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At least 19 recordsLinked to original sources
PubMed1986

Thickening of pelvic fascia in carcinoma of the rectum. Perirectal fascia or Waldeyer's fascia?

Computed tomography (CT) scan of the pelvis unreliably detects metastases to lymph nodes from rectal carcinoma. Alternative features of tumor spread visualized on pelvic CT scan may aid preoperative evaluation. Two patients in a series had thickened perirectal fascia due to tumor involvement. The perirectal fascia was recently described by others from CT scans of the pelvis. The extent of the perirectal fascia shown on CT scan correlated with descriptions of Waldeyer's fascia that stress its expansive nature enveloping internal iliac vessels and lymphatics. The perirectal fascia and Waldeyer's fascia are proposed to be synonymous, and lymphangitis carcinomatosa is proposed to account for a thickened perirectal/Waldeyer's fascia in rectal carcinoma. The fascial thickening also is found in inflammatory pathology of the rectum (probably due to inflammatory lymphangitis), and fascial thickening on pelvic CT scan is thus not an absolute indicator of carcinoma.

Fascia↗
PubMed2005

Denonvilliers' fascia lies anterior to the fascia propria and rectal dissection plane in total mesorectal excision.

PURPOSE: Opinion is divided whether Denonvilliers' fascia lies anterior or posterior to the anatomic fascia propria plane of anterior rectal dissection in total mesorectal excision. This study was designed to evaluate this anatomic relationship by assessing the presence or absence of Denonvilliers' fascia on the anterior surface of the extraperitoneal rectum in specimens resected for both nonanterior and anterior rectal cancer in males. METHODS: Surgical specimens were collected prospectively from males undergoing total mesorectal excision for mid and low rectal cancer, with a deep dissection of the anterior extraperitoneal rectum to the pelvic floor. Specimens were histopathologically analyzed using best practice methods for rectal cancer. The anterior aspects of the extraperitoneal rectal sections were examined microscopically for the presence or absence of Denonvilliers' fascia. RESULTS: Thirty rectal specimens were examined. Denonvilliers' fascia was present in 12 (40 percent) and absent in 18 specimens (60 percent). Denonvilliers' fascia was significantly more frequently present when tumor involved (55 percent) rather than spared the anterior rectal quadrant (10 percent; difference between groups 45 percent; 95 percent confidence interval, 30-60 percent; P = 0.024, Fisher's exact test). CONCLUSIONS: When tumors were nonanterior, rectal dissection was conducted on fascia propria in the usual anatomic plane, and Denonvilliers' fascia was not present on the specimen. It was almost exclusively found in anterior tumors, deliberately taken by a radical extra-anatomic anterior dissection in the extramesorectal dissection plane. Denonvilliers' fascia lies anterior to the anatomic fascia propria plane of anterior rectal dissection and is more closely applied to the prostate than the rectum.

Adult↗
PubMed2002

Pubovaginal sling using allograft fascia lata versus autograft fascia for all types of stress urinary incontinence: 2-year minimum followup.

PURPOSE: Allografts have been substituted for autografts as a pubovaginal sling to decrease postoperative morbidity, although to our knowledge their long-term durability is unknown. Since 1997, we have offered allograft fascia lata as an alternative to autograft fascia in women undergoing the pubovaginal sling procedure. We describe our continued experience with those with a minimum 2-year followup. MATERIALS AND METHODS: We retrospectively reviewed the records of 134 consecutive women with all types of stress urinary incontinence but without neurovesical voiding dysfunction or a significant degree of pelvic prolapse who underwent pubovaginal sling (allografts in 63 and autografts in 71) performed by a single surgeon. Rectus abdominis or fascia lata autograft and freeze-dried, gamma irradiated allograft slings were placed using identical techniques and a 2 x 12 cm. piece of fascia. Outcome analysis included a chart review, third party telephone interview and selective videourodynamics. Surgical outcome was categorized by daily pad use as cured-0, improved-1 or failed-greater than 1 pad. RESULTS: Of 140 women who received a pubovaginal sling 134 were still evaluable. Preoperative parameters were similar in each group. Mean followup plus or minus standard deviation was less in the allograft group (29 +/- 3 versus 44 +/- 7 months, p < 0.05). There was no statistical difference in the overall stress and urge incontinence cure rate in the allograft and autograft groups (45 of 63 cases and 55 of 71, p = 0.42), nor was there a difference in the total number with recurrent stress urinary incontinence (8 and 7, respectively, p = 0.58). In 24% and 16% of cases postoperative incontinence was due to urge incontinence in the allograft and autograft groups, respectively. Using allografts instead of autografts resulted in a significantly decreased postoperative pain and disability (p < 0.05). CONCLUSIONS: Using allograft fascia lata as an alternative to autologous fascia for a pubovaginal sling significantly decreases postoperative pain and disability without compromising efficacy at 2 years. Therefore, we believe that allograft fascia should remain a suitable alternative to autografts for pubovaginal slings.

Adult↗
PubMedDate not supplied

2003 William J. Stickel Gold Award. In vivo forces in the plantar fascia during the stance phase of gait: sequential release of the plantar fascia.

Plantar fasciotomies have become commonplace in podiatric and orthopedic medicine for the treatment of plantar fasciitis. However, several complications have been associated with plantar fascial release. It has been speculated that the cause of these complications is excessive release of the plantar fascia. The aim of this project was to determine whether the amount of fascia released, from medial to lateral, causes a significant increase in force in the remaining fascia. A dynamic loading system was developed that allowed a cadaveric specimen to replicate the stance phase of gait. The system was capable of applying appropriate muscle forces to the extrinsic tendons on the foot and replicating the in vivo timing of the muscle activity while applying force to the tibia and fibula from heel strike to toe-off. As the plantar fascia was sequentially released from medial to lateral, from intact to 33% released to 66% released, the real-time force and the duration of force in the remaining fascia increased significantly, and the force was shifted later in propulsion. In addition, the subtalar joint was unable to resupinate as the amount of fascia release increased, indicating a direct relationship between the medial band of the plantar fascia and resupination of the subtalar joint during late midstance and propulsion.

Awards and Prizes↗
PubMed2005

In vivo study to assess the viability and mass effect of fascia injection in comparison with block fascia graft.

Recently, fat injection has gained favor among plastic surgeons for soft tissue augmentation. However, fat injections lose 50% of their volume after 1 year. The profession is in need of an injectable bulking material that gives a long-lasting improvement. Using 30 male rats, this study investigated the stability of the size and structure of the injected fascia autograft and compared it with surgically transplanted fascia. The fascia graft was harvested from the back of the rat, big, and divided into two equal pieces. The first piece was minced into a paste and injected subcutaneously on the anterior surface of the right ear. The other piece was transplanted subcutaneously on the anterior surface of the left ear. The grafts were observed for any sign of resorption over 1 to 6 months.Grossly, injection and transplantation sites were palpable at the end of the observation periods. Microscopic examination showed that injected fascia maintains its histomorphologic structure. These findings indicate that the injected fascia graft is well tolerated, and the size of the graft remained stable. According to this study, fascia injection can result in bulking material that gives a long-lasting improvement, and can be a viable alternative to other methods.

Adipose Tissue↗
PubMed2004

Time dependent variations in biomechanical properties of cadaveric fascia, porcine dermis, porcine small intestine submucosa, polypropylene mesh and autologous fascia in the rabbit model: implications for sling surgery.

PURPOSE: We investigated time dependent variations in tensile strength, stiffness, shrinkage and distortion in 6 materials commonly used for transvaginal anti-incontinence surgery. MATERIALS AND METHODS: A total of 15 rabbits were randomized into 3 survival groups (2, 6 and 12 weeks, respectively). Each rabbit had human cadaveric fascia, porcine dermis, porcine small intestine submucosa, polypropylene mesh and autologous fascia implanted on the anterior rectus fascia. At harvest tensiometry and image analysis were performed on each sling. Results were compared to baseline for each sling type and the percent decrease from baseline was compared among sling types. RESULTS: Each type of human cadaveric fascia and porcine allografts showed a marked decrease (60% to 89%) in tensile strength and stiffness from baseline. Polypropylene mesh and autologous fascia did not differ in tensile strength from baseline. Polypropylene mesh increased in stiffness from baseline. Autologous fascia and small intestinal submucosa demonstrated a 41% and 50% decrease in surface area, respectively, at 12 weeks. CONCLUSIONS: To our knowledge the relative contribution of biomechanical properties of sling material to the success of anti-incontinence surgery is unknown. However, rapid loss of tensile strength and stiffness in porcine and cadaveric materials may contribute to the early re-emergence of symptoms following successful sling surgery. The results of this study add scientific validity to the increasing use of synthetics in anti-incontinence surgery. Urologists selecting a sling material should be aware of its time dependent biomechanical fate relative to other sling materials.

Animals↗
PubMed1985

Morphometric study of fat cell size in the fascia areolaris and fascia lamellaris of the inguinal region in men, women and pregnant women.

The fat cells of the fascia areolaris and fascia lamellaris of men, women, and pregnant women (aged between 20 and 35a) were morphometrically studied. The cell volumes showed the following average values: 4.423 X 10(5) micron3 and 2.004 X 10(5) micron3 for the fasciae areolaris and lamellaris respectively, in men; 6.236 X 10(5) micron3 and 3.964 X 10(5) micron3 in women, and 10.114 X 10(5) micron3 and 4.635 X 10(5) micron3 in the pregnant women. The analysis of variance showed significant differences between both sexes, and fasciae areolaris and lamellaris. The differences between women and pregnant women as far as the cell volume is concerned, in both fasciae, were not significant. As to the fascia areolaris, not the lamellaris, the difference between the sexes was significant.

Adipose Tissue↗
PubMed1984

Ultrastructural and morphometric study on fat cells of the so called subcutaneous "fascia areolaris" and "fascia lamelaris" in the human inguinal region.

The fat cells of the so called fascia areolaris and fascia lamelaris (Velpeau 1834; Sterzi 1910) of men and women (aged from 20 to 35 years) were ultrastructural and morphometrically (cell volume) studied. No noteworthy submicroscopic difference was observed between fascias. The cell volumes obtained from planimetric measures showed the following values: 3.770 X 10(5) microns and 2.497 X 10(5) microns in the fascia aerolaris and lamelaris of men, respectively. For the women the values were: 7.222 X 10(5) microns and 5.025 X 10(5) microns (Fig. 3). The analysis of variance shows significant differences between the sexes and between fascia areolaris and lamelaris. The difference between the fascias supports the Sterzi's (1910) description on the tela subcutanea as being formed by those two distinct layers.

Adipose Tissue↗
PubMed1997

Fascia lata in penile reconstructive surgery: a reappraisal of the fascia lata graft.

Various surgical techniques and innovations have been applied to manage complex penile deformities. As an adjunct to penile reconstructive surgery, use of fascia lata, the superficial connective tissue structure of the thigh, may also be considered. Herein, four case reports are described in which fascia lata was applied: penile deformity associated with multiple unsuccessful penile prosthesis surgeries; penile prosthesis migration after phalloplasty; partial penile loss after ablative penile cancer surgery; and penile fibromatosis (Peyronie's disease). Fascia lata was autogenously obtained from the lateral thigh in all cases and used for, respectively, corporoplasty, penile prosthesis fixation, penile elongation, and tunica albuginea grafting. Surgeries were successful in every instance, and each patient reported satisfactory neophallic appearance and function postoperatively. The functional anatomy of the fascia lata was investigated further with lower extremity cadaveric dissections. For penile reconstructive surgery, fascia lata offers an autogenous source, it can be expeditiously obtained causing minimal morbidity, and it serves as a viable graft material with good tensile strength. Its application derives from, and may extend to, other reconstructive surgeries.

Adult↗
PubMed2004

The repair of cerebrospinal fluid rhinorrhea: comparison of histopathologic findings with cadaveric human temporal fascia, dura mater, and autologous fascia in a rabbit model.

OBJECTIVES: To evaluate the repair of cerebrospinal fluid rhinorrhea through the transnasal approach, we investigated histopathologic findings of grafting with human temporalis fascia and dura mater in a rabbit model. DESIGN AND METHODS: Thirty-two rabbits were assigned to three groups according to the graft material to be used: human dura mater, human temporalis fascia, and autologous muscle fascia (control group). The repair of the surgically induced bony opening was performed via the transnasal approach. To evaluate healing process histopathologically, decapitation was performed at the end of 1, 2, 3, and 4 weeks in the control group; 1, 2, 3, 4, 32 and 40 weeks in the dura mater group; 4, 32 and 40 weeks in the temporalis fascia group. RESULTS: Macroscopically, adhesions to the cerebral cortex were not observed with any of the grafts. Histopathologically, complete healing occurred in four weeks in the control group. Healing took longer in both cadaveric graft groups, in which formation of giant cells was the most prominent feature at the end of four weeks, suggesting a late rejection. Nevertheless, these cells disappeared and complete resolution was observed at the end of 32 and 40 weeks. Despite prolonged healing, no adverse clinical effects were observed. CONCLUSION: This experimental model showed that human temporalis fascia can be used instead of dura mater in the repair of cerebrospinal fluid rhinorrhea.

Animals↗
PubMed1992

Histological comparison of autogenous canine fascia lata, Gore-Tex, lyophilized human fascia lata, and autogenous canine vein for vascular patch graft material in a canine arteriotomy model.

Autogenous fascia lata has found little clinical use as a vascular patch graft material. Previous experience, however, suggests that it possesses attributes that might make it useful in this regard. To assess its efficacy as a vascular patch graft, nine adult mongrel dogs each underwent four arteriotomies with placements of patch grafts. The four sites included both carotid arteries and both femoral arteries. In each animal, one of four patch graft materials (autogenous canine fascia lata, Gore-Tex, lyophilized human fascia lata, and autogenous canine vein) were placed as patch material at the arteriotomy site utilizing 7-0 running sutures and loop magnification. The site for placement of each graft material was rotated serially in the animals so that each site would have equal numbers of all four graft materials applied. The animals were killed at either 6 to 8 weeks or 11 to 12 weeks after angiography of all four vessels. The specimens were then evaluated histologically. No difference was observed among any of the patch graft materials with regard to myofibroblast plaque formation. Inflammatory responses were noted to be substantially less in the canine fascia lata group than in the other three groups. Granuloma formation, however, appeared to be most significant in the autogenous canine vein group. Only one vessel was occluded. Aneurysm or pseudoaneurysm formation was not noted in any specimen. It appears from the above results that autogenous fascia lata may be an appropriate alternative to currently utilized arterial patch graft materials and that it should be evaluated further for this purpose.

Animals↗
PubMed1976

Repair of abdominal and thoracic wall defects by bovine fascia (ox fascia).

Sheets of heterologous fascia (bovine fascia) were used to close large defects of the thoracic and abdominal wall in four patients with malignant neoplasms. The material was well tolerated by the body and provided adequate protection and support to the underlying viscera. Although the fascial graft was not covered by skin flaps in two patients with abdominal wall defects, it became readily incorporated into granulation tissue that was receptive to split thickness skin grafts. The fascia was used successfully in a contaminated field and control of active infection was possible without removing the graft. These findings demonstrate that heterologous fascia is particularly useful under conditions that are not suitable for the use of synthetic materials.

Abdominal Neoplasms↗
PubMed1992

Extrusion of enucleation implants: treatment with secondary implants and autogenous temporalis fascia or fascia lata patch grafts.

We performed one autogenous fascia lata graft and 11 autogenous temporalis fascia grafts in eight patients with extrusion of an orbital enucleation implant and in four patients with a bulging implant who could not wear a prosthesis. Excluding one patient with inadequate follow up, 10 of the 11 patients (91%) successfully retained their implant. One patient had severe conjunctivitis followed by anterior migration of his implant 2 1/2 years after patch grafting, necessitating replacement of the implant. We conclude that autogenous temporalis fascia patch grafting is an effective treatment for orbital enucleation implant extrusion or a bulging implant.

Adolescent↗
PubMed2005

Comparison of long-term outcomes of autologous fascia lata slings with Suspend Tutoplast fascia lata allograft slings for stress incontinence.

OBJECTIVE: This study was undertaken to compare the objective and subjective long-term surgical outcomes in patients receiving Tutoplast fascia lata allograft slings with those receiving autograft slings for the treatment of stress urinary incontinence (SUI). STUDY DESIGN: We reviewed all patients (n = 71) undergoing suburethral sling with either autologous fascia lata (n = 39) or Tutoplast fascia lata (n = 32) for urodynamic stress incontinence (USI) from October 1, 1998, to August 1, 2001. RESULTS: Of the original 71 patients, 47 were evaluated by objective and/or subjective means at a minimum of 2 years after surgery. Subjective quality of life measures, subjective continence, maximum urethral closure pressure, and bladder neck mobility were not different between the 2 groups. USI was demonstrated in 41.7% of allograft patients compared with no autograft patients (P = .007). CONCLUSION: Although patient reported cure of SUI is high for both sling types, USI recurs at a significantly higher rate in Tutoplast slings compared with autologous slings.

