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PubMed1993

[Clinical application of the fascia lata flap].

The clinical application of the musculo-cutaneous flap of musculus tensor fascia lata has been limited because it includes muscle and it is very thick. To correct this disadvantage, the ascending branch of the lateral femoral circumflex artery, which is the supplying artery, is dissected up to its entrance into the tensor muscle of the fascia lata, then the upper, middle and lower branches were identified, and the upper and middle branches are ligated, followed by resection of the muscle, resulting in a fascia lata flap supplied by the lower branch only. The flap contains the lateral femoral cutaneous nerve. It is a good flap to repair a defect of skin and to restore sensory function at the same time. It has been used in 15 cases with good effect.

Adolescent↗
PubMed1994

[Reconstruction of oral cavity and oropharyngeal defects with a pure muscle-fascia flap].

As a rule carcinomas of the oral cavity and oropharynx are not diagnosed in early stages. Surgical resections of these tumors including margins of safety invariably result in large defects. At present, one-stage flap techniques are preferred for reconstruction, as exemplified by pectoralis major myocutaneous flaps and free revascularized jejunum grafts. The skin island of the myocutaneous flap is underlayed by fat tissue as a sliding surface. Temporary sutures are necessary but have the disadvantage of producing a convex configuration. This shape compromises anatomical reconstruction of the oral cavity and oropharynx. Robertson et al. in 1985 demonstrated an alternative method for a muscle-fascia flap from the pectoralis major muscle. In comparison to the temporalis muscle-fascia flap, the pectoralis muscle-fascia flap is associated with a lesser incidence of complications. Although it is still too early to conclude their definitive use, their application in some cases is now being questioned because of such factors as reduced time of anesthesia.

Carcinoma, Squamous Cell↗
PubMed1993

[Laparoscopic herniorrhaphy of inguinal hernia. Reinforcement of the transverse fascia with surgical mesh].

A basic principle of inguinal herniorrhaphy is the reconstruction of the transverse fascia. This laparoscopic technique described, consists in an augmentation of the transverse fascia by nonabsorbable mesh in pre-peritoneal position. Some aspects should be recommended for laparoscopic herniorrhaphy: The anatomic structures must be dissected exactly. The prosthetic mesh should be fixed to the fascia by multiple staples. With indirect inguinal hernias the mesh should encircle the spermatic cord.

Adult↗
PubMed1993

[Clinical experiences with dehydrated temporalis fascia in tympanoplasty. Early and late results].

Dehydrated temporalis fascia, an allograft transplant tissue, is very useful in tympanoplasty and tympanomeatoplasty. In 87% of cases tympanic membrane grafts placed in patients with severe chronic otitis media have remained healed without change 4-6 years after surgery. All grafts also remained in position when placed on the posterior wall of the external auditory canal. Good healing was always seen without complications or inflammations. By using these grafts the duration of surgery could be reduced and the cosmetic risk of extending pre- or postauricular incisions to obtains autologous temporalis fascia was unnecessary, especially in revision surgery. The allograft is very easy to handle and is malleable and flexible. The main indications for use of allograft temporalis fascia are patients with chronic otitis media, traumatic tympanic membrane perforations or malformations of the middle ear (such as congenital atresias) requiring tympanic membrane replacement and lining of the posterior wall of the external auditory canal.

Adolescent↗
PubMed1995

The dorsal fascia dentata as a probe of fixation quality in the rodent brain.

