摘要:

The latissimus dorsi myocutaneous flap has proved valuable in breast reconstruction after radical mastectomy. The procedure has been used often and successfully at the Breast Reconstruction Center of Memorial Sloan-Kettering Cancer Center.Since the axis of the mastectomy scar often varies, we have found that adjusting the orientation and location of the skin islands is necessary to achieve maximal coverage on the chest wall and to place the transposed skin without tension precisely where it is most needed. These different skin island designs may necessitate a scar on the back that is not covered by a brassiere. This paper discusses and illustrates with clinical examples modifications that produce superior reconstructive results.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The mechanical properties of inflatable and gel-filled breast prostheses were evaluated using the Instron Universal Testing Machine. Prosthesis strength characteristics were evaluated in terms of compression strength (rather than tensile strength) because of the relationship to closed capsulotomy. The compression breaking strength of prostheses ranged from 0.62 to 10.8 pounds per square inch. There was considerable variation among prostheses. Pressures exceeding these values have been recorded during closed compression capsulotomy. The clinical relevance of these results is discussed.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Our study of experimental contracture in rats confirms the existence in laboratory animals of a phenomenon very much like human capsule contracture. The ultrastructural features of capsules in rats are essentially identical to those for humans and rabbits. Macrophages with siliconcontaining material were present. Star-shaped myofibroblasts with extended processes appeared in contracted and noncontracted capsules. The myofibroblasts contained bundles of 60 to 80 Å microfllaments with included dense bodies, convoluted nuclei, and extensive peripheral vesiculation. The myofibroblasts tended to be associated with more extensive ground substance and smaller diameter extracellular fibrils than were normal synthetic fibroblasts. The incidence of contracture was similar for implants beneath different amounts of overlying soft tissue dorsally and sternally, while compressibility and subjective softness were greater for implants beneath lesser amounts of overlying tissue. A greater mass of capsule formed beneath the heavier covering, however, suggesting that in clinical experience, cosmetically more acceptable results from submuscular prosthesis placement are probably due to a padding effect. Capsule glycosaminoglycans were primarily hyaluronic acid and dermatan sulfate. The occurrence of myofibroblasts in these capsules at a relatively late period (26 weeks) implicates myofibroblasts in the contracture mechanism, but details are still unknown. Contracture is a property of the capsule tissue; preliminary observations suggest that its occurrence is independent of species, anatomical site, surgical procedure, presence of extruded gel, presence of myofibroblasts, capsule thickness, or protein, collagen, or glycosarninoglycan composition. Cells within the capsule were geometrically asymmetrical, being extremely flattened in the plane parallel to the prosthesis surface.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The inframammary incision often used for subcutaneous mastectomy provides somewhat limited exposure and often less than optimal aesthetic results, especially if the patient has ptosis preoperatively. This paper describes a technique for subcutaneous mastectomy that involves a straightforward marking system, provides excellent exposure, and produces satisfactory aesthetic results. This technique can be applied to most cases in which subcutaneous mastectomy is indicated.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A new bilobed cutaneous and myocutaneous flap providing ipsilateral reconstruction possibilities in the head and neck is described. The flap incorporates the pectoralis major myocutaneous flap and the medially based deltopectoral flap in a single bilobed flap. Both flaps come from the same side to provide bulk and cutaneous coverage in a single flap.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The nasolabial flap was used for reconstruction of the nose, lip, and cheek in 23 patients with satisfactory results. From the standpoint of color and texture match, this flap was of considerable value for skin repair of the nose. As for the donor site, the limitation of the nasolabial flap is considered to be about 3 × 10 cm. The nasolabial flap is also discussed from the point of view of recent considerations on its special characteristics and applications.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A technique is described that employs local anesthesia in the reduction of fractured zygomatic arches. Its advantages are that the patient can easily be treated on an outpatient basis and the risks of general anesthesia are eliminated.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Thrombosis in clinical microvascular anastomoses is attributed to suture errors and utilization of severely damaged recipient arteries. Histopathological specimens from 24 microvascular anastomoses and 77 vessel biopsies from free tissue transfers and replantation cases were analyzed. Suture errors of any note were rare and occurred primarily in replantation cases in which team experience varied and fatigue was common. Recipient artery damage ranged from minimal to severe; clinical analysis confirmed the devastating effect of refractory spasm associated with intramural scarring from previous trauma. Additional studies by microvascular groups are needed to clarify the causes of thrombosis and the healing mechanism of microvascular anastomosis.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A reproducible, quantitative approach for measuring skin removed during face lifting is presented. The approach consists of measuring skin at four distinct points. These measurements are statistically analyzed and compared with seventeen patient variables. The approach is applicable to all varieties and techniques of face lifting. This method of quantification could serve as a standard means of defining the extent of face lifting, for use not only in operative reports but also in the literature.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Choline acetyltransferase (ChAC) measurement after complete transection of the sciatic nerve in rats revealed a steady increase in ChAC in the proximal nerve stump and a rapid drop in ChAC in the distal nerve stump. Ninety-six hours following transection no appreciable ChAC activity could be detected in the distal segment. The increase in the proximal segments was followed by a slight decline and leveling off at about twice the normal level. End-to-end nerve anastomosis, using the enzymatic nerve differentiation technique, could therefore be performed up to the first 96 hours. Nerve grafts could be used, with markedly improved results, up to the forty-fifth day following transection.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID