ABSTRACT
Background: Symblepharon occurs as chronic sequelae of severe chemical injuries. The risk of recurrence is high due to unpredictable wound healing of conjunctiva and tenons following excision in young patients. Gore-tex aids in prevention of the recurrence of pterygium 1. Purpose: To present a surgical video on role of Gore-tex in grade 4 Symblepharon lysis. Synopsis: A 28-year-old male with a previous history of Grade 4 chemical injury presented with symblepharon and total obliteration of both upper and lower fornices after one year in the right eye. He underwent symblepharon lysis, Living related conjunctival allograft, Amniotic membrane graft and Gore-tex. The video explains the surgical steps in detail. A 360-degree complete peritomy was done, Symblepharon was released from the corneal surface, and the fibrotic tissue was extensively dissected away from the corneal surface and released into the fornix. Further, cryopreserved AMG was placed over the entire raw ocular surface and sutured to the episclera with glue. Prepared Gore- tex was placed on the superior and inferior fornix and sutured with 10-0 nylon suture. Again, AMG was placed over the Gore-tex in the fornices and covered with glue. A small 2x2mm biopsy of limbal stem cells from the superior limbus was already excised from the fellow eye (CLAG) and then Lr-CLAL was prepared from the patient’s mother. These two grafts were placed on the nasal and temporal bulbar surface over the AMG and sutured to the underlying AMG and the episclera with glue. The entire surface was then covered with the AMG to promote epithelisation. At one month postoperative period, patient had stable ocular surface with intact Limbal conjunctival graft with mild conjunctival recurrence of fibrosis superiorly. Highlights: The video clearly explains the surgical steps of Symblepharon and the benefits of using Gore-tex.
ABSTRACT
The resultant dysphonia and aspiration in unilateral vocal cord palsy can be overcome with medialisation thyroplasty. With this background, we aim to determine the aetiology of the unilateral vocal cord palsy and effectiveness of the phonosurgical procedure with Gore-Tex as a sole treatment. Methods: Within a seven year period, 37 Gore-Tex medialisation thyroplasty were performed for unilateral vocal cord palsy at our institution and medical records were retrospectively reviewed. Results: There were 18 males and 19 females with mean age of 48.7 years (range 19–81 years). The predominant aetiology was thyroidectomy (43.2%) with benign thyroid disease predominates (n=13) over thyroid malignancy (n=3). Voice outcome was evaluated subjectively using visual analogue scoring system, results indicating that Gore-Tex medialisation thyroplasty was effective in addressing dysphonia in 62.5% (n=15) patients. However it alone cannot address aspiration seen in those with high vagal nerve lesion. Airway compromise occurred in two cases postoperatively (5.4%) presenting as acute stridor. Conclusion: In unilateral vocal cord palsy, Gore-Tex medialisation thyroplasty can effectively improve the resultant dysphonia and often accompanying aspiration which would otherwise be disabling for the patients.
ABSTRACT
Introduction Although medialization thyroplasty utilizing Gore-Tex (Gore and Associates, Newark, Delaware, United States) has been discussed in the literature, few reports have assessed voice quality afterward, and they did not use a full assessment protocol. Objective To assess the improvement in voice quality after medialization thyroplasty utilizing Gore-Tex in patients with glottic insufficiency of variable etiology. Methods Eleven patients with glottic insufficiency of different etiologies that failed compensation were operated by type 1 thyroplasty utilizing Gore-Tex. Pre- and postoperative (1 week, 3 months, and 6 months) voice assessment was done and statistical analysis was performed on the results. Results In all postoperative assessments, there was significant improvement in the grade of dysphonia (p < 0.004) and highly significant reduction in the size of glottic gap and prolongation of maximum phonation time (p < 0.0001). The difference in voice parameters in the early (1 week) and the late (3 and 6months) postoperative period was not significant. None of the patients developed stridor or shortness of breath necessitating tracheotomy, and there was no implant extrusion in any patient during the study period. Conclusion Gore-Tex medialization provides reliable results for both subjective and objective voice parameters. It leads to a satisfactory restoration of voice whatever the etiology of glottic incompetence is. This technique is relatively easy and does not lead to major complications. Further studies with larger number of patients andmore extended periods of follow-up are still required to assess the long-term results of the technique regarding voice quality and implant extrusion.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Dysphonia/etiology , Voice Disorders/rehabilitation , Endocrine Surgical Procedures , Signs and Symptoms , VoiceABSTRACT
OBJETIVO: evaluar los resultados terapéuticos en la corrección quirúrgica de afecciones oculares, con el uso del Gore-tex y con la modificación realizada a la técnica quirúrgica convencional de la suspensión al frontal. MÉTODOS: se realizó un estudio descriptivo prospectivo en una serie de 16 casos: 7 con ptosis, 5 con estrabismo y 4 con retracción palpebral inferior. Para la corrección de la retracción y la ptosis se utilizaron fragmentos del referido material y una sutura de Gore-tex en la corrección del estrabismo y en algunos casos con ptosis. Se colocaron 2 mm de Gore-tex por cada milímetro de retracción y de ptosis palpebral. Se corrigieron 2 dioptrías prismáticas por cada milímetro de retroinserción del músculo afectado. RESULTADOS: fueron satisfactorios en un total de 13 casos (87 %). La mayoría de los pacientes operados con la modificación realizada a la técnica de la suspensión al frontal disminuyeron los mm de caída hasta el nivel fisiológico palpebral. CONCLUSIONES: los resultados son satisfactorios en la mayoría de los casos operados con el uso del Gore-tex y con la técnica de suspensión al frontal modificada. .
OBJECTIVE: to evaluate the therapeutic results in the surgical correction of eye illnesses, with Gore-tex and with the modified conventional surgical technique of the frontalis suspension. METHODS: prospective and descriptive study in a series of 16 cases; 7 with ptosis, 5 with strabismus and 4 with inferior palpebral retraction. For the correction of the retraction and the ptosis, some Gore-tex fragments were used, and suture with this material for correction of strabismus and in some cases with ptosis. Two Gore-tex mm were placed per each mm of retraction and ptosis. Two prismatic dioptries were corrected per each mm of retroinsertion of the frontalis muscle. RESULTS: a total of 13 cases (87 %) had satisfactory results. Most of the patients operated on with the modified frontal suspension technique, reduced the amount of ptosis mm up to the palpebral physiological level. CONCLUSIONS: the results were satisfactory in most of the operated patients by using the Gore-tex and the modified frontalis suspension technique.
Subject(s)
Humans , Patents as Topic , Blepharoptosis/surgery , Duane Retraction Syndrome , Strabismus/surgery , Epidemiology, Descriptive , Prospective StudiesABSTRACT
Subject(s)
Female , Humans , Alveolar Bone Loss , Alveolar Process , Alveolar Ridge Augmentation , Bone Regeneration , Dentistry , Inlays , Mandible , Osteoblasts , Osteogenesis , Osteogenesis, Distraction , Polytetrafluoroethylene , Titanium , TransplantsABSTRACT
BACKGROUND AND OBJECTIVES: Gore-Tex is a popular graft material used in rhinoplasty. But there are several complications such as infection, seroma, and persistent swelling. Infection is the most common complication. The aim of this study was the evaluation of various protocols for Gore-Tex decontamination. SUBJECTS AND METHOD: Gore-Tex specimens were sectioned and separated into six groups. These were treated with povidone-iodine or antibiotics solution. Nasal cavity swab was performed both in the control group and patient group of chronic sinusitis. The culture of swab specimens incubated in agar plates were compared statistically. RESULTS: Povidone-iodine groups revealed significant decrease in the bacterial colony counts. CONCLUSION: The results suggested that impregnation of povidone-iodine supports the efficacy of decontamination Gore-Tex Implant.
