Journal of plastic, reconstructive & aesthetic surgery : JPRAS
-
J Plast Reconstr Aesthet Surg · Jun 2013
Practice of split-thickness skin graft storage and histological assessment of tissue quality.
Storage of split-thickness skin grafts (STSGs) represents a standard procedure in burn surgery. The purpose of this study was to evaluate clinical routine of STSG preservation. Further, we aimed at investigating the effect of storage on tissue integrity and cell viability, proliferation, apoptosis and vascularization. ⋯ Even though reportedly superior methods for skin grafts storage exist, most study participants applied the simplest method of storage. Our data underscore this practice. However, a reduced cell viability after 3 days of storage may have an influence on graft healing.
-
J Plast Reconstr Aesthet Surg · May 2013
Case ReportsDouble combined Z-plasty for wide-scar contracture release.
Z-plasty is one of the most widely employed techniques in plastic surgery and mainly serves the following purposes: elongation along the axis of the scar, dispersal of the scar followed by breaking up the straight-line scar and realigning the scar within the lines of minimal tension. It is useful especially to release linear-scar contracture, yet difficult for wide scars. This report describes a novel technique to release contracture effectively for any wide scars using a new design called double combined Z-plasty. ⋯ We performed this technique on eight patients. All wounds healed well and scar contracture was satisfactorily released. This procedure is very useful for wide-scar contracture, compared to conventional Z-plasty.
-
J Plast Reconstr Aesthet Surg · Apr 2013
Case ReportsPosttraumatic delayed cranio-orbital cerebrospinal fluid leakage: case report.
A 56-year-old man sustained subarachnoid haemorrhage, skull base fracture and multiple facial fractures in a traffic accident. Two weeks later, the patient developed a subperiosteal fluid collection into the orbit of the right side presenting with a progressive proptosis and an increased intraocular pressure. ⋯ In conclusion, our case indicates that careful monitoring of clinical signs and a follow-up radiography would be mandatory for patients with craniocerebral trauma despite a lack of the definite symptoms. Clinicians should consider the possibility that the cerebrospinal fluid (CSF) leakage into the orbit might occur in these patients.
-
J Plast Reconstr Aesthet Surg · Mar 2013
Comparative StudyTransversus abdominis plane (TAP) catheters inserted under direct vision in the donor site following free DIEP and MS-TRAM breast reconstruction: a prospective cohort study of 45 patients.
The transversus abdominis plane (TAP) block is a peripheral nerve block of T6-L1 intercostal nerves of the abdominal wall. The purpose of this study was to evaluate the usefulness of intermittent TAP blockade for the first two postoperative days following free muscle sparing-transverse rectus abdominis muscle (MS-TRAM) or deep inferior epigastric perforator (DIEP) flap reconstruction of the breast. Therapeutic--Level II evidence. ⋯ Intermittent delivery of bupivacaine through the TAP block significantly reduced postoperative parenteral opioid requirements following free MS-TRAM or DIEP flap reconstruction of the breast. This is the first report of the TAP block being inserted under direct vision to provide postoperative analgesia at the abdominal flap donor site following microsurgical breast reconstruction.
-
J Plast Reconstr Aesthet Surg · Mar 2013
Case ReportsDouble nerve transfer for elbow flexion in obstetric brachial plexus injury: a case report.
We report a case of a 10-month-old boy with a left extended upper type (C5-C7) obstetric brachial plexus injury that was treated with double nerve transfer (partial ulnar and partial median nerve transfer) to restore elbow flexion and spinal accessory nerve transfer to the suprascapular nerve to restore shoulder abduction. At 60 months' follow-up, shoulder abduction was 0-150° (M4) and elbow flexion was 0-140° (M5). Elbow, wrist and finger extension improved to M5. ⋯ No weakness on finger and wrist flexion was observed. Double nerve transfers to restore elbow flexion can be safely done in obstetric brachial plexus injuries with good results. Secondary surgeries may be needed to improve external rotation.