Annals of plastic surgery
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Annals of plastic surgery · Jan 2007
Sprayed cultured epithelial autografts for deep dermal burns of the face and neck.
The objective of this study was the assessment of clinical results after sprayed application of cultured epithelial autograft (CEA) suspensions onto deep dermal burn wounds of the face and neck. Nineteen patients with deep dermal burns of the face and neck were included into a prospective study. The average total body surface area burn was 15.1% (7%-46%; median: 13%). ⋯ Four patients had less than 9 months' follow-up. Excluding these patients from the analysis resulted in an average Vancouver Scar Scale score of 1.3 +/- 0.9 points (range, 0-3 points) and an average Donnersmarck and Hörbrand score of 8.0 +/- 7.4 points (range 0-22) for the remaining 9 patients. Our data show that enzymatic and careful surgical debridement and consecutive application of CEA suspensions using a spray technique results in excellent cosmetic outcomes compared with any other method.
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Annals of plastic surgery · Jan 2007
Case ReportsSoft-tissue reconstruction of an open tibial wound in the distal third of the leg: a new treatment algorithm.
Over the past 4 years, a total of 33 patients, each with an open tibial wound in the distal third of the leg, underwent a skin-grafted muscle flap reconstruction according to the new treatment algorithm developed by the author. When the size of the soft-tissue defect was less than 50 cm, a pedicled medial hemisoleus muscle flap was used for the soft-tissue coverage (n = 20). If the soleus muscle was traumatized, a small free muscle flap (ie, gracilis) was then used (n = 3). ⋯ Five patients with a free muscle flap required an additional operation, and 2 patients had a subsequent debulking procedure of the flap for contour improvement of the leg. Reliable soft-tissue coverage with a well-healed tibial wound, evident fracture healing, and good contour of the leg were achieved in all 33 patients during follow-up. Following this new treatment algorithm, a selected option for an open tibial wound in the distal third of the leg can provide reliable soft-tissue coverage for different sizes of open tibial wounds and may offer a more cost-effective approach for managing such a complex clinical problem.
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Annals of plastic surgery · Jan 2007
Case ReportsA safe and effective way for reduction of temporomandibular joint dislocation.
Anterior dislocation of the temporomandibular joint (TMJ) is a common problem which demands immediate reduction to relieve the discomfort. The most popular technique is to put the operator's thumbs over the molar teeth of the patient and push the dislocated jaw downward and backward. This maneuver takes a lot of effort and usually needs sedation. ⋯ From May 2000 to July 2005, there were 7 anterior mandible dislocations treated successfully by this method in Chang Gung Memorial Hospital. None of the patients need any adjuvant medication for sedation or relaxation. This technique is simple and effective, and the physicians are spared from the risk of bite trauma and unexpected disease transmission.