The Experts below are selected from a list of 975 Experts worldwide ranked by ideXlab platform
Rafael Acosta - One of the best experts on this subject based on the ideXlab platform.
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Perineal and posterior vaginal wall reconstruction with superior and Inferior Gluteal Artery perforator flaps
Microsurgery, 2009Co-Authors: Marcus J. D. Wagstaff, Warren Matthew Rozen, Iain S. Whitaker, Morteza Enajat, Thorir Audolfsson, Rafael AcostaAbstract:Perineal and posterior vaginal wall reconstruction following abdominoperineal and local cancer resection entails replacement of volume between the perineum and sacrum and restoration of a functional vagina. Ideal local reconstructive options include those which avoid functional muscle sacrifice, do not interfere with colostomy formation, and avoid the use of irradiated tissue. In avoiding the donor site morbidity of other options, we describe a fasciocutaneous option for the reconstruction of the perineum and posterior vaginal wall. We present our technique of superior and Inferior Gluteal Artery perforator (SGAP or IGAP) flaps to reconstruct such defects. Fourteen patients between 2004 and 2008 underwent 11 SGAP and three IGAP flaps. There were no flap failures or partial flap losses and no postoperative hernias. All female patients reported resumption of sexual intercourse following this procedure. Our experience in both the immediate and delayed setting is that this technique produces a good functional outcome with low donor-site morbidity.
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PR15 NEW TECHNIQUE IN PERINEAL AND POSTERIOR VAGINAL WALL RECONSTRUCTION: SUPERIOR AND Inferior Gluteal Artery PERFORATOR FLAPS
ANZ Journal of Surgery, 2009Co-Authors: Warren M. Rozen, Marcus J. D. Wagstaff, Iain S. Whitaker, Morteza Enajat, Thorir Audolfsson, Rafael AcostaAbstract:Purpose: Perineal and posterior vaginal wall reconstruction following abdominoperineal and local cancer resection requires replacement of dead space and restoration of function. Ideal reconstructive options include those which avoid muscle sacrifice, do not interfere with colostomy formation, and avoid the use of irradiated tissue. Methodology: We present our experience with a new technique for perineal and vaginal reconstruction: superior and Inferior Gluteal Artery perforator (SGAP or IGAP) flaps. We describe the operative technique and outcome in 14 consecutive patients. Six cases were performed as primary reconstruction and 8 cases were delayed, with all receiving preoperative radiotherapy. Results: Immediate reconstructions underwent preoperative imaging with ultrasound only, while delayed reconstructions underwent preoperative CTA. Postoperatively, patients were ambulated immediately, with all bed rest and sitting performed on the contralateral buttock or side for 4 weeks. There were no flap failures or partial flap losses, and no postoperative hernias. Four patients developed early minor wound dehiscence that was resutured in three cases. Revisional surgery was performed for reduction of three bulky flaps. All female patients reported resumption of sexual intercourse following this procedure. Conclusion: Gluteal Artery perforator flaps are good options for perineal reconstruction, avoiding the donor site morbidity associated with rectus abdominis or gluteus maximus muscle harvest.
Mustafa Hasdemir - One of the best experts on this subject based on the ideXlab platform.
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superior and Inferior Gluteal Artery perforator flaps in reconstruction of Gluteal and perianal perineal hidradenitis suppurativa lesions
Microsurgery, 2011Co-Authors: M Cigdem D Unal, M Oktay Ahmet D Yirmibesoglu, M Jale D Ozdemir, Mustafa HasdemirAbstract:Background: Hidradenitis suppurativa is a debilitating disease with a tendency to form abscesses, sinus tracts, and scar formation. In this report, our experience with reconstruction of hidradenitis lesions of the Gluteal and perianal/perineal area using superior and Inferior Gluteal Artery perforator flaps (SGAP and IGAP) are discussed.Patients: A prospective study was conducted in collaboration with the general surgery department for patients with Gluteal and perianal/perineal hidradenitis suppurativa between December 2005 and May 2010. Data of each patient included age, sex, disease localization, duration of symptoms, comorbidities, size of defect after excision, perforator flap chosen, complications, and postoperative follow-up.Results: Eleven SGAP and six IGAP flaps were used in 12 patients with Gluteal and perianal/perineal involvement. There was one flap necrosis for whom delayed skin grafting was performed. The mean follow-up period was 20 months without recurrences.Conclusion:Patients with Gluteal and perineal/perianal hidradenitis suppurativa are usually neglected by surgeons because of lack of collaboration of general and plastic surgery departments. Most surgical treatment options described in the literature such as secondary healing after excision and skin grafting prevent patients from returning to daily life early, and cause additional morbidities. Fasciocutaneous flaps other than perforator flaps may be limited by design such that both Gluteal regions may have to be used for reconstruction of large defects. SGAP and IGAP flaps have long pedicles with a wide arc of rotation. Large defects can be reconstructed with single propeller flap designs, enabling preservation of the rest of the perforators of the Gluteal region. © 2011 Wiley-Liss, Inc. Microsurgery, 2011.
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Superior and Inferior Gluteal Artery perforator flaps in reconstruction of Gluteal and perianal/perineal hidradenitis suppurativa lesions.
Microsurgery, 2011Co-Authors: Cigdem Unal, Jale Ozdemir, Oktay Ahmet Yirmibesoglu, Mustafa HasdemirAbstract:Background: Hidradenitis suppurativa is a debilitating disease with a tendency to form abscesses, sinus tracts, and scar formation. In this report, our experience with reconstruction of hidradenitis lesions of the Gluteal and perianal/perineal area using superior and Inferior Gluteal Artery perforator flaps (SGAP and IGAP) are discussed.Patients: A prospective study was conducted in collaboration with the general surgery department for patients with Gluteal and perianal/perineal hidradenitis suppurativa between December 2005 and May 2010. Data of each patient included age, sex, disease localization, duration of symptoms, comorbidities, size of defect after excision, perforator flap chosen, complications, and postoperative follow-up.Results: Eleven SGAP and six IGAP flaps were used in 12 patients with Gluteal and perianal/perineal involvement. There was one flap necrosis for whom delayed skin grafting was performed. The mean follow-up period was 20 months without recurrences.Conclusion:Patients with Gluteal and perineal/perianal hidradenitis suppurativa are usually neglected by surgeons because of lack of collaboration of general and plastic surgery departments. Most surgical treatment options described in the literature such as secondary healing after excision and skin grafting prevent patients from returning to daily life early, and cause additional morbidities. Fasciocutaneous flaps other than perforator flaps may be limited by design such that both Gluteal regions may have to be used for reconstruction of large defects. SGAP and IGAP flaps have long pedicles with a wide arc of rotation. Large defects can be reconstructed with single propeller flap designs, enabling preservation of the rest of the perforators of the Gluteal region. © 2011 Wiley-Liss, Inc. Microsurgery, 2011.
Marcus J. D. Wagstaff - One of the best experts on this subject based on the ideXlab platform.
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Perineal and posterior vaginal wall reconstruction with superior and Inferior Gluteal Artery perforator flaps
Microsurgery, 2009Co-Authors: Marcus J. D. Wagstaff, Warren Matthew Rozen, Iain S. Whitaker, Morteza Enajat, Thorir Audolfsson, Rafael AcostaAbstract:Perineal and posterior vaginal wall reconstruction following abdominoperineal and local cancer resection entails replacement of volume between the perineum and sacrum and restoration of a functional vagina. Ideal local reconstructive options include those which avoid functional muscle sacrifice, do not interfere with colostomy formation, and avoid the use of irradiated tissue. In avoiding the donor site morbidity of other options, we describe a fasciocutaneous option for the reconstruction of the perineum and posterior vaginal wall. We present our technique of superior and Inferior Gluteal Artery perforator (SGAP or IGAP) flaps to reconstruct such defects. Fourteen patients between 2004 and 2008 underwent 11 SGAP and three IGAP flaps. There were no flap failures or partial flap losses and no postoperative hernias. All female patients reported resumption of sexual intercourse following this procedure. Our experience in both the immediate and delayed setting is that this technique produces a good functional outcome with low donor-site morbidity.
