scholarly journals Lower Lid Reconstruction Utilizing Auricular Conchal Chondral-Perichondral Tissue in Patients with Neoplastic Lesions

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Pier Camillo Parodi ◽  
Fabrizio Calligaris ◽  
Fabrizio De Biasio ◽  
Giovanna De Maglio ◽  
Flavia Miani ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Soft Tissues ◽  
Good Alternative ◽  
Tissue Loss ◽  
Tissue Formation ◽  
Reconstruction Surgery ◽  
Neoplastic Lesions ◽  
Lid Reconstruction ◽  
Graft Tissue ◽  
Lid Surgery

Purpose. To assess surgical outcomes of lower lid reconstruction surgery using auricular conchal tissue.Methods. This prospective study included 20 patients that underwent reconstructive lower lid surgery using autologous auricle chondral-perichondral graft tissue. Auricle tissue was used to provide adequate support and protection with similar conjunctiva tarsal structures on overlying soft tissues in patients with pathologic inferior lid tissue loss requiring reconstructive surgery. Biopsies with histopathology and cytology analysis were taken after 1 year. Cytology analysis using CK19 was used to confirm newly formed conjunctiva overlying the graft.Results. All patients showed no graft rejection. Surgical outcomes were generally good, with minimal or no ocular complications. 16 of 20 patients had excellent results, showing good lid symmetry and esthetics, minimal auricular discomfort, patient satisfaction and proper lid function. Surgical outcomes were highly dependent on proper post-op conjunctiva formation. All patients were positive for CK19, thus indicating proper conjunctiva tissue formation.Conclusions. Lower lid reconstruction surgery using auricular chondral-perichondral conchal tissue is a good alternative in patients with neoplastic lesions. Autologous chondral-perichondral tissue provides good functional and mechanical support in the reconstructed lid, thus reducing the risks of ectropion and corneal exposure and ensuring a protected ocular surface.

scholarly journals Comparison of clinical, biomechanical, and histopathological effects of various suture techniques on repair of tendon rupture by using autograft

2017 ◽  
Vol 61 (2) ◽  
pp. 231-237
Author(s):  
Celal Şahin Ermutlu ◽  
Vedat Baran
Keyword(s):  
Good Alternative ◽  
Suture Technique ◽  
Suture Techniques ◽  
Tissue Loss ◽  
Group Iii ◽  
Interrupted Suture ◽  
Group I ◽  
Tendon Ruptures ◽  
The Right ◽  
And Control

AbstractIntroduction: The purpose of this study was to compare the effectiveness of four different suture techniques in the treatment of experimentally modelled tendon injuries with tissue loss with autograft and grafting applications in rabbits.Material and Methods: The study was performed on 30 male mature (2-year-old) New Zealand rabbits with mean body weight of 3.1 kg, divided into three equal groups. A graft measuring 1 cm in length was collected from the m. tibialis cranialis of each rabbit under general anaesthesia. The graft collected from the right tendon was transplanted into the left tendon, and the graft from the left tendon was transplanted into the right tendon. In all groups, a simple interrupted suture was placed on the left tendon as control, a Bunnell-Mayer suture was placed on the right tendon in group I, a Locking-Loop suture in group II, and a Horizontal U suture in group III. Both hindlimbs were bandaged for four weeks. The tendons were assessed biomechanically and histopathologically.Results: According to the results of the tensile testing, the maximum durability of the techniques ranked as follows: Bunnell-Mayer, Horizontal U, Locking-Loop, and control groups.Conclusion: The use of autografts was a good alternative for the treatment of tendon ruptures with tissue loss. Furthermore, even though there were no clinical or histopathological differences, the suture technique can be chosen based on the results of the tensile test.

scholarly journals Indications and Use of Hydrogen Peroxide during Microvascular Flap Reconstruction Surgery: A Literature and Procedural Use Review

2017 ◽  
Vol 02 (01) ◽  
pp. e23-e25
Author(s):  
E. Rodriguez-Collazo ◽  
D. Riddle ◽  
K. Schmidtke
Keyword(s):  
Hydrogen Peroxide ◽  
Arterial Disease ◽  
Tissue Loss ◽  
Flap Reconstruction ◽  
Muscle Belly ◽  
Reconstruction Surgery ◽  
Microvascular Flap ◽  
Peripheral Arterial

AbstractMicrovascular flap reconstruction surgery is a limb preservation procedure performed in an effort to maintain the integrity of the lower limb and avoid amputations. Individuals facing the prospect of amputation often have long-term diabetes with multiple comorbidities, including severe peripheral vascular disease; peripheral arterial disease; chronic ulcerations; and Charcot arthropathy. Long-term clinical research has shown that these patients are at much higher risk for secondary amputations after a first amputation is performed. According to Sohn et al, Charcot and ulcer groups had 4.1 and 4.7 amputations per 100 person-years, respectively. In patients younger than 65 years old at the end of follow-up, amputation risk, relative to patients with Charcot alone, was 7 times higher for patients with ulcer alone and 12 times higher for patients with Charcot and ulcer. Patients with infected hardware, suffering from acute ulcerative conditions, may also be candidates for this type of surgery due to extensive tissue loss secondary to infection. Microvascular flap reconstruction surgery is a highly technical surgery involving the use of orthoplastic techniques, which is performed under ×3.5 loupe magnification. Due to the inability to perform this procedure with the use of a tourniquet, visibility within the field is obfuscated from continuous blood flow along the dissected muscle belly. Hydrogen peroxide (H2O2) is an excellent alternative to tourniquet use. The use of H2O2 allows additional benefits, such as visual field clearance and antisepsis.

Short-term outcomes of laparoscopic D2 gastrectomy with complete mesogastrium excision (D2+CME) for advanced gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 43-43
Author(s):  
Daxing Xie ◽  
Jianping Gong
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Cells ◽  
Advanced Gastric Cancer ◽  
Surgical Outcomes ◽  
Soft Tissues ◽  
R0 Resection ◽  
D2 Lymphadenectomy ◽  
Short Term ◽  
The Mean

43 Background: D2 lymphadenectomy has been widely accepted as a standard procedure of surgical treatment for local advanced gastric cancer [1,2]. However, neither the dissection boundary nor the extent of the excision for perigastric soft tissues has been described [3-7]. Our previous researches demonstrate the existence of disseminated cancer cells in the mesogastrium [8, 9] and present an understandable mesogastrium model for gastrectomy [10]. Hence, the D2 lymphadenectomy plus complete mesogastrium excision (D2+CME) is firstly proposed in this study, aiming to assess the safety, feasibility and corresponding short-term surgical outcomes. Methods: All of these patients underwent laparoscopy assisted D2+CME radical gastrectomy with a curative R0 resection, and all the operation was performed by Prof. Jianping Gong, chief of GI surgery of Tongji Hospital, Huazhong University of Science and Technology. All participants provided informed written consent to participate in the study. This study was approved by the Tongji Hospital Ethics Committee. The standard surgical procedures in the video are described as follows. Reconstruction of the alimentary tract was done by extracorporeal anastomosis. Standard recovery protocols were followed in postoperative treatments. Results: 68 patients between September 2014 and March 2016 have been recruited with informed consent and underwent laparoscopic D2+CME by a single surgeon. The mean number of retrieved regional lymph nodes was 33.62±11.40 (ranges 14-55). The mean volume of blood loss was 12.44±22.89 ml (ranges 5-100). The mean laparoscopic surgery time was 127.82±17.63 mins (ranges 110-165). The mean hospitalization time was 16.5±3.3 days (ranges 8-28). No operative complication was observed during the hospitalization. Conclusions: The anatomical boundary of mesogastrium is well described and dissected within D2+CME surgical process. It proves to be safely feasible and repeatable with less blood lost, qualified lymph nodes, retrieval results, and other improved short-term surgical outcomes in advanced gastric cancer. Meanwhile, potential disseminated cancer cells fall into the mesogastrium can be eradicated by D2+CME. Clinical trial information: NCT01978444.