In microscopic sections of the rodent brain the dorsal fascia dentata frequently shows perineuronal swelling and neuronal swelling and shrinkage. Factors influencing the occurrence of such changes, which may mimic excitotoxic effects, have been examined using various schedules of anaesthesia and perfusion fixation. Laboratory mice anaesthetized with a low dose of sodium pentobarbital manifested prolonged excitation in comparison to those anaesthetized with a high dose: the occurrence of tremor and convulsions, however, was not related to the morphological changes in the fascia dentata. The changes were diminished by increasing the perfusion pressure (from 80 to 120 mmHg), by reducing the duration of the wash-out period with buffer (from 45 to 15 seconds) and by prolonging the perfusion time (from 7 to 15 minutes). They were abolished when 5% solution of glutaraldehyde was used instead of a 2.5%. The results show that the quality of brain fixation may be best assessed according to the morphology of the dorsal fascia dentata, and that the occurrence of acute swelling and shrinkage in this area should not be mistaken for pathological changes.

Anesthesia↗
PubMed1998

Combined fascia and mesh closure of large incisional hernias.

Large incisional hernias of the abdominal wall represent substantial defects of supportive tissues. The repair of these requires the mobilization of fascia or the use of a prosthetic mesh. A method for closing large midline incisional hernias using both the fascia and a mesh was described in 1979. This repair was used for six midline hernias and four large incisional hernias in the right subcostal region. No wound complications and no recurrences (median follow-up 1 year 5 months) were seen. The combined fascia and mesh repair can be successfully used for large incisional hernias of the anterior abdominal wall in areas other than the midline.

Fasciotomy↗
PubMed1989

Reconstruction of the four major ligaments in an unstable knee joint after dislocation by solvent-preserved human fascia lata transplantation. A case report.

Once the opportunity for primary repair of injured knee ligaments after traumatic dislocation has been lost, ligamentous reconstruction is difficult using only autogenic tissues because of the risk of loss of function at the donor site, so other substitutes are needed. The four major ligaments in the unstable knee of a 35-year-old man were reconstructed by solvent-preserved human fascia lata three months after traumatic open dislocation. The clinical results were satisfactory. Arthroscopic examination one year later showed that the reconstructed ligaments had good thickness and tension and were composed of autologous connective tissue without evidence of rejection. The literature on dislocation of the knee and on cruciate ligament reconstruction by allograft was reviewed, and a brief introduction to solvent-preserved human fascia lata was presented. The commercialization of this material has solved some common problems concerned with using allogenic tissues.

Adult↗
PubMed1975

Late hemodynamic results of fascia lata reconstruction of the right ventricular outlet.

Eight patients were catheterized between 1.2 and 2.4 years after reconstruction of the right ventricular outflow tract with autologous fascia lata. Whereas the immediate post-bypass pressures had demonstrated a maximum gradient of 15 mm. Hg across the fascial valve at the time of recatheterization, this varied from 55 to 142 mm. Hg (mean 83 mm. Hg). Right ventricular systolic pressure varied between 80 and 160mm. Hg (mean 106 mm. Hg). All but one patient had clinical evidence of pulmonary incompetence. Selective angiography with injection into the right ventricle and pulmonary artery demonstrated shrunken, thickened, immobile valve cusps with an abrupt stenosis of the fascial tube or a diaphragm across it. Re-operation has been done in five patients. In each, the graft tube functioned satisfactorily, but at the site of the "valve," no leaflets were visible, and the orifice of the conduit narrowed abruptly to 6 to 10 mm. in diameter. It is concluded that autologous fascia lata is unsuitable for reconstruction of the right ventricular outflow tract.

Adolescent↗
PubMed1979

Fascia lata urethrovesical suspension for recurrent stress urinary incontinence.

Although the physiologic mechanisms of normal micturition in the female subject are not fully understood, it is generally believed that urinary continence is maintained by a competent urethrovesical neck. Unfortunately, the patient who has had multiple operations for recurrent stress urinary incontinence often has a urethra that is shortened and fixed in scar tissue. In such patients, anterior colporrhaphy with operative release of the periurethral fibrosis and plication of the endopelvic fascia to create a functionally more normal urethrovesical junction will increase the chances for good results. A fascia lata support of the proximal 1 to 2 cm of the urethra ensures continued elevation of the urethra and with stress the sling provides a pulling-up effect. Fifty patients with a suburethral sling procedure are presented in detail. Forty-seven of these patients had a total of 121 prior operative procedures for stress urinary incontinence. Urologic studies are outlined. Forty-two patients (84%) were continent postoperatively, five were improved, and three had failures. Operative technique and complications are discussed.

Adult↗
PubMed1975

Temporomandibular joint arthroplasty with fascia lata.

Two patients with temporomandibular joint arthralgia and ankylosis were managed with arthroplasty and insertion of fascia lata. The role of physiotherapy, chances of facial nerve damage, role of steroids, and advantages of fascia lata are discussed.

Adult↗
PubMed1975

Viability properties in autologous fascia lata heart valve grafts: a transmission electron microscopical study.

Four frame-mounted autologous fascia lata heart valve grafts in situ for 18 to 41 months as well as one free-mounted fascia cusp in situ for 10 years were examined by transmission electron microscopy (TEM). In all cusps, areas of well-preserved subcellular structures were found as well as areas with degeneration and fragmentation of both nuclear and collagen fibers. Fibrocytes, fibroblasts, and a special cell form, the myofibroblast, were encountered. The appearance of this last cell form may explain the shrinkage phenomenon encountered in these valves, all retrieved at reoperation because of valve dysfunction. Some of the fascial cells thus stayed alive within the bloodstream for up to 10 years.

Aortic Valve↗
PubMed1981

The use and fate of fascia lata and sclera in ophthalmic plastic and reconstructive surgery.

The introduction and use of newer surgical materials, better surgical instruments, finer suture materials, and improved optical equipment have allowed us to advance certain techniques in ophthalmic surgery and ophthalmic plastic surgery. In oculoplastic surgery, fascia lata and sclera are but a few of these materials used with greater frequency. In this paper, a number of techniques are described depicting the use of fascia lata and sclera. A histologic study of these materials after variable periods of implantation is presented.

Adolescent↗
PubMed1982

Congenital ptosis. Results of treatment using lyophilized fascia lata for frontalis suspensions.

In a prospective collaborative study, congenital ptosis was repaired using lyophilized allogeneic fascia lata as the suspension material for frontalis sling procedures. Over 50 cases of unilateral and bilateral ptosis procedures were performed by pediatric ophthalmologists during the initial study period. No infections or evidence of tissue rejection were reported during a follow-up period of up to 24 months. Four failures, ascribed to slippage, were noted within the first several months and required regrafting. In an additional case, minimal slippage occurred, but resulted in satisfactory lid levels. All remaining cases achieved satisfactory cosmetic and functional results. Most collaborators found this form of preserved fascia lata to be superior to nylon polyfilament, cable-type suture. Clinical features of the patient population included a high incidence of strabismus (28%) and amblyopia (24%).

Adolescent↗
PubMed1986

Hecht fascia lata needle forceps.

A new instrument is presented for lid tunneling, grasping, and pulling through of the fascia lata in frontalis suspension surgery for ptosis. The instrument, the Hecht Fascia Lata Needle Forceps, is a modification of the small curved hemostat.

Blepharoptosis↗
PubMed1978

The tensor fascia lata musculocutaneous flap.

The tensor fascia lata (TFL) muscle, together with the overlying skin of the anterolateral thigh, makes a reliable musculocutaneous unit. It can be lengthened safely by taking the fascia lata and the skin of the anterolateral mid and lower thigh to within 8 cm of the knee. The skin of the longer flap is supplied by large perforating musculocutaneous arteries, the terminal branches of the vascular pedicle of the muscle. The shorter flap can easily be transposed over the trochanteric area, while the larger flap will cover not only the trochanter but also the ischial and sacral areas. The flap serves equally well as a transposition, island, or free flap. The anatomical and vascular basis of the flap is presented, together with its application in 21 patients. Possible further applications of the flap, including anterior rotation, are discussed.

Fascia↗
PubMed1981

Usefulness of the innervated tensor fascia lata flap in paraplegic patients.

Pressure sores in paraplegic patients are a well-known problem. Such patients can develop pressure necrosis and skin breakdown in spite of preventive measures and adequate surgical management. The occurrence and recurrence of these problems is due in large part to the patient's inability to perceive pressure discomfort in the insensible sitting area. Use of the innervated tensor fascia lata flap has great value in selected patients. A series of 9 patients is presented. In all patients, postoperative sensibility in the flap was maintained as in the preoperative stage. Follow-up of these patients shows that all flaps have remained healed and functioning The neuroanatomical features of the innervated tensor fascia lata flap make it a promising method for covering pressure sores and avoiding subsequent complications.

Fascia↗
PubMed1980

Ethylene oxide sterilization of bone, dura mater, and fascia lata for human transplantation.

The use of allogeneic human bone, dura, and fascia has achieved an enduring and accelerating role in the augmentation of spinal fusions and the repair of skeletal and dural defects. Primary sterilization of these nonviable cadaveric tissues magnifies the potential sources and ensures the microbiological sterility of the implant. Subsequent lyophilization facilitates preservation and distribution and reduces the immunogenicity of the graft. The evaluation of gaseous ethylene oxide (EO) as a sterilant was suggested by the delerious effects of alternative methods. Through a series of experiments, the following properties of EO sterilization were studied: (a) surface and interstitial sterilization; (b) the diffusion of EO into tissue, the formation of the reaction products ethylene chlorohydrin (EC) and ethylene glycol (EG), and the desorption of all three from tissues; (c) lyophilization and aeration in the removal of residues; and (d) minimization of residues through pretreatment. Gaseous EO is a very effective surface sterilant of wet bone, dura, and fascia and does not grossly alter these tissues. Its partial penetration through compact bone renders it less reliable for an interstitial antimicrobial effect, unless access to the interior is provided by serial openings. The toxicity of EO, EC, and EG mandates the desorption through lyophilization of these compounds (EC and EG are formed during sterilization with EO). Before sterilization, bone must be rid of marrow by vigorous irrigation with deionized water. The resultant reduction of the number of cells and of the available chloride decreases antigenicity and the formation of EC. Freeze-drying for more than 72 hours, in some cases augmented by prolonged aeration at room temperature, reduces EO, EC, and EG to acceptable levels. The accurate assay of residues in tissue requires acetone extraction for gas chromatography on rehydrated tissues because extraction of dry tissues gives falsely low results. Rigorous adherence to a protocol incorporating these findings justifies the acceptance of gaseous EO as a safe, relatively rapid, and inexpensive sterilant of bone and soft tissues.

Adult↗
PubMed1975

Aortic valve replacement with frame-supported autologous fascia lata grafts. II. Clinical and laboratory findings.

Thirty-five patients with a frame-supported autologous fascia lata graft implanted in the aortic annulus were investigated 11 to 36 months after operation. The group comprised 7 patients with pure aortic stenosis, 11 with combined stenosis and incompetence and 17 with pure aortic incompetence. Seven patients had concommitant mitral valve disease. The follow-up investigation included ECG, a work test on a bicycle ergometer, dynamic spirometry, roentgenological heart volume determination and haematological "screening tests" for intravascular haemolysis. Concomitant with a marked subjective improvement of the patients, there was a considerable objective improvement, as judged by physical working capacity, ECG signs of left ventricular hypertrophy and heart volume. The serum haptoglobin values were somewhat lower postoperatively (mean value 44 mg%), but no ahaptoglobinaemia occurred. Thus, no definite signs of intravascular haemolysis were noted. No thrombo-embolism occurred within this observation period, despite the fact that none of the patients with isolated aortic valve replacement were treated with anticoagulants. This investigation shows that a frame-supported autologous fascia lata valvular graft in the aorta can function well during a period of up to 3 years.

Adolescent↗