donor area
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2021 ◽  
Vol 23 (4) ◽  
pp. 319-323
Author(s):  
Pragati Gautam Adhikari ◽  
Sagun Narayan Joshi

This study was done to evaluate the outcome of pterygium excision with inferonasal conjunctival autograft at a tertiary eye care centre. Retrospective analysis of medical records of primary pterygia patients operated by a single surgeon between 2017 to 2020 were analyzed. A total of 43 patients who met the inclusion criteria were included in the study. The demographic variables, along with size of pterygium and recurrence over a period of six month follow up was noted. The mean age of patients was 46.97 years (29-74 years). The mean size of pterygium was 3.17 mm. Recurrence was seen in 3 eyes over a period of 6 months. Graft edema was observed in 11 patients and graft hemorrhage along with congestion was seen in 8 cases which resolved over a 3 weeks follow up period. Mild conjunctival scarring was seen over donor area in 5 of the eyes. Pterygium excision with inferior conjunctival autograft is an effective alternative technique to superotemporal autograft technique.


2021 ◽  
pp. 74-81
Author(s):  
A. A. Trefilov ◽  
E. V. Kryukov ◽  
V. N. Troyan ◽  
S. V. Tereshchuk ◽  
V. A. Suharev ◽  
...  

The study describes a clinical case of preoperative planning of an anterolateral femur perforator flap and a peroneal autograft to eliminate a maxillofacial defect. During preparation for the surgery, an anatomical feature of the structure of both extremities circulatory system was found, which did not allow full use of the donor area tissues for subsequent surgical intervention. This feature was identified by Doppler ultrasound, but the final picture became clear only due to the study by computed tomography angiography.


Author(s):  
Anil Garg ◽  
Seema Garg

AbstractFollicular unit extraction (FUE), now named as follicular unit excision, is one of the methods of harvesting hair follicles from the donor area for implanting in the recipient area. The occipital scalp area is the most common donor area, but nonscalp donor areas like beard, chest, and other hairy body parts can be used as donor hair follicle area. The extraction of the hair follicle leaves a tiny circular scar over the donor area. Over the past 20 years, various devices for FUE have been developed, starting from manual, simple motorized to highly advanced motors with rotation, oscillation, and vibration. Similarly, different types of punch are used: dull, sharp, ultrasharp, serrated, hybrid and specially designed punch blade for long hair follicles harvesting in various diameters from 0.7 mm to 1.1 mm. The follicles can be harvested either by manual method or by motorized method.


Author(s):  
Naiem T. Issa ◽  
Antonella Tosti

AbstractPreoperative diagnostic confidence and donor site assessment are important for all hair transplant surgery patients. While the majority of patients seek hair transplantation for male or female pattern hair loss (androgenetic alopecia [AGA]), there are mimickers that must be differentiated from patterned hair loss, as they alter the candidacy of the patient for transplantation. They are termed mimickers as they also can present with patterned hair loss. The use of trichoscopy has become increasingly popular for such use. Patterned hair loss mimickers, which include the underappreciated alopecia areata incognita (AAI) and fibrosing alopecia in patterned distribution (FAPD), can be identified clinically with key trichoscopic findings such as yellow dots and peripilar casts, respectively, that correlate with their histologic diagnosis. Donor hair density and putative hair pathology of the safe donor area can also by assessed via trichoscopy. This article discusses the use of trichoscopy, particularly for diagnosing mimickers of patterned hair loss as well as preoperative donor site assessment.


2021 ◽  
pp. 1-4
Author(s):  
Renato de Azevedo Ferreira ◽  
Leticia Arsie Contin ◽  
Vanessa Barreto Rocha ◽  
José Augusto Calil

<b><i>Introduction:</i></b> Cutaneous defects involving the frontal region and anterior hairline of the scalp can result from congenital or acquired conditions. The negative esthetic impact can cause disturbances in the psychic and social sphere of the patient, causing problems in interpersonal relationships and in the body image itself. The use of skin expanders is usually effective in this region due to the bone base providing support and stability for its use. <b><i>Case Report:</i></b> We describe the case of a 64-year-old woman submitted to reconstruction of the anterior hairline of the scalp due to scar sequelae after coronal rhytidoplasty followed by pustular erosive dermatosis. We used tissue expansion (50 mL of saline per week until it reached 300 mL) and advancement flap. <b><i>Discussion/Conclusion:</i></b> Scalp reconstruction also includes vascularized soft tissue coverage, acceptable cosmetic appearance, and minimal morbidity for the donor area. The correction of scalp scars must obey 2 basic principles: tissue similarity and natural capillary pattern (direction, angle, capillary growth, and proper capillary line design). Tissue expansion and skin flap techniques can successfully correct defects in extensive scarring alopecia such as in the presented case.


