ISSN:0148-7043    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The circulating prostaglandins have been implicated as mediators of microcirculatory derangements in skin and skin-muscle flaps. The study described here investigated the roles of thromboxane A2and prostacyclin, measured as thromboxane B2(TxB2) and prostaglandin 6-keto-F1a(PGF1a), in ischemic skin flaps, and the effects of thromboxane synthetase inhibition on flap blood flow and survival.A canine ventral island flap model was used to measure the appearance of TxB2and PGF1ain the central arterial and venous plasma, and in the tissue and venous effluent of acutely raised flaps; with and without pretreatment with the specific thromboxane A2synthetase inhibitor UK38485.Prostaglandin levels change significantly during flap elevation, and can be modified beneficially by thromboxane A2synthetase inhibition, causing dramatic increases in flap blood flow and survival, as predicted by intravital dye penetration. The results presented in this article suggest that the manipulation of these compounds may provide a method of producing a pharmacological delay phenomenon and perhaps even allow effective intervention in the failing flap.

ISSN:0148-7043    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A dermal surface fluorometer was used to monitor vascular perfusion in 22 patients who underwent reconstructive surgical procedures with a variety of flaps (e.g., skin flaps, musculocutaneous flaps, fasciocutaneous flaps, and Z-plasties). Sodium fluorescein (1.5 mg per kilogram of body weight) was administered intravenously at the completion of the operative procedure. Quantitative fluorescence readings were obtained at different points in each flap by means of the surface fluorometer (Fluoroscan). The readings were taken at several time intervals and compared with those of normal skin (control). A perfusion ratio was determined in each case according to the following formula: flap reading/(normal skin control reading x 100). Partial necrosis occurred in 4 patients, correlating with low fluorescein perfusion measurements. From our findings, it appears that a perfusion ratio of 15% or greater 10 minutes following injection will accurately predict tissue viability. No systemic reactions were observed in these patients. We believe that this minimally invasive technique should be of considerable assistance in the postoperative evaluation of flap viability.

ISSN:0148-7043    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

This study tested the hypothesis that the peripheral nerve in the presence of diabetes is more susceptible to chronic nerve compression than it is in the nondiabetic rat. A 1-cm length of sciatic nerve was subjected to chronic compression by banding with a Silastic tube in normal and in streptozotocin-induced diabetic rats. After six months of banding, both the amplitude and conduction velocity of the diabetic banded sciatic nerve were significantly reduced (p < 0.001) in comparison with the nondiabetic banded rats. These results suggest that in the presence of hyperglycemia, the peripheral nerve is more susceptible to chronic compression.

ISSN:0148-7043    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Deep tissue necrosis following debridement of electrical injuries can be so severe that amputation of the limb is often necessary. To preserve function and partially devitalized structures, and to lessen the necessity for amputation, several debridements followed by coverage with a vascularized fasciocutaneous flap can be advantageous.This article reports a successful case of a medial upper arm fasciocutaneous island flap used to cover a defect of the upper arm caused by an electrical burn. An angiography revealed that the ulnar collateral artery was not occluded, and thus it was used in the flap with successful results. The donor defect was closed primarily and did not require a skin graft.

ISSN:0148-7043    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Chronic subgaleal abscesses have been extremely rare since the advent of antimicrobial therapy. The majority of reported cases have occurred as acute infections following traumatic scalp lacerations or needle electrode insertion for fetal monitoring. The rich blood supply of the head makes widespread infection from a scalp surgical wound a very unlikely occurrence. Most acute infections of the scalp result in complete resolution with adequate early treatment. However, extensive purulent fibrosis of the scalp remains a potentially serious surgical complication. We report 2 cases of chronic necrotizing abscess of the scalp associated with a postsurgical scalp ulcer. The inflammatory process caused extensive necrotizing fibrosis (up to 2.5 cm thick) of the entire undersurface of the scalp and involved both the galea aponeurotica and the periosteum. We discuss the unique pathological features of this entity along with recommendations for its operative management and suggestions for flap design.

ISSN:0148-7043    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The Spitz nevus is usually identified as a nonpigmented nevus occurring in a juvenile. This report describes the clinical and histopathological findings of a pigmented Spitz nevus in an adult.

ISSN:0148-7043    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Omiderm, a synthetic temporary skin substitute, was used for the treatment of skin defects in a newborn who suffered from epidermolysis bullosa. Omiderm served as a biological barrier, and its transparency allowed close observation of the wound healing process and early detection of local infections when they occurred.

ISSN:0148-7043    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A chemically treated bovine skin, Dermodress, is presented as a new type of biological dressing for exposed tendons, bones, and nerves following extensive thermal or severe soft-tissue injuries to the hand. Its use enables the surgeon to postpone closure of defects with grafts or flaps until the presence of healthy, viable tissue is secured. The vital structures underneath the covering are kept moist, thus preventing necrosis and desiccation. Because of its adherence properties, Dermodress use also allows early mobilization and bathing, thereby accelerating rapid return of function.

ISSN:0148-7043    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Liquid silicone injection for soft-tissue augmentation remains a controversial procedure despite 30 years of clinical use which has demonstrated exceptional results in patients with severe facial atrophies. This article describes a case in which massive silicone injection was used to treat hemifacial atrophy. Over a 9-year period, 11 injections totaling 97 ml of liquid silicone were administered to the patient, representing the largest volume of silicone ever injected into the face. In the 16 years following the first injection, there have been no major complications and the patient has experienced a greatly enhanced body image and improved selfesteem. Although liquid silicone for injection remains under investigation, its use in patients with hemifacial atrophy may produce dramatic results with minimal complications.

ISSN:0148-7043    

出版商:OVID    

年代:1988

数据来源: OVID