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Biomedical subjects

I T Jackson

Publications and source records attributed to I T Jackson.

At least 37 records · Page 2Linked to original sources
PubMed1999

Importance of the pedicle length measurement in reduction mammaplasty.

Various measurements are still considered to be important for making decisions regarding the approach in reduction mammaplasty, even though the vast majority of techniques used are based on an inferior pedicle. This study was performed to analyze the variability of the suprasternal notch-to-nipple and nipple-to-inframammary fold distance measurements when using the inferior pedicle technique. In 92 patients, 184 breasts having various volumes were measured preoperatively, and the variability of the measurements of the suprasternal notch-to-nipple and nipple-to-inframammary fold distance was analyzed. The values of the distance from the suprasternal notch to nipple were dispersed over a wide range with a trimodal distribution, with peaks at the intervals of 23 to 27 cm, 28 to 33 cm, and 34 to 45 cm. In contrast, the values of the nipple-to-inframammary fold distance showed a normal distribution pattern, with the peak at 14 cm. The distance from the suprasternal notch to nipple has a fair relationship to the inframammary fold-to-nipple distance, the latter being concentrated in a smaller range (r = 0.51). The former is often used to decide whether a free-nipple graft should be performed. However, the relative consistency of the latter measurement has led to the conclusion that the free-nipple graft technique need never be considered.

Adult↗
PubMed1999

Full-thickness skin graft in the secondary repair of bilateral cleft lip. A case report.

A 13-week-old boy with bilateral complete cleft lip and palate is presented. He had three attempted repairs of his lip elsewhere over a period of four weeks, and all of these broke down. Consequently, a substantial amount of his prolabium became necrotic. After a preoperative orthodontic realignment of the cleft segments, a secondary lip/nose repair was performed. The mucosa was reconstructed by advancement flaps. The orbicularis muscle was dissected out from its abnormal insertion and reconstructed in the midline. The philtrum was reconstructed with a full-thickness skin graft from the right postauricular area. The six-month postoperative result was satisfactory. This technique could be considered as an alternative to primary Abbé flap in secondary reconstruction of the cleft lip, although long-term follow-up must be obtained.

Cleft Lip↗
PubMed1998

Midface membranous bone lengthening: A one-year histological and morphological follow-up of distraction osteogenesis.

Midface bone lengthening was performed on three young, adult sheep using distraction osteogenesis following osteotomy of the maxilla and mounting of an extraoral fixation device. The midface was gradually distracted, 2 mm/day, for 21 days, up to approximately 40 mm. A marked midface advancement was noted. Following a further 6 weeks of retention, the device was removed and the animals were followed for 1 year. Biopsies specimens were taken from the distracted area at the end of the distraction period, after the additional 6 weeks of retention, and finally 1 year later. A nondistracted area of the maxillary bone served as control. The specimens were analyzed histologically, histochemically, and by scanning electron microscopy for the ultrastructural pattern, mineralization, mineral content, and approximate Ca2+ concentration. Clinically and radiographically, all sheep fully bridged the experimental gap. Histologically, at the completion of distraction, collagen bundles and slender bone trabeculae oriented in the direction of the distraction could be seen. At the end of the retention period, the trabeculae thickened noticeably and were partially replaced by mature lamellar bone. At the end of 1 year and after completion of the process of remodeling, the pattern of the distracted area resembled the control area. The mineralization, as reflected by quantitative calcium analysis, compared with the nondistracted area, demonstrated a low rate of mineralization after 3 weeks of lengthening, increased 6 weeks later, and after 1 year became nearly the same as in the nondistracted area. In conclusion, distraction osteogenesis provides satisfactory quantitative and structural new bone.

Animals↗
PubMed1998

Prefabrication of mucosa-lined flaps: a preliminary study in the pig model.

There is a need in reconstructive surgery for flaps lined by nonkeratizing stratified squamous epithelium or mucous membrane. Applications could be found in nasal, oral, genital, and esophageal reconstruction and even in reconstruction of hollow intra-abdominal tubes. Prefabrication of lined flaps has so far been limited to a pretransfer grafting of split-thickness skin. However, in certain situations this does not satisfy the primary requirement of replacing "like with like." Also, the availability of donor sites for harvesting mucosa is limited. The present study involves prefabrication of mucosa-lined flaps without causing donor site morbidity. The study was carried out on six mini-Hartford pigs. Buccal mucosa was harvested from the cheeks; the sheet was divided into several smaller graft pieces of 1 to 2 cm2 area. These graft pieces were then applied to the deep fascia at a distance of 5 to 15 mm from one another, also to galea, and to the undersurface of skin flaps. The grafted area was isolated from the opposing surface with a silicone sheet or Marlex mesh. The grafts were allowed to take and, it was hoped, merge together to form a sheet graft of dimensions greater than those of the original. Two to 7 weeks after the initial grafting, the skin flap was elevated; the mucosal grafts were observed macroscopically for take and surface area and microscopically to confirm that the lining was indeed mucosa. The mucosa took well on both the fascia and galea and also on the undersurface of the skin; it enlarged in size, and the small pieces became confluent to form a single sheet. The increase in surface area varied from 33 percent at 11 days postgrafting to a maximum of 238 percent after 7 weeks. All pigs had positive cultures from the mucosa before implantation but only one developed gross infection leading to partial graft loss.

Animals↗
PubMed1998

A modification of the Kernahan "Y" classification in cleft lip and palate deformities.

The search for a universally accepted system of classifying cleft lip and palate deformities has yielded many models of varying complexity. Recently, there has been a trend toward symbolic classification systems that allow members of the cleft team to quickly assess the nature of the deformity. The existing systems, however, have limitations. These include inadequate description of the cleft lip deformity and complexity of nomenclature. A modification of Kernahan's striped Y classification is proposed that addresses these problems. This system was applied to 150 cleft patients, and it was found that it was able to describe all varieties of clefts encountered. In contrast, the Kernahan system could only describe 74.7 percent of the patients adequately.

Cleft Lip↗
PubMed1998

Long-term follow-up of cranial bone graft in dorsal nasal augmentation.

A follow-up of 363 cranial bone grafts for nasal reconstruction is presented. The main indications for the surgery were congenital, posttraumatic, or postrhinoplasty deformity. The results were satisfactory in the vast majority of cases. The complications associated with the grafts and with the donor site are discussed, as are the methods to treat and prevent these complications from occurring.

Adult↗
PubMed1997

Importance of separation of the nasopharyngeal and extradural spaces.

The extradural dead space must be separated from the nasopharynx to avoid a potentially lethal complication. This can be accomplished by a variety of methods involving vascularized flaps. However, the flap must be large enough to close the defect and it must be well vascularized. A case is presented to illustrate these important features.

Case Reports↗