A method for securing vomerine flaps to the hard palate in the repair of a complete cleft palate.
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Biomedical subjects
Publications and source records attributed to B Hirshowitz.
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Following burns of the upper respiratory tract, laryngotracheal stenosis is associated with considerable morbidity. This paper deals with the cumulative effect of various pathologic processes involved in burn trauma of the upper airway. Emphasis is placed on the extended use of endotracheal intubation and the avoidance of tracheostomy whenever possible. When laryngotracheal stenosis develops, it may be safely and successfully treated by prolonged stenting, as has been borne out by our experience with the T-shaped silicone tubes. Limited reconstructive procedures can be performed to facilitate proper placement of the stent. In our opinion, laryngotracheal resection and reconstruction are not the procedures of choice in burn cases. Our experience in following the preceding guidelines is described. Three illustrative cases serve to exemplify the difficulties and problems involved in the various stages of treatment and the results obtained. The patients are symptom-free 18 to 24 months following stenting, and all enjoy an adequate airway and good voice. There were no complications resulting from this treatment and we suggest that it is worthy of trial.
A patient with fibrous papules of the face as a part of tuberous sclerosis was treated by cryosurgery. The definite improvement attending this treatment was maintained over an eighteen-month follow-up period.
Meralgia paresthetica is not well known in the plastic surgery literature, and consequently the diagnosis of this entity may be overlooked. In view of the frequency with which the groin flap is presently employed, the possibility of damage to the lateral femoral cutaneous nerve of the thigh should be borne in mind. In this paper the clinical picture as well as the anatomy and pathophysiology of this disorder are described.
A clinicopathological study of 150 patients with primary malignant melanoma of the skin is presented. Information concerning the site, type, depth of invasion and thickness of the tumor is reported. The value of tumor thickness in assessing prognosis is emphasized.
A new technique for closure of rounded defects is described. The biwinged procedure consists of excising two equal triangles on either side of the defect, one above and one below the dissecting line. Closure is in the form of a step. It can be made to parallel in part a wrinkle or contour line, such as a nasolabial fold, a temporal region above and beside the eyebrow, an area over the lower border of the mandible, or on the dorsum of the hand. A mathematical comparison of the amount of healthy tissue in the biwinged excision and in six other procedures is presented.
A one-stage procedure is described for restoring the scrotum in a patient who suffered from Fournier's gangrene. The proximal superiomedial-based thigh flaps employed are most likely arterial flaps. These flaps are also well innervated, which makes them ideal for the purpose of scrotal reconstruction.
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A change in the accepted routine of cross-leg repair is suggested in the interest of safety. In order to avoid infection in the donor site the skin graft is cut first. The flap is raised before the defect is prepared so that the problems of tension and 'tenting' are eliminated. This enables the flap to be sutured under less than normal skin tension.
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A recently introduced polymer preparation (Iodoplex) is described. It is based on a new type of hydrophilic polymeric carrier into which iodine can be incorporated to the extent of 50% or more. Its main feature is that the polymer and the petroleum jelly base are water-insoluble. The iodine is slowly released from the polymer by body fluids, which are rich in protein and dead cells. Iodine has been found to be useful in the treatment of donor sites; no pain or discomfort attends its use, and the dressing peels off easily from the healed epithelium. A controlled study comparing iodoplex-impregnated and scarlet red-impregnated gauze on donor sites was carried out, and the use of Iodoplex was found to have some real advantages over scarlet red.
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