Elizabeth Brenda

Surgical treatment of the fractured and dislocated condylar process of the mandible

Most fractures of the mandible can be managed conservatively. This report is a retrospective evaluation of the clinical and radiological results in 17 patients with 21 dislocated fractures submitted to open reduction and fixation, employing steel wires and maxillomandibular fixation. Follow-up ranged from 7 to 55 months, (mean 29.5). Functional assessment showed good opening movements (mean 41.9 mm). There were no cases of ankylosis, pain, or paralysis of the facial nerve. Radiological assessment was normal when the lateral pterygoid muscle was maintained adherent to the fractured proximal segment. Radiological signs of bone resorption occurred when the fractured segment was detached from the lateral pterygoid muscle. In our opinion, dislocated condylar process fractures can be managed surgically and with steel wire ligatures and maxillomandibular fixation. Whenever possible, the lateral pterygoid muscle should be inserted into the fractured proximal segment, i.e. as an osteomuscular flap.

Autologous Fat Grafts: a Quantitative and Morphometric Study in Rabbits

The aim of this study was to assess the fate of autologous fat tissue grafts harvested and processed by five different methods: blunt suction, sharp suction, dissection, treatment, and lavage. Fat was harvested from the subcutaneous tissue of the interscapular region in 25 rabbits and injected into the subcutaneous area of the convex surface of the ear. Harvesting was by either open surgical excision or suction. Where open surgical excision was used, the fragments were cut into smaller pieces with scissors. Suction in the blunt and sharp suction groups was through cannulas with blunt or sharp edged suction holes, respectively. In both suction groups and the dissection group the harvested tissue was injected without further processing. In the treatment group 2 ml of cell 199 culture medium and Earles basic salt solution were added, and in the lavage group the tissue was washed with Ringers lactate. Animals were killed at 7 (n = 9), 180 (n = 8), and 360 (n = 8) days. Serial cross sections were taken from each recipient area and the specimens processed for histology. The images from each section were digitised in a computer and, with the assistance of image analysis software, the volume of remaining fat cells was calculated for each recipient area. The percentage volumes of fat cells found in each group at 360 days were: blunt suction 14% sharp suction 35%, dissection 45%, treatment 27%, and lavage 16% (p = 0.003).

Capsular hematoma as a late complication in breast reconstruction with silicone gel prostheses

This paper presents a rare complication of breast reconstruction with silicone gel prostheses in which formation of intracapsular hematomas in the mammary region occurred 3 years after surgery. Treatment by bilateral capsular excision was successful. The rarity of this occurrence and the progress of the case are the major reasons for this publication.

Umbilicoplasty for the abdomen with a thin adipose layer

The authors present a new technique for umbilicoplasty performed on nine patients who were followed up for at least a year. The method is based on the formation of four dermal flaps which after deepithelialisation and fixation reconstitute the umbilical anatomy. The depth of the new umbilicus depends upon the construction of a cylinder. This method is easily performed in patients with a thin abdominal adipose layer and gives good results.

Bilateral multiple muscle hernias of the leg repaired with Marlex mesh

We report a case of multiple muscle hernias of the legs, resulting from regular, intense, physical exertion. The multiple fascial defects were closed with Marlex mesh. On review after 5 years, there were no recurrences of the hernias.

Abdominoplasty with two fusiform plications

Two-fusiform plications are recommended for contouring the abdomen to produce a slimmer waistline in abdominoplasty, rather than the classical median xiphoid-pubic fusiform plication. This procedure was accomplished in 11 patients. After the dermoadipose flap was undermined, two fusiform shapes were marked at the transition of the sheaths of the rectus abdominis muscles with the external obliques. The slimmer waistline produced intraoperatively was maintained during the late postoperative period (mean 20 months), without loss of the natural contour between the rectus muscles. Maintenance of the natural contours of the abdominal muscles is of fundamental importance to reduce the embarrassment of a postabdominoplasty flat abdomen.

Abdominoplasty: modified plication

The authors present an addition to standard abdominoplasty techniques. Transverse plication of the aponeurotic layer in the epigastrium corrects the prominence in this area and helps the flap to reach the pubic region.

Otoplasty and its origins for the correction of prominent ears

The authors present a review of the literature concerning surgical correction of lop ear, re-examining the original procedures. Their own approach which combines the most suitable of several techniques described in the literature is presented. Using this approach they achieve good results stimulating them to continue utilizing this personal procedure.

ACTION OF PAPAIN, SUGAR, MINOXIDIL, AND GLUCAN ON EXCISIONAL WOUNDS IN RATS

Abstract Four topical drugs were studied with regard to their ability to promote healing of open wounds in 60 Wistar rats. Five study groups were defined. Four of the five groups received one of the following substances: papain, sugar, minoxidil, or glucan. The fifth group or control group received saline solution (NaCl, 0.9%). An experimental model with wound standardization (6 × 3.5 cm) was used. The raw area and new epithelium were quantified in each rat by taking photographs from which planimetry was performed. The closure of the first lesion occurred on the 49th postoperative day. Quantitative assessment of collagen deposition was performed using image analyzing software on slides stained with picrosirius and observed under polarized light. Epithelium formation was greatest in the minoxidil group, followed (in decreasing order) by the sugar, papain, control, and glucan groups. Significant differences in collagen deposition were observed among all the groups. The greatest amount of collagen was quantified in the glucan group, followed (in decreasing order) by the sugar, minoxidil, papain, and control groups. This data and possible mechanisms for the interference of each substance in wound healing are considered.

Critical analysis of methods of reconstruction of exenterated orbits

Reconstructive procedures were used on 14 patients who had undergone orbital exenteration and radiotherapy for malignant tumours. All patients were tumour free after a follow-up of between 5 and 18 years. Reconstruction was carried out in 3 stages. In the first operation the orbit was filled, in the second the orbital rims and eyelids were shaped, and in the third a cavity for a static eye prosthesis was created. Critical assessment of results showed that the first stage alone produced a marked improvement in appearance and occluded existing fistulae. The subsequent procedures improved aesthetic results further. Difficulties were encountered from retraction of the tissues and insufficient tissue mobility.