Hidehiko Yoshimatsu

Hidehiko Yoshimatsu
Japanese Foundation for Cancer Research · Department of Plastic and Reconstructive Surgery

About

159
Publications
23,293
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3,648
Citations
Citations since 2017
82 Research Items
2651 Citations
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20172018201920202021202220230100200300400500600
20172018201920202021202220230100200300400500600
20172018201920202021202220230100200300400500600
Introduction
Skills and Expertise

Publications

Publications (159)
Article
Background: Pedicled island flaps, including pedicled propeller flaps and pedicled transposition flaps, are widely used especially for coverage of soft tissue defects in the extremities and the trunk. However, due to its mobility limitations, the inset of the pedicled flaps can be challenging at times, especially when rotation or pressure is appli...
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Postoperative chyle leakage is an uncommon type of lymphorrhea characterized by a milky white lymphatic fluid. Here, we report a case of postoperative donor-site chyle leakage after breast reconstruction using a deep inferior epigastric artery perforator (DIEP) flap. A 50-year-old woman underwent unilateral secondary breast reconstruction using a D...
Article
Background: Donor site seroma formation and prolonged drainage duration are commonly seen after harvest of perforator-based abdominal flaps. The lymphatic network including the lymphatic vessels and the lymph nodes can be traumatized during harvest of a perforator-based abdominal flap, eventually causing seroma formation. The aim of this study was...
Article
Background: Despite the increasing popularity of autologous breast reconstruction, limited evidence is available. The aim of the present study was to compare the short-term outcomes of pedicled- and free-flap breast reconstructions. Methods: Using a nationwide Japanese inpatient database, we identified 13,838 patients who underwent breast recons...
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Background and Objectives: Prolonged drain stay and lymphorrhea are often problems at the donor site of the superficial circumflex iliac artery perforator (SCIP) flap. This study aimed to introduce a novel technique of the SCIP flap elevation: Deep Fat Saving (DFS) technique. Materials and Methods: Thirty-two patients who underwent the SCIP flap tr...
Article
Background and Objectives: Among many donor site options for autologous breast reconstruction, the use of the profunda femoris artery perforator (PAP) flap has become common in patients who are not suitable for the gold standard procedure, the deep inferior epigastric artery perforator flap. However, its limited volume has precluded its wide use in...
Article
Background Reconstruction after wide resection of a large sarcoma arising in the posterior trunk may require free-flap transfer to reduce the postoperative complications. Here, we describe the recipient vessels on the whole posterior trunk. Moreover, to show the reliability of these vessels, we describe an institutional series of free-flap reconstr...
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Docetaxel-based chemotherapy, which is administered before or after axillary lymph node dissection (ALND) in breast cancer patients with positive axillary lymph nodes, is reported as an independent risk factor for development of breast cancer-related lymphoedema (BCRL). Severe hardening of the soft tissue, which is a typical manifestation of BCRL w...
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The efficacy of lymphaticovenular anastomosis (LVA) for the treatment of primary lymphedema has been reported. Previous research suggested the efficacy of LVA on the anterior side of the lower limb, but no research has yet underlined the effectiveness of LVA on the posterior side. In the present study, we aimed to investigate the efficacy of LVA on...
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The incidence of upper extremity lymphedema after breast cancer treatment is reported to be 14% after axillary lymph node dissection (ALND) and 33% after ALND and regional lymph node dissection. The present report describes a novel method in which the afferent lymphatic vessels are harvested with their lymph nodes from the Zone 4 region as a separa...
Article
In the treatment of sarcoma, the reconstructive surgeon must consider not only limb salvage but also functional reconstruction. The aim of this study was to evaluate a functional reconstruction of a dorsal forearm defect after sarcoma resection using immediate tendon transfer. Patients who underwent reconstruction of a dorsal forearm defect after s...
Article
Background Currently, microsurgeons are in the era of supermicrosurgery and perforator flap reconstruction. As these reconstructions frequently utilize vessels that are smaller than a single millimeter, understanding of location of lymphatic vessels and perforator anatomy preoperatively is essential. To change with the times, the role of ultrasound...
Article
Severe trismus often causes significant compromise in quality of life due to severe impairment of oral functions. Treatment of trismus needs to be tailored to the cause. Here, we report the case of a successful treatment for severe trismus after maxillectomy using coronoidectomy, condylectomy, and vascularized fibula flap transfer. A 65‐year‐old fe...
Article
Background: The superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has gained acceptance among reconstructive microsurgeons, the minimal donor site morbidity being its greatest advantage. The purpose of this article is to introduce the use of preoperative ultrasonography to facilitate elevation and to avoid postoperative complicatio...
Article
Aplasia Cutis Congenita (ACC) in the scalp is a rare congenital malformation. The treatment for ACC with large defects involving the scalp, bone, and the dura is challenging. Local debridement of necrotic tissue is important to prevent lethal complications such as infection and meningitis. However, debridement has the risk of damaging the sagittal...
Article
Background: Breast reconstruction using autologous tissue has been widely performed, and its safety and usefulness have been reported. However, there are few reports on the long-term morphological evaluation of autologous breast reconstruction cases. We evaluated long-term change of breast shape using Vectra, a 3-dimensional imaging device, for br...
Article
The efficacy of the use of the pedicled ALT flap for buttock defects has not been established in the literature. Here, we present a case of a successful reconstruction of a large gluteal defect after sarcoma resection using a pedicled ALT flap assisted by preoperative computed tomographic angiography (CTA) and intraoperative indocyanine green (ICG)...
Article
Background Recent advances in the superficial circumflex iliac artery (SCIA) perforator flap transfer emphasized the necessity to comprehensively understand the lower abdominal vasculature. This study aimed to clarify the relationship among the superficial inferior epigastric artery (SIEA), the superficial branch (SCIAs), and the deep branch (SCIAd...
Article
Background: Toe-to-hand transfer is a favorable option for finger reconstruction, but donor site healing can be challenging. The superficial circumflex iliac artery perforator (SCIP) flap has yet to be used widely for toe reconstruction. The purpose of this report was to validate the efficacy of the sequential simultaneous free SCIP flap transfer...
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Background: Lymphaticovenular anastomosis (LVA) is a challenging procedure and requires a sophisticated supermicrosurgical technique. The aim of this study was to evaluate and establish a discrete supermicrosurgical anastomosis method using the "suture-stent technique". Methods: Forty-eight LVA sites of twenty patients with lower extremity lymph...
Article
Background During elevation of the superficial circumflex iliac artery (SCIA) perforator (SCIP) flaps, the flap pedicle must often be converted from the superficial branch to the deep branch of the SCIA, complicating and prolonging the procedure. The goal of the present study was to demonstrate the effectiveness of high-resolution ultrasonography t...
Article
Background A goal in ideal lower eyelid reconstruction is to achieve not only an esthetic recovery of the shape of the eyelid but also to obtain satisfactory eyelid function without damage to the corneal surface. In this report, we introduce our “Like with Like” reconstruction technique using a combined Hughes flap and swing skin flap. The Hughes f...
Article
Background Recently, the deep inferior epigastric perforator (DIEP) flap has become the gold standard for breast reconstruction, but it has some drawbacks such as abdominal bulging and hernia. To overcome these disadvantages, the superficial inferior epigastric artery perforator (SIEA) flap is used as an alternative option, but it has another probl...
Article
Background The use of intraoperative indocyanine green (ICG) angiography has been well documented for confirmation of arterial perfusion in transferred free flaps. However, no previous report has yet focused on whether ICG angiography can be used to detect congestion in free flaps. The present report investigates the feasibility of ICG angiography...
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The cover image is based on the Clinical Article Triple‐lobe combined latissimus dorsi and scapular flap for reconstruction of a large defect after sarcoma resection by Ryo Karakawa et al., https://doi.org/10.1002/micr.30627.
Article
Background Postoperative complications after flap‐coverage in sarcoma treatment can postpone postoperative adjunct treatments. Here, we present our experience with the use of the superficial circumflex iliac artery perforator (SCIP) flap after sarcoma resection. Patients and Methods Patients undergoing immediate reconstruction surgery with a flap...
Article
Breast reconstruction with a deep inferior epigastric artery perforator (DIEP) flap is now widely used. However, when the DIEP flap is not available, an alternative for patients who desire autologous breast reconstruction should be provided. This study aimed to introduce breast reconstruction with a lumbar artery perforator (LAP) flap for metachron...
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Soft tissue sarcomas are rare neoplasms that can occur on any part of the body. The operative position for the resection is determined depending on the site of the soft tissue sarcomas; intraoperative repositioning may be needed for reconstruction. We present the profunda femoris artery perforator (PAP) flap harvest technique (wherein the flap can...
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The profunda artery perforator (PAP) flap has become an alternative option for breast reconstruction. Reliable perforators arise through the adductor magnus muscle, and dissection of the perforator is straightforward. Recently, we have found that the PAP flap with the sensory nerves can be harvested as an innervated flap. We discuss the feasibility...
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A deep inferior epigastric perforator (DIEP) flap is one of the gold standards for autologous breast reconstructions. However, this flap cannot be chosen again if asynchronous contralateral breast cancer occurs in the future. To solve this problem, we propose an idea and design for a hemi-abdominal DIEP flap. The patient was a 50-year-old woman who...
Article
Background Detection and selection of the lymphatic vessels are important for maximizing therapeutic efficacy of lymphaticovenular anastomosis (LVA). Some imaging modalities have been reported to be useful for intraoperative identification of the lymphatic vessels, but they have limitations. In this article, we present new capabilities of intraoper...
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Background: Pancreaticoduodenectomy after esophageal resection is technically difficult, because blood flow of the gastric conduit should be preserved. Celiac axis stenosis (CAS) is also a problem for pancreaticoduodenectomy, because arterial blood supply for the liver comes mainly through the collateral route from the superior mesenteric artery (...
Article
Background In the setting of the reconstruction for a large defect, we must make the maximum use of the limited human tissue with the minimum damage. In this article, we report on reconstruction using a combination of three‐skin paddle latissimus dorsi and a scapular flap for a large defect after soft tissue sarcoma resection to minimize donor site...
Article
Background: Reconstruction after esophagectomy is conventionally performed with a gastric conduit. However, in cases where a gastric conduit is unavailable, reconstructive procedures vary in terms of flap type, operative timing, and conduit route. Single-stage surgery is associated with a long operation time and high surgical stress, resulting in...
Article
Background The superficial circumflex iliac artery perforator (SCIP) flap cannot be used for coverage of large defects. We introduce a novel flap design to overcome the SCIP flap's size limitation. Methods Data of patients who underwent coverage of defects exceeding 113 cm² (12 × 12 cm) using combined flaps composed of an SCIP flap and either a su...
Article
Background and Objectives : The profunda femoris artery perforator (PAP) flap is gaining popularity in microsurgical reconstruction. The complications that can occur after the PAP flap harvest include donor-site lymphedema, seroma, or cellulitis. The aim of this study was to evaluate and establish a safer technique for the elevation of lymphatic ve...
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Thanks to the introduction of virtual surgical planning (VSP), mandibular reconstruction using a fibula flap has become simplified, and patient-specific reconstruction is now possible. With a VSP software, surgical “cutting guides” and custom-made titanium plates can be designed to help surgeons. However, they are expensive and require extended per...
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Background: Vascularized lymph node transfer is the most common physiological procedure indicated for severe lymphedema. We describe a new physiological treatment strategy for lymphedema, lymphatic system transfer (LYST), which comprises transfer of the vascularized afferent lymphatic vessels along with their draining lymph nodes. Methods: All p...
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A phyllodes tumor of the breast is a rare neoplasm, accounting for 0.3%-1% of all breast cancers. The size is 4-5 cm on average but sometimes the tumor grows more and involves the entire breast. As for treatment, complete surgical resection is the standard for localized breast phyllodes tumors. The reconstruction of a large defect is challenging. H...
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Free flaps have evolved from musculocutaneous flaps to perforator-based cutaneous flaps. The subdermal plexus is now thought to play a significant role in skin paddle perfusion. We propose a new concept, the "intradermal plexus," allowing survival of dermis flaps, according to our study. Methods: A dermis flap was used in 6 cases to reconstruct s...
Article
Background: The deep branch of the superficial circumflex iliac artery (SCIA) should be included when a large superficial circumflex iliac artery perforator (SCIP) flap is necessary, or when anatomical structures perfused by the deep branch are procured. The aim of this study was first to describe the anatomical features of the "transverse branch"...
Article
Background: The profunda femoris artery perforator (PAP) flap is gaining popularity in microsurgical reconstruction. To establish a safer flap elevation technique, we focused on the topology of the accessory saphenous vein in the medial thigh area. We hypothesize that including the accessory saphenous vein in a PAP flap results in safer PAP flap t...
Article
Background: The current standard to locate lymphatic vessels for lymphovenous anastomosis (LVA) is the use of indocyanine green (ICG)-lymphangiography. Due to fluid retention and fibrosis of tissue in patients with lymphedema, often present in Caucasian patients, vessels deeper than 0.5 cm below the dermis cannot be visualized. We present our expe...
Article
Background: The profunda artery perforator (PAP) flap has recently been widely used for head and neck as well as breast reconstruction. Although this flap has various advantages, its vascular pedicle is relatively smaller and shorter than that of other workhorse flaps such as the anterolateral thigh flap. The posterior accessory saphenous vein (pA...
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Although soft tissue sarcoma, especially in the sole of the foot, is a rare disease, weight-bearing region reconstruction considering postoperative gait is needed. For functionally satisfactory sole reconstruction, it is important to cover the weight-bearing region with a nonbulky but durable skin paddle that can withstand a significant amount of s...
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Microtia with congenital aural atresia is challenging to achieve aesthetically and functionally good results. We herein present a case where a vascularized superthin superficial circumflex iliac artery perforator (SCIP) flap was used for reconstruction of the external auditory canal (EAC) and a full-thickness skin graft was used for reconstruction...
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Background Although free jejunal transfer is an established and reliable procedure for reconstruction after total pharyngolaryngectomy (TPL), vascular thrombosis remains a surgical challenge. To reduce the risk, a double-pedicled free jejunal flap transfer has been attempted using a root jejunal artery and an arcade artery, although several drawbac...
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Background:. In free-flap reconstruction of the midface, options for the recipient artery are quite limited; the superficial temporal artery and the facial artery are the most commonly used arteries. We report our approach for the use of the angular artery (the terminal branch of the facial artery) as the recipient artery in free-flap reconstructio...
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Background:. Identification and localization of functional lymphatic vessels are important for lymphaticovenular anastomosis. Conventional high-frequency ultrasound (CHFUS) has been reported to be useful for them, but it has some disadvantages. In this article, we present new capabilities of ultra high-frequency ultrasound (UHFUS) for imaging of th...
Article
Introduction: The clavicular region is acknowledged as one of the most suitable donor sites for reconstruction of the face or neck. Recently, a free thoracoacromial artery (TAA) perforator (TAAP) flap was reported as a new option for reconstruction of the face. However, the TAAP flap has several drawbacks including tedious intramuscular dissection...
Article
BACKGROUND: Harvesting the sartorius muscle and the iliac bone with a superficial circumflex iliac artery (SCIA) perforator flap can be a challenging procedure. The aim of this study was to describe the anatomical topology of the deep branch of the SCIA in fresh cadavers, which has not been reported in detail. METHODS: Twenty groin regions from 10...
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Full-text available
https://deepblue.lib.umich.edu/bitstream/2027.42/146635/2/micr30384_am.pdf
Article
Background: Recently, a superthin "pure skin perforator" flap without any subcutaneous tissue was proposed, but the vascularity is still unclear. The authors therefore investigated the vascularity of the proposed superficial circumflex iliac artery-pure skin perforator along with its clinical applications and findings on indocyanine green imaging....