Aged↗
PubMed2000

Tensor fasciae latae perforator flap for reconstruction of composite Achilles tendon defects with skin and vascularized fascia.

The surgical management of large defects of the Achilles tendon and overlying skin is very demanding and necessitates, as a rule, a free vascularized graft. The ideal characteristics of a thin layer of skin and a strong tendon component, combined with a reliable blood supply and minimal morbidity at the donor site, have only been partially met by all previous grafts used in this situation. The authors performed reconstructions in five patients with large defects of the Achilles tendon and overlying skin by using a perforator flap derived from the tensor fasciae latae flap. A vascularized skin-subcutis-fascia lata flap could be raised by dissecting out two to three perforating arteries through the tensor fasciae latae muscle to the ascending branch of the lateral circumflex femoral artery; the muscle was left in situ in the process. All the flaps took well without complications. At final examination after an average of 20 months, the reconstructed Achilles tendon showed good functional results, although there was a 50 to 70 percent reduction in power during plantar flexion when compared with the normal side. A very good aesthetic result could be obtained after a debulking operation was performed on the skin flap.

Achilles Tendon↗
PubMed1987

Reconstruction of soft tissue defects including the Achilles tendon with free neurovascular tensor fascia lata flap and fascia lata. Case report.

The combined loss of the Achilles tendon and the overlying soft tissue in the young ambulant patient with expectations of a normal life is a challenge. These patients need not only skin coverage but also dynamic, functioning repair. Two cases of major defects after tumour resection are presented. In each case the tendon was reconstructed using the remaining gastrocnemius aponeurosis reinforced with fascia lata. This was covered by a free tensor fascia lata (TFL) flap. In one of the cases the flap was transferred as a neurovascular free flap.

Achilles Tendon↗
PubMed2005

A single tensor fasciae latae musculocutaneous and fascia flap for composite reconstruction of urogenital and groin defect.

The tensor fasciae latae flap is a well known musculocutaneous flap used for many indications in the field of plastic surgery. The flap has some modifications to fit different reconstructive requirements of the defects. Osseous-muscle flap, osseous musculocutaneous flap, muscle flap, muscle-fascial flap and musculocutaneous-fasciocutaneous flap are some known alternatives. We used a modification of this well-known flap as musculocutaneous and fascia flap for a composite reconstruction of groin and urogenital defect. We reconstructed the groin defect with musculocutaneous part of the flap, and the defect over neourethra with the fascial extension and grafting. The aim of this modification was to reconstruct a genital defect with a thin and more pliable tissue to overcome the problem of distortion, kinking and thickness of the flap.

Adult↗
PubMed2006

Comparison of autologous rectus fascia and cadaveric fascia in pubovaginal sling continence outcomes.

OBJECTIVE: The purpose of this study was to compare autologous versus cadaveric grafts in pubovaginal slings. STUDY DESIGN: Women who had pubovaginal slings from 1994 to 2003 completed history, questionnaires, prolapse staging, and cough stress testing. Failure was defined by recurrent urinary incontinence symptoms and reoperation for stress incontinence. Group differences were evaluated using Student t test or chi-square test. The log-rank test was used to evaluate time to failure between the groups. RESULTS: Of 303 women enrolled, 153 had autologous and 150 had cadaveric grafts. Regular urine leakage (39.6% vs 28.3%, P = .04) and reoperation for stress incontinence (12.7% vs 3.3%, P = .003) occurred more in the cadaveric versus autologous group, respectively. Adjusting for differing follow-up times, the cadaveric versus autologous group experienced higher rates of urinary incontinence (16 vs 5 per 100 women-years, P < .0001) and higher rates of reoperation (4 vs 1 per 100 women-years, P < .0003). CONCLUSION: Autologous grafts used in pubovaginal slings have superior continence outcomes compared with cadaveric fascia.

Aged↗