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At least 667 records · Page 37Linked to original sources
PubMed1996

Treatment of scalp arteriovenous malformation.

We report seven patients with scalp arteriovenous malformations, including two patients with lesions > 10 cm in diameter, who were successfully treated. The principal complaint of each patient was a deforming mass. Each of four patients had a history of blunt traumatic injury. The lesions, each consisting of the nidus, feeders, and draining veins, evolved in all patients. The nidus consisted of fistulae, which exhibited various angioarchitectures as revealed by angiography. A hemangiomatous component was histologically recognized in one patient. In five patients, in whom the lesions were relatively small and whose nidi included only large fistulae, the malformations were remedied by surgical intervention alone or were cured with embolization alone using liquid adhesives. In the two patients with lesions > 10 cm, the nidi consisted of numerous large fistulae and plexiform fistulae in one patient and plexiform fistulae and a hemangiomatous component in the other patient. These patients were treated with a combination of transarterial embolization and surgical intervention. Preoperative embolization greatly reduced blood loss during resection. Total excision and scalp reconstruction using a soft tissue expander were performed in both patients. The cosmetic results were excellent in all of the patients, and no recurrence has been recognized during the follow-up period, which ranges from 31 to 99 months. The treatment of scalp arteriovenous malformations should strive to improve deforming features and to attain a permanent cure. Because each nidus includes a variety of anomalous angioarchitectural features, there should be different means and a combination of treatments for each patient. Embolization alone could be adequate treatment in relatively small lesions, the nidi of which consist only of several large fistulae. For malformations with more extensive, large fistulae or with anomalous components other than large fistulae, a combined endovascular and surgical approach and scalp reconstruction seems to be the best treatment.

Adult↗
PubMed1995

[Experimental study on rapid expansion of soft tissue].

Nine white pigs weighing about 15 kg were divided into three groups: rapid expansion group (REG), conventional expansion group (CEG) and control group (CON). Expansion was carried out under monitoring of interal pressure of the expander and blood flow of the skin over the expander. After completion of expansion, hemodynamic, physical, histologic and ultrastructure changes of the expanded skin were measured and recorded. The study showed: (1) The immediate retraction ratios of skin of three groups were 41.37%, 20.82% and 10.01%, respectively (P < 0.01). (2) The thickness of the epidermis of the three groups was not statistically different, though the dermis of the expanded skin was thinner than that of the control (P < 0.01). (3) The density of collagen in the dermis of the three groups was 80.57 +/- 5.47, 79.49 +/- 6.31 and 82.72 +/- 2.69, respectively; the density of elastin of the three groups was 2.88 +/- 1.24, 2.77 +/- 0.74 and 2.56 +/- 0.63, respectively (P < 0.05). We concluded that the delay phenomenon of the expanded flap depends mainly on the intensity of expansion. The immediate retraction ratio of the rapidly expanded skin was greater than that of conventionally expanded skin. Rapid expansion also results in tissue hypertrophy but does not cause destruction of collagen. With proper calculating the size of the defect and estimating immediate skin retraction, rapid expansion is feasible in clinical applications.

Animals↗
PubMedDate not supplied

[Tissue expansion of the superior limb].

UNLABELLED: In order to get better results in the treatment of the superior limbs defects we have attempted to take profit of the expansion tissue techniqu. PURPOSE: With the objective of studying the utilization of expansion tissue technique to repair defects in the superior limbs caused by scars or tattoos removal. METHODS: 6 patients with 7 superior limbs defects to be repaired were treated by the technique of tissue expansion with 8 tissue expanders. In 3 patients the lesions were caused by tattoos removal (4 lesions), 2 patients presented lesions caused by burn scars removal nd 1 patient showed lesion caused by removal of a childhood scar. RESULTS: The result of this procedure was excellent in 5 cases and provided total repair of the lesion. However hazards have occurred in one patient who showed a necrosis of the expansion neighbouring area (not a consequence of the expansion) and in other patient the aesthetic result was not satisfactory because he developed a hypertrophic scar. Good aesthetic results were obtained in the other 4 patients. CONCLUSIONS: We have had good results with the utilization of tissue expanders in the superior extremities. The superior limbs have good capacity of expansion and lead to good aesthetic results. Any significant hazards were observed as being a consequence of superior limb tissue expansion.

Arm↗
PubMed1996

[Clinical application of intraoperative sustained limited expansion].