Author(s):  
Shengchao Huang ◽  
Pu Qiu ◽  
Jianwen Li ◽  
Weizhang Chen ◽  
Zhongzeng Liang ◽  
...  

Abstract To discover the utility of pedicled latissimus dorsi kiss flap for the reconstruction of chest wall defect after mastectomy. This study was a systemic analysis of 12 female patients with breast tumors who were treated at Affiliated Hospital of Guangdong Medical University from January 2018 to December 2019. Among them, three patients had malignant lobular breast tumors, and nine patients had locally advanced breast cancer. After extensive resection of the primary tumor, the chest wall skin, and soft tissue, a large defect was left in the chest wall of each patient. Based on the design and structure of the kiss flap, two semicircular flaps of equal diameter were designed in the latissimus dorsi region, and their blood supply was retained from the same vascular trunk. Two flaps were transferred to the chest wall through a subcutaneous tunnel, and the incision in the donor area was sutured directly. Finally, two equal semicircle flaps were adjusted to fit the defect and then fixed on the chest wall. Referred to the design of the kiss flap, the area of the latissimus dorsi was increased to cover a larger chest wall defect. We have used this flap to reconstruct chest wall defects on twelve patients. Their age ranged from 24 to 62. The largest defect was 20 × 12 cm, and the smallest defect was 15 × 10 cm in diameter. Postoperative follow-up time was 5–9 months (mean time: 6.2 months): Follow-up observations demonstrated that all the flaps were healed well without edema or extravasation and donor area of all cases was closed well. In addition, no local recurrence or distant metastasis was observed in all patients.


2021 ◽  
Vol 23 (3) ◽  
pp. 513-517
Author(s):  
Mikhail V. Bolotin ◽  
Ali М. Mudunov ◽  
Ali М. Mudunov ◽  
Vasilii Yu. Sobolevsky ◽  
Azer А. Akhundov ◽  
...  

Background. Radial forearm free flap is one of the most frequently used in the head and neck reconstruction. A significant disadvantage is the appearance of the donor site. We have developed and introduced into clinical practice a V-shaped fabrication skin of the flap, which allows direct closure of the donor site and reduces morbidity. Aim. To assess the possibility of direct closure of the donor site and to reduce the morbidity of the donor site when performing the V-shaped fabrication of the skin area of the flap. Materials and methods. During the period from 2014 to 2020, the radial free flap was used in 43 cases. In 15 (35%) cases, a V-shaped fabrication of the skin area was used during flap harvest, which made it possible to carry out a direct closure of the donor site. The length of the skin area stretched from the top of the wrist, not reaching 34 cm to the elbow bend and varied from 715 cm, on average 12 cm. The width of the flap was determined by the elasticity of the forearm skin, was maximum in the middle third and varied from 2 up to 4 cm, averaging 3.3 cm. If necessary, the upper and lower edges of the skin area can be sutured together, as well as the entire medial edge of the flap. This technique increases the flap width by almost 2 times. This arrangement was applied in 8 cases. Results. When comparing the results of using the two techniques, the following data were obtained: "V-shaped" fabrication of the skin was used mainly in women (11/15 73%) for reconstruction limited defects in the retromolar region (5/15), soft (4/15) or hard palate (6/15). Most of the patients had localized T1-T2 (10/15) stage. None of the patients had any problems with the healing of the donor area. An excellent aesthetic result was obtained in all patients. In the group of standard harvest, the predominance of males was noted (17/28). Defects had a varied localization, most patients was with relapses after chemo-radiation treatment (10/28) or primary locally advanced T3-T4 stage process (6/28) 16, with a localized T1-T2 stage (11/28) 11, in one case, delayed reconstruction was performed. In all cases, the plastic of the donor site was performed with a split skin autograft. Partial necrosis of the donor site flap was observed in 9 patients (32%), in 4 cases with exposure of the flexor muscle tendon. Conclusion. As a result of the comparative analysis of the two methods, we concluded that the use of V-shaped fabrication of the skin area of the radial forearm flap allows to obtain better aesthetic results of the donor site, however, the use of this technique leads to a significant reduction in the length of the vascular pedicle and a decrease in the width of the flap.


Materials ◽  
2021 ◽  
Vol 14 (22) ◽  
pp. 7009
Author(s):  
Carlota Castro-Gaspar ◽  
Maria Victoria Olmedo-Gaya ◽  
Maria Nuria Romero-Olid ◽  
Maria Jesús Lisbona-Gonzalez ◽  
Marta Vallecillo-Rivas ◽  
...  

Cyanoacrylate tissue adhesive is proposed to promote soft tissue healing in oral surgery and minimize complications (pain, inflammation, and bleeding) associated with wound healing by secondary intention. The objective was to compare cyanoacrylate tissue adhesive (test group) with suture (control group) in terms of postoperative complications, operative time, and wound healing in the palatal donor area after harvesting a de-epithelialized gingival graft. A randomized controlled clinical trial was performed in 24 patients randomly assigned to one of two study groups. Data were gathered on wound bleeding, operative time, postoperative pain, inflammation, hyperesthesia, necrosis, and donor area healing time. Operative time was almost 50% shorter in the tissue adhesive cyanoacrylate group, a significant between-group difference (p = 0.003). Spontaneous bleeding in the donor area during the first 24 h was observed in 11.1% of the tissue adhesive cyanoacrylate group versus 88.9% of the suture group—a significant difference. No significant between-group difference was observed in postoperative pain, inflammation, or degree of healing over time. There were no cases of hyperesthesia or wound necrosis. Utilization of tissue adhesive cyanoacrylate rather than suture in palatal de-epithelialized gingival graft harvesting reduces postoperative bleeding during the first 24 h, as well as the operative time.


2021 ◽  
Vol 30 (10) ◽  
pp. 868-873
Author(s):  
Rafaela Ribeiro Marques ◽  
Pedro Soler Coltro ◽  
Juliano Baron Almeida ◽  
Júlio César Dias Castro ◽  
Jayme Adriano Farina Junior

Objective: Due to the similarities of glabrous skin, the plantar region is an excellent donor area for covering complex palmar–plantar wounds. However, taking grafts from the plantar area often results in significant morbidity at the donor site or non-integration of the graft due to the greater thickness of the plantar corneal layer. Method: This is a prospective case series including patients with burns or wounds who have been treated with a dermal graft using the bilaminar ‘trapdoor’ technique. This procedure is used to remove a thin graft from the deep plantar dermis after the partial elevation of the first layer including the entire epidermis and superficial part of the dermis. Results: At the donor area in the four patients in this case series, we observed healing at around 10 days, and absence of hypertrophic scar in all patients. There was complete re-epithelialisation between two and three weeks from the periphery to the centre of the deep dermal graft, and from the glandular epithelium transferred with the graft. During the follow-up, patients presented aesthetic and functional features of glabrous and amelanotic skin, with similar resistance to those of the adjacent areas of the wound in the palmar–plantar region. Conclusion: This technique has some advantages, such as less surgical time, minimal morbidity in the plantar donor area, easy integration of the grafts, and maintenance of the functional and aesthetic properties of glabrous skin both in the plantar donor area and in the palmar–plantar recipient region. Declaration of interest: The authors have no conflicts of interest to declare.


2021 ◽  
Vol 54 (04) ◽  
pp. 477-482
Author(s):  
Anil Kumar Garg ◽  
Seema Garg

AbstractHair transplant surgery per se has low risk, is relatively safe, and has minimum incidence of complications. However, it is a well-accepted fact that no medical science procedure exists without any potential risk of complications. The complication may be a single complaint in the form of pain, itching, dissatisfaction related to the procedure's outcome, or surgical complication in the form of infection, wound dehiscence or skin necrosis. Inadequate counselling increases unsatisfaction. Improper examination increases the complications, and incomplete medical history and history of allergy increases the risk during surgery.The author collected data of his 2896 patients, operated over a period of 10 years, and recorded the complains and complications. The most common complications were sterile folliculitis, noted in 203 patients, vasovagal shock in seven patients of, hypertensive crisis in one patient, hiccups in six patients, facial edema after hair transplant in 18 patients, graft dislodgement in 8 patients, infection in two diabetic patients, minor necrotic patches in recipient area in three patients, keloid development in one patient, numbness in 18 cases, and hypersensitivity in recipient and/or donor area. Donor area effluvium was seen in one case and three patients showed recipient area effluvium. Twenty-six patients were not happy with the results, and five cases showed partial loss of implanted hair. The overall significant life-threatening or major complications were zero, but the total minor complications' percentage was 0.10%.The key to minimize complaints and complications are detailed counselling, taking careful medical history and history of allergy, and proper examination of patients.


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