摘要:

The role of neutrophils, their presence, and their degree of infiltration was examined in ischemic skin flaps. In a rat model, caudally based dorsal flaps were studied and neutrophils were manipulated by giving cyclosporine at two different doses (15 and 30 mg per kilogram), administrated either for 5 days as a pretreatment or 15 minutes before flap elevation. The presence of neutrophils and lymphocytes in both intravascular and extravascular space was assessed at 15, 30, and 60 minutes by skin biopsies, taken after elevation of the flap, by direct quantitative counting under the light microscope. The correlation between the counts and localization of the neutrophils, but not the lymphocytes, and the percentage of necrosis showed an early and definite role of neutrophils on skin flap survival during ischemic insult. Cyclosporine-treated flaps showed a 24% to 37% increase in viability when compared to control flaps. These data suggest that neutrophils, probably their interactions and/or products, play an important role in ischemic flap survival, and cyclosporine A is able to inhibit neutrophil accumulation and sequestration.Cetinkale O, Bilgic L, Ayan F, Kandilci A. Neutrophil-mediated injury in ischemic skin flaps: amelioration of ischemic injury by cyclosporine in the rat.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

So far, the venous side of vascular changes in expanded skin has been neglected by plastic surgeons. In this experimental study, using a rabbit saphenous flap model, the author attempts to document the changes in the cutaneous venous tree that occur following expansion. Fifteen male New Zealand White rabbits were divided into three groups, with 5 animals in each: group I (expansion), with an inflated expander; group II (sham), with a noninflated expander; and group III (control), with no surgery prior to flap harvest. After an expansion period of 3 weeks with an 80-ml round tissue expander, the flaps were harvested and underwent microangiographic and histological examination in all groups. Using both legs of each animal, 10 flaps were studied for each group. The results revealed that, in the expanded skin, the cutaneous venous tree shows an increased vascularity associated with neovessel formation. In addition to the entire venous network being remarkably enlarged, the collateral and communicating veins bypassing the venous valves in the axial veins were extremely dilated. The periarterial microveins and the perivenous arterioles were also dilated and increased in number. Moreover, the venous valves were found to be incompetent following expansion. Possible mechanisms to explain these changes in the cutaneous venous system following expansion are discussed.Mutaf M. Venous changes in expanded skin: a microangiographic and histological study in rabbits.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Surgical treatment for short bowel syndrome has been directed toward slowing intestinal transit or increasing the absorptive surface area of the bowel. In the present work, we attempted to enhance bowel absorption by increasing vascularity, using the omentum's unique ability to revascularize incorporated tissue. After a 90% resection of small bowel with primary anastomosis in 5 mongrel dogs, an omental flap based on the right gastroepiploic vessels was incorporated into a seromuscular incision on the antimesenteric border of the remnant small bowel. Five control dogs underwent a similar resection and seromuscular incision with an omentectomy. Serum d-xylose assays, hemoglobin, and total protein levels were measured preoperatively and at 3, 6, 9, and 12 weeks postoperatively. Weekly weights were followed. The mean percent d-xylose absorption in the experimental group increased from 96% of the baseline at 3 weeks to 136%, 163%, and 179% at 6, 9, and 12 weeks respectively (p < 0.5). The control group maintained absorption levels between 54% and 74%. Weight loss in the experimental group was significantly less than the controls at weeks 6 and 9, but by 12 weeks, weights were similar for the two groups. Small bowel absorption of d-xylose was significantly enhanced by incorporation of the omentum into the bowel remnant.Williams JK, Carlson GW, Austin GE, Austin ED, Rand RP, Jurkiewicz MJ. Short gut syndrome: treatment by neovascularization of the small intestine.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We present a report of bilateralCandida albicansinfection of polyurethane-coated silicone gel prostheses and an acute onset of unilateral capsular contracture 4 years after breast augmentation. The patient was treated by removal of implants, antibiotic irrigation of the capsule cavities, and immediate replacement with new implants. Following histopathologic diagnosis, the patient was treated with a course of fluconazole and remains symptom free at the 12-month follow-up.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Ten cases suffering from facial contour deformities caused by loss of subcutaneous tissue are presented. Three cases had hemifacial microsomia, 3 had postmaxillectomy collapsed cheek, while the remaining 4 patients had Romberg's disease. All cases were treated by the insertion of a deepithelialized, revascularized lateral intercostal flap. The flaps used had dimensions ranging from 9 cm × 6 cm to 12 cm × 14 cm. The vascular pedicle of the flap is the lateral cutaneous branch of one of the lower four posterior intercostal bundles (usually the tenth or the eleventh). The flap is designed to have the pedicle in its center, thus allowing defattening of the edges at the primary surgery and minimizing the need for secondary debulking. Nine flaps were successful and one failed. All successful flaps gave a permanent and satisfactory correction of the deformity. The difficulties and advantages of the flap are presented.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Hematogenous osteomyelitis is infrequently seen in adults and primary involvement of the hand skeleton is extremely rare. Little has been reported about the foci of hematogenously spread infections. Two cases of hematogenous osteomyelitis of the hand originating from dental maxillary infections are reported. The first patient suffered an acute hematogenous osteomyelitis of the wrist joint, spreading from dental granulomas and massive periodontitis. Despite early radical debridement, attempts to salvage the wrist joint and the extensor tendons failed, so that a wrist fusion had to be performed. The functional outcome was poor. The second patient demonstrated a chronic hematogenous osteomyelitis of the fourth and fifth metacarpals originating from chronic maxillary sinusitis. Radical debridement and use of “spare parts” of the fifth metacarpal prevented an amputation of the fourth ray. The functional outcome was excellent. These cases emphasize the importance of including an examination of the dental maxillary area when searching for a primary focus of hematogenous osteomyelitis.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The fibular osteocutaneous free flap has become the most versatile method for reconstructing composite defects of the mandible. The complexity of the reconstruction increases substantially when both intraoral and extraoral defects are present, possibly dictating the need for an additional flap. For the smaller through-arid-through defects, a single skin island may be sufficient, but may be limited by inadequate reach. Although not routinely necessary, the skin island may be split completely to enhance the effective reach of the second paddle. One patient report is presented for which a moderately sized through-and-through defect of the mandible was reconstructed using a double skin paddle fibular osteocutaneous free flap.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A study was undertaken at St. Mary's Hospital to determine the number of reduction mammaplasty patients receiving blood transfusions during or after surgery. Only 3 of 192 patients in a 3-year period required blood. With the use of xylocaine 0.5% with 1:200,000 adrenalin injected into the breasts before surgery, bleeding was decreased. Thus, the only patient who received blood in the next 203 patients was one who had an autologous unit collected preoperatively and who did not really require it. None of the 11 patients with amounts of breast tissue removed weighing between 3,000 to 4,200 g required blood transfusions.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID