Wyniki wyszukiwania - Biblioteka Nauki

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The use of anterolateral thigh flap (ALTF) for functional tongue reconstruction with postoperative quality of live evaluati

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Krakowczyk Ł. , Maciejewski A. , Szymczyk C. , Wierzgoń J. , Półtorak S.

Polish Journal of Surgery

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2015

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tom 87(8)

384-388

EN

The use of microsurgery for oral reconstruction of cancer patients, has become standard treatment in restoring oral function. The free anterolateral thigh flap is one of the most preferred options in reconstruction after total, subtotal or hemiresection of the tonque due to squamous cell cancer. The aim of the study was to present the reconstructive method using anterolateral thigh free flap with evaluation of quality of live. Material and methods. Clinical material includes 46 consecutive patients with tongue cancer, who underwent complex surgical treatment between 2009 and 2011. There were 36 males and 10 females and the M: F ratio was 3.6: 1. All of them were reconstructed using the anterolateral thigh free flap. The quality of life was evaluated 6 months after completing the treatment, based on postoperative functional and aesthetic status. Results. The overall flap survival rate was 96%. Surgical complications were observed in 8 patients (17%). Donor site was closed primarly in 42 cases and in remaining 4 skin graft was required. In all 46 cases understandable speech and return to unrestricted diet mastication and swallowing were achieved. The mean follow-up period after treatment was 32 months. Analysis of aesthetic effects evaluated in 23 cases and shows generally very good results. According to average transformed scores the QOL can be characterized as excellent for >90, very good for 76-90, good for 51-75, moderate for 25-50 and bad for <25 points. Conclusions. Anterolateral thigh flap, with its versatility in design, long pedicle with a suitable vessel diameter, low donor site morbidity, and very good aesthetic effects, could be the ideal flap for functional tongue reconstruction.

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Review of surgical techniques for the reconstruction of the maxillofacial region used in the Department of Maxillo-Facial Surgery in Rzeszów

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Jan Frańczak J. , Paweł Pakla P. , Robert Brodowski R. , Wojciech Stopyra W. , Danuta Burdzy D. , Bogumił Lewandowski B.

European Journal of Clinical and Experimental Medicine

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2017

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nr 3

273–278

EN

Postoperative reconstruction of tissue loss within the head and neck after extensive resections due to malignant neoplasms or traumas has always been a challenge for maxillo-facial surgeons or ENT physicians. Due to the complex anatomical structure of the head and neck region, every patient requires an individual approach and there is no standard method of management appropriate for all patients. The number of patients treated for malignancy is increasing year by year. The possibility of performing extensive resections in the head and neck region are conditioned by appropriate reconstruction. Aim. The aim of the paper is to present the reconstructive methods used in the Clinical Department of Maxillofacial Surgery, F. Chopin Hospital No. 1 in Rzeszow. A short review of the most commonly used flaps is presented, taking into account their advantages, disadvantages and surgical technique in terms of their usefulness in daily clinical practice.

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The influence of age and comorbidities on the outcomes of surgical treatment with free tissue transfer: a retrospective study

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Czesak M. , Sobol M. , Bruzgielewicz A. , Niemczyk K. , Osuch-Wójcikiewicz E.

Polish Journal of Otolaryngology

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2020

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tom 74

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nr 4

8-12

EN

Introduction: Microvascular free tissue transfer enables the reconstruction of complex head and neck defects. The aim of the study was to assess the results of treatment of patients undergoing reconstructive surgery and to identify factors affecting these results, with particular reference to patient’s age. Materials and Methods: All patients who underwent free-flap head and neck reconstruction in our institution between 2010 and 2017 were included in this retrospective study. A series of 66 patients met the inclusion criteria and were divided into 2 age groups: group G1 aged <65 years (n = 41) and group G2 aged ≥65 years (n = 25). Minor local complications and general complications as well as comorbidities were analyzed. Results: No correlation was found between advanced age and the risk of free flap failure as well as the incidence of local minor complications. General complications were more frequent in the G2 group (32%) than in the G1 group (19.5%), although this is not a statistically significant difference. A statistically significant difference was found between the age and the patient’s health status according to ASA (P = 0.010). In the younger low-risk group, 12 patients (29.3%) had general and local complications, while in the older low-risk group only 1 (4%). General and local complications were found in 5 (12.2%) high-risk G1 patients and in 7 (28%) high-risk G2 patients. Conclusion(s): Patients with advanced head and neck malignant tumors should undergo reconstructive microsurgery regardless of age.

