摘要:

&NA;To determine whether women with cosmetic breast implants have distinct demographic, lifestyle, and reproductive characteristics that put them at increased risk for subsequent morbidity, the authors compared 1,369 such women to 2,211 women who had undergone breast reduction surgery, and to a random sample of 49,262 women from the general population of Sweden. Information was collected through self‐administered questionnaires, and comparisons were made using the prevalence odds ratio. Women with cosmetic breast implants were significantly (p<0.05) more likely to be current smokers, have a lower body mass index, have had a prematurely terminated pregnancy (induced abortion or miscarriage), and have had fewer live births than either women who underwent breast reduction or women from the general population. Type of implant (silicone gel or saline) did not modify the associations. Regardless of the comparison group used, studies of the health effects of breast implants need to consider that women who undergo cosmetic breast implantation have certain distinct characteristics.Fryzek JP, Weiderpass E, Signorello LB, Hakelius L, Lipworth L, Blot WJ, McLaughlin JK, Nyren O. Characteristics of women with cosmetic breast augmentation surgery compared with breast reduction surgery patients and women in the general population of sweden. Ann Plast Surg 2000;45: 349‐356

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;Many patients undergoing bilateral breast reduction surgery develop problems. Foremost among these problems is scar hypertrophy and its attendant symptoms. Although there is as yet no firm prognostic indicator for hypertrophy, scars that become hypertrophic often have a particular blood vessel pattern, observable by transcutaneous microscopy, showing vessels that lay transversely across the incision line with minimal crosslinks between them. Hypertrophic scars that develop in incision lines become wide, with the final width of the scar dependent on the maximum thickness during the growth stages before maturation and resolution. Close monitoring of scars forming in the incision line using the transcutaneous microscope detected this aligned vessel pattern before overt hypertrophy was seen. Use of the Pulsed Dye Laser caused disruption in the vessel pattern, appeared to inhibit additional hypertrophic development, and promoted early maturation of scars.Shakespeare PG, Tiernan E, Dewar AE, Hambleton J. Using the pulsed dye laser to influence scar formation after breast reduction surgery: a preliminary report. Ann Plast Surg 2000;45:357‐368

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;Superficial subdermal liposuction (SSL) was presented by the authors as an evolution in traditional liposuction in 1989. It allows one to treat the superficial fat to obtain better skin retraction during every liposuction procedure. The use of ultrasound (US) in liposuction began 10 years ago as the direct application of this energy to the adipose tissue using a probe to obtain the selective destruction of fat, followed by its aspiration. This technique gave rise to many complications and thus many concerns. The external delivery of US has been proposed to overcome some of the drawbacks associated with this procedure. The authors investigate the role of external ultrasound (EU) used in conjunction with SSL. When comparing EU and SSL with SSL alone, pretreatment with EU results in less bleeding during liposuction, aspirated fat that is clearer and more oily, and less bruising and swelling during the early postoperative period. EU is an ideal complementary procedure to SSL because the crumbling of the fat induced by US permits a more uniform aspiration of the subdermal fat layer, making skin retraction more even and effective.Gasperoni C, Salgerello M. The use of external ultrasound combined with superficial subdermal liposuction. Ann Plast Surg 2000;45:369‐373

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;Piercing has become a widespread fashion trend in Western industrialized nations within recent years. The invasive application of ornaments through cutaneous and mucosal surfaces enables the penetration of various pathogens into subcutaneous tissue. The authors describe the hazards of piercing and facial body art as they apply to 3 patients. Perichondrial auricular abscess, granulomatous perichondritis of the nasal ala, and embedding of a stud in the lower lip were the respective diagnoses. Literature was reviewed for the cultural origins and current practices of piercing, the legal background of piercing as a business, typical medical complications, and treatment recommendations. Numerous communications have been published on medical complications of piercing. The patients presented and the review of the literature illustrate that piercing is not a harmless fashion and that regulations of piercing as a business seem desirable to prevent further complications.Folz BJ, Lippert BM, Kuelkens C, Werner JA. Hazards of piercing and facial body art: a report of three cases and literature review. Ann Plast Surg 2000;45:374‐381

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;Elevation of the temporoparietal fascial flap by conventional T or Y incisions in the temporal region frequently leaves conspicuous scarring, hair thinning, or baldness. To avoid such undesirable effects, endoscopic‐assisted harvest of the temporoparietal fascial flap was performed in 9 patients with microtia. Through two horizontal incisions in the temporal region, the temporoparietal fascia was dissected, and the flap was harvested using bipolar scissors and coagulating shears. Flaps were dissected and harvested successfully without any complications in 7 patients, although extra incisions were required to facilitate coagulation in 2 patients. The authors introduce this harvesting technique and describe some representative cases. Using endoscopic guidance, this is a versatile, safe procedure with minimal morbidity, and is applicable to other reconstructive procedures that require a temporoparietal fascial flap, including the free flap.Takushima A, Asato H, Harii K. Endoscopic‐assisted harvest of the temporoparietal fascial flap. Ann Plast Surg 2000;45:382‐385

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;During hemifacial microsomia (HMF), an important phase of the treatment is elongation of the hypoplastic mandible, mainly the ramus, at an early stage. Twenty‐two patients with HFM were treated with distraction osteogenesis: 12 with an extraoral device (10 unidirectional and 2 multidirectional) and 10 with an intraoral device. The mean elongation with the extraoral device was 21 mm, and with the intraoral device was 17 mm, resulting in a more symmetrical facial appearance. The advantages and disadvantages of both methods are presented, based on the authors' experience and a review of the literature. The extraoral device permits elongation of a greater distance, enables extraoral control of the vector of elongation, and conserves the gonial angle by working in many directions. The main disadvantages of the extraoral device are the social inconvenience to the patient and the extraoral cutaneous scars. Conversely, the intraoral device is much more socially convenient to the patient and avoids residual scarring. However, in 2 patients treated with an intraoral device, an undesired contralateral open bite appeared as a result of reduced vector control. The intraoral method should always be considered first because of its previously mentioned advantages. However, in severely hypoplastic patients, when three‐dimensional correction and gonial angle control are necessary, or when there is a limited space along the planned distracted bone, the extraoral device has an advantage over the intraoral device.Rachmiel A, Aizenbud D, Eleftheriou S, Peled M, Laufer D. Extraoral vs. intraoral distraction osteogenesis in the treatment of hemifacial microsomia. Ann Plast Surg 2000;45:386‐394

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;In select cases, to prevent any functional loss and to initiate early function during the early burn period, the reconstructive procedure of choice may be flap coverage. In these circumstances, when the ideal flap donor site is burned, the clinician may be hesitant to raise this flap because of questionable flap survival. The authors conducted this study to determine whether a superficially or deeply burned skin island flap would survive when elevated during the early postburn period. If these flaps are usable, they could expand the options available for burn wound coverage. They used a rat epigastric island flap model, and divided 50 study animals into two groups. In group 1 (N = 25), the right epigastric flap site was burned superficially and the left side was left uninjured. Island flaps were raised on both sides 4 days after the burn injury. The flaps were then sutured back into their original sites, and were evaluated 5 days after the surgery. In group 2 (N = 25), the right epigastric flap site was burned deeply and the left side was left uninjured. Island flaps were raised 4 days after the burn injury on both sides, as in group 1. The flaps were then sutured back into place and were evaluated 5 days after the surgery. All of the control flaps on the rats' left sides survived in both groups. In addition, all the superficially burned flaps survived in group 1 (100%), and 21 of the deeply burned flaps survived in group 2 (84%). There was no significant difference between superficially and deeply burned flaps with regard to survival, and the burned flaps were as successful as the unburned control flaps in both groups (p= 0.11). Skin island flaps elevated after superficial or deep burn injury are reliable in this animal model.Borman H, Maral T, Demirhan B, Haberal M. Reliability of island flaps raised after superficial and deep burn injury. Ann Plast Surg 2000;45: 395‐398

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;The musculocutaneous tensor fascia lata (TFL) flap provides a small muscle belly and a strong fascial layer in combination with abundant skin coverage (15 × 40 cm), which makes the flap an attractive unit for composite free tissue transfer. The free TFL flap was used in nine cases of recurrent cancer of the chest wall (N = 7) and the abdominal wall (N = 2). The mean size of the full‐thickness defects after tumor excision measured 12 × 25 cm. The operating time ranged from 4 to 8 hours (mean operating time, 5.5 hours). The operation was performed with two teams, and no repositioning of the patient was necessary during the operation. By raising the TFL flap, no additional area of the trunk was involved. The authors did not experience a prolonged ventilation time in their group of multimorbid patients. The donor site was closed directly (4 of 9 patients) or split skin grafted (5 of 9 patients). There was no functional deficit. In one patient the venous anastomosis had to be revised. There were no further complications, and no flaps were lost. The hospital stay was short (21 days on average), the outcome successful, and primary healing was obtained. The free TFL flap proved to be a reliable flap that is easy technically to harvest. Thus the free TFL flap is a valuable backup procedure in tumor surgery.Heitmann C, Pelzer M, Menke H, Germann G. The free musculocutaneous tensor fascia lata flap as a backup procedure in tumor surgery. Ann Plast Surg 2000;45:399‐404

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;To investigate the potential utility of a suprascapular flap, the authors examined dissected cadavers to identify the ramification of the suprascapular artery, and directly injected 2.5% patent blue dye to observe the distribution of its cutaneous perforators. Results indicate that a suprascapular flap is not practicable. The branching pattern of the suprascapular artery from the subclavian artery varies widely, making dissection of the vessels highly problematic. Moreover, no constant presence of cutaneous perforators from the artery could be identified in either the suprascapular fossa or the shoulder.Kitazawa T, Matsuo K, Moriizumi T, Hataya Y. An anatomic examination of the suprascapular flap. Ann Plast Surg 2000;45:405‐407

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;Metabolism and remodeling of bony tissue are maintained and controlled by blood supply. In this study, bony tissue osteoinduced heterotopically by recombinant human bone morphogenetic protein‐2 (rhBMP‐2) in rat muscles with different amounts of blood supply was investigated. The implant beds were in the latissimus dorsi muscle (LDM) and in the space wrapped with an elevated latissimus dorsi muscle flap (LDMF). The blood flow was preestimated at two muscle sites using a laser Doppler blood flowmeter. The flow value of the LDM was 2.23 ± 0.17 ml/min/100 g (mean ± standard deviation). The flow values of the LDMF were 1.71 ± 0.22 ml/min/100 g 30 minutes after elevating the LDMF, 1.75 ± 0.20 ml/min/100 g after 1 week, 1.83 ± 0.19 ml/min/100 g after 2 weeks, and 1.99 ± 0.18 ml/min/100 g after 3 weeks. Bony tissues induced heterotopically by rhBMP‐2 were examined radiographically and histologically. On radiographs, radiopaque shadows in the LDM were almost as large as those in the LDMF. The radiopacity in the LDM was a little higher than that of the LDMF. The microscopic findings showed increased trabeculae and more hematopoietic marrow in the LDM than lamellalike bone in the LDMF. Mean bony area in the implant was 1.05 ± 0.26 mm2in the LDM, and was 0.70 ± 0.11 mm2in the LDMF. Bony proportions in the overall implant area were 18.3 ± 3.46% in the LDF and 12.1 ± 2.18% in the LDMF. The current study indicates that blood supply is an important factor for promoting heterotopic osteoinduction by rhBMP‐2 to produce massive bony tissue as an endogenous method of tissue engineering.Kusumoto K, Bessho K, Fujimura K, Akioka J, Okubo Y, Ogawa Y, lizuka T. The effect of blood supply in muscle and an elevated muscle flap on endogenous tissue‐engineered bone by rhBMP‐2 in the rat. Ann Plast Surg 2000;45:408‐414

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID