Versatility of Botulinum Toxin: A Use in Stabilization of Pedicled Muscle Flaps

Çelik, Esra Uzer; Tercan, Mustafa; Uzunismail, Adnan; Sağlam, Abdullah

doi:10.1097/01.prs.0000197214.57838.9b

Cited by 20 publications

(13 citation statements)

References 17 publications

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“…However, due to a lack of effects on the secretion of nitric oxide involved in vasodilation, BoNTA is effective in promoting vasodilation. Furthermore, experimental studies also have shown that a local use of BoNTA for the elevated flap raised the survival of a flap through the peripheral vasodilation based on the inhibition of the autonomic nervous system [18][19][20].…”

Section: Discussionmentioning

confidence: 98%

The Effect of Botulinum Toxin A on Fat Graft Survival

et al. 2012

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Section: Discussionmentioning

confidence: 98%

The Effect of Botulinum Toxin A on Fat Graft Survival

et al. 2012

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“…[23] Connection of existing innervation using microvascular flaps to line the pectoralis major and reconstructing the lips makes little sense as this will animate tissue that was not made to function at the recipient site. [24] Adding neuronal channels in the hope of new neuronal growth rarely works and may have unwanted results of paresthesia, dysethesia, and neuroma formation. [25] So although we have accepted that reconstruction may replace bulk and close defects, our current state of the art reconstructions lacks the ability to replace functionally complex native soft tissues.…”

Section: Issues To Be Addressed In Soft Tissue Reconstructionmentioning

confidence: 99%

Soft tissue engineering in craniomaxillofacial surgery

Kim¹,

Fasi²,

Feinberg³

2014

Ann Maxillofac Surg

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Craniofacial soft tissue reconstruction may be required following trauma, tumor resection, and to repair congenital deformities. Recent advances in the field of tissue engineering have significantly widened the reconstructive armamentarium of the surgeon. The successful identification and combination of tissue engineering, scaffold, progenitor cells, and physiologic signaling molecules has enabled the surgeon to design, recreate the missing tissue in its near natural form. This has resolved the issues like graft rejection, wound dehiscence, or poor vascularity. Successfully reconstructed tissue through soft tissue engineering protocols would help surgeon to restore the form and function of the lost tissue in its originality. This manuscript intends to provide a glimpse of the basic principle of tissue engineering, contemporary, and future direction of this field as applied to craniofacial surgery.

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“…6 Other pectoralis major musculocutaneous models have subsequently been described. 7,8 In 1999 Akyurek et al described the first pedicled pectoral skin flap in the rat. 9 In 2005, Ulusal et al described a free pectoral skin flap in the rat based on the axillary vessels.…”

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confidence: 99%

Free Pectoral Skin Flap in the Rat Based on the Long Thoracic Vessels

Allen

Chen²

2008

Annals of Plastic Surgery

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M iyamoto et al 1 investigated the vascular anatomy of the rat pectoral region in order to develop a new free pectoral skin flap model. Their study consisted of 2 experiments. Experiment 1 was an anatomical dissection of the rat pectoral region. Experiment 2 was the microsurgical-free transfer of 20 rat pectoral skin flaps to the cervical or groin region: half of the microsurgical anastomoses were end-toend and half were flow-through anastomoses. The authors concluded that the free rat pectoral skin flap is a simple and reliable model that may be used for microvascular experimentation and microsurgery training.In their study, Miyamoto et al found that the axillary artery diameter was larger than the femoral artery in rats, making it a better match for anastomoses to the long thoracic artery during cervical transfer. For this reason, they point out that the free pectoral skin flap more closely resembles a clinical free flap transfer than the superficial epigastric flap model. The authors admit that the chief disadvantage of the pectoral skin flap is the difficulty in dissecting the axillary vessels, because of the surrounding connective tissue. Furthermore, if dissection is careless or ligation of the axillary vessels fails, the operation can be complicated by difficult to control bleeding or air embolism. Although these are significant disadvantages, as in all new techniques, there is bound to be a learning curve. Moving forward, only time will tell how quickly and proficiently trainees can master this new flap.Although many different microsurgical models exist in an assortment of animal models, there is no one animal that has advanced our clinical knowledge as much as the rat. There are over 16 microsurgical models currently used in rats, including the epigastric skin flap, gastrocnemius muscle flap, latissimus dorsi muscle flap, pectoralis muscle flap, fibular bone flap, and omental flap. 2 Having a multitude of microsurgical models plays a key role in training new microsurgeons and improving our knowledge base. For example, advancements in clinical microsurgery have created numerous questions and the corresponding rat models have enabled us to look for new answers without resorting to large animals or sacrificing human safety. Moreover, the availability of molecular reagents for the rat has enabled researchers to study microvascular physiology on the cellular and subcellular levels. 3 The first rat pectoralis major muscle flap was described by Zhang et al in 1994. 4 Zhang's rat pectoralis major muscle flap, based on the lateral thoracic vessels, was transplanted to both the cervical region and the groin region and was used for delay procedures. 4 After the initial description of the rat pectoralis major muscle flap, researchers used the model to study muscle degeneration and skin changes resulting from ischemia or denervation 5 and balloon expansion for use in sternoplasty. 6 Other pectoralis major musculocutaneous models have subsequently been described. 7,8 In 1999 Akyurek et al described the first pedicled...

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Versatility of Botulinum Toxin: A Use in Stabilization of Pedicled Muscle Flaps

Abstract: In the pedicled muscle flaps, botulinum toxin A can be used easily and reliably for stabilization. It was concluded that detachment of the muscle flap might be prevented and operative morbidity decreased using this method.

Cited by 20 publications

References 17 publications

The Effect of Botulinum Toxin A on Fat Graft Survival

The Effect of Botulinum Toxin A on Fat Graft Survival

Soft tissue engineering in craniomaxillofacial surgery

Free Pectoral Skin Flap in the Rat Based on the Long Thoracic Vessels

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