ISSN:0148-7043    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

A new method of lower lip reconstruction using a full-thickness cheek island flap based on the facial vessels is described. The functional potential of the method is assessed in six patients. The technique outlined is simple in design and execution. It is capable of total lower lip reconstruction without appreciable microstomia. Other major techniques of lip reconstruction are briefly reviewed.

ISSN:0148-7043    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The replantation of amputated extremities is justified only by the ultimate good function and appearance of the replanted part. This paper is a critical review of our clinical experience with forearm replantation and revascularization in 6 patients over the past, ten years. All replanted parts survived. The long-term functional results of the forearm replants are analyzed. Return of function depends on nerve regeneration. The functional outcome in the first patient was unsatisfactory due to poor motor and sensory return. Specific attention directed to careful primary neurorrhaphy in subsequent cases yielded favorable results. We believe that two factors in particular are central in achieving good functional results in forearm replantation—careful repair of the severed major peripheral nerves, and postoperative hand rehabilitation programs.

ISSN:0148-7043    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The transverse abdominal island flap is not just another myocutaneous flap. Although it derives its blood supply from myocutaneous perforators, the portion of the skin and fat that overlies muscle comprises only about 20% of its surface. The surface area of the flap by far exceeds the surface area of the entire muscle that carries it. Its hemodynamics are more complicated than usual and consist of delicate communications between the superior and inferior deep epigastric systems and the deep and superficial epigastric systems across the midline. Its use in breast reconstruction has been as exciting as it is complex. We describe our experience with 60 consecutive patients and 65 transverse abdominal island flaps.

ISSN:0148-7043    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The majority of the cellular elements of a cancellous or cortical autograft do not survive transfer. The vascularity of the recipient site is of paramount importance to the revascularization of those elements that do survive and, thus, to the success of such bone grafts. A conventional bone graft placed in a recipient site rendered suboptimal by irradiation or trauma frequently fails to achieve the therapeutic goal even if it survives. In contrast, the cellular elements in bone transferred by microvascular surgical methods remain viable. Provided the microvascular anastomosis remains patent following transfer, it will survive and succeed even when placed in a suboptimal milieu. If rigidly fixed to viable bone by modern techniques of osteosynthesis, it heals by rapid primary union, not by the “creeping substitution” that characterizes the incorporation of conventional bone graft.Donor site selection depends primarily on recipient site needs. For segmental defects in long bones, portions of the fibula can be transferred on either the anterior tibial or peroneal vascular supply. For most other defects, particularly about the face and mandible, portions of the ileum can be transferred on the deep circumflex iliac artery system. With two operating teams, the time of surgery begins to approach that for conventional grafts. With increasing skill, the free transfer of bone becomes truly “free. ”

ISSN:0148-7043    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Island latissimus dorsi myocutaneous flaps are compared with island epigastric flaps in the dog in terms of their ability to reestablish blood flow and maintain tissue viability after increasing periods of warm ischemia. Blood flow in the vascular pedicles of the flaps was measured after one minute to ten hours of ischemia with an electromagnetic flowmeter. The histological condition of the cutaneous and muscular portions of these flaps was examined with light microscopy at the end of the ischemia period and after reflow.In comparison to the epigastric flap, the latissimus dorsi myocutaneous flap had a greater baseline flow before ischemia, a greater rise in flow above baseline (reactive flow) after ischemia, and an equal resistance to ischemia in terms of preservation of reactive hyperemia, recovery of nutritive flow to the skin, degree of histological changes in the skin, and patency of the vascular pedicle. Despite the vulnerability of the muscular component of the latissimus dorsi myocutaneous flap to ischemia, the muscle perforators remain patent and the dermis survived even after eight hours of warm ischemia.

ISSN:0148-7043    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

War has historically stimulated surgical activity. The mutilation caused by war has spurred imaginative solutions, leading to the development of plastic surgery principles. A review of history from ancient India until the beginning of our century shows how war has influenced the development of plastic surgery.

ISSN:0148-7043    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The lower portion of the latissimus dorsi muscle was absent in a patient who appeared to be normal on preoperative examination. This anatomical variation would probably have vitiated the success of a skin island placed below the level of the 10th or 11th ribs. Fortunately, our skin island was above this level.

ISSN:0148-7043    

出版商:OVID    

年代:1983

数据来源: OVID