摘要:

There is a need in plastic and reconstructive surgery for a method of monitoring flaps and replants pre- and postoperatively. This study evaluates color flow Doppler done as a monitoring technique for microvascular vessels. The capability of color flow ultrasound to monitor venous and arterial insufficiency and occlusion was studied by means of an experimental system in the Yucatan miniature swine model. A circulatory circuit in line with a magnetic flow probe is created. Measurements are made on the isolated hind limb of the animal. Color flow ultrasound is demonstrated to be a technique that is sensitive to venous and arterial insufficiency at flow rates as low as 3.0 ml/min. Characteristic waveform patterns are shown to predict arterial and venous insufficiency before they actually progress to occlusion. A clinical series of 25 postoperative patients is presented, consisting of volunteer studies as well as pre- and postoperative examinations of free flaps and replantations. Color flow ultrasound is shown to visualize a spectrum of pre- and postoperative microvascular conduits encountered in plastic and reconstructive surgery.

ISSN:0148-7043    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Three-dimensional computed tomographic scan images of facial deformities provide information that has been useful in planning and evaluating therapy. However, the benefits of computed tomographic imaging in cosmetic plastic surgery are often insufficient to justify exposing the patient to radiation. This report describes application of an optical, noncontact, threedimensional surface digitizer with subsecond scanning time for 360-degree examination of the human head. The resultant threedimensional surface data are suitable for computer graphics display and manipulation, and for noncontact skin surface measurement. The scanner provides accurate and complete coverage of complex facial surfaces. This system was applied to digitization of the human head in the planning and evaluation of facial plastic surgery. The results indicate that the resulting image is accurate enough to detect subtle dimensional changes resulting from surgery, including postoperative edema and surface changes due to face-lift. This type of scanning can assist in a number of tasks performed by plastic surgeons, including collecting anthropomorphic measurements, preoperative and postoperative assessment, volume monitoring, customizing of implants, and interactive planning.

ISSN:0148-7043    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A study was designed to determine how soon an athlete who undergoes rigid fixation of a facial fracture can return to full competition. The impact resistance of a rigidly fixated malar complex fracture was studied and compared with that of an intact malar complex. Twelve fresh human cadaver heads were used. A custom-designed impact device was used to deliver a blow of a specific energy to each intact malar complex. The subsequent fractures were rigidly fixated at three points using titanium miniplates and screws. A second impact of identical energy was delivered. The forces generated and the subsequent displacement of hard and soft tissues were recorded after each impact. It was concluded from this study that an impact to a rigidly fixated malar complex fracture produced less force and greater displacement of hard and soft tissues than an impact of identical energy to an intact malar complex. The potential for sustaining more severe maxillofacial injuries after an initial facial fracture should be seriously considered. The results suggest that sufficient time should be allowed for the bony healing of a facial fracture to occur, even after rigid fixation, before an athlete can resume full contact activities.

ISSN:0148-7043    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Breast reconstruction has been performed using neighboring skin flaps and more recently by using myocutaneous flaps. Nowadays, more conservative techniques have been proposed. Quadrantectomy combined with chemotherapy and radiotherapy offers similar survival time after treatment when compared with a more radical procedure. Techniques used by plastic surgeons for partial or total breast reconstruction have become inadequate for patients with mild breast resections. In effect, surgeons have been qualified for extensive resections, but not for small reconstructions. Lesions left after quadrantectomy become, in many situations, a difficult problem to solve aesthetically, due to the positioning of the defect in different quadrants. I describe here a new procedure that uses a breast tissue flap with its pedicle on the costal cage. Breast island flaps, also called “plug flaps,” were created specifically after quadrantectomy or other types of partial breast resection, for an easier reconstruction. The anatomical basis of breast island flaps was studied in cadavers. The surgical technique and results are described and illustrated in clinical cases.

ISSN:0148-7043    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Transposition of frontalis muscle to the tarsus is an effective technique for correction of blepharoptosis with poor levator function. This is refined by division of the frontalis muscle flap into three strips, which are sutured separately to the upper tarsal border. Thirty-six patients with blepharoptosis (54 eyelids) had tripartite frontalis muscle flap procedures. The ptosis was congenital in 33 patients. Forty-eight eyelids had poor levator function. Six had fair levator function. The frontalis action ranged from 8 to 14 mm. The average of follow-up evaluation was 32 months. The postoperative results were evaluated by Berke's criteria, various sensation tests of the forehead, and presence of forehead wrinkles. The tripartite frontalis muscle flap provided an even distribution of upward pull on the tarsus without tenting the lid margin. Ptosis on superior and primary gaze, an intrinsic complication of maximal levator resection or frontalis suspension, was not observed after this procedure. Lagophthalmos was transitory, usually disappearing within 3 months. Lid lag was mild-to-moderate. Mild hypesthesia of the forehead returned completely to normal in all patients, followed more than 24 months. Slight lowering of the medial portion of the eyebrow and incomplete wrinkling of the forehead on upward gaze were mild cosmetic defects after correction in 4 patients with unilateral ptosis. The tripartite frontalis flap technique is recommended for patients with bilateral congenital ptosis and fair-to-poor levator function, and for unilateral ptosis, if either contralateral brow lift or bilateral frontalis transposition is appropriate.

ISSN:0148-7043    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

In this study the effectiveness of a single-passage perfusion with hypertonic citrate solution on the cold ischemia tolerance in epigastric free flaps in Dark-Agouty rats was investigated. In the control group a significant decline in survival percentage was observed when the storage time was extended from 72 hours to 96 hours. A single (pressure controlled) passage perfusion with hypertonic citrate solution was able to prevent this decline.

ISSN:0148-7043    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Minimizing the morbidity of in utero surgery or, perhaps more important, capturing the unique characteristics of scarless remodeling, as is the fetal response to injury, demands better elucidation of the observed variations from adults in whom the normal progression of wound healing leads to fibrosis. Species-dependent fetal phlogistic responses and wound scar formation represent a temporal continuum before the onset of adult patterns. We have analyzed skin collagen synthesis and content in Sprague-Dawley rats as one possible factor in this evolution showing that the fetal characteristics of a high percentage of type III collagen relative to type I and low total collagen content are maintained as long as the first 10 to 15 days postpartum. Although extrapolation of such a crucial “golden period” to justify the delay of human surgical procedures while still capturing the benefits of the fetal milieu remains speculative, anecdotal observations of minimal scar formation lend some credibility for performing less invasive maneuvers in the neonate.

ISSN:0148-7043    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Angiogenesis was examined by a three-dimensional model in vitro, using human umbilical vein endothelial cells (HUVECs) cultured in a collagen gel. An abundant capillary-like network with a lumen structure was identified histologically and shown to have formed at a collagen density of 0.05% or 0.10% instead of 0.15%, for either type I or type III collagen. At the same density, type III collagen induced a capillary-like network with HUVECs at an earlier stage of culture than type I collagen. In a two-dimensional culture, HUVECs were viable and proliferated to a great extent on the culture dish coated with collagen. This was particularly so in the case of type III collagen at lower density (5 ng/cm2). Type III collagen at a sufficiently low density is thus shown useful for studying angiogenesis in vitro. The capillary-like network that formed in the three-dimensional culture appeared somewhat labile, but became stable with the continuous addition of endothelial cell growth supplement and increase in the plating number of HUVECs.

ISSN:0148-7043    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Congenital cutis laxa is a deforming disease that may present for plastic surgical consultation during childhood. Failure to differentiate cutis laxa, with near normal wound healing, from the other forms of hyperelasticity syndromes with poor wound healing, has historically led to conflicting recommendations regarding the surgical management of patients presenting with loose skin. A face-lift and direct nasolabial fold excision was performed in a 10-year old patient with congenital cutis laxa with a good result. The other major syndromes presenting with loose skin as a clinical feature are reviewed and distinguished from cutis laxa. Plastic surgical procedures can be aesthetically and psychologically beneficial in children with congenital cutis laxa, and can be recommended without overt fear of wound disruption, poor scarring, and medical catastrophies that can occur with other hyperelasticity syndromes.

ISSN:0148-7043    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We report the successful surgical treatment of a 24-year-old male with an aggressive metastasized eccrine poroma. The primary lesion was on the left plantar surface and resembled a pyogenic granuloma. Two months after we excised this lesion, the patient presented with a mass on the left groin, apparently a metastatic occurrence related to the tumor. We performed a radical lymph node dissection with no adjunctive treatment. Five years later, the patient is apparently free of any related disease.

ISSN:0148-7043    

出版商:OVID    

年代:1993

数据来源: OVID