View clinical trials related to Flap Necrosis.
Filter by:Flap reconstruction is utilised increasingly for repair of skin and soft tissue defects following pelvic exenteration. Many methods have been proposed but the outcomes associated with each remain largely unknown and the choice dependant on surgeon preference and patient/ disease characteristics. This review sought to assess the preferred methods for perineal reconstruction following pelvic exenteration by retrospectively assessing the outcomes associated with each at an international, multi-centre level.
The purpose of this pilot study is to investigate whether two major vasopressors (norepinephrine vs. phenylephrine) used for treatment of hypotension during breast reconstruction with free flap transfer surgery have different effects on blood flow of the flap vessel measured by transit time flowmetry. Since there are few prior studies that compared the effects of these two vasopressors on the blood flow of the flap, this study will be conducted in the form of a pilot study in order to establish the evidence for the future randomized controlled trial.
Abstract Introduction For local reconstruction on upper extremity or as a distant micro vascular flap Lateral arm free flap is an excellent source of tissue with the advantages including short operation time, thin pliable tissue, non-dominant vessel and minimal donor site morbidity, it fulfills the goal of an optimal reconstruction of form, function, and aesthetics .Here the investigator share his experience of lateral arm fasciocutaneous flap, investigator found it effective in covering defects secondary to trauma, malignancy and burns. Methods A retrospective data analysis was done to analyze our usage of lateral arm flap. This included patient's age, sex, primary problem, area involved, size of the flap and outcome of the flap 3 weeks post operatively. For free flaps this also included the recipient artery used for anastomosis and the number of veins anastomosed. Results There were 21 flaps done over a period of five years. This included 11 free flaps and 10 pedicle flaps. Average size of free flap was 12x5 cm and that of pedicle flap was 8x5 cm. In the free flap group, there was failure in 2 flaps both of which were due to arterial anastomoses in zone of injury. In the pedicle flap group however, there were no failures. Conclusion Lateral arm flap is a reliable flap with consistent anatomy that can be used for coverage in different parts of the body.
Skin flaps following mastectomy breast surgery that do not have enough oxygen are at risk for necrosis which can increase wound healing problems, postoperative recovery time and be costly to the hospital systems and affect the patient quality of life, poor esthetic results and overall reconstructive success. Mastectomy skin flap necrosis (MSFN) has an incidence of 10-15% with higher rates (7% - 30%) in mastectomy procedures with immediate reconstruction. Intraoperative assessment of the circulation in skin flaps is currently done with clinical assessment tools utilizing somewhat subjective identifiers such as flap color, capillary refill, temperature and dermal edge bleeding to determine the viability of the flap. Several technologies have been developed to assist in the clinical judgement of skin flaps but these technologies are not yet widely used because of the cost of the technology, the time required to image the patient, the intravenous injection of indocyanine green (ICG) dye required for contrast and the inability to image repeatedly and in different environments (pre-op, intra-op and post-op). A new commercially available imaging technology uses NIR spectroscopy to measure regional tissue hemoglobin oxygenation, using images that are taken 12 inches away from the patient. Preclinical data shows that NIR can predict necrosis in flaps but clinical data is needed to characterize and assess the value of the technology in plastic and reconstructive surgery. The purpose of this research study is to explore the ability of NIR imaging to predict skin flap tissue viability in the clinical setting of immediate breast reconstruction procedures. Study Design: This is a prospective, non-interventional study that will explore the ability of NIR imaging to predict of tissue viability in immediate breast reconstruction procedures. Necrosis will be scored using the SKIN score. Participation in the study will not impact patient care; all patients will receive standard care.