Chondroblastomas are rare entities accounting for approximately 1% of all primary bone tumors. We describe a case of a 7-year-old girl with a giant chondroblastoma of the maxilla, treated with bilateral class III maxillectomy and reconstruction with a double-barreled and double skin paddle fibular free flap. We show evidence of an excellent aesthetic outcome at 6 months' follow up with no evidence of tumor recurrence.
Surgical technique is considered the most important determining factor in the success of the flap, resulting in an overall complication rate with flap loss risk < 1%. Another important aspect to maintain a high success rate is close monitoring of the flap to identify early variations of the inflow, allowing the possibility of early anastomosis revision surgery, resulting in a more favorable prognosis.
1Multiple methods for flap monitoring have been implemented over time; however, clinical judgment is still the most reliable method.2-8 Other methods used for monitoring perforator flaps are direct thermography, implantable Doppler, external Doppler, microdialysis, infrared oximetry flow, angiography, and images transmitted by electronic devices. These are but a few of the currently designed systems.
4,9-18The aim of this study is to report on a new device for temperature monitoring and its application for mobile telephones.
Materials and Methods
Design of the DeviceThe 15 Â 10 Â 5 cm device design is shown in ►Fig. 1. The blue liquid-crystal display (LCD) screen and the external characteristics are displayed. Input power transmitter and radiofrequency antenna signal can be observed. The device has an output for the temperature sensor through a 2-m long cable.This device works through a negative temperature coefficient medical grade sensor placed on the skin flap and Keywords ► perforator flaps ► remote monitoring ► mobile device
AbstractBackground Surveillance and monitoring of perforator flaps has been well established for many years as a reliable method to detect early changes in the blood flow of the flap. In this manner, early flap revisions could be performed in cases of probable thrombosis. Methods We performed a pilot study that included the first 12 patients to use this device. A temperature sensor electrode was used for remote monitoring of perforator flaps using a mobile phone in real time via a general pocket radio service and short messages developed by the authors, allowing the surgeon to check the temperature from any location. Results The device continually displays the temperature of the flaps in real time performing a curve with measurements every 5 minute using the web page. A significant difference (p < 0.05) is shown between flaps with sufficient flow and flaps with venous thrombosis. Conclusion Real-time direct thermography via the surgeon's mobile phone is a reliable method for flap monitoring, facilitating monitorization during the time when the surgeon is away from the hospital.
A forequarter amputation is a radical ablative surgical procedure that includes the entire upper extremity with its shoulder girdle. We present a 53-year-old woman with a solid slow growing tumor in her right shoulder of 15 x 20 cm in diameter. Resection and immediate reconstruction with a free radial forearm flap extended from the distal third of the arm to the midpalmar region, taking the humeral artery and the cephalic vein as a main peddicle. The final outcome is shown at six weeks after the surgery.
Durante muchos años, la región abdominal ha sido donadora de abundante tejido bien perfundido basado en el plexo subdérmico, el cual constituye una red intrincada de microvasos que se distribuyen en toda el área de la piel de la pared de dicha región. Método: Mediante una cohorte retrospectiva, se tomaron en cuenta los primeros 100 colgajos abdominales basados en la arteria epigástrica inferior profunda (DIEP, deep inferior epigastric perforator) para reconstrucción
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