F. Contedini - Academia.edu (original) (raw)

Papers by F. Contedini

Research paper thumbnail of Vascular pedicle ossification of free fibular flap: is it a rare phenomenon? Is it possible to avoid this risk?

Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2013

Free fibula flap is the most common free tissue transfer for maxillary and mandibular reconstruct... more Free fibula flap is the most common free tissue transfer for maxillary and mandibular reconstructions. The distal part of the harvested bone is transferred, while the proximal part is removed by sub-periosteum dissection. The vascularized periosteum attached to the vascular pedicle has osteogenic potential. 61 patients reconstructed with free fibula flaps were divided in 2 groups: 41 flaps performed with a standard technique and 20 flaps performed by dissecting the periosteum from the pedicle. Patients were followed up with orthopantomography and CT scan at 6, 12, 18 and 24 months after surgery. The minimum follow-up time was 18 months. With retrospective analysis of the first group we diagnosed 7 pedicle ossifications on 41 reconstructions (17%). In the second group, no pedicle ossification was observed (p < 0.05). The dissection of periosteum from the vascular pedicle of free fibula flaps avoids the risk of ossification.

Research paper thumbnail of ALT flap for oral cavity reconstruction

Research paper thumbnail of TFL flap as an alternative to the ALT where these are not appropriate perforators

Research paper thumbnail of La ricostruzione della parete addominale

Research paper thumbnail of Progettazione delle ricostruzioni mandibolari con lembo di fibula con metodica CAD CAM: metodica standard di pianificazione della dima di taglio per il perone

Research paper thumbnail of Utilizzo dei lembi liberi per il miglioramento della funzione di deglutizione dopo exeresi oncologica

Research paper thumbnail of Repair of bilateral lower limb injuries using a free latissimus dorsi cross-leg flap

European Journal of Plastic Surgery, 1999

Current microsurgical techniques are used in single stage repair of distal lower limb defects. Th... more Current microsurgical techniques are used in single stage repair of distal lower limb defects. The previously popular cutaneous and fasciocutaneous flaps have been practically shelved. However, in selected cases, the vessels of a lower limb can still be employed to vascularize a harvested flap for the repair of a contralateral defect. In cases where the vessels of a traumatized leg are severely damaged or jeopardized, vascular components of the opposite limb can be exploited to provide the blood supply for the flap chosen to cover the defect. There are times when trauma to both legs may require a single large flap (latissimus dorsi) which if properly vascularized can bridge a bilateral defect. This could bring about the revival of the cross-leg flaps. Four cases are reported: in one, the flap was vascularized from a healthy limb to cover a contralateral exposed fracture and an avulsed heel. In three other cases, the latissimus dorsi was utilized to fill large post-traumatic bilateral defects at the distal lower limb level. In these cases the limb with the best vascular system was chosen for flap anastomoses and fixation was then applied.

Research paper thumbnail of Vascular pedicle ossification of free fibular flap: is it a rare phenomenon? Is it possible to avoid this risk?

Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2013

Free fibula flap is the most common free tissue transfer for maxillary and mandibular reconstruct... more Free fibula flap is the most common free tissue transfer for maxillary and mandibular reconstructions. The distal part of the harvested bone is transferred, while the proximal part is removed by sub-periosteum dissection. The vascularized periosteum attached to the vascular pedicle has osteogenic potential. 61 patients reconstructed with free fibula flaps were divided in 2 groups: 41 flaps performed with a standard technique and 20 flaps performed by dissecting the periosteum from the pedicle. Patients were followed up with orthopantomography and CT scan at 6, 12, 18 and 24 months after surgery. The minimum follow-up time was 18 months. With retrospective analysis of the first group we diagnosed 7 pedicle ossifications on 41 reconstructions (17%). In the second group, no pedicle ossification was observed (p < 0.05). The dissection of periosteum from the vascular pedicle of free fibula flaps avoids the risk of ossification.

