Current Issue : April - June Volume : 2012 Issue Number : 2 Articles : 7 Articles
The creation of musculoskeletal tissue represents an alternative for the replacement of soft tissue in reconstructive surgery.\nHowever, most of the approaches of creating artificial tissue have their limitations in the size as the maximally obtainable dimension\nof bioartificial tissue (BAT) is limited due to the lack of supporting vessels within the 3-dimensional construct. The seeded\nmyoblasts require high amounts of perfusion, oxygen, and nutrients to survive. To achieve this, we developed a 3-dimensional\nscaffold which features the epigastric artery as macroscopic core vessel inside the BAT in a rat model (perfused group, n = 4) and a\ncontrol group (n = 3) without the epigastric vessels and, therefore, without perfusion. The in vivo monitoring of the transplanted\nmyoblasts was assessed by bioluminescence imaging and showed both the viability of the epigastric artery within the 3-dimensional\nconstruct and again that cell survival in vivo is highly depending on the blood supply with the beginning of capillarization within\nthe BAT seven days after transplantation in the perfused group. However, further studies focussing on the matrix improvement\nwill be necessary to create a transplantable BAT with the epigastric artery as anastomosable vessel....
Eyelid bags and blepharochalasis are the result of relaxation of lid structures like the skin, the orbicularis oculi, and mainly the\r\norbital septum. Therefore, this aged appearance cannot be improved sufficiently with only a skin and orbicularis oculi resection.\r\nTo improve this appearance, we use a very effective method of tucking of the orbital septum with infraeyebrow excision of the skin\r\nand the orbicularis oculi. Between January 2005 and April 2011, 103 patients (206 lids) were treated. There were 89 female and 14\r\nmale patients whose ages ranged from 43 to 75 years (mean = 65.2 years). After infraeyebrow excision, blepharoplasty with tucking\r\nof the orbital septum, the concealed lid crease becomes apparent and a good rejuvenation effect is obtained in all patients....
Many operative approaches have been described for the open reduction of subcondylar fractures and rigid fixation. However,\r\nfracture portions are deep and embedded among facial nerves so that visual surgery in this region is extremely limited. Once the\r\noperative field is exposed, the displacement of the condylar head is often dislocated by the anteromedial pull of the lateral pterygoid\r\nmuscle and the fracture end of the condylar process is pulled up to the mandibular fossa by contraction of the masseter muscle.\r\nWemade a new retractor to achieve a better field of view. It is possible to pull down the condylar process by opening the tips of the\r\nretractor using the specially made wrench system without special effort and keep the condylar process in the same position during\r\nreduction. In using this retractor, the fracture stumps were clearly exposed and more easily reposited....
Skin graft is one of the most indispensable techniques in plastic surgery and dermatology. Skin grafts are used in a variety of clinical\r\nsituations, such as traumatic wounds, defects after oncologic resection, burn reconstruction, scar contracture release, congenital\r\nskin deficiencies, hair restoration, vitiligo, and nipple-areola reconstruction. Skin grafts are generally avoided in the management\r\nof more complex wounds. Conditions with deep spaces and exposed bones normally require the use of skin flaps or muscle flaps.\r\nIn the present review, we describe how to perform skin grafting successfully, and some variation of skin grafting....
Facial clefts are extremely rare congenital deformities and there are only a few technique reports for surgical reconstruction of\r\nclefts in the literature. In this article, we report a Tessier no. 3 incomplete cleft reconstruction with alar transposition and irregular\r\nZ-plasty in a 2-year old female patient....
Biobrane has become an indispensible dressing with three established indications in acute burns care at our institution: (1) as\nthe definitive dressing of superficial partial thickness facial burns, (2) after tangential excision of deep burns when autograft or\ncadaver skin is unavailable, and (3) for graft reduction. This paper details our initial experience of Biobrane for the management\nof superficial partial thickness facial burns in children and the protocol that was compiled for its optimal use. A retrospective\nanalysis of theatre records, case notes and photographs was performed to evaluate our experience with Biobrane over a one-year\nperiod. Endpoints included length of stay, analgesic requirements, time to application of Biobrane, healing times, and aesthetic\nresults. Historical controls were used to compare the results with our previous standard of care. 87 patients with superficial partial\nthickness burns of the face had Biobrane applied during this period. By adhering to the protocol we were able to demonstrate\nsignificant reductions in hospital stay, healing time, analgesic requirements, nursing care, with excellent cosmetic results. The\nprotocol is widely accepted by all involved in the optimal management of these patients, including parents, anaesthetists, and\nnursing staff....
The WHO surgical checklist was introduced to most UK surgical units following the WHO ââ?¬Å?Safe Surgery Saves Livesââ?¬Â initiative.\r\nThe aim of this audit was to review patientââ?¬â?¢s safety in the delivery of surgical care and to evaluate the practical application of\r\nthe new WHO surgical checklist. We conducted a retrospective audit of patients who received operative treatment under general\r\nanaesthesia at our Plastic Surgery Department, involving a total number of 90 patients. TheWHOform was compared to its former\r\nequivalents. Complications or incidents occurring during or after surgery were recorded. Using the departmentââ?¬â?¢s previous surgical\r\nchecklist, ââ?¬Å?Time outââ?¬Â was only performed in only 30% of cases. One patient arrived at theatre reception without a completed\r\nconsent form, and two clinical incidents were reported without patients suffering harm. Following introduction of current WHO\r\nsurgical checklist, ââ?¬Å?Time outââ?¬Â was recorded in 80% of cases. In all cases, the newWHO surgical checklist was used and no incidents\r\nwere reported. TheWHO surgical checklist provides a structured frame work that standardizes the delivery of care across hospitals\r\nand specialized units; however, it will take some time and practice for teams to learn to use the checklist effectively and reliably....
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