New flow-through perforator flaps with a large, short vascular pedicle are proposed because of their clinical significance and high success rate for reconstruction the lower legs. Of 13 consecutive cases, authors describe two cases successful transfer new short-pedicle anterolateral or anteromedial thigh flap coverage soft-tissue defects in This has thin fatty layer small fascial component, is vascularized originating from segment descending branch lateral circumflex femoral system. The...

The authors describe, in the first report of this type replantation surgery, a high success rate using delayed venous anastomosis 16 consecutive distal phalangeal replantations under digital block. Among these replantations, seven fingers (43.8 percent) showed postoperative congestion and five were reoperated on with drainage All successfully drained by additional single or double vein graft. As result, 13 survived (81.3 percent rate). operations performed

The purpose of this study was to determine the usefulness a new flap model, superficial inferior epigastric artery (SIEA) for supermicrosurgical training. Experimental groups were randomly divided into three 10 rats each. In each group SIEA flaps elevated and then returned their original locations with or without vascular anastomosis vessels. Group 1: free flap, 2: 1 hour ischemia time, 3: 4 hours 4: anastomosis. viability rate 80% 1, 50% 2, 40% 3. All nonvascularized (group 4) underwent...

Lymphaticovenular anastomosis plays an important role in the surgical treatment of lymphedema. The outcomes lymphaticovenular are evaluated based on changes edema; however, isolated assessment itself is difficult. authors used animal experimental model to conduct a detailed examination histologic associated with and determined factors for success.The was created using lumbar lymph ducts iliolumbar veins Wistar rats. performed under microscope reviewed postoperative optical electron...

We established the Microvascular Research Center Training Program (MRCP) to help trainee surgeons acquire and develop microsurgical skills. Medical students were recruited undergo MRCP assess effectiveness of for surgeons.Twenty-two medical with no prior experience, who completed course from 2005 2012, included. The comprises 5 stages training, each specific passing requirements. Stages 1 2 involve anastomosing silicone tubes blood vessels chicken carcasses, respectively, within 20 minutes....

Lymphedema is classified into two main types: secondary lymphedema accompanied by lymph node excision surgery or radiotherapy; and idiopathic lymphedema. Here we experienced a very rare case of lymphatic edema resulting from cardiac that the patient underwent 50 years previously.A 62-year-old woman progressive unilateral lower leg for recent years. After undergoing at another hospital age 12 years, she gradually developed left edema. The cause was unclear it remained untreated. Her symptoms...

Background Most studies that examined risk factors for wound complications after head and neck reconstruction analyzed various collectively. Moreover, they included a wide variety of resection areas materials. To overcome these limitations, both the area method were constrained in present study. Methods Patients who underwent free jejunal graft pharyngolaryngoesophagectomy hypopharyngeal cancer enrolled. The outcomes interest abscesses, fistulas, cervical skin flap necrosis. Results...

Background Radiation therapy is an essential treatment for head and neck cancer. However, the condition of operative field entirely altered after radiation therapy. This study aimed to examine effects preoperative on complications in patients who underwent reconstruction with flaps. Methods We retrospectively reviewed 252 instances flaps 240 between October 2000 May 2011 at Okayama University Hospital. Of participants, 51 had exposure (21.3%) 189 no (78.7%). Postoperative were divided into...

The risk factors for thrombus formation in anastomotic vessels free-flap head and neck reconstruction have been previously reported. However, the evidence is inconsistent.In total, 773 patients who underwent free jejunal graft after pharyngolaryngoesophagectomy hypopharyngeal cancer were enrolled at 12 institutions Japan from 1995 to 2006. Both resection area applied method constrained overcome limitations of previous studies. After exclusion recurrent cases, odds ratios (ORs) 95% confidence...

To date, many techniques have been reported for vaginoplasty in male-to-female trans-sexual (MTFTS) patients, such as the use of a rectum transfer, penile-scrotal flap and reversed penile flap. However, none these procedures is without its disadvantages. We developed newly kind vaginoplasty, M-shaped perineo-scrotal (M-shaped flap), using skin from both sides scrotum, shorn hair by preoperative laser treatment. applied this new type 7 MTFTS patients between January 2006 2007. None flaps...

Background In this article, we reviewed the training results of medical students using Microvascular Research Center Training Program (MRCP), and proposed an ideal microsurgical program for all individuals by analyzing who did not have any surgical experience. Methods As 2015, a total 29 completed MRCP. most recent 12 students, number trials performed each stage rats needed to complete were recorded. Additionally, measured operating time upon finishing 5 six after it became current program....

Abstract Axillary necrotizing fasciitis (NF) is quite rare and requires special management with respect to debridement delayed surgical reconstruction. A 76‐year‐old man presented our emergency department a 2‐day history of high fever, severe left axillary pain redness. few hours later, he developed discoloration hemorrhagic bulla in the axilla, redness enlarged on trunk. Emergency was performed. The blackish necrosis axilla completely excised erythematous areas chest wall were cut down...

