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At least 613 records · Page 34Linked to original sources
PubMed1995

[Immediate and late reconstruction of the breast using tissue expanders].

From 1988 up to 1994, 64 patients were submitted to reconstruction of the breast using tissue expanders. A silicone prosthesis was implanted in a second operation. The technique was used both for immediate and delayed breast reconstruction after radical modified mastectomies. Surgical procedures as well as indications, advantages and complications of the technique were discussed. Good results were achieved in 89% of cases. Tissue expander is a valid option for breast reconstruction even though late complications due to the capsular contraction did occur.

Adult↗
PubMed1995

Unilateral breast atrophy.

This represents the only known case of acquired unilateral breast atrophy described after previously normal bilateral breast development. Our patient developed left breast atrophy with normal microscopic examination (biopsy) subsequent to infectious mononucleosis. Her reconstruction utilized tissue expansion followed by prosthetic augmentation of the affected side. Despite an exhaustive search, no definitive cause to explain these findings has been found. Perhaps there is some unknown underlying viral etiology that may have further implications for other breast pathology.

Adolescent↗
PubMedDate not supplied

[Immediate use of an expander during mastectomy. Analysis of 120 cases].

This study analyses a series of 116 patients, in whom mastectomy was followed by immediate insertion of temporary tissue expander. The technique is safe, simple and quick. It carries an acceptably low complication rate. Moreover, it does not interfere with any other local or general adjuvant therapy, if needed. The advantages are rapid post operative healing and psychological recovery, creation of a favorable site for a better quality breast reconstruction. Later on, any procedure for the breast reconstruction can be used. We concluded, that this procedure may be recommended more often; 62% of cases of mastectomies in this series.

Adult↗
PubMedDate not supplied

[Tissue expansion in head and neck regions].

The Authors describe their experience with the use of 56 tissue expanders implanted in the head and neck regions of 45 patients observed in a follow-up of an average of 25 months. They emphasize the various possibilities of reconstructive surgery with the use of tissue expanders and the different mental approach required in order to organize surgical when this technique is employed. The criteria used in the selection of the type of tissue expanders is outlined and useful advice concerning the formulation of a surgical plan which employs the most favourable approach in making to avoid poor functional or aesthetic results or secondary complications is presented. Furthermore the surgical technique used to obtain adequate pockets for the insertion of tissue expanders in the different anatomical areas of the head and neck is described. The Authors affiem that in order to avoid damage to the surrounding neurovascular structures and to obtain good tissue expansion, the correct level of dissection is imperative. The options of using different anatomical areas during reconstructive surgery are discussed. For example, the insertion of a tissue expander in the forehead permits the availability of a large amount of usable tissue during nasal reconstruction, thus leaving the donor area without tension and with minimal scarring. Many different causes of baldness can be treated with the use of tissue expanders, such as posttraumatic injury, burns or infections. Tissue expansion can be utilized in the cheek area for the reconstruction of the lower eyelids, the paranasal and the mandibular area. Tissue expanders used in the cervical area can be utilized for reconstructive surgery of the lower lip or the mandibular area. In addition, the Authors discuss possible complications of this technique such as infection, suture distension and tissue expander extrusion. Recommendations are discussed in order to prevent these major complications. Having reviewed their personal experience the Authors feel they can confirm the reliability of this revolutionary technique in the field of plastic and reconstructive surgery. The use of tissue expanders permits the surgeon to obtain improved functional and aesthetic results which only a few years ago were not conceivable.

Female↗
PubMed1995

Expanded pectoralis major myocutaneous flaps in head and neck surgery.

The use of tissue expanders in head and neck surgery has been popularized since the early 1980s. Tissue expanders are currently used in nasal reconstruction, alopecia, and other head and neck defects when there is inadequate tissue or when transposition of a local flap would create a significant donor-site deformity. Occasionally, situations in head and neck reconstruction arise where local, regional, or free flaps are not available or sufficient for head and neck reconstruction. In these situations, the use of controlled tissue expansion can be employed for enlarging myocutaneous flaps for head and neck reconstructive surgery. Two cases illustrated here present the principles and techniques of this means of reconstruction.

Aged↗
PubMed1995

[Continuous skin expansion for covering soft tissue defects of the foot sole].

Reconstruction of the weight-bearing area of the sole of the foot is a major surgical problem, regardless of the aetiology of the soft-tissue defects. Numerous reconstruction methods have been described for coverage of plantar defects of the heel with local and free flaps. Skin expansion and skin traction have been described by several authors. According to the Ilizarov technique, a new method has been devised for the closure of posttraumatic soft-tissue defects in the weight-bearing area of the sole by skin stretching with Kirschner wires without the aid of either local or free flaps. The operative procedure is very simple: the sharp ends of Kirschner wires are bent with pliers into hook-shaped semicircles. These ends are then inserted into the skin of the sole at intervals of 3-4 mm, alternately close to and distant from the wound edge. The opposite ends of the K-wires are sandwiched between two small AO plates. These plates are pressed together with screws and nuts; additionally, the ends of the K-wires are bent around the plates to prevent loosening. A frame is set up around the heel and connected to the tibial external fixator. The two plates with the K-wires clamped between are mounted on the threaded rods of an Ilizarov external fixation system. Then the foot is temporarily fixed to the tibia in neutral position by a Schanz screw inserted into the first metatarsal. The soft-tissue defect is treated with moist compresses changed daily.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Experimental study of peripheral nerve expansion with a tissue expander].

If a peripheral nerve could be elongated by a tissue expander (TE) without apparent damage, the length gained could be used to overcome a nerve gap without recourse to nerve graft. An experimental study was made to investigate whether this method for repairing a nerve gap is feasible. The tissue expander was designed by the authors and the median nerve of rabbits were stretched with TE at the rate of about 1 mm/day. The results showed that when the elongation rate was 18.4%, the motor nerve conduction velocity (MCV) was 67.8% and the myelinated nerve fibres (MNF) was 82.9% of the control nerves. In a further study nerve grafting and nerve expansion for repairing segmental nerve loss were compared with 10 mm defects. 4 months later the MCV, MNF, isometric contraction force (ICF) and muscle wet weight (MWW) were not significantly different between the 2 techniques. But with the 15 mm defects, elongated nerve were inferior to the nerve grafting method.

Animals↗
PubMed1994

Congenital giant pigmented nevi.

A congenital giant pigmented nevus is a rare skin condition which can involve nearly the entire skin surface. The exact lifetime risk of melanoma developing in a person with a giant nevus is unknown, but is approximated at 6%-12%.

Buttocks↗
PubMed1994

[Application of the polyglycolic acid (PGA) pledgets or sheet for pulmonary fistulas and defects of the pleura].

A felt-like bioabsorbable prosthesis (Polyglycolic Acid (PGA) pledget and sheet; Medifit feft) was used for pulmonary fistula in a total of 10 patients. "Fibrin glue A" was absorbed into the PGA prosthesis previously. And next, the part of pulmonary fistula was coated with "Fibrin glue B", and then covered with the fibrin-absorbed PGA prosthesis. The prosthesis adhered to the diseased part of pulmonary pleura immediately, and therefore, in all these 10 patients, the post-operative air-leakage was stopped up to 4 days and neither side effect nor complication was observed.

Adult↗
PubMed1994

Morbidity after intraperitoneal insertion of saline-filled tissue expanders for small bowel exclusion from radiotherapy treatment fields: a prospective four year experience with 34 patients.

UNLABELLED: When prolonged small bowel exclusion (SBE) from external radiotherapy (RT) fields or immediate exclusion of bowel from brachytherapy sources is required for a patient without adequate omentum, there are no simple proven methods available for accomplishing these goals. We report a prospective study of SBE by intraperitoneal, saline-filled tissue expanders (TE). Thirty-four patients had exclusion of small bowel from either external radiotherapy (RT) ports (20), afterloading catheter treatment fields (5), both (5), or from intracavitary implants (4). Twenty-seven TEs were placed in the pelvis and 7 in the iliolumbar fossa. TE volume ranged from 400-1500 cc (median 550 cc). Patients had rectal (n = 15), colon (6), endometrial (4), anal (3), and vaginal (1) cancers and sarcomas (5). Fifteen patients had recurrent neoplasms, 13 of which were in previously irradiated fields. Nine patients had colorectostomies directly behind the TE, and 12 had other bowel (6) or ureteral (3) anastomoses or bladder repairs (3) adjacent to the TE. RESULTS: TEs remained in the patients from 6 to 173 days (median 95). Morbidity included three early TE withdrawals before RT was begun, one for a prolonged ileus, one for a perineal wound dehiscence, and one for an unrelated small bowel obstruction. Two patients (5.9%) early in the series had post-withdrawal complications (non-lethal small bowel fistulas requiring reoperation), although in a recent cohort of patients no post-withdrawal complications occurred using a different placement technique (0/17 vs. 2/14, P = 0.2). The patient injury complication rate was 4/34 (11.8%). None of these limited or delayed RT, but RT was limited to less than that planned in one other by TE deflation (total complication rate 14.7%). There were no clinical infections involving the prostheses, even though one patient had an abdominal wound dehiscence, 3 had pelvic abscesses, and 2 had exposure of the TE through the vagina (1 planned, 1 at dehisced vaginal cuff) after TE placement. We noted no acute and one possible late RT complication in these patients (18 months median follow-up, range 3-43 months). Small bowel was displaced from > 95 per cent of the RT treatment volume in 70 per cent and from > 75 per cent of the treatment volume in 89 per cent of 27 evaluable patients treated with external RT. CONCLUSION: Intraperitoneal placement of a saline-filled tissue expander is a simple, safe and effective means of small bowel exclusion from RT portals.

Adult↗
PubMed1994

[Breast reconstruction after mastectomy].

A variety of procedures can be used in breast reconstruction following mastectomy depending on the condition of the residual tissue. A silicone implant or tissue expander is used when the skin and subcutaneous fatty tissue are preserved, although silicone implants are no longer used in the United States. Alternatively, a lateral abdominal flap, lateral thoracic flap, latissimus dorsi flap, or rectus abdominus myocutaneous flap may be used. We have performed breast reconstruction using the latissimus dorsi myocutaneous flap without a silicone implant, and the vertical axis of the rectus abdominus myocutaneous flap was also used. Nipple-areola reconstruction was also investigated.

Abdominal Muscles↗