Subject(s)
Humans , Agar , Anti-Bacterial Agents , Decontamination , Nasal Cavity , Polytetrafluoroethylene , Povidone-Iodine , Rhinoplasty , Seroma , Sinusitis , TransplantsABSTRACT
PURPOSE: Infection, foreign body reaction and decreased volume of implant are common complications after augmentation rhinoplasty with Gore-tex(R) implant. The author experienced two cases of recurrent foreign body granuloma in the patients who underwent Gore-tex(R) removal because of infection after augmentation rhinoplasty. and treated them with complete removal of Gore-tex(R). METHODS: Case 1: A 49 year-old female visited our clinic for recurrent foreign body reaction on nasal dorsum and tip area. The patient underwent augmentation rhinoplasty with Gore-tex(R) 3 years ago and implant was removed due to infection 9 months ago. Excision of the granuloma was performed and a piece of foreign body suspicious to be a Gore-tex(R) implant debris was detected under the subcutaneous pocket. The implant fragments were removed and nasalis muscle rotation flap was performed to cover the lesion. The specimen was proved to be Gore-tex(R) in histological study. Case 2: A 31 year-old-male with recurrent foreign body granuloma on the nasal tip area visited our clinic. 10 years ago, the patient had augmentation rhinoplasty with silicone implant and then, he underwent revisional rhinoplasty five times including nasal implant removal, which was performed 9 months ago. The authors excised the granuloma and found a small sized foreign body suspicious to be a Gore-tex(R) implant debris under the granuloma. The foreign body was excised and identified to be Gore-tex(R) in histological study. RESULTS: In both cases, the lesions were healed without any complications and there were no evidences of recurrence up to 6 months of follow-up. CONCLUSION: The Gore-tex(R) is known to be weak against mechanical force. These properties of Gore-tex(R) make it difficult to remove the implant completely. In the patient who have infection after augmentation rhinoplasty with Gore-tex(R), the operator should take care to perform the complete removal without remaining fragment of the implant.
Subject(s)
Female , Humans , Follow-Up Studies , Foreign Bodies , Foreign-Body Reaction , Granuloma , Granuloma, Foreign-Body , Muscles , Recurrence , Rhinoplasty , SiliconesABSTRACT
Recurrence of cervical cancer at a skin incision site is uncommon. We met a patient who received an incomplete operation for cervical cancer and she was transferred to our hospital. When she underwent the first operation she was misdiagnosed as having a benign uterine mass and she received an abdominal total hysterectomy. But the postoperative pathologic finding was cervical cancer. Therefore she was then referred for postoperative cisplatin-5FU concurrent chemo-radiotherapy. Five months after the concurrent chemo-radiotherapy, one solitary metastatic mass was found in the abdominal scar. We performed wide excision. The fascia defect at the excision site was so wide we could not perform the primary closure. Therefore, we used a polytetrafluoroethylene (Gore-Tex(R)) patch as a fascia substitute and we reconstructed the abdominal wall with a fasciocutaneous flap. Then she received cisplatin concurrent chemo-radiation therapy.
Subject(s)
Humans , Abdominal Wall , Cicatrix , Cisplatin , Fascia , Hysterectomy , Polytetrafluoroethylene , Skin , Uterine Cervical NeoplasmsABSTRACT
BACKGROUND AND OBJECTIVES: For nasal augmentation surgery, several materials have been used. Porous material, expanded polytetrafluoroethylene (Gore-Tex(R)) contains numerous pores which allow stability of the implant, but this advantage has been tempered by unpredictable outcomes. The purpose of this study is to evaluate morphological and histological changes of reinforced Gore-Tex(R) in the rabbit model. MATERIALS AND METHOD: Twenty New Zealand white rabbits were used. The reinforced Gore-Tex(R) block was implanted in the nasal dorsum. According to the duration of implantation, rabbits were divided into four groups such as 1, 3, 6 and 12 months. The animals were grossly examined with respect to the status of the Gore-Tex(R). We evaluated the three-dimensional size of the implants over time and used light and electron microscopy to investigate the histological changes associated with the whole tissue blocks. RESULTS: Grossly, none of the implants was lost or extruded and there was no evidence of wound infection. Diminution rates of thickness, width and height in the implants were respectively 16.7%, 7.5%, and 3.5%. Histologically, the growth of connective tissue was observed in all specimens and internodal space was decreased by connective tissue ingrowth as time goes on. Neovascularization was observed in the groups for which duration was longer than 6 months, and degenerative changes were also observed in the groups over 6 month of implanted duration. CONCLUSION: The reinforced e-PTFE should be carefully trimmed because of the possibility of decreasing size over time. And additional studies are needed to further investigate the stability of Gore-Tex(R).
Subject(s)
Animals , Rabbits , Connective Tissue , Imidazoles , Light , Microscopy, Electron , Nitro Compounds , Polytetrafluoroethylene , Reinforcement, Psychology , Rhinoplasty , Wound InfectionABSTRACT
Many allograft materials have been used for performing augmentation rhinoplasty. But in cases involving complications such as infection, inflammation and foreign body reaction, these should be removed and replaced with an autograft material which is more suitable for revision surgery. Frequently, the use of autograft materials, including bone and cartilage, are restricted by many limitations such as unavailability, insufficiency in volume, and resorption. By using the dermofat, however, we achieved good surgical results in revision rhinoplasty from the aspect of volume and donor site morbidity. Thus, we report this case with a review of the literature.
Subject(s)
Humans , Allografts , Autografts , Cartilage , Follow-Up Studies , Foreign-Body Reaction , Inflammation , Polytetrafluoroethylene , Reoperation , Rhinoplasty , Tissue Donors , TransplantsABSTRACT
Augmentation rhinoplasty is one of the most popular aesthetic procedure in Asians. Numerous alloplastic implants have been used until now, but no accurate comparative analysis about the implant materials has been reported yet. This study in animal model was designed to determine the safety and effectiveness of various implant materials in augmentation rhinoplasty. The 15 x 15 x 2 mm sized square shaped plate of Gore-Tex(R), silicone rubber, and 15 x 15 x 1.5 mm sized Medpor(R) were implanted under panniculus carnosus of the abdomen wall of rat. And tissue specimens including the implant and surrounding soft tissue were obtained by en bloc excision in 6 months after implantation. The implants were estimated in weight and volume, and also the specimens were examined grossly and microscopically. The results revealed that increase of average weight 26.9%, decrease of average volume 55.4% in Gore-Tex(R) implant, increase of each average weight and volume 62.6%, 8.7% in Medpor(R) implant and very slight increase of both average weight and volume 4.7%, 1.1% in silicone rubber implant. Grossly, the Gore-Tex(R) was deformed, Medpor(R) was strongly adherent to surrounding soft tissue and the silicone rubber was well encapsulated and easily peeled off. Microscopically, silicone rubber showed foreign body reaction slightly and there were no inflammatory responses in all alloplastic implants. In our study, silicone rubber showed very proper alloplastic features for augmentation rhinoplasty due to causing no inflammatory response, no physical change, and no deformity.
Subject(s)
Animals , Humans , Rats , Abdomen , Asian People , Congenital Abnormalities , Foreign-Body Reaction , Models, Animal , Rhinoplasty , Silicone ElastomersABSTRACT
As the large defect of peripheral nerve occurs, the autologous nerve graft is the most ideal method but it has many limitations due to donor site morbidities. Various materials have been developed for the nerve defect as the conduits, but none of these materials is satisfactory. Among them, Gore-Tex(R) tube seems to be one of the most ideal nerve conduit materials at peripheral nerve defect. Many researches have focused on finding the neurotrophic factors. It is recently demonstrated that Valproic acid(VPA) has an effect of axonal regeneration as a neurotrophic factor without enzymatic degradation and toxicity problems. The purpose of this study is to evaluate the effect of VPA on the nerve regeneration at the peripheral nerve defect. A 10 mm gap of rat sciatic nerve was made and Gore-Tex(R) tube filled with biceps femoris muscle was placed at the nerve defect site. We let the rat take VPA as drinking water in experimental group and did not give VPA to the control group. We estimated the results as electrophysiologic and histological aspects for 16 weeks after the surgery. The nerve conduction velocity, total myelinated axon count, myelin sheath thickness and mean nerve fiber diameter significantly increased in VPA-treated experimental group when compared to the control (p < 0.05). From the above results, we conclude that VPA promotes the nerve regeneration at the peripheral nerve defect site. It is suggested that Gore-Tex(R) tube filled with skeletal muscle and VPA administration may be a good substitute for autologous nerve graft.
