Use of double skin paddle for pharyngoesophageal reconstruction using tubed radial forearm free flap

Ahmed, Abdul; Visavadia, Bhavin; Farrell, Roy; Gilhooly, Michael

doi:10.1016/j.bjoms.2014.01.022

Cited by 9 publications

(5 citation statements)

References 2 publications

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“…This is the preferred approach to covering adjacent or through-and-through defects. In Case 1, the bi-paddle flap was converted to a single-perforator de-epithelialized flap to cover the defects and eliminate lumen (7,17).…”

Section: A B C D Ementioning

confidence: 99%

“…For variations of two perforators, if they originate from different vessels, the sequential chimeric flap is considered appropriate, as in Case 2. This approach allows for flexible design, a larger cutaneous area, and low donor site morbidity (7,17); primary closure can be achieved. However, hemodynamic resistance may occur in the distal flap after vascular anastomosis, thus increasing the possibility of vascular compromise.…”

Section: A B C D Ementioning

confidence: 99%

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Intraoperative salvaging of failure to harvest the bi-paddle anterolateral thigh flap: a case series

Yang

et al. 2022

Ann Transl Med

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Background: The size and versatility of anterolateral thigh (ALT) flap enables a bi-paddle flap to cover complex and extensive defects optimally. However, it is characterized by variations in the sources of blood vessels and in the number of perforators, which increases the chances of failure of harvesting a bi-paddle flap. We present our method to overcome such failure. This is the first study exploring the optimal salvaging algorithm to overcome harvesting failure with the bi-paddle ALT flap.Methods: From January 2014 to December 2020, in 9 patients to be treated with bi-paddle ALT flap for soft-tissue defects (range, 48-288 cm 2 ), there was failure of flap harvest because of perforator variations. We redesigned and converted the flaps to other forms for harvest intraoperatively, based on the characteristics of the defect, and the number and sources of perforators.Results: Salvage of flap harvest was successfully performed in all 9 cases. In 4 cases the flap with a single perforator was converted to widened-single-perforator flaps; in 2 cases, a single perforator was converted to a de-epithelialized flap; in 2 cases of 2 perforators from different main branches, conversion was to sequential chimeric flaps; in the remaining case of 2 perforators from the descending branch and transverse branch, conversion was to a combined transverse-and-descending branches flap. Venous compromise occurred in only 1 case, and the patient survived after revised surgery. Local infection in the receiving area occurred in 3 cases, and was cured by wound dressing. All flaps survived (follow-up 5-24 months).Conclusions: Despite preoperative preparation, anatomic variations resulted in failure of bi-paddle ALT flap harvesting. As shown by our results, it is feasible to redesign and convert the bi-paddle flap to other forms based on the defect characteristics, and the number and sources of perforators.

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Section: A B C D Ementioning

confidence: 99%

Section: A B C D Ementioning

confidence: 99%

Intraoperative salvaging of failure to harvest the bi-paddle anterolateral thigh flap: a case series

Yang

et al. 2022

Ann Transl Med

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“…Recently, the common materials used to reconstruct hypopharynx are autogenous flaps, including pedicled flaps and free flaps. The pedicled flaps include pectoralis major pedicled flaps, supraclavicular artery flaps, and free flaps include radial forearm free flap, anterolateral thigh free flap, jejunal free flaps, temporomandibular free flaps, serratus anterior free flap, gracilis muscle free flap, etc (5,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). It causes secondary injury to sick patients and is difficult to complete second repair when the autogenous flaps necrosed.…”

Section: Introductionmentioning

confidence: 99%

Development of a decellularized hypopharynx with vascular pedicle scaffold for use in reconstructing hypopharynx

Hou

et al. 2022

Artificial Organs

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Background:Hypopharynx reconstruction after hypopharyngectomy is still a great challenge. Perfusion decellularization is for extracellular matrix (ECM) scaffolding and had been used in organ reconstruction. Our study aimed to prepare an acellular, natural, three-dimensional (3D) biological hypopharynx with vascular pedicle scaffold as the substitute materials to reconstruct hypopharynx.Result:Scanning electron microscope (SEM) and immuno showed that the decellularized hypopharynx with vascular pedicle scaffold retained intact native anatomical ECM structure. Myoblasts were observed on the recellularized scaffolds with bone marrow mesenchyml stem cells (BMSCs) induced by 5-azacytidine implanted in the rabbit greater omentum by immunohistochemical analysis. Conclusion:the decellularized hypopharynx with vascular pedicle scaffold prepared by detergent perfusion in our study has an potential to be an alternative material to pharynx reconstruction.

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“…2,3,[5][6][7][8][9] Patients with a history of prior radiation have been reported to be more likely to have wound complication such as fistula formation. [1][2][3][4]10 Furthermore, strictures associated with scarring and poor healing are also associated with poorer patient voice and swallowing outcomes. [1][2][3][4]10 Utilization of free tissue transfer confers multiple advantages in reconstruction of pharyngeal defects.…”

mentioning

confidence: 99%

“…[1][2][3][4]10 Furthermore, strictures associated with scarring and poor healing are also associated with poorer patient voice and swallowing outcomes. [1][2][3][4]10 Utilization of free tissue transfer confers multiple advantages in reconstruction of pharyngeal defects. It offers the ability to withstand adjuvant radiation therapy due to their vascularized nature.…”

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confidence: 99%

Pharyngeal Reconstruction with Microvascular Free Tissue Transfer

Sokoya

Bahrami

Vincent

et al. 2019

Seminars in Plastic Surgery

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Reconstruction of pharyngoesophageal defects after total laryngectomies and extirpation of hypopharyngeal and upper esophageal carcinomas presents a challenging task. Goals of reconstruction include adequate voice rehabilitation and restoration of normal swallowing. The reconstructive armamentarium contains many options for reconstruction and creation of a new upper digestive tract. This review article focuses on the most commonly used free tissue transfer options for the reconstruction of these defects, with an assessment of their advantages and disadvantages.

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Use of double skin paddle for pharyngoesophageal reconstruction using tubed radial forearm free flap

Cited by 9 publications

References 2 publications

Intraoperative salvaging of failure to harvest the bi-paddle anterolateral thigh flap: a case series

Intraoperative salvaging of failure to harvest the bi-paddle anterolateral thigh flap: a case series

Development of a decellularized hypopharynx with vascular pedicle scaffold for use in reconstructing hypopharynx

Pharyngeal Reconstruction with Microvascular Free Tissue Transfer

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