摘要:

There is a highly dependable free flap donor site of moderate size on the posterolateral aspect of the distal upper arm. The area is supplied by the posterior radial collateral artery, a direct continuation of the profunda brachii. The flap area is supplied by a direct cutaneous nerve. It can be raised on its own, with underlying tendon, with bone, or with fascia only. This article describes our findings in 32 cadaver dissections and in 23 clinical cases.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Successful repair of 8 large meningomyeloceles is reported. Because these defects varied in size, shape, and location, no single procedure applied to all. Advancement flaps and both vertical and horizontal bipedicle flaps were used successfully. The latissimus dorsi and gluteus maximus muscles have been used as paired flaps. All four muscles can be mobilized simultaneously. Muscle flaps are preferable to skin flaps when feasible. The sac remnant is also available to contribute to closure when all else fails. Embryology and pathological anatomy are reviewed.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Both the function and appearance of thick split-thickness plantar skin grafts to resurface palmar skin defects are examined in this retrospective study. If defects in the hand are covered by grafts from hair-bearing donor sites, these grafts will show increased pigmentation and contrast clearly with the surrounding skin, particularly in the case of patients with heavy skin pigmentation. To avoid this pigmentation, we have used the thick split-thickness skin grafts taken from the plantar region of the foot. The most important aspect of the method is the removal of split-thickness skin with a thick dermal layer. Since 1975, we have used this method in 64 patients and conducted follow-ups on 41 of them. The results of follow-ups indicate that this method is quite successful and useful, especially in patients with dark skin. In general, there was no excessive pigmentation of the grafted skin; color and texture of grafted skin matched the surrounding skin; function recovery is good owing to similar skin structure; thick split-thickness skin with a thick dermal layer prevents contracture of grafted skin; grafted skin withstands trauma; donor site need not be grafted; and the scar at the donor sites is hidden and produced no morbidity. It must be noted, however, that one-third of all patients were lost to follow-up, and the results in these patients are not known.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Sixty-two patients with cleft lip and palate or cleft palate were randomly assigned an operative technique for primary palatorrhaphy: V-Y pushback, Langenbeck, or Langenbeck with pharyngeal flap. Early speech results were evaluated in 52 patients. There were no differences among the treatment groups in late complications, hearing, middle ear disease, velopharyngeal competence, or need for speech therapy, speech bulbs, or secondary pharyngeal flaps. As previously reported, the in-hospital morbidity in these patients was greater with V-Y pushback (more blood transfusions) and Langenbeck plus pharyngeal flap (more upper airway obstruction) palatorrhaphies than with the Langenbeck procedure. The addition of a pharyngeal flap to primary palatorrhaphy seems unnecessary in at least 75% of patients. Therefore, we currently recommend the Langenbeck palatorrhaphy for primary cleft palate repair, although further longitudinal studies of these patients are needed to assess later speech results and maxillary growth.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

In burn patients normal wound healing contraction may lead to contracture deformity requiring secondary reconstruction. Full-thickness skin grafts are observed to inhibit both contraction and myofibroblasts by an unknown mechanism. The temporary synthetic skin substitute Biobrane has become an acceptable alternative to cadaver allografts for many burn and reconstruction wounds. We have postulated that this synthetic membrane might also share the ability to inhibit wound contraction. By comparing open and Biobrane closed wounds in 20 rats, we have demonstrated a significant (p < 0.005) difference in wound size during the time that the Biobrane is adherent to the wound. Linear regression curves are used to express the rate of contraction and demonstrate a threefold decrease. Alternative mechanisms for this inhibition are postulated, including mechanical stenting versus direct inhibition of contractile myofibroblasts.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A controlled experimental study of microvascular surgery in rabbits showed that arteries can tolerate dryness for at least 5 hours and veins can tolerate dryness for at least 2 hours. In clinical free-tissue transfer, therefore, drying of the vessel during the usual process of anastomosis is not a major concern.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Benign hypertrophy of the masseter muscle is an uncommon entity important in the differential diagnosis of head and neck masses, particularly a unilateral mass located in the cheek. Ten cases of benign masseteric hypertrophy are reviewed, current surgical treatment is described, and the pertinent literature is summarized.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The medial head of the gastrocnemius flap is a large, versatile flap that can be used to cover areas above the popliteal fossa, thereby minimizing the necessity for amputation in many traumatic injuries to this area. By advancing the medial head of the gastrocnemius muscle and rotating it on the neurovascular pedicle of the medial sural vessels, we have covered a 17 cm × 20 cm defect of crushed muscle, tendon, and bone in a leg that was traumatically amputated proximal to the knee. This procedure makes possible muscular coverage for bone, stainless steel plate, and reanastomosed arteries and veins above the knee and provides skin coverage extending to 70% of the circumference of the popliteal fossa. Autografting provides coverage for the remainder of the wound. Subsequent extension and flexion of the viable knee joint was achieved.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Degloving injuries of the external nose are severe soft tissue avulsions requiring meticulous repair to prevent airway embarrassment and to provide the best aesthetic result. Usually the underlying nasal scaffolding remains intact, but associated facial fractures or other facial injuries are common and must not be overlooked. Two representative cases are reported to provide an overview of the salient features in the pathogenesis of injury and to reiterate the proper approach for treatment.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

An unusual case of multiple chondrosarcomas of the hand arising from multiple enchondromas is presented. Chondrosarcoma is an unusual tumor of the hand that requires careful clinical, radiological, and pathological examination for accurate diagnosis. These tumors can usually be managed successfully by wide local excision or ray amputation. However, long follow-up is indicated.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID