William Lineaweaver

Publications (11)14.65 Total impact

• Article: Commentary: End-to-end versus end-to-side motor and sensory neurorrhaphy in the repair of acute muscle denervation.

  William Lineaweaver, Feng Zhang
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  ABSTRACT: ABSTRACT: This manuscript is a commentary on a study by Jaeger et al cited in the study.
  Annals of plastic surgery 06/2012; 68(6):643. · 1.29 Impact Factor
• Article: Comparisons of outcomes from repair of median nerve and ulnar nerve defect with nerve graft and tubulization: a meta-analysis.

  Mei Yang, Jeremy L Rawson, Elizabeth W Zhang, Peter B Arnold, William Lineaweaver, Feng Zhang
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  ABSTRACT: In this study, an updated meta-analysis of all published human studies was presented to evaluate the recovery of the median and the ulnar nerves in the forearm after defect repair by nerve conduit and autologous nerve graft. Up to June of 2010, search for English language articles was conducted to collect publications on the outcome of median or ulnar nerve defect repair. A total of 33 studies and 1531 cases were included in this study. Patient information was extracted from these publications and the postoperative outcome was analyzed using meta-analysis. There was no significant difference in the postoperative recovery between the median and the ulnar nerves (odds ratio = 0.98). Sensory nerves were found to achieve a more satisfactory recovery after nerve defect repair than motor nerves (P < 0.05). Median nerve can also achieve more satisfactory recovery in both sensory and motor function than ulnar nerve (P < 0.05). There was no statistical difference between tubulization and autologous nerve graft in repairing defects less than 5 cm. Based on the results of this study, a median nerve with sensory impairment was associated with improved postoperative prognosis, while an ulnar nerve with motor nerve damage was prone to a worse prognosis. Tubulization can be a good alternative in the reconstruction of small defects.
  Journal of Reconstructive Microsurgery 07/2011; 27(8):451-60. · 1.43 Impact Factor
• Article: Methicillin-resistant Staphylococcus aureus hand infections in a suburban community hospital.

  Ovunc Akdemir, William Lineaweaver
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  ABSTRACT: Of hand infections treated in a suburban community hospital, 65% were found to have cultures positive for methicillin-resistant Staphylococcus aureus (MRSA). This incidence of MRSA infection is comparable to MRSA infection rates found in county hospitals and trauma center hand infection populations. MRSA should be recognized as a common primary pathogen in hand infections.
  Annals of plastic surgery 03/2011; 66(5):486-7. · 1.29 Impact Factor
• Article: Acute and sustained effects of vascular endothelial growth factor on survival of flaps and skin grafts.

  Feng Zhang, William Lineaweaver
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  ABSTRACT: Over the past 15 years, we have completed 10 experimental studies of the effects of vascular endothelial growth factor (VEGF) on the survival of flaps and skin grafts. We have reviewed these studies to summarize evidence for 2 distinct phases of VEGF actions. The 10 studies were reviewed and classified as demonstrating acute VEGF effects (with VEGF administered at the time of procedures) or sustained VEGF effects (with VEGF administered 24 hours or more before procedures). Acute effects of VEGF included increased survival of skin flaps, muscle flaps, and full thickness skin grafts, increased viability markers in hind limb replants, selective cytokine suppression, and variable modulation of nitric oxide synthase expression. Sustained VEGF effects included extension of skin flap territories, accelerated maturation of tubed pedicle flaps, and increased neovascularization. VEGF effects coincide with descriptive mechanisms of tissue survival. The acute VEGF effects of tissue edema and vasodilation parallel serum imbibition and inosculation. The sustained VEGF effect of neovascularization may be mechanisms of permanent tissue survival at new sites, as well as delay phenomena. Manipulation of these VEGF effects could lead to strategies for achieving greater predictability in flap and graft survival.
  Annals of plastic surgery 03/2011; 66(5):581-2. · 1.29 Impact Factor
• Article: Effects of comorbidities and implant reinforcement on outcomes after component reconstruction of the abdominal wall.

