[Cosmetic facial surgery: a bird's eye view]. / Cosmetische aangezichtschirurgie in vogelvlucht.

Surgical procedures that rejuvenate and/or harmonize the face are known for their long-lasting and clinically relevant positive effects on the psychological well-being and quality of life of the client. Despite the popularity of cosmetic injectables, facelift surgery remains the most powerful and durable treatment for restoring aging symptoms, especially in the female face. Skin correction of the upper eyelids is the most commonly performed aesthetic facial surgery. This article provides an overview of the most important cosmetic surgical procedures for the face, focusing on the facelift, neck lift, forehead lift, upper and lower eyelid correction, subnasal lip lift and rhinoplasty. The indications, contraindications, treatment techniques, advantages and disadvantages are explained. Due to the increasing demand for cosmetic treatments, it is important that dentists and oral and maxillofacial surgeons have knowledge of these procedures in order to provide optimal information, referral or treatment when desired.

The treatment of soft-tissue defects of the lower leg after a traumatic open tibial fracture.

The treatment of large soft-tissue defects of the lower leg remains a challenge. The timing of the operation, the most suitable type of tissue, and the decision between local or free flap coverage still remains under discussion. Fifty-two patients were treated with local or free flap coverage after a traumatic soft-tissue defect of the lower leg. We compared the results after treatment with local versus free flaps and fasciocutaneous flaps versus musculocutaneous flaps. In the case of primary reconstruction, we also compared the results regarding the timing of the operation: patients treated within 72 h after the trauma versus patients treated after 72 h. Thirty-five patients (67%) have been treated because of posttraumatic soft-tissue defects and, therefore, insufficient fracture coverage. Seventeen patients (33%) were treated because of a chronic osteomyelitis that arose after the trauma. In our study, we did not find a statistically significant difference between the postoperative complications of local and free flaps. A significant increase could be demonstrated in the number of revisions after treatment with a free flap. Treatment with a fasciocutaneous flap in the entire study group was associated with significantly more postoperative complications than treatment with a musculocutaneous flap. There was no significant difference in results after early or late flap coverage. Patients treated with local or free flaps achieved equal outcomes, except for the number of postoperative revisions in which local flaps required lesser revisions. Treatment with a musculocutaneous flap is preferable to treatment with a fasciocutaneous flap regarding postoperative complications. The timing of operation proved not to be a discriminating factor.

Comparison of arterial and venous patency in a rat model of subendothelium-stimulated thrombosis.

The effectiveness of anticoagulants and platelet aggregation inhibitors was compared using comparable rat models of arterial and venous thrombosis. A mechanical endothelium-denuding injury was created on the lumenal surface of donor Lewis rat carotid arteries. These were cut into 4-5 mm lengths and grafted into femoral veins and arteries of recipient syngeneic rats using microvascular anastomotic techniques. Recipients received either systemic heparin, or aspirin with dipyridamole, or saline (control). In the arteries, the 1-day patency rate was 94% in the heparin-treated rats, but only 50% in the aspirin/dipyridamole group and 44% in the control group. The venous patency rate was 56% in the heparin group, 31% in the aspirin/dipyridamole group, and 0% in the control group. This unique model for comparing thrombosis in arteries and veins shows that anticoagulation is more effective than inhibition of platelet aggregation in the rat arterial system, with less of a differential effect in the venous system.

Tannic acid as a topical agent in burns: historical considerations and implications for new developments.

The usage of tannic acid (TA) as a topical agent in burns in the past and the present is described. Its introduction by Davidson in 1925 led to the widespread use of TA. The high infection risk during times of war and reports of liver damage after application of high doses of undefined TA mixtures brought discredit to the TA treatment. German and Chinese authors have been able to refute these claims and propagate a safe therapeutic regimen. Recent animal experimental and clinical investigations confirm the many advantages: pain reduction, rapid haemodynamic stabilization, delayed primary excision, early mobilization and good cosmetic results.

A comparative burn wound model in the New Yorkshire pig for the histopathological evaluation of local therapeutic regimens: silver sulfadiazine cream as a standard.

A standard burn wound model was developed in the pig to enable evaluation of histopathological parameters of wound healing under different circumstances. Wounds on one flank were treated with silver sulfadiazine 1% cream (SSD, Flammazine-Duphar), which is a standard treatment. On identical places of the contralateral side different topical agents were applied. From the SSD treated burns a typical histopathologic picture of wound healing under SSD could be derived: SSD has the potential to preserve viable dermal tissue, epidermal regeneration is rather slow and irritated, while the formation of granulation tissue is pronounced, with an abundance of myofibroblasts.