior flap is positioned ventrally over the femoral neck and fixed to the anterior capsule and the anterior edge of the greater trochanter. The anterior flap is placed directly on the proximal femur. For this purpose, a groove is prepared in the area of the proximal femur using a spherical burr to freshen up the future footprint. The anterior flap is positioned from the tip of the greater trochanter towards the insertion of the vastus lateralis muscle. Subsequently, the anterior flap is fixed to the created groove with transosseous sutures and positioned under the elevated vastus lateralis muscle in 15° abduction of the leg. To provide additional stabilization to the tendinous part of the anterior flap, a screw is inserted distally to the greater trochanter. The vastus lateralis muscle is attached to the distal tip of the anterior flap, and the remaining gluteus maximus muscle is sutured to the fascia lata to cover the anterior flap. Additionally, a flap of the tensor fascia latae muscle can be mobilized and adapted to the reconstruction. Layered wound closure is performed., Results: The technique of a gluteus maximus transfer represents a method for the treatment of chronic abductor deficiencies and improves abduction function as well as the gait pattern in short-term follow-ups. Fifteen patients (mean age at time of surgery 62 years) had after a mean follow-up of 2.5 years. The modified Harris Hip Score (mHHS) improved from 48 points preoperatively to 60 points at follow-up. Preoperatively, 100% had a positive Trendelenburg sign; at follow-up, this was about 50%., (© 2024. The Author(s).)
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- 2024
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10. Die mikrochirurgische Defektversorgung der Nase.
- Author
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Steiner, C., Bottini, G. B., Neubert, M., Nogami, S., Wittig, J., Brandtner, C., and Gaggl, A.
- Abstract
Copyright of Die MKG-Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2022
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11. Die Versorgung tumorchirurgisch bedingter Gesichts- und Kopfhautdefekte – ein alternatives Praxiskonzept anhand von Fallvorstellungen.
- Author
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Born, Andreas
- Abstract
Copyright of Der MKG-Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2022
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12. [Predictive parameters for anatomical surgical success in full-thickness macular holes : A retrospective evaluation of 391 eyes].
- Author
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von Goscinski C, Gözlügöl N, Schick T, Schöneberger V, Gietzelt C, Altay L, Cursiefen C, and Schaub F
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- Humans, Retrospective Studies, Male, Female, Aged, Middle Aged, Treatment Outcome, Aged, 80 and over, Tomography, Optical Coherence, Surgical Flaps, Prognosis, Retinal Perforations surgery, Vitrectomy methods, Visual Acuity physiology
- Abstract
Background: Full-thickness macular hole (FTMH) is a rare disease. Not all FTMHs can be closed by primary surgical intervention., Objective: This work aims to characterize a large patient population with FTMHs and to detect possible predictive factors for anatomical treatment success., Materials and Methods: The study comprises a retrospective analysis of all consecutive idiopathic macular holes between March 2008 and June 2019 at the University Eye Hospital Cologne. Epidemiologic data, preoperative parameters (size of the FTMH), and surgical technique were examined in relation to the closure rate following primary surgery., Results: The anatomical closure rate for idiopathic FTMH after primary surgery was 83.6%. No association between age, gender, and lens status and closure rate could be shown. Regarding anatomical surgical success, the favorable prognostic factors identified were a small FTMH size, short symptom duration, performance of transconjunctival 23-gauge vitrectomy, and application of the inverted flap technique of the internal limiting membrane (ILM)., Conclusion: Surgical treatment represents a valuable treatment option for patients with macular holes due to good prospects of success. Prompt intervention after diagnosis using 23-gauge vitrectomy and an ILM flap with gas tamponade seems to result in the most favorable outcomes., (© 2024. The Author(s).)
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- 2024
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13. [Fillet flap transfer as alternative to conventional lower limb amputation].
- Author
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Harnoncourt L, Gstoettner C, Pflaum L, Laengle G, and Aszmann OC
- Subjects
- Humans, Surgical Flaps, Prosthesis Fitting methods, Treatment Outcome, Plastic Surgery Procedures methods, Amputation, Surgical methods, Amputation Stumps innervation, Amputation Stumps surgery, Artificial Limbs
- Abstract
Background: The fitting of a prosthesis after lower limb amputation is associated with several challenges. Skeletal stump-prosthesis interfaces and selective nerve transfer can partially overcome these but are also associated with new impairments that emphasize the necessity of innovative approaches. The concept of so-called spare part surgery with the use of fillet flaps could play an important role in this respect., Objective: An overview of the classical prosthesis-associated discomforts, advantages and disadvantages of treatment strategies and presentation of alternative surgical concepts., Material and Methods: A selective literature search was carried out considering the experiences of the authors and perspectives with respect to the advantages and disadvantages of the surgical treatment options. Furthermore, a clinical case is presented., Results and Conclusion: The transfer of the sole of the foot as a fillet flap to the weight-bearing region of the amputation stump offers a number of benefits, such as creating a fully weight-bearing stump, prevention of neuralgia, preserved sensation and conservation of the body image. As long as the calcaneal region is not impaired, this technique can be performed in amputations below as well as above the knee. The question of whether parts of the bone should be included in the transfer must be individually evaluated for each patient. This approach enables optimization of the residual limb stump for the subsequent fitting of a prosthesis for the patient., (© 2024. The Author(s).)
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- 2024
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14. [Reconstruction options for infection-related defects : Plastic surgery armamentarium].
- Author
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März V, Vogt PM, and Schlottmann F
- Subjects
- Humans, Surgical Flaps, Surgical Wound Infection therapy, Surgical Wound Infection surgery, Plastic Surgery Procedures methods, Debridement methods
- Abstract
Background: The occurrence of infections has always been feared in all surgical disciplines. Plastic reconstructive surgery faces the challenge of treating infection-related defects on a patient-specific basis, which requires a multidisciplinary treatment concept. Satisfactory treatment success can only be achieved through radical debridement for infection cleansing, optimization of the perfusion situation paired with targeted anti-infective treatment and, if necessary, with soft tissue reconstruction by plastic surgery., Objective: This article presents the current possibilities of plastic and reconstructive surgery with respect to the reconstruction of infection-related defects., Material and Methods: Proven and reliable strategies are presented and supplemented by promising experimental approaches., Results: Due to the often multilayered defect situation caused by infections, from the epidermis to cancellous bone, the entire armamentarium of plastic and reconstructive surgery is used for reconstruction., Conclusion: The early involvement of plastic surgery in the treatment of infections and the interdisciplinary and multimodal treatment approach have proven their worth in the treatment of complex infection situations., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
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- 2024
- Full Text
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15. [Plastic surgery for defect coverage of soft tissue defects].
- Author
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M Vogt P
- Subjects
- Humans, Soft Tissue Injuries surgery, Surgical Flaps, Plastic Surgery Procedures methods
- Published
- 2024
- Full Text
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16. [Secondary defect coverage and functional reconstruction].
- Author
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Thunich S and Krezdorn N
- Subjects
- Humans, Surgical Flaps, Microsurgery methods, Plastic Surgery Procedures methods
- Abstract
Secondary reconstruction in trauma surgery is crucial for restoring both functional and esthetic results in patients with complex defects. Established reconstructive techniques in plastic surgery offer a wide range of options for an effective treatment. This applies not only to covering large defects with free flaps but especially also for the functional reconstruction of bony, neural and musculotendinous impairments. Advances in the fields of microsurgery and 3D printing show innovative approaches to further improve the therapeutic options. A multidisciplinary approach, requiring close collaboration between trauma and plastic surgeons, is necessary to optimize treatment plans and outcomes. The effective management of complications and qualified postoperative care are essential for the success of reconstructive measures., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2024
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17. [Acute and post-acute soft tissue reconstruction].
- Author
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Al Meklef R, Rein S, and Kremer T
- Subjects
- Humans, Debridement methods, Surgical Flaps innervation, Male, Burns surgery, Soft Tissue Injuries surgery, Plastic Surgery Procedures methods
- Abstract
Background: The precise analysis of the injured structures requiring reconstruction in complex wound defects is a prerequisite for successful restoration., Objective: The fundamental reconstructive strategies for soft tissue defects of the extremities including injuries to vessels, nerves and burn wounds in the context of the acute and post-acute trauma phases are presented., Material and Methods: The different phases of soft tissue reconstruction are described. Recommendations for action with respect to the reconstruction of the functional structures are described. Two clinical case examples illustrate the approach., Results: The acute reconstruction phase is defined as the period 0-72 h after the traumatic event and includes surgical debridement, primary reconstruction of nerves and vessels using interpositional grafts if necessary and temporary soft tissue reconstruction. Combined thermomechanical trauma requires early debridement combined with internal fixation of open fractures. In the post-acute reconstruction phase, which is generally defined as a period of up to 6 weeks after the traumatic event, definitive soft tissue reconstruction is performed. In the case of long reinnervation distances, nerve transfer or motor replacement plastic surgery is performed in the post-acute phase., Conclusion: The reconstruction of soft tissue after trauma necessitates a stage-dependent approach. In the acute phase procedures aim at the immediate preservation of the limb. In the post-acute phase, definitive soft tissue reconstruction is performed to enable maximum functional preservation. Combined thermomechanical injuries require early surgical treatment in order to prevent infections., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2024
- Full Text
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18. Defektrekonstruktionen an der Hand.
- Author
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Witt, Mathias and Altintas, Mehmet A.
- Abstract
Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2021
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19. Breast reconstruction during the COVID-19 pandemic in resource-limited settings
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Al-Benna, Sammy and Gohritz, Andreas
- Subjects
reconstructive surgical procedures ,mammaplasty ,breast implantation ,surgical flaps ,severe acute respiratory syndrome coronavirus 2 ,covid-19 ,pandemics ,Surgery ,RD1-811 - Abstract
The coronavirus disease 2019 (COVID-19) is a novel, rapidly changing pandemic. It has affected specialized medical services in unprecedented ways. Surgical decision making, always the most important aspect of care has taken on an added layer of complexity in the face of the COVID-19 pandemic. Therefore, recommendations for breast reconstruction during COVID-19 remain challenging and unclear. This article reviews the impact of the COVID-19 pandemic and suggests potential approaches that could be considered in the absence of validated strategies in breast reconstruction.
- Published
- 2021
- Full Text
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20. Rekonstruktive Chirurgie beim Oropharynxkarzinom.
- Author
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Remmert, S. and Hasenberg, S.
- Abstract
Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2021
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21. Extralevatorische abdominoperineale Exstirpation (ELAPE).
- Author
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Stelzner, Sigmar and Holm, Torbjörn
- Abstract
Copyright of Colo-Proctology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2021
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22. [Local flap reconstruction techniques after frontal sinus drainage type II and III according to Draf].
