Calvarial and Scalp Reconstruction

2019 ◽  
Author(s):  
Matthew M Hanasono
Keyword(s):  
Tissue Expander ◽  
Tissue Expansion ◽  
Skin Grafting ◽  
Free Flaps ◽  
Cranial Bone ◽  
Wound Complications ◽  
Neurosurgical Procedures ◽  
Advantages And Disadvantages ◽  
Scalp Reconstruction

Scalp reconstruction involves nearly the entire spectrum of reconstructive surgery, including skin grafting, local flaps, and microvascular free flaps. Additionally, tissue expansion can play important role in maximizing outcomes. In recent years, reconstructive algorithms specific to scalp reconstruction have been developed that consider not only the size of the defect, but the quality of local tissues.  Many materials have been used for calvarial reconstruction and most modern alloplasts are as reliable as autologous bone, although each as its own advantages and disadvantages.  Simultaneous scalp and calvarial reconstruction is now routinely performed.  Remaining challenges include management of wound complications over alloplasts and of the infected cranial bone flap following neurosurgical procedures. This review contains 15 figures, 5 tables, and 41 references. Keywords: scalp, calvarium, cranioplasty, free flap, tissue expander, skin graft, bone graft, titanium mesh, methylmethacrylate, polyetheretherketone (PEEK)

scholarly journals Minimising the donor area morbidity of radial forearm phalloplasty using prefabricated thigh flap: A new technique

2017 ◽  
Vol 50 (01) ◽  
pp. 091-095 ◽  
Author(s):  
Aditya Aggarwal ◽  
Hardeep Singh ◽  
Sanjay Mahendru ◽  
Vimalendu Brajesh ◽  
Sukhdeep Singh ◽  
...  
Keyword(s):  
Donor Site ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Skin Grafting ◽  
Free Flaps ◽  
Standing Position ◽  
Donor Site Morbidity ◽  
New Technique ◽  
Donor Area ◽  
Radial Forearm

ABSTRACTPhalloplasty is indicated in various conditions of penile loss or absence. There are numerous techniques for phalloplasty including the pedicle and free flaps with the ultimate goal of micturition in standing position, attaining adequate size, aesthesis and sensations for sexual intercourse. Radial forearm phalloplasty is the gold standard flap to achieve above results but gives a very bad scar on the forearm. We present a technique of using prefabricated thigh flap to reduce the morbidity of donor area. The descending branch of lateral circumflex femoral pedicle was placed in a subcutaneous plane over tissue expander. After attaining an adequate size of flap with tissue expansion, it was delayed 3 weeks before phalloplasty. Prefabricated flap was thin and of large size replicating the radial forearm flap used for phalloplasty. Whole forearm defect was covered with the thigh flap, and the thigh could be closed primarily. This new technique of using prefabricated thigh flap has significantly reduced the donor site morbidity both aesthetically and functionally without the use of skin grafting in the whole procedure.

Tissue expansion as an alternative to skin grafting for closure of skin deficits

1992 ◽  
Vol 82 (5) ◽  
pp. 249-259 ◽  
Author(s):  
GR Johnson ◽  
P Han ◽  
JA Giacopelli
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Subcutaneous Tissue ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Skin Grafting ◽  
High Rate ◽  
Expansion Process ◽  
Technical Aspects ◽  
Tissue Expanders

Recent advances in the technical aspects of tissue expanders for closure of skin deficits have led to an overall reduction in the high rate of complications typically associated with their usage. The authors provide a review of the recent refinements in the technique of the tissue expansion process. A discussion of current and future applications using this technique in the treatment of various lower extremity pathologies, including clubfoot, is presented. A case report on the use of a subcutaneous tissue expander for the treatment of a failed skin graft of the medial ankle is included.

scholarly journals Free Tissue Reconstruction of the Scalp

2019 ◽  
Vol 33 (01) ◽  
pp. 067-071 ◽  
Author(s):  
Mofiyinfolu Sokoya ◽  
Emily Misch ◽  
Aurora Vincent ◽  
Weitao Wang ◽  
Sameep Kadakia ◽  
...  
Keyword(s):  
Free Tissue Transfer ◽  
Free Flaps ◽  
Advantages And Disadvantages ◽  
Scalp Reconstruction ◽  
Tissue Transfer ◽  
Scalp Defects ◽  
Calvarial Defects ◽  
Reconstructive Option ◽  
Tissue Reconstruction

AbstractReconstruction of scalp defects can be accomplished by many methods, but larger defects, especially those in which the periosteum is absent or calvarial defects are present, require free tissue transfer. Various methods of scalp reconstruction, as guided by the defect components and size, are presented herein, with a focus on free tissue transfer. Different free flaps for scalp reconstructed are described with a comparison of their advantages and disadvantages. Overall, free tissue transfer for scalp defects provides a reliable, durable, and cosmetically adequate reconstructive option.

