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Treatment of Pressure Sores
Published in J G Webster, Prevention of Pressure Sores, 2019
The third method uses myocutaneous (muscle and skin) flaps to obliterate a cavity and increase the blood supply. Figure 14.9 shows an schematic drawing of how a muscle flap is used to surgically close a sacral ulcer. Muscle or portions of muscle and skin can be moved into the wound to close it. This is beneficial because it replaces lost tissues, creates padding, and reduces the risk of new pressure sores (Black and Black 1987). Kauer and Sonsino (1986) stress that a minimal amount of skin and muscle should be used during transposition techniques in case of possible recurrences. Rosen et al (1986) note that the use of muscle flaps is better than large, regional skin flaps because muscle flaps are more reliable, heal more rapidly, and cause fewer complications. Infected parts of bones may have to be excised in certain cases (Guttmann 1976). Any removal or recontouring of underlying bony prominences to reduce pressure should be done conservatively (Rosen et al 1986). If a free flap, one totally disconnected from its original site, is used, care must be taken to reconstruct the arteries, veins, and nerves. This is complex, and therefore, free flaps are only used when simpler flaps cannot be used (Black and Black 1987).
4D X-ray Computed Tomography
Published in Paolo Russo, Handbook of X-ray Imaging, 2017
Amit Mehndiratta, Soenke H. Bartling, Rajiv Gupta
Figure 41.15 shows the selected frames from the 4D dynamic scan of a lower limb of a patient with traumatic lower limb injury reconstructed with free-flap tissue transfer (rectus abdominis muscle flap). The first image, during the arterial phase, confirmed the integrity of the posterior tibial arterial anastomosis to arterial pedicle of the free flap. The followed parenchymal phase showed faint enhancement of the entire flap, indicating good perfusion to the flap. The integrity of the venous anastomosis was confirmed in the venous phase, which showed flow through the venous pedicle, as indicated by the coupler. Figure 41.15 also shows an enlarged view at the level of a venous coupler, showing arterial mixed and venous phases. The figure has been adapted and modified from Mehndiratta et al. (2015).
Thermography by Specialty
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Free flaps are technically more difficult because the arterio-venous perforators must be located and preserved so that they can be microsurgically re-anastomosed to vessels in the placement site.239 Problems arising with arterial or venous flow in a free flap will appear similar to those appearing in a pedicle flap.
Classifier Feature Fusion Using Deep Learning Model for Non-Invasive Detection of Oral Cancer from Hyperspectral Image
Published in IETE Journal of Research, 2022
Pandia Rajan Jeyaraj, Bijaya Ketan Panigrahi, Edward Rajan Samuel Nadar
Medical imaging is one of the emerging techniques for detecting cancer and to classify the nature of cancer. The drawbacks in surgical cancer resection are free flap introduction in the cancer area, skin removal, and invasive techniques. This makes imaging techniques more useful for cancer treatment. Among several techniques for imaging a defected portion of an organ the thermal imaging of the defect cell and its two-dimensional discrete [2] and hyperspectral image cubes [3] obtained with thermal image will give an exact prediction. In the digital scanning technique, the need for an effective algorithm has increased for the accurate prediction of cancer. The application of hyperspectral thermal imaging for the cancer margin detection is essential for recovering the normal healthy tissue that is identified. This technique can handle a large amount of data in connected internet of thing environments also. Several data analyses and predictive technology are used in line with the hyperspectral image analysis.
Biomechanical analysis of mandibular defect reconstruction based on a new base-fixation system
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Haipo Cui, Liping Gao, Jing Han, Jiannan Liu
The mandible is located below the face and is the only movable bone of the skull. It is mainly involved in important functions such as chewing, swallowing, occlusion, language, and expression. Partial resection of the mandible becomes clinically necessary due to tumor, trauma, cancer, and other factors. In order to maintain the important functions of the mandible after surgery, it needs to be reconstructed. The ideal state of mandibular reconstruction includes the following three requirements: (i) the appearance of the face should be close to normal after restoration; (ii) dentition and occlusal relationships should be normal; (iii) mastication and the language function should be normal or nearly normal (Ciocca et al. 2012; Azuma et al. 2014; Rubio-Palau et al. 2016). At present, fibula free flap grafting is the most common method for repairing mandibular defects. Hidalgo first used the fibula to repair mandibular defects during surgery in 1989 (Hidalgo 1989). The fibula has gradually become the most common donor area for the repair of large-scale defects of the mandibular bone in clinics due to the following characteristics: the sufficient amount of bone tissue that is resident in the fibula, the dual blood supply of the periosteum and the bone flap, the ability to withstand greater masticatory force, the simple preparation of a bone flap, the easier three-dimensional shaping of a bone flap, and its suitability for the implementation of dental implants (Grohmann et al. 2015).
Automated maxillofacial reconstruction software: development and evaluation
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2020
Hannah Kim, Tae-Geun Son, Hyunchul Cho, Eungjune Shim, Bo-Yeon Hwang, Jung-Woo Lee, Youngjun Kim
We presented an automatic surgical planning system for mandibular reconstruction with a fibula free flap. It was verified by retrospectively conducted evaluations that the proposed automated results were almost identical to the plans of an expert, and the processing time was dramatically shortened compared with manual planning. Moreover, various cases can be handled with the proposed correction functions without much additional required time. The proposed surgical guide design module can also lighten the effort required for surgical preparation and surgery. It is expected that the proposed system can be utilized not only for retrospective simulations but also for actual surgical planning, which requires diverse trials and considerations for patients with high effectiveness and time efficiency.