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At least 325 records · Page 18Linked to original sources
PubMed1997

Skin grafting in otology.

Proper healing after surgery of the external auditory canal and open-cavity mastoid depend on epithelialization of exposed surfaces. This may be retarded by the formation of abundant granulation tissue or cicatrix, which can be dealt with by the use of thin, split-thickness skin grafts. This technique, which has received little attention in the literature, is described in detail and nine cases treated for various disorders are illustrated. Patient ages ranged from 5 to 80 years and the mean follow-up was 17.2 years. Results, complications, and caveats for successful grafting are presented.

Adult↗
PubMed1997

Management of nasopharyngeal and oropharyngeal stenosis in children.

Nasopharyngeal stenosis and oropharyngeal stenosis are rare and challenging problems in the pediatric population. The most common etiology is currently the surgical trauma associated with adenotonsillectomy. Stenosis can vary from a thin band to a complete obstructing cicatrix. Presenting symptoms range from mild hyponasal speech to severe airway obstruction. We present a series of eight children with varying degrees of stenosis and associated symptoms. Choice of treatment varied with the severity of disease. In our series, successful interventions included triamcinolone acetonide injection, lysis of adhesions, rotational and advancement mucosal flaps, and jejunal free flap. Preoperative evaluation and individualized surgical repair are essential for successful treatment.

Adenoidectomy↗
PubMed1979

Pseudoneurilemoma of the spinal canal.

Two cases are presented with the myelographic appearance of an intradural tumor believed to be neurilemoma. In one instance the defect was undoubtedly caused by a cicatrix which developed over a period of years, consequent to postoperative spinal fluid fistula. In the second case a herniated disk at the L2-3 level was mistaken as artifact and its true nature was revealed only at operation seven years later. It was suspected to be neurilemoma because of the myelographic appearance and persistence of the lesion.

Cicatrix↗
PubMed1988

Rhinoscleroma.

We have described a case of rhinopharyngeal rhinoscleroma, and reviewed the clinical behavior and management of this disease. Selective long-standing antibiotic treatment was successful in halting the process. Treatment of the advanced cicatrix with carbon-dioxide laser vaporization yielded excellent results.

Adult↗
PubMed1992

Fibreoptic intubation in cicatricial membranes of the pharynx.

Two patients presented with almost total obliteration of the pharynx. In one, a membrane developed after corrosive poisoning; in the other, the oropharynx was filled with a dense cicatrix in the sclerosing phase of rhinoscleroma. In both patients, a single opening in the membrane provided access to both the larynx and oesophagus. Fibreoptic intubation allowed both a thorough assessment of the pathology and subsequently the passage of a cuffed tracheal tube to secure the airway. To overcome the problem of respiratory obstruction while the fibrescope passed through the opening in the membrane, either rapid intubation, or a technique using pre-oxygenation and voluntary hyperventilation followed by breath-holding during bronchoscopy, was used. The thin calibre and manoeuvrability of the flexible fibreoptic bronchoscope makes fibreoptic intubation an excellent technique of airway management in cicatricial membranes of the pharynx.

Adult↗
PubMed1983

Autogeneic fat transplants in the epidural space in routine lumbar spine surgery.

This report presents our experience with the use of autogeneic fat patch grafts to protect the exposed dura mater during lumbar spine operations. A total of 44 consecutive surgical procedures was performed primarily for discogenic or spondylotic disease from 1979 to 1982. Prophylactic antibiotics were used in 21 (48%) cases. The autogeneic fat transplants were well accepted by all recipients during 10.4 (1 to 32) months of follow-up. Fat grafts, greater than 1 cm in thickness, were easily identified on subsequent computed tomographic (CT) scans. There were no postoperative wound infections. However, 1 patient developed a large subcutaneous sterile fluid accumulation at the fat donor site, which required surgical intervention. Our results, both short and long term, indicate that autogeneic fat transplants may be well tolerated in the lumbar spine area. The fat graft viability as demonstrated by CT scanning and histological examination supports the contention that autogeneic fat interposed between dura mater and overlying musculature may serve as a barrier limiting the growth of cicatrix into the spinal canal.

Adipose Tissue↗
PubMed2001

Small-bowel obstruction secondary to subcutaneous small-bowel entrapment: a late complication of laparostomy for necrotizing pancreatitis.

Laparostomy is a well recognized strategy for the management of patients who have necrotizing pancreatitis and may require multiple re-intervention. The open wound can be left to heal through a process of granulation and contraction. This article describes intestinal obstruction secondary to entrapment of a loop of small bowel within the cicatrix of the contracting cutaneous scar. An awareness of the potential for entrapment of the small bowel in the healing scar is critical for clinicians using laparostomy in the management of acute necrotizing pancreatitis.

Cicatrix↗
PubMed2007

Effect of UV irradiation on cutaneous cicatrices: a randomized, controlled trial with clinical, skin reflectance, histological, immunohistochemical and biochemical evaluations.

The aim of this study was to examine the effect of ultraviolet (UV) irradiation on human cutaneous cicatrices. In this randomized, controlled study, dermal punch biopsy wounds served as a wound healing model. Wounds healed by primary or second intention and were randomized to postoperative solar UV irradiation or to no UV exposure. Evaluations after 5 and 12 weeks included blinded clinical assessments, skin reflectance measurements, histology, immunohistochemistry, and biochemical analyses of the N-terminal propeptide from procollagen-1, hydroxyproline, hydroxylysine, and proline. Twelve weeks postoperatively, UV-irradiated cicatrices healing by second intention: (i) were significantly pointed out as the most disfiguring; (ii) obtained significantly higher scores of colour, infiltration and cicatrix area; and (iii) showed significantly higher increase in skin-reflectance measurements of skin-pigmentation vs. non-irradiated cicatrices. No histological, immunohistochemical or biochemical differences were found. In conclusion, postoperative UV exposure aggravates the clinical appearance of cicatrices in humans.

Adult↗
PubMedDate not supplied

Surgical reconstruction of severe cicatricial ectropion in a puppy.

A three-month-old chow chow mixed-breed puppy was presented with severe cicatricial ectropion of the upper eyelids after being burned maliciously. The burn wounds healed by second intention with contracture, causing eversion, elevation, and immobilization of the upper eyelids. The puppy was unable to blink or close the upper eyelids due to cicatrix (i.e., scar) formation. Surgical repair using tissue-relaxing procedures was successful in reducing corneal exposure and improving the puppy's appearance.

Animals↗
PubMedDate not supplied

[Experimental study of cytokines complex inhibitory effect on wound healing after glaucoma filtering operations: histopathological and immunochemical findings].

Experiments on a model of glaucoma filtering operation in 25 rabbits showed that the natural cytokine complex inhibited the operation wound healing in comparison with the control. The complex was prepared by an original method (culturing peripheral blood leukocytes) at Immunology Department of the Russian State Medical University. Histopathological study revealed delayed formation of cicatricial tissue under the effect of cytokines. Decreased proliferation of fibroblasts and their decreased functional activity (decreased synthetic activity of glycosaminoglycanes and collagen) was detected in cicatricial tissue. Immunohistochemical studies showed that in remote periods (after 3-8 months) type IV membrane collagen formed in new cicatricial tissue, while in the control, types III and I collagens predominated in cicatricial tissue. Immunohistochemical structure of the cicatrix in experiment correlated with fine fibrous structure of cicatricial tissue, characterized by high permeability. Possible mechanisms of the inhibitory effect of the natural cytokine complex on the course of operation wound healing after glaucoma-filtering surgery are discussed.

Animals↗
PubMed1999

Cyclosporin A effects on extra oral connective tissue in heart transplanted patients.

Gingival overgrowth (GO) is an adverse side-effect of Cyclosporin A (CsA) therapy. There is wide evidence that fibroblasts are the primary cellular influence on GO and it has been hypothesised that people developing GO have fibroblasts with an abnormal susceptibility to CsA. The purpose of the study was to analyse, on a macroscopic scale, the Cyclosporin effects on soft connective tissues in order to show whether subjects with an abnormal gingival connective reaction to Cyclosporin may have macroscopic signs of a similar reaction in connective tissues other than oral cavity. Twenty-two heart transplanted patients were enrolled in the study. All patients had been on a CsA-based immunosuppression regimen for at least six months (33.2 +/- 20.5). Hyperplastic Index (HI) was considered as the periodontal parameter relating to GO. Macroscopic evidence of the residual cicatrix following thoracotomy (P1) and connective tissue hyperproduction in the subclavian region conditioning the difficulty in probing the vein during myocardial biopsies (P2) were considered as the parameters relating to extraoral cicatricial activity. Both non parametric statistical analysis (Mann Whitney U-test, linear correlation by Spearman) and parametric analysis (Student t-test) were used to investigate the relationship between HI (dependent variable) and P1, P2 (independent variables). Results failed to demonstrate any significant correlation between gingival overgrowth and cicatricial tissue hyperproduction in sites other than the oral cavity. We conclude that the hyperproduction of collagen leading to GO in a certain percentage of subjects treated with CsA is a reaction limited to the oral cavity and not a consequence of a systemic fibroblastic hyperactivity. Our data suggest that the collagen disregulation at gingival level may be a consequence of a local perturbation whose aetiological factors are however still not known.

Adult↗
PubMed2000

[Removable draining aponeurotic and muscular-aponeurotic sutures in the prevention of suppuration of laparotomy wounds].

Clinico-instrumental investigations and experimental studying of the regeneration of laparotomy wounds sutured by removable draining aponeurotic and muscular-aponeurotic sutures have shown less pronounced course of aseptic inflammation in the wounds. It has been established that the removable aponeurotic sutures substantially decrease the frequency of postoperative suppurations of laparotomy wounds in patients operated on the colon mainly for colorectal carcinoma. The original authors' sutures provide the formation of a cicatrix of the laparotomy wound by the 20th day of the postoperative period and completely prevent the appearance of ligature fistulas.

Aged↗
PubMed2001

[Establishment and application of experimental animal model for hypertrophic scar].

OBJECTIVE: To establish a real animal model for hypertrophic scar. METHODS: 388 wounds on the ears of 47 rabbits were created including rounds 6 mm in diamiter on ventrol or dorsal side and 1.5 cm x 4.5 cm rectangular wounds. Histological and histochemical analyses, in situ hybridization and cell apoptosis were tested. RESULTS: 70 percent of the wounds can from excess dermal scarring which is similar to human hypertrophic scar. The hight of excess dermal scarring is as 3-4 times high as original ventol skin. The excess scarring can last 150 days at the most. while 80 percent appears on rectangular wounds and it lasts more than 262 days. Large amount of fibroblasts, nodular and spiral structures exist in excessive dermal scarring. Local injection of TGF-beta 1 and IFN-r can promote and inhibit the formation of excessive dermal scarring respectively. SDS-PAGE shows that type III collagen content increased in excessive dermal scarring. In situ hybridization shows long-lasting expression of type I and III precollagen mRNA in excessive dermal scarrint. TGF-beta 1 mRNA also cope with that of precollagen. Fibroblast apoptosis in excessive dermal scarring of this model indicate that fibroblast apoptosis plays an important role in the process of occurrance, development of abnormal scar. CONCLUSION: After wounding, rabbit ears can produce excessive dermal scarring which is similar to human hypertrophic scar. This can be used as an experimental model for the study of cicatrix.

Animals↗
PubMedDate not supplied

[Causes, prognosis and prevention of cicatrical corneal astigmatism].

Penetrating wounds of the eyeball in 57-66% cases are associated with corneal involvement leading to the development of cicatricial astigmatism and decrease of the functional results. We investigated the causes of posttraumatic cicatricial corneal astigmatism, possibilities of its prediction, prevention, and correction. The results of treatment of 256 patients with corneal wounds and cicatrices are analyzed. Our analysis confirmed that the severity of astigmatism in corneal wounds directly depends on the wound size, edge status, direction, location, and structure of the forming cicatrix. Adequate and timely primary debridement of the corneal wound with intraoperative keratometric control plays the key role in minimization of cicatricial astigmatism. Early therapy with drugs stimulating the regeneration processes promotes more complete recovery of corneal tissue structure and decrease of astigmatism severity. Timely dosed slackening or removal of sutures makes possible modulation of astigmatism development. A formula is proposed, using which makes it possible, on the basis of initial data on the corneal wound, to estimate the possibility of corneal astigmatism, i.e. predict the outcome of the injury.

