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Ruslanovych F, Andriyovych Z, Oleksandrovych Z, Pavlovych K. Enlarged perforating flaps of the anterior thoracic and abdominal wall: A novel approach to autologous breast reconstruction. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-33865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Aim. To develop methods for obtaining enlarged perforating flaps on the anterior surfaces of the thoracic and abdominal walls. Material and methods: The study included 16 patients with post-burn breast deformities aged from 5 to 22 years. In the upper part of the anterior surface of the chest, the flaps were formed on the basis of 2, 3 anterior intercostal artery perforator and thoracoacromial artery perforator with the inclusion of the vascular network of the thoracic branch of the supraclavicular artery. In the lower part of the thoracic and upper abdominal wall, there were also enlarged flaps based on the superior epigastric artery perforator with the connection of vascular networks 6, 7 anterior intercostal artery perforator and perforator deep inferior epigastric artery. The obtained flaps were moved by direct advancement, rotation and transposition methods. Results: The largest area of the wound defect was closed with flaps that were moved by rotation and it was 1.8 times larger than the area of wounds closed by direct advancement and 1.3 times larger than if using transposition flaps. The use of stretched perforating flaps from the anterior surface of the thoracic and abdominal walls allowed to obtain a positive result in 90.4% of cases with the short-term treatment, and in all cases with the long-term treatment. Conclusion: A simple technique based on the proposed methods can be widely used for the reconstruction of the upper and lower quadrants of the breast and intermammary and submammary spaces.
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He J, Cui H, Qing L, Wu P, Guliyeva G, Yu F, Tang M, Tang J. Strategies for selecting perforator vessels for transverse and oblique DIEP flap in male pediatric patients: Anatomical study and clinical applications. Front Pediatr 2022; 10:978481. [PMID: 36210945 PMCID: PMC9542642 DOI: 10.3389/fped.2022.978481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Transverse and oblique deep inferior epigastric artery perforator (DIEP) flaps are widely used in breast, lower extremity, urogenital, head and neck reconstruction. In this report, we present our experience with selecting perforator vessels for transverse and oblique DIEP flaps based on an anatomical study and clinical cases. MATERIALS AND METHODS A detailed anatomical study of the DIEP flap was carried out using a standardized injection of lead oxide in 10 fresh cadavers. Additionally, 35 male pediatric patients (age 5-12 years) underwent lower extremity reconstruction with a DIEP flap. A transverse DIEP flap was used when the defect template did not exceed zone IV, while an oblique DIEP flap was used when the defect template exceeded zone IV. RESULTS Perforators located below the umbilicus in zones I and II were rich in transverse anastomoses across the midline of the abdominal wall, which is the basis for the transverse DIEP flap. Perforators lateral to the umbilicus in zone I had true anastomoses with the musculophrenic artery, the morphological basis for the oblique DIEP flap. The DIEP flap design was transverse in 20 patients and oblique in 15. Flap sizes ranged from 8 × 4.5 cm2 to 24 × 9 cm2. One oblique DIEP flap was necrosed totally, and it was repaired by a latissimus dorsi musculocutaneous flap. CONCLUSION The transverse DIEP flap design based on the perforator located below the umbilicus in zone I is recommended for small skin and soft tissue defects. We recommend the use of the oblique DIEP flap design based on the perforator lateral to the umbilicus in zone I as an extended flap to reconstruct large tissue defects.
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Affiliation(s)
- Jiqiang He
- Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Huairui Cui
- Department of Anatomy, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Liming Qing
- Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Panfeng Wu
- Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Gunel Guliyeva
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, United States
| | - Fang Yu
- Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Maolin Tang
- Department of Anatomy, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Juyu Tang
- Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China
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Yu J, Luo Z, Wu P, Tang J. Novel Design of the Chimeric Deep Inferior Epigastric Artery Perforator Flap that Provides for Three-Dimensional Reconstruction of Composite Tissue Defects of the Heel in Children. Orthop Surg 2021; 13:216-224. [PMID: 33448701 PMCID: PMC7862167 DOI: 10.1111/os.12887] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022] Open
Abstract
Objective The aim of the present study was to report a novel design of the chimeric deep inferior epigastric artery perforator flap (DIEP) to achieve dead space filling, Achilles tendon bridging, and skin resurfacing simultaneously with minimal donor‐site morbidity. Methods From September 2012 to May 2016, a retrospective study was carried out on six pediatric patients with composite soft tissue defects of the heel that were repaired with the chimeric DIEP flap. The chimeric flap design included a flap of the anterior sheath of the rectus, a block of rectus muscle, and a large skin paddle. All the parts were supplied by a common artery. After harvesting the flap, all element parts were inserted at the corresponding sites in a tension‐free manner. With one set of vessel anastomoses at the recipient site, accurate repair with tendon reconstruction, dead space elimination, and wound covering were accomplished. The donor site incisions were closed initially. Data on patient age, medical history, injury severity, defect size, flap dimensions, recipient vessels, donor site closure, complications, and follow‐up were collected and reviewed. Results Five of the six chimeric DIEP flaps survived without complications. The remaining one case experienced partial necrosis of the skin paddle caused by venous congestion, which healed after routine dressing changes. Primary donor site closure was accomplished in all cases. The mean follow‐up was 18.6 months (range, 10–36 months). Five patients had satisfactory aesthetic and functional outcomes; one patient needed a secondary debulking procedure. Compared to the unaffected side, the affected side showed no obvious difference for ankle movement, tiptoe function, and patient gait during the follow‐up period. Good ankle function was observed in all patients. There was no donor site breakdown, with only a slightly noticeable linear scar. Conclusion The chimeric DIEP flap reduced the operative time, solved the problem of deficiency of recipient vessels, and attained satisfactory functional and aesthetic outcomes with low donor site morbidity. Therefore, it is a promising option for three‐dimensional reconstruction of composite defects with dead space and Achilles tendon defects as well as skin loss in children.
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Affiliation(s)
- Junyi Yu
- Department of Hand and Microsurgery, Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Zhenhua Luo
- Department of Hand and Microsurgery, Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Panfeng Wu
- Department of Hand and Microsurgery, Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Juyu Tang
- Department of Hand and Microsurgery, Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
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Mayo-Yáñez M, Rodríguez-Pérez E, Chiesa-Estomba CM, Calvo-Henríquez C, Rodríguez-Lorenzo A. Deep inferior epigastric artery perforator free flap in head and neck reconstruction: A systematic review. J Plast Reconstr Aesthet Surg 2020; 74:718-729. [PMID: 33334702 DOI: 10.1016/j.bjps.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/08/2020] [Accepted: 11/12/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Perforator flaps yield the best results for the patient with the least morbidity, and they should be considered the gold standard in head and neck reconstruction. Although deep inferior epigastric perforator (DIEP) flap is considered as the gold standard in breast reconstruction, its use in head and neck reconstructive surgery does not seem so widespread. The objective of this study is to conduct a systematic review of the use, applications and results of the DIEP flap in the head and neck area. METHODS Search was conducted in different indexed databases (PubMed/MEDLINE, the Cochrane Library, Scielo and Web of Science) and through meta-searcher Trip Database with deep inferior epigastric perforator flap AND head neck keywords. Studies on animal and human experiments published in peer-reviewed journals, where investigators assessed the use of DIEP flap, according to the Koshima criteria, in the head and neck area were considered. RESULTS A total of 31 articles and 185 flaps with 95% of survival were found. Thrombosis or venous stasis is the most frequent cause of flap loss and 16.1% presented some type of complication, the most frequent being the dehiscence. The most use was in the reconstruction of glossectomy defect secondary to squamous cell carcinoma (30.51%), being able potentially to re-establish sensory innervation in oral cavity. The assessment of risk bias (National Institutes of Health) highlights the lack of uniformity, with no standardisation of the outcome variable collection and monitoring. DISCUSSION By virtue of its versatility, reliable vascular supply and high flap survival rate, the DIEP flap reconstruction could be an option in complicated 3-dimensional head and neck defects while maintaining the standard of low donor site morbidity.
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Affiliation(s)
- Miguel Mayo-Yáñez
- Otorhinolaryngology - Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), As Xubias 84, 15006 A Coruña, Galicia, Spain; Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), 15782 Santiago de Compostela, Galicia, Spain; Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France.