Can trust become a factor of economic growth? Dynamic changes in the level of trust of Russian youth

2020 ◽  
pp. 92-107 ◽  
Author(s):  
A. I. Bakhtigaraeva ◽  
A. A. Stavinskaya
Keyword(s):  
Institutional Environment ◽  
Negative Effects ◽  
Dynamic Changes ◽  
Generalized Trust ◽  
Level Of Education ◽  
Advantages And Disadvantages ◽  
The Future ◽  
Analysis Of Dynamics

The article considers the role of trust in the economy, the mechanisms of its accumulation and the possibility of using it as one of the growth factors in the future. The advantages and disadvantages of measuring the level of generalized trust using two alternative questions — about trusting people in general and trusting strangers — are analyzed. The results of the analysis of dynamics of the level of generalized trust among Russian youth, obtained within the study of the Institute for National Projects in 10 regions of Russia, are presented. It is shown that there are no significant changes in trust in people in general during the study at university. At the same time, the level of trust in strangers falls, which can negatively affect the level of trust in the country as a whole, and as a result have negative effects on the development of the economy in the future. Possible causes of the observed trends and the role of universities are discussed. Also the question about the connection between the level of education and generalized trust in countries with different quality of the institutional environment is raised.

Psychological influences on wound healing

2019 ◽  
Vol 98 (8) ◽  
pp. 312-314
Keyword(s):  
Wound Healing ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Wound Complications ◽  
State Of Mind ◽  
Life Threatening ◽  
Psychological Influences ◽  
Fear And Anxiety ◽  
Care Costs

Surgical wound complications remain a major cause of morbidity; although usually not life threatening, they reduce the quality of life. They are also associated with excessive health care costs. Wound healing is affected by many factors – wound characteristics, infection, comorbidities and nutritional status of the patient. In addition, though, psychological stress and depression may decrease the inflammatory response required for bacterial clearance and so delay wound healing, as well. Although the patient´s state of mind can be influenced only to a certain extent, we should nevertheless stick to ERAS (Enhanced Recovery After Surgery) guidelines and try to diminish fear and anxiety by providing enough information preoperatively, pay due attention to postoperative analgesia and seek to provide an agreeable environment.

Data Integrity Techniques in Cloud Computing: An Analysis

2017 ◽  
Vol 7 (8) ◽  
pp. 121 ◽  
Author(s):  
Neha Thakur ◽  
Aman Kumar Sharma
Keyword(s):  
Cloud Computing ◽  
Cloud Storage ◽  
Data Integrity ◽  
Advantages And Disadvantages ◽  
Security Models ◽  
Cloud Storage Service ◽  
Storage Service ◽  
Cloud Users ◽  
It Enterprises

Cloud computing has been envisioned as the definite and concerning solution to the rising storage costs of IT Enterprises. There are many cloud computing initiatives from IT giants such as Google, Amazon, Microsoft, IBM. Integrity monitoring is essential in cloud storage for the same reasons that data integrity is critical for any data centre. Data integrity is defined as the accuracy and consistency of stored data, in absence of any alteration to the data between two updates of a file or record.  In order to ensure the integrity and availability of data in Cloud and enforce the quality of cloud storage service, efficient methods that enable on-demand data correctness verification on behalf of cloud users have to be designed. To overcome data integrity problem, many techniques are proposed under different systems and security models. This paper will focus on some of the integrity proving techniques in detail along with their advantages and disadvantages.

Problems of Distance Education

2018 ◽  
Vol 7 (1) ◽  
pp. 14-23 ◽  
Author(s):  
Rostislav Fojtík
Keyword(s):  
Distance Education ◽  
Distance Learning ◽  
Computer Science ◽  
Full Time ◽  
Advantages And Disadvantages ◽  
E Learning ◽  
Educational Requirements

Abstract Distance learning and e-learning have significantly developed in recent years. It is also due to changing educational requirements, especially for adults. The article aims to show the advantages and disadvantages of distance learning. Examples of the 20-year use of the distance learning form of computer science describe the difficulties associated with the implementation and implementation of this form of teaching. The results of students in the full-time and distance form of teaching in the bachelor’s study of computer science are compared. Long-term findings show that distant students have significantly lower scores in the first years of study than full-time bachelor students. In the following years of study, the differences diminish, and students’ results are comparable. The article describes the possibilities of improving the quality of distance learning.

