Journal of reconstructive microsurgery
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J Reconstr Microsurg · Jan 2015
ReviewFunctional abdominal wall reconstruction using an innervated abdominal wall vascularized composite tissue allograft: a cadaveric study and review of the literature.
Large, composite abdominal wall defects represent complex problems requiring a multidisciplinary approach for reconstruction. Abdominal wall vascularized composite allotransplantation (AW-VCA) has been successfully performed in 21 patients, already receiving solid organ transplants, to provide immediate abdominal closure. The current study aims to establish a novel anatomic model for AW-VCA that retains motor and sensory function in an effort to preserve form and function while preventing complications. ⋯ Motor function and sensory recovery is expected in other forms of vascularized composite allotransplantation, such as the hand or face; however, this has never been tested in AW-VCA. This study demonstrates feasibility for the transplantation of large, composite abdominal wall constructs that potentially retains movement, strength, and sensation through neurotization of both sensory and motor nerves.
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J Reconstr Microsurg · Oct 2014
Case ReportsChronic pelvic pain after laser prostatectomy: treatment by resection of the perineal branches of the pudendal nerve.
Development of chronic pelvic pain after laser resection for benign prostatic hypertrophy has not been described previously (Clavien IIIb complication). The etiology of this chronic pain, which persisted despite medical chronic pain and urologic management for 5 years, was proven to be of pudendal nerve origin by local anesthetic blockade of the pudendal nerves bilaterally at the ischial spines. ⋯ Relief of perineal pain and pain with micturition occurred in the immediate postoperative period. Pain relief and resumption of all normal activity occurred by 3 months postoperatively and continues 13 months following the surgery.
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J Reconstr Microsurg · Jul 2014
Nerve transfer to the deltoid muscle using the nerve to the long head of the triceps with the da Vinci robot: six cases.
Nerve transfer to the deltoid muscle using the nerve to the long head of the triceps is a reliable method for restoration of deltoid function. The aim of this retrospective study was to report the results of nerve transfer to the deltoid muscle using the nerve to the long head of the triceps procedure using a robot. ⋯ The advantages of robotic microsurgery are motion scaling and disappearance of physiological tremor. Reasons for failure of the endoscopic technique could be explained by insufficient pressure. We had no difficulty using the robot without the sensory feedback. The robot-assisted nerve transfer to deltoid muscle using the nerve to the long head of the triceps was a feasible application for restoration of shoulder abduction after brachial plexus or axillary nerve injury. Therapeutic Study. Level of Evidence IV.
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J Reconstr Microsurg · Jun 2014
Comparative StudyIntercostal nerve transfer to neurotize the musculocutaneous nerve after traumatic brachial plexus avulsion: a comparison of two, three, and four nerve transfers.
The purpose of this study was to compare the outcomes of different numbers of intercostal nerve (ICN) transfers for elbow flexion and to determine whether age, body mass index (BMI), type of injury, and preoperative delay influence the outcomes. From 2004 to 2010, 32 (30 included) consecutive patients underwent ICN transfer to the musculocutaneous nerve following brachial plexus injury. Elbow flexion strength was evaluated according to the British Medical Research Council (BMRC) grading system. ⋯ There is no significant difference among the outcomes of two, three, and four ICN transfers to the musculocutaneous nerve. Two ICN transfers are sufficient for useful recovery of elbow flexion. Younger patients achieve better results.