| | - Esther Rodríguez-Pérez
- Plastic, Aesthetic and Reconstructive Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Galicia, Spain
| | - Carlos Miguel Chiesa-Estomba
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France; Otorhinolaryngology - Head and Neck Surgery Department, Hospital Universitario Donostia, 20014 Donostia, Gipuzkoa, Spain
| | - Christian Calvo-Henríquez
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), 15782 Santiago de Compostela, Galicia, Spain; Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France; Otorhinolaryngology - Head and Neck Surgery Department, Complexo Hospitalario Universitario Santiago de Compostela (CHUS), 15706 Santiago de Compostela, Galicia, Spain
| | - Andrés Rodríguez-Lorenzo
- Plastic and Maxillofacial Surgery Department, Uppsala University Hospital, 751 85 Uppsala, Sweden; Department of Surgical Sciences (IKV), Uppsala University, 751 05 Uppsala, Sweden
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Chimeric Anterolateral Thigh and Rectus Femoris Flaps for Reconstruction of Complex Oral and Maxillofacial Defects. J Craniofac Surg 2020; 32:1841-1844. [DOI: 10.1097/scs.0000000000007228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Cai YC, Li C, Zeng DF, Zhou YQ, Sun RH, Shui CY, Pei J, Liu W, Wang X, Jiang ZH, Tang ZQ, Jiang J, Wang W. Comparative Analysis of Radial Forearm Free Flap and Anterolateral Thigh Flap in Tongue Reconstruction after Radical Resection of Tongue Cancer. ORL J Otorhinolaryngol Relat Spec 2019; 81:252-264. [PMID: 31533123 DOI: 10.1159/000502151] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/15/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Surgery is still the preferred treatment for tongue cancer. Reconstruction should be performed immediately after extensive resection of the tumor. The purpose of this study was to investigate the clinical effect, advantages, and disadvantages of radial forearm free (RFF) flap and anterolateral thigh (ALT) flap in tongue reconstruction after radical resection of tongue cancer. METHODS Thirty-nine cases of tongue reconstruction with RFF flap or ALT flap from 2014 to 2018 were analyzed. The survival of the flap, the functional status after repair, and the influence on the donor area were examined, in addition to the advantages and disadvantages of the flap and the critical points of the technique. RESULTS Twenty-one cases with RFF flaps and 18 cases with ALT flaps showed complete flap survival. Among them, 1 case involved a venous vessel crisis after an ALT operation, and the flap survived after reoperation after thrombus removal and anastomosis. The recovery of tongue function was as follows: 41.0% patients exhibited normal speech, 43.6% patients exhibited near-normal speech, 12.8% patients exhibited vague speech, and 2.6% patients could not speak. There was no significant difference between the 2 groups (p = 0.134). The recovery of tongue flexibility was as follows: 41.0% of the patients had normal postoperative tongue flexibility, 43.6% of the patients had slightly limited tongue flexibility, 12.8% of the patients had severely limited tongue flexibility, and 2.6% of the patients were completely limited. The difference between the 2 groups was statistically significant (p = 0.045). The postoperative diet of patients was as follows: 51.3% of patients had a regular diet, 33.3% of patients had soft foods, 12.8% of patients received a fluid diet, and 2.6% of patients could not eat after the operation. There was no significant difference between the 2 groups (p = 0.209). The satisfaction of donor area was as follows: 46.2% of the patients were satisfied with the donor area, 51.3% of the patients were basically satisfied with the donor area satisfaction, and 2.6% of the patients were not satisfied with the donor area satisfaction. There was no significant difference between the 2 groups (p = 0.809). CONCLUSION The RFF flap is the most widely used technique in tongue reconstruction, especially in patients with tongue defects less than half of tongue tissue. However, for a large number of tissue defects caused by radical resection of advanced tongue cancer, the ALT flaps can provide a sufficient tissue volume, conceal scars after the operation, cause fewer complications in the donor area, and facilitate tongue function and aesthetic quality.
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Affiliation(s)
- Yong-Cong Cai
- Department of Head and Neck Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Chao Li
- Department of Head and Neck Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China,
| | - Din-Fen Zeng
- Department of Head and Neck Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yu Qiu Zhou
- Department of Head and Neck Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Rong Hao Sun
- Department of Head and Neck Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Chun Yan Shui
- Department of Head and Neck Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiao Pei
- Department of GCP Center, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Liu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xu Wang
- Chengdu Medical College, Chengdu, China
| | - Zheng Hua Jiang
- Department of Head and Neck Surgery, Central Hospital of Mianyang City, Mianyang, China
| | - Zheng Qi Tang
- Department of Head and Neck Surgery, The Third People's Hospital of Zigong City, Zigong, China
| | - Jian Jiang
- Department of Head and Neck Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Wang
- Department of Head and Neck Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Miyamoto S, Arikawa M, Fujiki M. Deep inferior epigastric artery perforator flap for maxillary reconstruction. Laryngoscope 2018; 129:1325-1329. [DOI: 10.1002/lary.27646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/22/2018] [Accepted: 09/04/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Shimpei Miyamoto
- Division of Plastic and Reconstructive SurgeryNational Cancer Center Hospital Tokyo Japan
| | - Masaki Arikawa
- Division of Plastic and Reconstructive SurgeryNational Cancer Center Hospital Tokyo Japan
| | - Masahide Fujiki
- Division of Plastic and Reconstructive SurgeryNational Cancer Center Hospital Tokyo Japan
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Outcomes of 270 Consecutive Deep Inferior Epigastric Perforator Flaps for Breast Reconstruction. Ann Plast Surg 2018; 80:S388-S394. [DOI: 10.1097/sap.0000000000001341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Microsurgical Engineering: Bilateral Deep Inferior Epigastric Artery Perforator Flap with Flow-Through Intraflap Anastomosis. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1554. [PMID: 29464149 PMCID: PMC5811279 DOI: 10.1097/gox.0000000000001554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 09/08/2017] [Indexed: 11/26/2022]
Abstract
Squamous cell carcinoma (SCC) of the head and neck affects a significant number of people around the world every year. Treatment generally entails surgical resection, radiotherapy, chemotherapy, or some combination of the three. Following resection, microsurgical reconstruction can provide definitive coverage, replace many tissue types simultaneously, and bring healthy tissue to irradiated wound beds. Microsurgical engineering, the manipulation and reorganization of native vascular tissue, can further augment the adaptability of free tissue transfer to complex, compromised wound beds. We present one such case. The patient described in the following report was treated for a recurrent SCC of the left face, which required extensive resection resulting in a complex, composite tissue defect with compromised vascular supply. Using the principals of microsurgical engineering, definitive coverage of the defect, with accept- able aesthetic result, was achieved via bipedicle, DIEP flap with flow-through intraflap anastomosis.
