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Y-shaped venous anastomosis combined with free flap for the treatment of complex craniofacial trauma.

J Stomatol Oral Maxillofac Surg

January 2025

Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, 563000 China; The Collaborative Innovation Center of Tissue, Damage Repair and Regeneration Medicine of Zunyi Medical University, 563000 China. Electronic address:

Background: Complex craniofacial trauma is defined as those traumatic injuries that are not responding to initial treatment and may involve chronic infection, tissue exposure, and soft tissue contusions. Typical reconstruction using a Y-shaped microvascular venous anastomotic free flap is labor intensive. Although free flap grafts have been used in many applications, their use for combined microvascular anastomotic therapy remains an unexplored but attractive possibility.

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Background: Penetrating cardiac trauma is an entity with high pre and intrahospital mortality due to complications such as cardiac tamponade and massive hemothorax. A ventricular septal defect (VSD) occurs in 1-5% of cases and can present early or late. The management strategy for VSD resulting from penetrating cardiac trauma is uncertain.

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Introduction: The reverse sural flap (RSF) is a random-type, pedicled flap based on sural artery perforators indicated for traumatic lower-extremity wounds. The RSF has demonstrated comparable results to free flap placement in the adult population for reconstruction of distal third defects, but few reports describe its application and outcomes in the pediatric population.

Methods: We investigated RSF application in pediatric patients (<18 years of age) through systematic review and meta-analysis.

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Transesophageal echocardiography (TEE) is one of the cornerstones of cardiac imaging in inpatient and intra-operative settings. TEE is considered a safe procedure, but it may result in serious complications, such as esophageal injury, vocal cord paralysis, arrhythmia, hypotension, seizure, and cardiac arrest. Herein, we discuss one of the rare complications, esophageal perforation, and a conservative approach to managing the patient in a 64-year-old female who underwent a TEE prior to a scheduled valvular surgery.

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Esophageal perforation (EP) resulting from nonaccidental trauma in a neonate is extremely rare. We report a previously healthy 12-day-old neonate presenting with stridor, respiratory distress, and bloody vomitus. Clinical, radiographic, and endoscopic evaluations confirmed the diagnosis of EP.

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