methods of reconstruction
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Author(s):  
Katherine Hicks ◽  
J. Regan Thomas

Skin grafts may be used for coverage of facial defects in situations in which alternative methods of reconstruction, such as local flaps, are not an option. They may also be beneficial for patients who wish to avoid or who are not good candidates for more complex reconstruction. Full-thickness skin grafts often have a better color and texture match to adjacent skin when compared to split-thickness grafts; however, split-thickness grafts have lower metabolic demand and increased survival rate. Composite grafts may be very useful in the repair of defects with unique contour and support requirements, such as the nasal ala and eyelid. With all grafts, thoughtful planning and sound surgical technique are critical in achieving the best possible functional and aesthetic result.


2021 ◽  
Vol 6 (6) ◽  
pp. 55-62
Author(s):  
A.M. Potapenko ◽  
◽  
M.S. Lazareva ◽  
K.M. Storozhyshina ◽  
P.E. Mokhnachev ◽  
...  

The article provides data on the assessment of the state of broad-leaved forest crops created during the reconstruction of low-value forest stands in the forest fund. The effectiveness of various methods of reconstruction of measures depending on the share of broad-leaved species in the composition of forest crops is analyzed. It was found that during the period 2006–2018 reconstruction was carried out on an area of 3628 hectares in the Republic of Belarus using corridor (69 %), curtin-group (22 %) and continuous (9 %) methods. It is shown that the average survival rate of forest crops in the continuous reconstruction method was 84, corridor — 71 %, and preservation, respectively, — 61 and 63 %. The sub-topological forest crops created during the curtin-group reconstruction had an unsatisfactory condition (average survival and preservation — 40 %). It is recommended when creating broadleaf forest crops during the reconstruction of low-value forest stands to take into account their age, composition, forest growing conditions, as well as the biogroup placement of plantings, which ensures faster closing of crops in rows, and contributes to their favorable growth and formation, and to create an optimal width of corridors 4...6 meters, which will ensure uniform and sufficient distribution of light in forest crops.


2021 ◽  
Vol 55 (s42-s2) ◽  
pp. 393-428
Author(s):  
Don Daniels

Abstract Practitioners of syntactic reconstruction have not acknowledged that arbitrariness and iconicity influence syntactic change, and that they therefore need to be incorporated into methods of reconstruction. I argue that iconicity creates a directional tendency in syntactic change, privileging structures that are more iconic. I propose a method for incorporating this fact into methods of syntactic reconstruction. I demonstrate the application of this method on two pieces of reconstructed syntax: orientation serial verb constructions and left-peripheral topics. Both case studies are from Proto-Sogeram, the ancestor to ten languages of Papua New Guinea. A third, briefer case study concerns Proto-Carib.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Katharina Mitchell ◽  
Chad Crigger ◽  
Chad Morley ◽  
John Barnard ◽  
Vidas Dumasius

In this paper, we describe two cases of Fournier’s gangrene (FG) in which Integra grafting was used for reconstruction. FG is a progressive necrotizing infection occurring in the perineal region and on the external genitalia. Reconstructive options using local tissue are limited due to the destruction this infection imposes on the soft tissue. Integra graft is a bilaminate artificial dermis made of shark chondroitin 6-sulfate and bovine collagen. It is applied to the wound bed after debridement and establishment of a healthy, well-vascularized wound base. The patients in this case series had large defects which could not be closed primarily with tissue beds and would not have been appropriate for skin grafting. Therefore, an Integra graft was placed. In both patients, the wound beds were appropriate for skin grafting after three weeks. Without the Integra graft, both of our patients would have needed to wait a considerable amount of time prior to reconstruction. Our case series further illustrates and supports the use of Integra grafts in such a scenario following Fournier’s gangrene which has only previously been published on three occasions, all of which demonstrated successful outcomes.


Sensors ◽  
2021 ◽  
Vol 21 (16) ◽  
pp. 5635
Author(s):  
Kwancheol Shin ◽  
Jennifer L. Mueller

Bedside imaging of ventilation and perfusion is a leading application of 2-D medical electrical impedance tomography (EIT), in which dynamic cross-sectional images of the torso are created by numerically solving the inverse problem of computing the conductivity from voltage measurements arising on electrodes due to currents applied on electrodes on the surface. Methods of reconstruction may be direct or iterative. Calderón’s method is a direct reconstruction method based on complex geometrical optics solutions to Laplace’s equation capable of providing real-time reconstructions in a region of interest. In this paper, the importance of accurate modeling of the electrode location on the body is demonstrated on simulated and experimental data, and a method of including a priori spatial information in dynamic human subject data is presented. The results of accurate electrode modeling and a spatial prior are shown to improve detection of inhomogeneities not included in the prior and to improve the resolution of ventilation and perfusion images in a human subject.