- Author
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Sommer F and Weber RK
- Subjects
- Surgical Flaps, Endoscopy, Mucous Membrane, Drainage, Frontal Sinus surgery
- Abstract
Background: Extended endonasal endoscopic frontal sinus surgery is characterized by bone resection beyond the lamellae of the frontal sinus and is currently classified according to Draf as type IIa, type IIb, modified type III (also referred to as type IIc), and type III. This approach is indicated when the surgical goal cannot be achieved through complete removal of the anterior ethmoidal cells. Numerous studies indicate restenosis rates ranging from 7 to 36%, despite creation of maximal openings. Exposed bone, which tends to epithelize slowly with significant crusting and the risk of uncontrolled wound healing depending on the local environment and other factors, is considered a contributing factor. Covering the exposed bone with mucosa can significantly reduce the risk of restenosis., Methods and Results: A variety of flap techniques for frontal sinus drainage in Draf III procedures are presented, including some variants that were part of presentations at the 2023 Congress of the European Rhinologic Society in Sofia, Bulgaria. These include combinations of free mucosal grafts, pedicled mucosal flaps, and hybrids combining both techniques. Additionally, the results of current studies are presented., Conclusion: The results and achieved opening areas in contemporary Draf III surgeries are significantly improved and larger compared to the early stages of these procedures. A multitude of published studies consistently demonstrate that outcomes are markedly improved with mucosal coverage. Depending on the prevailing anatomy, mucosal conditions, and the extent of the surgical intervention, the most suitable technique should be selected. Therefore, proficiency in various methods is crucial. The use of a flap technique (free, pedicled, or combinations thereof) should be defined as the standard when performing extended frontal sinus surgery (Draf IIb, IIc, III, or endonasal frontal sinus surgery [EFSS] 4-6)., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
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- 2024
- Full Text
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23. Sphinkterschonende operative Therapie der chronischen Analfissur durch primäre plastische Deckung.
- Author
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Hancke, E.
- Abstract
Copyright of Colo-Proctology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2020
- Full Text
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24. Retrograd gestielte Lappenplastiken der dorsalen Metakarpalarterien (DMCA).
- Author
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Sauerbier, Michael, Arsalan-Werner, Annika, and Neubrech, Florian
- Abstract
Copyright of Operative Orthopädie und Traumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2020
- Full Text
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25. Geschlechtsangleichung von Frau zu Mann : Phallusplastik.
- Author
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Sohn, M., Rieger, U., and Morgenstern, S.
- Subjects
URETHRA surgery ,PENIS surgery ,SURGICAL flaps ,PLASTIC surgery - Abstract
Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2020
- Full Text
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26. Welche Maßnahmen sind sinnvoll zum Strukturerhalt des Alveolarfortsatzes nach Zahnextraktion?
- Author
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Weng, Dietmar, Stock, Vera, and Schliephake, Henning
- Subjects
ALVEOLAR process ,DENTAL extraction ,DENTAL implants ,META-analysis ,BONE grafting ,CONTROL groups ,WOUND healing ,SURGICAL flaps ,ORAL surgery - Abstract
Copyright of European Journal of Oral Implantology is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2011
27. [Treatment strategies for fracture-related infections with concurrent soft tissue damage].
- Author
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Alt V, Rupp M, Kerschbaum M, Prantl L, and Geis S
- Subjects
- Humans, Treatment Outcome, Surgical Flaps, Wound Healing physiology, Fracture Fixation, Internal adverse effects, Plastic Surgery Procedures
- Abstract
Fracture-related infections are the predominant complication following surgical fracture treatment. The distal lower leg, e.g., in pilon tibial fractures, is at a high risk of infection due to poor soft tissue coverage, particularly in cases of open fractures in this area. Fracture-related infections with significant soft tissue damage require special attention alongside treatment of the infection itself. In general, the principle is that healing of fracture-related infection is not possible without sufficient soft tissue coverage. Therefore, it is crucial to integrate both soft tissue damage and fracture-related infection into a comprehensive treatment plan from the beginning. An interdiscpilinary treatment approach between trauma and plastic surgery is often necessary and beneficial. In cases, where fracture fixation devices or bone is exposed, mid- or long-term use of vacuum-assisted wound therapy is not advisable due to a higher risk of reinfection. Hence, an interdisciplinary treatment strategy involving trauma and plastic surgery should prioritize early soft tissue closure, referred to as the "orthoplastic approach". If this cannot be done in the own hospital, early patient transfer is indicated to ensure optimal interdisciplinary therapy with early soft tissue closure and simultaneous trauma surgical treatment to control the infection and enable bone healing. Free fasciocutaneous or muscle flap techniques in combination with adequate trauma surgical and antibiotic therapy lead to good reliable results in these situations., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2024
- Full Text
- View/download PDF
28. Weichgewebssarkome: Extremitätenerhalt durch plastisch-rekonstruktive Verfahren.
- Author
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Lehnhardt, M., Sogorski, A., Wallner, C., Wagner, M., Dadras, M., Behr, B., and Harati, K
- Abstract
Die Therapie der Wahl bei Weichteilsarkomen mit lokalisiertem Befall besteht weiterhin in der kompletten chirurgischen Entfernung im Gesunden. Das Ziel der operativen Therapie ist die Erlangung tumorfreier Resektionsränder im Sinne einer R0-Resektion. Keine andere Therapiemöglichkeit kann diese wichtige onkologische Kondition ebenbürtig ersetzen. Die enorme Entwicklung im Bereich der rekonstruktiven plastischen Chirurgie und hier insbesondere die Fortschritte in der Lappentechnik und Mikrochirurgie erlauben den Extremitätenerhalt und die funktionelle Rekonstruktion auch bei ausgedehnten Fällen. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
29. [The Bochum Temporal Bone Course - Part 6: Tympanomeatal flap, exostosis of external canal and reconstruction of the ossicular chain].
- Author
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Weiss NM, van Ackeren K, Volkenstein S, and Dazert S
- Subjects
- Humans, Temporal Bone surgery, Surgical Flaps, Retrospective Studies, Exostoses, Ossicular Prosthesis, Ossicular Replacement
- Abstract
Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.
- Published
- 2023
- Full Text
- View/download PDF
30. Ersatz des Beckenbodens.
- Author
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Parodi, C. and Menke, H.