  George Varkarakis, Justin Daniels, Karah Coker, Tanya Oswald, Arno Schleich, Alan Muskett, Orunc Akdemir, William Lineaweaver
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  ABSTRACT: A series of patients undergoing component reconstruction of midline abdominal wall separations was analyzed to assess the effects of comorbidities and biological implant reinforcements on outcomes. Thirty-nine patients were identified as fitting the technical definition of component repairs and having at least 12 months of documented follow-up. This group of procedures had a 67% primary healing rate, 18% and 13% rate of major and minor complications, respectively, and a total of 90% successful reconstructions after secondary procedures. Variables assessed for outcome influences included etiology of the abdominal wall separation, obesity, diabetes, hypertension, and biological implant reinforcements, including absorbable mesh and biological implants. None of these factors significantly influenced outcome, although first time repairs and reinforced repairs had suggestively higher success rates. This data suggest that comorbidities do not influence outcomes of component abdominal wall repairs, and assessments of the problem and ongoing technical refinements of the procedure should be studied further.
  Annals of plastic surgery 05/2010; 64(5):595-7. · 1.29 Impact Factor
• Article: Repair of partial nerve injury by bypass nerve grafting with end-to-side neurorrhaphy.

  Chunhui Song, Tanya Oswald, Hede Yan, Michael B Chen, Jian Zhang, Tongyi Chen, William C Lineaweaver, Feng Zhang
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  ABSTRACT: The purpose of this study was to investigate the efficacy of bypass nerve grafting with end-to-side neurorrhaphy in repair of the partial nerve injury in a rabbit model. Thirty-six adult male New Zealand rabbits were divided into three groups. A partial nerve injury was created by removal of a segment of the lateral fascicle of the left peroneal nerve. In group one, the injured nerve was repaired with nerve graft bypassing the injury site in an end-to-side fashion 4 weeks after injury. In group two, the injured nerve was repaired with end-to-end interpositional nerve grafting 6 weeks after injury. The injured nerve without repair was used as the control. Sixteen weeks after nerve repair, in groups one and two, and 20 weeks after the initial nerve injury in the control group, the nerves were dissected for electrophysiological examination and biopsied for histology and molecular markers expression. The nerve repair with interpositional nerve grafting achieved maximal functional recovery. However, motor nerve conduction velocity and compound motor action potential in nerve repair with bypass nerve grafting were significantly higher than that in the nerve injury without repair. Histologically, the regenerated myelinated axons and unmyelinated axons were present in the distal peroneal nerves in the bypass nerve grafts. The axon counts in nerve repair with the bypass nerve grafting were also significantly higher than that in the nerve injury without repair. The comparisons of the ciliary neurotrophic factor and the calcitonin gene-related peptide gene expressions between nerves with and without repair were significantly different. End-to-side bypass nerve grafting can significantly improve functional recovery in the nerve with partial injury and may be a useful repair strategy in neuromas-in-continuity.
  Journal of Reconstructive Microsurgery 09/2009; 25(8):507-15. · 1.43 Impact Factor
• Article: Management strategies following microsurgical flap failure.

  William Lineaweaver, Ovunc Akdemir, Arno Schleich
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  ABSTRACT: Although increasingly rare, failed microsurgical flaps are a complicated clinical problem when they occur. Review of reports of management following microsurgical flap failure offers an outline of options. A substantial number of breast and extremity patients elect abandonment of reconstruction. The majority of head and neck, breast, and extremity patients proceed to nonmicrosurgical reconstructive options. Head and neck patients (38%) and 35% of extremity patients elect to have second microsurgical flaps, and 84% of these procedures were successful. Patient management following microsurgical flap failure includes strategic abandonment of reconstruction in some cases, use of conventional procedures in a majority of cases, and further microsurgical procedures in one-third of cases. The reconstructive surgeon should have this range of possibilities available for these difficult cases.
  Microsurgery 09/2009; 30(1):61-3. · 1.61 Impact Factor
• Article: Vascular endothelial growth factor upregulates inducible nitric oxide synthase expression in the muscle flap ischemia model in the rat.

  Zeng-Gan Chen, Babara Persons, Lin Lin, William C Lineaweaver, Feng Zhang
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  ABSTRACT: The purpose of this investigation was to elucidate the regulation of inducible nitric oxide synthase (iNOS) expression by vascular endothelial growth factor (VEGF) in a muscle flap ischemia model in rats. The gracilis muscle flap model was chosen. Sixty adult male Sprague Dawley rats were randomly divided into two groups (n = 30). After 4 hours ischemia, the experimental group received VEGF treatment, and the control group was given saline in the same fashion. At time intervals of 0, 2, 6, 12, and 18 hours (n = 6 for each time interval) after injection, tissue samples were biopsied for reverse transcriptase polymerase chain reaction, routine hematoxylin-eosin staining, and CD31 immunohistochemical staining. The result showed that iNOS expression is increased in the gracilis muscle flap ischemia model in rats compared with the control group within 6 hours after ischemia (p < 0.05). In the VEGF group, iNOS expression increased rapidly over the first 2 hours, but no statistically significant difference was observed at 12 and 18 hours between the two groups (p > 0.05). We concluded that the application of VEGF could maintain the structure of capillaries and upregulate iNOS expression during the first 6 hours after ischemia in the ischemic muscle flap of a rat model. These findings may provide the evidence to study the mechanism of VEGF in improving flap survival.
  Journal of Reconstructive Microsurgery 01/2009; 25(4):219-25. · 1.43 Impact Factor
• Article: Evaluation of fructose 1,6 diphosphate for salvage of ischemic gracilis flaps in rats.

  Vipul Sud, Sheila G Lindley, Olga McDaniel, Alan E Freeland, Feng Zhang, Wanda Dorsett-Martin, Steven A Bigler, William Lineaweaver
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  ABSTRACT: Fructose 1, 6 diphosphate (FDP), a metabolic intermediate, provides an alternative mechanism to circumvent the rate-limiting step in the Kreb's cycle. This agent has been observed to prevent the effects of ischemia on heart tissue and kidney function and the effects of endotoxic shock. It has been shown conclusively to minimize the adverse effects of ischemia-reperfusion injury in experimental pedicled skin flaps in animals. The present study was done to evaluate the effect of intra-arterial administration of FDP on salvage of ischemic microvascular transfer of gracilis muscle flaps in rats, with the premise that it might prolong the ischemia time of muscle flaps at room temperature, thus increasing chances of flap survival. Irrigation with FDP did not change the quantitative survival of the flaps, but there was qualitative improvement on histologic evaluation and DNA analysis. Decreased inflammatory damage and DNA fragmentation were seen at the 2.5-hr period. Histologic staining for mitochondrial oxygenation in gracilis muscle also showed increased uptake in the FDP-treated group vs. control at the 2.5-hr ischemia period. Further experiments with different modes of FDP administration should be carried out to identify more effective means of amelioration of flap ischemia.
  Journal of Reconstructive Microsurgery 05/2005; 21(3):191-6. · 1.43 Impact Factor
• Article: Limited segmental resection of symptomatic lower-extremity lymphodystrophic tissue in high-risk patients.

  Tanya M Oswald, William Lineaweaver
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  ABSTRACT: In obese patients, lymphodystrophic tissue can create large masses that are microscopically indistinguishable from chronic lymphedema. This tissue can be disabling, especially in the lower extremities. The tissue is refractory to conservative therapy and is prone to cellulitis and abscess formation. The patients are regarded as being at high risk for surgical complications due to obesity and related illnesses. We report two cases of patients with lesions severely limiting walking. The two patients weighed 490 and 520 lb, respectively. One patient had hypertension and asthma; the other had arrhythmias and chronic venous thrombosis. One patient had wedge resection of the right groin (23 lb) and knee (5 lb), and the second patient had resection of the right thigh (65 lb) and left thigh (84 lb). All procedures were done separately. Both patients reported improvement in walking. Simple wedge excision was an effective, minimally complicated treatment for these patients.
  Southern Medical Journal 08/2003; 96(7):689-91. · 0.83 Impact Factor
• Article: Reconsidering the soleus muscle flap for coverage of wounds of the distal third of the leg.

  Joel B Beck, Frank Stile, William Lineaweaver
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  ABSTRACT: Traditionally, cross-leg flaps and microsurgical flaps have been used to reconstruct defects of the distal third of the leg. In the authors' experience, the soleus muscle has also provided suitable tissue for coverage of these lesions in a notable number of cases. During a 2-year period, the authors treated 28 patients who required flap coverage of defects of the lower third of the leg. In this group, the soleus muscle was used successfully in 8 patients. All of these procedures resulted in healed wounds. The remaining patients underwent reconstruction with microsurgical flaps, fasciocutaneous local flaps, and a gastrocnemius muscle flap. Their experience has demonstrated that the soleus muscle is a valuable tool and should be included in the treatment algorithm for reconstructing lesions of the distal third of the lower extremity.
  Annals of Plastic Surgery 07/2003; 50(6):631-5. · 1.32 Impact Factor