摘要:

The success of fasciocutaneous flaps is based on the existence of epifascial vascular networks and reliable blood supply. However, there has been no thorough classification of the vascular anatomy of the fascia and skin and there is some confusion in regard to cutaneous vascular nomenclature. We divide the vascular systems involved in the cutaneous circulation into four categories. This permits classification of skin flaps into five types (cutaneous, fasciocutaneous, adipofascial, septocutaneous, and mus-culocutaneous flaps). Fasciocutaneous flaps can be further divided into six types, according to the patterns of the vascular input to the fasciocutaneous plexus. This classification has been demonstrated to be related to clinical effects. Nine new free and island flaps are discussed.

ISSN:0148-7043    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

We have used tissueexpanderstotreat 10 patients with breast deformities, 2 the result of burns and 8 congenital in origin. The expanders are placed in the subglandular plane and expanded incrementally until the desired amount of growth is obtained. In patients with congenital deformities, the desired size of the reconstructed breast (implant size) is determined during the expansion phase. Reconstructions of the nipple-areola complex are done either at the time of the exchange or as separate procedures.Patients with burn deformities present a variety of problems not seen with the congenital deformities. The expander is placed in the subglandular plane and filled to the desired volume. We have noted a marked permanent softening of the scar and grafts encasing the breast, which persists after the expander is removed and the breast reconstructed. The interval between expansion and definitive reconstruction is delayed for several months to allow scar softening to take place. If the parenchyma is not burned and pedicle tissue is not required, the expander can be deflated and the skin coverage observed to determine if it will remain soft. If it does, the expander can be removed and the breast reconstructed. In patients who require pedicle coverage in the reconstruction and who have unburned scar surrounding the breast, massive overexpansion is carried out. The pedicle skin is used to resurface the breast after removal of the appropriate areas of scar and skin grafts. In all burned patients, the inframammary fold must be reconstructed if the breast is to be protuberant. The nipple-areola complex also requires reconstruction.To date there has been great acceptance by patients with both congenital and burn deformities; however, we believe that tissue expansion techniques offer possibilities that have not as yet been fully explored.

ISSN:0148-7043    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

In microtia with conchal remnant (type B microtia), there are various degrees of deformity; consequently, different surgical procedures are required for individual cases. To clarify and simplify these complicated surgical techniques, type B microtia is divided into two types, type BI and type BII, from the standpoint of the emphasis on conchal creation. The methods of treatment are discussed.

ISSN:0148-7043    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Twelve cases of squamous cell carcinoma arising in scars of the skin are analyzed. Correlation of tumor aggressiveness, tumor differentiation, intensity of small lymphocyte infiltration, and nature of adjacent collagen tissue to tumor stroma was investigated. All tumors were predominantly well differentiated. Nine patients had no metastasis or recurrence after surgical treatment of the primary tumor. Three patients developed widespread metastases and died less than 2 years after operation. The tumors of these latter patients contained areas of pleomorphic and spindle cells and had minimal infiltrates of small lymphocytes. In contrast, the 9 patients who remained free of tumor had moderate infiltrates of small lymphocytes, and in just 1 of the 9 was an area of pleomorphic tumor cells found. Prognosis in scar carcinoma, therefore, may be related to tumor differentiation and the degree of host response with small lymphocytes to the tumor, rather than to the universally poor prognosis recorded in the past.

ISSN:0148-7043    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

This article proposes a classification system for mastectomy reconstruction based on skin and muscle deficiency. This system is helpful in planning surgery and in presenting lecture material. It could also be helpful in organizing material in future publications on mastectomy deformity by providing guidelines regarding the choice of procedure as it corresponds to the degree of deformity. Finally, it may enhance our ability to develop statistical measures for comparing different reconstructive techniques.

ISSN:0148-7043    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

In this preliminary report, a new self-locking pin for small bones and phalanges is presented. Its mechanical characteristics were tested and compared with those of a pair of crossed Kirschner wires in cadaver phalanges and with results presented in the literature. Extraction of the pin after callus formation was tested in vivo (on an experimental animal). The results prove the mechanical fixation efficiency of the single small-diameter self-locking pin and its easy removal from the new callus.

ISSN:0148-7043    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The changes of vascular patterns in pedicle skin flaps were studied in rats at various intervals after operation using microangiography, with the following results: (1) Vascular change was observed in the marginal area of the flap after operation, possibly related to the release of an angiogenic factor during anaerobic metabolism. (2) Both primary and secondary revascularization were observed in the flap, but the main process was found to be primary revascularization. (3) Four days after operation, revascularization was observed. (4) Longitudinal rearrangement of the vessels in the flap could not be observed. (5) At sutured areas where the stitches remained, severe vascular reaction continued for a longer period.

ISSN:0148-7043    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Pendulosity rarely occurs in flap transposition in the area of the head and neck. It is related to physical and physiological factors that derive from the volume of tissue transplanted, the neatness of its fit into the wound, its supportive facilities, its functional activity, its relation to gravity, and the effect of its perimeter scar tissue bed and venous drainage system. It is amazing that this condition does not appear more commonly when one considers that as much as 1,000 cc of inert tissue may be transposed as a volumetric mass, either with a singular vascular pedicle or as a singular microvascular anastomosis or a randomized soft tissue pedicle base. The difficulty is almost always compounded by the fact that the tissue does not contain a specific lymph drainage facility. The. majority of these physiological handicaps, however, are accommodated by the receptiveness of the tissues of the wound and the venous drainage of the flap. If these should fail, edema and then pendulosity will occur. The condition can be improved by repositioning and a reduction in the size of the flap.

ISSN:0148-7043    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1986

数据来源: OVID