scholarly journals Systematic Analysis of Literature on the Marketing of Healthcare Systems. Challenges for Russian and Romanian Healthcare Systems

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 656
Author(s):  
Vladimir Bulatnikov ◽  
Cristinel Petrişor Constantin
Keyword(s):  
Quality Of Healthcare ◽  
Healthcare Systems ◽  
Business Environment ◽  
Competitive Advantages ◽  
Systematic Analysis ◽  
Scientific Databases ◽  
Advantages And Disadvantages ◽  
Funds Allocation ◽  
New Perspective

This paper aims at finding the most dominant ideas about the marketing of healthcare systems highlighted in the mainstream literature, with a focus on Russia and Romania. To reach this goal, a systematic analysis of literature was conducted and various competitive advantages and disadvantages of the medical models that require special attention from the governments are considered. In this respect we examined 106 papers published during 2006 to 2020 found on four scientific databases. They were selected using inclusion and exclusion criteria according to PRISMA methodology. The main findings of the research consist of the opportunity to use marketing tools in order to improve the quality of healthcare systems in the named countries. Thus, using market orientation, the managers of healthcare systems could stimulate the innovation, the efficiency of funds allocation and the quality of medical services. The results will lead to a better quality of population life and to an increasing of life expectancy. As this paper reviews some articles from Russian literature, it can add a new perspective to the topic. These outcomes have implications for government, business environment, and academia, which should cooperate in order to develop the healthcare system using marketing strategies.

scholarly journals Repair Exposure of the Postauricular Tissue Expander Using the Modified Brent Method: A 7-Year Experience

2021 ◽  
pp. 014556132110079
Author(s):  
Tongyu Cao ◽  
Qingguo Zhang
Keyword(s):  
Soft Tissue ◽  
Skin Flap ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Ear Reconstruction ◽  
Lower Pole ◽  
Tension Free ◽  
Subsequent Exposure ◽  
Free Closure ◽  
Complicated Conditions

Objectives: Ear reconstruction is a challenging surgery for the complicated conditions in patients with microtia. The tissue expansion techniques were necessary and relatively safe for patients with insufficient soft tissue. However, complications such as necrosis of expanded flap and exposure of tissue expander limited the popularization of this method. This study described the use of modified Brent method to handle the exposure of the postauricular tissue expander. Methods: From January 2013 to December 2019, 27 ear reconstruction patients with trauma or necrosis on an expanded skin flap and subsequent exposure of tissue expander were treated with modified Brent method, which consisted of 3 stages: removal of the expander, tension-free closure of wound, and framework fabrication; elevation of reconstructed ear; lobule rotation; and minor modification. Results: Fifty-six percent of exposures occurred in the lower pole of the tissue expander. Exposure usually occurred 54.5 days after implantation. The majority of reconstructed ears had a satisfactory appearance and showed relatively stable outcomes. Only one case of cartilage exposure required revision surgery and was repaired by the temporoparietal fascia. Conclusion: With reasonable distribution of expanded flap, prolonged interval, and sutures under tension-free conditions, complications like the occurrence of trauma or necrosis-induced exposure of tissue expander can be repaired efficiently by a staging modified Brent method.

scholarly journals Adjuvant Radiotherapy after Surgical Excision in Keloids

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 730
Author(s):  
Jeong Won Lee ◽  
Ki Ho Seol
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adjuvant Therapy ◽  
Local Control ◽  
Adjuvant Radiotherapy ◽  
Surgical Excision ◽  
Recurrence Rates ◽  
High Tendency ◽  
Advantages And Disadvantages

Keloids are a benign fibroproliferative disease with a high tendency of recurrence. Keloids cause functional impairment, disfigurement, pruritus, and low quality of life. Many therapeutic options have been used for keloids. However, the high recurrence rates have led to the use of adjuvant therapy after surgical keloid excision. There are different radiotherapy regimens available, and the advantages and disadvantages of each are still unclear. The aim of this review is to explain the appropriate radiotherapy regimen for keloids as well as discuss the recent reports on keloid management with radiotherapy. Adjuvant radiotherapy after surgical excision for keloids yields excellent local control with tolerable side effects. Hypofractionated radiotherapy with a BED of more than 28 Gy (α/β value of 10) after excision is recommended in the light of its biologic background.

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