Expanded forehead (Fricke) flap for large defect of lateral canthal area

1993 ◽  
Vol 16 (3) ◽  
Author(s):  
F. Moschella ◽  
A. Cordova
Keyword(s):  
Large Defect ◽  
Fricke Flap

scholarly journals Small bowel obstruction due to retroperitoneal hernia following renal transplant: a case report

2020 ◽  
Vol 2020 (11) ◽  
Author(s):  
Atta Nawabi ◽  
Adam C Kahle ◽  
Clay D King ◽  
Perwaiz Nawabi
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Common Type ◽  
Postoperative Phase ◽  
Oral Contrast ◽  
Large Defect ◽  
Retroperitoneal Dissection ◽  
Unclear Etiology

Abstract Para duodenal hernias, the most common type of retroperitoneal hernias, are thought to occur naturally from abnormal gut rotation because of fusion folds within the peritoneum. Retroperitoneal hernias are a rare postoperative complication and have not been described after renal transplantation via a retroperitoneal approach. This case report presents a 48-year-old male with intestinal obstruction after renal transplant due to herniation into the retroperitoneum via an incidentally created peritoneal defect. We suggest computed tomography with oral contrast be used in the early postoperative phase to assess for obstruction in patients with prolonged ileus of unclear etiology who have undergone retroperitoneal dissection. Small peritoneal defects should be closed during dissection. Larger, or multiple peritoneal defects should be extended to make a single, large defect to decrease the possibility of bowel herniating and becoming incarcerated.

scholarly journals Bipolar Bone Defects in Shoulders With Primary Instability: Dislocation Versus Subluxation

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110035
Author(s):  
Shigeto Nakagawa ◽  
Wataru Sahara ◽  
Kazutaka Kinugasa ◽  
Ryohei Uchida ◽  
Tatsuo Mae
Keyword(s):  
Bone Defect ◽  
Older Patients ◽  
Bone Defects ◽  
Defect Size ◽  
Level Of Evidence ◽  
Glenoid Defect ◽  
Large Defect ◽  
Important Indicator ◽  
Defect Score ◽  
Primary Instability

Background: In shoulders with traumatic anterior instability, a bipolar bone defect has been recognized as an important indicator of the prognosis. Purpose: To investigate bipolar bone defects at primary instability and compare the difference between dislocation and subluxation. Study Design: Cohort study; Level of evidence, 3. Methods: There were 156 shoulders (156 patients) including 91 shoulders with dislocation and 65 shoulders with subluxation. Glenoid defects and Hill-Sachs lesions were classified into 5 size categories on 3-dimensional computed tomography (CT) scans and were allocated scores ranging from 0 (no defect) to 4 points (very large defect). To assess the combined size of the glenoid defect and Hill-Sachs lesion, the scores for both lesions were summed (range, 0-8 points). Patients in the dislocation and subluxation groups were compared regarding the prevalence of a glenoid defect, a bone fragment of bony Bankart lesion, a Hill-Sachs lesion, a bipolar bone defect, and an off-track Hill-Sachs lesion. Then, the combined size of the bipolar bone defects was compared between the dislocation and subluxation groups and among patients stratified by age at the time of CT scanning (<20, 20-29, and ≥30 years). Results: Hill-Sachs lesions were observed more frequently in the dislocation group (75.8%) compared with the subluxation group (27.7%; P < .001), whereas the prevalence of glenoid defects was not significantly different between groups (36.3% vs 29.2%, respectively; P = .393). The combined defect size was significantly larger in the dislocation versus subluxation group (mean ± SD combined defect score, 2.1 ± 1.6 vs 0.8 ± 0.9 points, respectively; P < .001) due to a larger Hill-Sachs lesion at dislocation than subluxation (glenoid defect score, 0.5 ± 0.9 vs 0.3 ± 0.6 points [ P = .112]; Hill-Sachs lesion score, 1.6 ± 1.2 vs 0.4 ± 0.7 points [ P < .001]). Combined defect size was larger in older patients than younger patients in the setting of dislocation (combined defect score, <20 years, 1.6 ± 1.2 points; 20-29 years, 1.9 ± 1.5 points; ≥30 years, 3.4 ± 1.6 points; P < .001) but was not different in the setting of subluxation (0.8 ± 1.0, 0.7 ± 0.9, and 0.8 ± 0.8 points, respectively; P = .885). An off-track Hill-Sachs lesion was observed in 2 older patients with dislocation but was not observed in shoulders with subluxation. Conclusion: The bipolar bone defect was significantly more frequent, and the combined size was greater in shoulders with primary dislocation and in older patients (≥30 years).

On partitions of {1,?,2m + 1}\{k} into differencesd,?,d +m ? 1: Extended Langford sequences of large defect

2004 ◽  
Vol 12 (6) ◽  
pp. 421-442 ◽  
Author(s):  
Vaclav Linek ◽  
Shai Mor
Keyword(s):  
Large Defect

scholarly journals Vascularization of Nanohydroxyapatite/Collagen/Poly(L-lactic acid) Composites by Implanting Intramuscularly In Vivo

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hai Wang ◽  
Xiao Chang ◽  
Guixing Qiu ◽  
Fuzhai Cui ◽  
Xisheng Weng ◽  
...  
Keyword(s):  
Lactic Acid ◽  
Orthopaedic Surgery ◽  
Bone Substitutes ◽  
Bone Defects ◽  
Large Defect ◽  
Natural Bone ◽  
Composition And Structure ◽  
Large Bone ◽  
Large Bone Defects

It still remains a major challenge to repair large bone defects in the orthopaedic surgery. In previous studies, a nanohydroxyapatite/collagen/poly(L-lactic acid) (nHAC/PLA) composite, similar to natural bone in both composition and structure, has been prepared. It could repair small sized bone defects, but they were restricted to repair a large defect due to the lack of oxygen and nutrition supply for cell survival without vascularization. The aim of the present study was to investigate whether nHAC/PLA composites could be vascularized in vivo. Composites were implanted intramuscularly in the groins of rabbits for 2, 6, or 10 weeks (n=5×3). After removing, the macroscopic results showed that there were lots of rich blood supply tissues embracing the composites, and the volumes of tissue were increasing as time goes on. In microscopic views, blood vessels and vascular sprouts could be observed, and microvessel density (MVD) of the composites trended to increase over time. It suggested that nHAC/PLA composites could be well vascularized by implanting in vivo. In the future, it would be possible to generate vascular pedicle bone substitutes with nHAC/PLA composites for grafting.

scholarly journals Reconstruction of a Large Anterior Ear Defect after Mohs Micrographic Surgery with a Cartilage Graft and Postauricular Revolving Door Flap

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Stephanie Nemir ◽  
Lindsey Hunter-Ellul ◽  
Vlad Codrea ◽  
Richard Wagner
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Structural Integrity ◽  
Revolving Door ◽  
Cartilage Graft ◽  
Full Thickness ◽  
Mohs Micrographic Surgery ◽  
Micrographic Surgery ◽  
Large Defect ◽  
And Cartilage

A novel postauricular revolving door island flap and cartilage graft combination was employed to correct a large defect on the anterior ear of an 84-year-old man who underwent Mohs micrographic surgery for an antihelical squamous cell carcinoma. The defect measured 4.6 × 2.4 cm and spanned the antihelix, scapha, a small portion of the helix, and a large segment of underlying cartilage, with loss of structural integrity and anterior folding of the ear. The repair involved harvesting 1.5 cm2of exposed cartilage from the scaphoid fossa and then sculpting and suturing it to the remnant of the antihelical cartilage in order to recreate the antihelical crura. The skin of the posterior auricle was then incised just below the helical rim and folded anteriorly to cover the cartilage graft. The flap remained attached by a central subcutaneous pedicle, and an island designed using the full-thickness defect as a stencil template was pulled through the cartilage window anteriorly to resurface the anterior ear. This case demonstrates the use of the revolving door flap for coverage of large central ear defects with loss of cartilaginous support and illustrates how cartilage grafts may be used in combination with the flap to improve ear contour after resection.

Preparation of Fibrous Scaffolds Containing Calcium and Silicon Species

2011 ◽  
Vol 493-494 ◽  
pp. 840-843
Author(s):  
Akiko Obata ◽  
Hiroki Ozasa ◽  
Julian R. Jones ◽  
Toshihiro Kasuga
Keyword(s):  
Tissue Engineering ◽  
Hybrid Materials ◽  
Fiber Diameter ◽  
Fiber Spinning ◽  
High Porosity ◽  
Cotton Wool ◽  
Tissue Engineering Scaffolds ◽  
Large Defect ◽  
Nanofibrous Structure ◽  
Versatile Technique

Materials for bone defect filling should have 3D macroporous structure and be flexible to be packed into complex defects with limited entrance space. Tissue engineering scaffolds should also mimic the structure and morphology of the host tissue. Electrospinning is a versatile technique to produce materials with micro/nanofibrous structure, large surface area and high porosity. Electrospun materials are very promising for tissue engineering due to the possibility of mimicking the fibrous structure of natural extra cellular matrix (ECM). Siloxane-containing vaterite (SiV)/poly (L-lactic acid) (PLLA) hybrids (SiPVH) with controlled silicate and calcium ions releasing ability has been produced in our group. They have also demonstrated good cell infiltration into the electrospun hybrid materials that had fiber diameters greater than 10 μm. However, these electrospun hybrid materials were planar (2D) and are not suitable for large defect regeneration. In this work, the development of a fabrication technique for the production of 3D cotton wool-like structures with fiber diameter in the range of 10 μm was performed. SiPVH cotton wool-like structure containing 0, 30 and 60 wt % SiV were prepared by blowing air in the direction perpendicular to fiber spinning. Si-vaterite particles and small pores were found on the surface of the fibers. The fiber diameter of the samples were found to be in the range of 10 ~ 20 μm. Stretch tests showed more than 50 % extension for the SiPVH cotton wool-like material containing 30 wt % SiV (SiPVH30). This extension was similar to that observed for the PLLA cotton wool-like material. The results suggest that the SiPVH30 cotton wool-like material are good candidates for bone tissue engineering scaffolds.

The Use of Engineered Bilayered Skin (MyDermTM) in the Management of Massive Skin Defect in Grade III Gustilo-Anderson Open Fracture

2017 ◽  
Vol 16 (3) ◽  
pp. 212-216
Author(s):  
Nor Hazla Mohamed Haflah ◽  
Min Hwei Ng ◽  
Mohd Heikal Mohd Yunus ◽  
Amaramalar Selvee Naicker ◽  
Ohnmar Htwe ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Open Fracture ◽  
Wound Closure ◽  
Posterior Tibial Artery ◽  
Soft Tissue Coverage ◽  
Skin Defect ◽  
Vascular Repair ◽  
Posterior Compartment ◽  
Large Defect ◽  
Large Skin

Open fracture Gustilo-Anderson grade IIIC is associated with higher risk of infection and problems with soft tissue coverage. Various methods have been used for soft tissue coverage in open fractures with large skin defect. We report a case of a patient who had grade IIIC open fracture of the tibia with posterior tibial artery injury. The patient underwent external fixation and reduction. Because of potential compartment syndrome after vascular repair, fasciotomy of the posterior compartment was performed. This wound, however, became infected and because of further debridement, gave rise to a large skin defect. A tissue engineered skin construct, MyDermTM was employed to cover this large defect. Complete wound closure was achieved 35 days postimplantation. The patient then underwent plating of the tibia for nonunion with no adverse effect to the grafted site. The tibia eventually healed 5 months postplating, and the cosmetic appearance of the newly formed skin was satisfactory.

scholarly journals Uretero-transappendix-cystoneostomy as a technique for the reconstruction of the lower part of the ureter

2005 ◽  
Vol 62 (12) ◽  
pp. 931-933
Author(s):  
Novak Milovic ◽  
Pero Janjic ◽  
Vladimir Bancevic ◽  
Srdjan Kupresanin
Keyword(s):  
Renal Function ◽  
Case Report ◽  
Surgical Techniques ◽  
Large Defect ◽  
Boari Flap ◽  
Gun Shot ◽  
Psoas Hitch ◽  
The Right

Background. Any large missing part of the ureter may be replaced by transureteroureterostomy, psoas hitch, Boari flap, nephrectomy, renal autotransplanation or by the implementation of an intestinal graft. Case report. A patient with a defect of the lumbal- pelvic portion of the right ureter, after the management of a penetrating and perforating gun shot wound was presented. The missing part of the ureter was successfully replaced with an appendix. The technique of uretero-transappendixcystoneostomy complete with a Boari flap and a psoas hitch was used. Conclusion. By the use of an original combination of surgical techniques, a large defect of the ureter and the defect of the bladder, as well as the preservation of the renal function was achieved in a more successful manner.

scholarly journals Transsphenoidal endoscopic appro ach in the treat ment of spontaneous cerebrospinal fluid (CSF) leak

2019 ◽  
Vol 178 (2) ◽  
pp. 10-14
Author(s):  
V. Y. Cherebillo ◽  
S. A. Karpischenko ◽  
N. S. Puzakov ◽  
O. A. Stancheva
Keyword(s):  
Cerebrospinal Fluid ◽  
Nasal Cavity ◽  
Pathological Condition ◽  
Research Centre ◽  
Csf Leak ◽  
Medical Institute ◽  
Large Defect ◽  
Endoscopic Endonasal ◽  
National Medical ◽  
Treat Ment

Introduction. Spontaneous nasal liquorrhea is a pathological condition associated with defect between nasal cavity and intracranial structures that lead to the expiration of the CSF from the nasal cavity.The objective is to evaluate the effectiveness of endoscopic endonasal approach in the CSF leak treatment.Material and methods. For the period from 2008 to 2018, 38 patients with spontaneous nasal liquorrhea were examined and treated in Pavlov First Saint Petersburg State Medical University, the clinic of neurosurgery of Kirov Medical Institute and Almazov National Medical Research Centre. All patients underwent plastic surgery of the CSF fistula by endoscopic endonasal aproach.Results. Only in 4 cases, there was a large defect, the failure of the closure of which required repeated surgical intervention in 1–2 weeks after the initial operation.Conclusion. The use of autologous tissues (muscle or fat autograft) is the method of choice for repeated surgical plastics of the cerebrospinal fluid fistula or in a large size defect (more than 5 mm).

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