摘要:

Microsurgical reconstruction can often benefit from the thin, pliable, and vascular characteristics of free fascia flaps. Investigation to identify donor sites and to maximize reliability of these flaps continues. Microfil injections of the thoracodorsal artery confirm the ability to use the fascia overlying the serratus anterior muscle as a free flap based on this vessel. We have used this flap in distal extremity wounds in 4 patients with one failure (venous thrombosis). Free fascia flaps from other donor sites have been used in 9 patients in a variety of locations (head and neck, hand, and extremity) with excellent results. We conclude that when thin, well-vascularized tissue is required for reconstructive purposes the skin-grafted free fascial flap provides excellent durable coverage with minimal donor site complications.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A total of 34 breasts were reconstructed in 21 women, with the bipedicle transverse rectus abdorninis island flap technique. Thirteen women had bilateral breast reconstructions and 8 had unilateral reconstructions. The indications for using this technique are (1) bilateral breast defects, (2) a radical mastectomy defect, (3) limited donor tissue or tissue compromised by prior abdominal surgery, and (4) a large, remaining breast that requires matching. Four selected women are presented to illustrate each indication. In all but 1 woman, the abdominal islands were bisected and transferred to the chest defects with their respective rectus muscles and vascular pedicles. Complications included 2 women with abdominal wall hernia, 3 women with minimal peripheral skin necrosis of the reconstructed breasts, and 1 woman with Raynaud's disease with partial flap loss. Follow-up ranged from 3 to 57 months. Bipedicle rectus abdominis flaps provide improved vascularity and allow greater flexibility in bilateral and unilateral breast reconstruction.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Contour deformities of the lateral forehead are not uncommon after direct injuries or extirpative procedures, or as a sequela to iatrogenic maneuvers for juxtaposed craniomaxillofacial endeavors. Transposition of noncutaneous local vascularized autogenous tissues for augmentation of these defects has minimal inherent risks and little donor site morbidity. Although the temporoparietal fascia has previously been described as a first choice in this regard, if unavailable due to concomitant injury or absence of the superficial temporal vessels, the temporalis muscle itself provides an excellent second option that deserves consideration.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Long-term reviews of patients undergoing augmentation mammaplasty seem to be rare. Recently, a long-term study of patients who had undergone augmentation with polyurethane foam—covered prostheses was undertaken. However, at the time that study was published, the longest follow-up was just over 4 years. We have been using the polyurethanecoated prosthesis almost exclusively for nearly 20 years. The procedure is performed by one surgeon using a consistent technique, and all implantations were retroglandular. In reviewing this series, a follow-up rate of nearly 60% was achieved in patients augmented for periods of 1 to 19 years. The length of this study, together with a high follow-up compliance rate, makes this an unusual contribution to the literature on augmentation mammaplasty.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The effect of hyperbaric oxygen, administered during storage, on the survival of replanted limbs was evaluated in rats. The right hindlimbs of male Sprague-Dawley rats were severed and were replanted by microvascular anastomoses after storage in either room air or hyperbaric oxygen (100% oxygen at 2.9 atm absolute) at 23°C for 5 hours. The administration of hyperbaric oxygen during storage improved limb survival from 50% in the room-air, control rats to 100% (p < 0.05). The gastrocnemius muscle of limbs treated with hyperbolic oxygen demonstrated a higher level of energy reserves (creatine phosphate, adenosine triphosphate, glycogen, and glucose) than the same muscle in room-air, control rats. The mechanisms of the beneficial effect of hyperbaric oxygen on limb survival appears to be related to preservation of high-energy phosphates and glycogen.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Microfixation represents a technical advance that has been developed for the specific needs of the infantile and pediatric craniomaxillofacial skeleton. The microplates provide significant skeletal stability despite their size and are relatively easy to apply and adjust after placement. The advantages and the technical aspects of microfixation use versus those of minifixation in smaller skeletal structures are presented. The range of applications in pediatric craniofacial surgery is demonstrated and reviewed in our series of 65 children, with a greater than 1-year follow-up.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Aesthetic platysma surgery during rhytidectomy has gained popularity for contour restoration of the jaw line, cervicomental angle, as well as anterior neck defects. The superficial musculoaponeurotic system—platysma flap is elevated and suspended in a cephaloposterior direction by suturing to the investing fascia overlying the stenocleidomastoid muscle and the mastoid bone. This procedure is usually performed without total visualization of the great auricular nerve, possibly placing this nerve at risk during suspension. Anatomical dissections of the great auricular nerve were performed bilaterally on 10 cadavers to delineate its course in the superior neck and identify anatomy pertinent to the elevation of flaps and placement of sutures during superficial musculoaponeurotic system—platysma suspension.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The response of soft-tissue blood flow to a segmental osteotomy of the canine tibial diaphysis was investigated. Forty-three dogs underwent unilateral tibial osteotomies to create a 2.5-cm avascular diaphyseal segment, which was then rigidly stabilized with a plate. Blood flow measurements of the limbs that underwent surgery and control limbs were made using cerium 141 microspheres. One month after surgery, blood flow to the caudal musculature was increased 1.4-fold and at 2 and 3 months was twofold the value of the control side. The cranial musculature blood flow was 2.4-fold the control value at 1 month and 1.4-fold the control value at 2 and 3 months. Skin blood flow was significantly elevated at 1 month after surgery (p < 0.0277), but by 2 and 3 months, skin flow had decreased to 1.4-fold and 1.3-fold of control values (p = 0.22). Bone marrow and cortical blood flows were still significantly elevated at 3 months after surgery. Muscle blood flow remains markedly elevated 3 months after surgery. This study demonstrates the importance of soft-tissue blood flow to the process of revascularization, remodeling, and incorporation of avascular cortical bone.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Nine Krukenberg procedures were performed in 5 bilateral amputee patients suffering severe electrical injuries of both hands and wrists. The surgical procedure yielded functioning pincers in 7 of 9 operations. The patients could perform their daily activities very well and showed pronounced improvement in their self-confidence, self-reliance, and quality of life. The postoperative rehabilitation of these patients was not difficult. The Krukenberg procedure should be considered a substitute for prosthesis, especially in developing countries.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

An interesting case is presented of a woman with obstructive sleep apnea due to mandibular hypoplasia who was successfully treated with mandibular advancement. After a postoperative complication, the correction was salvaged by using a previously undescribed bipedicled osteocutaneous scapular free flap.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID