Heating cutting tip of nail biopsy instrument.
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Biomedical subjects
Publications and source records attributed to L M Field.
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BACKGROUND: Full thickness mucous membrane coverage is desired for a variety of reconstructive tasks involving the oral cavity and vermilion area of the lips. OBJECTIVE: This article will inform the readership that the vestibular (oral labial) mucosal area of the lower lip close to the sulcus may provide adequate full-thickness mucous membrane graft tissue for such purposes. METHOD: A series of photographs from a number of representative cases with accompanying commentary will enable the surgeon to easily incorporate this technique into his/her practice. CONCLUSION: The lips vestibular mucosa will be found to be an invaluable ally in accomplishing non-deforming coverage of superficial mucosal defects without unnecessary surgical invasion of visible lip/chin structures.
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The majority of lip repairs may be better facilitated by initially repairing the infravermilion cutaneous defect and then separately considering repair of the mucosal and, when present, submucosal defect. These sequential considerations allow a variety of reconstructive approaches to be applied to the different types of tissue lost above and below the vermilion border. Many of the sequelae of standard wedge excisions and their resultant repairs may be avoided by utilizing sequential infravermilion and supravermilion lip reconstruction.
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Reconstruction of earlobe curvature in a scar-deformed and displaced earlobe was accomplished by a combination of 1) hypertrophic scar debulking, 2) partial defect closure by scar tissue flap advancement to re-establish the cephalic extent of the neck at the infralobular crease, and 3) second-intention healing of the noncovered lower earlobe, preserving its surgically re-established curved configuration. Although this article specifically addresses scarring deformities of the earlobe, the same principles could be applied to congenital, noncicatricial tenting deformities.
Enlarged configurations of one or both lips from hereditary and racial differences are common phenomena. Congenital anamolies and acquired malformations are more unusual. The author reviews the principles of lip size reduction, and demonstrates photographically the serial steps necessary to accomplish that goal on the lower lip.
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The particular anatomy of the scalp largely dictates utilization of its parts and adjacent attached integument for reconstructive purposes. Unusually large movements of scalp skin are generally required with a variety of basic techniques and ancillary procedures. Rotation flaps are considered the prime "work-horses" for scalp flap reconstructions. Anatomic factors will be interspersed with clinical applications, and a series of photographs and commentary will highlight these considerations.
The author describes a modified mucous-membrane advancement flap for the repair of defects following the removal of premalignant actinic cheilitis or squamous cell carcinoma. The advantages of this modification over other techniques include a more broadly resurfaced lip bilaterally, and prevention of punctate scarring at the lateral oral commissures by use of a continuous mucous membrane in and around the commissures themselves.
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Construction of the alar rim is an extremely challenging problem. Utilizing supradefect nasal tissue as a hinged "turn-down" flap combined with perinasal tissue mobilized as an inferiorly-based transposition flap allowed the formation of a thin and properly contoured rim configuration.
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