Annals of plastic surgery
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Annals of plastic surgery · Mar 1998
Portable fluoroscopy in the management of zygomatic arch fractures.
Operative methods that do not allow intraoperative visualization of the fracture fragments in patients with isolated zygomatic arch fractures often result in inadequate reduction. This article describes a technique using a portable, surgeon-operated fluoroscopic machine that can be used preoperatively, intraoperatively, and postoperatively in patients with isolated zygomatic arch fractures. Using the portable fluoroscopic unit, reduction of isolated zygomatic arch fractures was performed in 9 consecutive patients over a period of 1.5 years. ⋯ The use of portable fluoroscopy intraoperatively allows for dynamic visualization of instrumentation and the immediate confirmation of the adequacy of fracture reduction. Moreover, this technique may eliminate the need for postoperative CT in isolated zygomatic arch fractures. Portable fluoroscopy may also have a place in the management of certain zygomatic complex fractures.
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Annals of plastic surgery · Feb 1998
The effect of full-thickness abdominal wall burns sustained during childhood on subsequent childbearing ability.
The effect of full-thickness burns of the abdomen during childhood on subsequent pregnancy was evaluated. Eight hundred female pediatric patients treated for acute burns during a 14-year period (1975-1989) at the Shriners Burns Institute were reviewed. Through a combination of clinical follow-up, questionnaires, or phone interviews, data were obtained regarding the histories of 31 pregnancies in 19 patients who had required excision and skin grafting of > or = 50% of their abdominal wall during management of their acute burns. ⋯ Despite a subjective sensation of increased tension on the scar in 25% of the patients, no interference with these patients carrying a full-term pregnancy directly attributable to the burn scar was identified. Follow-up and examination during the third trimester of pregnancy demonstrated how the burned and unburned portion of the abdominal wall accommodated the enlarged uterus. This review demonstrates that after extensive burns to the abdomen, which have been treated with excision and skin grafting during childhood, the scarred abdominal wall accommodates full-term pregnancy without the need for surgical release.
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Annals of plastic surgery · Feb 1998
Rubber foam and staples: do they secure skin grafts? A model analysis and proposal of pressure enhancement techniques.
The significance of even pressure application and protection against shearing forces using a tie-over dressing of skin grafts has been stressed previously. Several methods for pressure enhancement have been described with no quantification or comparison between the different techniques. Rubber foam and metal staples are commonly used for simple and quick application of the dressings. ⋯ The original silk thread tie-over dressing exerted a relatively low pressure but was uniformly distributed. A regular stapled tie-over dressing applied a ring-shaped pressure with minimal projection. Other methods are described providing different contact areas with the grafts and different pressures.
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The purpose of this study was to evaluate cutaneous blood flow in the human body to better establish normal flow ranges and to determine whether the location, side of the body, sex, and age affect the flow range at seven different sites. From March 1993 to February 1994 a Periflux system 4001 laser Doppler flowmeter was used to measure the cutaneous microflow circulation of 1,680 selected points in 120 volunteers. The mean normal cutaneous blood flow of 120 volunteers was between 4 and 9 perfusion units (PU) except in the head, neck, hand, and foot. ⋯ The group of subjects in their sixties proved to have the lowest cutaneous blood flow-32% less than the teenagers. Gender differences were not noted. There were no significant differences in blood flow in regard to the side of the body.
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Annals of plastic surgery · Nov 1997
Comparative StudyA comparison of donor and recipient site sensation in free tissue reconstruction of the oral cavity.
In patients who undergo oral cavity reconstruction, loss of sensation plays a vital role in producing disturbances in postoperative oral function. Microsurgical techniques have provided a method of addressing this deficit through the use of sensate cutaneous free flaps in which microneural anastomoses are performed between a sensory nerve supplying the flap, and a recipient nerve in the head and neck. The purpose of this study was to compare the cutaneous sensation of the radial forearm flap and lateral arm flap donor sites, the two most commonly used intraoral sensate flaps. ⋯ The lateral arm flap donor site is a more sensitive region than the radial forearm flap donor site. However, the lateral arm flap donor site is less sensitive than the tip of tongue and hard palate, while the radial forearm flap donor site is less sensitive than the tip of tongue, hard palate, lateral tongue, and cheek. This suggests that for certain locations, intraoral sensate flaps may require measures such as sensory reeducation protocols to approach normal recipient site sensation.