- Abstract
Copyright of Colo-Proctology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2018
- Full Text
- View/download PDF
31. Anatomische Rekonstruktion nach weiblicher Genitalbeschneidung.
- Author
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O'Dey, Dan mon
- Abstract
Copyright of Journal für Ästhetische Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2018
- Full Text
- View/download PDF
32. Defektdeckung mit posteriorem Oberschenkellappen.
- Author
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Boyce, M. K., Mett, T. R., Ipaktchi, R., and Vogt, P. M.
- Abstract
Copyright of Operative Orthopädie und Traumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2018
- Full Text
- View/download PDF
33. Rekonstruktion der aktinisch geschädigten Unterlippe.
- Author
-
Thiele, O. C. and Mischkowski, R. A.
- Abstract
Copyright of Der MKG-Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2018
- Full Text
- View/download PDF
34. Klassische Methoden der Unterlippenrekonstruktion.
- Author
-
Krimmel, M. and Reinert, S.
- Abstract
Copyright of Der MKG-Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2018
- Full Text
- View/download PDF
35. [Differential therapeutic Approaches in congenital Malformations of the Hand]
- Author
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Darja, Sippel and Wiebke, Hülsemann
- Subjects
Fingers ,Thumb ,Humans ,Syndactyly ,Hand ,Surgical Flaps - Abstract
With the same clinical picture, different pathological changes must be expected in congenital malformations of the hand. Therefore, knowledge of these pathologies is crucial for planning the surgical approach. The approaches to common malformations are dealt with as examples. These include the double thumb and the syndactyly.In the case of the double thumb with an asymmetrical contour, the result is improved by augmenting parts of the redundant double thumb. In this case, a different incision is required than in simple resection.In the frequently performed syndactyly separations, there are many techniques that have been proven to achieve a good result. But only if principles such as local displacement flap plasty for commissure formation, tension-free wound closure, no longitudinal incisions and no bilateral preparation of a finger are observed here too. If it can be assumed preoperatively that a good surgical result cannot be achieved with the conventional technique of syndactyly separation, pre-treatment using an external fixator for transverse soft tissue distraction is the method of choice.The timing of surgery takes into account not to disturb the motor development of the affected person.Bei gleichem Krankheitsbild muss bei kongenitalen Fehlbildungen der Hand mit unterschiedlichen pathologischen Veränderungen gerechnet werden. Daher ist das Wissen um diese Pathologien für die Planung des operativen Zugangsweges entscheidend. Exemplarisch werden in diesem Beitrag die Zugänge häufiger Fehlbildungen abgehandelt. Hierzu zählen der Doppeldaumen und die Syndaktylien.Beim Doppeldaumen mit asymmetrischer Kontur wird durch Augmentation von Anteilen des wegfallenden Daumens das Ergebnis verbessert. In diesem Fall ist eine andere Schnittführung als bei der einfachen Resektion erforderlich.Bei den häufig durchgeführten Syndaktylietrennungen gibt es viele Techniken, die nachweislich ein gutes Ergebnis erreichen. Aber nur, wenn auch hier Prinzipien wie lokale Verschiebelappenplastiken für die Kommissurbildungen, ein spannungsfreier Wundverschluss, keine longitudinalen Inzisionen und keine bilaterale Präparation eines Fingers beachtet werden. Ist präoperativ davon auszugehen, dass ein gutes Operationsergebnis mit der herkömmlichen Technik der Syndaktylietrennung nicht erreicht werden kann, ist die Vorbehandlung mittels Fixateur externe zur queren Weichteildistraktion die Methode der Wahl.Der Operationszeitpunkt berücksichtigt, die motorische Entwicklung des Betroffenen nicht zu stören.
- Published
- 2022
36. [Incisions in surgical Treatment of Dupuytren's Disease]
- Author
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Karlheinz, Kalb, Jakob Richard, Schnegg, and Polina, Dimitrova
- Subjects
Dupuytren Contracture ,Humans ,Hand ,Surgical Flaps ,Fasciotomy ,Skin - Abstract
Therapeutic options to treat Dupuytren`s disease vary considerably. Nevertheless, limited fasciectomy remains the method of choice in advanced disease. Correct incisions are of crucial importance in this kind of surgery.With the inclusion of relevant literature, we present principles of correct incisions and our personal approach in different stages of the disease. History and a subtle clinical examination are essential to plan the surgery. Important details are quality of skin and extent and characteristics of pathological tissue. Generally accepted basic incisions are longitudinal incisions with subsequent Z-plasties and Zig-Zag-Incisions with several modifications. Extensive deficit of skin necessitates local flaps. In the palm we prefer an ulnar-based flap design and in special cases a Z-plasty. Depending on the extent of the disease, various combinations of these basic techniques are necessary. Incisions must respect general principles in hand surgery, allow exposition of the pathological tissue, utilise mobile parts of skin for usage as flaps and respect vascularisation of resulting flaps.In complex cases, individualised incisions or general hand surgical principles and correction of the resulting skin deficit are crucial elements necessary for successful surgery. By sticking to these principles, experienced hand surgeons can implement different solutions.Die Konzepte zur Behandlung der Dupuytrenschen Kontraktur differieren erheblich. Nichtsdestotrotz bleibt die partielle Aponeurektomie die operative Methode der Wahl bei fortgeschrittener Erkrankung. Ein wesentlicher Aspekt dieser Operation ist ein korrekter Zugangsweg. Unter Einbeziehung der Literatur erfolgt die Darstellung grundlegender Prinzipien, sowie des konkreten eigenen Vorgehens bei unterschiedlichen Ausgangsbefunden.Voraussetzung für eine korrekte Operationsplanung und damit einer adäquaten Schnittführung ist neben sorgfältiger Anamnese eine subtile Erfassung des individuellen Befundes. Relevante Parameter sind Befundausdehnung und Hautqualität. Anerkannte Basisinzisionen sind an den Fingern Längsinzisionen mit Auflösung durch Z-Plastiken und Zick-Zack-Inzisionen mit vielen Variationen. Bei ausgeprägterem Hautdefizit kommen Lappenplastiken zum Einsatz. In der Hohlhand bevorzugen wir einen ulnarseitig gestielten Lappen, alternativ eine Hohlhand-Z-Plastik. Befundabhängig sind Kombinationen notwendig. Entscheidend ist die Beachtung handchirurgischer Prinzipien, suffiziente Exposition des Situs, Ausnutzung verschieblicher Hautareale und die Beachtung der Vaskularisation resultierender Hautlappen.Bei komplexem Ausgangsbefund ist eine individualisierte Schnittführung unter Beachtung der handchirurgischen Grundprinzipien mit Ausgleich des antizipierten Hautdefizits ein wesentliches Element für den Erfolg des Eingriffes, wobei die konkrete Umsetzung bei erfahrenen Handchirurgen stark variieren kann.
