The Experts below are selected from a list of 3060 Experts worldwide ranked by ideXlab platform
Brian S Doyle - One of the best experts on this subject based on the ideXlab platform.
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the Gluteus Maximus Muscle splitting myocutaneous flap for treatment of sacral and coccygeal pressure ulcers
Plastic and Reconstructive Surgery, 1995Co-Authors: Salah Rubayi, Brian S DoyleAbstract:We describe a modified technique using the Gluteus Maximus Muscle as a splitting myocutaneous flap to close specifically low sacral and coccygeal pressure ulcers. Twenty-eight patients with sacral or coccygeal stage IV pressure ulcers (average size 4 × 4 cm) underwent a Gluteus Maximus Muscle-splitt
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the Gluteus Maximus Muscle splitting myocutaneous flap for treatment of sacral and coccygeal pressure ulcers
Plastic and Reconstructive Surgery, 1995Co-Authors: Salah Rubayi, Brian S DoyleAbstract:We describe a modified technique using the Gluteus maximum Muscle as a splitting myocutaneous flap to close specifically low sacral and coccygeal pressure ulcers. Twenty-eight patients with sacral or coccygeal stage IV pressure ulcers (average size 4 x 4 cm) underwent a Gluteus Maximus Muscle-splitting myocutaneous flap when conservative treatment failed to heal the ulcer. Twenty-seven of the 28 patients had complete healing of the pressure ulcer site at an average follow-up of 15 months (range 2 to 40 months). Complications occurred in 7 patients, requiring revision of the flap in 2 patients. The advantages of this technique include reduced blood loss, preservation of most of the Gluteus Maximus for future use, and retained function of the Gluteus Maximus for stair climbing and single-limb support in the ambulatory patient. We recommend the Gluteus Maximus Muscle-splitting myocutaneous flap as the procedure of choice for closure of small low sacral or coccygeal ulcers in both the ambulatory and nonambulatory patient.
Akira Ikeda - One of the best experts on this subject based on the ideXlab platform.
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the gluteal perforator based flap for repair of sacral pressure sores
Plastic and Reconstructive Surgery, 1993Co-Authors: Isao Koshima, Takahiko Moriguchi, Shugo Soeda, Shinsaku Kawata, Shigeo Ohta, Akira IkedaAbstract:A gluteal perforator-based flap employing the Gluteus Maximus Muscle perforators located around the sacrum is described. A cadaveric study disclosed the existence of several significant perforators all around the gluteal region. Among these, the parasacral perforators originating from the internal pudendal artery and lateral sacral artery have proven useful for the repair of sacral pressure sores. A total of eight decubitus in seven patients were treated with gluteal perforator-based flaps. There were no postoperative complications, such as flap necrosis and wound infection, with the exception of fistula formation in one case. This flap requires no transection or sacrifice of the Gluteus Maximus Muscle, and elevation time for the flap is short. However, the perforators are located at various sites and thus require some careful dissection.
M B Laskowski - One of the best experts on this subject based on the ideXlab platform.
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351 motor unit distribution from the inferior gluteal nerve in the Gluteus Maximus Muscle
Journal of Investigative Medicine, 2005Co-Authors: K C Gilbert, Steven J. Lampa, A S Norton, M B LaskowskiAbstract:Purpose A motor unit consists of an alpha motor neuron and all of the Muscle fibers that it innervates. During embryonic development, many neuronal connections from motor units are formed on the same Muscle fiber. Most of these synaptic connections are then eliminated leaving only one nerve terminal to synapse on a Muscle fiber. Of interest in our lab are the elements that cause these neuronal axons to seek out their respective target tissues and survive the period of synapse elimination. The mouse Gluteus Maximus Muscle is innervated primarily by a single nerve, the inferior gluteal nerve. Because the Gluteus Maximus Muscle is thin, it approximates a 2-dimensional space. This allows us to eliminate the issue of depth from this study and focus instead on position in only the x- and y-directions. The single-nerve innervation and Muscle thinness facilitate our ability to test the hypothesis that the inferior gluteal nerve forms a positionally-restricted map over the rostrocaudal axis of the Gluteus Maximus Muscle. Methods We examined the distribution and characteristics of single motor units of the inferior gluteal nerve supplying the Gluteus Maximus Muscle. We used mice genetically engineered to express Yellow Fluorescent Protein (YFP) in motor neurons and their axons. The YFP protein contains a fluorophor that can be visualized by confocal fluorescent microscopy. Each axon was traced through the Muscle to its respective terminal endings. We then measured the positions and areas of these nerve terminals. The number of nerve terminals was also recorded as a function of their rostrocaudal distance across the Muscle. Results Single motor units were found to occupy intervals of approximately 20–;30% of the total rostrocaudal length of the Muscle. Motor units with a relatively larger number of nerve terminals were found to cover larger rostrocaudal intervals. Also it was found that the nerve terminal areas varied widely within a given motor unit. Conclusions These results show that it is possible to map individual motor units and that variability exists in both position and nerve terminal area within a single motor unit. Ultimately our observations may be generalizable to other areas, including the CNS. This work may be useful in development of therapeutic techniques for injuries causing nervous tissue damage.
