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PubMed1997

Complications of fascia lata harvesting for ptosis surgery.

AIMS/BACKGROUND: The aim of this study was to assess the morbidity associated with harvesting autogenous fascia lata for brow suspension ptosis surgery. METHODS: A retrospective study by postal questionnaire of 24 consecutive patients. RESULTS: Early postoperative problems with pain on walking (67%), limping (38%), and wound pain (57%) occurred mostly for less than 1 week. The final cosmetic appearance of the scar caused minor concern in 38% of patients. CONCLUSION: Fascia lata is the preferred material for permanent ptosis correction when a brow suspension is required. Most of the patients, following fascia lata harvest, experienced some symptoms of leg pain and limping for less than 1 week. The only long term problem was the scar. 38% of patients found the final cosmetic appearance caused minor concern.

Adolescent↗

PubMed1995

Reconstruction of laryngotracheal war injuries with the median layer of the deep cervical fascia.

Surgical exploration and immediate reconstruction with the median layer of the deep cervical fascia (MLDCF) was performed in 8 of 22 patients with exogenous war injuries of larynx and cervical trachea. A surgical technique of reconstruction with the median layer of the deep cervical fascia is described. The 7 surviving patients had good respiration without signs of stenosis of the larynx and/or the trachea. Four had good and 3 satisfactory, phonation, and none had swallowing difficulties. Owing to the simplicity of the surgical approach, its size and biological properties, the median layer of deep cervical fascia proved itself to be a suitable material in the immediate reconstruction of exogenerous war injuries of the larynx and cervical trachea.

Adolescent↗

PubMed1981

Visibility and thickening of the renal fascia on computed tomograms.

The renal fascia can be seen on CT scans (using appropriate window settings) in most patients except those with very little fat. CT confirms current anatomical concepts; however, contrary to the illustrations shown in the literature, it clearly demonstrates that the anterior pararenal space normally exists only at the level of the retroperitoneal organs. A lesion would distend the space. While visualization of the renal fascia on normal urograms may be an indication of renal disease, a thin renal fascia on CT scans has no pathological significance. Thickening is nonspecific: it is not pathognomonic of tumor, nor is it helpful in differentiating pancreatitis from neoplasm. On the other hand, lack of fascial thickening may be helpful in ruling out renal extension of a neighboring lesion.

Carcinoma, Hepatocellular↗

PubMed2003

Patch urethroplasty using a fascia lata autograft in male rabbits.

INTRODUCTION: Urethral reconstruction is difficult when the genital skin is not available for surgery. We evaluate the feasibility of using the autologous fascia lata as a graft for urethral repair. MATERIALS AND METHODS: 10 male rabbits underwent urethroplasty after creation of a ventral urethral defect. The defect was repaired using a graft harvested from the fascia lata. The animals were divided into three groups and sacrificed at 2, 4 and 12 weeks postoperatively. Radiologic control was performed after 10-12 days and before sacrifice. RESULTS: In the 10 rabbits subjected to surgery, no case of death or wound infection was observed. During urethrography, a fistula was observed in 2 animals. In the remainder (n = 8), histological analysis showed the preservation of the original laminar structure without graft shrinkage or fibrosis. On the luminal side of the patch, a new line of urothelium appeared in the 2nd week after surgery. After 3 months, the new epithelium was multilayered and the graft edges were not detectable. No voiding dysfunction was detectable in 8 rabbits. CONCLUSIONS: Our study suggests the feasibility of using the autologous fascia lata for urethral patch repair.

Animals↗

PubMed2004

Tension-free vaginal tape efficacy in relation to collagen quantity of pubocervical fascia.

OBJECTIVE(S): To investigate whether the quantity of collagen types I and III in the pubocervical fascia of women with genuine stress incontinence (GSI) affects the efficacy of the tension-free vaginal tape (TVT) procedure. METHODS: Sixty-three patients participated in the study and were divided in 2 groups as follows: 37 patients with GSI and pelvic organ prolapse stage I (group 1), and 26 patients with pelvic organ prolapse stage I but not GSI (control group). Urodynamic studies confirmed the diagnosis of GSI. Biopsies were obtained during surgery from the pubocervical fascia. RESULTS: The quantity of collagen types I and III was statistically significantly reduced in patients with GSI compared to the control group. The efficacy of the TVT procedure in patients with a significant reduction in collagen type I was an 82.1% cure. In patients with a significant reduction in collagen type III, the TVT efficacy was an 85.1% cure. The efficacy of the TVT procedure was not statistically significantly different between patients with GSI and a significant reduction in collagen types I and III, and patients with no reduction in collagen types I and III. CONCLUSIONS: The significantly reduced quantity of collagen types I and III in the pubocervical fascia of women with GSI does not affect the efficacy of the TVT procedure at an average of 25 months of follow-up.

Adult↗

PubMed1989

Autogenous skin and fascia grafts as topical hemostatic agents in splenic injuries.

Splenic salvage techniques were developed since the immunologic importance of the spleen has been recognized. Various synthetic products, such as Avitan, Collastat Gel foam, Superstat, Thrombostat, were used and lately even pig skin was tested for its hemostatic ability. In this study, a canine splenic bleeding model was used to test autologous split-thickness skin-graft hemostatic effect, compared to pig skin, human skin and canine fascia. Lyophilized pig skin was tested on 12 splenic wounds, lyophilized human skin on 10, canine skin on 10, canine fascia on 10 and simple pad gauze on 10 other splenic wounds. Each animal served as its own control. Pig skin was more effective than canine skin (p less than 0.01), but the canine skin was more effective than human skin (p less than 0.01) and canine fascia (p less than 0.05). Long-term implantation of the canine skin graft caused fibrosis and epidermoid cyst formation, but they were of no clinical significance in the dog. In conclusion, autologous split thickness graft, always at hand, was found to be an effective hemostatic procedure and proved to be safe in the dog.

Animals↗

PubMed2000

Airway flow dynamics and voice acoustics after autologous fascia augmentation of paralyzed vocal fold.

The aim of this study was to assess the effect of vocal fold medialization, accomplished by injection of autologous fascia, on airflow dynamics and voice acoustics. Ten patients with unilateral vocal fold paralysis were included. Flow-volume spirometry, body plethysmography, and acoustic analysis of voice were performed within 1 week before injection of autologous fascia and 4 to 14 months after operation. Medialization of the paralyzed vocal fold decreased the mean peak inspiratory flow (PIF) from 4.63 L to 4.10 L (p = .012). The acoustic characteristics of the voice improved: the values of jitter, shimmer, and mean noise-to-harmonics ratio decreased significantly (p = .006, p = .017, and p = .047, respectively), and the mean maximal phonation time almost doubled (p = .002). Changes in PIF and shimmer showed a negative correlation (r = -.857, p = .007). In conclusion, injection of autologous fascia improves voice acoustics, but induces a slight abnormal limitation on PIF. The results also suggest that improvement in voice acoustics is most prominent in subjects with the least deterioration in inspiratory airflow.

Aged↗

PubMed2004

Combination of fascia transplantation and fat injection into the vocal fold for sulcus vocalis: long-term results.

Fat injection and fascia transplantation alone have been used to treat patients with sulcus vocalis. No information is available on the effectiveness of these two procedures used in concert to treat sulcus vocalis. The objectives of this study were to conduct the two procedures together and report the long-term results. This article assesses, retrospectively, the effectiveness of the combination treatment of fascia transplantation and fat injection (FTFI) in patients with sulcus vocalis (n = 22). Perceptual acoustic, phonatory function, and videolaryngostroboscopic data were evaluated before and after FTFI treatment in 18 patients. The mean follow-up time was 16.6 months. Sixteen patients had excellent results, 3 reported improvement, and 3 indicated no change. Phonatory function improved significantly in terms of phonation time, grade, roughness (p < .05), and breathiness (p < .001). The videolaryngostroboscopic rating showed significant improvement in vocal fold vibration amplitude and excursion of the mucosal wave (p < .05). Type 3 sulcus responded better to this treatment than did type 2 (sulcus vergeture). No postoperative complications were noted. The FTFI technique consists of an autogenous implant and delivers positive results. It may be considered as an option for patients with sulcus vocalis. It has been demonstrated to achieve excellent results in a majority of patients and to deliver a better prognosis than fat injection alone. Although resorption of fat and fascia is associated with FTFI, the FTFI procedure may be repeated multiple times.

Adipose Tissue↗

PubMed1995

Anatomy of the Achilles tendon and plantar fascia in relation to the calcaneus in various age groups.

Ten adult cadaver feet, three neonatal feet, and the feet of two fetuses were dissected to investigate whether an anatomical continuity exists between the fibers of the Achilles tendon and the plantar fascia. Histologic sections of the feet were done in three age groups: neonate, persons in their mid-20s, and the elderly. As the foot ages, there appears to be continued diminution of the number of fibers connecting the Achilles tendon and plantar fascia. The neonate has a thick continuation of fibers, while the middle-aged foot has only superficial periosteal fibers that continue from tendon to fascia. The elderly feet show simply an insertion of fibers of both structures into the calcaneus with periosteum in between.

Achilles Tendon↗

PubMed1995

An anatomic analysis of endoscopic plantar fascia release.

Eighteen fresh-frozen cadaver foot specimens underwent release of the plantar fascia via a newly described endoscopic technique. A 75% release was attempted on each specimen in order to represent a partial fascial release. Each specimen was then dissected to assess the success of the procedure. Five separate measurements were recorded evaluating the reproducibility of the procedure, adequacy of the release considering accepted etiologies for chronic heel pain, and the possibility of damage to local structures. Partial release was noted to be possible, but controlling the exact percentage of the incision was difficult. The release averaged 82% of the width of the fascia, with a range of 53% to 100%. There was no damage in any specimen to the first branch of the lateral plantar nerve, the structure considered most at risk during the procedure. Release of the deep fascia of the abductor hallucis muscle was not possible with this approach.

Cadaver↗

PubMedDate not supplied

Uses of fascia in ophthalmology and the benefits of autogenous sources.

Fascia has long been available for use in ophthalmology. Although slow in its development, it has been used in a variety of clinical entities; ptosis, telecanthus, retinal detachment, scleral wall defects, impending or extruded implants, lower lid ptosis, and retracted upper lids. It is a versatile, ideal tissue for the use in repair and reconstruction of the eye and adenexa. Although complications are minimal, they can virtually be eliminated by using autogenous fascia. The increased surgical time and minimal patient morbidity are justified by the decrease in the complication rate. Autogenous fascia is not recommended in children under 3 1/2 years of age due to the small size of the leg.

Blepharoptosis↗

PubMed1991

Deep fascia of the foot. Anatomical and clinical considerations.

The deep fascia of the foot lies beneath the subcutaneous tissue and surrounds the intrinsic foot muscles. Depending on its location, the composition of the deep fascia varies. In some areas it is thin, while in other areas it is greatly thickened to form retinacula and the plantar aponeurosis. Selected clinical considerations that relate to the deep fascia of the foot are described. These include the following: plantar fasciitis, infection, compartment syndrome, calcaneal fracture, and neuroma.

Calcaneus↗

PubMedDate not supplied

Sectioning the plantar fascia. Effect on first metatarsophalangeal joint motion.

A study on the effect of sectioning the plantar fascia on the range of motion at the first metatarsophalangeal joint is presented. Dorsiflexion and plantarflexion range-of-motion data from 18 patients who had no first metatarsophalangeal joint pathology and had undergone an in-step plantar fasciotomy for recalcitrant plantar fasciitis were analyzed. The average increase in dorsiflexion of the first metatarsophalangeal joint after plantar fascia release was 9.8 degrees, which represented a statistically significant increase using a paired t-test. Thus release of the plantar fascia can be considered a potential adjunct to hallux limitus surgery.

Biomechanical Phenomena↗

PubMedDate not supplied

[Angiographic analysis of the tensor fascia lata vascularized flap].

Vascularisation of the flap of tensor fasciae latae originates from the ascending branch of the lateral circumflex femoral artery which enters through the medial side of fascia lata tensor as a dominant branch. Knowing the vascular and characteristics of a vascular peduncle is of great importance while taking the flap, so knowing the site of the source of lateral circumflex femoral artery diameter at the source, the number of the terminal branches and the number of ascending branch anastomoses of lateral circumflex femoral artery are the basic significance for successful taking of the flap and its clinical application. Our investigations were done on clinical material, and the study was based on investigations of angiographies of the femoral artery. Measuring the diameter in the source of ascending branch we found that it was 33 mm while the diameter in the bifurcation of the terminal branches of ascending branch was 2.41 mm in average. The length of vascular peduncle of ascending branch was 68.88 mm in average. Vascular peduncle of the flap of tensor fasciae latae has appropriate length and diameter for microvascular anastomosis.

Adult↗

PubMed2002

Spigelion hernia: fascia lata repair is an alternative option in absence of prolene mesh.