Research paper thumbnail of Free microvascular flaps in oncological surgery of the limbs

La Chirurgia degli organi di movimento

Surgery plays a role of primary importance in the treatment of sarcomas of the soft tissues. The ... more Surgery plays a role of primary importance in the treatment of sarcomas of the soft tissues. The first objective of surgical treatment is the local control of the disease. Local recurrence is a serious event, that often requires amputation, and favors metastatic progression of the disease. Currently, except in very rare cases, conservative treatment is the treatment of choice, as it has by now been demonstrated that its results are equivalent to those obtained when demolitive surgery is used. In the distal sites of the limbs, superficial localization of the tendons, ligaments, and joints, the absence of anatomical compartments, make it difficult to perform wide conservative surgery. To this must be added that patients are often sent to see a specialist after a previous inadequate operation, and the presence of a contaminated surgical scar often requires exeresis of a wide area of the skin, sufficient to obstruct healing by primary intention. The use of revascularized free flaps allo...

Research paper thumbnail of Lembi liberi microvascolari per la ricostruzione cervicofacciale: comparazione dei risultati oncologici e ricostruttivi fra pazienti giovani e anziani

Research paper thumbnail of Cross-leg as salvage procedure after free flaps transfer failure: a case report

Posttraumatic wounds of the lower leg with soft tissue defects and exposed fractures are a recons... more Posttraumatic wounds of the lower leg with soft tissue defects and exposed fractures are a reconstructive challenge due to the scarce availability of local tissues and recipient vessels. Even when a free tissue transfer can be performed the risk of failure remains considerable. When a free flap is contraindicated or after a free flap failure, the cross-leg flap is still nowadays a possible option. We report a case of a male with a severe posttraumatic wound of the lower leg with exposed tibia fracture firstly treated with two consecutive latissimus dorsi muscular free flaps, failed for vascular thrombosis; the coverage was then achieved with a cross-leg flap with acceptable results.

Research paper thumbnail of Three-Dimensional Reconstruction of the Oral Cavity Using the Free Anterolateral Thigh Flap

Plastic and Reconstructive Surgery, 2002

Oral cavity reconstruction after removal of locally advanced tumors is particularly difficult bec... more Oral cavity reconstruction after removal of locally advanced tumors is particularly difficult because anatomical restoration must accurately reproduce the original structure and enable effective and fast rehabilitation of mastication, swallowing, and phonation. The authors report their 2-year experience with 17 patients surgically treated for oral cavity cancer with reconstruction performed with the free anterolateral thigh flap. Thanks to its thinness and pliability, this flap has proven to be perfectly adaptable to the structural peculiarities of the resected areas and has enabled the authors to considerably reduce the cosmetic and functional complications in the donor area observed with other flaps (such as the radial forearm flap). Flap grafting has always been complete and regular, and no intraoperative and postoperative complications have been observed. Swallowing recovery has always been satisfactory. On the basis of the authors&amp;amp;amp;amp;amp;amp;#39; results, their current approach to oral cavity reconstruction is based on the use of flaps that enable anatomical restoration of the resected areas and reduce morbidity of the donor site. They believe that the anterolateral thigh flap can offer all of these opportunities, and the surgery can be simultaneously performed by two surgical teams.

Research paper thumbnail of Use of ???Perforator Flaps??? in Skull Base Reconstruction after Tumor Resection

Plastic and Reconstructive Surgery, 2002

Large neoplasms of the maxillofacial region (especially nasopharyngeal and maxillary bone tumors)... more Large neoplasms of the maxillofacial region (especially nasopharyngeal and maxillary bone tumors) may invade the cranial base by direct extension. The advent of sophisticated computed tomography and magnetic resonance imaging has provided an accurate ...

