[Total nasal reconstruction with total rib cartilage framework].

OBJECTIVE: To investigate a new technique for nasal reconstruction with total rib cartilage framework. METHODS: The expanded frontal flap was fabricated by skin expansion and flap delay to cover the reconstructed nose. The dorsal flap was reversed as the lining of reconstructed nose. The whole framework was made by rib cartilage. Secondary revision operation was also performed to make the reconstructed nose more natural. RESULTS: Total nasal reconstruction was performed successfully in 37 cases. Each patient underwent 4-7 operation during a period of 6-8 months. 32 patients were followed up for 12-24 months. The reconstructed nose had a natural skin color and symmetric appearance with good ventilation and less scar. Both doctors and patients were satisfied with the results. CONCLUSION: Satisfactory cosmetic result and ventilation function can be achieved by nasal reconstruction with total rib cartilage framework.

[Correction of secondary nasal deformity of cleft lip with autogenous costal cartilage framework].

OBJECTIVE: To investigate the correction of secondary nasal deformity of cleft lip with autogenous costal cartilage framework. METHODS: 237 cases with secondary nasal deformity of unilateral cleft lip were treated. The rib cartilage was harvested through a mini-invasive incision, and was fabricated as a C-shaped framework, as well as some cartilage fragments. Through transcolumella incision, the C-shaped framework was implanted to support the depressed alar and the cartilage fragments were used to augment the nasal base. RESULTS: Satisfactory cosmetic and functional results were achieved in all the patients with primary healing. 93 patients were followed up one year after operation with good cosmetic results. CONCLUSIONS: Autogenous costal cartilage framework can be used for the correction of secondary nasal deformity of cleft lip with satisfactory results.

[Closure of cystic cavity-type bedsore by subcutaneous undermining dissection with continuous negative pressure drainage].

OBJECTIVE: To investigate the clinical effect of subcutaneous undermining dissection with continuous negative pressure drainage for the closure of cystic cavity-type bedsore. METHODS: 12 patients with cystic cavity-type bedsore underwent surgical debridement and the wounds were closed after subcutaneous undermining dissection. The negative pressure drainage was put in the deep space. The healing process was observed. RESULTS: Completed healing was achieved in all the 12 cases. The skin wounds healed after 17-20 days and the deep spaces closed after 36-43 days. 12 cases were followed up for 1 year with no occurrence. CONCLUSIONS: It is an easy and effective method to treat cystic cavity -type bedsore by subcutaneous undermining dissection with continuous negative pressure drainage.

Repairing facial injury with refining plastic surgery techniques.

The purpose of this study was to evaluate the refining plastic surgery techniques for repairing facial surface injury. For this purpose, 82 patients with facial surface injury were recruited in the study. All wounds were repaired by refining plastic surgery techniques. The wounds were processed by fine wound excision and plastic surgery repair technique. The deep tissue fracture and dislocation were sutured and reduced using 8-0 absorbable suture and the skin wounds were sutured using 8-0 cosmetic suture. The facial injuries showed good rates of healing with fine debridement and fine recovering. The minimum scarring was observed and good cosmetic effect was achieved. We conclude that refining plastic surgery techniques including fine debridement and fine recovering are ideal for the reconstruction of facial injuries.

Treating cutis verticis gyrata using skin expansion method.

The objective of this study was to evaluate the feasibility and clinical effect of repairing scalp defect after the excision of cutis verticis gyrata using expanded scalp skin flaps. For this purpose, 8 patients with cutis verticis gyrata were subjected to scalp skin expander implantation under the skin. After saline injection and scalp expansion for 2-3 months, the cutis verticis gyrata was excised and the expanded scalp flaps were applied to recover the skin defect. As a result, the flaps and hair grew well without contractures and significant scarring, suggesting that this method is useful for surgical correction of cutis verticis gyrata.

[A clinical study of flap necrosis protection with dexamethasone].

OBJECTIVE: This clinical study was to find an effective method to prevent flap from necrosis. METHODS: When a flap showed blood flow problems, dexamethasone of 0.3 mg/kg was given intravenously for 2 days. Then the dose was decreased to 0.2 mg/kg at the third and the fourth day. At the fifth and the sixth day, dexamethasone of 0.1 mg/kg was given. RESULTS: A total of 51 flaps with blood flow problems was treated with this method. Thirty of them recovered completely; 18 survived mostly and 3 failed. CONCLUSION: Early application of dexamethasone can effectively ameliorate blood flow problems of the flap.