A STUDY ON DIFFERENT SURGICAL OPTIONS OF LOWER THIRD LEG DEFECTS AND ITS OUTCOME

2021 ◽  
pp. 32-34
Author(s):  
Ajay Kumar Pathak ◽  
Md Ghulam Jeelani Naiyer ◽  
Pragati Awasthi
Keyword(s):  
Reconstructive Surgery ◽  
Soft Tissues ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Tissue Loss ◽  
Conventional Teaching ◽  
Surgical Options ◽  
Soft Tissue Loss ◽  
Flap Cover ◽  
Upper Third

Background: The bones of the lower third are vulnerable to injury. Due to the paucity of soft tissues around them, the fractures that occur are often open. Most muscles become tendons at that level and in the case of soft tissue loss, skin graft may not sufce and flap cover becomes mandatory. Conventional teaching recommends gastrocnemius muscle and myocutaneous aps and fasciocutaneous aps for the upper third leg defects, soleus aps for the middle third defects and free aps for the lower third defects. Aim: Different surgical options in management of lower third leg defects. Material And Method: The study was conducted from JANUARY 2018 to December 2019, in the Department of Plastic & Reconstructive Surgery Institute of Post Graduate Medical Education and Research (IPGME&R) and SSKM Hospital, KOLKATA. Result: 70 patients admitted to the Department of Plastic & Reconstructive Surgery and referred patients from Department of General Surgery & Orthopaedic Surgery, IPGME&R and SSKM Hospital, KOLKATA. Association of FLAP LOSS with Pedicled ap was statistically signicant (p=0.0259). We found that association of DONOR SITE MORBIDITYwith Pedicled ap was not statistically signicant (p=0.7679). Conclusion: We consider that perforator propeller aps are ideal in reconstructing small-medium defects of the middle and distal third of the leg, being safe, easy to perform, providing similar tissue in texture and thickness of damaged tissues, with low donor-site morbidity.

scholarly journals Longline hook testing in the mouths of pelagic odontocetes

2014 ◽  
Vol 72 (5) ◽  
pp. 1706-1713 ◽  
Author(s):  
William A. McLellan ◽  
Logan H. Arthur ◽  
Sarah D. Mallette ◽  
Steven W. Thornton ◽  
Ryan J. McAlarney ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Mechanical Tests ◽  
Tissue Loss ◽  
Grampus Griseus ◽  
Pilot Whales ◽  
Serious Injury ◽  
Soft Tissue Loss ◽  
Longline Fisheries ◽  
Pseudorca Crassidens

Abstract Several species of odontocete cetaceans depredate bait and catch and, as a result, become hooked and entangled in pelagic longline fisheries. The present study measured how selected commercial longline hooks, including “weak hooks”, behaved within odontocete mouths. Five hooks (Mustad-16/0, Mustad-18/0, Mustad J-9/0, Korean 16, and Korean 18) were tested on three species of odontocetes known to interact with longline fisheries—short-finned pilot whales (Globicephala macrorhynchus), Risso's dolphins (Grampus griseus), and false killer whales (Pseudorca crassidens). Specimens were secured to a stanchion, hooks were placed in the mouth at multiple positions along the dorsal lip, and the force required to pull each hook free was measured. The soft tissue lips of these odontocetes were capable of resisting forces up to 250 kg before failing. The polished steel M-16, M-18, and J-9 hooks straightened at forces between 50 and 225 kg, depending on hook gauge. When straightened, these hooks exposed the sharpened barb, which sliced through the lip tissue, usually releasing the hook intact. The K-16 and K-18 hooks behaved very differently, breaking at higher forces (110–250 kg) and consistently just at the barb; usually, there was measurable soft-tissue loss and often shards of the hook were retained within those soft tissues. The different behaviours of these two hook types—the M and J type polished steel vs. the K type carbon steel—were consistent across all species tested. Mechanical tests were also conducted to determine if hooks could fracture the mandible of these same odontocetes. Only the M-18 and K-18 hooks had sufficiently large gapes to hook around the mandible, and both hook types fractured bone in short-finned pilot whales and Risso's dolphins. These results support other lines of evidence indicating that longline hooks can cause serious injury to these species, and suggest possible steps to mitigate these impacts.

