The functional and aesthetic results were evaluated
as acceptable by all patients. Based on our results, a free SCIA/SIEA flap has the following advantages in soft-tissue reconstruction of the upper extremity: (1) if necessary, flap thinning may be performed safely at the time of flap elevation and (2) flaps are harvested using a lower abdominal incision so that it causes minimal donor site scar. © 2009 Wiley-Liss, Inc. Microsurgery, 2010. “
“Skin graft coverage of critical marginal wounds in microsurgical cases is the earliest described method for coverage of exposed vessels, nerves, and other vital structures at the margins of replanted or transplanted tissue. A case of immediate graft coverage of vein and nerve graft repairs in a gunshot wound is presented Acalabrutinib nmr with a 5-year follow-up demonstrating stable coverage, salvage of the microsurgical reconstruction, and no contracture. Compared to
recently described strategies of interval biosynthetic dressings and delayed skin grafting, immediate skin grafts application remains the most effective management of these wounds. © 2013 Wiley Periodicals, Inc. Microsurgery, 2013. “
“From 2000 to 2006, 35 infants with total obstetric brachial plexus palsy underwent brachial plexus exploration and reconstruction. The mean age at surgery was 10.8 months (range 3–60 months), and the median age was 8 months. All infants were followed for at least 2.5 years (range 2.5–7.3 years) with an average follow-up of 4.2 years. Assessment was performed using the Toronto Active Movement scale. Surgical procedures Selleck RXDX-106 included neurolysis, neuroma excision and interposition nerve grafting and neurotization, using spinal accessory nerve, intercostals and Epothilone B (EPO906, Patupilone) contralateral C7 root.
Satisfactory recovery was obtained in 37.1% of cases for shoulder abduction; 54.3% for shoulder external rotation; 75.1% for elbow flexion; 77.1% for elbow extension; 61.1% for finger flexion, 31.4% for wrist extension and 45.8% for fingers extension. Using the Raimondi score, 18 cases (53%) achieved a score of three or more (functional hand). The mean Raimondi score significantly improved postoperatively as compared to the preoperative mean: 2.73 versus 1, and showed negative significant correlation with age at surgery. In total, obstetrical brachial plexus palsy, early intervention is recommended. Intercostal neurotization is preferred for restoration of elbow flexion. Tendon transfer may be required to improve external rotation in selected cases. Apparently, intact C8 and T1 roots should be left alone if the patient has partial hand recovery, no Horner syndrome, and was operated early (3- or 4-months old). Apparently, intact nonfunctioning lower roots with no response to electrical stimulation, especially in the presence of Horner syndrome, should be neurotized with the best available intraplexal donor. © 2010 Wiley-Liss, Inc. Microsurgery, 2010.
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