The Experts below are selected from a list of 17817 Experts worldwide ranked by ideXlab platform
Giles R Scuderi - One of the best experts on this subject based on the ideXlab platform.
-
total knee arthroplasty wound complication treatment algorithm current soft Tissue Coverage options
Journal of Arthroplasty, 2019Co-Authors: Nirav H. Amin, Oren Z Lermen, Matthew J. Simmons, Joshua N. Speirs, Fred D. Cushner, Giles R ScuderiAbstract:Abstract Background Wound complications associated with soft Tissues defects following total knee; arthroplasty (TKA) present challenges for the orthopedic surgeon. The scale of early; complications include less morbid problems, such as quickly resolving drainage and small superficial eschars, to persistent drainage and full-thickness Tissue necrosis, which may require advanced soft Tissue Coverage. Methods This review outlines current wound management strategies and provides an algorithm to help guide treatment and clinical decision making. Conclusion A surgeon’s understanding of soft Tissue Coverage options is essential in protecting the knee prosthesis from a deep infection and to obtain an optimal functional outcome.
Nirav H. Amin - One of the best experts on this subject based on the ideXlab platform.
-
total knee arthroplasty wound complication treatment algorithm current soft Tissue Coverage options
Journal of Arthroplasty, 2019Co-Authors: Nirav H. Amin, Oren Z Lermen, Matthew J. Simmons, Joshua N. Speirs, Fred D. Cushner, Giles R ScuderiAbstract:Abstract Background Wound complications associated with soft Tissues defects following total knee; arthroplasty (TKA) present challenges for the orthopedic surgeon. The scale of early; complications include less morbid problems, such as quickly resolving drainage and small superficial eschars, to persistent drainage and full-thickness Tissue necrosis, which may require advanced soft Tissue Coverage. Methods This review outlines current wound management strategies and provides an algorithm to help guide treatment and clinical decision making. Conclusion A surgeon’s understanding of soft Tissue Coverage options is essential in protecting the knee prosthesis from a deep infection and to obtain an optimal functional outcome.
Steven L Moran - One of the best experts on this subject based on the ideXlab platform.
-
soft Tissue Coverage of the mangled upper extremity
Seminars in Plastic Surgery, 2015Co-Authors: Christopher J Salgado, Steven L Moran, Harvey ChimAbstract:Mangled upper extremity injuries usually involve high-impact trauma with crushing and tearing of the limb and its associated soft Tissue structures. Such trauma is particularly mutilating because of the nature of the injury and the involvement of structures vital for proper function. Although advancements in flap technique and improvements in bone fixation methods have enabled good functional and clinical outcomes in limb salvage reconstruction, this remains a challenging area. Attempts at limb preservation should be fully exhausted before consideration is given for amputation, which results in significantly decreased function. Here the authors focus on the various modalities of soft Tissue Coverage available including allogenic substitutes, the adjunctive use of negative pressure wound therapy, and the design and utilization of flaps to address various defect configurations for the goals of wound healing, aesthetics, and functional restoration in the mangled upper extremity.
-
soft Tissue Coverage and outcome of gustilo grade iiib midshaft tibia fractures a 15 year experience
Plastic and Reconstructive Surgery, 2008Co-Authors: Umar Choudry, Steven L Moran, Zeynep KaracorAbstract:Background: The authors describe a 15-year experience with Gustilo grade IIIB fractures of the midtibia based on the type and timing of soft-Tissue Coverage. Methods: A retrospective chart review was performed and patient demographics, risk factors, choice and timing of Coverage, fracture outcome, and limb survival data were collected. Results: Sixty-five fractures were treated. Soft Tissue Coverage was performed either acutely [ 1 week (52 percent); with either a soleus muscle flap [group A; n = 25 (38 percent) ] or a free Tissue transfer [group B; n = 40 (62 percent)]. In group A, 17 (68 percent) were performed acutely (subgroup Al) and eight (32 percent) were delayed (subgroup A2). In subgroup Al, eight (47 percent) had uncomplicated healing, whereas seven (41 percent) ended in nonunion. In subgroup A2, all eight patients went onto nonunion. The overall limb survival rate for group A was 92 percent (n = 23). In group B, 14 (35 percent) were performed acutely (subgroup B1) and 26 (65 percent) were delayed (subgroup B2). In subgroup B1, six (43 percent) had uncomplicated healing, and six (43 percent) ended in nonunion. In subgroup B2, six (23 percent) healed primarily, and 17 (65 percent) went onto nonunion. The overall limb survival rate for group B was 88 percent (n = 45). Conclusions: Soft-Tissue Coverage is not the only determinant for successful outcome. Delayed Coverage resulted in higher nonunion rates. Despite high nonunion rates, 89 percent of fractures ultimately healed successfully.
