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At least 559 records · Page 31Linked to original sources
PubMed1998

Clinical and urodynamic predictors of delayed voiding after fascia lata suburethral sling.

OBJECTIVE: To determine the time to resumption of normal voiding after a fascia lata sling and whether any clinical, operative, or urodynamic variables predict it. METHODS: Between January 1993 and September 1996, 62 women underwent fascia lata suburethral sling operations for intrinsic sphincter deficiency or recurrent stress incontinence. The demographic, operative, and urodynamic data of 61 of these patients were analyzed. RESULTS: The mean number of days to resumption of normal voiding was ten. Three patients (5%) developed permanent retention. Patients 65 years and older were more likely than younger patients to have prolonged catheterization (16 versus 7 days, P=.008). Women who had additional procedures voided at a mean of 15 days compared to nine days for those having slings only (P=.029). A preoperative urine flow rate less than 20 mL/sec was associated with late voiding. There was no significant relationship between preoperative voiding mechanism and voiding time. CONCLUSION: Resumption of normal voiding occurred earlier than reported by others. Age over 65 years, additional surgical procedures, and low peak flow rates were risk factors for delayed voiding. Time to normal voiding was independent of the preoperative voiding mechanism.

Adult↗
PubMed2000

Transversalis fascia rediscovered.

The transversalis fascia is a layer in the make-up of the posterior inguinal wall. It is the deepest, thinnest, and least important layer in terms of the prevention of herniation. It is a segment of the wider endoabdominal fascia. The true posterior wall of the inguinal canal is formed, in varying degrees, by the muscles or aponeuroses of the internal oblique and transversus abdominis. Plainly, Daedalus was not needed to show surgeons and anatomists how to make a labyrinth out of a rabbit hole!

Animals↗
PubMed1984

Use of temporalis fascia in eyelid reconstruction.

Full-thickness eyelid defects, as a result of trauma, continue to present a dilemma to the reconstructive surgeon. The authors present a technique of utilizing a temporalis fascia graft to hammock and support a nasal septal cartilage graft as part of reconstruction of the lower eyelid and the lateral canthus after traumatic avulsion. The static suspension afforded by the fascia helps produce proper apposition of the lower eyelid to the globe and provides lateral canthal support. This tissue implant is well tolerated in the eyelid and is readily available in the ophthalmic surgical field.

Eyelids↗
PubMed1996

Tympanic membrane reconstruction using formaldehyde-formed autogenous temporalis fascia: twenty years' experience.

This study describes 20 years' experience with autogenous temporalis fascia that is formed and shaped by formaldehyde cross-linking with special Fasciaform (Hear America, Palo Alto, Calif.) molds in the repair of large tympanic membrane perforations. One hundred twenty operations in 113 patients were performed between 1973 and 1993 to close large perforations in patients with intact ossicular chains. All perforations were successfully closed by this technique. Audiometric studies indicated that the postoperative air-borne gap was closed to within 0 to 10 dB in 63% and to within 0 to 20 dB in 97%. One patient had a 15-dB sensorineural hearing impairment. Graft lateralization requiring revision occurred in three patients, two of whom had previous unsuccessful tympanoplasties. Comparisons of adult vs. pediatric groups and primary vs. revision groups were made. The technique ensures the removal of any ectopic epithelium on the medial surface of the tympanic membrane remnant and provides for easy graft placement and stability during healing without the use of middle ear Gelfoam (Upjohn Co., Kalamazoo, Mich.). The formaldehyde-formed fascia graft or Fasciaform graft technique provides an effective method of closing large perforations with excellent functional results and minimal complications.

Adolescent↗
PubMedDate not supplied

Fibromatosis of the cervical fascia.

Fibromatosis is a rare benign soft-tissue tumor of fibroblastic origin arising from the aponeurotic structures. Preoperative diagnosis of fibromatosis of the deep cervical fascia is difficult from clinical presentation alone. We report a case of a tumor of the cervical fascia space for which the radiologic appearance did not exhibit specific characteristics. Critical analysis of the radiologic images combined with fine-needle aspiration findings were helpful in suggesting preoperatively the diagnosis of fibromatosis, which was confirmed histologically after surgical resection.

Adult↗
PubMed1996

Compression neuropathy of the palmar cutaneous branch of the median nerve by the antebrachial fascia.

An isolated compression neuropathy of the palmar cutaneous branch of the median nerve is described in a woman who presented with a small tender mass over the anterior aspect of her distal forearm and complete numbness over the thenar eminence. Surgical exploration revealed thickening of the palmar cutaneous nerve as it passed upwards through the antebrachial fascia on the ulnar aspect of the flexor carpi radialis tendon. Neurolysis of two separate fascicles of the palmar cutaneous branch of the median nerve and excision of a window of antebrachial fascia resulted in complete return of sensation over the thenar eminence.

Adult↗
PubMed1996

Biomechanical changes of cadaveric finger flexion: the effect of wrist position and of the transverse carpal ligament and palmar and forearm fasciae.

This study was designed to investigate whether the position of the wrist or sectioning of the transverse carpal ligament (TCL), as well as the palmar fascia and forearm fascia, modifies the biomechanical behavior of the finger flexion, as defined by changes of excursion, load (force), and work of the flexor tendons. The parameters were measured in fresh-frozen cadaver hands with the wrist in 30 degree extension, neutral, and 30 degree flexion, before and after division of the TCL. Having the wrist in extension improved excursion efficiency, whereas flexing the wrist produced the opposite effect, with a 16% decrease in excursion efficiency after division of the TCL. Change in excursion efficiency between the intact and cut TCL was 8% in the flexed position, 5% in the neutral position, and 0.3% in the extended position. Change in load efficiency between intact and cut TCL was 11% in the flexed position, 6% in the neutral position, and 0% in the extended position. Change in the work efficiency between intact and cut TCL groups was noted most with the wrist in the flexed position (13%), compared to a small change (3%) in neutral wrist position and no change in wrist extension. A significant decrease in the excursion efficiency of the flexor tendons was demonstrated when the wrist was in the flexed position. Any increase in the excursion of the flexor tendons could clinically result in decreased grip strength when the wrist is flexed. Furthermore, the effects of TCL division were not significant when wrist position was in extension.

Biomechanical Phenomena↗
PubMedDate not supplied

Resection of talocalcaneal middle facet coalition. Interposition with a tensor fascia lata allograft: a case report.

Tensor fascia lata is utilized in the management of complex soft-tissue injuries and defects, but has not been described in the literature in the use of tissue interposition with resection of talocalcaneal middle facet coalitions. This article is a case presentation of a resection of a middle facet coalition with interposition of an allograft of tensor fascia lata. At 14 months postoperative follow-up, range of motion of the subtalar joint was noted to be 20 degrees, and without pain or crepitus. There was no radiographic evidence of degenerative changes in Chopart's joint. The patient returned to all routine and sports activities without pain. He was satisfied with the outcome of the procedure.

Adolescent↗
PubMedDate not supplied

Plantar fascia rupture: diagnosis and treatment.

Two patients with spontaneous medial plantar fascia rupture due to a definite injury with no prior symptoms, were referred to our institution. Clinically, there was a tender lump in the sole, and magnetic resonance imaging confirmed the diagnosis. Nonoperative treatment was sufficient in curing the acute total rupture. Endoscopic release was used on the partially ruptured plantar fascia, but it is probably more optimal in the acute phase. The literature provides no comparative data on operative or nonoperative treatment efficacy for this rare condition.

Adult↗
PubMedDate not supplied

Bilateral fascia iliaca catheters for postoperative pain control after bilateral total knee arthroplasty: a case report and description of a catheter technique.

BACKGROUND AND OBJECTIVES: The pain following total knee arthroplasty can be associated with significant morbidity, especially in the elderly. Regional anesthetic techniques attenuate or eliminate postoperative pain, which may reduce this morbidity. METHODS: A 74-year-old patient with history of an epidural abscess underwent elective bilateral total knee arthroplasty for degenerative joint disease. Bilateral lumbar plexus catheters were placed via the fascia iliaca compartments. Lidocaine was infused postoperative through both catheters, and serum lidocaine levels were followed. RESULTS: The patient received significant postoperative pain relief based on physical and subjective examination. There were no complications or untoward effects related to the technique. CONCLUSION: Lumbar plexus blockade with continuous local anesthetic infusion via the fascia iliaca compartment is an effective means of providing postoperative analgesia after total knee arthroplasty when epidural analgesia is contraindicated.

Aged↗
PubMedDate not supplied

Glottic insufficiency: the use of fat and fascia grafts.

Glottic insufficiency has been managed since the beginning of the twentieth century. The autologous grafts, as fat and muscular fascia, have shown safety and good results. The authors discuss the advantages and disadvantages of using fat and fascia in the management of glottic insufficiency, regarding historical aspects, inflammatory process and surgical techniques.

Adipose Tissue↗
PubMed1982

Tympanic membrane grafting with fascia, pericardium and vein.

Fascia and preserved homologous vein and pericardium have been used in consecutive order in 250 ear operations. Though successful closure of the defect, in cases with chronic ear infection, tended to be better with pericardium, auditory gain with pericardium seemed to be less than with fascia and vein. The differences, however, were not statistically significant. For the reason that it is easier to obtain, vein is the graft of choice in our institution when homologous graft is needed.

Cholesteatoma↗
PubMed1998

Congenital ptosis: longterm results using stored fascia lata.

PURPOSE: Frontalis brow suspension, using stored donor fascia lata, allows early correction of severe congenital ptosis. We report longterm results of 18 patients, (29 ptotic eyelids). METHODS: Patient records were retrospectively reviewed. Lid position at the first and subsequent post-operative visits was recorded, as was the time when ptosis recurred. RESULTS: The mean follow-up period was 42.9 months (range 7 to 84 months). All patients achieved a Good initial result. Partial ptosis recurrence was noted in 7 patients (10 eyelids), within 18 months of surgery. One of these patients required reoperation. Lid position did not change after the first 18 months. No late failures were encountered. CONCLUSION: Longterm lid position is remarkably stable after early surgical correction of severe congenital ptosis using stored fascia lata.

Blepharoptosis↗
PubMed1997

Study of biochemical substrate and role of metalloproteinases in fascia transversalis from hernial processes.

The aim of this study was to examine the fascia transversalis (FT) from patients with direct and indirect hernia in an attempt to identify possible differences between each type of hernia. FT samples were obtained from 36 patients presenting inguinal hernia (23 indirect hernia and 13 direct hernia) who underwent surgery. We have analysed the ultrastructure of the fascia surrounding the hernial lesions, the proline and lysine hydroxylation in the tissue, the type I-type III collagen ratio and the presence of metalloproteinases. We have not detected ultrastructural differences in the collagen fibrils from FT in direct and indirect hernias. However, the interfibrillar matrix was more abundant in direct hernias, showing abundant electron-dense particles. No differences in proline hydroxylation were observed between each type of hernia. A small decrease in lysine hydroxylation was detected in patients with direct hernia. Enzyme-linked immunosorbent assays (ELISAs) showed no statistically significant differences in the type I-type III collagen absorbance ratios. Immunohistochemistry revealed no differences in the expression of matrix metalloproteinase-1. FT from patients presenting direct hernia showed a very strong staining vs. metalloproteinase-2 when compared with that observed in indirect hernia.

Collagen↗
PubMed1997

Plasma bupivacaine levels after fascia iliaca compartment block with and without adrenaline.

Twenty children undergoing unilateral surgery on the thigh received a fascia iliaca compartment block using 2 mg.kg-1 of bupivacaine with (Group A) or without (Group P) adrenaline 1/200,000. Venous blood samples were taken as 5, 10, 15, 20, 25, 30, 40, 50 and 60 min after injection and assayed for concentrations of bupivacaine. In all subjects an adequate block was produced. Plasma concentrations of bupivacaine in Group P were significantly higher than those in Group A (P < 0.05). The median maximum plasma concentration (Cmax) was 1.1 micrograms.ml-1 (range 0.54-1.29 micrograms.ml-1) in Group P and 0.35 microgram.ml-1 (range 0.17-0.96 microgram.ml-1) in Group A. The median time taken to attain Cmax (Tmax) was 20 min (range 10-25 min) in Group P and 45 min (range 5-50 min) in Group A. The median time to first analgesia was 9.75 h (range 3-15 h) in Group P and 10.5 h (range 2.5-21 h) in Group A. The study confirmed the efficacy of the fascia iliaca compartment block in children and showed that when performed with 2 mg.kg-1 of bupivacaine it is associated with plasma concentrations of bupivacaine well within acceptable limits. The addition of adrenaline 1/200,000 to the local anaesthetic solution reduces the maximum plasma concentration reached.

Adolescent↗
PubMed2001

Donor fascia in urogynaecological procedures: a canine model.

OBJECTIVE: To explore the in vivo characteristics of donor fascia used in urogynaecological procedures, in a canine model. MATERIALS AND METHODS: Two experiments were conducted. In the first, donor fascia grafts were obtained from 12 dogs, the grafts freeze-dried and half were irradiated. The grafts were used for sacrocolpopexy and suburethral slings in each of five dogs. The dogs were killed at 2, 6 and 12 weeks after graft implantation, the grafts retrieved and assessed using tensilometry. In the second experiment, unirradiated sacrocolpopexy grafts were implanted in eight dogs; four grafts were placed under no tension and four under moderate tension. At 8 weeks, the grafts were retrieved and assessed by tensilometry. Measures of strength in both experiments included the ultimate tensile strength, ultimate strain and stiffness. All measures were compared using Kruskal-Wallis nonparametric tests in both studies. RESULTS: In the first experiment, a significant minority (23%) of grafts had complete loss of strength. Measures of graft strength did not vary when analysed according to donor dog, host dog, history of graft irradiation, duration of implantation or location of graft. In the second experiment, grafts placed under no tension tended to have lower tensile strength (chi2(1) = 3.125, P = 0.077), lower stiffness (chi2(1) = 3.125, P = 0.077) and lower ultimate strain (chi 2(1) = 3.182, P = 0.074). CONCLUSION: Graft irradiation as an isolated variable did not predispose grafts to failure in vivo. Biomechanical factors at the implantation site are likely to play a critical role in determining ultimate graft strength.

Animals↗
PubMed1999

Upper extremity salvage using the tensor fascia lata flap: report of two cases.

The tensor fascia lata pedicled flap was successfully used to salvage 3 severely injured upper extremities in 2 patients. Both patients had undergone 3 prior free tissue transfers without complete closure of their wounds. All 3 tensor fascia lata flaps (2 myocutaneous, 1 myofascial) survived entirely. We believe this flap offers a distinct advantage compared with the groin flap when pedicled flap coverage of the upper extremity is required.

Adult↗
PubMed2003

Dorsal hand coverage with free serratus fascia flap.

In reconstructing a defect on the dorsum of the hand, with the extensor tendons exposed or even missing, functional, as well as cosmetic, goals are of major importance. The authors present three cases of extensor tendon reconstruction, combined with soft-tissue reconstruction, with the free serratus fascia flap, the connective tissue over the serratus muscle, for dorsal hand coverage. The flap consists of thin and well-vascularized pliable tissue, with gliding properties excellent for covering exposed tendons. It is based on the branches of the thoracodorsal artery, which are raised in the flap, leaving the long thoracic nerve intact on the serratus muscle. Coverage of the flap with split-thickness skin graft is done immediately. The free serratus fascia flap is an ideal flap for dorsal hand coverage when the extensor tendons are exposed, especially because of low donor-site morbidity.

Adult↗