Annals of plastic surgery
-
Despite the development of multiple cranial bone substitutes, calvarial reconstruction remains a significant challenge. Although autologous bone is preferred in many cases, its usefulness may be limited by difficulty with contouring, resorption, and donor site availability and morbidity. ⋯ Computer-designed implants have the advantages of minimizing operative time for preparation, shaping, and insetting. We report our initial clinical experience in 6 patients with computer-designed, prefabricated polyetheretherketone implants, which may have significant advantages over other alloplastic materials in terms of strength, stiffness, durability, thermal conductivity, and radiographic translucency.
-
Annals of plastic surgery · Jun 2009
The effect of enalapril on skin flap viability is independent of angiotensin II AT1 receptors.
Random pattern skin flaps are still widely used in plastic surgery. However, necrosis in the distal portion resulting from ischemia is a serious problem, increasing the cost of treatment and hospitalization. To enhance skin flap viability, a variety of pharmacologic agents have been intensively investigated. ⋯ Different doses of enalapril (5, 20, and 50 mg/kg) and losartan (5 mg/kg) were administrated 30 minutes prior to elevate the flap. Flap survival area was evaluated on the seventh postoperative day. Enalapril improved survival area in a dose-dependent manner, but losartan failed to improve survival area, which suggested that the effect of enalapril was not mediated through AT1 receptors.