摘要:

Seventeen free flaps were used to reconstruct severe injuries to the foot over the last 36 months at the University of Cincinnati College of Medicine. The type of free flaps used included six fasciocutaneous free flaps and eleven free muscle flaps with split-thickness skin grafts. The fasciocutaneous flaps were either radial forearm or scapular flaps. The muscle flaps used were gracilis, rectus, or latissimus dorsi muscle flaps. Each type, with their specific advantages, disadvantages, and indications for use as they apply to the anatomical areas of the foot, are described. Regardless of the type of free flap used, careful preoperative planning, attention to the size and location of the anatomical defect, and correct contouring and insetting should allow for maximal functional result and minimize postoperative morbidity.

ISSN:0148-7043    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In this article I present a nonmicrosurgical technique for transferring the radial forearm flap for reconstruction of defects in the head and neck. The technique is described briefly and experience with 7 patients is presented. The advantages of this method are discussed.

ISSN:0148-7043    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Five cases of partial eyebrow reconstruction using subcutaneous pedicle flaps from the ipsilateral eyebrow are presented. Proper use of this method will enable safe one-stage transfer of the skin and the eyebrow hair, preserving the natural hair direction and properties. It will also leave minimal scars and dog-ears. This method is especially suitable for the reconstruction of moderate- to small-sized eyebrow defects.

ISSN:0148-7043    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Although combined suction-assisted lipectomy (SAL) and surgical abdominoplasties have been described, the surgical excisions have in general been small and limited to the lower portion of the lower abdomen (i.e., just above the pubis). For the obese patient this is an insufficient lipectomy. SAL alone is unsatisfactory because the marked skin excess will not shrink sufficiently to allow a desired final result. Surgical abdominoplasty alone is also insufficient in the obese patient because the thickness of the abdominal panniculus is not reduced and, additionally, secondary to tissue tension with wound closure, some necrosis of skin above the pubis is not unusual. In this article results are described from a small consecutive series of obese patients treated with a combined extensive SAL, surgical lipectomy, and surgical abdominoplasty. The sequence of fat removal is different than that which has been previously described. In all of the patients the results were pleasing, and there were only two relatively minor complications.

ISSN:0148-7043    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Adherence of bacteria to prosthetic grafting material is thought to play an important role in the ultimate development of prosthetic infections. To evaluate the role of bacterial adherence in the initiation and colonization of prosthetic materials, Proplast II, Gore-Tex, and silicone were evaluated for adherence of Escherichia coli and Staphylococcus aureus. Bacteria were radio labeled and incubated with the study material. Adherence was determined by scintillation. Adherence to Proplast II and Gore-Tex reached a maximum at approximately 45 minutes of incubation and demonstrated a detachment phenomenon with E. coli. Similar results were noted with S. aureus, but with a maximal attachment at approximately 30 minutes. Interestingly, bacterial attachment to silicone continued to increase throughout the time of the incubation. In addition, adherence of S. aureus was at a faster rate than E. coli.Attachment of bacteria is a multifactorial process. However, the PTFE graft demonstrates a slower rate of attachment, lower total number of attached bacteria, and faster detachment. The importance of this phenomenon may help explain the foreign body effect of increased susceptibility to infection of foreign materials.

ISSN:0148-7043    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

After enucleation, a spherical implant of some material is placed into the muscle cone to give bulk to the orbital socket area. This also allows better movement of the artificial eye prosthesis, which is placed in the socket to give the appearance of a normal eye. If there is loss of the spherical implant because of infection or extrusion for other reasons, there is a resulting enophthalmos of the prosthetic eye. Replacement of this spherical implant with another implant of alloplastic material often results in secondary extrusion. In other cases, there is downward displacement of the spherical implant with pressure against the prosthesis and lower lid. This causes undue stretching of the lower fornix and lid area with inability to hold the prosthesis in place. To correct these two problems, we have found that an autogenous cartilage graft is useful for an implant that will not extrude and that holds its position. Examples of this technique and preoperative and postoperative cases are described here. We have used this technique over the past 11 years and have achieved good success in 15 patients.

ISSN:0148-7043    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The ulnar arterial circulation to bilateral hands of 683 men and 787 women was assessed with the Allen radial artery compression test. Of the 2,940 arms, the Allen test showed abnormalities in 105 (3.6%). The incidence of abnormality generally increased with age: 2.2% in the first decade and 6.9% after the ninth decade. It is very likely that circulatory failure in the hand develops after several decades among those whose radial artery was removed in their youth. When the radial artery is removed in the young, attention should therefore be paid to future consequences.

ISSN:0148-7043    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The course of the subscapular artery was studied in 20 rabbits. Its course was constant, giving two branches to the latissimus dorsi muscle after which the vessel sent a branch (S1) that perforated the panniculus carnosus to supply a large territory of skin. In a separate experiment, the contribution of the S1branch to the viability of the rabbit latissimus dorsi musculocutaneous flap was evaluated. From this experiment it can be concluded that, first, it is possible in a rabbit to elevate a large skin flap based solely on a muscle perforator (S1), which survives completely. Second, in the rabbit latissimus dorsi musculocutaneous flap, S1is the major blood supply to the skin component. Damage to it severely diminishes skin flap survival, even if the vascular supply to the underlying muscle is completely intact.

ISSN:0148-7043    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

One theory of the cause of connective tissue capsule formation around silicone mammary prostheses is based on an immunological interaction. In an in vitro pilot study, it is shown that intraluminal cyclosporine A, a potent T-lymphocyte–specific immunosuppressive agent, can diffuse slowly through the outer shell of a standard double-lumen silicone breast implant. Round silicone tissue expanders containing 50 mg of cyclosporine A were implanted subcutaneously in 10 rats. Ten animals served as controls. Evaluation was performed after three months. A significant decrease in collagen capsular thickness of 21.6 ± 5.4 µm (mean ± standard deviation was measured histomorphometrically in the treated group compared with 39.6 ± 8.6 µm in the control group (p < 0.001).

ISSN:0148-7043    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The scalp has become a popular donor site for splitthickness skin, and few complications have been reported. However, we have been troubled by 5 patients in whom the donor site did not epithelialize but rather turned into dried granulation tissue with embedded growing hairs, a situation rather like concrete with steel reinforcing rods. The pathophysiology is not clear but seems to be related to thick grafts from hair-bearing areas. We treated the lesions by removing the granulation tissue, shaving the hair, and treating the wound as a new donor site. Four lesions healed with total or near total regrowth of hair, and one required a small skin graft.

ISSN:0148-7043    

出版商:OVID    

年代:1990

数据来源: OVID