ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The surgery of microtia is a procedure that demands surgical and artistic skills, as well as precise planning of interventions. In cases where a functioning inner ear is present, functional and esthetic reconstruction is performed jointly with ear, nose, and throat surgeons. The middle ear plasty is performed through a transmastoidial approach at the time of the second stage of the outer ear reconstruction. We demonstrate the special requirements of this team approach and also pay a tribute to Burt Brent, who has set the standards of modern ear reconstruction.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

From January 1979 to April 1989, 19 neurosensory tensor fasciae latae flaps were used to cover ischial pressure sores in paraplegic patients. This flap provides protective sensation and improves the sensory control of the filling status of the rectum and the sitting control in a wheelchair. Patients were reexamined between 12 and 110 months; no recurrence or new pressure sores were seen. Indications, early and late complications, and evolution of the sensation are discussed.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The superiorly based, denervated gastrocnemius muscle flap is able to perform an aesthetically excellent and functionally good cover for defects of the upper one-third of the calf, including the knee, and the lower one-third of the thigh. A consecutive series of 41 muscle and musculocutaneous gastrocnemius flaps was analyzed. Thirty-six patients (88% of the patients who underwent surgery) could be reexamined. The mean follow-up time was 36 months, with a minimum time of 12 months. At the time of examination, all skin defects as well as the incidental concomitant osteomyelitis had completely healed; however, 40% of the patients have required secondary operations. One-half of the patients have a functional deficiency, and 20% showed areas with loss of sensation. After surgery with musculocutaneous flaps, all patients complained about the sensory loss of the saphenous nerve, and peripheral edema was seen more often than after surgery with a simple muscle flap. Muscle flaps with residual innervation showed more secondary wound breakdown and more contraction pain, due to spasms. The best results concerning function and aesthetics are achieved with denervated muscle flaps covered by a split-thickness skin graft. In this variation, the flap showed good and stable coverage without bulk, as well as minimal donor-site deformity; therefore, primary denervation must be considered. The anatomy of the motor nerves to the gastrocnemius muscle is shown.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Sensibility and sensory reinnervation were investigated in 19 patients who underwent, after mastectomy, a breast reconstruction using myocutaneous flaps. A comparative study in reinnervation of the flaps has been performed either after surgery with a latissimus dorsi flap with prosthesis or after surgery with a simple or double pedicle transverse rectus abdominal flap. Ten patients with latissimus dorsi flaps and 9 patients with transverse rectus abdominal flaps were tested. The tests included stimulation with touch, pressure, pin prick, and temperature. The patients were also interviewed regarding their impressions, a subjective sensibihty. These results show that the recovery of sensibility by patients who underwent surgery with the transverse rectus abdominal flap technique is superior, objectively and subjectively.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

To evaluate the early and long-term results of the latissimus dorsi musculocutaneous flap for breast reconstruction, a series of 92 women who underwent surgery at my department from 1979 to 1989 was critically reviewed. Special attention was directecd to the late foreign body reactions leading to deformation, asymmetry, and induration of the reconstructed breast. Guidelines regarding prevention of capsular contraction are discussed and some essential surgical refinements outlined.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Posttraumatic fingertip reconstruction with a free toe pulp neurovascular flap, first described in 1979, has not been frequently reported. We present our results with 8 free transfers of the toe pulp and demonstrate the successful restoration of a well-padded and sensitive fingertip. All patients, studied with a follow-up of up to 20 months, recovered a discriminative sensibility of the thumb and main fingers, with a stationary two-point discrimination test between 5 and 12 mm and a moving two-point discrimination test between 4 and 8 mm. In spite of the good results obtained, we believe this procedure must be chosen only in certain circumstances. We present the indications and the contraindications for this digital reconstruction.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In patients with difficult facial reconstructions, one of the most important requirements is to plan well, before beginning treatment. It is known that it is important to consider the aesthetic unit of the face. Each cutaneous area is to be reconstructed by a single, separate graft or flap. We present 4 patients illustrating difficult situations. Special attention has been drawn to the choices for each separate graft or flap. This study was made possible with the aid of a medical illustrator who prepared a real dissection of our final reconstruction. In fact, after these difficult operations, we often forget exactly what was previously done and we believe that a good catamnesis of our surgical adventure can be useful to share with other surgeons who deal with the same difficult procedures.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Extrinsic ectropion is caused by loss of skin around the orbital margins. Every patient with cicatricial ectropion should be assessed thoroughly to determine if the cause is intrinsic, extrinsic, or both. This assessment is extremely important when dealing with severe deformities after burns, cancer, or noma, for example. The assessment allows a proper planning of surgery. As a rule, the original size and location of the missing tissues should be recreated and the defect replaced by homologous tissues.

ISSN:0148-7043    

出版商:OVID    

年代:1991

数据来源: OVID