Annales de chirurgie plastique et esthétique
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Facial locoregional anesthetics (ALR) with nervous blocks are simple and reliable to perform, need little technical resources with a very low iatrogenic risk. These blocks allow anesthesia without deforming wound banks using the same materials as usual local anesthetic procedures. Three principal nervous blocks, in a straight line along the vertical pupil axis, allow managing - even extensive - facial wounds. ⋯ It is a good alternative to local anesthetic for the treatment of extensive and deep areas which is performed with a lower number of injections and a high rate of success. These techniques are easy to learn and practise. These anesthetic techniques allow a nice treatment of different kinds of facial wounds from simple suture to flaps.
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Ann Chir Plast Esthet · Dec 2009
Case Reports[Complete aesthetic reconstruction of nose and adjacent facial units with optimized use of free flaps, cartilaginous grafts and forehead flap combinations].
Facial reconstruction with only free microvascular flaps has rarely produced an aesthetic result. Menick : "Distant skin always appears as a mismatched patch within residual normal facial skin." In addition, earlier techniques using a single large nasal lining flap or bilateral nasal lining vaults incurred a high incidence of airway obstruction. ⋯ Microvascular free flaps have proved to be highly reliable and efficacious for restoration of missing elements of the nasal lining and adjacent facial soft-tissue defects in total and subtotal nasal reconstruction. Combined with a forehead flap, this aesthetic approach allows for reconstruction of the center of the face layer-by-layer and facial unit by facial unit. Specific attention is paid to the artistic creation of normal nasal dimensions, proportion, and form using carved and assembled cartilage grafts and by secondary subcutaneous contouring. In addition, this technique produces a patent airway.
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Ann Chir Plast Esthet · Dec 2009
[Cultured keratinocyte cells from foreskin and future application for burns in children].
We tested in vitro the keratinocytes capacity for division and differentiation. The donor site was the human foreskin. ⋯ The keratinocytes resulting from foreskin have a high capacity of division. These cells can divide a long time before differentiation. The observations enable us to propose with our patients the keratinocytes from foreskin for wound healing especially for burns in children.
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Ann Chir Plast Esthet · Dec 2009
[Incidence and microbiology of infectious complications with the use of artificial skin Integra in burns].
Integra dermal substitute is used as biomaterial after thermal injury. This artificial skin allows temporary coverage after burns excision, transformation of matrix in neo dermis and definitive engraftment. Infections are the most common complication of this technique. ⋯ Delayed application of Integra after burns could explain higher incidence of infection. Pseudomonas aeruginosa and Staphylococcus aureus were more frequently isolated than other pathogens. Standardized technique for wounds coverage with Integra is necessary to reduce incidence of infections and improve functional results in burns patients.