- Published
- 2022
37. Die komplexe Rekonstruktion der Vulva nach weiblicher Genitalverstümmelung/Genitalbeschneidung.
- Author
-
O'Dey, D. and O'Dey, D M
- Abstract
Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
- Full Text
- View/download PDF
38. Rekonstruktion mit dem supraklavikulären Insellappen.
- Author
-
Bruchhage, K.-L., Leichtle, A., and Wollenberg, B.
- Abstract
Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
- Full Text
- View/download PDF
39. [Management of urethral stricture]
- Author
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Stefan, Tritschler and Vincent, Beck
- Subjects
Male ,Urethral Stricture ,Treatment Outcome ,Urethra ,Humans ,Urologic Surgical Procedures ,Constriction, Pathologic ,Surgical Flaps - Abstract
Urethral strictures most frequently affect the bulbar but are also observed in the penile, glandular, or membranous urethra. They are often iatrogenic. Radiologic diagnosis can be established easily and safely by cystourethrography. Simple Sachse urethrotomy can result in permanent relief in the case of short bulbar strictures in initial findings. Recurrent structures or strictures in other locations should however be treated by open surgery, as cure cannot be achieved by other means. Depending on the diagnosis and comorbidities, end-to-end anastomosis, graft/flap urethroplasty, or perineal urethrostomy can be performed. If open surgery is delayed, aggravation of the diagnosis and worsening of the prognosis can be expected, regardless of the applied treatment.Harnröhrenstrikturen betreffen am häufigsten die bulbäre, aber auch die penile, glanduläre oder membranöse Harnröhre und sind häufig iatrogen bedingt. Sie können radiologisch einfach und sicher mit dem Zystourethrogramm diagnostiziert werden. Bei kurzstreckigen Erstbefunden der bulbären Harnröhre kann eine einfache Urethrotomie nach Sachse bereits zu einer dauerhaften Sanierung der Erkrankung führen. Im Falle eines Rezidivs oder an anderen Lokalisationen sollte jedoch ein offenes operatives Verfahren angewendet werden, da ansonsten keine Heilung mehr erreicht werden kann. Dabei stehen in Abhängigkeit vom Befund und der Begleiterkrankungen die End-zu-End-Anastomose, die Graft- bzw. Flap-Urethroplastik und die perineale Urethrostomie zur Auswahl. Bei Verzögerung der offenen chirurgischen Therapie kommt es zu einer Aggravation des Befundes und zu einer Verschlechterung der Prognose der Erkrankung, unabhängig von der dann angewendeten Therapie.
- Published
- 2021
40. Plastische Rekonstruktionsverfahren der Brustwand nach Mediastinitis.
- Author
-
Ried, M., Geis, S., Potzger, T., Neu, R., Klein, S., Prantl, L., Hofmann, H., and Dolderer, J.
- Abstract
Sternal osteomyelitis as a direct consequence of advanced mediastinitis or as in most cases after median sternotomy is still associated with a prolonged hospital stay, increased morbidity and postoperative mortality. Early diagnosis and an adequate surgical treatment are decisive for the prognosis. Prerequisites for a secondary stabilization of the chest wall using wires or plates are sterile wound conditions. Diverse reconstructive techniques are available for anterior chest wall reconstruction depending on the defect size and localization. The various reconstructive methods including local and free flap coverage are described in this review article. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
41. Lappenplastiken bei fortgeschrittenem Morbus Dupuytren.
- Author
-
Lukas, B. and Lukas, M.
- Abstract
Copyright of Operative Orthopädie und Traumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2016
- Full Text
- View/download PDF
42. [Reconstruction of defects on the hand]
- Author
-
Mathias, Witt and Mehmet A, Altintas
- Subjects
Soft Tissue Injuries ,Hand Injuries ,Humans ,Plastic Surgery Procedures ,Hand ,Surgical Flaps - Abstract
From a reconstructive viewpoint, injuries of the hand are particularly challenging. They are often associated with exposed tendons, bones, nerves and vessels, whereas little skin and soft tissue reserves are available for coverage. Functional and esthetic requirements necessitate a differentiated approach, depending on the location and extent of the defect. This article gives an overview of reconstruction techniques and flap surgery on the hand for various defect sizes and locations.Aus rekonstruktiver Sicht stellen Handverletzungen besondere Herausforderungen dar, da sie oft mit freiliegenden Sehnen, Knochen und Leitungsstrukturen einhergehen und da an der Hand nur wenige Haut-Weichteil-Reserven zur Deckung vorhanden sind. Funktionelle und ästhetische Gesichtspunkte verlangen, je nach Lokalisation und Defektausmaß, ein differenziertes Vorgehen. Der vorliegende Beitrag gibt einen Überblick über Rekonstruktionstechniken und Lappenplastiken an der Hand für verschiedene Defektgrößen und Defektlokalisationen.
