摘要:

We examined regeneration of Meissner corpuscles in palm skin grafts. In only one of the specimens (split-thickness skin graft from the sole of the foot), numerous regenerated Meissner corpuscles were found in the dermal papilla. This suggests that the nerve pattern of the graft depends on reinnervation from the recipient site and the regeneration of encapsulated nerve endings contained in the graft. It is recommended that skin grafts containing the encapsulated nerve endings be used in digits to obtain a satisfactory recovery of the sensory function.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Peripheral nerve repair remains one of the most difficult problems in hand surgery; the results of conventional epineurial and fascicular suture repair are a major limitation to the rehabilitation of the patient. The aim of this study was to evaluate a tubulization technique of nerve repair by wrapping a membrane of hypoantigenic collagen around the nerve at the fascicular level.Cat ulnar and median nerves were used as a multifascicular nerve model. Thirty-eight animals were studied. Ten animals were included in long-term studies comparing fascicular tubulization to either epineurial suture or fascicular suture nerve repair.Histologically, the tube repairs demonstrated improved organization at the repair site compared with either suture technique. Tube repair is not significantly different statistically by quantitative histological and physiological evaluation methods from epineurial suture or fascicular suture repairs. Further studies in more clinically applicable animal models are required before this technique can be considered as an alternative to present clinical nerve suture techniques.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

An in vitro wound model was created to determine the mechanism by which bacteria cause skin graft failure. A wound surface was simulated by a human fibrin clot. Staphylococcus aureus or group A streptococcus was incubated over the clot. Either saline, human plasminogen, aprotinin, or epsilon-aminocaproic acid (EACA), or a combination of these, was added to the tubes. After 30 hours, the tubes were examined for the presence of the clot. The supernatent was then examined for the presence of fibrin degradation products (FDP).S. aureuswas incapable of destroying the fibrin clot without the presence of plasminogen in the culture media. Group A streptococcus was capable of some clot degradation, but this was markedly improved in the presence of plasminogen. High FDP levels correlated with the destruction of the clot. Both aprotinin and EACA were capable of preserving the fibrin clots. In this study we carefully controlled the chemical and bacterial milieu on a simulated wound.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The author hypothesized the possibility of reducing the extent of the scar formed at the inframammary sulcus in reduction mammaplasty and mastopexy by burying the dog-ear of excess skin in the region of the inframammary sulcus using a pursestring suture after first removing the epithelium. The results of 15 patients with follow-up periods ranging from 20 to 150 days encourage further application of this technique, which leaves a very small, aesthetically satisfactory scar.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Reverse digital artery flaps were performed successfully to resurface the major fingertip defect in 10 patients and the volar defect of the middle phalanx in 1. This thin flap with its long vascular pedicle containing a digital artery and its perivascular cuff tissue has a wide arc of transposition. It can be used to reconstruct the defect located from the proximal phalanx to the fingertip of all fingers. No loss of the flap in this series was noted. The procedure is a time-saving, one-stage operation. Patients who received this procedure had no uncomfortable immobilization of the hand or long hospitalization. It also causes no disfigurement and no functional loss of the involved digit. Our clinical experience showed favorable results.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The physiological factors that allow for the survival of ischemic skin flaps have not been clearly elucidated. Previous work by others has shown that elevation of a flap 24 hours before an episode of complete ischemia significantly improved survival, presumably by delaying the onset of the no-reflow phenomenon. The current study, using an epigastric flap, investigated the role of thromboxane in these events by observing postischemic plasma levels of thromboxane B2, the stable metabolite of the short-lived thromboxane A2. Acutely ischemic flaps were compared with those elevated 24 hours before ischemia.After the ischemic insult, blood was drawn from the venous effluent of the flaps. Thromboxane levels after 4 hours of ischemia were significantly decreased (p< 0.001) in the postischemic period in those flaps elevated 24 hours before ischemia compared with flaps that had undergone ischemia acutely. Moreover, acutely ischemic flaps had significantly more thromboxane than nonischemic controls (p< 0.001). These results confirm the importance of thromboxane metabolism in the no-reflow phenomenon.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Pathophysiology of lymphedema is not an enigma. It is caused by a low-output failure of the lymph vascular system in combination with an inadequate scavenging of stagnating plasma protein by macrophages. Axillary venous diseases alone never cause chronic postmastectomy edema. In the diagnosis of lymphedema, invasive methods (i.e., direct lymphography and venography) are not only unnecessary but are potentially harmful and do not give any information of therapeutic relevance. Lymphedema of the limbs without reflux of lymph or chyle is not a surgical disease. It can be treated successfully by the skillful application of specific physiotherapeutic measures free of any side effect. The results of this therapy can be maintained if the patient's compliance is good.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Five cases of severely collapsed nose as a result of infection were corrected by excision of intranasal scar and lining the intranasal defect with median forehead island skin flaps based on supratrochlear vessels. Simultaneous bone grafting was undertaken to support the reexpanded nose. Clinical experiences are presented.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A rare variety of frontoethmoidal meningoencephalocystocele is reported. Transillumination of the mass and cross-fluctuation to the anterior frontanelle are diagnostic. Herniation of the anterior horn of the lateral ventricle is probably being reported for the first time.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Internal hemipelvectomy was used to treat recalcitrant pressure sores in the absence of flap options following leg fillet. The bony hemipelvis was resected in the sub-periosteal plane, resulting in the removal of the iliac wing, ischium, and pubic rami. This procedure creates enough mobile soft tissue to allow even large ulcer defects to be closed primarily. We have used the technique successfully in 5 patients; follow-up ranged from 4 to 30 months. Internal hemipelvectomy is a treatment option for end-stage pressure ulcers in lieu of hemicorporectomy.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID