Annals of plastic surgery
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Effects of wet (saline in a vinyl chamber), moist (hydrocolloid dressing), and dry (sterile gauze dressing) environments on wound repair were studied in a porcine partial-thickness wound model. Chambers were exchanged and refilled daily with normal saline containing penicillin G (100 U/ml) and streptomycin (100 micrograms/ml). Hydrocolloid and gauze dressings were kept in place until biopsy of the wound site. ⋯ Thickness of the epidermis in wet, moist, and dry wounds was 204 +/- 23, 141 +/- 12, and 129 +/- 18 (mean +/- SEM), respectively. Moist wounds had more subepidermal inflammatory cells than wet wounds. In comparison to dry wounds, the moist or the wet healing environment resulted in less necrosis and faster and better quality of healing in the formation of the newly regenerated epidermis.
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Annals of plastic surgery · Dec 1994
Ethanol injection sclerotherapy for Baker's cyst, thyroglossal duct cyst, and branchial cleft cyst.
Six patients with Baker's cysts, 3 with branchial cleft cysts, and 2 with thyroglossal duct cysts were treated with percutaneous aspiration and absolute ethanol sclerotherapy using a 7-French pigtail catheter. Cystography was performed before ethanol injection to confirm that there was no extravasation and that it was a monocystic lesion. ⋯ The major complication of hypoesthesia of the popliteal region was observed in 1 patient treated for Baker's cyst. The results of this series suggest that ethanol sclerotherapy is the treatment of choice for Baker's cyst, branchial cleft cyst, and thyroglossal duct cyst.
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Annals of plastic surgery · Oct 1993
The rat rectus abdominis myocutaneous flap: a true myocutaneous flap model.
Investigations of experimental flaps in lower-order animals have concluded that the cutaneous vascular anatomy of "loose-skinned" animals is not analogous to that of humans. This is particularly relevant with respect to myocutaneous flaps. The interpretation of results of studies in lower-order animals raises questions as to the applicability of these data to the human condition. ⋯ The rat rectus abdominis muscle and overlying cutaneous island constitutes a true myocutaneous territory. This has not been described in a low-order laboratory animal. The flap can be based on single or double, superior or inferior, epigastric vessels with predictable flap survival. The superiorly based and double pedicle flap demonstrates nearly complete viability. This model should serve as a useful investigational tool in the laboratory study of myocutaneous flaps.
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Although tissue expansion has many advantages over other reconstructive options, potential complications require consideration. The purpose of this study was to evaluate the experience of tissue expansion in the infant and child. During the 6-year period from 1985 to 1990, a total of 147 expanders were placed in 76 patients. ⋯ Twenty of the 76 patients studied suffered from complications, a rate of 26%. Despite the high complication rate, complications did not compromise the final result because they occurred near the end of the expansion period and usually involved one of the many implanted expanders. With the appropriate selection of patients, tissue expansion has proved extremely valuable as a reconstructive option in the pediatric patient.
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Annals of plastic surgery · Jun 1993
The role of alloplastic skeletal modification in the reconstruction of facial burns.
The external appearance of the face is largely dictated by its supporting facial skeleton. After an extensive thermal injury, the underlying facial skeleton may need to be either augmented or restored to maintain the functional and aesthetic appearance of the face. The factors that make a structural reconstruction difficult are poor vascularity and compliance of the scar tissue, extreme contractile forces of the scar, and unstable skin coverage. ⋯ There were no other implant-related complications. We believe that skeletal modification is an important step for a successful facial burn reconstruction. Porous polyethylene offers a promising solution for the complex reconstructive problem of using an alloplast in the environment of a facial burn.