Microsurgery: A Useful and Versatile Tool in Surgical Field

Saxena, Amita

doi:10.4172/2161-1076.1000194

Cited by 5 publications

(4 citation statements)

References 17 publications

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“… 2 Other limitations of replantation include cost, time efficiency, and increased operating times. 4 Nonmicrosurgical techniques such as healing by secondary intention using various dressings, reconstruction with local or regional flaps as well as repositioning of the amputated part as a composite graft have become an alternative and popular method in recent times.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Composite Grafts for Pediatric Fingertip Amputations: A Systematic Review

Jester

Han

Singh

et al. 2023

Indian J Plast Surg

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Introduction The aim of this study was to explore the outcomes of composite grafts in fingertip amputations in children as well as the contributing factors that may affect outcomes. Methods Literature search was conducted across six databases in March 2022 to select studies on the use of composite grafts on fingertip amputations in the pediatric population. Results Twelve articles with 735 composite grafts were identified for review. Most fingertip injuries occurred in the less than 5-year age group and were due to crush type injuries. In studies that reported “complete” graft take as a separate outcome measure, 17.3% of fingertips with this result were observed. In the studies that reported “complete” and “partial” graft take together as an outcome measure, 81.6% of fingertips achieved this outcome. A lower proportion of failed graft take was observed in more distal fingertip amputations. Infection (3.8%) and nail abnormalities (3.4%) were the most common complications following composite grafting. Conclusion Composite grafting can be considered as a useful method of treatment in this population. Clinicians should be aware of the potential complications following this method of treatment such as infection and nail abnormalities. More proximal fingertip amputations may warrant other surgical interventions (beyond Level II on the modified Ishikawa/Ishikawa classification). Significant heterogeneity was observed within the studies, mainly due to lack of standardization in assessment and reporting of outcomes.

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Section: Introductionmentioning

confidence: 99%

Outcomes of Composite Grafts for Pediatric Fingertip Amputations: A Systematic Review

Jester

Han

Singh

et al. 2023

Indian J Plast Surg

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“…Therefore, providing a clear visualization of both the surgical tool and the tissue structure is of great importance to the microsurgery guidance. Conventionally, surgeons use surgical microscopes to magnify the field of view, but the view is restricted to an en face perspective with limited depth information [2]. Alternatively, some tomographic imaging modalities, such as ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) provide structure information inside the tissue but still suffer from limited resolution [3], radiation exposure [4] and incompatibility with surgical tools [5].…”

Section: Introductionmentioning

confidence: 99%

Analysis and evaluation of BC-mode OCT image visualization for microsurgery guidance

Wei

Guo

Kang

2019

Biomed. Opt. Express

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Optical coherence tomography (OCT) has been gaining acceptance in image-guided microsurgery as a noninvasive imaging technique. However, when using B-mode OCT imaging, it is difficult to continuously keep the surgical tool in the imaging field, and the image of the tissue beneath the tool is corrupted by shadow effects. The alternative using C-mode OCT imaging is either too slow in imaging speed when operating in a high-resolution mode, or provides a poor image resolution in a high-speed mode, with the sweep rate less than one million hertz. Moreover, the 3-dimensional rendering of C-mode OCT image makes it difficult to visualize the tissue structure and track the surgical tool beneath the tissue surface. To solve these problems, we propose a BC-mode OCT image visualization method. This method uses a sparse C-scanning scheme, which provides a set of high-resolution B-mode OCT images at sparsely spaced cross sections. The final BC-mode OCT image is obtained by averaging the image set, with inter frame variance processing to enhance the signal of the surgical tool and tissue layers. The performance of BC-mode OCT images, such as image resolution, signal to noise ratio (SNR), imaging speed, and surgical tool tracking accuracy, is analyzed theoretically and verified experimentally. The feasibility of the proposed method is evaluated by guiding the insertion of a 30-gauge needle into the cornea of an ex-vivo human eye freehand. The results show that this provides better visualization of both the surgical tool and the tissue structure than the conventional B-or Cmode OCT image.

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“…With the introduction of microsurgery, surgeons are able to transfer numerous flaps from several donor sites to virtually any anatomical unit requiring tissue restoration. 1,2 Consequently, as the spectrum of probabilities widened to almost endless possibilities of flaps, the quest for a versatile reconstructive alternative among plastic surgeons became an everlasting challenge. 2 Bone free flaps or composite bone flaps (CBFs) can reconstruct different areas such as the mandible and the zygomaticomaxillary complex following extensive oncological resection or trauma.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

The Versatility of the DCIA Free Flap: A Forgotten Flap? Systematic Review and Meta-Analysis

Escandón

Bustos

Escandón

et al. 2021

J Reconstr Microsurg

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Background Studies reporting on the deep circumflex iliac artery (DCIA) free flap are restricted to a limited number of patients and areas of application. The aim of this review was to assess the reliability and versatility of the DCIA free flap during reconstruction. Methods A comprehensive review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines using PubMed, Web of Science, Cochrane CENTRAL, and SCOPUS. A critical analysis of pooled data was performed to assess outcomes employing the DCIA free flap. Results A total of 445 DCIA free flaps were included. The main recipient sites were head and neck (72.35%), lower extremity (20.67%), and upper extremity (6.74%). The main indications for reconstruction were tumor resection (73.8%) and trauma (17.43%). Fifty non-DCIA flaps were required to finalize the reconstruction of several defects. The pooled flap failure rate using the DCIA free flap was 4% (95% confidence interval: 1–8%). No significant heterogeneity was present across studies (Q statistic 22.12, p = 0.14; I 2 = 27.68%, p = 0.139). Complication rates for head and neck and limb reconstruction were 57.37 and 40.16%, respectively. The average length and surface area of bone flaps were 7.79 cm and 22.8 cm2, respectively. The area of the skin paddles was 117 cm2. Conclusion The DCIA free flap has shown to be a versatile reconstructive alternative for head and neck and short-medium size limb defects. However, the complexity of functions, the recipient site location, and a potential large defect can detract from the use of the DCIA free flap as an initial reconstructive option for head and neck and extensive limb defects.

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Microsurgery: A Useful and Versatile Tool in Surgical Field

Cited by 5 publications

References 17 publications

Outcomes of Composite Grafts for Pediatric Fingertip Amputations: A Systematic Review

Outcomes of Composite Grafts for Pediatric Fingertip Amputations: A Systematic Review

Analysis and evaluation of BC-mode OCT image visualization for microsurgery guidance

The Versatility of the DCIA Free Flap: A Forgotten Flap? Systematic Review and Meta-Analysis

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