Between January 2001 and December 2007, we performed vaginoplasty as sex reassignment surgery in a total of 14 male-to-female transsexual (MTFTS) patients [1]. Several complications occurred such partial flap necrosis, rectovaginal fistula formation hypersensitivity the neoclitoris. Just after operation, some feel that their penises still exist, but by several weeks postoperatively, this sensation has disappeared. Herein report case MTFTS whom phantom erectile penis persisted for much longer.

Secondary reconstructive operations are needed when patients with head and neck cancers have complications such as tumor recurrence after initial treatment. These procedures also performed to improve the function appearance of region for many cancer survivors. We reviewed who underwent secondary reconstruction considered significance this procedure survivors, well its associated problems.Among patients, 20 their and/or appearance. The goal was functional improvement in eight cases, ten both...

現在，癌切除後の再建において確立された術式はなく，施設間の再建方法の多様性が逆に治療成績の大きな差を生み出している。そこで，各施設間における再建方法に関する多施設共同研究を行い，過去10年間の治療成績を調査した。切除範囲を統一するため，下咽頭原発で咽頭喉頭頸部食道摘出後の再建症例のみを対象とした。症例数は計764例。移植材料は空腸が最も多く764例中715例（93.7%）であった。照射歴，化学療法歴，総手術時間，総出血量，膿瘍形成率，瘻孔形成率，経口摂取開始までの期間，術後入院日数において各施設の現状に違いが見られた。総手術時間と総出血量に正の相関関係を，症例数と平均総手術時間に負の相関関係を認めた。PGE1の使用と血栓形成には有意な相関を認めなかった。照射の既往により創傷治癒の遅延を認めた。多変量解析にてペンローズドレーンの使用と長時間の手術が有意に膿瘍・瘻孔形成率を増大させた。今回の結果をふまえ，今後標準的再建手技の確立を目指してゆく。

We treated 2 different types of intersexual patients who underwent a vaginoplasty with the pudendal-thigh flap. One was female testicular feminization syndrome for whom we reconstructed total vagina flap, and other an adrenogenital enlarged introitus same approach. There were no complications such as flap necrosis. In addition, there stricture neo-vagina urinary problem.

Despite various options for the reconstruction of soft tissue defects in distal forearm, perforator-based propeller flap is rarely used. Here, we presented 2 cases forearm injuries that were repaired using recurrent branch anterior interosseous artery flap. Patients these 57 and 67 years age. Wounds resulting from farming machine injury pyogenic extensor tenosynovitis following cat bite wounds localized to dorsum hand. Defect dimensions 5 cm × 10 8 cm. The 12 7 21 4 sized was designed...

There is a medical team approach used in many hospitals for oral cancer patients. The members are head & neck surgeons and plastic surgeons, or surgeons. However, Japan, it very difficult to cooperate with except the case of extractions health care, because both treat carcinomas there therefore conflict their scope practice. We believe desirable patients tumors extending other regions, should be charge occlusion carcinomas. treated two collaboration resecting tumors, reconstructing,...

The long-term changes in tissues implanted the oral cavity and pharynx after head neck reconstruction have not been fully evaluated. This study aimed to clarify morphological changes, durability, potential for secondary carcinogenesis such tissues. In our single-center study, rough 54 cases of intraoral pharyngeal skin mucosal flaps were evaluated more than 10 years flap transfer. addition, literature on development second carcinomas from was reviewed. mean follow-up period transferred 148...

The goals of head and neck reconstruction after malignant tumor resection include obtaining good postoperative function appearance minimizing operative invasiveness. However, the most important are reducing local complications discharging patient early, because patients requiring tend to have poorer prognoses. Local delay wound healing, treatment, recovery eating speech functions. Thus, when shown be necessary by clinical observation imaging findings, we open area promptly attempt diagnose...

The collaboration of various medical teams is crucial for the appropriate treatment cancer patients. However, in Japan, it very difficult oral surgeons to cooperate with head and neck due conflicts those There have been few studies on this subject. In current work, we report surgeons, plastic operations two patients gingival carcinomas mandible. We first prepared plaster 3D models patients'mouths by means ink-jet from CT data. pre-bent reconstruction plates using preoperative models....

口腔・咽頭領域は，摂食・会話機能に最も関わる部位で外科的治療により術後機能の障害が引き起こされる。そして，術後機能は切除範囲によって左右される。では，再建手技や術後のリハビリテーションの目的はどこにあるのだろうか。組織が同じように残されていても，術後の機能が良好な患者さんと不良の患者さんがいることを良く経験する。これは，不適切な再建手技や，嚥下指導なしの訓練，患者さんの意欲などに起因していることが多い。このことから，再建外科の最大の目的は，残存組織の機能を最大限に活かすことに集約される。そのためには，残存組織量に準じた切除範囲の詳細な分類とそれに対する適切な再建手技の開発・改良が必要となって来る。これまでに我々は，様々な欠損に対して分類と機能評価を施行してきた。形成外科として今，何を考えているのか，そして合併症を含め何が課題となっているのかについて述べる。