Tumor-like Lesions of Bone and Soft Tissues and Imaging Tips for Differential Diagnosis

2020 ◽  
Vol 24 (06) ◽  
pp. 613-626
Author(s):  
Sebnem Örgüç ◽  
Remide Arkun
Keyword(s):  
Differential Diagnosis ◽  
Structural Changes ◽  
Soft Tissues ◽  
Soft Tissue Tumors ◽  
Imaging Findings ◽  
Neoplastic Lesions ◽  
Tumors Of Bone ◽  
System Tumor ◽  
Tumor Like Lesions ◽  
Similar Imaging

AbstractIn the musculoskeletal system, tumor-like lesions may present similar imaging findings as bone and soft tissue tumors and can be defined as tumors on radiologic examinations. Misinterpretation of the imaging findings can lead to inappropriate clinical management of the patient.There is still some debate regarding the pathophysiology and origin of tumor-like lesions that include congenital, developmental, inflammatory, infectious, metabolic, reactive, posttraumatic, post-therapeutic changes, and some miscellaneous entities causing structural changes. Although tumor-like lesions are historically defined as non-neoplastic lesions, some of them are classified as real neoplasms.We discuss a spectrum of entities mimicking tumors of bone and soft tissues that include various non-neoplastic diseases and anatomical variants based on imaging findings.

A Structural Model for the Flexural Mechanics of Nonwoven Tissue Engineering Scaffolds

2006 ◽  
Vol 128 (4) ◽  
pp. 610-622 ◽  
Author(s):  
George C. Engelmayr ◽  
Michael S. Sacks
Keyword(s):  
Tissue Engineering ◽  
Soft Tissues ◽  
Structural Model ◽  
Fiber Diameter ◽  
Polyglycolic Acid ◽  
Mechanical Effect ◽  
Effective Stiffness ◽  
Tissue Formation ◽  
Functional Requirements ◽  
Tissue Engineering Scaffolds

The development of methods to predict the strength and stiffness of biomaterials used in tissue engineering is critical for load-bearing applications in which the essential functional requirements are primarily mechanical. We previously quantified changes in the effective stiffness (E) of needled nonwoven polyglycolic acid (PGA) and poly-L-lactic acid (PLLA) scaffolds due to tissue formation and scaffold degradation under three-point bending. Toward predicting these changes, we present a structural model for E of a needled nonwoven scaffold in flexure. The model accounted for the number and orientation of fibers within a representative volume element of the scaffold demarcated by the needling process. The spring-like effective stiffness of the curved fibers was calculated using the sinusoidal fiber shapes. Structural and mechanical properties of PGA and PLLA fibers and PGA, PLLA, and 50:50 PGA/PLLA scaffolds were measured and compared with model predictions. To verify the general predictive capability, the predicted dependence of E on fiber diameter was compared with experimental measurements. Needled nonwoven scaffolds were found to exhibit distinct preferred (PD) and cross-preferred (XD) fiber directions, with an E ratio (PD/XD) of ∼3:1. The good agreement between the predicted and experimental dependence of E on fiber diameter (R2=0.987) suggests that the structural model can be used to design scaffolds with E values more similar to native soft tissues. A comparison with previous results for cell-seeded scaffolds (Engelmayr, G. C., Jr., et al., 2005, Biomaterials, 26(2), pp. 175–187) suggests, for the first time, that the primary mechanical effect of collagen deposition is an increase in the number of fiber-fiber bond points yielding effectively stiffer scaffold fibers. This finding indicated that the effects of tissue deposition on needled nonwoven scaffold mechanics do not follow a rule-of-mixtures behavior. These important results underscore the need for structural approaches in modeling the effects of engineered tissue formation on nonwoven scaffolds, and their potential utility in scaffold design.

Technetium-99m MDP Demonstration of Neoplastic Lesions Involving Bone and Adjacent Soft Tissues

1986 ◽  
Vol 11 (2) ◽  
pp. 98-101 ◽  
Author(s):  
JOHN MATHEWS ◽  
JAMES D. SLAVIN ◽  
RICHARD P. SPENCER
Keyword(s):  
Soft Tissues ◽  
Technetium 99M ◽  
Neoplastic Lesions

Foot Salvage After Loss of the First and Second Metatarsal Rays with a Free Fibular Osteocutaneous Flap

2011 ◽  
Vol 101 (6) ◽  
pp. 531-536 ◽  
Author(s):  
Christopher J. Salgado ◽  
Chih-Hung Lin ◽  
David A. Fuller ◽  
Alissa N. Duncan ◽  
Liliana Camison ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
High Energy ◽  
Metatarsal Bone ◽  
Tissue Loss ◽  
Metatarsal Bones ◽  
Second Metatarsal ◽  
Independent Ambulation ◽  
Soft Tissue Loss ◽  
Osteocutaneous Flap

Severely comminuted fractures of the metatarsal bones with significant bone and soft-tissue loss have commonly subjected patients to proximal amputation procedures. We describe two patients who experienced high-energy traumatic injuries to their limbs that resulted in significant destruction of their first and second metatarsal bones with overlying soft-tissue trauma not amenable to local coverage. In both cases, a vascularized free fibular osteocutaneous flap was used to reconstruct the metatarsal bone defect and traumatized soft tissues so that a proximal amputation was avoided. At an average of 14 months of follow-up, both patients had recovered well and regained independent ambulation, with one patient being able to play soccer. We show that the free fibular osteoseptocutaneous flap is useful in reconstructing significant metatarsal bone defects and in avoiding amputations in this patient population. The skin component of the flap may be used to fill soft-tissue losses, and the fibula bone may be osteotomized so that more than one ray may be reconstructed. (J Am Podiatr Med Assoc 101(6): 531–536, 2011)

scholarly journals Hard and soft tissue augmentation of vertical ridge defects with the “hard top double membrane technique”: introduction of a new technique and a case report

2022 ◽  
Vol 9 (1) ◽  
pp. 26-43
Author(s):  
Fabrizio Belleggia ◽  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Soft Tissues ◽  
Bone Architecture ◽  
Soft Tissue Augmentation ◽  
Tissue Loss ◽  
Autogenous Bone ◽  
Collagen Membrane ◽  
Membrane Technique ◽  
Porcine Xenograft

<abstract> <p>Vertical ridge defects (VRD) of the jaws often require both bone and keratinized mucosa (KM) reconstruction. A new staged procedure is proposed to restore both hard and soft tissues in the VRD through a case report. A patient required the lower right second premolar and first molar rehabilitation. The first surgery aimed to restore the bone architecture through the use of a titanium reinforced dense-PTFE (TR-dPTFE) membrane, positioned and stabilized on top of tenting screws. This membrane didn't cover the whole defect, it just created an hard top that avoided the collapse of a collagen membrane that was placed over it. This resorbable membrane was stabilized with tacks and covered the whole defect, protecting a mixture of autogenous bone and porcine xenograft both lingually and buccally. The second surgery was performed after a 5 month healing time either to remove the tenting screws and the TR-dPTFE membrane, and to augment KM with a gingival graft harvested from the palate. Both regenerated hard and soft tissues were left to mature for 7 months before the third surgery. In this last stage implants insertion and healing abutments application were carried out in a straightforward way, since bone and KM had been previously restored. Two bone samples, harvested for histologic evaluation, stated a great amount of new bone formation. This new approach allowed inserting implants in matured and stable regenerated bone and augmented KM, avoiding the hard and soft tissue loss around implant neck that can affect the VRD treatments during healing.</p> </abstract>

Sign in / Sign up

Export Citation Format

Share Document