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PR15 NEW TECHNIQUE IN PERINEAL AND POSTERIOR VAGINAL WALL RECONSTRUCTION: SUPERIOR AND Inferior Gluteal Artery PERFORATOR FLAPS
ANZ Journal of Surgery, 2009Co-Authors: Warren M. Rozen, Marcus J. D. Wagstaff, Iain S. Whitaker, Morteza Enajat, Thorir Audolfsson, Rafael AcostaAbstract:Purpose: Perineal and posterior vaginal wall reconstruction following abdominoperineal and local cancer resection requires replacement of dead space and restoration of function. Ideal reconstructive options include those which avoid muscle sacrifice, do not interfere with colostomy formation, and avoid the use of irradiated tissue. Methodology: We present our experience with a new technique for perineal and vaginal reconstruction: superior and Inferior Gluteal Artery perforator (SGAP or IGAP) flaps. We describe the operative technique and outcome in 14 consecutive patients. Six cases were performed as primary reconstruction and 8 cases were delayed, with all receiving preoperative radiotherapy. Results: Immediate reconstructions underwent preoperative imaging with ultrasound only, while delayed reconstructions underwent preoperative CTA. Postoperatively, patients were ambulated immediately, with all bed rest and sitting performed on the contralateral buttock or side for 4 weeks. There were no flap failures or partial flap losses, and no postoperative hernias. Four patients developed early minor wound dehiscence that was resutured in three cases. Revisional surgery was performed for reduction of three bulky flaps. All female patients reported resumption of sexual intercourse following this procedure. Conclusion: Gluteal Artery perforator flaps are good options for perineal reconstruction, avoiding the donor site morbidity associated with rectus abdominis or gluteus maximus muscle harvest.
Thorir Audolfsson - One of the best experts on this subject based on the ideXlab platform.
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Perineal and posterior vaginal wall reconstruction with superior and Inferior Gluteal Artery perforator flaps
Microsurgery, 2009Co-Authors: Marcus J. D. Wagstaff, Warren Matthew Rozen, Iain S. Whitaker, Morteza Enajat, Thorir Audolfsson, Rafael AcostaAbstract:Perineal and posterior vaginal wall reconstruction following abdominoperineal and local cancer resection entails replacement of volume between the perineum and sacrum and restoration of a functional vagina. Ideal local reconstructive options include those which avoid functional muscle sacrifice, do not interfere with colostomy formation, and avoid the use of irradiated tissue. In avoiding the donor site morbidity of other options, we describe a fasciocutaneous option for the reconstruction of the perineum and posterior vaginal wall. We present our technique of superior and Inferior Gluteal Artery perforator (SGAP or IGAP) flaps to reconstruct such defects. Fourteen patients between 2004 and 2008 underwent 11 SGAP and three IGAP flaps. There were no flap failures or partial flap losses and no postoperative hernias. All female patients reported resumption of sexual intercourse following this procedure. Our experience in both the immediate and delayed setting is that this technique produces a good functional outcome with low donor-site morbidity.
