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Visualization of Superficial Circumflex Iliac Artery Perforator Flap Pedicle with Ultrasound: Revealing the Concept of Pedicle Axiality.
[BACKGROUND] The superficial circumflex iliac artery perforator (SCIP) flap has gained popularity in microsurgical reconstruction, yet anatomical variations of the pedicle poses challenges in flap elevation. The primary aim of this study is…
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State-of-the-Art Medical Imaging Supporting Supermicrosurgery: A Scoping Review, Practical Guidelines, and Illustrative Case Report.
In the era of supermicrosurgery, clinicians need more precise imaging modalities to know the exact microvascular and lymphatic anatomy of the patient. The goal of this review is to answer the research question "What are the state-of-the-art…
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Bridging the Gap between Microsurgery and Supermicrosurgy: A Rat Study for 0.3 mm Vascular Anastomosis Comparing a Robotic-assisted vs. Conventional Approach.
Supermicrosurgery involving vessels ≤0.3 mm remains among the most technically demanding procedures in reconstructive surgery. Robotic platforms have shown potential to enhance precision, but their feasibility at this extreme scale requires…
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Clinical Significance of Hyperhomocysteinemia in Free Flap Failure: A Case Report.
Failure of a microvascular free flap remains rare, yet multiple failures can occur, particularly in the presence of hypercoagulable conditions. This case series highlights our experience with a rare hypercoagulable state: hyperhomocysteinem…
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Further Validating the Robotic Microsurgery Platform through Preclinical Studies on Rat Femoral Artery and Vein.
This research aims to validate the proficiency and accuracy of the robotic microsurgery platform using rat femoral vessel model.A total of 256 rat femoral vessels were performed, half using robotic and the other by manual microanastomosis b…
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The evolution of perforator flaps and the future of microsurgery.
Perforator flaps have transformed reconstructive microsurgery by enabling tissue-specific reconstruction while preserving muscle, fascia, and nerves, minimizing donor site morbidity. Modern techniques-including superthin, ultrathin, and pur…
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Refining Surgical Precision: The Impact of Color Doppler Ultrasound-Guided Perforator Mapping on Anterolateral Thigh Flap for Oncologic Patients.
This study investigates the impact of preoperative ultrasound mapping using color Doppler ultrasound (CDU) on surgical outcomes for anterolateral thigh (ALT) free flap reconstructions.A retrospective review was conducted on patients who wer…
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How to Start and Build Microsurgery Practice-Topics on Success and Sustainability: Global/International.
Many young microsurgeons begin their careers at established hospitals where microsurgery resources are limited. This article shares the authors' experiences in overcoming challenges and establishing a microsurgery practice in a new hospital…
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Does Lymphovenous Anastomosis Effect Mammalian Target of Rapamycin Inhibitor-associated Lymphedema Patients?
The mammalian target of rapamycin (mTOR) inhibitors are used to prevent organ transplant rejection and are preferred over other immunosuppressants due to its low nephrotoxicity. However, mTOR inhibitors have been associated with various adv…
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Lipedema associated with Skin Hypoperfusion and Ulceration: Soft Tissue Debulking Improving Skin Perfusion.
Lipedema is a progressive connective tissue disease with enlargement of adipose tissue, fibrosis, fluid collection, and dermal thickening. Herein, we present a case of lipedema associated with skin hypoperfusion and ulceration in which soft…
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Maximizing the Versatility of Thin Flap from the Groin Area as a Workhorse Flap: The Selective Use of Superficial Circumflex Iliac Artery Perforator (SCIP) Free Flap and Superficial Inferior Epigastric Artery (SIEA) Free Flap with Precise Preoperative Planning.
[BACKGROUND] This study aimed to evaluate the usefulness of the selective use of the superficial circumflex iliac artery perforator (SCIP) and the superficial inferior epigastric artery (SIEA) flap as a workhorse flap from the groin area w…
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A Retrospective Case Series on Free Flap Reconstruction for Ischemic Diabetic Foot: The Nutrient Flap Further Explained.
[BACKGROUND] This retrospective case series compares the outcomes and postoperative oxygen levels in patients who underwent free flap versus primary closure/local flap reconstruction for ischemic diabetic foot wounds to determine the influe…
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Supermicrosurgery in Lower Extremity Reconstruction.
Supermicrosurgery is defined as microsurgery working on vessels less than 0.8 mm, allowing applications in smaller-dimension microsurgery, such as lymphedema, minimal invasive reconstruction, small parts replantation, and application of per…
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Free Tissue Transfer after Open Transmetatarsal Amputation in Diabetic Patients.
[BACKGROUND] Transmetatarsal amputation (TMA) preserves functional gait while avoiding the need for prosthesis. However, when primary closure is not possible after amputation, higher level amputation is recommended. We hypothesize that rec…
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Reconstruction Using Free Flaps for Diabetic Heel Defects: Outcomes and Risk Factor Analysis.
[BACKGROUND] Overall success rate after diabetic foot reconstruction using free flap has been acceptable, but certain parts of the foot like the heel remains more challenging. [PATIENTS AND METHODS] This retrospective study reviewed 37 p…
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The Role of Duplex Ultrasound in Microsurgical Reconstruction: Review and Technical Considerations.
[BACKGROUND] With the technological advances, microsurgery has evolved to the era of supermicrosurgery since its inception. With the popularization of these flaps, proficiency in using tools such as color Doppler ultrasound (CDU) has becom…
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Best New Flaps and Tips for Success in Microsurgery.
[LEARNING OBJECTIVES] After reviewing this article, the participant should be able to: 1. Understand the trends in reconstruction using flaps. 2. Understand the surgical anatomy and elevation of the three best flaps: superficial circumflex …