4

The influence of age and comorbidities on the outcomes of surgical treatment with free tissue transfer: a retrospective study

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Czesak M. , Sobol M. , Bruzgielewicz A. , Niemczyk K. , Osuch-Wójcikiewicz E.

Otolaryngologia Polska

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2020

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tom 74(4)

8-12

EN

Introduction: Microvascular free tissue transfer enables the reconstruction of complex head and neck defects. The aim of the study was to assess the results of treatment of patients undergoing reconstructive surgery and to identify factors affecting these results, with particular reference to patient’s age. Materials and Methods: All patients who underwent free-flap head and neck reconstruction in our institution between 2010 and 2017 were included in this retrospective study. A series of 66 patients met the inclusion criteria and were divided into 2 age groups: group G1 aged <65 years (n = 41) and group G2 aged ≥65 years (n = 25). Minor local complications and general complications as well as comorbidities were analyzed. Results: No correlation was found between advanced age and the risk of free flap failure as well as the incidence of local minor complications. General complications were more frequent in the G2 group (32%) than in the G1 group (19.5%), although this is not a statistically significant difference. A statistically significant difference was found between the age and the patient’s health status according to ASA (P = 0.010). In the younger low-risk group, 12 patients (29.3%) had general and local complications, while in the older low-risk group only 1 (4%). General and local complications were found in 5 (12.2%) high-risk G1 patients and in 7 (28%) high-risk G2 patients. Conclusion(s): Patients with advanced head and neck malignant tumors should undergo reconstructive microsurgery regardless of age.

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Superficial temporal artery among Kenyans: pattern of branching and its relation to pericranial structures

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Mwachaka P. , Sinkeet S. , Ogeng'o J.

Folia Morphologica

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2010

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tom 69

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nr 1

EN

The superficial temporal artery, one of the terminal branches of the external carotid artery, is used for temporoparietal, parieto-occipital flaps and forehead flaps in reconstructive surgery. The topographic anatomy of this artery exhibits ethnic variations. Therefore, this study aimed to determine the branching pattern of the superficial temporal artery and its relation to specified landmarks in the pericranial region among Kenyans. Sixty superficial temporal arteries from thirty adult cadavers (18 male, 12 female), obtained from the Department of Human Anatomy, were examined during dissection. The number of branches and pattern of branching of the superficial temporal artery was recorded. Specific measurements were taken from the branching point to the lateral canthus, tragus, and midpoint of the arch of the zygoma. Classical bifurcation into a parietal and a frontal branch was seen in 16 (53.3%) cases. Double frontal and double parietal branches were reported in 26.7% and 13.3% of cases, respectively. Only two cases had a trifurcation. The point of origin of the branches in most cases (80%) was above the arch of the zygoma. The mean distance to the midpoint of the arch of the zygoma was 50.8 ± 20.9 mm, to the lateral canthus 58.6 ± 24.3 mm, and to the tragus 44.1 ± 18.5 mm. The branching pattern among Kenyans, therefore, differs from the classical descriptions. A good understanding of the forehead vascularity aids in the design of flaps and minimizes postoperative complications. (Folia Morphol 2010; 69, 1: 51–53)

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Zastosowanie metody laserowej przepływometrii dopplerowskiej do oceny ukrwienia zespolenia przełykowego u chorych poddawanych operacji rekonstrukcji przełyku

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Przywara S. , Wallner G. , Dąbrowski A. , Terlecki P. , Zubilewicz T. , Michalak J. , Wroński J.

