The Internet Journal of Plastic Surgery最新文献

{"title":"Traumatic Hemi Facial Soft Tissue Amputation. Immediate Surgical Flap Reconstruction","authors":"J. Mohammad","doi":"10.5580/27b4","DOIUrl":"https://doi.org/10.5580/27b4","url":null,"abstract":"Large soft tissue defects of the face present a challenging reconstructive problem to the surgeon. Optimal treatment of facial soft tissue injury includes definitive reconstruction of the main aesthetic units of the face. The author presents a case of immediate soft tissue flap reconstruction of the face following a car accident. The accident resulted in significant loss of the left soft facial structures with exposed facial bone i.e. hemi facial soft tissue amputation. Immediate soft tissue reconstruction was performed utilizing a rotation cervico pectoral flap to cover the lower half of the face and transposition of a temporoparietal scalp flap to cover the upper half. Surgical case and post operative aesthetic results are being presented in this case report.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124826675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compartment Syndrome In Meningiococcal Septicemia","authors":"A. Rahoma, A. Malek","doi":"10.5580/11b9","DOIUrl":"https://doi.org/10.5580/11b9","url":null,"abstract":"The clinical syndrome results from the activation and continued stimulation of the immune system by proinflammatory cytokines. This process is caused directly by bacterial components, such as endotoxins released from the bacterial cell wall, and indirectly by the activation of inflammatory cells.. Combined, the processes produce multiorgan failure that usually causes cardiorespiratory depression and, possibly, renal, neurological, and gastrointestinal failure.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124661668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Leg Flaps Comparison Between Free Versus Local Flaps","authors":"A. Bhatti, Adeniran Adeshola, T. Ismael, Nathan H Harris","doi":"10.5580/35c","DOIUrl":"https://doi.org/10.5580/35c","url":null,"abstract":"Background: In lower leg defects with bone, hardware, or articular joint exposure, a free tissue transfer is often the only valuable option. However, in well-selected clinical cases, local flaps are still indicated because they provide an alternative for the more demanding and risky microsurgical procedure. Methods: Twenty-six muscle flaps (performed in 26 patients) were reviewed retrospectively and compared with a series of 24 free flaps (23 patients) for lower leg reconstruction of almost similar indications. All patients with defects less than 25 cm2, peripheral vascular disease, deep defects, and osteomyelitis were excluded in order to obtain the same surgical indications .Also excluded were cases which needed split skin graft. Results: The overall surgical results were comparable, but more medical complications, a longer operative time, and a longer hospital stay were seen in the free muscle group. Conclusions: Free flap coverage is not mandatory to cover bone in the lower leg. The non-free flap can provide a good alternative for free flap coverage. This flap seems to have fewer medical complications, requires a shorter operative time and hospital stay, and can provide better aesthetic results than a free muscle flap depending upon selection of cases. Presented at the Sir Peter Feyer Memorial meeting of surgery, in Galway, Ireland, Sep1 to Sep 2, 2006,","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125154815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Options For Axillary Contractures","authors":"P. Olaitan, I. Onah, A. Uduezue, N. E. Duru","doi":"10.5580/1ff1","DOIUrl":"https://doi.org/10.5580/1ff1","url":null,"abstract":"Background: The axilla is one of the most frequently affected areas by post burn contractures with associated cosmetic and functional problems. A variety of therapeutic options exist but when this is not properly chosen or post operative rehabilitation is not properly adhered to, recurrence is often seen. The aim of this paper is to highlight the various management options used in managing these problems in a burn unit and itemize complications commonly encountered. Materials And Methods: This is a retrospective review of cases of axillary contractures managed at the National Orthopaedic Hospital over a period of 5 years. The sources of information were the operation registers and the case notes of the patients. Information obtained include age, sex, part of the axilla involved, other associated post burn problems, option(s) of treatment, complications and results. Results: A total of 37 patients presented with axillary contractures involving 42 axillae. Their ages range between 2 and 47 years with a mean of 23.1 years. There were 20 males and 17 females. Surgical options used includes local fasciocutaneous flaps, 18(42.8%)axillae, single z-plasty in 6 (14.3%) axillae, split thickness skin graft in 6(14.3%) axillae, multiple z-plasty in 3(7.1%)and myocutaneous flaps including latismus dorsi in 5(11.9%), double opposing z-plasty in 2(4.8%) while v-y plasty and 5-flaps z-plasty were used in 1(2.4%) each.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132928754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Method for the Objective Assessment of Thenar Atrophy","authors":"L. Galea, J. Agius, Charles Sciberras","doi":"10.5580/3d3","DOIUrl":"https://doi.org/10.5580/3d3","url":null,"abstract":"Purpose: Although thenar atrophy is caused by a variety of clinical conditions, it is commonly associated with carpal tunnel syndrome. Thenar atrophy has been mostly assessed subjectively. The purposes of the study are to test a simple, novel, objective and quantitative test for the assessment of thenar atrophy; and to correlate this test with subjective evaluation of thenar atrophy. Methods: The apparatus consisted of a box with a clear glass sheet on the top uncovered surface, with a digital camera placed in the base of the box. Group 1 included 106 healthy volunteers with a total of 212 hands. Group 2 was formed from 36 patients with a total of 72 hands with carpal tunnel syndrome. Thenar atrophy was classified subjectively as none, mild, moderate and severe. Patients and subjects were asked to press their hands facing down on the glass sheet and digital photos were taken. The technique relies on the fact that the area where pressure is exerted on the palm blanches. Photos were transferred to photo processing software. After enhancement the photos were transferred to an image analysis software. The thenar area (A) and the rest of the palm area (B) were measured. The thenar ratio was calculated as A divided by A plus B multiplied by hundred. Results: Hands with thenar atrophy had a statistically significant lower thenar ratio than healthy hands (19.9±6.7 vs 35.6±8.0; P value <0.0001). Subjective assessment of atrophy correlated with the thenar ratio. Conclusions: This method can be used as a simple objective test for the assessment and follow-up of thenar atrophy.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131135851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposed Otoplasty Model: Innovative Use for a Hearing Aid Demonstration Mould","authors":"L. H. Wu, K. Pang, Y. Ng, S. Yeak","doi":"10.5580/1ba3","DOIUrl":"https://doi.org/10.5580/1ba3","url":null,"abstract":"Prominent ear is a cosmetic deformity that can have severe emotional and behavioural effect on a child. Otoplasty describes the surgical procedures designed to give the auricle a more natural and anatomic appearance. Otoplasty can be categorized as either cartilage splitting (cutting) or cartilage scoring. Cartilage-splitting involve full-thickness incisions through the cartilage and repositioning of large blocks of auricular cartilage. Cartilage-scoring such as Stentroms' scoring techniques involves making partial-thickness incisions, while attempting to avoid sharp anglulations and to re-produce smooth curves in the cartilage. Our proposed otoplasty model is based on modifications of an existing hearing aid model which is readily available in our clinic. The modified ear moulds allow residents to practise on ear cartilage moulding techniques before operating on patients.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114577222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Square Peg into a Round Hole”: Closure of a Laparotomy Wound Dehiscence with a Modified Rhomboid Flap","authors":"A. Collins, S. H. Shah, Tom O’Reilly","doi":"10.5580/1e71","DOIUrl":"https://doi.org/10.5580/1e71","url":null,"abstract":"The case of closure of a laparotomy wound dehiscence using a modified rhomboid flap is reported. A 61-year-old man, with a body mass index of 37.3 and a 120 pack-year smoking history, developed an incisional hernia following a left hemicolectomy. Repeated recurrences resulted in four mesh repairs. The fourth was complicated by a polymicrobial wound infection and superficial dehiscence in the supra-umbilical portion of the wound. The residual defect, composed of granulation tissue overlying polypropylene mesh, measured 10cm by 12cm. Both vacuum-assisted closure and split thickness skin grafting were attempted before successfully closing the defect with a modified rhomboid fasciocutaneous flap. Although there have been many technical innovations since the advent of rhomboid flaps, it offered a simple, yet effective therapeutic option in this case. INTRODUCTION First described by Alexander Limberg [1], the classical rhomboid flap is constructed around a defect converted into a geometric four-sided rhombus. Later modifications suggested that the flap could also be used to fill circular and irregular shaped defects [2]. A modified rhomboid flap was used, in this case, to close an irregularly shaped laparotomy wound dehiscence. CASE REPORT A 61-year-old man, with a body mass index of 37.3 and a 120 pack-year smoking history, developed an incisional hernia following a left hemicolectomy. Repeated recurrences resulted in four mesh repairs over a nine-year period. The fourth repair was complicated by a polymicrobial wound infection, and following clip removal on the tenth post-operative day, superficial dehiscence in the supra-umbilical portion of the wound. Vacuum-assisted closure therapy was commenced. Two months later the defect, composed of granulation tissue overlying polypropylene mesh, measured 10cm by 12cm (Figure 1). A fenestrated split thickness skin graft was applied. It was complicated by a beta haemolytic streptococcus wound infection and only 40% take was achieved (Figure 2). Figure 1 Figure 1: Superficial dehiscence in the supra-umbilical portion of the wound resulting in a 10 by 12cm defect composed of granulation tissue overlying polypropylene mesh. “Square Peg into a Round Hole”: Closure of a Laparotomy Wound Dehiscence with a Modified Rhomboid Flap 2 of 3 Figure 2 Figure 2: Modified rhomboid fasciocutaneous flap oversized to allow for debridement of the defect. The defect was subsequently closed using a modified rhomboid fasciocutaneous flap incorporating the laparotomy scar (Figure. 3). The flap was oversized to allow for debridement of the defect and inserted using a combination of polyglactin and poliglecaprone sutures and skin clips. The post-operative course was uneventful and the wound healed without complication (Figure 4). The cosmetic appearance was satisfactory to the patient. Figure 3 Figure 3: Healed wound at 16 weeks post procedure. DISCUSSION Most commonly used in head and neck reconstruction [2], rhomboid flaps may also p","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122446724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sushruta: The first Plastic Surgeon in 600 B.C.","authors":"S. Saraf, R. Parihar","doi":"10.5580/1456","DOIUrl":"https://doi.org/10.5580/1456","url":null,"abstract":"Sushruta, one of the earliest surgeons of the recorded history (600 B.C.) is believed to be the first individual to describe plastic surgery. Sushruta who lived nearly 150 years before Hippocrates vividly described the basic principles of plastic surgery in his famous ancient treatise 'Sushruta Samhita' 1,2 in 600 B.C. 'Sushruta Samhita'(Sushruta's compendium) which is one of the oldest treatise dealing with surgery in the world indicates that he was probably the first surgeon to perform plastic surgical operations. This paper presents a historical window into various contributions of Sushruta to plastic surgery and allied fields which were described in 'Sushruta Samhita' more than 2500 years ago. Although many people consider Plastic Surgery as a relatively new specialty, the origin of the plastic surgery had his roots more than 4000 years old in India, back to the Indus River Civilization. The mythico-religious shlokas (hymns) associated with this civilization were compiled in Sanskrit language between 3000 and 1000 B.C. in the form of Vedas, the oldest sacred books of the Hindu religion. This era is referred to as the Vedic period (5000 years B.C) in Indian history during which the the four Vedas, namely the Rigveda, the Samaveda, the Yajurveda, and the Atharvaveda were compiled. All the four Vedas are in the form of shlokas (hymns), verses, incantations and rites in Sanskrit language.3 ‘Sushruta Samhita' is believed to be a part of Atharvaveda. 4 ‘Sushruta Samhita'(Sushruta's compendium), which describes the ancient tradition of surgery in Indian medicine is considered as one of the most brilliant gems in Indian medical literature. This treatise contains detailed descriptions of teachings and practice of the great ancient surgeon Sushruta (Figure-1) which has considerable surgical knowledge of relevance even today. Figure 1 Figure 1: Sushruta (600 B.C.) The ‘Sushruta Samhita' contains the major surgical text of the Vedas and is considered to be the most advanced compilation of surgical practices of its time. ‘Sushruta Sushruta: The first Plastic Surgeon in 600 B.C. 2 of 7 Samhita' encomprises not only the teaching regarding the plastic surgery but contains composite teachings of the surgery and all the allied branches including midwifery and making it a comprehensive treatise on the entire medical discipline. Sushruta believed that knowledge of both surgery and medicine are essential to constitute a good doctor who otherwise “is like a bird with only one wing.” In fact, Sushruta emphasized in his text that unless one possesses enough knowledge of relevant sister branches of learning, one cannot attain proficiency in one's own subject of study. According to Sushruta, “Any one, who wishes to acquire a thorough knowledge of anatomy, must prepare a dead body and carefully observe and examine all its parts”. The method of study was to submerge the body in water and allow it to decompose followed by examination of the decomposing body at intervals ","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116048488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete Cleft Palate: A New Scheme Of Treatment","authors":"A. Rahoma","doi":"10.5580/8d8","DOIUrl":"https://doi.org/10.5580/8d8","url":null,"abstract":"The problems of complete cleft palate still represent a great challenge because of the potential associated sequalae and complications with the current treatment scheme which necessitated finding out a new scheme of treatment that can minimize these problems.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125010587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid Resusciatation Early In Major Burns: Ten Years Experience In Saudi Arabia","authors":"A. Hussein, A. Rahoma","doi":"10.5580/677","DOIUrl":"https://doi.org/10.5580/677","url":null,"abstract":"In the period from January 1992 up to the end of July 2001, the Burns Unit in King Khalid-C-Hospital in the North West of Saudi Arabia received 735 cases of burns. The cases had various causes, age groups, degrees, depth and extent. The formula used in treating these burns patients was a modification of Parkland formula. The fluid used was Ringer lactate solution. This fluid was continiously administered until the general condition of the patient was stabilized. Early oral intake was encouraged in all patients and was started as early as the second day in most cases. Colloids were given once the patient is stabilised, and according to the individual patients' needs. The results of this treatment regime significantly avoided renal complications and ensured perfect patient rehydration.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121676344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}