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Fingertip replantation is a technical challenge for microsurgeons. For successful fingertip replantation, it is important to monitor the replanted fingertip vascularity for the early detection and revision of vascular compromise. Laser speckle contrast imaging (LSCI) is a camera-based technique that measures the perfusion by illuminating the tissue...
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Background In a setting of flap congestion, early detection and rapid reexploration are important. Some studies described the efficacy of blood glucose measurement for flap monitoring.¹ However, the sensitivity and specificity of this method were not high enough to determine whether reexploration should be done or not. The purpose of this study was...
Article
Background: Lymph system plays important roles in maintaining fluid balances, immune system, and lipid metabolism. After tissue replantation or transfer, some cases suffer from long-lasting edema or lymphedema due to interruption of main lymph flows, but its mechanism is yet to be clarified. Methods: Medical charts of 38 patients who underwent I...
Article
Background The superficial circumflex iliac artery (SCIA)-based iliac bone flap has yet to be widely used. The purpose of this article is to validate the feasibility of SCIA-based iliac bone flap transfers for reconstruction of small to moderate-sized bony defects. Retrospective outcome comparisons between SCIA-based iliac bone flaps and fibula fla...
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F ree for the tissue reconstruction transfer has become of fingers. the The method identification of choice of recipient veins is one of the most important points to consider for successful finger replantation and free flap reconstruction of fingers, including toe-to-finger transfer, hemipulp flap transfer, and digital artery perforator flap transf...
Chapter
For the successful performance of microsurgical lymphatic surgery for lymphedema, it is important to identify functional lymphatic vessels and determine the location of lymphatic vessels preoperatively. Combination of microsurgical lymphatic surgery and preoperative using medical equipment (direct method, physiologic method, and indirect method) en...
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Bone perfusion evaluation methods in cadaver studies have yet to be established. The aim of this report was to introduce and validate the feasibility of indocyanine green (ICG) fluorescence angiography for evaluation of bone perfusion in the femoral medial condyle in cadavers. In 4 fresh nonembalmed cadavers (2 female), the descending genicular art...
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Plastic and reconstructive surgery relies on the knowledge of angiosomes in the raising of microsurgical flaps. Growing interest in muscle-sparing perforator flaps calls for reliable methods to assess the clinical feasibility of new donor sites in anatomical studies. Several injection techniques are known for the evaluation of vascular territories....
Article
Background: Usually, anterolateral thigh (ALT) defects with width more than 8 cm cannot be closed directly. Although several methods of using local flaps exist, flap mobility of these methods is limited. We introduced a perforator-based propeller flap for such reconstruction. Their maximal mobility, which minimizes their size, is their greatest ad...
Article
In free-flap reconstruction of the lower extremity, due either to trauma or pre-existing vascular disease, healthy vessels may not be readily available in the proximity of the defect. A variety of options including a cross-leg free flap, vein grafts, arteriovenous loops, and "bridging" flaps have been used to address the issue. The purpose of this...
Article
Background: Volume measurement is one of the most common evaluations for lower-extremity lymphedema. However, volume comparison between different patients with different physique may be inappropriate, and it is difficult to evaluate localized limb volume change using leg volume evaluation. Methods: Localized leg volumes (Vk, k = 1-5) and localiz...
Article
Background: Lymphaticovenular anastomosis (LVA) is a useful treatment option for compression-refractory lower extremity lymphedema (LEL), but its efficacy largely depends on severity of lymphosclerosis. To maximize LVA efficacy, it is important to elucidate factors associated with severe lymphosclerosis (SLS). Methods: Medical charts of 134 LEL...
Article
Background: The region between the proximal interphalangeal (PIP) and the metacarpophalangeal (MP) creases has greater laxity than other regions in the fingers, allowing for primary closure of the donor site. We postulated if we could consistently locate perforators from the region between the PIP and the MP crease on the radial side of the middle...