Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Sep 1997
Implementation of parameters in the expansion ratio of mesh skin grafts.
Expansion of a mesh skin graft depends on factors pertaining to the graft itself as well as on parameters of the meshing device. With regard to the graft, we examine the efficiency of graft handling and thickness of the skin graft. With regard to the parameters of the meshing apparatus, which determine the expansion ratio: (1) d equals the distance between the cutting blades, which will become the width of the mesh ribbons and is an underestimated parameter for expansion; and (2) L equals the length of cut, which determines proportionally the expansion ratio. ⋯ The authors present a mathematical formula of expansion ratio that allows for an objective comparison of skin meshing apparatuses. It is concluded that optimal mesh skin grafting is based on mathematical principles rather than on inventive instrumentation. Furthermore, an analysis of the mechanical parameters as given by the manufacturers is important in anticipating healing time per expansion ratio.
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Plast. Reconstr. Surg. · Sep 1997
Comparative StudyEffects of extradural anesthesia on microcirculatory blood flow in free latissimus dorsi musculocutaneous flaps in pigs.
Free musculocutaneous flaps are used frequently in plastic surgery to reconstruct soft-tissue defects after radical cancer surgery and trauma. Despite improved surgical techniques, some of these flaps fail due to insufficient blood supply. Extradural anesthesia causes both sensory (pain relief) and sympathetic (vasodilatation) block that may be advantageous in free-flap surgery. ⋯ It causes a significant decrease in cardiac output, mean arterial pressure, and microcirculatory blood flow in slightly hypovolemic animals. During phenylephrine infusion, the microcirculatory blood flow in free flaps slightly improves due to the increase in mean arterial pressure. We suggest that extradural anesthesia for microvascular surgery should be used with great caution until human data are available.
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Plast. Reconstr. Surg. · Sep 1997
Island fasciocutaneous flap based on the proximal perforators of the radial artery for resurfacing of burned cubital fossa.
In the vast majority of burned patients, the injury is limited to the skin and superficial subcutaneous tissue, and the vasculature of the deeper fascia is spared. This fact encouraged me to design a flap in which the burned scar tissue is employed. ⋯ The flap is used to resurface the anterior as well as the lateral burned cubital fossa after excision of the scar tissue and release of contracture. An anatomic study as well as clinical approach has been conducted.