Acta Bio-Optica et Informatica Medica. Inżynieria Biomedyczna

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2005

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tom Vol. 11, nr 3-4

32-34

PL

W pracy omówiono wykorzystanie metody laserowej przepływometrii dopplerowskiej do oceny ukrwienia zespolenia przełykowego u chorych poddawanych operacji rekonstrukcji przełyku. Metoda laserowej przepływometrii dopplerowskiej umożliwia śródoperacyjną, obiektywną ocenę przepływu krwi w mikrokrążeniu okolicy zespolenia przełykowego, a także w samym substytucie formowanym, w celu zastąpienia patologicznie zmienionego odcinka przełyku. Jej rutynowe wykorzystanie może zmniejszać prawdopodobieństwo wystąpienia powikłań pooperacyjnych w postaci przetok w okolicy zespolenia czy zwężeń.

EN

The paper presents application of laser Doppler flowmetry in the assessment of microcirculatory perfusion in the area of esophageal anastomosis in patients undergoing reconstructive surgery of esophagus. The method enables objective evaluation of blood flow in microcirculation of anastomosis area as well as In the substitute used for reconstruction. Routine measurements with laser Doppler flowmetry may diminish the rate of postoperative complications such as anastomosis leakage or stenosis.

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Evaluation of the impact of decellularization and sterilization on tensile strength transgenic porcinedermal dressings

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Joszko K. , Gzik-Zroska Β. , Kowalewska E. , Klama-Baryła A. , Suchoń S. , Burkacki M. , Wolański W.

Acta of Bioengineering and Biomechanics

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2019

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tom Vol. 21, no. 3

87--97

EN

The aim of this paper was to evaluate which method of acellularization and sterilization is optimal, in the meaning of which processes have the least impact on the deterioration of mechanical properties of porcine tissues used for xenogeneic applications. Methods: The static tensile probe was conducted for 80 skin specimens obtained from transgenic swine, which are used as a wound dressing for skin recipient. Obtained data were subsequently analyzed with the use of statistical methods. Results: It was found that Young’s modulus for the samples after the sterilization process for the dispase substance and the mixed method (SDS + trypsin) were statistically significantly changed. In the case of dispase, Young’s modulus value before the sterilization process was 12.4 MPa and after the value increased to 28.0 MPa. For the mixed method (SDS + trypsin) before the sterilization process Young’s modulus value was 5.6 MPa and after it was increased to 6.3 MPa. The mixed method (SDS + trypsin) had the slightest effect on changing the mechanical properties of the samples before and after the sterilization process. Conclusions: It was confirmed that different methods of acellularization and the process of sterilization have an influence on the change of mechanical properties of the skin of transgenic swine. In the authors’ opinion, the mixed method (SDS + trypsin) should be recommended as the best one for the preparation of transgenic porcine dermal dressings because it ensures a smaller probability of dressing’s damage during a surgical procedure.

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Gait changes in patients after reconstruction of facial bones with fibula and iliac crest free vascularized flaps

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Syczewska M. , Krajewski R. , Szczerbik E. , Kalinowska M.

Acta of Bioengineering and Biomechanics

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2018

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tom Vol. 20, no. 1

185--190

EN

Patients with malignant tumours of the oral cavity require its surgical removal and reconstruction of the bone and soft tissues. The grafts are obtained either from leg (fibula) or pelvis (iliac crest). The removal of grafts from the locomotor apparatus can impair the gait. The aim of this study was to find out how the localization of donor site influences the gait pattern. Methods: Results obtained for 30 patients were analyzed (16 fibula graft, 14 iliac crest graft). Patients underwent instrumented gait analyses three times (VICON system): before surgery, 2–4 month after the surgery, and 4–8 months after the surgery. Results: In both groups several gait parameters were changed. Two parameters changed in both groups: gait speed and cadence. In patients receiving iliac crest graft the changed gait variables were: pelvic rotation, hip range in sagittal plane (operated side), knee range in sagittal plane (operated side), foot dorsiflexion in swing on both sides. In patients receiving fibula flap the changed gait variables were: tilt, range motion of the tilt, minimum hip flexion (operated side), time to maximum knee flexion (non-operated side), GGI (non-operated side) and step length (nonoperated side). Conclusions: The primary gait deviations occurring after surgery, and the compensatory mechanisms which subsequently arise depend on the localization of graft donor site. The results indicate that the patients in whom fibula flap was used have less problems with gait pattern after the surgery than the patients receiving iliac crest graft.