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ephrin a5 overexpression degrades topographic specificity in the mouse Gluteus Maximus Muscle
Developmental Brain Research, 2004Co-Authors: Steven J. Lampa, A S Norton, M B Laskowski, S Potluri, W FuscoAbstract:Motor neurons project onto specific Muscles with a distinct positional bias. We have previously shown using electrophysiological techniques that overexpression of ephrin-A5 degrades this topographic map. Here, we show that positional differences in axon terminal areas, an entirely different parameter of neuromuscular topography, are also eliminated with ephrin-A5 overexpression. Therefore, we now have both morphological and electrophysiological approaches to explore the mechanisms of neuromuscular topography.
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a morphological technique for exploring neuromuscular topography expressed in the mouse Gluteus Maximus Muscle
Journal of Neuroscience Methods, 2004Co-Authors: Steven J. Lampa, Sasanka Potluri, A S Norton, M B LaskowskiAbstract:Motor neuron pools innervate Muscle fibers forming an ordered topographic map. In the Gluteus Maximus (GM) Muscle, as well as additional Muscles, we and others have demonstrated electrophysiologically that there exists a rostrocaudal distribution of axon terminals on the Muscle surface. The role of Muscle fiber type in determining this topography is unknown. A morphological approach was designed to investigate this question directly. We combined three different methods in the same Muscle preparation: (1) the uptake of activity-dependent dyes into selected axon terminals to define the spinal segmental origin of a peripheral nerve terminal; (2) the fluorescent labeling of nicotinic acetylcholine receptors to determine motor endplate size; (3) the immunocytochemical staining of skeletal Muscle to determine fiber subtype. We applied these methods to the mouse GM Muscle to determine the relationship between Muscle fiber type and the topographic map of the inferior gluteal nerve (IGN). Results from this unique combination of techniques in the same preparation showed that axon terminals from more rostral spinal nerve segments of origin are larger on rostral Muscle fibers expressing myosin heavy chain (MyHC) IIB epitope than caudal type IIB fibers. Because type IIB fibers dominate the GM, this suggests that for these rostral axons terminal size is independent of fiber type. How this axon terminal size is related to the topographic map is the next question to be answered.
Salah Rubayi - One of the best experts on this subject based on the ideXlab platform.
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the Gluteus Maximus Muscle splitting myocutaneous flap for treatment of sacral and coccygeal pressure ulcers
Plastic and Reconstructive Surgery, 1995Co-Authors: Salah Rubayi, Brian S DoyleAbstract:We describe a modified technique using the Gluteus Maximus Muscle as a splitting myocutaneous flap to close specifically low sacral and coccygeal pressure ulcers. Twenty-eight patients with sacral or coccygeal stage IV pressure ulcers (average size 4 × 4 cm) underwent a Gluteus Maximus Muscle-splitt
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the Gluteus Maximus Muscle splitting myocutaneous flap for treatment of sacral and coccygeal pressure ulcers
Plastic and Reconstructive Surgery, 1995Co-Authors: Salah Rubayi, Brian S DoyleAbstract:We describe a modified technique using the Gluteus maximum Muscle as a splitting myocutaneous flap to close specifically low sacral and coccygeal pressure ulcers. Twenty-eight patients with sacral or coccygeal stage IV pressure ulcers (average size 4 x 4 cm) underwent a Gluteus Maximus Muscle-splitting myocutaneous flap when conservative treatment failed to heal the ulcer. Twenty-seven of the 28 patients had complete healing of the pressure ulcer site at an average follow-up of 15 months (range 2 to 40 months). Complications occurred in 7 patients, requiring revision of the flap in 2 patients. The advantages of this technique include reduced blood loss, preservation of most of the Gluteus Maximus for future use, and retained function of the Gluteus Maximus for stair climbing and single-limb support in the ambulatory patient. We recommend the Gluteus Maximus Muscle-splitting myocutaneous flap as the procedure of choice for closure of small low sacral or coccygeal ulcers in both the ambulatory and nonambulatory patient.
Eui Cheol Jeong - One of the best experts on this subject based on the ideXlab platform.
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A dual padding method for ischial pressure sore reconstruction with an inferior gluteal artery perforator fasciocutaneous flap and a split inferior Gluteus Maximus Muscle flap.
Archives of plastic surgery, 2019Co-Authors: Gordon K. Lee, Saehoon Yoon, Eui Cheol JeongAbstract:BACKGROUND Various surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based fasciocutaneous flap and a Muscle flap is expected to resolve the disadvantages of previously introduced surgical methods. METHODS Fifteen patients with ischial pressure ulcers with chronic osteomyelitis or bursitis, who underwent reconstructive procedures with an inferior gluteal artery perforator (IGAP) fasciocutaneous flap and a split inferior Gluteus Maximus Muscle flap from January 2011 to June 2016, were analyzed retrospectively. The split Muscle flap was rotated to obliterate the deep ischial defect, managing the osteomyelitis or bursitis, and the IGAP fasciocutaneous flap was rotated or advanced to cover the superficial layer. The patients' age, sex, presence of bursitis or osteomyelitis, surgical details, complications, follow-up period, and ischial sore recurrence were reviewed. RESULTS All ischial pressure ulcers were successfully reconstructed without any flap loss. The mean duration of follow-up was 12.9 months (range, 3-35 months). Of 15 patients, one had a recurrent ulcer 10 months postoperatively, which was repaired by re-advancing the previously elevated fasciocutaneous flap. CONCLUSIONS The dual-flap procedure with an IGAP fasciocutaneous flap and split inferior Gluteus Maximus Muscle flap for ischial pressure ulcer reconstruction is a useful method that combines the useful characteristics of perforator and Muscle flaps, providing thick dual padding with sufficient vascularization while minimizing donor morbidity and vascular pedicle injury.