-
soft Tissue Coverage of the elbow a reconstructive algorithm
Orthopedic Clinics of North America, 2008Co-Authors: Mark A Jensen, Steven L MoranAbstract:Soft Tissue defects can occur for various reasons, but they are primarily due to trauma, tumor, and infection. Coverage choices may include primary closure, skin grafting, local cutaneous flaps, fasciocutaneous transposition flaps, island fascial or fasciocutaneous flaps, muscle or myocutaneous pedicled flaps, and microvascular free-Tissue transfer. Despite the multitude of options for Coverage, the authors have found four flaps to provide reliable Coverage for most elbow deficits within their practice; these flaps are the latissimus dorsi flap, the radial forearm flap, the anconeus flap, and the free anterior lateral thigh flap. This article provides an overview of treatment options for elbow Coverage, with specific emphasis on the use of these four specific flaps.
-
soft Tissue Coverage of the elbow an outcome analysis and reconstructive algorithm
Plastic and Reconstructive Surgery, 2007Co-Authors: Umar Choudry, Steven L Moran, Sami KhanAbstract:Background Soft-Tissue defects surrounding the elbow can be a challenging problem for the reconstructive surgeon. Multiple reconstructive options are available, but there are few published outcome studies. The authors performed an outcome analysis of soft-Tissue Coverage for elbow defects to determine the benefits and limitations of various reconstructive options in this problematic area. Methods A retrospective review was performed of all elbow defects requiring flap Coverage from 1988 to 2005. Patient demographics, defect characteristics, type of flaps used, complications, and long-term outcomes were analyzed. The t test was used for statistical comparison. Results A total of 99 flaps were performed in 96 patients. Forty-seven percent of the defects were secondary to trauma. Sixty-six percent of the flaps used were pedicled flaps and 19 percent were free flaps. The most common pedicled flap used was the radial forearm flap, whereas the most commonly used free flap was the latissimus dorsi muscle flap. Reconstructive failures occurred in 10 percent of patients; these 10 patients required a second flap for limb salvage. The pedicled latissimus dorsi muscle flap had the highest complication rate (57 percent), with distal necrosis being the most frequent complication. The pedicled latissimus dorsi flap was associated with a higher complication rate when compared with the radial forearm flap (p = 0.01). Conclusions The pedicled latissimus was associated with a high rate of distal necrosis when it was used to cover defects distal to the olecranon. The authors recommend the use of the radial forearm flap or a free flap for soft-Tissue Coverage of defects lying over the proximal ulna.
Kevin J Bozic - One of the best experts on this subject based on the ideXlab platform.
-
medial gastrocnemius flap Coverage for treatment of skin necrosis after total knee arthroplasty
Clinical Orthopaedics and Related Research, 2006Co-Authors: Michael D Ries, Kevin J BozicAbstract:Skin necrosis after total knee arthroplasty is a rare complication that can rapidly lead to deep infection of the prosthetic components. The medial gastrocnemius transposition flap usually provides adequate soft Tissue Coverage to salvage the total knee arthroplasty. However, variations in defect lo
Evelyn Regar - One of the best experts on this subject based on the ideXlab platform.
