The Internet Journal of Plastic Surgery最新文献

{"title":"An Atraumatic Technique For Transposition Of Veins And Vascular Pedicles Of Free Flaps","authors":"E. Wilson, N. Jallali, N. Kang","doi":"10.5580/144c","DOIUrl":"https://doi.org/10.5580/144c","url":null,"abstract":"Vessel transfer through a subcutaneous tunnel is a frequent procedure. We report on a modification on a previously reported method. TECHNIQUE Passing vein grafts and the vascular pedicles of free flaps through a subcutaneous tunnel can be a time consuming process and may damage the vessels. For several years, the senior author of this article has used a rapid and relatively atraumatic technique to achieve this, modifying a previously published method (1). To transfer a vessel, the tip of a Yankauer sucker is gently pushed through the subcutaneous tissues, between the two sites of interest. The sucker is left in place creating a tunnel. Rarely, the Yankauer cannot be passed through easily and sharp dissection is required. Once the Yankaeur is in the correct position, the vein graft/pedicle is placed carefully into the open end of the sucker (Figure 1). Figure 1 Figure 1: Interpolation of the left cephalic vein to supercharge a venously congested DIEP flap. Gentle suction is then applied to the blunt end of the sucker.. The negative pressure pulls the vessels into the lumen of the Yankaeur, which is then gently withdrawn, pulling the vessels through the subcutaneous tunnel with it. Any twist in the vessels is (coincidentally) unravelled at the same time. We routinely use this technique to tunnel vein grafts and the vascular pedicles of free flaps and believe it is a safe, rapid and simple method. CORRESPONDENCE TO E. Wilson, Department of Plastic Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk, NR4 7UY Tel: 01603286286 Email: ewanwilson@doctors.org.uk References 1. Scott, M. J. and S. P. Kay (1993). “A simple atraumatic method of pedicle delivery during free tissue transfer.” British Journal of Plastic Surgery. 46(4): 340. An Atraumatic Technique For Transposition Of Veins And Vascular Pedicles Of Free Flaps 2 of 2 Author Information E. Wilson RAFT Institute for Plastic Surgery, Mount Vernon Hospital N. Jallali RAFT Institute for Plastic Surgery, Mount Vernon Hospital N. Kang RAFT Institute for Plastic Surgery, Mount Vernon Hospital","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"82 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":"115051637","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":"Morpheic Basal Cell Carcinoma: Transformation Or Original Pathology?","authors":"A. Widgerow, T. Christofides","doi":"10.5580/14e2","DOIUrl":"https://doi.org/10.5580/14e2","url":null,"abstract":"Morpheic basal cell carcinomas (BCC) are considered aggressive and difficult to control. Can prior treatment of a regular BCC initiate its change to a morpheic pattern? 36 patients with diagnosed morpheic BCC were selected. Details of previous surgery and histologic diagnosis were recorded. Out of the 36 patients only 11 had morpheic BCC without previous treatment. Of the 21 who had had prior treatment, 9 had previous histological results available, of which only 1 had an original diagnosis of morpheic BCC. The study prompts the following questions: 1. After treatment can a BCC transform into a more aggressive morpheic type? 2. Can a background of fibrosis such as that produced by freezing, curetting or that seen with chronic wounds initiate a change in the character of the basal cell to the morpheic form to allow its survival in the scar tissue? Presented at the Annual Meeting of The Association of Plastic And Reconstructive Surgeons of Southern Africa, Sun City, South Africa, October 2001.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2005-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125375653","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":"Successful Non-Microvascular Nasal Tip Replantation After Traumatic Avulsion","authors":"P. Seymour, R. Winokur, G. Artz, E. Pribitkin","doi":"10.5580/1ece","DOIUrl":"https://doi.org/10.5580/1ece","url":null,"abstract":"Objectives: To present a case of a traumatic avulsion of the nasal tip treated successfully with non-microvascular replantation Methods: Illustrative case report Results: A 37-year-old male presented to Thomas Jefferson University Hospital with a traumatic avulsion of his nasal tip from a human bite. The avulsed tissue was 2cm in size, included the lower lateral cartilage and involved multiple subunits of the nose. Replantation was performed 8 hours after the traumatic incident. Leeches were applied to the re-implanted tissue immediately following surgical repair. Two weeks after surgery 80% graft survival was noted. The residual defect was reconstructed with a pedicled columellar graft. Conclusions: This case presents evidence that non-microvascular replantation of full thickness composite tissue can result in survival with acceptable clinical outcomes. In this particular case, tissue survival obviated forehead flap reconstruction and its associated morbidity. Future studies to determine the effects of time, size and leech therapy on replanted tissues are needed.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2005-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128472263","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":"Innervated Gluteus Maximus For Huge Thigh & Groin Defects","authors":"A. Rahoma, P. R. Sengupta, K. Pan","doi":"10.5580/f2b","DOIUrl":"https://doi.org/10.5580/f2b","url":null,"abstract":"Gluteus maximus is a bulky muscle with three sources of blood supplying also a skin flap that extends from iliac crest down to the popliteal fossa. The myocutaneous flap has been used long time ago, as an insensate flap, to cover defects in the buttocks.9,10,12 In this study we use this muscle as a sensate flap keeping sensory and motor nerves, to cover major defects in the buttocks and groin. This study included seven cases with different indications. The technique depends upon full mobilization of the muscle based on two main vascular pedicles to maintain adequate vascularity and nerve supply of the transposed flap.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2005-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131342231","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":"Rare Case Of Exostosis Following Dog Bite: A Case Report","authors":"Z. Shariff, J. Giannas, J. Srinivasan","doi":"10.5580/1c25","DOIUrl":"https://doi.org/10.5580/1c25","url":null,"abstract":"Dog bites are major public health problems(4). These are associated with acute and chronic complications needing admission to the hospital. Acute complications include life threatening rabies, various types of infections with associated complications(3), soft tissue loss and fractures(1). Chronic complications in the form of cosmetic deformities and chronic osteomyletis(2) are well documented. Dog bites are contaminated wounds and convention dictates that any surgical treatment should be performed at the earliest opportunity(5). We present a rare case of exostosis in the tibia one year following dog bite. CASE REPORT A 19 year girl presented to the plastic surgery following an English terrier bite on the left leg. She had an open wound of about 4-5cms with loss of skin. This was managed with early debridement and secondary intention wound healing. At the time of presentation, x-ray revealed no bony injuries. The wounds healed well and the patient was followed up in the clinic. One year later, patient complaint of noticing a bone swelling at the site of now well healed wound. X-ray revealed a bony spicule( Fig 1). Figure 1 Figure 1: Showing bone spicule Rare Case Of Exostosis Following Dog Bite: A Case Report 2 of 3 There was no recent history of injury to the area. It was thought that periosteal stripping followed by a phenomenon of exostosis might have lead to the formation of the bone spicule. A decision of removal of the bony spicule was made. DISCUSSION Dog bites are known to cause complications. These complications include early and late complications. Most dreaded complication includes rabies. Early debridement and appropriate treatment is necessary. Bone complications in the form of osteomyleties are recorded. But periosteal stripping followed by calcification forming bony swelling is not recorded. The author tries to emphasis the even though at the time of presentation there was no clinical evidence of bone injury, periosteal reaction can lead to a similar phenomenon of exostosis in such injuries. CORRESPONDENCE TO Mr. Zakir Shariff, 23, Rosemary Way, Beverly. HU17 0SS. UK Phone: 07793538278 Email : zakirshariff@hotmail.com References 1. Fourie L, Cartilidge D: Fracture of the maxilla following dog bite to the face, Injury. 1995 Jan;26(1):61-2. 2. Desai SS, Groves RJ, Glew R: Subacute Pasteurella osteomyelitis of the hand following dog bite.Orthopedics. 1990 Jun;13(6):653-6 3. Goldstein EJC: Bite wounds and infection. Clin Infect Dis 1992, 14:633-640 4. Hoff GL, Cai J, Kendrick R, Archer R: Emergency department visits and hospitalizations resulting from dog bites, Kansas City, MO, 1998-2002.Mo Med. 2005 Nov- Dec;102(6):565-8 5. Akhtar N, Smith MJ, McKirdy S, Page RE: Surgical delay in the management of dog bite injuries in children, does it increase the risk of infection?, Br J Plast Surg. 2005 Sep 8; Rare Case Of Exostosis Following Dog Bite: A Case Report 3 of 3 Author Information Zakir Shariff, MS, MRCSEd SHO, Plastic Surgery, Lancashi","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2005-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114250563","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":"Designing A Portal To Validated Cosmetic Surgery Information Websites","authors":"A. Parikh, A. Clarke, P. Butler","doi":"10.5580/1ca6","DOIUrl":"https://doi.org/10.5580/1ca6","url":null,"abstract":"Introduction: Patients are increasingly accessing the Internet to obtain medical information. However, there have been many concerns about the difficulty in assessing the accuracy of this information. Although many website rating tools exist, the vast majority of these are unusable by consumers. Finding valid and up to date information can be very challenging and time consuming for patients. Methods: We analysed the first 200 websites are a Google search on \"cosmetic surgery\" using a combination of consumer and clinician based website rating tools. After identifying the \"top scoring\" websites we designed a \"gateway\" website and used these sites as links. Results: Eighty-nine percent of the websites did not meet the standard as described by the website rating tools. We also describe the method of design of the \"gateway\" website. Conclusions: Patients need to be better informed about the difficulty in obtaining accurate, valid information on the Internet. By directing patients to validated websites, clinicians can ease this problem. There are several resource issues that need to be addressed in order to maintain a website. WHAT WAS KNOWN BEFORE THE STUDY? Obtaining valid, accurate and up to date medical information is very difficult for the layperson. The usage of the Internet to obtain medical information is on the rise. There have been many instruments designed to assess the quality of health information websites; the vast majority of these cannot be used practically by laypersons. Physicians are often unlikely to recommend other websites as URL's change and many sites are not maintained and reviewed regularly. In disciplines such as cosmetic surgery, physicians may be reluctant to recommend a competitor's website. WHAT THIS STUDY ADDS Independent clinicians are best placed to assess the quality of medical websites. There is no need to design anymore websites on cosmetic surgery (or any other discipline) as there are over 16 million in existence. Using a combination of consumer and clinician based website assessment tools a “gateway” website has been designed. This “gateway” site can be recommended without any prejudice and is regularly maintained.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"93 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2005-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127981142","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":"Acute Remote Preconditioning Augments Random Skin Flap Survival, But Not Recipient-Bed Isolated Flaps In Rats","authors":"Y. Coban, E. Bulbuloglu","doi":"10.5580/1e76","DOIUrl":"https://doi.org/10.5580/1e76","url":null,"abstract":"This study proposes that acute remote preconditioning (ARIP) can effectively enhance random skin flap survival.The study was a randomized controlled trial using male sprague-Dawley rats as subjects. For acute remote preconditioning, left hindlimb ischemia was achieved by clamping the femoral artery and vein.After 1 hour's ischemia, the limb reperfusion was done for 30 minutes. Then, a 3by 9cm dorsal caudal-based, random pattern skin flap was elevated and reaproximated for flap survival studies. Thirty rats were divided into three groups of 10 rats each. The first group had only the flap raised, while the second and third groups had acute remote preconditioning protocol before the flap elevation. In the third group, a silicone sheet was inserted beneath the flap in order to prevent neovascularisation from the bed. The amount of flap necrosis was measured on the seventh postoperative day. ARIP (acute remote ischemic preconditioning) group had the most improved skin flap survival rate, and the flap survival rates between the ARIP+silicone sheet and control groups was not statistically different (p>0.05). These findings indicate that remote ischemic precontioning enhances random skin flap survival, when it is performed just before the flap harvest and the isolation of recipient bed abolishes this ameloriating effect.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2005-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116989975","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":"Median Cleft Of The Lip: A Rare Facial Anomaly","authors":"S. Saraf","doi":"10.5580/642","DOIUrl":"https://doi.org/10.5580/642","url":null,"abstract":"Median cleft lip is a midline vertical cleft through the upper lip in the absence of a prolabial ramnant. The incidence is about 1: 10,00,000 births. This may occur as a sporadic event or as a part of an inherited sequence of anomalies. It arises embryologically from incomplete fusion of the medial nasal prominences. The author presents a rare case of median cleft lip,broad nose, wide ala with hypertelorism. The embryology, presentation and surgical technique for treating these cases are discussed.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"158 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2005-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121048667","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":"The Harry Potter Forehead Scar Following A Lightning Injury","authors":"N. Shamsian, M. Jones, M. Brough, R. Standish, J. Humberson","doi":"10.5580/558","DOIUrl":"https://doi.org/10.5580/558","url":null,"abstract":"Lightning strikes kill 1,000 people per year worldwide. They are also responsible for several hundred deaths and thousands of injuries each year in this country. Survivors sustain a variety of neurological, cardiac, musculoskeletal, and dermatological injuries. Eye and ear injuries are also noted in the literature. We report a case of a 14 year old girl. CASE REPORT This is a case report of a 14 year old girl who presented to The Royal Free Hospital Plastic Surgery Unit with a forehead lesion. Four years previously, she had been struck by lightning whilst walking on a gravel road. She was wearing a metal hair-clip at the time. The lightning apparently struck her right trainer and caused a hole. She noticed a well–demarcated, mobile, hard lesion a few months later. A scar was also present over the supra-orbital area as shown in the photograph below.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2005-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127794893","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":"Treatment Of Self Inflicted Scars With Overgrafting: Destigmatization","authors":"C. Baytekin, A. Menderes, F. Mola, H. Fidaner, A. Barutçu","doi":"10.5580/241c","DOIUrl":"https://doi.org/10.5580/241c","url":null,"abstract":"Treatment of self inflicted scars is allways a difficult task. These scars are usually on the nondominant forarm and extend as parellel white lines. Patients are stigmatised by the community due to this scars and want to get rid of them. Treatment of these scars is different than routine scar revisions. This will be a destigmatization action. After request of our patient to transform the scar into another form of scar , we use split thickness excision of the lesion and subsequent grafting of the area with STSG. Although there is an increase in total scar area and an extra donor site scar, destigmatisation of the patients is achieved.","PeriodicalId":284795,"journal":{"name":"The Internet Journal of Plastic Surgery","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2005-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128401771","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}