Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +/- 29 min) and in those that survived (92 +/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1055/s-2004-833500 | DOI Listing |
Phytomedicine
December 2024
Hebei Key Laboratory of Critical Disease Mechanism and Intervention, Department of Pathophysiology, Neuroscience Research Center, The Key Laboratory of Neural and Vascular Biology, Ministry of Education, Hebei Medical University, 361 Zhongshan East Road, Shijiazhuang 050017, China. Electronic address:
Background: In China, stroke is the primary cause of adult death and disability. Because of the increased rate of blood vessel reperfusion, it is important to prevent cerebral ischemia-reperfusion injury, in which glutamate (Glu) excitotoxicity plays a critical role. The most important Glu transporter, GLT-1, is essential for the regulation of Glu, which is dependent on Na-K-ATPase (NKA)-induced ion concentration gradient differences.
View Article and Find Full Text PDFInt J Med Robot
February 2025
Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Background: The emergence of telesurgery has received global interest, with secure network transmission identified as a crucial determinant of its success. This study aimed to evaluate the safety and viability of employing quantum cryptography communication in remote partial nephrectomy.
Methods: The surgeon operated on the patient from a distance of over 260 km using remote control of a surgical robot.
Unlabelled: Mild hypoxic-ischemic encephalopathy is common in neonates with no evidence-based therapies, and 30-40% of patients experience adverse outcomes. The nature and progression of mild injury is poorly understood. Thus, we studied the evolution of mild perinatal brain injury using longitudinal two-photon imaging of transgenic fluorescent proteins as a novel readout of neuronal viability and activity at cellular resolution.
View Article and Find Full Text PDFAsian Cardiovasc Thorac Ann
January 2025
Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan.
Background: Endovascular abdominal aneurysm repair (EVAR) offers a less invasive approach to treating abdominal aortic aneurysms (AAA) compared to open repair. However, EVAR is associated with higher rates of reintervention. This study investigates the early and mid-term outcomes of patients who underwent late open conversion including aneurysmorrhaphy after EVAR at our institution.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Anesthesiology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
Introduction: For patients with breast cancer receiving preoperative neoadjuvant chemotherapy with anthracyclines, there is an increased risk of postoperative myocardial injury due to the cardiotoxicity of the chemotherapeutic agents. The optimal intraoperative blood pressure regulation regimen for these patients is unclear. This study is being conducted to determine whether targeting mean arterial pressure (MAP) to 100%-120% of the patient's baseline blood pressure reduces the incidence of myocardial injury after non-cardiac surgery (MINS) compared with targeting MAP to 80%-100%.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!