Utilization of Silicone Sheet as a Protective Guide During Transoral Robotic Tongue Base Surgery

This article presents a simple technique where a silicone sheet is used during transoral robotic surgery (TORS) to protect the upper airway structures from thermal damage during a base of tongue procedure. We review 10 cases of TORS tongue base reduction with the use of this technique, with no complications and with reduction of thermal damage to the lingual epiglottis and surrounding pharyngeal wall. Furthermore, it served as a guide during tongue base dissection to provide visual and tactile feedback to the inferior limit of resection, as well as to protect the endotracheal tube. The silicone sheet is an ideal material for use as a thermal barrier due to its widespread availability, intrinsic thermal properties, and translucency. The technique of using the silicone sheet is easy to implement and may prove useful to many transoral robotic surgeons, especially for newly trained TORS users and trainees.

Scars: questions of prevention and treatment

Each year in the developed countries of the world 100 million patients acquire scars; and there are 11 million keloid scars among them. Aim of the study. Evaluate the effectiveness of treatment and dynamics of scar condition when using self-adhesive dressings (silicone sheet; silicone patch) with a layer of soft silicone. Patients and methods. A clinical prospective observational study of the dynamics of scarring conditions using selfadhesive dressings with a layer of silicone sheet (soft silicone) was conducted in 27 patients. Results. It was shown that by the third visit (42 days after inclusion in the study); the color changed towards lightening and disappearing red; in the largest group with dark red scars at the beginning of the study 43.7% completed the study with light pink scars; 43.7% with hyperpigmented and 5.26% with normopigmented (р 0.0001). Also significant was the dynamics of changes in the position of the scar relative to the level of normal skin (р 0.0001) with level alignment in case it was initially lower than the level of normal skin. The condition of the scar surface by the third visit normalized; in all patients the surface became even (p = 0.0044). There was a marked increase in the number of easily displaceable scars (from 11.1% to 37.0%; p = 0.0003). Also; by the third visit; itching disappeared in all patients (р 0.0001). Conclusion. Overall; the study showed marked improvement across all parameters studied. Silicone sheet; one of the most widely used forms of silicone-based dressings; to be an effective treatment scar management.

A Novel Bespoke Hypertrophic Scar Treatment: Actualizing Hybrid Pressure and Silicone Therapies with 3D Printing and Scanning

The treatment of hypertrophic scars (HSs) is considered to be the most challenging task in wound rehabilitation. Conventional silicone sheet therapy has a positive effect on the healing process of HSs. However, the dimensions of the silicone sheet are typically larger than those of the HS itself which may negatively impact the healthy skin that surrounds the HS. Furthermore, the debonding and displacement of the silicone sheet from the skin are critical problems that affect treatment compliance. Herein, we propose a bespoke HS treatment design that integrates pressure sleeve with a silicone sheet and use of silicone gel using a workflow of three-dimensional (3D) printing, 3D scanning and computer-aided design, and manufacturing software. A finite element analysis (FEA) is used to optimize the control of the pressure distribution and investigate the effects of the silicone elastomer. The result shows that the silicone elastomer increases the amount of exerted pressure on the HS and minimizes unnecessary pressure to other parts of the wrist. Based on this treatment design, a silicone elastomer that perfectly conforms to an HS is printed and attached onto a customized pressure sleeve. Most importantly, unlimited scar treating gel can be applied as the means to optimize treatment of HSs while the silicone sheet is firmly affixed and secured by the pressure sleeve.

An in vitro grafting method to quantify mechanical forces of adhering tissues

AbstractsGrafting is an indispensable agricultural technology for propagating useful tree varieties and obtaining beneficial traits of two varieties/species—as stock and scion—at the same time. Recent studies of molecular events during grafting have revealed dynamic physiological and transcriptomic changes. Strategies focused on specific grafting steps are needed to further associate each physiological and molecular event with those steps. In this study, we developed a method to investigate the tissue adhesion event, an early grafting step, by improving an artificial in vitro grafting system in which two pieces of 1.5-mm thick Nicotiana benthamiana cut stem sections were combined and cultured on medium. We prepared a silicone sheet containing five special cutouts for adhesion of cut stem slices. We quantitatively measured the adhesive force at these grafting interfaces using a force gauge and found that graft adhesion started 2 days after grafting, with the adhesive force gradually increasing over time. After confirming the positive effect of auxin on grafting by this method, we tested the effect of cellulase treatment and observed significant enhancement of graft tissue adhesion. Compared with the addition of auxin or cellulase individually, the adhesive force was stronger when both auxin and cellulase were added simultaneously. The in vitro grafting method developed in this study is thus useful for examining the process of graft adhesion.

Reduction of cicatricial stenosis after canalplasty for auditory exostoses

BackgroundCanalplasty for auditory exostoses is reserved for symptomatic patients. This study reviewed the outcomes of our technique regarding cicatricial stenosis.MethodA chart review was conducted on patients undergoing canalplasty for auditory exostoses between 2002 and 2017. The surgical technique is described.ResultsThe study comprised 43 adults (50 operated ears). Exostoses were bilateral in 40 cases (94 per cent) and occlusive in 33 (66 per cent). After drilling, the external auditory meatus was covered with a graft in 34 cases (68 per cent) and a silicone sheet was used in 32 (64 per cent). Cicatricial stenosis appeared in eight cases (16 per cent). Skin grafts were not used in six of these eight cases (p < 0.04), and silicone sheets were used only in one of these eight (p < 0.01).ConclusionCanalplasty is challenging because of its potential complications. Our data showed that the use of skin grafts and silicone sheets to cover the bared external auditory meatus was associated with a lower rate of cicatricial stenosis.