Annals of plastic surgery
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Annals of plastic surgery · Feb 1996
Comparative StudyAn evaluation of excision with application of autografts or porcine xenografts within 24 hours of burn injury.
An evaluation of feasibility and safety of excising burn wounds within 24 hours of injury was carried out. Over a 2-year period, 124 patients were admitted and taken to the operating room within 24 hours of initial burn injury. All cases were from one surgeon's practice. ⋯ Twenty-three patients required readmission for further treatment, usually including surgery. It appears that excision within 24 hours of injury is safe. There is the obvious benefit of a reduced hospital stay by decreasing the time to surgery and the theoretical advantage obtained by early removal of sources of infection.
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Annals of plastic surgery · Jan 1996
Case ReportsScarpa's adipofascial flap for repair of wide scalp defects.
Scarpa's fascia is a prominent superficial fascial system of the body. It consists of a single membrane between the superficial fatty layer and deep fatty layer, and lies widely in the lower abdominal wall. ⋯ The disadvantages of this flap are that the territory with a single artery may be smaller than a skin flap with the same artery and oversurfacing of the graft results in a poor cosmetic appearance. Scarpa's adipofascial flap is indicated when the defects are in an exposed area, especially in children, young patients, and females, and when this procedure is combined with a skin-expanding method in the secondary repair.
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Annals of plastic surgery · Jan 1996
Microsurgical reconstruction of the head and neck: interdisciplinary collaboration between head and neck surgeons and plastic surgeons in 305 cases.
Three hundred five microsurgical free flaps have been performed for defects of the head and neck by a team of two head and neck surgeons and two plastic surgeons over a 9-year period, with a success rate of 91.2%. The most common flaps used were the jejunum (89), radial forearm (57), rectus abdominis (48), latissimus dorsi (40), scapular (32), fibula (15), and iliac crest (11). Thirty-three flaps required reexploration for anastomotic thrombosis or hematoma (10.8%), of which 18 flaps were salvaged (54.5%). ⋯ The radial forearm flap and free jejunal transfer have become the preferred choices for intraoral reconstruction and pharyngo-esophageal reconstruction, respectively. There still remains no universally accepted flap for mandibular reconstruction, but the fibular osteocutaneous flap and a reconstruction plate protected by a radial forearm flap have largely superseded the iliac crest and scapular osteocutaneous flaps. Radical resection of tumors of the head and neck with immediate reconstruction by microsurgical free tissue transfer followed by adjuvant radiation therapy provides the best possible chance for cure and functional and social rehabilitation of the patient.
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Annals of plastic surgery · Jan 1996
Hemostasis at skin graft donor sites: evaluation of topical agents.
Blood loss from split-thickness skin graft donor sites may be significant. Various topical agents have been used to decrease this blood loss, including thrombin and epinephrine solutions of varying concentrations. ⋯ This mixture, in comparison with other topical agents, produces rapid hemostasis and offers the advantages of easy use, ready availability, and low cost. The blood loss savings based on this hemostatic technique is quantifiable and significant.
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Annals of plastic surgery · Dec 1995
The effects of lipo-prostaglandin E1 on axial pattern flaps in rabbits.
The effects of lipo-prostaglandin E1 (lipo-PGE1), lipid microspheres containing PGE1, on axial pattern flaps were examined using 12 x 20 cm axial pattern flaps based on the right superficial inferior epigastric vessels on the abdomens of rabbits. The surviving area of the skin flap in the lipo-PGE1 group (0.197 +/- 14.1 cm2; n = 10) was significantly increased (p < 0.02) compared with the saline control group (110.4 +/- 5.5 cm2; n = 10). Changes in pedicle blood flow after lipo-PGE1 administration were determined using an ultrasonic pulsed Doppler flowmeter (n = 5). ⋯ Blood flow in the skin flap surface was improved 5 to 15 minutes after lipo-PGE1 administration, and it was maintained for as long as 60 minutes. Venous occlusion of the skin flap was also improved (n = 3). In conclusion, lipo-PGE1 increased the blood flow in the axial pattern flaps, resulting in significant enlargement of the surviving skin flap area.