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Kubo T, Seike S, Kiya K, Maeda D, Inohara H, Hosokawa K. Simultaneous reconstruction of orbital defect and parotid contour deformity by a single muscle-sparing VRAM flap with double-skin islands. JPRAS Open 2017. [DOI: 10.1016/j.jpra.2017.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kang SY, Spector ME, Chepeha DB. Perforator based rectus free tissue transfer for head and neck reconstruction: New reconstructive advantages from an old friend. Oral Oncol 2017; 74:163-170. [PMID: 28739194 DOI: 10.1016/j.oraloncology.2017.06.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/26/2017] [Accepted: 06/30/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To demonstrate three reconstructive advantages of the perforator based rectus free tissue transfer: long pedicle, customizable adipose tissue, and volume reconstruction without muscle atrophy within a contained space. MATERIALS AND METHODS Thirty patients with defects of the head and neck were reconstructed with the perforator based rectus free tissue transfer. RESULTS Transplant success was 93%. Mean pedicle length was 13.4cm. Eleven patients (37%) had vessel-poor necks and the long pedicle provided by this transplant avoided the need for vein grafts in these patients. Adipose tissue was molded in 17 patients (57%). Twenty-five patients (83%) had defects within a contained space, such as the orbit, where it was critical to have a transplant that avoided muscle atrophy. CONCLUSIONS The perforator based rectus free tissue transfer provides a long pedicle, moldable fat for flap customization, and is useful in reconstruction of defects within a contained space where volume loss due to muscle atrophy is prevented.
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Affiliation(s)
- Stephen Y Kang
- The Ohio State University, Department of Otolaryngology-Head and Neck Surgery, Columbus, OH, USA
| | - Matthew E Spector
- University of Michigan, Department of Otolaryngology-Head and Neck Surgery, Ann Arbor, MI, USA
| | - Douglas B Chepeha
- University of Michigan, Department of Otolaryngology-Head and Neck Surgery, Ann Arbor, MI, USA; University of Toronto, Department of Surgical Oncology, Toronto, Ontario, Canada.
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Liu Y, Zang M, Zhu S, Chen B, Ding Q. Pre-expanded Paraumbilical Perforator Flap. Clin Plast Surg 2017; 44:99-108. [DOI: 10.1016/j.cps.2016.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Superficial circumflex iliac artery perforator flap for tongue reconstruction. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:373-80. [DOI: 10.1016/j.oooo.2015.10.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 10/23/2015] [Accepted: 10/30/2015] [Indexed: 11/23/2022]
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Ulatowski Ł, Kaniewska A. The Use Of The Diep Flap In The Modern Reconstructive Surgery. POLISH JOURNAL OF SURGERY 2015; 87:472-81. [DOI: 10.1515/pjs-2015-0091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Indexed: 11/15/2022]
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A Classification System for Partial and Complete DIEP Flap Necrosis Based on a Review of 17,096 DIEP Flaps in 693 Articles Including Analysis of 152 Total Flap Failures. Plast Reconstr Surg 2013; 132:1401-1408. [DOI: 10.1097/01.prs.0000434402.06564.bd] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Onoda S, Azumi S, Hasegawa K, Kimata Y. Preoperative identification of perforator vessels by combining MDCT, doppler flowmetry, and ICG fluorescent angiography. Microsurgery 2013; 33:265-9. [DOI: 10.1002/micr.22079] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 11/05/2012] [Accepted: 11/08/2012] [Indexed: 11/10/2022]
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