Author(s):  
Mark Alekseevich Soborov

The modern approach to the correction of aortic dissection involves the most complete reconstruction of the entire pathologically altered segment of the vessel, which is often impossible due to the vastness of the lesion and the associated severity of surgery. Reduction of intraoperative trauma can improve survival in the immediate postoperative period, and the completeness of reconstruction to reduce the number of complications and relapses in the long term. In this chapter, the methods of reconstruction of the aorta in case of distal dissection from a conventional open surgery to endovascular techniques, or usage of their combination for minimization of surgical trauma, are reviewed.


Author(s):  
M. V. Borodin ◽  
S. Yu. Zakharov ◽  
R. P. Belikov ◽  
V. I. Bobrovsky

THE PURPOSE. To determine the number of reconstructed, newly installed and replaced 10 / 0.4 kV transformer substations, consider an improved technology for installing a "pillow" under the foundation of a kiosk-type 10 / 0.4 kV transformer substation and determine the time spent on its installation. METHODS. The article presents an analysis of data on the number of reconstructed, newly installed and replaced 10 / 0.4 kV transformer substations, an algorithm for installing an improved "pillow" under the foundation of a 10 / 0.4 kV kiosk-type transformer substation. RESULTS. In the course of the experiment on the installation of an improved "pillow" under the foundation of the CTS, the time of work was determined. The total time spent on the construction of an improved "pillow" under the foundation of a kiosk-type CTS was 580 minutes, which is just over 9.5 hours. Also the standardized time of work during the installation of an improved "pillow" under the foundation of a kiosk-type CTS Also, the standardized time for performing work during the installation of an improved "pillow" under the foundation of a kiosk- type package transformer substation has been proposed. CONCLUSIONS. The use of the data presented in the article on the number of reconstructed, newly installed and replaced 10 / 0.4 kV transformer substations will allow scientists and specialists to develop and propose new methods of reconstruction and construction technologies for various transformer substations, as well as determine the economic efficiency of new foundations for transformer substations. The technology of kiosk-type CTS foundation installation described in the article will allow not only to increase the operational characteristics of the CTS, but also ensure the fire safety of the installed equipment. The technical solution specified in the article can be used during the reconstruction and construction of a 10 / 0.4 kV kiosk-type package transformer substation. The proposed algorithm for mounting an improved "pillow" under the foundation of a kiosk-type package transformer substation is universal, since it can be used at a package transformer substation of various capacities.


Author(s):  
M. V. Borodin ◽  
S. Yu. Zakharov ◽  
R. P. Belikov ◽  
V. I. Bobrovsky

THE PURPOSE. To determine the number of reconstructed, newly installed and replaced 10 / 0.4 kV transformer substations, consider an improved technology for installing a "pillow" under the foundation of a kiosk-type 10 / 0.4 kV transformer substation and determine the time spent on its installation. METHODS. The article presents an analysis of data on the number of reconstructed, newly installed and replaced 10 / 0.4 kV transformer substations, an algorithm for installing an improved "pillow" under the foundation of a 10 / 0.4 kV kiosk-type transformer substation. RESULTS. In the course of the experiment on the installation of an improved "pillow" under the foundation of the CTS, the time of work was determined. The total time spent on the construction of an improved "pillow" under the foundation of a kiosk-type CTS was 580 minutes, which is just over 9.5 hours. Also the standardized time of work during the installation of an improved "pillow" under the foundation of a kiosk-type CTS Also, the standardized time for performing work during the installation of an improved "pillow" under the foundation of a kiosk- type package transformer substation has been proposed. CONCLUSIONS. The use of the data presented in the article on the number of reconstructed, newly installed and replaced 10 / 0.4 kV transformer substations will allow scientists and specialists to develop and propose new methods of reconstruction and construction technologies for various transformer substations, as well as determine the economic efficiency of new foundations for transformer substations. The technology of kiosk-type CTS foundation installation described in the article will allow not only to increase the operational characteristics of the CTS, but also ensure the fire safety of the installed equipment. The technical solution specified in the article can be used during the reconstruction and construction of a 10 / 0.4 kV kiosk-type package transformer substation. The proposed algorithm for mounting an improved "pillow" under the foundation of a kiosk-type package transformer substation is universal, since it can be used at a package transformer substation of various capacities.


2021 ◽  
pp. 61-62
Author(s):  
Satvik N Pai ◽  
Mohan M Kumar

Giant cell tumor (GCT) of bone is a locally aggressive tumor of bone. GCT involving the distal radius poses certain unique challenges in management. The resection of the tumor will almost always end up requiring a reconstructive procedure of the joint, for which several different methods of reconstruction have been explored. We present a case of a 29 year old lady with distal radius GCT. We performed a wide resection of the tumor, reconstructed the distal radius with free bula graft and did a wrist arthrodesis using locking compression plate. We found that it provided a stable, painless wrist joint and good functional outcome.


2021 ◽  
pp. 73-81
Author(s):  
Yu.V. Chepurnyi ◽  
D.M. Chernohorskyi ◽  
O.I. Zhukovtseva ◽  
A.V. Kopchak

Introduction. Zigoma and orbital defects still become an actual problem of maxilla-facial surgery due to limited possibilities to precise restoration of their complex anatomy. Functional unity of zigoma and orbit in aspects of eyeball support and protection increases requirements to reconstructive precision. The total and subtotal defects are the most difficult for reconstruction when traditional methods of reconstruction demonstrate unconvincing efficiency. Complex anatomy of zigoma and orbit, as combination of convexities, depressions limited an application of free or vascularised bone transplants for precise 3D restoration of the face. Facing this, new possibilities of reconstructed were developed, based on CAD/CAM technologies. Application of patient specific implants (PSI), designed according personal anatomy of the patient and manufactured by additive technologies, open new modalities to reconstruction in orthognatic surgery, cranioplasty and others, demonstrated promising results. So, these achievements and experience possible could be implemented for zigoma reconstruction. The aim of the study was to evaluate and compare clinical efficacy of zigoma and orbital defect treatment with traditional methods of reconstruction. Materials and methods. To reach this purpose, fifty-one patients, who underwent reconstruction procedures regarding zigoma defects, were enrolled to retrospective study. All of them were clinically examined before and after surgery. CT examination was performed before, 1 week and 1 year after surgery in all cases. The patients, included to the study, were divided on two groups – main and control, equal concerning age, sex and anatomical-topographic patterns of the defects. The main group consisted of 27 patients, who underwent zigoma reconstruction with PSI. The rest of the patients, treated with traditional approach (free or vascularised bone grafting, reconstructive plates or reconstruction with temporal muscle), were included to control group. Clinical efficacy was evaluated applying esthetical estimation of experts according to ranking scale. Additionally, frequency of complication and precision of reconstruction according to CT were analysed. Orbital volume differences were calculated for cases of orbital reconstruction. Results. Comparative analysis of esthetical results revealed higher quality of reconstruction in a main group. The patients did not require any further surgical procedures in 66,7% of cases, in contrast, in a control group additional interventions were indicated or performed in 85,3% of patients (p<0,05). Mean rate of aesthetic estimation by experts were 3,15+1,2 in main group and 1,96+0,8 in control. Follow-up period was longer than 12 months for both main and control groups. Mean follow-up were 20,4 ±9,3 and 26,2 ± 13,5 months respectively. During follow-up any kind of complications were observed between the patients of the main group in 14,8% of cases as well in control – 54,2 % (p=0,01). The main complication between the patients of first group was exposure of the implants, which was noted only in 3 cases, and was caused mainly extension of soft tissues above the implant or compromised soft tissue covering due to incomplete vascularisation of the flaps. At the same time the most frequently observed complications of the main group were total or partial resorption of the grafts (two cases), implant exposure (n=7) and limitation of mouth opening. Additionally, deformity of the fixators with bone fragment displacement was noted in 25,0 % cases. Eyeball displacement was defined in 66,7% of all cases. Mean volume difference in main group was 1,5±0,7 см3, when between patients of control it was 2,3±1,2см3 (р=0,032). The frequency of diplopia was equal for both group. Conclusions. The main advantage of PSI application for zigoma reconstruction is the possibility of the precise 3D restoration of its complex anatomy, renewal of the correct position of the zigoma. Relatively to the clinical tasks, PSI could be used as fixator or endoprosthesis separately or with bone graft procedures. In some clinical situations separate application of PSI as endoprosthesis may be consider as effective alternative for free tissue transfer procedures.


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