摘要:

Through a transfixion incision, a rhomboidal portion of both the depressor muscle of the nasal septum and the orbicular muscle of the mouth are excised. The remaining columellar tissues are brought nearer to each other by means of a mattress suture tied over a double-foam bolus.This simple procedure yields three advantages: (1) Tip projection, (2) nasolabial angle opening, (3) Interalar distance reduction, especially in the black population, avoiding the Weir-Joseph procedures.This simple and harmless procedure renders better results than the use of cartilage grafts or silicone implants aiming to project the tip or to open the nasolabial angle. Also, in some cases the patients' smile is enhanced.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A study of the volumes of the right and left breasts of 598 subjects was undertaken using biostereometric analysis. This measurement uses close-range stereophotogrammetry to characterize the shape of the breast, and is noncontact, noninvasive, accurate, and rapid with respect to the subject involvement time. Using chi-square tests, volumes and volumetric differences between breast pairs were compared with handedness, perception of breast size by each subject, age, and menstrual status. No significant relationship was found between the handedness, age, or menstrual status of the subject and the breast volume. Several groups of subjects were accurate in their perception of breast size difference. Analysis did confirm the generally accepted clinical impression of left-breast volume dominance. These results are shown to be consistent with those of a previous study using 248 women.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Over the last five years 10 patients in our practice have developed second- or third-degree burns following breast reconstruction. This has occurred in the reconstructed breasts of patients who have had tissue expansion, latissimus dorsi flaps, and transverse rectus abdominis musculocutaneous (TRAM) flaps. Second- or third-degree burns have also occurred on the abdomen following TRAM flap procedures. The lack of normal sensation in the surgical areas has been the common etiological factor. Aggressive wound care has led to primary and secondary healing in all patients without the need for skin grafts. Patient education preoperatively and postoperatively is necessary to prevent this potential complication.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

We review a 10-year experience with multiple microvascular transplants (MMTs) performed on 94 patients undergoing reconstruction of complex extremity and head and neck wounds. One hundred ninety-eight flaps were performed with an overall success rate of 95%. Patients were classified into two groups: Group I comprised 38 patients who received simultaneous MMTs (76 total flaps); two flaps were transplanted in the initial operative procedure. Group II consisted of 56 patients undergoing reconstruction with sequentially transplanted MMTs (122 total flaps). The success rates of the two groups were not statistically different (97% vs. 93.4%). Complications were similar in both groups, although sequential reconstruction of lower extremity wounds had a higher frequency of complications and flap failures than the simultaneous method. Patients receiving simultaneous MMTs required more emergent reexplorations, but salvage rates were high (87.5%), particularly in upper extremity reconstructions. We suggest that simultaneous MMTs are a reliable, cost-effective method of reconstructing complex injuries. They reduce patient morbidity by eliminating second hospitalizations and reoperations without increased complications or flap failure.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A new technique for mechanical end-to-side anastomoses using the UNILINK anastomotic system is presented. The technique, based on the concept of vessel wall eversion over paired ring pins, is described as is a new device for vessel expansion.To evaluate the technique of end-to-side anastomosis, we detached the left renal artery in 18 rabbits and then reanastomosed them end-to-side to the aorta using the UNILINK anastomotic system. Renal blood flow was evaluated before and after anastomoses with a laser Doppler flowmeter. Animals were separated into three groups of 6 and were killed at 24 hours, 2 weeks, and 16 weeks, respectively. To evaluate the acute effects of vessel expansion, 7 additional rabbits underwent expansion of the aorta without subsequent anastomosis. All vessels were evaluated with light and scanning electron microscopy. A patency rate of 100% was achieved in the 18 animals; histological changes at the anastomotic site were comparable to those described previously for this mechanical anastomotic system. The animal model demonstrates that it is both technically possible and efficacious to perform end-to-side anastomoses of arteries with the UNILINK anastomotic system.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A reliable, reproducible, simple examination of facial sensibility is described. Evaluation of 60 healthy subjects established normal values, trends, and variations of facial sensibility. Comparison of these normal values with 20 posttraumatic patients revealed that postfacial fracture sensibility testing was abnormal. Abnormalities in pressure threshold testing was most consistently associated with functional sensory complaints. Twelve of the 20 patients had significant sensory complaints at one year following the trauma.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The effect of time of vascular island skin flap elevation on tolerance to a subsequent 12-hour period of warm ischemia was studied. Sixty rats were separated into five equal groups; the rat epigastric island flap was used as the model.In group 1 flaps were elevated and immediately subjected to 12 hours of complete ischemia by application of microvascular clamps to both artery and vein of the pedicle. In group 2 the flap was elevated, and after 12 hours of recovery ischemia was induced for 12 hours. Groups 3 to 5 were similar to group 2 except that the time interval between initial elevation and subsequent ischemia varied: 24 hours for group 3; 72 hours for group 4; 144 hours for group 5.Necrosis was evaluated on postoperative day 7. Those flaps elevated 24 hours before ischemic insult (group 3) had significantly better survival than all other groups (p< 0.025 at least). There were no significant differences between the other groups.Flap elevation 24 hours before a complete ischemic episode significantly increased tolerance to ischemia. Elevating a flap earlier or later than 24 hours did not have any significant benefit.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Resection of cutaneous malignancies of the medial canthus and lower lid create challenging wound closure problems. The V—Y flap closure technique achieves wound closure using adjacent tissue while minimizing closure tension. Twenty-three patients underwent resection of basal cell carcinomas in these two anatomical regions. In 22 patients a single V—Y flap was used to close the defect. In 1 patient two flaps were used. There were 2 patients with transient ectropion. No tissue loss or other complications occurred.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A randomized, prospective, double-blind study designed to compare the effectiveness of the use of cloxacillin with the result of nontreatment in patients undergoing surgical intervention of axillary hyperhidrosis was conducted from August 1987 to October 1987 at the Veterans General Hospital, Taipei, Taiwan. Forty-two patients were enrolled in this study. Fifty wounds (25 patients) were control subjects, and 34 wounds (17 patients) received cloxacillin. The positive bacterial culture rates of the tissues and draining from patients in the treatment group compared with the control group was statistically significantly lower(p< 0.01). No significant differences presented in relation to age, sex, complication rate, fever index, and length of hospital stay. Prophylactic antibiotic is of no value in elective surgical intervention of axillary hyperhidrosis.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The application of the subcutaneous pedicle flap for perineal defects is presented. We recognize from clinical experience that the perineal area has a sufficient subcutaneous vascular network from internal and external pudendar arteries. We found that the subcutaneous pedicle flaps can be used safely in the perineal area the same as the facial area. The perineal defect that reaches to the vaginal orifice or anus needs to be reconstructed three dimensionally, not flat. The subcutaneous pedicle flap with vertical pedicle can produce natural shape and depth of the perineum.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID