British journal of plastic surgery最新文献

{"title":"Release of oral submucous fibrosis and reconstruction using superficial temporal fascia flap and split skin graft—a new technique","authors":"N.J. Mokal ,&nbsp;R.S. Raje ,&nbsp;S.V. Ranade ,&nbsp;J.S. Rajendra Prasad ,&nbsp;R.L. Thatte","doi":"10.1016/j.bjps.2005.04.048","DOIUrl":"10.1016/j.bjps.2005.04.048","url":null,"abstract":"<div><p>Long standing oral submucous fibrosis is associated with involvement of the oral submucosa and the muscles of mastication leading to difficulty in mouth opening. Various surgical modalities are mentioned for release but each has its own limitations. This article introduces a new technique of release of submucous fibrosis and reconstruction using superficial temporal fascia flap and split skin graft. The surgical technique involves a pre-auricular incision extending into the temporal region with dissection carried out in the sub follicular plane to develop the superficial temporal fascia flap to its maximum extent. The masseter muscle origin is released from the zygomatic arch and the temporalis muscle insertion is released from the coronoid process through an external approach. The entire fibrosed mucosa is released intraorally to create a mucomuscular defect thus achieving full mouth opening. The superficial temporal fascia flap is then brought in and sutured to the intraoral defect, which is then covered with a split thickness skin graft. This procedure is performed bilaterally.</p><p>A total of five patients were treated with this new technique and all of them showed good mouth opening in long term follow up. There was no donor site morbidity. The incision line is well hidden in the hair bearing area. A well vascularised superficial temporal fascia flap brings in good blood supply to the area of affected muscle and mucosa to improve its function.</p></div>","PeriodicalId":9252,"journal":{"name":"British journal of plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjps.2005.04.048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25221613","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":"Extensive facial adenoma sebaceum: successful treatment with mechanical dermabrasion: case report","authors":"Kusai A. El-Musa,&nbsp;Ramzi S. Shehadi,&nbsp;Sameer Shehadi","doi":"10.1016/j.bjps.2005.04.021","DOIUrl":"10.1016/j.bjps.2005.04.021","url":null,"abstract":"<div><p>This report documents the successful elimination of disfiguring sebaceous adenomas from the face of a 21-year-old male patient with mechanical dermabrasion.</p></div>","PeriodicalId":9252,"journal":{"name":"British journal of plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjps.2005.04.021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25225322","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 management of midline transcranial nasal dermoid sinus cysts","authors":"M. Hanikeri,&nbsp;N. Waterhouse,&nbsp;N. Kirkpatrick,&nbsp;D. Peterson,&nbsp;I. Macleod","doi":"10.1016/j.bjps.2005.05.021","DOIUrl":"10.1016/j.bjps.2005.05.021","url":null,"abstract":"<div><p>The most common congenital midline nasal masses are nasal dermoid sinus cysts (NDSC) [Hughes GB, Sharpino G, Hunt W, Tucker HM. Management of the congenital midline nasal mass—a review. <em>Head Neck Surg</em> 1980;<strong>2</strong>:222–33.<span>¹</span>]. Their clinical importance hinges on their potential to communicate with the central nervous system. Preoperative diagnosis of an intracranial extension allows for referral to a craniofacial team with the appropriate skills and experience for a transcranial approach. All patients with a NDSC require imaging with high resolution multiplanar MRI scans and complimentary fine cut CT scan to reveal the anatomical extent of the tract and its relationship to the anterior cranial fossa.</p><p>A single-stage craniofacial approach to resection of midline NDSC extending to the anterior cranial base is effective with minimal morbidity [Yavuzer R, Bier U, Jackson IT. Be careful: it might be a nasal dermoid cyst. <em>Plast Reconstr Surg</em> 1999;<strong>103</strong>:2082–3; Denoyelle F, Ducroz V, Roger G, Garabedian EN. Nasal dermoid sinus cysts in children. <em>Laryngoscope</em> 1997;<strong>107</strong>:795–800; Rohrich RJ, Lowe JB, Schwartz MR. The role of open rhinoplasty in the management of nasal dermoid cysts. <em>Plast Reconstr Surg</em> 1999;<strong>104</strong>:2163–70; Rahbar R, Shah P, Mulliken JB, et al. The presentation and management of nasal dermoid—a 30-year experience. <em>Arch Otolaryngol Head Neck Surg</em> 2003;<strong>129</strong>:464–71; Posnick JC, Bortoluzzi P, Armstrong DC, Drake JM. Intracranial nasal dermoid sinus cysts: computed tomographic scan findings and surgical results. <em>Plast Reconstr Surg</em> 1994;<strong>93</strong>:745–54 [discussion 755–56]; Bartlett SP, Lin KY, Grossman R, Kratowitz J. The surgical management of orbitofacial dermoids in the pediatric patient. <em>Plast Reconstr Surg</em> 1993;<strong>91</strong>:1208–15.<span>2</span>, <span>3</span>, <span>7</span>, <span>9</span>, <span>11</span>, <span>18</span>]. The cyst and tract are accessed through a combination of a nasal and transcranial approach. This allows visualisation and dissection of the tract with only a small incision on the nasal dorsum to include the cutaneous punctum when present. Transnasal endoscopic techniques have been advocated where the dermoid is located within the nasal cavity and there is little or no cutaneous involvement [Weiss DD, Robson CD, Mulliken JB. Transnasal endoscopic excision of midline nasal dermoid from the anterior cranial base. <em>Plast Reconstr Surg</em> 1998;<strong>101</strong>:2119–23.<span>²⁶</span>].</p><p>We present a review of five cases referred to our unit between 1999 and 2004 with a diagnosis of a midline nasal dermoid sinus cyst and radiological evidence of intracranial communication. All cases had a communication with the anterior cranial fossa diagnosed preoperatively and were treated surgically with a craniofacial approa","PeriodicalId":9252,"journal":{"name":"British journal of plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjps.2005.05.021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25235263","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":"Oro-nasal fistula development and velopharyngeal insufficiency following primary cleft palate surgery—an audit of 148 children born between 1985 and 1997","authors":"D.S. Inman,&nbsp;P. Thomas,&nbsp;P.D. Hodgkinson,&nbsp;C.A. Reid","doi":"10.1016/j.bjps.2005.05.019","DOIUrl":"10.1016/j.bjps.2005.05.019","url":null,"abstract":"<div><p>We present an audit of primary cleft palate surgery in our unit including rates of two important post-operative complications.</p><p>Multidisciplinary audit clinics ran from March 1998 to April 2002 to follow up all local patients with a cleft lip or palate who had undergone primary palatal surgery in our unit. One hundred and forty eight patients were studied. Patient ages at follow-up ranged from 3 years and 10 months to 17 years and 4 months. Two surgeons performed the primary surgery. One hundred and twenty eight Wardill-Kilner and 20 Von Langenbeck repairs were performed.</p><p>We found a 4.7% rate of oro-nasal fistula development requiring surgical closure, and a 26.4% rate of velopharyngeal insufficiency (VPI) requiring subsequent pharyngoplasty. We noted that the type of cleft involved affected the rate of VPI, 16% of patients with unilateral cleft lip and palate versus 29.2% of patients with a solitary cleft palate requiring secondary surgery.</p><p>Outcome of surgery was determined by a ‘Cleft Audit Protocol for Speech’ (CAPS) speech therapy assessment at follow-up clinics. Only 14.9% of all patients assessed demonstrated any degree of hypernasality.</p><p>Our results compare favourably with other recent studies including the Clinical Standards Advisory Group (CSAG) report into treatment of children with cleft lip and palate.</p></div>","PeriodicalId":9252,"journal":{"name":"British journal of plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjps.2005.05.019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25235107","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":"Correction of long term joint contractures of the hand by distraction. A case report","authors":"P. Natividade da Silva,&nbsp;R. Barbosa,&nbsp;P. Ferreira,&nbsp;A. Ferreira,&nbsp;E. Malheiro,&nbsp;A. Silva,&nbsp;J. Reis,&nbsp;J. Amarante","doi":"10.1016/j.bjps.2005.04.028","DOIUrl":"10.1016/j.bjps.2005.04.028","url":null,"abstract":"<div><p>Joint contractures are a common complication of hand trauma. The conventional treatment consists of arthrolysis, tenolysis and occasionally arthrodesis. Frequently, this does not achieve a good result, particularly when there has been a long delay in presentation. Progressive lengthening of a joint by distraction (joint distraction) allows the release of joint contractures even in cases of failure of traditional methods.</p><p>We present a case of a delayed (20 years) work related traumatic flexion deformity of the PIP joint of the left index and middle fingers. This was the result of a complete division of both flexor tendons of both fingers.</p><p>The range of movements, both active and passive, was limited to 90/100° in the index finger and 95/100° in the middle finger. Following joint distraction using our lengthening device (Antão™, Portugal) the patient was able to achieve an active and passive range of movements of 10/100° for the PIP joint of the index finger and 40/100° of the middle.</p><p>This clinical case shows the simplicity and application of our technique for the correction of joint contractures.</p></div>","PeriodicalId":9252,"journal":{"name":"British journal of plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjps.2005.04.028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24917553","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":"","authors":"N. Kang","doi":"10.1016/j.bjps.2005.05.006","DOIUrl":"10.1016/j.bjps.2005.05.006","url":null,"abstract":"","PeriodicalId":9252,"journal":{"name":"British journal of plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjps.2005.05.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127878890","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":"Post-ablative reconstructon of the medial canthus and medial orbital wall using conchal cartilage graft with three illustrative cases","authors":"G. Dagregorio ,&nbsp;V. Darsonval","doi":"10.1016/j.bjps.2005.04.027","DOIUrl":"10.1016/j.bjps.2005.04.027","url":null,"abstract":"<div><p>When the medial third of the upper or lower eyelid has to be reconstructed after full-thickness tumour excision, we usually use Hübner tarsomarginal grafts, but when medial canthal lesions spread to the medial orbital wall without invading the orbital margin, conchal graft becomes our first surgical option. Previously reported solutions to this difficult problem are few and concern more directly medial orbital wall fractures. We found no article dealing specifically with the use of conchal graft in post-ablative reconstruction of the medial orbital wall. Nevertheless the concha presents great advantages over bone grafting or rib cartilage, because it is more flexible and malleable. And it is less prone to extrusion or infection as may be allografts implants. It is a very effective way to repair medial orbital defects, but graft reorientation must be perfect to match exactly the medial orbital wall concavity.</p></div>","PeriodicalId":9252,"journal":{"name":"British journal of plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjps.2005.04.027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25208069","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 use of pimonidazole to characterise hypoxia in the internal environment of an in vivo tissue engineering chamber","authors":"S.O.P. Hofer,&nbsp;G.M. Mitchell,&nbsp;A.J. Penington,&nbsp;W.A. Morrison,&nbsp;R. RomeoMeeuw,&nbsp;E. Keramidaris,&nbsp;J. Palmer,&nbsp;K.R. Knight","doi":"10.1016/j.bjps.2005.04.033","DOIUrl":"10.1016/j.bjps.2005.04.033","url":null,"abstract":"<div><p>The distribution of hypoxic cells in an in vivo tissue engineering chamber was investigated up to 28 days post-implantation.</p></div><div><h3>Methods</h3><p>Arteriovenous loops were constructed and placed into bi-valved polycarbonate chambers containing 2×10⁶ rat fibroblasts in basement membrane gel (BM gel). Chambers were inserted subcutaneously in the groin of male rats and harvested at 3 (<em>n</em>=6), 7 (<em>n</em>=6), 14 (<em>n</em>=4) or 28 (<em>n</em>=4) days. Ninety minutes before harvest, pimonidazole (60<!--> <!-->mg/kg) was injected intraperitoneally. Chamber tissue was removed, immersion fixed, paraffin embedded, sectioned and stained immunohistochemically using hypoxyprobe-1 Mab that detects reduced pimonidazole adducts forming in cells, where pO₂&lt;10<!--> <!-->mmHg.</p></div><div><h3>Results</h3><p>At 3 days a fibrin clot/BM gel framework filled the chamber. Seeded fibroblasts had largely died. The majority of 3 day chambers did not demonstrate tissue growth from the AV loop nor was pimonidazole binding present in these chambers. In one chamber in which tissue growth had occurred strong pimonidazole binding was evident within the new tissue. In four out of six 7 day chambers a broader proliferative zone existed extending up to 0.4<!--> <!-->mm (approximately) from the AV loop endothelium which demonstrated intense pimonidazole binding. The two remaining 7 day chambers displayed even greater tissue growth (leading edge&gt;0.7<!--> <!-->mm from the AV loop endothelium), but very weak or no pimonidazole binding. At 14 and 28 days the fibrin/BM gel matrix was replaced by mature vascularised connective tissue that did not bind pimonidazole.</p></div><div><h3>Conclusion</h3><p>Employing a tissue engineering chamber, new tissue growth extending up to 0.4<!--> <!-->mm from the AV loop endothelium (chambers≤7 days) demonstrated intense pimonidazole binding and, therefore, hypoxia. Tissue growth greater than 0.5<!--> <!-->mm from the AV loop endothelium (7–28 days chambers) did not exhibit pimonidazole binding due to a significant increase in the number of new blood vessels and was, therefore, adequately oxygenated.