RESUMO
Use of a three-dimensional CT scan as an adjunct for planning chest-wall and breast reconstruction in Poland's syndrome is presented with follow-up MRI with three-dimensional reformation to demonstrate the results of the implant reconstruction. The imaging techniques are capable of accurately portraying the three-dimensional tissue deficit and asymmetry. This imaging may assist in the choice of muscle transposition flaps and reconstructive technique.
Assuntos
Mama/anormalidades , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/métodos , Síndrome de Poland/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Adolescente , Implantes de Mama , Feminino , Humanos , Mamoplastia/métodos , Síndrome de Poland/cirurgia , Dispositivos para Expansão de TecidosRESUMO
The long-term patency of the 2.5 mm mechanical microvascular anastomotic device (the Unilink system) was evaluated in 10 cases of free flap transfer in nine patients between July 1991 and July 1993. Flap survival indicated adequate patency to time of healing. All cases were considered critical end-to-end venous anastomoses, without a parallel conventional microvascular hand-sewn anastomosis associated with the coupling device. The types of flaps used were seven rectus abdominous and one each of serratus anterior and lateral arm muscles and a free jejunum. There were no postoperative complications requiring reexploration. The 2.5 mm device had a rate of 100% flap take with complete healing at an average of 15 months postoperatively. Selected Doppler flow studies depicted the coupler device in vivo with duplex scan verification of venous patency. The 2.5 mm coupler is a versatile anastomotic device for vessels with a diameter of 2.4-3.2 mm. This expands the applicability of the UNILINK system for use in larger diameter vessels.
Assuntos
Retalhos Cirúrgicos , Procedimentos Cirúrgicos Vasculares/instrumentação , Anastomose Cirúrgica/instrumentação , Humanos , Estudos Retrospectivos , Grau de Desobstrução VascularRESUMO
Vein grafts are used frequently in microvascular surgery, but an adequate supply of autogenous veins is not always available. The search for an ideal substitute for autogenous vein continues. We present a case of lower extremity reconstruction made difficult by lack of suitable autogenous vein for venous outflow from a rectus abdominus free flap. A 36 cm cryopreserved allograft saphenous vein was used on an emergency basis for this problem.