-
Tissue Coverage of a hydrophilic polymer coated zotarolimus eluting stent vs a fluoropolymer coated everolimus eluting stent at 13 month follow up an optical coherence tomography substudy from the resolute all comers trial
European Heart Journal, 2011Co-Authors: Juan Luis Gutierrezchico, Carlo Di Mario, Robert Jan Van Geuns, Evelyn Regar, Willem J Van Der Giessen, Henning Kelbaek, Kari Saunamaki, Javier Escaned, Nieves Gonzalo, Francesco BorgiaAbstract:Aims To compare the Tissue Coverage of a hydrophilic polymer-coated zotarolimus-eluting stent (ZES) vs. a fluoropolymer-coated everolimus-eluting stent (EES) at 13 months, using optical coherence tomography (OCT) in an ‘all-comers' population of patients, in order to clarify the mechanism of eventual differences in the biocompatibility and thrombogenicity of the devices. Methods and results Patients randomized to angiographic follow-up in the RESOLUTE All Comers trial ([NCT00617084][1]) at pre-specified OCT sites underwent OCT follow-up at 13 months. Tissue Coverage and apposition were assessed strut by strut, and the results in both treatment groups were compared using multilevel logistic or linear regression, as appropriate, with clustering at three different levels: patient, lesion, and stent. Fifty-eight patients (30 ZES and 28 EES), 72 lesions, 107 stents, and 23 197 struts were analysed. Eight hundred and eighty-seven and 654 uncovered struts (7.4 and 5.8%, P = 0.378), and 216 and 161 malapposed struts (1.8 and 1.4%, P = 0.569) were found in the ZES and EES groups, respectively. The mean thickness of Coverage was 116 ± 99 µm in ZES and 142 ± 113 µm in EES ( P = 0.466). No differences in per cent neointimal volume obstruction (12.5 ± 7.9 vs. 15.0 ± 10.7%) or other areas–volumetric parameters were found between ZES and EES, respectively. Conclusion No significant differences in Tissue Coverage, malapposition, or lumen/stent areas and volumes were detected by OCT between the hydrophilic polymer-coated ZES and the fluoropolymer-coated EES at 13-month follow-up. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT00617084&atom=%2Fehj%2F32%2F19%2F2454.atom
-
incomplete stent apposition and delayed Tissue Coverage are more frequent in drug eluting stents implanted during primary percutaneous coronary intervention for st segment elevation myocardial infarction than in drug eluting stents implanted for stab
Jacc-cardiovascular Interventions, 2009Co-Authors: Nieves Gonzalo, Peter Barlis, Patrick W Serruys, Hector M Garciagarcia, Yoshinobu Onuma, Jurgen Ligthart, Evelyn RegarAbstract:Objectives The aim of this study was to compare the frequency of incomplete stent apposition (ISA) and struts not covered by Tissue at long-term follow-up (as assessed by optical coherence tomography [OCT]) in drug-eluting stents (DES) implanted during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) versus DES implanted for unstable and stable angina. Background Incomplete stent apposition and the absence of strut endothelialization might be linked to stent thrombosis. DES implanted for STEMI might have a higher risk of thrombosis. Methods Consecutive patients in whom OCT was performed at least 6 months after DES implantation were included in the study. Stent struts were classified on the basis of the presence or absence of ISA and Tissue Coverage. Results Forty-seven lesions in 43 patients (1,356 frames, 10,140 struts) were analyzed (49% stable angina, 17% unstable angina, 34% STEMI). Median follow-up time was 9 (range 7 to 72) months. Drug-eluting stents implanted during primary PCI presented ISA more often than DES implanted in stable/unstable angina patients (75% vs. 25.8%, p = 0.001). The frequency of uncovered struts was also higher in the STEMI group (93.8% vs. 67.7%, p = 0.048). On multivariate analysis, DES implantation in STEMI was the only independent predictor of ISA (odds ratio: 9.8, 95% confidence interval: 2.4 to 40.4, p = 0.002) and the presence of uncovered struts at follow-up (odds ratio: 9.5, 95% confidence interval: 1.0 to 90.3, p = 0.049). Conclusions DES implanted for STEMI had a higher frequency of incompletely apposed struts and uncovered struts as assessed by OCT at follow-up. DES implantation during primary PCI in STEMI was an independent predictor of ISA and the presence of uncovered struts at follow-up.