Since May 1993, the technique of intraoperative sustained limited expansion (ISLE) had been applied clinically in 21 cases for the immediate reconstruction of soft tissue defects. Satisfactory results were obtained in 18 cases (85.7%), and failed in 3 cases (14.3%). ISLE had been applied successfully in various regions of the body. It had been shown that the results were dependent on the extent of soft tissue defect, the extent of intraoperative tissue gain, and the time of intraoperative sustained expansion.

Adolescent↗
PubMed1996

[Intraluminal expansion of a small intestine segment--animal experiment principles and possible clinical application].

In this study we expanded ileal segments of 8 pigs with an intraluminal expander over a period of 6 to 8 weeks till the volume had reached approximately sixfold of the starting volume. The morphological and morphometrical examinations showed flattened villi with elongated crypts and especially an increase in the thickness of the muscularis. The villi appeared flattened through scanning microscopy as well, but the structure of the microvilli was nearly normal. The proliferative activity in the muscularis, estimated immunohistochemically by a monoclonal antibody against PCNA, showed a threefold increase. So it can be assumed, that the increased thickness of the muscle layer was caused not only by muscle cell hypertrophy but also by hyperplasia. The activity of the alpha-glucosidase, a brush border enzyme, was clearly reduced. The minor cause of this effect was the direct damage of the microvilli from the expander, but the major cause was the exclusion of the ileal segment from the small bowel passage and the resulting lack of nutrients. With our technique it seems possible to create an ileum pouch, a stomach substitute or a urinary bladder substitute.

Animals↗
PubMed1997

Application of a tissue expander for stabilizing graft position in living-related liver transplantation.

In living-related liver transplantation, a portion of the whole liver, usually the left lateral segment or the left lobe, is harvested for use as the graft liver. A relatively small graft may twist around the hepatic venous anastomosis, causing outflow blockage. After an initial experience of such a complication in the early post-transplantation period in one case, we began to apply a tissue expander to obliterate the dead space left after emplacement of a relatively small graft. Commercially available tissue expanders, ordinary employed in plastic surgery, were used for five pediatric recipients (6-14 yr old) whose ratio of graft weight to recipient body weight ranged from 0.74 to 1.72. The expander, filled with 240-350 ml saline, was put into the space to the right of the graft. Aspiration of the expander content was started after the 5th-7th postoperative day (POD), at a rate of 50 ml of fluid a day. The expanders were taken out on the 11th-14th POD after complete removal of the content. Complications observed in the five cases were right shoulder pain (5/5), fluid collection after removal of the expander(2/5), chylous ascites (1/5), and one instance of bile leakage. All the complications were successfully managed and controlled conservatively. There was no outflow obstruction detected by Doppler ultrasonography before or after removal of the expander. This is a simple and safe method for preventing the early onset of outflow block after partial liver transplantation.

Adolescent↗
PubMed1997

Tissue expansion in the upper extremities.

In this article, the authors demonstrate current concepts of soft-tissue reconstruction using tissue expansion principles. History, pathophysiology, and biomechanics of tissue expansion are reviewed. Anatomic areas of expander use in the upper extremity have been delineated, as well as new concepts of nerve and arterial elongation using intraoperative expansion techniques. The authors outline their current technique of upper extremity tissue expansion in the preoperative, intraoperative, and postoperative settings, allowing the reader to appreciate the technique of tissue expansion and its role in soft-tissue reconstruction of the upper extremity.

Adult↗
PubMed1997

Labial skin-flap vaginoplasty using tissue expanders.

In severe vaginal malformations, when the distance between the upper vaginal pouch and perineum is too long (6 cm or more), reconstruction of the vagina can be performed by colonic interposition or by long cutaneous flaps obtained by the tissue expansion technique. Two female adolescents were treated using expanded labial skin flaps. Dissection and anastomosis between the vaginal remnant and cutaneous tube was performed by the transtrigonal approach. Results were satisfactory at 2.5-year follow-up. In our opinion, expanded labial skin-flap vaginoplasty has three main advantages: (1) it permits the construction of a large, soft, well-vascularized neovagina using non-hair-bearing labial skin; (2) it obviates postoperative dilations and prevents delayed strictures; and (3) a transtrigonal approach permits an easy vaginal dissection and a careful, tension-free anastomosis.

Adolescent↗
PubMed1997

[Usage of intra-operative scalp expansion for primary wound closure in cranio-facial operation].

The size of detects in scalp for which primary wound closure can be applied is limited. Cases with a scalp defect for which primary wound closure is difficult to perform are frequently seen. In these cases, an attempt is made to close the wound by extending the margin of an incision produced by extensive subgaleal undermining or galeal incisions. However, its effectiveness is limited. We performed in such cases intra-operative scalp expansion with a tissue expander for primary wound closure, and this technique has yielded good results. A case with craniosynostosis and five cases with cranioplasty received this procedure. Four of these cases had a previous history of undergoing surgery for carvarial bone defect three to five times from the same incision. The scalp at the carvarial bone defect had a scar and was atrophic with great depression. It was expected that the expansion of cranium resulting from cranioplasty would make it difficult to perform primary wound closure. During the surgery, a tissue expander was placed subgaleally in an osseous area prior to the bone operation, and intermittent air expansion was carried out for 20 to 30 minutes by means of air inflation and deflation to expand the scalp. In all of these cases little tension was generated by the wound closure despite the lapse of time during the bone operation. In consequence, primary wound closure was accomplished easily, and the reliable closure of the galea made it possible to prevent the scar widening. This is a simple and easy technique combining primary wound closure of the scalp with intra-operative scalp expansion. We believe that the technique should be considered for cases for whom primary closure of compression deformity is difficult or in whom there is a wound at the carvarial reconstruction site. The technique and typical cases are reported.

Aged↗
PubMed1997

[Use of iterative expansion in the early surgical treatment of complex nevi of the head in children].

Extensive of congenital pigmented nevi to the face in an infant is an indication for early exeresis to prevent the risk of degeneration. Search for the best esthetic result has led many authors to healthy skin to a maximum, often relying on tissue expansion. The aim of this study was to present the combination of two expansion techniques, prosthetic expansion and differed natural expansion. Five infants with congenital pigmentary nevi extending to more than 50% of a facial anatomic unit were treated. Total treatment was achieved in all patients with three or four procedures. By combining different expansion techniques early treatment can be proposed with good esthetic results and moderate cost.

Child↗
PubMed1997

[Facial profile improving interventions using tissue expansion techniques].

If there is a lack of soft tissue in the face, no matter what the cause, the reconstruction should be performed using tissue from neighboring areas because tissue in the same aesthetic and functional area guarantees the best results. Two methods of dilation are described for such skin expansion explained by examples, and substantiated by statistics: (1) dilation with the aid of osteosynthesis plates; and (2) dilation with tissue expansion. To make an objective evaluation, only cases where considered that were finished 3 years ago.

Cephalometry↗
PubMed1998

Use of saline-filled tissue expanders to protect the small bowel from radiation.

Over the past 7 years, 58 saline-filled tissues expanders (TEs) have been temporarily placed in 57 patients. The indications for TE placement were: small bowel exclusion from external-beam radiation therapy (N = 25), interstitial RT (N = 16), or both (N = 13) when there was insufficient omentum to provide adequate exclusion. Of the 57 patients, 24 had primary tumors (4 colon, 4 endometrial, and 11 rectal cancer; 3 sarcomas, 1 schwannoma; and 1 vaginal cancer). The remaining 33 patients (58%) had recurrent cancers (3 anal, 8 colon, and 16 rectal cancers; and 6 sarcomas), of whom 26 (79%) had received prior RT. Of the 58 TEs, 15 were placed superior to the iliac vessels and 43 were placed in the pelvis. Complications included post-withdrawal enterocutaneous fistulae in four patients, TE deflation in three patients, and TE extrusion in one patient. Improvements in TE design and removal techniques have reduced the incidence of these complications. When no native tissue is available for small bowel exclusion, the saline-filled TE is a safe, effective substitute.

Colorectal Neoplasms↗
PubMed1997

Repair of a cheek defect with the tissue expander method: a case report.

A 28-year-old female had a severe depressed deformity of the left cheek due to false local injection of ZnCl2 into her buccal mucosa instead of an anesthetic. After several attempts at plastic surgery in another hospital with unsatisfactory results, she was treated surgically in our clinic using cheek skin expanded by a tissue expander. The outcome was satisfactory.

Adult↗
PubMed1994

Assessment of three different methods of tissue dilation for ceramometal restoration.

Tissue dilation is one of the key factors in obtaining accurate duplication of subgingival finishing lines and hence excellent marginal adaptation of the restoration. Elastic impression materials do not displace the tissue. Therefore, the tissue must be displaced away from the prepared teeth or a small ribbon of the free gingiva must be removed to expose the finishing line before making the impression.

Adult↗
PubMed1998

Penile enlargement surgery.

Aesthetic surgery to improve the appearance of the penis, scrotum, and pubic region has successfully evolved. Penile lengthening is performed by releasing the suspensory ligament of the penis followed by use of penile weights. Girth is increased by wrapping a dermal-fat graft around the penile circumference. The choice of surgery is determined by the patient's anatomy and desires.

Adult↗