scholarly journals Ear Reconstruction

2021 ◽  
pp. 731-745
Author(s):  
Paritkumar Ladani
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Congenital Deformity ◽  
Ear Reconstruction ◽  
No Donor ◽  
Rib Cartilage ◽  
Self Confidence ◽  
Emerging Trends ◽  
The Face ◽  
Reconstructive Techniques

AbstractMicrotia is a congenital deformity of the external ear, with a prevalence rate of approximately 1 in 10,000 live births worldwide. The auricle is a distinguishing feature of the face. Its deformity may have severe psycho-social implications on the affected children, affecting their self-confidence. Current reconstructive techniques for microtia mainly include the auricular prosthesis, implantation of alloplastic or an autologous rib cartilage framework. Alloplastic implant reproduces an excellent shape of the ear with no donor site morbidity, however its bio-integration is questionable and may make them prone for extrusion and infection. Sub-cutaneous implantation of autologous rib cartilage still remains the gold-stand treatment for microtia. However this technique has its surgical morbidities and skill demands, which makes it difficult to master. Translational research in the fields of tissue engineering for generation of bone and cartilage for ear reconstruction are emerging trends.

scholarly journals Cosmetic Tattooing of Free Flaps following Head and Neck Reconstruction

2013 ◽  
Vol 6 (1) ◽  
pp. 61-63 ◽  
Author(s):  
Martin D. Batstone ◽  
Carly M. Fox ◽  
Mary E. Dingley ◽  
C. Peter Cornelius
Keyword(s):  
Head And Neck ◽  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Head And Neck Reconstruction ◽  
No Donor ◽  
Neck Reconstruction ◽  
The Face ◽  
The Aesthetic ◽  
The One

Free flap reconstruction of the head and neck is a widespread procedure. The aesthetic outcome is frequently compromised by color mismatch between the donor site skin and the complex pigmentation of the face. Various surgical procedures have been described to improve the appearance of external skin paddles. Medical tattooing is commonly used for nipple pigmentation in breast reconstruction and cosmetic procedures such as permanent makeup. This article describes the technique and its application to head and neck reconstruction. Medical tattooing can be used to improve the cosmetic appearance of head and neck free flaps. There is no donor site morbidity and subtle changes in color can be replicated. The article describes the technique of medical tattooing with the use of illustrative cases. Medical tattooing is a viable alternative for improving the appearance of cutaneous skin paddles following head and neck reconstruction with free flaps. Its advantages include no donor site morbidity, availability of an infinite range of colors, no requirement for general anesthesia, and the ability to use multiple colors in the one flap for complex pigmentation requirements. Its disadvantages include the need for specialized skills and equipment and the fading of color over time.

scholarly journals Poly(ε-Caprolactone) Resorbable Auxetic Designed Knitted Scaffolds for Craniofacial Skeletal Muscle Regeneration

2020 ◽  
Vol 7 (4) ◽  
pp. 134
Author(s):  
Monica V. Deshpande ◽  
Andre J. West ◽  
Susan H. Bernacki ◽  
Kun Luan ◽  
Martin W. King
Keyword(s):  
Skeletal Muscle ◽  
Muscle Regeneration ◽  
Mechanical Performance ◽  
Cell Attachment ◽  
Donor Site ◽  
Alternative Therapy ◽  
Donor Site Morbidity ◽  
Dermal Fibroblasts ◽  
Skeletal Muscle Regeneration ◽  
Congenital Deformity

Craniofacial microsomia is a congenital deformity caused by asymmetric development of the skull (cranium) and face before birth. Current treatments include corrective surgery and replacement of the deformed structure using autograft tissue, which results in donor site morbidity. An alternative therapy can be achieved by developing a resorbable scaffold for skeletal muscle regeneration which will help restore the symmetry and function of the facial muscles and reduce donor site morbidity. Two resorbable weft knitted scaffolds were fabricated using poly(ε-caprolactone) multifilament yarns with unique auxetic design structures possessing negative Poisson’s ratio (NPR). These scaffolds exhibit their NPR elasticity through an increase in total volume as well as no lateral narrowing when stretched longitudinally, which can provide orientated mechanical supports to the cell growth of skeletal muscle regeneration. These scaffolds were evaluated for the required physical properties, mechanical performance and biocompatibility by culturing them with neonatal human dermal fibroblasts so as to determine their cell metabolic activity, cell attachment and proliferation. This study can facilitate the understanding and engineering of textile-based scaffolds for tissues/organs. The work also paves a pathway to emerge the NPR textiles into tissue engineering, which has an extensive potential for biomedical end-uses.

Autologous osteochondral graft for traumatic defects of finger joints

2011 ◽  
Vol 37 (3) ◽  
pp. 251-257 ◽  
Author(s):  
W. C. Wu ◽  
M. W. M. Fok ◽  
K. Y. Fung ◽  
K. H. Tam
Keyword(s):  
Donor Site ◽  
Joint Space ◽  
Donor Site Morbidity ◽  
Finger Joint ◽  
Osteochondral Graft ◽  
Range Of Movement ◽  
No Donor ◽  
The Mean ◽  
Open Injuries

Finger joint defects in 16 adults were treated with an autologous osteochondral graft from the base of the second metacarpal, the radial styloid, the base of the third metacarpal or the trapezoid and these patients were followed up from between 12 and 62 months. There was no donor site morbidity. One patient had resorption of the graft and developed pain. The joint was subsequently fused. The mean range of movement was 55.8% of the opposite normal joint. At follow up, 15 patients had no discomfort or mild discomfort. Three had mild narrowing of the joint space and two had slight joint subluxation. Only two patients with concomitant severe injury to the same limb had difficulty performing daily activities. Ten were open injuries and these had poorer outcomes. A hemicondylar defect of a finger joint can be treated using an osteochondral graft obtained from the same hand.

scholarly journals Regional Grafts for Closure of Postsurgical Defect in Anterior Maxilla: Versatility of Chin Graft and Local Rotational Flap

2013 ◽  
Vol 4 (1) ◽  
pp. 47-50
Author(s):  
Varsha Sunil Manekar
Keyword(s):  
Donor Site ◽  
Surgical Flaps ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Anterior Maxilla ◽  
Mucosal Defect ◽  
Rotational Flap ◽  
Osseous Defect ◽  
The Right ◽  
Autogenous Grafts

ABSTRACT The management of postsurgical defect is a challenge for the maxillofacial surgeon. With the success of various autogenous grafts and surgical flaps the reconstruction surgery creates definitive results. This article is a case report of reconstruction of osseous defect and closure of soft tissue fenestration in the right anterior maxilla. An autogenous corticocancellous graft from the mandibular symphysis is used for reconstruction of the osseous defect of around 15 × 15 mm. The mucosal fenestration of around 10 × 10 mm is closed by rotational flap based in the labial sulcus. The defect and the donor site healed uneventfully. Both osseous and mucosal defect healed with esthetic results. Thus, the regional flaps prove the versatility by convenience of graft taking, no donor site morbidity and biological resemblance of tissues. How to cite this article Manekar VS. Regional Grafts for Closure of Postsurgical Defect in Anterior Maxilla: Versatility of Chin Graft and Local Rotational Flap. Int J Head and Neck Surg 2013;4(1):47-50.

scholarly journals Case Report

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. NP38-NP40 ◽  
Author(s):  
Sanjay Naran ◽  
Joseph E. Imbriglia
Keyword(s):  
Case Report ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Metacarpophalangeal Joints ◽  
Active Function ◽  
Patient Reported ◽  
Long Term Follow Up

Background: A case is discussed in which a young girl was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits at the age of four. At 39 years of age, she presented incidentally to our clinic and was observed to have a very functional hand with mobile metacarpophalangeal joints in all reconstructed digits. Methods: We present a case report which is discussed in the context of long-term follow-up, and phalangeal growth in the absence of distraction, and a review of the current literature in regards to outcomes for this modality of treatment. Results: We document growth of the transplanted phalanges, despite surgery occurring after the reported optimum age of before 18 months, and the patient not undergoing distraction. The patient reported no donor site morbidity in regards to function or psychosocial impact. Furthermore, we observed active function at the metacarpophalangeal joints of all operated digits. Conclusions: We report the longest follow-up (35 years) following nonvascularized proximal toe phalangeal transfer for short finger type symbrachydactyly. We highlight the long-term functional outcome of nonvascularized toe phalangeal transfers, and present an overview of the current outcome literature for this type of procedure, advocating that nonvascularized toe phalangeal transfers remain a viable treatment option for select cases of symbrachydactyly.

Aneurysmal Bone Cysts in the Hand Treated by Free Non-Vascular Transfer of Metatarsal or Proximal Phalanx from the Foot

1993 ◽  
Vol 18 (6) ◽  
pp. 736-741 ◽  
Author(s):  
G. S. RAO ◽  
P. KEOGH ◽  
H. WEBSTER ◽  
P. G. LUNN ◽  
F. D. BURKE
Keyword(s):  
Donor Site ◽  
Bone Cyst ◽  
Proximal Phalanx ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Joint Reconstruction ◽  
Articular Surfaces ◽  
Aneurysmal Bone Cysts ◽  
And Function ◽  
Second Toe

Two cases of aneurysmal bone cyst in the hand are reported. In one case the entire first metacarpal was resected and grafted using the fourth metatarsal. In the second case diaphysectomy of the middle phalanx of the index digit was performed, and the proximal phalanx of the second toe was used as graft. Satisfactory length and function were maintained, the grafts remained viable and there was no donor site morbidity. Transplant of a metatarsal or toe phalanx to the hand, as a free non-vascularized graft, is a relatively straight forward operation, requires minimal refashioning of the graft, provides articular surfaces for joint reconstruction and leaves little donor site morbidity.

Facial Defect Reconstruction with Scalp Skin Grafts

2017 ◽  
Vol 33 (04) ◽  
pp. 419-422 ◽  
Author(s):  
Matthew Voorman ◽  
John Frodel ◽  
Chelsea Obourn
Keyword(s):  
Donor Site ◽  
Case Series ◽  
Donor Site Morbidity ◽  
Ear Reconstruction ◽  
Skin Grafts ◽  
Facial Skin ◽  
Skin Defects ◽  
Facial Defect ◽  
Thickness Skin ◽  
Scalp Skin

AbstractThe objective of this study is to demonstrate the benefits of scalp-based split-thickness skin grafts as a reconstructive modality for facial skin defects, noting advantages relative to traditional harvest sites. The study is presented as a case series with chart review set in a tertiary referral center. We reviewed the charts of patients with facial skin defects whose reconstruction required more skin than could be harvested with standard full-thickness skin grafting techniques and, accordingly, included a split-thickness skin graft from the adjacent scalp. Preoperative and postoperative photographs, along with operative and postoperative records, were used to evaluate final cosmetic results and complications. We reviewed 15 patients, with ages ranging from 6 to 90 years. Common indications were skin cancer resection, avulsive skin trauma, and ear reconstruction. While patients generally had good cosmetic outcomes, with excellent color matching relative to traditional distant donor sites, a major advantage of the scalp donor site was low donor-site morbidity. Scalp donor sites were commonly reepithelialized at 7 to 10 days postoperatively and had low reported pain scores. There were no major complications. Reconstruction of facial skin defects that require skin coverage with split-thickness skin grafts can optimally be harvested from adjacent scalp skin, providing adequate cosmesis but, perhaps most importantly, much lower donor-site morbidity than with traditional nonhair-bearing donor sites.

Onlay Fascial Grafts to Silicone-Polytetrafluorethylene Composite Implants in Augmentation Rhinoplasty: A Retrospective Study of 241 Cases

2019 ◽  
Vol 39 (11) ◽  
pp. 1182-1190
Author(s):  
Lee Seng Khoo ◽  
Cheng-I Yen ◽  
Chun-Shin Chang ◽  
Hung-Chang Chen ◽  
Chih-Jung Huang ◽  
...  
Keyword(s):  
Patient Group ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Control Group ◽  
Complication Rates ◽  
Augmentation Rhinoplasty ◽  
Level Of Evidence ◽  
No Donor ◽  
Asian Ethnicity

Abstract Background Silicone-polytetrafluoroethylene composite implants are fast gaining popularity in Asian rhinoplasty. Nonetheless, implant displacement, erythematous reactions, and infections still occur in the authors’ patient group during long-term follow-up. Objectives The authors reported successful experience of combining the utilization of silicone-polytetrafluoroethylene composite implants with onlay temporal fascial grafts to circumvent these complications. Methods Sixty-four patients of Asian ethnicity underwent augmentation rhinoplasty utilizing an I-shaped composite implant with an onlay fascial graft from January 2015 to June 2018, with a mean follow-up period of 13.5 months. This patient group was compared with a control group of 177 Asian patients who underwent augmentation rhinoplasty utilizing the same composite implant but without the addition of a fascial graft; the control group was treated from February 2012 to June 2015, with a mean follow-up of 42.0 months. Complications were compared between these 2 patient groups, specifically focusing on malposition/deviations, erythema, and infections. Results There was a marked decrease in complication rates with the addition of an onlay temporal fascial graft to cover the composite implant in augmentation rhinoplasty (7.8% vs 14.7%) as well as the rate of erythematous reactions (0% vs 6.2%, P = 0.04), infection (1.6% vs 1.1%), and implant malposition/deviation (0% vs 4.5%). Harvesting the temporal fascia and fashioning the onlay graft added an additional 33 minutes on average per procedure. No donor site morbidity was encountered. Conclusions Although the operative time increased, the benefits of adding onlay fascial grafts to silicone-polytetrafluoroethylene implants in alloplastic augmentation rhinoplasty outweigh the drawbacks, as evidenced by the decrease in erythematous reactions. Level of Evidence: 4

scholarly journals Pick-up Test: An Indication for Opponensplasty in Patients with Severe Carpal Tunnel Syndrome

2009 ◽  
Vol 17 (2) ◽  
pp. 183-186 ◽  
Author(s):  
Siu-Leung Yip ◽  
Chi-Hung Yen ◽  
Wai-Lam Chan ◽  
Hon-Bong Leung ◽  
Kan-Hing Mak
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Motor Deficit ◽  
No Donor ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Test Failure

Purpose. To use a pick-up test to assess thenar motor deficit and results of opponensplasty. Methods. Eight consecutive patients with idiopathic severe carpal tunnel syndrome and severe thenar motor deficit were identified. All were females aged 39 to 60 (mean, 53) years and right-hand dominant. The severity of thenar motor deficit was assessed using the pick-up test. Failure to pick up a coin with the thumb and index finger only in a normal pulp-to-pulp pincer grip was an indication for an opponensplasty (in addition to open carpal tunnel release) to hasten recovery of thumb abduction. Treatment outcome was assessed using the pick-up test at 6, 8, and 12 weeks. Results. Preoperatively, all patients were unable to perform the pick-up test. At postoperative 6 weeks, all patients could pick up the coin with no difficulty and were satisfied with the result of opponensplasty. There was no relapse at subsequent follow-ups and no donor-site morbidity in terms of cosmesis, scar pain or infection. Grip strength and the range of wrist motion were 63% and 92% of the normal side, respectively. Conclusion. The pick-up test is a simple and reliable means of identifying those in need of an opponensplasty.

The Use of Thick Split Thickness Grafts from the Instep in Paediatric Hand Surgery

1985 ◽  
Vol 10 (2) ◽  
pp. 185-189
Author(s):  
CHRISTOPHER WARD ◽  
JENNIFER ECCLESTONE
Keyword(s):  
Clinical Study ◽  
Hand Function ◽  
Donor Site ◽  
Skin Grafting ◽  
Hand Surgery ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Recipient Site ◽  
Aesthetic Result ◽  
Good Aesthetic Result

In skin grafting the hand restoration of function must always be the priority, but an acceptable appearance is also important and care should be taken in selecting a skin graft that matches the recipient site. The disadvantages of some traditional donor sites are outlined. A clinical study of thick, split-thickness grafts from the instep is described from which it is concluded that a good aesthetic result can be achieved without compromising hand function—but only in children and adolescents among whom there was no donor site morbidity.

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