摘要:

Cranioplasty using a synthetic material is less than ideal, especially if there is a history of infection at the defect site. Split-rib cranioplasty is a practical approach even in patients with a positive history of infection at or around the defect. We briefly review the historical background of split-rib cranioplasty and report our experience with this procedure in 12 patients. Forty-two pieces of rib, with an average length of 13 cm, were used for reconstruction. We had only 1 complication—a pneumothorax following removal of the rib graft. The follow-up period ranged from three to thirty-six months. All patients had complete regeneration of the donor rib and solid protection of the brain.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

This review emphasizes two of the difficult problems associated with electrical injury to the hand and forearm. Early wound closure to preserve important vascular, nerve, and tendon structures in the hand must be considered, recognizing the tendency for continued necrosis of tissue in this type of injury. Tissue fibrosis, even in areas of the hand not grossly injured, may develop, progressively compromising function. Five patients are presented to illustrate the early care and rehabilitation of these patients.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The preparation of human amniotic membrane obtained from cesarean delivery placentas for use in the treatment of acutely burned pediatric patients is presented. The technique of membrane harvesting and cleansing, bacteriological monitoring during various phases of preparation, and a method of ultracold long-term banking are described. A total of 187 membranes were stripped under aseptic conditions, cultured, treated in 0.025% sodium hypochlorite (NaOCl) for one minute and recultured. Fourteen organisms were recovered prior to NaOCl treatment, and only 8 organisms after treatment. Amnions that grew any organism after hypochlorite treatment (23%) were deemed unsuitable for clinical use. Clinical experience with amniotic membranes in 36 acutely burned patients suggests that amnion is a cost-effective biological dressing, acceptable as an immediate dressing on superficial second-degree burns. It is also acceptable as an adjunct to meshed autograft over fascia, and as a temporary covering on recently excised wounds prior to autografting.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Since few comprehensive statistics on results of rhinoplasties have been published since Klabunde and Falces' article [1] in 1964, a retrospective study of 200 consecutive patients was undertaken. These patients underwent rhinoplasty by a single surgeon and were followed for a minimum of six months. A separate reviewer studied patient satisfaction, physician satisfaction, rate of revision, and type of complications, including obstruction of airway, nasal deformity, hematoma, infection, hemorrhage, and psychological reactions. The incidence of infection, hemorrhage, and revisions has lessened in the past fifteen years.Patients not referred by a physician were more than twice as likely to be dissatisfied as those who were physicianreferred (p < 0.005). A higher percentage of female patients was dissatisfied than of male patients (p < 0.05). The incidence of dissatisfaction increased significantly among patients in their fifth decade as compared with that in younger patients (p < 0.01). No statistically significant difference was found in the incidence of dissatisfaction among single, married, widowed, or divorced patients.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The author's experience with Oriental blepharoplasty, comprising 5,000 operations in twelve years, is shared.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Reconstruction of the ankle, heel, and foot remains a challenging, often frustrating problem for surgeon and patient alike. Little local soft tissue is available for the reconstruction, and often the underlying disorder precludes use of some procedures. The ankle and the heel are vital musculoskeletal structures, responsible for shock absorption, weight-bearing, and locomotion, and their dysfunction inflicts discomfort and disability on the individual that commonly lasts many months or even over a year. Soft tissue defects on the weight-bearing versus the non-weight-bearing surfaces present two quite different problems.Many surgical modalities, beginning with a skin graft and ending with microvascular transplantation of sensile tissues, are now available to the reconstructive surgeon for resurfacing the sole of the foot. We present a classification of heel ulcers based on their etiology, location, size, and the status of the peripheral circulation; offer new operative modalities and update the operations already available; and suggest an orderly approach to selecting an operation for reconstructing the foot.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

We present a seven-year follow-up of a previously published case of 4-finger replantation in one hand. Replantation of the digits proved justified, yielding favorable results in sensory return, motor function, and appearance.We note that finger replantations distal to the proximal interphalangeal joint are associated with better functional results than those at more proximal levels. Impaired motion of the distal interphalangeal joint does not appreciably restrict the function of the hand, provided adequate range of active movement is preserved at the metacarpophalangeal and proximal interphalangeal joints. An uninjured proximal interphalangeal joint is critical in achieving favorable motor return after finger replantation. Technical excellence in digital nerve repair contributes to favorable sensory axonal regrowth. Digital replantation distal to the proximal interphalangeal joint may be viewed as primary microneurovascular reconstruction of a problem finger amputation stump. We believe, in the case of sharp amputation distal to an intact proximal interphalangeal joint, that single-digit replantation is indicated, given the likelihood of favorable functional and aesthetic results.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A patient with severe postreplantation lymphedema, successfully treated with an axillary pattern flap, is presented.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The Iconoclast is an instrument that facilitates blunt dissection in areas where this basic technique is difficult because of anatomical or postsurgical adherence. Medial and inferior undermining in augmentation mammaplasty in primary and revisional cases is described. The instrument capitalizes on the gripping rather than the spreading strength of the surgeon's hand, allows easy penetration of tissues to be spread apart, and diminishes severance of blood vessels. We have used the Iconoclast for almost two years in selected cases and have had no problems or complications attributable to it.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID