Tadashi Okazaki

Earlobe Reconstruction Using a Subcutaneous Island Pedicle Flap after Resection of “Earlobe Keloid”

background. A large keloid of the earlobe is a difficult case in which to obtain a satisfying result by nonsurgical therapies. In this case, surgical resection of keloids should be considered as a first step in therapy. However, it is difficult to reconstruct the earlobe cosmetically after resection of the lesion. objective. To discuss the usefulness of the subcutaneous island pedicle flap in earlobe keloid surgery. methods. Five earlobe keloids in five patients (four females and one male) were resected and reconstructed by subcutaneous island pedicle flap. results. In all patients, there were no keloid recurrences and no adjuvant therapies used during the follow‐up periods, which ranged from 10 to 26 months. The reconstructed earlobes were almost symmetrical. conclusion. In the selected cases, use of the subcutaneous island pedicle flap is a viable method to be considered for reconstruction after resection of earlobe keloids.

Reconstruction of full-thickness lower eyelid defects using a blepharoplasty technique with a hard palate mucosal graft

The authors report a method of reconstruction of a full-thickness lower eyelid defect using a blepharoplasty technique utilizing excess skin of the lower eyelid with a hard palate mucosal graft. In all patients the hard palate mucosa took well, and good functional and aesthetic results were obtained. The most suitable indication of this technique might be for the defect occurring horizontally (for which direct closure is difficult to apply) and located in the lateral side of the lower eyelid (when a large amount of excess skin can be utilized). The authors conclude that although the shape and size of the defect to which this method can be applied is restricted, this is a useful option in the reconstructive methods of a full-thickness lower eyelid defect.

An experience of pubic hair reconstruction using free temporoparietal fasciocutaneous flap with needle epilation

Lack of pubic hair may cause suffering for pubescent and adult patients; thus, rapid and precise reconstruction is required for their mental health. We reported pubic hair reconstruction for burn alopecia using a free temporoparietal fasciocutaneous flap transfer with needle epilation. Fourteen months after the reconstruction, an acceptable aesthetic result was obtained, and our patient is satisfied with her reconstructed pubic hair. We conclude that reconstruction using a free temporoparietal fasciocutaneous flap with needle epilation is a useful method for selected patients.Patient satisfaction after surgery to correct the prominent ear relates to the degree of retroposition of the ear. Angular breaks in the cartilage seen with other cartilage-transecting procedures (and even after conchal resections), which are noticed by patients, led to the development of this technique. It is an easy operative technique that may be modified to suit all prominent ears, including the constricted cup ear, and it does not leave any sharp, visible ridges in the region of the anti-helix or concha. The procedure combines and modifies a number of techniques that have been described previously, which allows more flexibility in the treatment of this deformity.

Vulval reconstruction using rectus abdominis musculocutaneous flap transfer with secondary liposuction in extramammary Paget's disease

Two female patients with vulval skin defects after extramammary Pagets disease were reconstructed using a pedicled, distally based rectus abdominis musculocutaneous flap. After the operation, the bulkiness of the flap, which might be a major problem in the application for a vulval skin defect, was improved successfully by flap volume reduction with secondary liposuction. We conclude that rectus abdominis musculocutaneous flap transfer with secondary liposuction is one of the acceptable methods for reconstructing vulval skin defects.

The difference of HSP72 induction in rat’s systemic organs after burn injury depends on burned body surface area

Abstract We have previously reported that in severely burned rats, the induction of 72-kD stress protein (HSP72) increased in various systemic organs. In this present study, in order to compare the stress response of systemic organs to burn injury of a smaller total body surface area with those of an extensive burn, we investigated the induction of 72-kD heat shock protein (HSP72) in various organs (brain, hypophysis, lung, heart, liver, pancreas, spleen, kidney, adrenal gland, and skeletal muscle) of burned rats. A dermal burn was developed on the skin by immersing the rats in hot water (90° C) for three seconds. At 0, 24 and 48 h after burn injury, the HSP72 induction of various organs was examined by Western blot analysis. In the single hind leg burn, the level of HSP72 did not increase at any time in all ten organs. In the double hind leg burn, at 48 h, the induction of HSP72 increased more than 1.5 fold compared to the control in the hypophysis (1.6 fold) and the heart (1.8 fold). These results indicate that the double hind leg burn causes a stress response in the hypophysis and the heart, while the single hind leg burn does not cause this stress response. In extensively burned rats, the degree of the stress response of the systemic organs to the burn injury depends on the burn size, and the intensity of “burn stress” to the systemic organs in a double or single hind leg burn is relatively small compared with those in extensive burns at the molecular level.

PLASTIC SURGERY FOR CUTANEOUS SEEDING OF BILE DUCT CANCER FOLLOWING PERCUTANEOUS BILIARY DRAINAGE

Abstract A case of cutaneous seeding of bile duct cancer along a drainage tube is reported. The cutaneous lesion, which caused pain and bleeding, was resected and the defect covered by a transposition flap. After the operation, the pain abated. This is the third case reported in the English literature and the first case reported in the field of plastic surgery.

One-stage reconstruction of an acquired major ear defect using an auricular cartilage sling and temporal fascial flap

To reconstruct a major middle third auricular defect, a two-stage operation is usual, using a skin flap with cartilage support. In this paper, a one-stage operation for an acquired ear defect using an auricular cartilage sling and temporal fascial flap with skin grafting is reported. The auricular cartilage graft was harvested along the antihelix and used for the reconstruction of the helical rim. This is a simple, easy, and safe method of one-stage reconstruction for an acquired ear defect in properly selected patients.