Subject(s)
Animals , Humans , Rats , Axons , Drinking Water , Linear Energy Transfer , Muscle, Skeletal , Myelin Sheath , Nerve Fibers , Nerve Growth Factors , Nerve Regeneration , Neural Conduction , Peripheral Nerves , Regeneration , Sciatic Nerve , Tissue Donors , Transplants , Valproic AcidABSTRACT
When a large peripheral nerve defect occurs, an autologous nerve graft is the most ideal method of recinstruction. But an autologous nerve graft has many limitations due to donor site morbidities. Many previous focused on finding the ideal nerve conduit. Among them, Gore-Tex(R) has several advantages over other conduits. It can be manipulated to a suitable size, does not collapse easily, and it is a semi- permeable material that contain pores. A round shaped nerve can be newly formed because of its smooth inner surface. The purpose of this study was to evaluate the availability of Gore-Tex(R) tube as a nerve conduit at the peripheral nerve defect in the rat sciatic nerve. The 10 mm nerve gap was made in each group. A Gore-Tex(R) tube filled with skeletal muscle was inserted and autologous nerve graft was harvested, respectively. In the experimental group, we placed a 0.5mm thickness, 30micrometer pored, 1.8mm in diameter and 14mm length tube with skeletal muscle inserted inside. In the control group, the nerve gap was inserted with a rat sciatic nerve. We estimated the results electrophysiologically and histologically to 16 weeks postoperatively. Results in the nerve conduction velocity, total myelinated axon count, myelin sheath thickness and mean nerve fiber diameter, the experimental group was substantially lower than that of the control group, but the statistic difference was not significant (p<0.05). The morphology was very similar in both groups, microscopically. From the above results, We conclude that Gore-Tex(R) qualifies as an ideal nerve conduit. It is suggested that Gore-Tex(R) tube filled with skeletal muscle may, substitute for an autologous nerve graft.
Subject(s)
Animals , Humans , Rats , Axons , Muscle, Skeletal , Myelin Sheath , Nerve Fibers , Neural Conduction , Peripheral Nerves , Sciatic Nerve , Tissue Donors , TransplantsABSTRACT
The lateral capsular ligament of temporomandibular joint(TMJ) prevents mandibular condyle from lateral displacement in case of fractures related with condyle. When the condylar fracture with lateral extracapsular displacement occurs, open reduction and reconstruction of capsular ligament must be considered. However, many patients exhibit limitation of functional movements of the TMJ after such surgery. This may be a result of myositis, myospasm, fibrosis of bilaminar zone, adhesion of TMJ capsule. When the joint problem occurs, non surgical treatment must be attempted firstly. But if it fails, the surgical reconstruction must be considered. We reconstructed the lateral capsular ligament of TMJ with E- PTFE(Expanded Polytetrafluoroethylene, Gore-tex(R)) patch after removing scar tissues and adhesions. This surgical method showed improvements in movement as well as the pain of the joint. No side effect has detected from occlusion for about 2 years. There was no foreign body reaction or irritation to the capsule, since E-PTFE was biologically inert. We believe that the E-PTFE patch could be used as primary material of capsular ligament of TMJ reconstruction, insertion material in high tensioned capsule and reinforcement material in weakened capsule.
Subject(s)
Humans , Cicatrix , Fibrosis , Foreign-Body Reaction , Joints , Ligaments , Mandibular Condyle , Myositis , Polytetrafluoroethylene , Temporomandibular JointABSTRACT
Augmentation rhinoplasty is one of the most popular aesthetic procedures in Asians. Numerous alloplastic implants have been used, however alloplastic implants may cause many problems in nasal and perinasal areas because of thin soft tissue cover. For these reasons, an ideal implant should be nonpalpable, readily exchangeable and biocompatible. Among these alloplastic implants, Gore-Tex(R) is a polymer of carbon bound to fluorine composed of solid nodes connected by very fine fibers. It has been reported that this material become permeated and surrounded by mature connective tissue, forming a strong supporting envelop for the material, yet the implant is easily removed because of limited tissue ingrowth. Since it's development, Gore-Tex(R) has found many applications in the field of facial plastic and reconstructive surgery. From November, 2001 to December, 2002, Gore-Tex(R) implants were removed from 17 patients due to several problems such as; decreased dorsal height, tip deformity, chronic inflammation. The implants were very hard to remove and coinciding injury of the surrounding tissue were inevitable. An analysis of the length and thickness changes in these removed implants was made. The results showed, decrease in length and thickness with a volume loss averaging, 46.3% in 45x4.0mm implants, 49.3% in 50x5.0mm implants. In view of the experiences of 17 cases of Gore-Tex(R) implants in rhinoplasty, we have concluded that Gore-Tex(R) implants were structurally unstable, fibrovascular tissue ingrowth into pores were minimal, the implants were very hard to remove and the implants caused a postoperative volume reduction. Therefore, Gore-Tex(R) use in augmentation rhinoplasty should be approached with caution.
Subject(s)
Humans , Asian People , Carbon , Congenital Abnormalities , Connective Tissue , Fluorine , Inflammation , Plastics , Polymers , Polytetrafluoroethylene , RhinoplastyABSTRACT
Chitosan has been widely researched as bone substitution materials and membranes in orthopedic/periodontal applications. Chitosan nanofiber membrane was fabricated by chitosan nanofiber using electrospinning technique. The structure of the membrane is nonwoven, three-dimensional, porous, and nanoscale fiber-based matrix. The aim of this study was to evaluate the biocompatibility of chitosan nanofiber membrane and to evaluate its capacity of bone regeneration in rabbit calvarial defect. Ten mm diameter round cranial defects were made and covered by 2 kinds of membranes (Gore-Tex membrane, chitosan nanofiber membrane) in rabbits. Animals were sacrificed at 4 weeks after surgery. Decalcified specimens were prepared and observed by microscope. Chitosan nanofiber membrane maintained its shape and space at 4 weeks. No inflammatory cells were seen on the surface of the membrane. In calvarial defects, new bone bridges were formed at all defect areas and fused to original old bone. No distortion and resorption was observed in the grafted chitosan nanofiber membrane. However bone bridge formation and new bone formation at the center of the defect could not be seen in Gore-Tex membranes. It is concluded that the novel membrane made of chitosan nanofiber by electrospinning technique may be used as a possible tool for guided bone regeneration.
Subject(s)
Animals , Rabbits , Bone Regeneration , Chitosan , Membranes , Nanofibers , Osteogenesis , Polytetrafluoroethylene , TransplantsABSTRACT
BACKGROUND AND OBJECTIVES: This study was done to evaluate the safety of Gore-Tex as a nasal implant. Materials and METHOD: A retrospective multicenter study was carried out on 15 surgeons from 11 general hospitals and 4 private practice clinics regarding the safety of the Gore-Tex as a nasal implant. The study involved 853 patients, of whom 656 received primary surgery and 197 revision surgery. Gore-Tex was mainly used as a dorsal implant in a form of sheet or as a reinforced nasal implant. RESULTS: The overall complication rate associated with Gore-Tex was 2.5% (21 cases). Infection was the most common complication (18 cases ; 2.1%) followed by 2 cases of seroma and 1 case of persistent nasal swelling. In 19 out of 21 complication cases, the graft needed removal to control the infection or seroma (91% removal rate). Nine cases of infection developed in both primary cases (1.37%) and in revision cases (4.57%), which suggests a higher association rate between infection and revision cases (p=0.0062). Infection developed within 1 month in 5 cases while 9 cases developed infection after 6 months of operation. Other complications such as aesthetic problems (malpositioning of the implant or dorsal irregularities) were found in 15 cases (1.8%) and hematoma in 1 case. CONCLUSION: The infection rate of Gore-Tex used in rhinoplasty was about 2% and it rose significantly in the revision cases. If infected, almost all of the implanted Gore-Tex needs removal; therefore, we suggest judicious use of Gore-Tex in rhinoplasty.
Subject(s)
Humans , Hematoma , Hospitals, General , Polytetrafluoroethylene , Private Practice , Retrospective Studies , Rhinoplasty , Seroma , TransplantsABSTRACT
Various materials have been proposed for use in aesthetic and reconstructive augmentation of the face. Three basic types of material are currently available: autografts, homografts, and alloplasts. Alloplastic materials have been used widely for soft tissue augmentation. Many synthetic material have been developed for alloplasty; among these, the porous material, Gore-Tex(r)(ePTFE) allows minimal fibrous tissue ingrowth but the amount is sufficient to confer some stability of the implant in soft tissue over time. The purpose of this study is to evaluate the tissue reaction and size change of Gore-Tex in rabbits. A precise pockets were made in the plane below the panniculus carnosus and periosteum. The 25x5x3mm sized rectangular shape of Gore-Tex(r) was then inserted into the pocket. Tissue specimens including skin and implant were obtained in 1, 3, 6 months after implantation. The specimens were examined grossly and microscopically. Grossly, none of the implants were lost or extruded and there was no evidence of wound infection, hematoma, or seroma formation. Thickness of implants under periosteum decreased more than panniculus carnosus. Results of light microscopy revealed a mild inflammatory cell reaction in the early implant group(1 month) at the tissue-implant interface. Within the substance of the material, tissue ingrowth was not observed in the early implant group(1 month and 3 months), but was observed in the late implant group(6 months). In this study the Gore-Tex appears to be a safe and reliable substance for use in augmentation of bony and soft tissue structure of the face.
Subject(s)
Rabbits , Allografts , Autografts , Hematoma , Microscopy , Periosteum , Polytetrafluoroethylene , Seroma , Skin , Wound InfectionABSTRACT
To date, for facial soft tissue augmentation, numerous implant materials have been used, including autogenous, homogenous, and alloplastic grafts. Among these, the porous material, Gore-tex(R) has a pore (0.5-30 microns, average 22 microns) which allows sufficient but limited soft tissue ingrowth to anchor implants, but not so much to make removal difficult or destructive to adjacent structures. In addition, this material has some advantage: non-carcinogenic, non-allergic, less capsule formation and reduced chance of infection due to high vascularity. In the past years Gore-tex(R) has found multiple applications in facial plastic and reconstructive surgery. However this alloplastic material can be associated with potentially severe complications and side effects such as soft tissue reaction, infection, extrusion, exposure, etc. There have been also adverse criticism of Gore-tex(R) : relative difficulties in postoperative removal, in carving implant, higher infection and extrusion rates in scarred tissue and thicker implant as well as postoperative volume reduction. In order to analyze results depending on the implantation site, the presence of scar on recipient site, thickness and type of implant, a retrospective chart review of 56 patients(69 cases) was undertaken of all patients who underwent facial soft tissue augmentation with Gore-tex(R) graft from November 1998 to November 2001 in a wide variety of situations. All cases were categorized as either primary(normal recipient site) or secondary(scarred recipient site) cases and the thickness of each graft used in millimeters was recorded. Postoperative follow up revealed a stable implant material with no major complications relating to the graft material and no differences in developing complications according to the implantation site, the presence of scar, thickness and type of implant. All patients were highly satisfied with their results.
Subject(s)
Humans , Cicatrix , Follow-Up Studies , Plastics , Retrospective Studies , TransplantsABSTRACT
Post-hysterectomy vaginal vault prolapse is rare complication. There are many surgical procedures to correct this problem. But abdominal colposacropexy, using Marlex mesh or Gore-Tex graft is standard procedure. We experienced one case who had repair of post-hysterectomy vaginal vault prolapse by transabdominal sacral colpopexy using Gore-Tex graft and report with brief review of literatures.