Spigelian hernia is rare. Seven cases of Spigelian hernia are presented. These include two recurrent Spigelian hernias. Incisional hernias through Spigelian aponeurosis after Pfannensteil incision are not included. Clinical examination is the mainstay of diagnosis. The true incidence is possibly higher, as a low Spigelian hernia is not recognised and often diagnosed as a direct inguinal hernia. Ultrasound scanning is recommended, as it is non-invasive and easily available and can detect the hernial orifice in the Spigelian fascia at an early stage. Recurrence of Spigelian hernia took place in two cases through the site of prolene stitch of a previous repair. Hernioplasty with tension free fascia lata graft/prolene mesh was carried out in all cases. The cost of fascia lata graft is only a scar in the thigh. In a mean follow-up of 3.1 -year no patient has reported back with recurrence This is the ideal substitute for the patients in developing countries where synthetic meshes are still not freely available.

Adolescent↗

PubMed2002

[Auricular reconstruction with Medpor framework and temporal-parietal fascia flap].

OBJECTIVE: In search of a simpler and safer technique for auricular reconstruction with good appearance. METHODS: Medpor implant was used as auricular framework, and covered by temporal fascia flap and skin graft. RESULTS: Ear reconstruction was successfully achieved in 19 cases, the newly formed ears all had good appearance after edema disappeared 1 or 2 months postoperatively. CONCLUSION: Medpor is a kind of good implant material because it is steady in nature, easy to be sculptured. Temporal fascia flap is rich in blood supply, tough and tensile in biomechanics. So the combination of Medpor implant framework with temporal fascia flap is preferable in auricular reconstruction.

Adolescent↗

PubMed1992

Evaluation of expanded polytetrafluoroethylene (e-PTFE) and autogenous fascia lata in frontalis suspension. A comparative clinical study.

Ptosis palpebrae superioris is mainly treated by frontalis suspension with autogenous fascia lata. In this study we evaluated the potential of an expanded polytetrafluoroethylene (ePTFE) soft tissue patch to function as a frontalis sling in 13 patients with ptosis palpebrae superioris. Functional and cosmetic results and the satisfaction of the patients were scored positive or negative and statistically compared with 13 patients in whom fascia lata was used. The mean follow-up was ten months. Although no complications occurred in either group the patients in the ePTFE group were less satisfied (p < 0.01) and showed inferior functional (p < 0.05) and cosmetic results (p < 0.01) as compared to the fascia lata group. Histological analysis of an explanted piece of ePTFE revealed that tissue ingrowth into the patch was lacking, which might have led to poor anchorage and subsequently a recurrence of the ptosis. We believe that ePTFE is not the material of first choice in frontalis suspension.

Adolescent↗

PubMed2003

[Sacropexy with abdominal fascia in treatment of vaginal prolapse vault of menopausal women].

INTRODUCTION: Vaginal vault prolapsed is a rare complication, with a frequency from 0.2 to 1% after hysterectomy, which is presented due to a bad surgical technique in fixation of the vault suspension elements, as well others factors as the multiparity, menopause, chronic lungs disease, obesity, smoking and weak physical activity. There are many techniques reported to correct this pelvic disease, although the conventional sacropexy has been established for abdominal way, where the diversity of materials of fixation is varied, including natural material as the abdominal fascia and aponeurosis of muscle rectos. OBJECTIVE: This descriptive and clinical study was carried out in a group of patient with vaginal vault prolapsed, with the objective to know the results and experience of this correction with the surgical technique of sacropexy utilizing abdominal fascia. MATERIAL AND METHODS: 32 menopausal patient with mean age of 53.9 years, 5 gestations, as well as index of Quetelet of 26.2, were studied, a following of a year was carried out. In these women the main symptom were the sensation of vaginal strange body and subsequently urinary incontinence of effort. Moreover, considering to all group the mean in presentation of the vaginal vault prolapsed after hysterectomy was of 7.7 years, with surgical time of 129 minutes and bled of 172 milliliters. RESULTS. The 97.5% of the patient returned to its sexual life without difficulties and only one referred dyspareunia. Post-surgical complications were not presented and only a patient presented vault prolapsed again (0.31%). CONCLUSIONS: With this results we can consider that the sacropexy with abdominal fascia is a good technique for the correction of the vaginal vault prolapsed in healthy menopausal women with regular sexual activity and then is a natural material who cause not any.

Fascia↗