</p></div>","PeriodicalId":9252,"journal":{"name":"British journal of plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjps.2005.04.033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25211445","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 combined free partial vastus lateralis with anterolateral thigh perforator flap reconstruction of extensive composite defects","authors":"N.A.S. Posch,&nbsp;M.A.M. Mureau,&nbsp;S.J. Flood,&nbsp;S.O.P. Hofer","doi":"10.1016/j.bjps.2005.04.022","DOIUrl":"10.1016/j.bjps.2005.04.022","url":null,"abstract":"<div><p>Myocutaneous (MC) free flaps are useful for many reconstructive indications. Perforator flaps have become standard of care. The anterolateral thigh flap (ALT) donor site is popular. With the ALT flap varying sizes of vastus lateralis (VL) muscle can be harvested as a MC flap. The skin islands of these flaps have a great range of freedom when dissected on their perforator. It was hypothesised that the VL–ALT perforator flap would offer adequate tissue volume combining maximal freedom in planning with minimal donor site morbidity. From November 2001 to February 2003 a free partial VL with ALT perforator flap was used in 11 patients to reconstruct large defects. Indications for adding a muscular component were exposed bone, skull base, (artificial) dura, or osteosynthesis material, open sinuses, and lack of muscular bulk. Flaps were planned as standard ALT flaps, after which three types of dissection were performed: I. true MC flap; II. muscle flap with a skin island on one perforator, which could be rotated up to 180°; III. chimera skin perforator flap with muscle being harvested on a separate branch from the source vessel or on a side branch of the skin perforator. Mean skin size of the MC-ALT flaps was 131<!--> <!-->cm². Mean muscle part size of the MC-ALT flaps was 268<!--> <!-->cm³. Muscular parts were custom designed for all defects. No total or partial flap failures were seen. Colour mismatch was seen in 6 of 8 patients, when skin was used in the facial area in this all white population. Excessive flap bulk was found in 8 of 11 patients at 6 weeks, however, only in 2 of 11 patients after 6 months. Patients were satisfied with the functional result (8 of 11 patients) as well as the cosmetic result of their reconstruction (7 of 11 patients). All less satisfied patients had received their flap for external facial skin reconstruction. Donor site morbidity was minimal. The combined free partial VL with ALT perforator flap proved valuable as a (chimera type) MC flap with maximal freedom of planning to meet specific reconstructive demands and minimal donor site morbidity.</p></div>","PeriodicalId":9252,"journal":{"name":"British journal of plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjps.2005.04.022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25211447","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 anatomic basis of the gracilis perforator flap","authors":"Efstathios G. Lykoudis ,&nbsp;Georgia-Alexandra Ch. Spyropoulou ,&nbsp;Catherine C. Vlastou","doi":"10.1016/j.bjps.2005.01.026","DOIUrl":"10.1016/j.bjps.2005.01.026","url":null,"abstract":"<div><p>Another perforator flap, the gracilis perforator flap, has recently been added to the armamentarium of reconstructive surgeons. A detailed study of the anatomy of this flap was undertaken in this study. Forty-seven dissections were performed in cadavers and clinical cases of gracilis muscle harvesting for various reconstructive reasons. According to our findings, at least one musculocutaneous perforator of large calibre was found in the majority of the dissections performed (87%), emanating from the proximal third of gracilis. All the perforators were located within a radius of 7<!--> <!-->cm from the point of entrance of the gracilis main vascular pedicle. In their majority, they emanated proximal to that point (83%) from the middle part (anteroposterior axis) of the muscle (62%). The intramuscular course of the perforators was easily followed and few muscular branches were encountered, before they joined the main vascular pedicle. A sensory branch of the anterior obturator nerve, accompanying the perforators, was occasionally found (29%). Finally, a superficial vein, branch of the greater saphenous, was always found within the skin territory of the flap in all dissections performed in cadavers.</p></div>","PeriodicalId":9252,"journal":{"name":"British journal of plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjps.2005.01.026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40940492","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}