[Use of preserved allogeneic fascia for the treatment of ventral hernia].
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OBJECTIVE: To improve the survival of mesenchymal stem cells (MSCs) for prefabrication of an osteo-musculo-cutaneous flap. METHODS: In a mouse model, the compound of MSCs and p(3HB-co-3HH) were embeded in the latissimus dorsi muscle as an experimental group and the muscle pocket of the buttock as the control. The examinations of the HE staining, hybridization in situ of osteonectin mRNA and Von kossa staining were used to evaluate the results. RESULTS: The expression of osteonectin mRNA and the Von kossa staining showed that the latissimus dorsi muscle group was superior to the control in 2 weeks and 4 weeks after the surgery in vivo. CONCLUSION: The results indicate that the above-mentioned technique may be a good alternative for the prefabrication of the osteo-musculo-cutaneous flap.
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OBJECTIVE: This study aimed to detect if continuous local infusion of levobupivacaine with the On-Q Painbuster system provided postoperative analgesia of similar quality to morphine + ketorolac i.v. in patients undergoing cesarean section. MATERIALS AND METHODS: Using a randomized prospective double-blind study, 20 women undergoing cesarean section with a standardized spinal technique were randomly assigned into two groups to receive either 10 mg morphine + 120 mg ketorolac + saline solution up to 96 ml with an elastomeric pump i.v. (group A) or local infusion of levobupivacaine 0.2% with the On-Q PAINBUSTER system (group B). Both groups were administered ketorolac i.v. in bolus in case of pain. RESULTS: The two groups differed in their VAS scores with group A experiencing significantly less pain than group B; the consumption of analgesics was significantly lower in group A than in group B. CONCLUSIONS: The i.v. system with morphine and ketorolac is more effective than levobupivacaine subcutaneous infusion in reducing postoperative pain associated with cesarean section.
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An intra-articular reconstruction of the anterior cruciate ligament (ACL) in chronic and acute ruptures is described, which we call doubling-back ACL substitution. The McIntosh graft is used to fix it, starting from the posterior origin of the ACL and passing to the anterior region of its insertion and through the anteromedial tibial head, returning over the top with isometric conditions. Since April 1987, this procedure has been applied in 60 patients this way, 48 of whom we saw again between April and June 1990. There are only 2 unstable joints; 46 patients have stable knees. Most of them are engaging in sport again.
A 14-year-old male adolescent underwent incomplete amputation of his right ear. Revascularization of the remnant was achieved by means of a temporoparietal fascial-island flap. It was sutured between the dorsal aspect of the cartilage and the dorsal skin of the ear. The postoperative course was uneventful. It healed with no complications.
The authors relate their experience in the treatment of subcutaneous disruption of the Achilles tendon with tenorraphy and neutering tenoplasty by quadriceps muscular aponeurosis. The results obtained in 33 patients confirm the effectiveness of this method.
The authors analyze the results of 6 transplantations of dermofascial rear flaps from the sole and of a radial transplant from the forearm, made to replace maxillofacial defects after tumor removal and injuries. Radial artery-based grafts were found preferable, the possibility of taking a skin-and-bone transplant being among the advantages of such transplantations. The authors recommend a wide use of radial grafts from the forearm for elimination of head and neck defects, oral cavity defects included.
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