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https://www.readbyqxmd.com/read/27920067/injectable-diphenhydramine-used-as-anaesthetic-for-wide-local-excision-with-flap-closure
#1
Laura E Pickett, Jillian Macdonald
BACKGROUND: Lidocaine-allergic patients pose a challenge for cutaneous surgical procedures. We present a case of a successful wide local excision with flap closures on the face using topical tetracaine followed by infiltration with 1% diphenhydramine. CASE SUMMARY: An 84-year-old woman, with a lidocaine intolerance, presented to the Mohs surgery clinic for wide local excision of a nodular basal cell carcinoma on her right medial cheek. Successful anaesthesia was achieved using topical 4% tetracaine followed by intradermal and subcutaneous injection of 1% diphenhydramine...
December 5, 2016: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/27896441/pterygium-surgery-using-the-principle-of-contact-inhibition-results-of-13-years-experience
#2
Tsutomu Hara, Takako Hashimoto, Takeshi Hara
PURPOSE: To report a technique to prevent pterygium recurrence using the principle of contact inhibition. METHODS: Two hundred and fifteen patients (232 eyes; average age, 64.1 years) with primary pterygia who underwent pterygium surgery at the Hara Eye Hospital between 1999 and 2012. We retrospectively evaluated the patients who underwent the following procedure to prevent pterygium recurrence. The surface conjunctiva on the pterygium body was not removed. After removing the pterygium body, by placing a narrow pedicle autoconjunctival flap along the corneal limbus and tying it tightly to the front area of the residual conjunctiva, there is no room for the active residual tissue to proliferate, thus preventing a recurrence by contact inhibition...
November 28, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/27894585/pre-expanded-intercostal-perforator-super-thin-skin-flap
#3
REVIEW
Yunjun Liao, Yong Luo, Feng Lu, Hiko Hyakusoku, Jianhua Gao, Ping Jiang
This article introduces pre-expanded super-thin intercostal perforator flaps, particularly the flap that has a perforator from the first to second intercostal spaces. The key techniques, advantages and disadvantages, and complications and management of this flap are described. At present, the thinnest possible flap is achieved by thinning the pre-expanded flap that has a perforator from the first to second intercostal spaces. It is used to reconstruct large defects on the face and neck, thus restoring function and cosmetic appearance...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894583/pre-expanded-supraclavicular-artery-perforator-flap
#4
REVIEW
Norbert Pallua, Bong-Sung Kim
The supraclavicular artery perforator (SAP) flap is a versatile flap for the reconstruction of head and neck defects. Recently, the authors have modified the SAP flap by using an anterior branch of the transverse cervical artery. The anterior SAP flap allows the harvest of a tissue island in the deltopectoral fossa, which is even thinner, is more pliable, and shows a superior color match to the face and neck compared with the original SAP flap. Pre-expansion increases flap size considerably, enabling the coverage of extended defects without the need of microsurgery...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894582/pre-expanded-transverse-cervical-artery-perforator-flap
#5
REVIEW
Huifeng Song, Jiake Chai
The face and neck are important areas for function and appearance. High-quality skin flaps should be used to reconstruct defects in the cervicofacial region. This article introduces the pre-expanded transverse cervical artery perforator flap, which can be used for cervicofacial reconstruction after burns, trauma, and tumor resection with excellent results. This perforator flap is one of the best options for cervicofacial reconstruction in terms of color and texture match, and has fewer flap complications. With regard to the expanded flap, the donor site can be sutured directly leaving only an inconspicuous linear scar...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894581/pre-expanded-super-thin-skin-perforator-flaps
#6
REVIEW
Chunmei Wang, Sifen Yang, Lee L Q Pu
Patients with severe postburn scar contractures underwent reconstruction of skin defects after scar excision with pre-expanded super-thin skin perforator flaps supplied primarily by perforators via the "bridging effect" from the branches of the adjacent arteries as 2-stage procedures. Pre-expansion is an innovative technique and may improve the anastomoses between subdermal vascular plexuses and extend the supplying area of these vessels to the flap. Such a flap becomes super thin, but with a prefabricated blood supply it can be used for reconstruction of skin defects of the face, neck, or other body part with improved functional and cosmetic outcomes...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894579/future-perspectives-of-pre-expanded-perforator-flaps
#7
REVIEW
Lee L Q Pu, Chunmei Wang
Although clinical application of a pre-expanded perforator flap is primarily focused on face and neck reconstructions, such a flap has also been used to reconstruct defects in the trunk, extremities, or hands. With better understanding of the improved blood supply to the flap and the mechanism on the prefabrication of blood supply within the flap, the pre-expanded perforator flap will definitely play a more important role in reconstructive surgery and can be used in selected patients by many plastic surgeons worldwide with good reconstructive and cosmetic outcomes...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894577/pre-expanded-prefabricated-monoblock-perforator-flap-for-total-facial-resurfacing
#8
REVIEW
Tao Zan, Yashan Gao, Haizhou Li, Bin Gu, Feng Xie, Qingfeng Li
In this article, we present the pre-expanded, prefabricated supercharged cervicothoracic monoblock perforator flap for total or subtotal facial resurfacing. This technique can be a reliable reconstruction option for extensive facial skin defect with undamaged muscles and deep structures, which could provide excellent aesthetic and functional outcomes with acceptable complications. Our approach may replace a conventional "skin-only" face allotransplantation in selected patients.
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894576/pre-expanded-bipedicled-supratrochlear-perforator-flap-for-simultaneous-reconstruction-of-the-nasal-and-upper-lip-defects
#9
REVIEW
Shaoqing Feng, Zheng Zhang, Wenjing Xi, Davide Lazzeri, Yong Fang, Yi Xin Zhang
The double "S" principle should be followed for facial reconstruction: the "similarity" of the donor site to the defect area and the reconstruction should be based on the different "subunits" of the face. In this article the pre-expanded, bipedicled supratrochlear perforator flap method is described, which is used for the resurfacing of both nasal and upper lip defects. This method can provide 2 independent flaps with sufficient tissue from 1 single donor site, resurfacing the nasal and upper lip units separately and providing an unparalleled color and texture match and ideal reconstructive result...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894574/an-overview-of-pre-expanded-perforator-flaps-part-2-clinical-applications
#10
REVIEW
Chunmei Wang, Jing Zhang, Hiko Hyakusoku, Ping Song, Lee L Q Pu
Pre-expanded perforator flaps have several advantages over their traditional counterparts owing to the thin, more pliable nature, larger size, and minimum morbidity of the donor site. Recently, plastic surgeons have begun to use pre-expanded perforator flaps to reconstruct defects of almost the entire body, including the cervicofacial region, axilla, trunk, and extremities resulting from scar, congenital melanocytic nevi, hemangiomas, and neurofibromas. Such a versatile flap is especially appropriate for face and neck resurfacing, which requires more optimal functional and cosmetic outcomes...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27893628/watershed-areas-in-face-transplantation
#11
Bahar Bassiri Gharb, Russell S Frautschi, Brianna C Halasa, Gaby D Doumit, Risal S Djohan, Steven L Bernard, Brian R Gastman, Maria Z Siemionow, Francis A Papay, Antonio Rampazzo
BACKGROUND: Maxillary artery has traditionally been considered the main blood supply of the facial skeleton. However, the deep and concealed location makes the harvest of facial allografts based on this artery challenging, giving preference to the facial artery. There is growing evidence that the junction between the hard and soft palate may represent a watershed area in facial artery based allografts. The aim of this study was to review the occurrence of partial allograft necrosis and modify the available craniofacial techniques allowing for a reliable harvest of maxillary artery based facial allografts...
November 21, 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27890228/tissue-engineered-prevascularized-bone-and-soft-tissue-flaps
#12
REVIEW
F Kurtis Kasper, James Melville, Jonathan Shum, Mark Wong, Simon Young
The complex shapes of skeletal components of the craniofacial region combined with the prominence of the face and paucity of overlying soft tissue create significant challenges for the reconstructive surgeon. The in vivo bioreactor strategy is a promising alternative to microvascular surgical techniques that combines tissue engineering principles with microvascular reconstructive techniques to create patient-specific, prevascularized bone flaps for reconstruction of complex maxillofacial defects. This article discusses the use of traditional vascularized bone flaps; preclinical studies using the in vivo bioreactor approach; case reports that have attempted this novel technique; and future challenges and considerations in the development of patient-specific, prevascularized bone flaps for maxillofacial reconstruction...
February 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27882130/the-use-of-expanded-polytetrafluoroethylene-in-depressed-deformities-of-the-face
#13
Xiaowei Liu, Yiming Zhang, Shaoliang Wang, Zeyuan Lei, Xiang Li, Dongli Fan
Expanded polytetrafluoroethylene (ePTFE) has been extensively used for facial soft tissue augmentation procedures, and is regarded as safe and reliable and suitable as a permanent implant. This implant is generally used in the lower third of the face for lips filling, nasal augmentation, nasolabial folds and chin augmentation, and rarely for congenital or acquired depressed deformities of the face. The aim of the present study was to assess the effects of ePTFE in congenital or acquired depressed deformities of the face...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27820904/morphology-of-cyprid-attachment-organs-compared-across-disparate-barnacle-taxa-does-it-relate-to-habitat
#14
Hamad Al-Yahya, Hsi-Nien Chen, Benny K K Chan, Ryusuke Kado, Jens T Høeg
This study used morphometric analyses to compare the structure of the third antennular segment, also called the attachment organ, in cyprid larvae from cirripede species representing a diverse set of taxonomic groups. The aim was to investigate the degree of morphological variation in view of the diversity of habitats, settlement substrata, and modes of life found in the Cirripedia. In all cyprids the third segment features a flat surface (the attachment disc) covered with small cuticular villi thought to function in adhesion...
October 2016: Biological Bulletin
https://www.readbyqxmd.com/read/27781155/the-influence-of-flight-style-on-the-aerodynamic-properties-of-avian-wings-as-fixed-lifting-surfaces
#15
John J Lees, Grigorios Dimitriadis, Robert L Nudds
The diversity of wing morphologies in birds reflects their variety of flight styles and the associated aerodynamic and inertial requirements. Although the aerodynamics underlying wing morphology can be informed by aeronautical research, important differences exist between planes and birds. In particular, birds operate at lower, transitional Reynolds numbers than do most aircraft. To date, few quantitative studies have investigated the aerodynamic performance of avian wings as fixed lifting surfaces and none have focused upon the differences between wings from different flight style groups...
2016: PeerJ
https://www.readbyqxmd.com/read/27774923/development-and-validation-of-a-low-cost-microsurgery-ear-trainer-for-low-resource-settings
#16
M P A Clark, B D Westerberg, J E Mitchell
OBJECTIVE: Chronic suppurative otitis media is a neglected condition affecting up to 330 million people worldwide, with the burden of the disease in impoverished countries. The need for non-governmental organisations to hardwire training into their programmes has been highlighted. An ear surgery simulator appropriate for training in resource-poor settings was developed, and its effectiveness in facilitating the acquisition of headlight and microsurgical skills necessary to safely perform procedures via the ear canal was investigated...
October 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27771260/upper-lip-lift-with-a-t-shaped-resection-of-the-orbicularis-oris-muscle-for-asian-perioral-rejuvenation-a-report-of-84-patients
#17
Bai-Lin Pan
BACKGROUND: An overlong upper lip or philtrum indicates aging. In the current study, a procedure for upper lip lift to alleviate this defect is illustrated and assessed for its esthetic effects and risks. METHODS: A total of 84 Chinese patients with overlong upper lip underwent surgery for upper lip lift from 2012 to 2014. Skin excision height was designed on the basis of the golden proportion of the lower region of the face. The incision was made at the subnasal (inferior border of the columella-nostril-alar) region...
September 15, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27766402/management-of-implant-exposure-in-one-stage-breast-reconstruction-using-titanium-coated-polypropylene-mesh-sub-mammary-intercostal-perforator-flap
#18
Michele Antonio De Riggi, Nicola Rocco, Giulio Gherardini, Emanuela Esposito, Massimiliano D'Aiuto
INTRODUCTION: One-stage implant-based breast reconstruction using titanium-coated polypropylene mesh is a novel approach widely used in Europe. Complication rates in breast reconstruction with the use of titanium-coated meshes seem to be comparable to those in patients with implant-based breast reconstruction alone. However, the use of synthetic meshes in implant-based breast reconstructive surgery leads to new clinical scenarios with the need for the breast surgeon to face new complications...
December 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/27757349/cross-face-nerve-grafting-with-infraorbital-nerve-pathway-protection-anatomic-and-histomorphometric-feasibility-study
#19
Joseph Catapano, Daniel R B Demsey, Emily S Ho, Ronald M Zuker, Gregory H Borschel
Smiling is an important aspect of emotional expression and social interaction, leaving facial palsy patients with impaired social functioning and decreased overall quality of life. Although there are several techniques available for facial reanimation, staged facial reanimation using donor nerve branches from the contralateral, functioning facial nerve connected to a cross-face nerve graft (CFNG) is the only technique that can reliably reproduce an emotionally spontaneous smile. Although CFNGs provide spontaneity, they typically produce less smile excursion than when the subsequent free functioning muscle flap is innervated with the motor nerve to the masseter muscle...
September 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27755421/microcystic-adnexal-carcinoma-of-the-nasal-tip-treated-with-surgical-excision-and-rotational-forehead-skin-flap
#20
Min Seok Kang, Eun Jung Lee, Ji Seop Kim, In Sik Yun, Hyung Kwon Byeon
Microcystic adnexal carcinoma (MAC) is a rare malignant cutaneous adenocarcinoma that typically occurs in the head and neck, particularly at the central face. There are only slightly more than 300 patients reported worldwide, and most patients occur in Caucasians. A 72-year-old man was referred to our hospital for definitive treatment of known MAC from previous biopsy. Wide excision of nasal tip and reconstruction of nasal defect with paramedian forehead flap and nasolabial flap transposition were performed rather than conventional Mohs surgery, due to grossly evident disease...
October 14, 2016: Journal of Craniofacial Surgery
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