Use of external reservoirs in tissue expansion.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to I T Jackson.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A new instrument for harvesting craniotome bone dust is described. This has been designed with the contours of the skull in mind and the ideal bone fragment size for satisfactory graft take.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Hailey-Hailey disease is a benign, chronic genodermatosis manifested by recurrent lesions with a predilection for the intertriginous areas. The malodorous, weeping sores are a source of great discomfort to the patient. Medical therapy controls most lesions adequately; however, some are refractory. Experience with excision of skin involved with Hailey-Hailey disease is reported. The best results were obtained in those patients whose wounds were resurfaced with split skin grafts. Primary suture was associated with recurrent disease and residual morbidity. The findings of other isolated reports in the literature are also summarised. The results show that surgical control of Hailey-Hailey disease is indicated in recalcitrant cases.
A patient is presented who developed a gross maxillary deformity resulting from thalassaemia major. An outline of the general condition is presented and the operative measures used to correct this particular case are described. It is interesting to note that although this was done in rather primitive conditions, the patient achieved a satisfactory aesthetic and functional result.
A case has been presented of retrieval of a maxillary third molar that had been displaced into the infratemporal fossa. The unusual location of the tooth combined with the novel approach to its removal makes this case unique. The coronal approach to the lateral orbital wall is safe, relatively straightforward and has minimal postoperative complications. This patient's postoperative course was uncomplicated, he suffered no untoward sequelae, and was relieved to have the "lost" third molar recovered.
Breast reconstruction immediately after mastectomy is being used with increasing frequency. In a study of the first 100 consecutive patients at our institution who underwent this procedure, with (21 patients) or without (79 patients) later nipple reconstruction, 85% responded affirmatively on a follow-up questionnaire when asked whether they would recommend the procedure to other patients. Moreover, 32% rated their cosmetic results as "perfect." No deaths occurred in the immediate postoperative period, but 13 patients had major complications--most commonly, wound infection or displacement or partial extrusion of the implant. All infections, however, occurred early in the study, and with increasing experience and improved selection of patients, the associated morbidity decreased. For the entire group, the mean duration of hospitalization was 7.8 days, similar to that for patients who undergo mastectomy without reconstruction (7.5 days). The high patient acceptance and the overall good results in this preliminary study support the use of breast reconstruction immediately after mastectomy.
A large series of cranial bone grafts performed during a 6-year period is presented. The types of grafts are discussed and the techniques of taking the grafts are described. The complications have been few. Full-thickness skull penetration occasionally occurs but should not be a cause for concern. The skull has gradually become our main bone graft donor site.
In 16 women who underwent face lift operations, we performed intraoperative stretching of the undermined facial and neck skin using either a silicone bag for expansion or skin traction sutures. The object of this endeavor was to attempt to harness the viscoelastic properties of the skin to maximize the amount of skin excision and so improve the overall long-term operative results. We believe we were successful with both techniques. It is not clear at this juncture whether the long-term results of this one-stage procedure will approximate those of the two-stage procedure, which were consistently satisfactory.
Vascularized skull bone grafts based on a pedicle of temporalis muscle have been used in 30 zygomatic arch and malar reconstructions, 1 mandible reconstruction, and 1 palate reconstruction. The surgical technique, complications, and postoperative results are reviewed. Technetium bone scans obtained within one week of operation confirm blood supply to the transferred bone. After a mean follow-up of 13 months, there is no evidence of bone graft resorption. We have used a team approach and careful surgical technique, and no serious complications have been encountered.
The conjunctival approach to the infraorbital rim and the orbit is discussed. A series of patients is presented with a small number of complications. The technique is described and the important factors in preventing problems are emphasized.
The standard liposuction apparatus with 1.5-mm spatula cannula has been used to aspirate hematomas early and to debride areas of fat necrosis. This technique has proved to be of great value in hematomas following face lifting and posttraumatic scalp hematomas and in fat necrosis generally.
The condition of allergic aspergillosis of the paranasal sinuses is presented. Two cases are added to the seven previously described in the world literature. The clinical, radiologic, and pathologic features are outlined, and a careful follow-up regime is advised.
The use of tissue expanders having external reservoirs is presented. Twenty-four patients had 36 tissue expanders placed in the scalp, face, neck, upper limbs, chest, and lower limbs. All patients, apart from one, were taken to completion. This patient had erosion of the skin over expander and was only partially completed after removal of the expander. Apart from one instance of deflation at the end of the expansion where the skin could still be used, there were no other complications, in particular, no infections. The advantages of this technique are reduced operating time, ease of injection into the reservoir, lack of pain for the patient, early detection of reservoir or filling tube junction leakage, and lack of complications associated with the reservoir. This procedure is not recommended on at least theoretical grounds for breast expansion, where a permanent implant is to be inserted.
A new method of approach for the correction of upper eyelid ptosis is described. This involves both conjunctival and skin incisions. It allows for greater ease of identification of the levator aponeurosis and appears to facilitate in the identification of Müller's muscle. Although advised for all patients requiring ptosis correction, it is particularly recommended in those patients in whom the eyelids are involved with extensive posttraumatic scarring.
A 57-year-old woman developed diffuse erythema of the nose that had been diagnosed as acne rosacea for 18 months. Biopsy showed infiltration deep in the nasal skin of a squamous cell carcinoma that extended from the nasal septum. Nasal septal tumors are rare; the most common is squamous cell carcinoma.