Research paper thumbnail of Anterolateral thigh free flap for tracheal reconstruction after parastomal recurrence

Head & Neck, 2009

Background. Stomal recurrence after total laryngectomy is 1 of the most serious issues in head an... more Background. Stomal recurrence after total laryngectomy is 1 of the most serious issues in head and neck surgery, both because of the complexity of its management and because of its morbidity. Prior to the introduction of free-tissue transfer, mediastinal tracheostomy has been the standard reconstructive procedure with high rate of complications. The ideal reconstructive solution to these problems must provide well-vascularized soft tissues that can cover the defect after resection and also allow suturing of the tracheal remnant to skin edges without tension.

Research paper thumbnail of Mandibular reconstruction with revascularized free flap

Research paper thumbnail of Nuovi lembi nella chirurgia ricostruttiva post-oncologica degli arti/New flaps in post-oncologic reconstructive surgery of the limbs

Research paper thumbnail of Abdominal Wall Transplantation with Microsurgical Technique

American Journal of Transplantation, 2007

Many patients undergoing intestinal or multivisceral transplantation have a past history of compl... more Many patients undergoing intestinal or multivisceral transplantation have a past history of complete midgut removal with the loss of the domain of the abdominal compartment or have severely damaged abdominal walls from repeated laparotomies, tumours or enterocutaneous fistulae. These patients may encounter severe abdominal wall closure problems at the end of transplantation, resulting in increased morbidity and mortality. It is, therefore, of paramount importance to properly cover transplanted organs in order to reduce postoperative complications. Abdominal wall transplantation was recently proposed for closure of patients undergoing both small-bowel and multivisceral transplantation: the results are encouraging. However, the technical procedure proposed requires the procurement of long segments of iliac vessels as far as the vena cava and the aorta. Since donor multiorgan procurement involves many surgical teams, the removal of these vessels, with the abdominal graft, led to their unavailability for vascular surgeons. Here we present three consecutive cases of abdominal wall transplantation in which, by taking advantage of microsurgical experience, we were able to carry out a transplantation of the abdominal wall by direct anastomosis of the epigastric vessels, obtaining a very good outcome.

Research paper thumbnail of Applicazioni della tecnologia cad / cam nelle ricostruzioni microchirurgiche della mandibola

Research paper thumbnail of Vascular pedicle ossification of free fibular flap: is it a rare phenomenon? Is it possible to avoid this risk?

Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2013

Free fibula flap is the most common free tissue transfer for maxillary and mandibular reconstruct... more Free fibula flap is the most common free tissue transfer for maxillary and mandibular reconstructions. The distal part of the harvested bone is transferred, while the proximal part is removed by sub-periosteum dissection. The vascularized periosteum attached to the vascular pedicle has osteogenic potential. 61 patients reconstructed with free fibula flaps were divided in 2 groups: 41 flaps performed with a standard technique and 20 flaps performed by dissecting the periosteum from the pedicle. Patients were followed up with orthopantomography and CT scan at 6, 12, 18 and 24 months after surgery. The minimum follow-up time was 18 months. With retrospective analysis of the first group we diagnosed 7 pedicle ossifications on 41 reconstructions (17%). In the second group, no pedicle ossification was observed (p < 0.05). The dissection of periosteum from the vascular pedicle of free fibula flaps avoids the risk of ossification.

Research paper thumbnail of ALT flap for oral cavity reconstruction

Research paper thumbnail of TFL flap as an alternative to the ALT where these are not appropriate perforators

Research paper thumbnail of La ricostruzione della parete addominale

Research paper thumbnail of Progettazione delle ricostruzioni mandibolari con lembo di fibula con metodica CAD CAM: metodica standard di pianificazione della dima di taglio per il perone

Research paper thumbnail of Utilizzo dei lembi liberi per il miglioramento della funzione di deglutizione dopo exeresi oncologica

Research paper thumbnail of Repair of bilateral lower limb injuries using a free latissimus dorsi cross-leg flap

European Journal of Plastic Surgery, 1999

Current microsurgical techniques are used in single stage repair of distal lower limb defects. Th... more Current microsurgical techniques are used in single stage repair of distal lower limb defects. The previously popular cutaneous and fasciocutaneous flaps have been practically shelved. However, in selected cases, the vessels of a lower limb can still be employed to vascularize a harvested flap for the repair of a contralateral defect. In cases where the vessels of a traumatized leg are severely damaged or jeopardized, vascular components of the opposite limb can be exploited to provide the blood supply for the flap chosen to cover the defect. There are times when trauma to both legs may require a single large flap (latissimus dorsi) which if properly vascularized can bridge a bilateral defect. This could bring about the revival of the cross-leg flaps. Four cases are reported: in one, the flap was vascularized from a healthy limb to cover a contralateral exposed fracture and an avulsed heel. In three other cases, the latissimus dorsi was utilized to fill large post-traumatic bilateral defects at the distal lower limb level. In these cases the limb with the best vascular system was chosen for flap anastomoses and fixation was then applied.

Research paper thumbnail of Vascular pedicle ossification of free fibular flap: is it a rare phenomenon? Is it possible to avoid this risk?

Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2013

Free fibula flap is the most common free tissue transfer for maxillary and mandibular reconstruct... more Free fibula flap is the most common free tissue transfer for maxillary and mandibular reconstructions. The distal part of the harvested bone is transferred, while the proximal part is removed by sub-periosteum dissection. The vascularized periosteum attached to the vascular pedicle has osteogenic potential. 61 patients reconstructed with free fibula flaps were divided in 2 groups: 41 flaps performed with a standard technique and 20 flaps performed by dissecting the periosteum from the pedicle. Patients were followed up with orthopantomography and CT scan at 6, 12, 18 and 24 months after surgery. The minimum follow-up time was 18 months. With retrospective analysis of the first group we diagnosed 7 pedicle ossifications on 41 reconstructions (17%). In the second group, no pedicle ossification was observed (p < 0.05). The dissection of periosteum from the vascular pedicle of free fibula flaps avoids the risk of ossification.

Research paper thumbnail of Free microvascular flaps in oncological surgery of the limbs

La Chirurgia degli organi di movimento

Surgery plays a role of primary importance in the treatment of sarcomas of the soft tissues. The ... more Surgery plays a role of primary importance in the treatment of sarcomas of the soft tissues. The first objective of surgical treatment is the local control of the disease. Local recurrence is a serious event, that often requires amputation, and favors metastatic progression of the disease. Currently, except in very rare cases, conservative treatment is the treatment of choice, as it has by now been demonstrated that its results are equivalent to those obtained when demolitive surgery is used. In the distal sites of the limbs, superficial localization of the tendons, ligaments, and joints, the absence of anatomical compartments, make it difficult to perform wide conservative surgery. To this must be added that patients are often sent to see a specialist after a previous inadequate operation, and the presence of a contaminated surgical scar often requires exeresis of a wide area of the skin, sufficient to obstruct healing by primary intention. The use of revascularized free flaps allo...

Research paper thumbnail of Lembi liberi microvascolari per la ricostruzione cervicofacciale: comparazione dei risultati oncologici e ricostruttivi fra pazienti giovani e anziani

Research paper thumbnail of Cross-leg as salvage procedure after free flaps transfer failure: a case report

Posttraumatic wounds of the lower leg with soft tissue defects and exposed fractures are a recons... more Posttraumatic wounds of the lower leg with soft tissue defects and exposed fractures are a reconstructive challenge due to the scarce availability of local tissues and recipient vessels. Even when a free tissue transfer can be performed the risk of failure remains considerable. When a free flap is contraindicated or after a free flap failure, the cross-leg flap is still nowadays a possible option. We report a case of a male with a severe posttraumatic wound of the lower leg with exposed tibia fracture firstly treated with two consecutive latissimus dorsi muscular free flaps, failed for vascular thrombosis; the coverage was then achieved with a cross-leg flap with acceptable results.

Research paper thumbnail of Three-Dimensional Reconstruction of the Oral Cavity Using the Free Anterolateral Thigh Flap

Plastic and Reconstructive Surgery, 2002

Oral cavity reconstruction after removal of locally advanced tumors is particularly difficult bec... more Oral cavity reconstruction after removal of locally advanced tumors is particularly difficult because anatomical restoration must accurately reproduce the original structure and enable effective and fast rehabilitation of mastication, swallowing, and phonation. The authors report their 2-year experience with 17 patients surgically treated for oral cavity cancer with reconstruction performed with the free anterolateral thigh flap. Thanks to its thinness and pliability, this flap has proven to be perfectly adaptable to the structural peculiarities of the resected areas and has enabled the authors to considerably reduce the cosmetic and functional complications in the donor area observed with other flaps (such as the radial forearm flap). Flap grafting has always been complete and regular, and no intraoperative and postoperative complications have been observed. Swallowing recovery has always been satisfactory. On the basis of the authors&amp;amp;amp;amp;amp;amp;#39; results, their current approach to oral cavity reconstruction is based on the use of flaps that enable anatomical restoration of the resected areas and reduce morbidity of the donor site. They believe that the anterolateral thigh flap can offer all of these opportunities, and the surgery can be simultaneously performed by two surgical teams.

Research paper thumbnail of Use of ???Perforator Flaps??? in Skull Base Reconstruction after Tumor Resection

Plastic and Reconstructive Surgery, 2002

Large neoplasms of the maxillofacial region (especially nasopharyngeal and maxillary bone tumors)... more Large neoplasms of the maxillofacial region (especially nasopharyngeal and maxillary bone tumors) may invade the cranial base by direct extension. The advent of sophisticated computed tomography and magnetic resonance imaging has provided an accurate ...

Research paper thumbnail of Anterolateral thigh free flap for tracheal reconstruction after parastomal recurrence

Head & Neck, 2009

Background. Stomal recurrence after total laryngectomy is 1 of the most serious issues in head an... more Background. Stomal recurrence after total laryngectomy is 1 of the most serious issues in head and neck surgery, both because of the complexity of its management and because of its morbidity. Prior to the introduction of free-tissue transfer, mediastinal tracheostomy has been the standard reconstructive procedure with high rate of complications. The ideal reconstructive solution to these problems must provide well-vascularized soft tissues that can cover the defect after resection and also allow suturing of the tracheal remnant to skin edges without tension.

Research paper thumbnail of Mandibular reconstruction with revascularized free flap

Research paper thumbnail of Nuovi lembi nella chirurgia ricostruttiva post-oncologica degli arti/New flaps in post-oncologic reconstructive surgery of the limbs

Research paper thumbnail of Abdominal Wall Transplantation with Microsurgical Technique

American Journal of Transplantation, 2007

Many patients undergoing intestinal or multivisceral transplantation have a past history of compl... more Many patients undergoing intestinal or multivisceral transplantation have a past history of complete midgut removal with the loss of the domain of the abdominal compartment or have severely damaged abdominal walls from repeated laparotomies, tumours or enterocutaneous fistulae. These patients may encounter severe abdominal wall closure problems at the end of transplantation, resulting in increased morbidity and mortality. It is, therefore, of paramount importance to properly cover transplanted organs in order to reduce postoperative complications. Abdominal wall transplantation was recently proposed for closure of patients undergoing both small-bowel and multivisceral transplantation: the results are encouraging. However, the technical procedure proposed requires the procurement of long segments of iliac vessels as far as the vena cava and the aorta. Since donor multiorgan procurement involves many surgical teams, the removal of these vessels, with the abdominal graft, led to their unavailability for vascular surgeons. Here we present three consecutive cases of abdominal wall transplantation in which, by taking advantage of microsurgical experience, we were able to carry out a transplantation of the abdominal wall by direct anastomosis of the epigastric vessels, obtaining a very good outcome.

Research paper thumbnail of Applicazioni della tecnologia cad / cam nelle ricostruzioni microchirurgiche della mandibola