- Published
- 2021
43. [Nasal reconstruction with paramedian forehead flaps]
- Author
-
Marie-Luise, Schiffmann and Dominik, Schlarb
- Subjects
Nose Neoplasms ,Humans ,Forehead ,Nose ,Rhinoplasty ,Surgical Flaps - Abstract
The nose has an important function in the esthetic perception of the face. The esthetic coverage of defects on the nose is therefore of particular importance; however, the position is exposed to sunlight and poses a particular risk for the development of non-melanoma skin cancer (NMSC) and melanomas. After tumor excision, the size of the defect is decisive for defect closure. In addition, multilayer defects in which the cartilage or mucous membranes must be reconstructed by plastic surgery, represent a particular challenge for the surgeon. There are various options for reconstruction depending on the extent of the defects on the nose. This article gives an overview of the paramedian forehead flap, the indications and implementation.Die Nase hat eine entscheidende Funktion in der ästhetischen Wahrnehmung des Gesichts. Die ästhetische Deckung von Defekten an der Nase ist daher von besonderer Wichtigkeit. Die sonnenexponierte Lage stellt jedoch ein besonderes Risiko für die Entwicklung von NMSC („non-melanoma skin cancer“) oder Melanomen dar. Nach Tumorexzision ist die Größe des Defekts für den Defektverschluss entscheidend. Darüber hinaus stellen mehrschichtige Defekte, bei denen auch der Knorpel oder die Schleimhaut plastisch rekonstruiert werden müssen, eine besondere Herausforderung für den/die Chirurg:in dar. Je nach Ausmaß von Defekten an der Nase gibt es verschiedene Möglichkeiten, eine Rekonstruktion vorzunehmen. Dieser Beitrag gibt eine Übersicht über den paramedianen Stirnlappen, die Indikationsstellung sowie die Durchführung.
- Published
- 2021
44. [The proximally pedicled anterolateral thigh flap for reconstruction of complex soft tissue wounds of the hip and caudal trunk region]
- Author
-
H, Lauer, O, Goertz, K, Landscheidt, and J F, Hernekamp
- Subjects
Treatment Outcome ,Thigh ,Humans ,Plastic Surgery Procedures ,Groin ,Surgical Flaps ,Aged ,Pelvis - Abstract
Groin and lower trunk defects are common problems, especially for elderly patients. While groin defects are often due to prior vascular interventions, trochanteric defects are mainly caused by pressure sores. Plastic reconstructive methods are manifold; however, the pedicled anterolateral thigh (ALT) flap is supposed to be reliable with sustainable results.We present our experiences using the pedicled ALT flap for soft tissue reconstruction in patients with large wounds of the medial and lateral proximal thigh.A total of 16 patients with groin and lower trunk defects due to prior vascular surgery or pressure sores received locoregional soft tissue reconstruction using a proximal pedicled ALT flap. Patient characteristics, defect size, surgery time, clinical outcome and complication rate were assessed.With the exception of two cases, sufficient soft tissue reconstruction was achieved. In all, 81,3% of patients were categorized as ASA (American Society of Anesthesiologists) 3. The average duration of surgery was 149 min. Length of stay was 18,3 days. A total of 31% needed revision surgery due to limited wound healing problems. Two patients died. All patients showed healed wound conditions when they were discharged.The proximal pedicled ALT-flap is a reliable method for soft tissue reconstruction in groin and lower trunk defects. This reconstructive procedure enables reliable wound closure, especially in elderly patients with substantially reduced general health condition.EINLEITUNG: Wundheilungsstörungen im Bereich der Leiste und der Trochanterregion sind insbesondere bei älteren und immobilen Menschen komplex und problematisch. Eine Vielzahl von rekonstruktiven Möglichkeiten steht zur Verfügung, wobei diese insbesondere in Bezug auf vorliegende Nebenerkrankungen und die dreidimensionale Wundkonfiguration evaluiert werden müssen.In der vorliegenden Arbeit werden die Vor- und Nachteile sowie verschiedene Indikationen der proximal gestielten ALT(„anterior lateral thigh“)-Lappenplastik aufgearbeitet und die Ergebnisse im eigenen Patientengut beschrieben.Zwischen Januar 2017 und Oktober 2020 wurden 16 Patienten mit großen Leisten oder Trochanterwunden durch eine gestielte ALT-Lappenplastik behandelt. Es wurden die Größe der Wunden, die Dauer und Komplikationen der operativen Behandlungen sowie das Nebenerkrankungsprofil der Patienten untersucht.Der komplette Wundverschluss konnte mit zwei Ausnahmen erreicht werden. Es waren im Durchschnitt 0,63 Revisionseingriffe erforderlich. Insgesamt 81,3 % der Patienten wurden als ASA (American Society of Anesthesiologists) 3 eingestuft. Zwei Patienten verstarben während des stationären Aufenthalts im zeitlichen Intervall nach der Operation. Die Operationsdauer betrug im Durchschnitt 149 min. Der Krankenhausaufenthalt lag bei durchschnittlich 18,3 Tagen. Die Komplikationsrate lag bei 31 % (5 von 16), wovon drei Patienten Minorkomplikationen aufwiesen. Alle entlassenen Patienten zeigten geschlossene Wundverhältnisse.Die gestielte ALT-Lappenplastik ist eine gute rekonstruktive Behandlungsoption für ausgewählte, komplexe Wunden im proximalen Oberschenkel‑/Leistenbereich. Die Rate an limitierten Wundrevisionen ist erhöht, wobei letztlich eine sehr gute Weichteilrekonstruktion auch bei älteren, deutlich vorerkrankten Patienten erreicht werden kann.
