Zhaovargas3495
Abrasions and laceration of face are very common injury in a road traffic accident. Complex Hemi-facial Degloving injury of face is very rare injury in road traffic accident. Reconstruction of face and rehabilitation of patient poses a great challenge to treating surgeon. Here a case of hemifacial Degloving injury of face in A 45-year-old female patient from India is reported.Congenital anomalies of the nose are rare but may be associated with syndromes affecting craniofacial structures. Herein, we report a case of a congenital absence of lower lateral cartilage seen during an open rhinoplasty in a 23-yr-old lady with no underlying health conditions. Medical and surgical history were unremarkable and there were no evidences conducted of any previous traumatic facial injuries. During physical examination, a significant nostril asymmetry was noted to be present. In addition, cotton test showed no evidence of obstruction. The absence of lower lateral cartilage on the right side was noted during the degloving stage of the open rhinoplasty. Absence of lower lateral cartilage poses a technical challenge in surgery and in order to reconstruct this structure, cartilage can be harvested from concha, lower lateral cartilage, septum and cartilaginous dorsal hump during an open approach rhinoplasty.Knee rotationplasty is a suitable reconstructive and limb salvage procedure for infected femur and knee prostheses. It involves external rotation of the lower limb with an intact neurovascular bundle to function as a knee joint. Functionally, it has better outcomes when compared to alternate options like above knee amputation. It results in better cortical reorganization and superior stance mechanics, enabling a more efficient gait and better quality of life. Here we report a 57-yr-old male who underwent modified rotationplasty for an infected knee endoprosthesis as a composite lower leg free flap.Although trigger finger is common, pediatric trigger thumb is uncommon. In trigger thumb the finger is held in flexed position. The etiology of trigger finger is unknown and can occur isolated without any relation to other syndromes, however there are some evidences that suggest genetic etiology. We reported 2.5 year old twins both having bilateral trigger thumb. Grandfather of the twins had the disease. Although trigger thumb and finger have the same presentation, they can involve different anatomical structures. selleck inhibitor Bent or straightening of thumb or finger would produce painful popping and clicking and the affected finger or thumb can get stuck in bent and extended position. Based on physical examination and symptoms trigger finger are classified into four stages and each has its own treatment. There are evidences that support congenital hypothesis in pediatric trigger thumb such as bilateral presentation in identical twins, first degree familiar association and etc. Before the 1st year of life, 30% of trigger thumb will get resolved and it is better to postpone the surgery until 2 year of age. A1 pulley release has a good result in pediatric trigger thumb treatment.Pure periorbital electrical injuries are uncommonly reported and may cause both immediate and delayed complications. These injuries are rare and pose a difficult challenge for both ophthalmologist and plastic surgeon. Here we report an unusual case of pure periorbital electrical injury in a 12-yr old boy while drinking water from water dispenser.Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic dermatosis, characterized by painful ulcerative, bullous, or pustular skin conditions. Pathergy is usually used to describe PG which refers to initiation or exacerbation of the disease after accidental or iatrogenic skin trauma. Diagnosis of postoperative PG is challenging not only due to its presentation mimics infectious wounds, but also because there are no standard laboratory parameters for diagnosis. Herein, we present a case of a 46-year-old female patient who had recurrent bilateral breast wound erythema, swelling, pain and necrosis after breast reduction mammoplasty at Centro Hospitalar Conde São Januário Macau SAR in 2018. We diagnosed her postoperative PG and successfully treated her with oral prednisolone with significant therapy response.Basal cell carcinoma (BCC) is the most frequent malignant eyelid tumor, followed by squamous cell carcinoma, sebaceous gland carcinoma and malignant melanoma. These eyelid malignancies represent main reason for eyelid reconstruction in ophthalmoplastic surgery which can be challenging. Lower eyelid orbicularis oculi myocutaneous flap was used for reconstructive purpose in four consecutive patients with a full thickness upper eyelid BCC. Digital photographs were taken at baseline, 1 month, 3 and 6 months after surgery to assess clinical outcome. Four patients underwent full thickness upper eyelid reconstruction with a lower eyelid orbicularis oculi myocutaneous flap after BCC radical resection with 3-mm safe margins. Histological subtypes showed tumor complete excision in all cases. No patient showed local recurrence at a mean 12 months follow-up. The high functional-esthetical success rate of the modified Hughes procedure corresponds with the beneficial results, which have been reported in previous publications. None of the treated patients complained about forced temporary closure of eyelid. In all four cases treated, aesthetic and functional outcome were satisfactory.The adhesion of mandibular condyle to the glenoid fossa by bone or fibroblastic tissue is called temporomandibular joint (TMJ) ankylosis. Trauma and infection are the main reasons for affecting TMJ ankylosis. TMJ arthroplasty is the treatment of choice for this situation. This study was aimed at reporting a new technique for the treatment of chronic TMJ ankylosis caused as a result of a car accident in patients who referred to Ghaem Teaching Hospital, Mashhad, Iran. The primary Maximum Mouth Opening (MMO) of the patient was equal to 2.5 mm. Interpositional arthroplasty was done using Temporoparietal Fascia Flap (TPFF) based on the superficial temporal artery. The MMO was increased to 35 mm after regular post-operative physiotherapy and a one-year follow-up. There was no sign of reanykylosis during this time. Interpositional arthroplasty using TPFF could be an appropriate treatment option. TPFF is thin and has a reliable blood supply. It seems that TPFF has less complication compared to other Interpositional materials like temporalis muscle flap.Facial nerve (FN) impacts the function of the facial musculature by creating muscle tone at rest as well as the muscles' voluntary and involuntary contractions. Temporary or permanent loss of FN function could be due to different etiologic factors. Acute facial paralysis (FP) could be significantly stressful for the patient and the family and apart from supportive measures management options are quite restricted. While botulinum toxin (BTX) injection in the FP setting has been used mostly to address the compensatory hyperkinesia in the non-paralyzed side of the face, there are evidence to suggest contralateral injection of the non-paralyzed face with BTX may improve/enhance the recovery time of the FP in cases where the FP has a reversible cause. While further studies are underway, using the current evidence as discussed could potentially justify the current usage of contralateral BTX injection and biofeedback exercises in the setting of the temporary FP specialty due to lack of effective alternative management options.
Given the potential usefulness of Acellular Dermal Matrices (ADM) for wound healing, we aimed to evaluate the stability, histological characteristics, and effectiveness of ADM compared with cryopreserved dermis (CPD) in rat models.
This experimental study was conducted in the Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran, from January to March 2015. The prepared ADM and CPD were transplanted to the full-thickness skin defects on the back of Sprague-Dawley rats. Forty-five days after grafting, the tissues were harvested for histological examination. These two types of the dermis' quality and stability were compared with consideration of the following factors; inflammation, fibroblasts migration, vascularization, collagen formation, capsule formation, and microabscess formation.
From 19 selected rates, nine received CPD, and ten were treated with ADM. After transplantation, the mean (SD) weight of ADM and CPD grafts were 1.74 (0.07) and 1.45 (0.77), respectively (
<0.001). The frequency of inflammation was significantly higher in CPD grafts (
<0.01). Higher grades of collagen organization, fibroblast spreading, and vascularization were more frequent in ADM grafts (
<0.01). The frequency of capsule and microabscesses formation was not significantly different between studied groups.
ADM have a superior effect than CPD in the wound healing process. Both samples had a similar effect in capsule and microabscesses formation and higher costs of ADM preparation. According to the physicians' decision and evaluation of the process's cost-effectiveness, CPD could be appropriately used as an alternative to ADM.
ADM have a superior effect than CPD in the wound healing process. Both samples had a similar effect in capsule and microabscesses formation and higher costs of ADM preparation. According to the physicians' decision and evaluation of the process's cost-effectiveness, CPD could be appropriately used as an alternative to ADM.
Randomized skin flaps have been used as a basic treatment modality for covering skin defects for a long time but they have always been in the risk of an inherent ischemia. Fibroblast growth factor 1 is a known angiogenic factor in in vitro studies which has shown conflicting results in in vivo investigation. We aimed to determine the effect of recombinant fibroblast growth factor on the angiogenesis rate of random cutaneous flap in animal model of rats.
This experimental study was conducted on 24 adult male rats randomized to 2 groups. In the first group FGF1 was injected subdermally in equally divided doses and distances of random flap surface in days 1, 3 and 5. In second group, normal saline was injected as control. Flap surgery was done on day 21 after first injection. The extent of necrosis and angiogenesis (mean vessel density) were assessed in day 14 after surgery.
The mean percentage of clinically apparent necrosis was 35.2% (±10.5) in intervention (FGF1) group and 38.1% (±8.7) in control (normal saline), respectively. Mean vessel density was 86.20±5.6/mm2 in control group and 90.17±5.5/mm2 in intervention group, which showed no statistically significant difference.
Mean vessel density and mean percentage of clinically apparent necrosis area were similar in 2 groups of rats with random cutaneous flaps receiving FGF1 or normal saline.
Mean vessel density and mean percentage of clinically apparent necrosis area were similar in 2 groups of rats with random cutaneous flaps receiving FGF1 or normal saline.
This study was designed for the evaluation of Acellular Dermal Matrix (ADM) as a scaffold for adipose-derived stem cell transferring in the rat model.
This experimental study was done in the Burn Research Center of Iran University of Medical Sciences and Bonyakhteh Research Center, Tehran, Iran according to the standards of laboratory animals. Overall, 26 healthy Sprague-Dawley rats were used. Two of them were used to prepare ADM. In group one, the first wound on each, rat was spread with the mixture of fibrin gel and autologous stem cell. Only the stem cells combined with fibrinogen were spread on the other wound. In group two, the first wound on each rat was covered only with ADM, and the second wound was covered with gauze Vaseline. To perform sampling we used observation and photography at 7-30 days. Overall, 48 samples were taken of all the rats using skin punch biopsy on the 30th day for histopathology evaluation.
There were significant differences in each group; however, the difference between different groups on days was not significant.