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Problematyka rekonstrukcji dużych ubytków tchawicy materiałami alloplastycznymi

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Ścierski W. , Namysłowski G. , Błażewicz M. , Pilch J.

Inżynieria Biomateriałów

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2003

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tom R. 6, nr 26

27-33

PL

Do chwili obecnej nie wynaleziono odpowiedniego materiału alloplastycznego, którego zastosowanie w chirurgii rekonstrukcyjnej dużych segmentowych ubytków tchawicy dawałoby dobre długotrwałe wyniki w badaniach doświadczalnych. Głównym problemem są ponowne zwężenia (powstające przede wszystkim w związku z brakiem urzęsionego nabłonka na wewnętrznej powierzchni protezy), odrzucenia całego przeszczepu, lokalne i infekcje i krwotoki. Wciąż prowadzone są badania, których celem jest wytworzenie materiału o odpowiednich właściwościach fizykochemicznych oraz umożliwiającym migrację komórek i pokrycie wewnętrznej powierzchni nabłonkiem oddechowym. W artykule przedstawiono ogólny stan wiedzy na temat rekonstrukcji dużych ubytków tchawicy oraz przegląd literatury dotyczący zastosowania materiałów alloplastycznych w badaniach doświadczalnych na zwierzętach.

EN

There is no appropriate alloplastic material developed to date, the use of which in reconstructive surgery of large segment trachea defects would bring about positive long-term experimental results. The principal problems are related to re-stenosis (due to lack of ciliated epithelium on the inside surface of the prosthesis), total rejection of graft, local injection and bleedings. Intensive investigations are still being carried out, focused mainly on formulation of the material with appropriate physico-chemical properties allowing for migration of cells and covering of the inside surface by respiratory epithelium. This paper presents current state of knowledge on reconstruction of large tracheal defects, as well as the review of available literature relative to application of alloplastic materials in experimental works on animals.

10

Forgotten Faces of the Great War: The Wounded Servicemen in Henry Tonks’ Surgical Portraits

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Gorgula M.

Świat i Słowo

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2019

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tom 32(1)

87-102

EN

Henry Tonks’ pastel portraits of the wounded Great War servicemen have perplexed researchers for years. These stunning pieces of art made by the surgeongone- artist remain an example of a fascinating but shunned history of the war. Unlike other war art, usually representing the wounded covered with bandages or as stoic or martyred heroes, these portraits defy the conventional, idealized memorializing. They are uncannily raw and frank, with fleshy wounds revealed and soldiers staring blatantly, almost defiantly at the onlookers, making Tonks’ portraits impossible not to be questioned beyond their medical function. They were meant to document ‘before’ and ‘after’ images of the wounded, making the artist a “historian of facial injuries” and thus fulfilling a strictly medical, recording function. And yet, these portraits pose much more complex questions of ethics, aesthetics and memorializing, mostly through the ‘healing’ properties of art, which gave the depicted soldiers back some semblance of humanity they were stripped off so unexpectedly, losing an important part of their selves, i.e. their faces. Although focusing on unsettling subject, Tonks’ portraits perform a particular memorial function since they represent a direct, almost intimate experience of war, recording a hidden history that contributes to a more coherent and fleshier understanding of World War I.

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The effect of prophylactic doses of nadroparin and therapeutic doses of betamethasone on skin flap survival in rats

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Bielecki M. , Karpik M. , Skowronski J.

Folia Histochemica et Cytobiologica

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2009

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tom 47

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nr 4