- Published
- 2021
45. [Results of the Limberg flap procedure in acute and chronic pilonidal abscesses]
- Author
-
Jamal, Driouch, C, Braumann, J, Dehnst, M, Ikram, G, Alnammous, D, Bausch, and T, Glatz
- Subjects
Pilonidal Sinus ,Postoperative Complications ,Treatment Outcome ,Recurrence ,Humans ,Neoplasm Recurrence, Local ,Abscess ,Surgical Flaps - Abstract
A number of different treatment algorithms are recommended for the treatment of an acute pilonidal abscess and a chronic pilonidal sinus. While a 1-stage surgical procedure using excision or plastic reconstruction according to Limberg or Karydakis is suggested for chronic pilonidal sinus, a 2‑stage procedure is recommended for an acute pilonidal abscess. The aim of this study was to compare the results of the 1‑stage surgery with plastic reconstruction according to Limberg for acute pilonidal abscess and chronic pilonidal sinus in terms of recurrence, disorders of wound healing, inpatient length of stay and patient satisfaction.From 2009 to 2014 a total of 39 patients were included in this prospective observational study: 21 patients with acute pilonidal abscess and 18 patients with chronic pilonidal sinus. All patients were surgically treated with a 1‑stage procedure using the Limberg flap method. The groups were compared in terms of postoperative complication rates and frequency of recurrence.Both groups were basically comparable with respect to demographic characteristics and risk factor profiles. Analysis of the postoperative results showed a comparable rate of postoperative wound healing disorders (10% vs. 17%, p = 0.647). In the group with acute pilonidal abscesses there was no recurrence during the observational period, while in the chronic pilonidal sinus group there were 2 (11%) recurrences (p = 0.206).The results of the Limberg flap procedure regarding acute pilonidal abscesses were comparable to those of chronic pilonidal sinus. The results of this study show a trend to a lower risk of recurrence. The use of the Limberg flaps therefore also seems to be an adequate treatment option in an acute infection situation.HINTERGRUND: In der Behandlung des Sinus pilonidalis werden unterschiedliche Therapiealgorithmen für den akuten sowie den chronischen Sinus pilonidalis empfohlen. Während sich beim chronischen Sinus pilonidalis ein einzeitiges Vorgehen als Exzision oder plastische Rekonstruktion nach Limberg oder Karydakis anbietet, ist die empfohlene Vorgehensweise beim akuten Pilonidalabszess zweizeitig. Ziel dieser Studie war es, die Ergebnisse der einzeitigen Operation mit Limberg-Plastik bei akutem Pilonidalabszess und chronischem Sinus pilonidalis bezogen auf Rezidive, Wundheilungsstörungen, stationärer Liegedauer sowie Patientenzufriedenheit zu vergleichen.Von 2009 bis 2014 wurden 39 Patienten in die prospektive Beobachtungsstudie eingeschlossen. 21 Patienten mit akutem Pilonidalabszess, 18 mit chronischem Sinus pilonidalis. Alle Patienten wurden einzeitig mittels Limberg-Rautenplastik operativ behandelt. Die Gruppen wurden in Bezug auf postoperative Komplikationsrate und Rezidivhäufigkeit miteinander verglichen.Beide Gruppen waren im Wesentlichen vergleichbar. Die Analyse der postoperativen Ergebnisse zeigte eine vergleichbare Rate an Wundheilungsstörungen (10 % vs. 17 %, p = 0,647). In der Gruppe des akut abszedierten Sinus trat kein Rezidiv im Beobachtungszeitraum auf, während sich in der chronischen Gruppe 2 (11 %) Rezidive zeigten (p = 0,206).Die Ergebnisse der Limberg-Plastik als einzeitige Therapie des Pilonidalabszesses sind mit denen beim chronischen Sinus pilonidalis vergleichbar. Es zeigt sich ein Trend zu einem geringeren Rezidivrisiko. Der Einsatz der Limberg-Plastik scheint daher auch in der akuten Infektsituation eine adäquate Therapieoption.
- Published
- 2021
46. [Plastic-surgical coverage of an extended defect on the scalp using a bipedicled vascularised flap after removal of two cutaneous squamous epithelial carcinomas]
- Author
-
Nils, Heim and Christian Tim, Wilms
- Subjects
Scalp ,Skin Neoplasms ,Carcinoma, Squamous Cell ,Humans ,Plastic Surgery Procedures ,Plastics ,Surgical Flaps - Abstract
Covering huge scalp defects is often a great challenge. Different aspects play a major role in planing and performing the covering of vast defects. We present the case of a patient with a squamous cell carcinoma of the scalp, measuring 8 × 9 centimeters. After histopathological work-up confirmed the suspected diagnosis and measurements of the carcinom were taken via CT-scan, we operated the patient. The carcinoma already reached into the sinus sagittalis superior. The huge defect was covered by two vascularized bipedicled flaps which were moved into the defect from anterior and posterior. The presented surgical technique appears to be a sufficient way in covering huge defects of the scalp.Generell stellt die Deckung von ausgedehnten Defekten am Skalp eine große Herausforderung dar. Bei großen Defekten spielen ästhetische und funktionelle Faktoren wie Kompromittierung der Perfusion der Lappenplastiken nach Tumorresektion, natürliches Angebot an Gewebe zur Deckung bei Rotationslappenplastiken aber auch der Verlauf der natürlichen Haargrenze eine Rolle, die die erfolgreiche Deckung erschweren. Wir berichten über den interessanten Fall eines Patienten, der sich mit einem etwa 8 × 9 cm großen kutanen Plattenepithelkarzinom des Skalps vorstellte. Nach histologischer Sicherung und Bestimmung von Größe und Topografie des Befunds mittels Schichtbildgebung erfolgte die chirurgische Entfernung des bis in den Sinus sagittalis superior reichenden Befundes. Die Deckung des großen Defekts erfolgte mit zwei doppelt gestielten Brückenlappen welche in fronto-occipitaler und occipito-frontaler in gegenläufiger Richtung in den zentralen Defekt geschwenkt wurden. Diese Art der doppelten Brückenlappenplastik stellt eine suffiziente Möglichkeit der Defektdeckung für Defekte der beschriebenen Art dar.
