摘要:

Our present facelift technique is a double-layered operation, consisting of standard skin flap dissection in the cheeks and undermining in the neck, often across the midline. The underlying foundation for the lift is created by superficial musculoaponeurotic system advancement in the cheeks, partial medial and lateral transection of the platysma muscle in the neck, and suturing together of the medial borders of the platysma in the submental region. We do not divide the platysma completely. When ancillary procedures are indicated, the operations are done in two stages because of the increased operating time required.We believe the improvement in quality and duration of results makes the increased time, effort, and expense worthwhile, though scientific proof of our impression is not yet available. A method for objective evaluation of results is suggested.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

We describe a reliable composite osteomyocutaneous flap used for mandibular reconstruction in 14 patients. The flap is composed of the pectoralis major muscle and the attached fifth or sixth rib, with the overlying skin. This flap is tunneled superiorly under the neck skin. The muscle protects the great vessels. The skin lines the oral cavity or fills an external skin defect, and the rib replaces lost mandible. The rib seems to be adequately vascularized to survive, and does not resorb. Boney union is painless and clinically firm. One flap in the series was lost, and the rib was removed in 3 others. There was 1 persistent fistula.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

One of the 2 patients introduced here had osteoradionecrosis, which has been difficult to reconstruct. The other had a massive adamantinoma that required replacement of the mandible from the midportion of the right ramus to the left angle with the iliac bone using the conventional method. The grafted iliac bone was severely absorbed, however. The mandible in both cases was successfully reconstructed with an osteocutaneous compound flap, using the deep circumflex iliac vessels as the stem. This method is considered a very good procedure for reconstruction of the mandible, which has been difficult by conventional procedures. Because the diameter of the stem is large, vascular anastomosis can be readily performed with an extremely high degree of safety. Pulsation of the stem can be palpated on follow-up even one year after surgery, and there are no signs of bone reabsorption.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Our experience with 9 patients who have undergone reconstruction with free flap transfers following resection of squamous cell carcinoma in the head and neck area is presented. The dorsalis pedis flap was used in 3 patients, the iliofemoral (groin) flap in 4, and the latissimus dorsi myocutaneous flap in 2. Four patients had received preoperative irradiation and 5 received postoperative irradiation. Despite minor partial flap necrosis in 3 patients and the development of oral cutaneous fistulas in 2, all the flaps were successful in providing the necessary coverage. Reoperation in 1 patient was necessary because of thrombosis of the venous anastomosis.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A simple two- or three-stage procedure is described that reduces the large breast with little inconvenience or discomfort to the patient while reconstructing the ablated one without the need of additional donor area scars and muscular disabilities.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The authors review the technical refinements that have come about through their increased use of the latissimus dorsi flap for reconstruction of the female breast following mastectomy, referring to over 90 of their cases. These refinements involve careful selection of patients in whom the flap is used; planning the flap, including determination of the limits of the muscle; and the location and shape of the skin island. Placement of the patient on the table and the position of her arms and hips are discussed. The dissection and transfer of the flap, as well as closure of the donor defect, can present particular problems, which are outlined. Implant placement, wound closure, and postoperative care of the patient are also discussed.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A retrospective look at a twenty-year experience with parotid tumors and the initial surgical treatment of both benign and malignant lesions led us to question superficial lobectomy as the treatment of choice in the extirpation of parotid neoplastic tissue. This may represent a local or regional experience. It is hoped, however, that these findings will stimulate others to examine their results, so that we may get a more comprehensive picture of the adequacy of superficial parotid gland lobectomy in treating parotid tumors.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Eight patients, 7 with hidradenitis suppurativa and 1 with chronic recurrent staphylococcal abscesses, all of whom failed to respond to antibiotic therapy, conservative therapeutic measures, and surgery, were experimentally placed on Staphage Lysate. Treatment after appropriate skin testing consisted of subcutaneous injections of 0.1 ml and intranasal installation of 0.3 ml of Staphage Lysate. Treatments were weekly for twelve weeks, biweekly for six months, and then monthly. Complications, which occurred early, were minimal and involved rash, vertigo, malaise, chills, nausea, fever, and headache. Six of the 8 patients reported noticeable improvement in odor, consistency, and amount of drainage and considerable decreases in pain. Seven of the 8 patients reported improvement in the ability of lesions to drain spontaneously, and a decrease in the frequency of inflammatory nodules. All 8 patients reported that the inflammatory periods were definitely shorter. Early data suggests that Staphage Lysate is a useful adjuvant in the treatment of hidradenitis suppurativa.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

We describe a modification of the biceps femoris myocutaneous flap for reconstruction of ischial pressure ulcer defects. In this modification, all neural and vascular pedicles are preserved and the flap is advanced into the ischial defect rather than transposed as described in the literature. With this method, no transferred tissue is lost. Besides ensuring good tissue survival, the flap preserves a maximum number of reconstructive options in the event of ischial pressure ulcer recurrence. These advantages make the biceps femoris myocutaneous advancement flap our first choice for reconstruction of ischial pressure ulcer defects.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Poland's syndrome includes anomalies of the breast, thorax, and upper extremity. Unilateral hypoplasia of the breast and pectoral muscle are seen most frequently, and the resulting problem of breast reconstruction must be addressed. The latissimus dorsi myocutaneous flap is one of the most useful reconstructive tools in this situation. A case is presented of Poland's syndrome with hypoplasia of the latissimus dorsi muscle—an abnormality not generally associated with Poland's syndrome. The latissimus dorsi muscle should be carefully evaluated preoperatively in such patients, to make sure it is adequate for reconstructing the absent breast and pectoral muscle.

ISSN:0148-7043    

出版商:OVID    

年代:1981

数据来源: OVID