摘要:

The method of distraction osteogenesis was used to move several facial segments in different directions with formation of new bone. On 3 young adult sheep a Le Fort II osteotomy, combined with circumferential orbital osteotomies, was performed. The periosteum over the osteotomies was preserved. Titanium bone screws were placed as bone markers. The segments were fixed with pins and plates to a combined distraction apparatus in order to advance the segments in different directions. By a gradual distraction, the midface was advanced forward by 30 mm. The left orbit was moved laterally 20 mm and the right orbit was moved forward 20 mm. In both orbits there was a concomitant globe movement. New bone formation in the distracted area was obvious radiographically, clinically, and histologically. In conclusion, multiple segmental distraction is possible in the adult sheep face and may offer three-dimensional (3D), controlled correction of complex face deformities.Rachmiel A, Levy M, Laufer D, dayman L, Jackson IT. Multiple segmental gradual distraction of facial skeleton: an experimental study. Ann Plast Surg 1996:36:52-59

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Thirty PTFE prostheses (internal diameter, 1.0 mm; length, 5.0 mm; fibril length, 30 µm) were implanted into rats' femoral veins by means of a coupling device (3M precise microvascular anastomosis system, 3M, St Paul, MN) and evaluated with electron microscopy at regular intervals from 1 day to 3 weeks after implantation to study, in detail, the healing process. Eighty-three percent of mechanically anastomosed grafts were found to be patent. At 1 and 3 days after implantation, the whole length of PTFE was covered with a clot layer containing platelets and a fibrin network. After 1 week, endothelial-like cells originating from the anastomotic sides grew in across the anastomoses. At 3 weeks, the prostheses were completely covered by an endotheliallike cell layer. These results demonstrate that the degree of neo-endothelialization in the microvenous PTFE prosthesis anastomosed with 3M rings was not delayed, as was seen in the healing of microarterial PTFE tubing that was mechanically anastomosed.Oguchi H, Torii S. Healing of microvenous polytetrafluoroethylene (PTFE) prostheses implanted into the rat femoral vein by means of 3M precise. Ann Plast Surg 1996;36:60-64

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The fetal wound healing matrix is exceptionally rich in hyaluronic acid (HA). Fetal wounds heal without scarring or contraction. Noting these observations, we cultured adult dermal explants in the presence of various concentrations of medical-grade HA in vitro. In the presence of HA, fibroblasts migrated from the dermal explant and multiplied more rapidly than control explants. Subsequently, sterile toothpicks were used to disrupt (wound) fibroblast monolayers mechanically and the rate of closure was monitored. Cells cultivated in the presence of 5 mg/ml of exogenous HA changed in morphology and closed the wound more quickly than control cultures. Cells surrounding the wound extended numerous podalic processes and showed increased interdigitation. The effect of HA on cell proliferation is usually discussed in terms of the mechanical effects HA exerts on cells and the extracellular matrix. The physiological effect of HA may lie in its ability to act as an accessory receptor in cooperative ligand-binding pathways. For example, HA may bind growth and/or other factors, and thereby increase the effective concentration of these factors at the cell surface.Shepard S, Becker H, Hartmann JX. Using hyaluronic acid to create a fetal-like environment in vitro. Ann Plast Surg 1996;36:65-69

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A study was performed to compare the effects of reamed versus unreamed locked intramedullary nailing on soft-tissue blood flow in a fractured sheep tibia model. After creation of a standardized short spiral fracture, each tibia was stabilized by insertion of a locked intramedullary nail. Ten animals were randomized into two groups: one that had reaming prior to nail insertion and one that did not. Blood flow was measured in real time, using laser Doppler flowmetry. Skin and muscle perfusion measurements were made at three locations (proximal diaphysis, fracture site, and distal diaphysis) and at five time intervals (postfracture; postnail insertion; and at 2-week, 6-week, and 12-week follow-ups). All animals were sacrificed at 12 weeks postoperatively. Muscle blood flow remained elevated longer in the reamed group than in the unreamed group, following completion of the procedure. Muscle perfusion was significantly greater in the reamed group than in the unreamed group (p < 0.033) and was significantly greater than skin perfusion at 2 weeks (p < 0.024). There was no difference in skin perfusion between the reamed and unreamed groups at any time interval. The study demonstrates that muscle perfusion is altered following reamed and unreamed intramedullary nailing. The findings demonstrate the change in blood flow in the surrounding soft-tissue envelope during the process of revascularization, following devascularization of a segment of tibial cortex by intramedullary nailing.Schemitsch EH, Kowalski MJ, Swiontkowski MF. Soft-tissue blood flow following reamed versus unreamed locked intramedullary nailing: a fractured sheep tibia model. Ann Plast Surg 1996;36:70-75

