Early detection onset of flap failure using near infrared spectroscopy.

Background: Near-infrared spectroscopy (NIRS) is widely used to assess flap perfusions by measuring tissue oxygen saturation (StO). However, the StO level for the onset of perfusion failure is still a controversial issue.

Aim: This study proposes a new threshold of StO level for detecting the onset of perfusion failure as early as possible to increase flap salvage rates.

Does ischemic preconditioning increase flap survival by ADORA2B receptor activation?

Background: Ischemic preconditioning (IPC) is defined as raising tolerance to subsequent ischemic stress by exposing tissues to sub-lethal ischemia. Although many candidates have been suggested, recent studies have clearly demonstrated that adenosine-mediated ADORA2B receptor (ADORA2BR) activation is the main mechanism involved in IPC. While the tissue-protective role of this mechanism has been demonstrated in different ischemia/reperfusion (I/R) models, its role in flap surgery-derived I/R damage has not to date been investigated.

Reconstruction of midfoot bone and soft tissue loss with chimeric partial scapula and latissimus dorsi muscle flap and short perforator-based skin flap following gunshot injuries: Report of two cases.

In this report we present two cases of gunshot injury related midfoot defects, reconstructed with a chimeric partial scapula and latissimus dorsi muscle flap and short perforator-based skin flap. The first case, a 14 years old male, had 10 × 8 cm medial plantar and 6 × 4 cm dorsal foot defects and the second case, a 55 years old female, had only 8 × 6 cm dorsal foot defect. In both cases the defects were associated with fractures, one with lateral cuneiform and cuboid with 90% bone loss and the other with navicular bone, respectively.

The Effect of Normovolemic and Hypervolemic Hemodilution on a Perforator Flap with Twisted Pedicle Model: Experimental Study in Rats.

Background: Several studies showed the detrimental effect of pedicle torsion on flap survival; however, the impact of hemodilution in this peculiar condition has never been investigated. This study evaluated the effect of acute normovolemic and hypervolemic hemodilution on flap survival in a perforator flap with twisted pedicle model.

Methods: Sixty-three female Wistar rats were divided into three groups of 21 rats each: group 1, superficial inferior epigastric artery flap, which was elevated bilaterally and transposed back to the abdominal wall with different angles of rotation (i.

The Effect of Normovolemic and Hypervolemic Hemodilution on a Microsurgical Model: Experimental Study in Rats.

Background: Nowadays, postoperative flap perfusion impairment still occurs in free flap surgery; despite several studies on microcirculatory physiology, the effect of hemodilution is still extremely controversial. The aim of this study was to investigate the impact of acute normovolemic and hypervolemic hemodilution on the incidence of flap survival rate in a microsurgical rat model.

Methods: Forty female Wistar rats were divided into four groups of 10 rats each: in group 1, a superficial inferior epigastric artery flap was elevated until femoral vessels were isolated, sectioned, and anastomosed without hemodilution; in group 2, surgery with previous acute normovolemic hemodilution was performed; in group 3, surgery with previous hypervolemic hemodilution was performed; and group 4, was used as a negative control to validate the microsurgical model.

Experiences with functional gracilis muscle flap in lower lip reconstruction.

Objective: Reconstruction of the lips is pivotal because the lips play an essential role in facial aesthetics and have unique functional properties. We presented our experience in reconstruction of total or subtotal lower lip defects with functional gracillis muscle flap covered split-thickness skin graft (STSG) in patients.

Methods: Between 2009 and 2011, seven patients underwent resection of lower lip squamous cell carcinoma and lip reconstruction.