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PR15 NEW TECHNIQUE IN PERINEAL AND POSTERIOR VAGINAL WALL RECONSTRUCTION: SUPERIOR AND Inferior Gluteal Artery PERFORATOR FLAPS
ANZ Journal of Surgery, 2009Co-Authors: Warren M. Rozen, Marcus J. D. Wagstaff, Iain S. Whitaker, Morteza Enajat, Thorir Audolfsson, Rafael AcostaAbstract:Purpose: Perineal and posterior vaginal wall reconstruction following abdominoperineal and local cancer resection requires replacement of dead space and restoration of function. Ideal reconstructive options include those which avoid muscle sacrifice, do not interfere with colostomy formation, and avoid the use of irradiated tissue. Methodology: We present our experience with a new technique for perineal and vaginal reconstruction: superior and Inferior Gluteal Artery perforator (SGAP or IGAP) flaps. We describe the operative technique and outcome in 14 consecutive patients. Six cases were performed as primary reconstruction and 8 cases were delayed, with all receiving preoperative radiotherapy. Results: Immediate reconstructions underwent preoperative imaging with ultrasound only, while delayed reconstructions underwent preoperative CTA. Postoperatively, patients were ambulated immediately, with all bed rest and sitting performed on the contralateral buttock or side for 4 weeks. There were no flap failures or partial flap losses, and no postoperative hernias. Four patients developed early minor wound dehiscence that was resutured in three cases. Revisional surgery was performed for reduction of three bulky flaps. All female patients reported resumption of sexual intercourse following this procedure. Conclusion: Gluteal Artery perforator flaps are good options for perineal reconstruction, avoiding the donor site morbidity associated with rectus abdominis or gluteus maximus muscle harvest.
Morteza Enajat - One of the best experts on this subject based on the ideXlab platform.
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Perineal and posterior vaginal wall reconstruction with superior and Inferior Gluteal Artery perforator flaps
Microsurgery, 2009Co-Authors: Marcus J. D. Wagstaff, Warren Matthew Rozen, Iain S. Whitaker, Morteza Enajat, Thorir Audolfsson, Rafael AcostaAbstract:Perineal and posterior vaginal wall reconstruction following abdominoperineal and local cancer resection entails replacement of volume between the perineum and sacrum and restoration of a functional vagina. Ideal local reconstructive options include those which avoid functional muscle sacrifice, do not interfere with colostomy formation, and avoid the use of irradiated tissue. In avoiding the donor site morbidity of other options, we describe a fasciocutaneous option for the reconstruction of the perineum and posterior vaginal wall. We present our technique of superior and Inferior Gluteal Artery perforator (SGAP or IGAP) flaps to reconstruct such defects. Fourteen patients between 2004 and 2008 underwent 11 SGAP and three IGAP flaps. There were no flap failures or partial flap losses and no postoperative hernias. All female patients reported resumption of sexual intercourse following this procedure. Our experience in both the immediate and delayed setting is that this technique produces a good functional outcome with low donor-site morbidity.
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PR15 NEW TECHNIQUE IN PERINEAL AND POSTERIOR VAGINAL WALL RECONSTRUCTION: SUPERIOR AND Inferior Gluteal Artery PERFORATOR FLAPS
ANZ Journal of Surgery, 2009Co-Authors: Warren M. Rozen, Marcus J. D. Wagstaff, Iain S. Whitaker, Morteza Enajat, Thorir Audolfsson, Rafael AcostaAbstract:Purpose: Perineal and posterior vaginal wall reconstruction following abdominoperineal and local cancer resection requires replacement of dead space and restoration of function. Ideal reconstructive options include those which avoid muscle sacrifice, do not interfere with colostomy formation, and avoid the use of irradiated tissue. Methodology: We present our experience with a new technique for perineal and vaginal reconstruction: superior and Inferior Gluteal Artery perforator (SGAP or IGAP) flaps. We describe the operative technique and outcome in 14 consecutive patients. Six cases were performed as primary reconstruction and 8 cases were delayed, with all receiving preoperative radiotherapy. Results: Immediate reconstructions underwent preoperative imaging with ultrasound only, while delayed reconstructions underwent preoperative CTA. Postoperatively, patients were ambulated immediately, with all bed rest and sitting performed on the contralateral buttock or side for 4 weeks. There were no flap failures or partial flap losses, and no postoperative hernias. Four patients developed early minor wound dehiscence that was resutured in three cases. Revisional surgery was performed for reduction of three bulky flaps. All female patients reported resumption of sexual intercourse following this procedure. Conclusion: Gluteal Artery perforator flaps are good options for perineal reconstruction, avoiding the donor site morbidity associated with rectus abdominis or gluteus maximus muscle harvest.