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Chronic, burning facial pain as a result of cosmetic facial surgery has rarely been reported. During the year of 1994, two female patients presented themselves at our Pain Relief Clinic with chronic facial pain that developed following aesthetic facial surgery. One patient underwent bilateral transpalpebral surgery for removal of intraorbital fat for the correction of the exophthalmus, and the other had classical face and anterior hairline forehead lifts. Pain in both patients was similar in that it was bilateral, symmetric, burning in quality, and aggravated by external stimuli, mainly light touch. It was resistant to multiple analgesic medications, and was associated with significant depression and disability. Diagnostic local (lidocaine) and systemic (lidocaine and phentolamine) nerve blocks failed to provide relief. Psychological evaluation revealed that the two patients had clear psychosocial factors that seemed to have further compounded their pain complaints. Tricyclic antidepressants (and biofeedback training in one patient) were modestly effective and produced only partial pain relief.Eisenberg E, Yaari A, Har-Shai Y. Chronic, burning facial pain following cosmetic facial surgery. Ann Plast Surg 1996;36:76-79

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A 66-year-old woman with an abdominal wound caused by infected synthetic mesh had failed to heal in spite of many surgical attempts to close the wound. A sealed transparent vinyl chamber was glued to the periphery of the wound and antibiotics in high concentrations (up to 2,500 times the minimum inhibitory concentration) were delivered through the chamber. The wound fluid in the chamber was used for analysis of microbial activity, concentration of residual antibiotics, and growth factor activity. After 10 weeks of treatment, the wound was closed and has not recurred in 24 months.Eriksson E, Perez N, Slama J, Page CP, Andree C, Maguire JH. Treatment of a chronic, nonhealing abdominal wound in a liquid environment. Ann Plast Surg 1996;36:80-83

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Rupture of a flexor tendon in the nonrheumatoid population is rare. Localizing the level of the tendon rupture can be a difficult task. We describe an individual who presented with the sudden inability to flex the index finger of the hand, which had been subjected to a severe electrical injury. Physical exam demonstrated lack of index finger flexion at the distal joint. The patient denied any pain or history of recent trauma. Preoperative magnetic resonance imaging (MRI) successfully located the proximal and distal ends of the ruptured flexor digitorum profundus tendon in the forearm. MRI allows for accurate preoperative assessment of tendon position and degree of retraction, thereby facilitating surgical planning and approach. Accurate localization of tendon pathology preoperatively minimizes unnecessary dissection, shortens the operative procedure, and clarifies operative planning.Concannon MJ, Duffy FJ Jr, Palmer WE, May JW Jr. Late rupture of a flexor tendon after electrical injury: tendon localization using magnetic resonance imaging. A case report. Ann Plast Surg 1996;36:84-87

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Scarpa's fascia is a prominent superficial fascial system of the body. It consists of a single membrane between the superficial fatty layer and deep fatty layer, and lies widely in the lower abdominal wall. We describe a case with a wide scalp defect resulting from a resection of a dermatofibrosarcoma, and reconstruction of the defect with Scarpa's adipofascial flap (i.e., a combined paraumbilical perforator-based adipofascial flap-groin adipofascial flap). The primary advantage of Scarpa's adipofascial flap for scalp defects is that (1) the donor site is most acceptable for a free flap with a minimal donor scar and minimal dysfunction; (2) even in cases in which large flaps are used, donor defects can be closed directly without skin grafting; (3) in the obese patient, this flap is preferable because of cosmetic improvement of the abdominal wall; (4) the donor area has so many perforators that an extended adipofascial flap can be obtained with a combination of these perforators; and (5) the flap may be nourished with one of several arteries, such as the superficial or deep inferior epigastric artery, or the superficial or deep circumflex iliac artery. The disadvantages of this flap are that the territory with a single artery may be smaller than a skin flap with the same artery and oversurfacing of the graft results in a poor cosmetic appearance. Scarpa's adipofascial flap is indicated when the defects are in an exposed area, especially in children, young patients, and females, and when this procedure is combined with a skin-expanding method in the secondary repair.Koshima I, Inagawa K, Jitsuiki Y, Tsuda K, Moriguchi T, Watanabe A. Scarpa's adipofascial flap for repair of wide scalp defects. Ann Plast Surg 1996;36:88-92

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We report a successful replantation of an above-elbow amputated left arm in a 26-year-old female with a good, functional, longterm result. The patient was at 18 weeks estimated gestational age at the time of surgery. Major upper extremity replantation during pregnancy has not been previously described in the literature. Current operative and perioperative aspects, including considerations that favored microsurgical replantation in this unusual case, are discussed.Haws MJ, Erdmann D, Brown RE. Above-elbow arm replantation during pregnancy. Ann Plast Surg 1996;36:93-96

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Unilateral complete nasal stenosis is a rare condition and is usually acquired. The alar wing and nasal vestibule may be disturbed because of stenosis. We operated on 2 patients with complete nasal stenosis by using the H-flap technique described in this paper. Anterior nares are formed by this technique and, in one case, we used a cartilage graft for creating symmetry of the alar wings. Functional and aesthetic anterior nares are obtained by this technique.Bozdoĝan MN, Demir Z, Coşkunfirat OK, Velidedeoĝlu HV, Şahin Ü, Türkgüven Y. H-plasty: a new modification for correction of nasal stenosis. Ann Plast Surg 1996;36:97-100

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID