Surgical reconstruction of palpebral and periorbital region

1979 ◽  
Vol 64 (3) ◽  
pp. 422
Author(s):  
A. Chicralla ◽  
Jorge M. Psillakis
Author(s):  
J. Hanker ◽  
K. Cowden ◽  
R. Noecker ◽  
P. Yates ◽  
N. Georgiade ◽  
...  

Composites of plaster of Paris (PP) and hydroxylapatite (HA) particles are being applied for the surgical reconstruction of craniofacial bone defects and for cosmetic surgery. Two types of HA particles are being employed, the dense sintered ceramic (DHA) and the porous, coralline hydroxylapatite (PHA) particles. Excess water is expressed out of the moistened HA/PP mixture prior to implantation and setting by pressing it in a non-tapered syringe against a glass plate. This results in implants with faster setting times and greater mechanical strengths. It was therefore of interest to compare samples of the compressed versus noncompressed mixtures to see whether or not any changes in their microstructure after setting could be related to these different properties.USG Medical Grade Calcium Sulfate Hemihydrate (which has the lowest mortar consistency of any known plaster) was mixed with an equal weight of Interpore 200 particles (a commercial form of PHA). After moistening with a minimum amount of water, disc-shaped noncompressed samples were made by filling small holes (0.339 in. diameter x 0.053 in. deep) in polypropylene molds with a microspatula.


2007 ◽  
Vol 177 (4S) ◽  
pp. 197-197 ◽  
Author(s):  
Hazem O. Orabi ◽  
Tamer A. Aboushwareb ◽  
Yuan Yuan Zhang ◽  
James J. Yoo ◽  
Anthony Atala

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 474-481 ◽  
Author(s):  
Radak ◽  
Babic ◽  
Ilijevski ◽  
Jocic ◽  
Aleksic ◽  
...  

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.


1998 ◽  
Vol 11 (04) ◽  
pp. 205-210 ◽  
Author(s):  
H. Burbidge ◽  
E. Firth ◽  
S. Fox ◽  
S. Guerin

SummaryAchilles mechanism rupture in four of five dogs was treated with tenorrhaphy using a modified surgical technique designed to optimise accurate apposition of tendon to bone. Two bone tunnels were drilled in the calcaneal tuber from a plantomedial - dorsolateral, and plantolateral – dorsomedial direction respectively. The distal ends of the tendons were sutured to the calcaneal tuber using a Krachow suture pattern. The remaining dog had a mid-tendon Achilles mechanism rupture. A resinous half cast was placed on the cranial aspect of the tarsocrural joint of all five dogs, for a minimum of six weeks, in order to provide limited post operative support. Du e to insufficient cast material two of the support splints failed and one of these cases also required a second surgical procedure. A varying amount of soft tissue irritation was noted in each case. All of the five Achilles mechanisms healed, and all of the dogs returned to normal function.Five dogs with surgical reconstruction of the Achilles mechanism were stabilised postoperatively with a resinous half cast placed on the cranial aspect of the tarsocrural joint for a minimum of six weeks. Two of these casts failed at the tarsocrural joint when six folds of casting material were used; all subsequent cases had eight folds applied. Variable soft tissue irration was observed under the cast in each case. A modified surgical technique using a Krachow suture pattern allowed good tendon-bone apposition. All five Achilles mechanisms healed, and all dogs returned to normal function. Bilateral lesions were identified in 3 of the 4 dogs examined.


RSBO ◽  
2017 ◽  
Vol 1 (2) ◽  
pp. 114
Author(s):  
Priscila Alves Teixeira ◽  
Carmen L. Mueller Storrer ◽  
Felipe Rychuv Santos ◽  
Aline Monise Sebastiani ◽  
Tatiana Miranda Deliberador

The periodontal treatment of teeth with furcation defect is clinically challenging. In cases of class II furcation defects, the regenerative surgery shows low morbidity and good prognosis when correctly indicated. The aim of the presentstudy is to report a treatment option for class II furcation defect through autogenous bone graft associated with the Bichat’s fat pad. Case report: A 59-year-old female patient was diagnosed with class II furcation defect in the left mandibular first molar. The treatment comprised surgical reconstruction of the defect with a combination of maxillary tuberosity bone graft and Bichat’s fat pad. The clinical and radiographic follow-up of 180 days showed bone formation inthe furcation area and absence of probing depth. Conclusion: An association of autogenous graft form the maxillary tuberosity with a Bichat’s fat pad proved to be a safe, low cost, and effective therapy for the regenerative treatment of class II furcation.


2014 ◽  
Vol 2 (1) ◽  
pp. 10-13
Author(s):  
R. Salyutin ◽  
D. Dombrowski ◽  
M. Komarov ◽  
N. Sokolov ◽  
S. Palyanitsya ◽  
...  

In the group of patients (n = 21, mean age 54 ± 5.8 years) with chronic lower limb ischemia stage IIB who were non-liable for reconstructiverestoration surgery, we have established positive clinical effects of local transplantation of human fetal liver progenitor cells. Complex examination following 1, 3, 6 and 12 months after transplantation included duplex scanning of limb arteries, x-ray contrast arteriography and laser Doppler flowmetry as well as measuring pain-free walking and evaluating life quality based on individual questionnaire data.Owing to the transplant “Cryopreserved human fetal liver progenitor cells” the patients demonstrated stable increase of life quality index and pain-free walking as well as improvement of general health allowing assign them to the group of patients with lower ischemia stage,  quicker social rehabilitation and lesser risk of disabling surgery (р < 0.05). Also, there were observations of improved microcirculation in the ischemic extremities owing to activation of endothelium-independent mechanisms of vasodilatation, reduced myotonus and neurotonus of the pre-capillaries and improved endothelium-dependent influence on the microhaemodynamic and, hence, an increased reserve capillary blood flow (p < 0.05).Analysis of the obtained results indicates prospects and effectiveness of using fetal liver cells transplantation in the patients who are not liable for surgical reconstruction of the vascular bed.


Author(s):  
Naji S. Madi ◽  
Rayane Issa ◽  
Youssef Koaik ◽  
Muhyeddine Al-Taki

Abstract Background The deltoid is a large triangular muscle at the shoulder. It attaches proximally to the clavicle, acromion and scapula, while distally it attaches to the lateral deltoid tuberosity. Ruptures are rare, and the literature only reports cases of proximal detachment. In this article, we report the first case of distal traumatic deltoid muscle detachment and its successful management. Case A young female sustained a traumatic injury following a Jet Ski accident with loss of consciousness. A complete distal rupture of the deltoid muscle was diagnosed after the basic functions were regained and a thorough musculoskeletal examination could be conducted. A conservative approach helped her to regain an acceptable shoulder function, but there was persistent pain upon activity and cosmetic scarring. The patient underwent surgical reconstruction. Postoperatively, she recovered satisfactorily. Discussion Distal detachment of the deltoid muscle is rare. The choice for surgical treatment may be undertaken based on several factors including functional status and patient-based assessment.


2021 ◽  
pp. 229255032110247
Author(s):  
Pavlo O. Badiul ◽  
Sergii V. Sliesarenko ◽  
Nataliia O. Cherednychenko ◽  
Olga V. Morgun

Background: Reconstruction with the use of perforator flaps makes it possible to make the skin surface resistant to the influence of mechanical factors and as similar to the lost skin cover as possible. However, while planning any flap, along with the design of the required shape and size, its blood supply should be taken into account to ensure optimal viability. Therefore, the task to precisely determine the topographic–anatomical relationships suitable for the formation of a pedicle of perforators is still relevant. The aim of this study was to increase the efficiency of surgical reconstruction of wound defects by transposition of locoregional perforator flaps. Methods: The authors conducted a retrospective analysis of 72 cases of reconstruction by means of locoregional perforator flaps with vascular pedicle detachment to determine the efficiency of preoperative diagnostic preparation with the help of multidetector-row computed tomographic angiography (MDCT) in the process of reconstruction. Thirty-seven individual cases of surgical interventions were chosen using a case-controlled study from the study group when MDCT with angiography was used for preoperative planning of perforator flaps, as well as 35 control cases similar in terms of important predictive peculiarities with the reconstruction at the same level of difficulty. The patient groups were precisely matched by gender ( P = .950), age ( P = .804), flap area ( P = .192), and type of reconstruction that was performed. Results: In all cases, the location of the perforator with a diameter greater than 1.0 mm was marked. All perforators determined during MDCT scanning were faultlessly localized intraoperatively. The distance between the intraoperative position of the perforator and the position obtained in the result of the examination did not exceed 1 cm. There was no need to change the planned design of the flap intraoperatively. In all cases where MDCT was performed, the duration of the surgical procedure varied from 60 to 150 minutes (average: 120.77 [18.90] minutes) and was reduced by 49.40 minutes (95% CI: 39.17-59.63) compared with the patients who did not undergo preoperative visualization of perforators where the average duration of the operation was 170.17 (19.19) minutes (from 140 to 220 minutes). Among the patients examined by MDCT, surgical complications were noted in 5 cases (13.51%) compared to 14 cases (40.00%) in the control group. Conclusions: The preoperative MDCT for the locoregional perforator flap reconstruction makes it possible to increase the efficiency of patient treatment given the reduction in surgery duration by 49.40 minutes (95% CI: 39.17-59.63) on average and the reduction in the level of postsurgery complications from 40% to 13.5% compared with the group of patients in whom presurgical visualization was not performed ( P = .031).


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