- Published
- 2021
47. [Contemporary management of urethral strictures in women]
- Author
-
Lennart, Kühnke, Margit, Fisch, and Malte W, Vetterlein
- Subjects
Male ,Urethral Stricture ,Treatment Outcome ,Urethra ,Mouth Mucosa ,Humans ,Urologic Surgical Procedures ,Female ,Surgical Flaps - Abstract
Urethral strictures in women are rare and patients may present with varying symptoms. Hence, clinical guidelines regarding diagnostic algorithms and treatment approaches are scarce. Several small case series have presented results for several operative techniques, but patient cohorts are generally heterogeneous and relatively small, which hampers reliable comparability across institutions. The present narrative review aims to provide a contemporary overview of the literature regarding the clinical and therapeutical approach in women with urethral strictures.Iatrogenic reasons such as previous catheterization or genitourinary surgical interventions are the most common cause of female urethral strictures. In daily clinical routine, physical examination is the cornerstone for differential diagnosis and may aid in the decision to expand diagnostic workup by urethrocystoscopy, urethrography, or magnetic resonance imaging in case of suspected anatomic or morphologic cause of voiding disorder. Endoscopic approaches such as dilation or urethrotomy only provide short-term symptomatic relief and open urethroplasty is more commonly associated with durable long-term success. Regarding the surgical approach, there are comparable operative techniques at hand, using vaginal or labial flaps or oral mucosal grafts. Given the relative rarity of female urethral strictures with only small case series published, a statement regarding the superiority of one approach over the other is hardly possible. As for all rare disorders, multi-institutional, large patient series are needed to generate reliable evidence and to improve standards in the perioperative care of women with urethral strictures.Harnröhrenstrikturen der Frau sind ein seltenes Krankheitsbild mit individueller Symptomatik. Vor diesem Hintergrund mangelt es an klinischen Leitfäden, die sich mit Diagnostik und Therapie dieser Erkrankung befassen. Mittlerweile liegen einige Ergebnisse zu verschiedenen Operationstechniken vor, ein direkter inter-institutioneller Vergleich wird jedoch durch heterogene Patientenkohorten und kleine Fallzahlen erschwert. Die vorliegende Arbeit befasst sich mit einer aktuellen narrativen Literaturübersicht relevanter Artikel zur klinischen Diagnostik und zu den Therapiemöglichkeiten bei weiblicher Harnröhrenstriktur.Iatrogene Ursachen wie eine vorangegangene Katheterisierung oder ein urogenitaler operativer Eingriff sind die häufigsten Gründe für die Entstehung einer Harnröhrenstriktur bei der Frau. Im klinischen Alltag stellt die körperliche Untersuchung einen wichtigen Grundstein in der Differentialdiagnostik dar, um bei Verdacht auf eine anatomisch-morphologische Ursache der Harnblasenentleerungsstörung weitere diagnostische Maßnahmen (Urethrozystoskopie, Urethrographie, MRT) einzuleiten. Therapeutisch sind minimal-invasive Eingriffe wie Harnröhrenbougierungen oder Urethrotomien oftmals nur mit kurzfristigem Erfolg assoziiert, sodass die offene Harnröhrenrekonstruktion mit langfristigeren Therapieerfolgen hier eine Sonderstellung einnimmt. Zur Verfügung stehen neben offenen Harnröhrenplastiken mit gestielten Lappen aus Vaginal- oder Labialschleimhaut auch die Verwendung freier Transplantate, vor allem dem Mundschleimhaut-Autotransplantat. Aufgrund der genannten Seltenheit der Erkrankung mit nur kleinen publizierten Fallserien ist jedoch eine Beurteilung der vergleichenden Wirksamkeit der verschiedenen Techniken nur schwer möglich. Wie bei allen seltenen Erkrankungen bedarf es hier der Etablierung von multizentrischen, großen Serien, um die Standards im perioperativen Vorgehen zu verbessern.
- Published
- 2021
48. [Soft tissue reconstruction of the lower extremity with cross-leg flap as a salvage procedure]
- Author
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Berivan, Taskin, Richard, Bender, Sebastian, Schäller, Jan, Wilke, Dietmar, Pennig, and Lijo, Mannil
- Subjects
Leg ,Soft Tissue Injuries ,Treatment Outcome ,Lower Extremity ,Humans ,Plastic Surgery Procedures ,Limb Salvage ,Surgical Flaps ,Leg Injuries - Published
- 2021
49. [Closure of persisting rectourethral fistula after suprasymphyseal adenoma enucleation of the prostate by combining the Bressel-Naujox and gracilis flap procedure].
- Author
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Reichert M, Schüler P, Stepniewski A, Felmerer G, Trojan L, and von Knobloch HC
- Subjects
- Male, Female, Humans, Prostate, Surgical Flaps, Rectal Fistula etiology, Urethral Diseases etiology, Gracilis Muscle, Urinary Fistula diagnostic imaging
- Abstract
When taking into consideration the basic principles of fistula surgery, numerous options are available for the surgical repair of rectourethral fistulas. However, there is no standard regarding which surgical method should be used under which circumstances-due to the heterogeneity of this disease. This case report describes the individual adaptation of a surgical technique that is used for the treatment of vesicovaginal fistulas to treat a rectourethral fistula in a patient who had already undergone an unsuccessful fistula closure attempt. Successful closure of the fistula was achieved on the basis of an established method using tissue interposition., (© 2022. The Author(s).)
- Published
- 2023
- Full Text
- View/download PDF
50. Der submentale Insellappen zur Rekonstruktion im Kopf-Hals-Bereich.
- Author
-
Bruchhage, K.-L., Wollenberg, B., and Schröder, U.
- Abstract
Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2015
- Full Text
- View/download PDF
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