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Micro CME Part2 - Lippincott Williams &...

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311'+51 -01' *. , #!$#""('2 51*= 1)',= LK 2& 0' '+& "(#!.? &-0--01* 0209 EMCO++F= 6', EMCP++F> .'* *,%2& S+= 7&'& , *,%2&, 9 ',*5',% 151.5*0 205,)> .06020* .0-02-01 E+',-0 615*0 15..*9F ""&,)#"? &-0--01* ,06 E+-2-0F= *20* 52,-51 0,&1 - ',20-12*1 ,061 E1,1-09F $ !"'#"'? T8MM + E.0'+09 *-150F= MM8NP + E1)', %0$ -,-0 1'2F ,"('? 0% 1':= *-,% .'* ELP +F> , 5,3-,* 20,10 ',"('? *20* .-1'3-,',%> *0% 10 E*11 ' ,-1-.'F> 5,3-,* 1&-5*0 *-11= ,-2 515**9 *','**9 ,-3* . #"('? &'+0' #.1 .-11'* 7'2& 151.5*0'1 8'1 #.1 E100251= .01.5*0= 2@F> .-11'* 2- 0'1 1)', 1 .0-02-0 #. EF> 0' 6''*'29 0'1 7'2& #. /513-,*> , 0'1 -, +',-0 .0620* .0-02-01 1 250,-60 #.
Transcript
Page 1: Micro CME Part2 - Lippincott Williams & Wilkinsdownload.lww.com/.../PermaLink/PRS/...2012_11_08_SAINTCYR_204… · 311'+51 -01' * . 2& , #!$#" "('2 51 * = 1)',= lk 0' ' + & " (#!.?
Page 2: Micro CME Part2 - Lippincott Williams & Wilkinsdownload.lww.com/.../PermaLink/PRS/...2012_11_08_SAINTCYR_204… · 311'+51 -01' * . 2& , #!$#" "('2 51 * = 1)',= lk 0' ' + & " (#!.?
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Page 4: Micro CME Part2 - Lippincott Williams & Wilkinsdownload.lww.com/.../PermaLink/PRS/...2012_11_08_SAINTCYR_204… · 311'+51 -01' * . 2& , #!$#" "('2 51 * = 1)',= lk 0' ' + & " (#!.?

1. 

Tans

ini I

. Sop

ra il

mio

nuo

vo p

roce

sso

di a

mpu

tazi

one

della

m

amm

ella

. Gaz

etta

Med

ica

Italia

na 1

906;

57:1

41.

2. 

Ran

dolp

h, L

. C.,

Bar

one,

J.,

Ang

elat

s, J

., et

al.

Pre

dict

ion

of

post

oper

ativ

e se

rom

a af

ter l

atis

sim

us d

orsi

bre

ast r

econ

stru

ctio

n.

Pla

st. R

econ

str.

Sur

g. 2

005;

116

: 128

7-90

. 3. 

Spe

ar S

L, H

ess

CL.

A re

view

of t

he b

iom

echa

nica

l and

func

tiona

l ch

ange

s in

the

shou

lder

follo

win

g tra

nsfe

r of t

he la

tissi

mus

dor

si

mus

cles

. Pla

st R

econ

str S

urg.

200

5 Ju

n;11

5(7)

:207

0-3.

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Mel

issa

Cro

sby

MD

A

ssis

tant

Pro

fess

or

Dep

artm

ent o

f Pla

stic

Sur

gery

M

D A

nder

son

Can

cer C

ente

r H

oust

on, T

exas

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• –  –  – 

•  • 

–  – •  •  • 

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–  –  – 

• 

–  – 

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Ski

n P

addl

e La

tissi

mus

Dor

si

Mus

cle

with

Ski

n P

addl

e

Latis

sim

us D

orsi

M

uscl

e w

ith Im

plan

t U

nder

neat

h

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D. H

amm

ond

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•  • –  – 

•  • 

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Def

ect

LD fl

ap d

esig

n

LD fl

ap

LD fl

ap in

set

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– 

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**P

rese

rve

med

ial b

ranc

h of

th

orac

odor

sal n

erve

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• 

– 

•  •  • B

ostw

ick

PR

S 1

980

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perfo

rato

rs

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•  •  • 

Cou

rtesy

P. C

hevr

ay

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Rev

erse

Lat

issi

mus

Dor

si M

uscl

e Fl

ap E

leva

ted

and

Inse

t Bef

ore

Ski

n G

raft

Pos

t Ope

rativ

e R

esul

t

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•  •  • 

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Cou

rtesy

D. C

hang

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•  •  • 

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– 

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Cou

rtesy

R. S

kora

cki

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Cou

rtesy

R. S

kora

cki

perfo

rato

r

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•  •  • 

• 

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•  • 

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•  • 

–  – 

• 

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•  •  •  • 

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–  –  –  –  –  –  –  –  – 

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Maj

ority

of G

raci

lis c

utan

eous

vas

cula

rity

is p

oste

rior i

n th

igh

Bre

ast r

econ

stru

ctio

n w

ith T

UG

flap

s

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The

Mus

cle-

Sp

arin

g

Free

TR

AM

Fla

p/D

IEP

Fla

p

Mic

hel S

aint

-Cyr

, MD

, FR

CS

(C)

Dep

artm

ent o

f Pla

stic

Sur

gery

UTS

W M

edic

al C

ente

r at

Dal

las

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DIE

A Va

scul

arity

and

bra

nchi

ng p

atte

rn

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Zone

s of

Per

fusi

on M

edia

l Per

fora

tor

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–  –  – 

Type

2

DIE

A

Med

ial b

ranc

h

Late

ral b

ranc

h

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– 

• 

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TRA

M v

s M

S-1

M p

< 0

.816

TRA

M v

s M

S-1

L p

< 0

.817

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Pre

serv

atio

n of

med

ial s

egm

ent

Late

ral p

erfo

rato

rs

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Pre

serv

atio

n of

lat &

med

seg

men

ts

Late

ral p

erfo

rato

rs

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Pre

serv

atio

n of

late

ral s

egm

ent

Med

ial p

erfo

rato

rs

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Pre

serv

atio

n of

lat &

med

seg

men

ts

Late

ral a

nd m

edia

l per

fora

tors

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•  •  • 

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•  •  •  • 

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•  • 

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•  •  • 

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Med

ial b

ranc

h of

DIE

A

DIE

A

Late

ral b

ranc

h of

D

IEA

Rec

tus

Can

div

ide

med

ial

bran

ch o

f DIE

A to

in

crea

se p

edic

le le

ngth

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9-11

cm

ped

icle

le

ngth

Mor

e fre

edom

for

inse

tting

and

mic

ro

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Mar

k or

ient

atio

n of

pe

dicl

e to

pre

vent

tw

istin

g la

ter

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•  •  • 

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De-

epith

eliz

e fla

p an

d ta

per p

rior t

o in

setti

ng

(imm

edia

te

reco

nstru

ctio

ns)

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Fasc

ial s

parin

g te

chni

que

allo

ws

for p

rimar

y fa

scia

l cl

osur

e

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