Astigmatism↗
PubMedDate not supplied

Laser in the management of stenosing oropharyngeal scleroma.

We present here our experience of laser for the management of stenosed oropharyngeal scleroma. The diagnosis of scleroma was made 14 years ago and the patient underwent repeated procedures like dilatation, diathermy excision of adhesions and cryosurgery during this period. He attended our out-patient department with complaints of dysphagia and difficulty in breathing, progressing to stridor. On examination, severe oropharyngeal stenosis due to cicatrization extending between the base of the tongue and the post-pharyngeal wall was seen. Using CO2 laser, cicatrix was released by making radial cuts and the oropharyngeal opening was widened. No tracheostomy was needed; no blood loss occurred and the patient was discharged on the next day.

Cicatrix↗
PubMedDate not supplied

[MRI and computerized tomography in the evaluation of lumbar spine after herniated disk surgery].

The authors analyze the results of comprehensive radio-diagnosis in 44 patients previously operated on for lumbar hernias. All the findings of magnetic resonance tomography and computer-aided tomography were divided into 3 groups: (1) natural consequences of a surgical intervention without clinical manifestations; (2) complications after a surgical intervention; (3) recurrent hernias or hernias on an adjacent level. The most intricate problem was the differential diagnosis between a recurrent hernia and a postoperative epidural cicatrix. Criteria to distinguish between these two conditions are suggested. The authors emphasize that the optimal variant for examination of the patients operated on is a combination of magnetic resonance tomography and computer-aided tomography.

Adult↗
PubMed2003

[Influence of gastroesophageal reflux on the reparative process in burn of the esophagus].

Experience in endoscopic examination and treatment of 282 patients with isolated and combined chemical burn of the esophagus (CBE) of different severity is presented. Endoscopic treatment, performed in combination with chemotherapy, consisted in irradiation of burn surface with low-energy laser 'Mustang' through the canal of the endoscope. The procedure was performed 3 times a week up to complete epithelization of burn ulcers. Both in primary esophagogastroduodenoscopy and in repeated examinations sphincter function of the cardia, presence and sizes of axial hiatal hernia, changes of esophageal mucosa and presence of gastroesophageal reflux were analyzed. It is demonstrated that CBE was associated with dysfunction of the cardia in more than 90% cases. Rate of erosive and ulcerous reflux-esophagitis was 24.6-34%; cicatrix stricture of the esophagus - 6.3-12.2% in isolated and combined CBE, respectively. Severity of reflux-esophagitis and its complications was determined by severity of chemical burn.

Adult↗
PubMedDate not supplied

[Surgical treatment of extensive defects of the tissues and trophic ulcers in the area of the heel tendon using an L-shaped flap].

Operations were conducted on 22 patients with defects in soft tissues and trophic ulcers of cicatrix in the region of the calcaneal tendon. In 16 patients with extensive cicatricial lesions occupying two distal thirds or the whole region, an L-shaped flap of skin and fat was used, it was formed on the postero-lateral distal third of the leg, in the zone of the lateral malleolus and the lateral surface of the foot. The flap measured 20-22 cm in length and 6-7 cm in width. The ratio of the vertical part of the flap to the horizontal part was 3:1, 2:1, or 1:1 depending on the level of the defect and the area of the wound. The flap is mobilized strictly along the fascia so as not to injure the subcutaneous fat. The sural nerve is included in the flap to preserve its sensitivity, the rich venous network of the small saphenous vein provides for drainage, while the perforating arteries of the anterior tibial and fibular arteries, entering the base of the flap, ensure a sufficiently stable collateral circulation. Necrosis of the end of the flap occurred in 2 among 16 patients, in obliteration of the leg arteries (1) and cutting of tissues in the zone of the flap base (1) during previous surgical intervention. Complete healing was achieved in all cases; there were no recurrences in follow-up periods of 6 months to 8 years. The L-shaped flap retained its normal properties, the deformity of the donor site was negligible.

Achilles Tendon↗