Reconstruction of large lower lip defects: a new method.

Lower lip defects may be due to some congenital or acquired problems, such as congenital naevi, hemangiomas, tumors, traumas, or infectious disease. The degree of substance loss may be skin, muscle, or mucoso, or a combination of one or all layers. In large defects of the lower lip, the challenge is to accomplish a result that meets the criteria of successful reconstruction. We present 3 patients with large defects of the lower lip from tumor ablation who underwent satisfactory reconstruction with a new method not previously described in the English-language literature.

Effect of parenteral pentoxifylline and topical nitroglycerin on skin flap survival.

Flap necrosis is still a significant complication in all types of flap surgery. The effect of parenteral pentoxifylline and nitroglycerin in improving survival of ischemic skin flaps was tested in Wistar rats. In the control group (n = 15) the mean viable length of the flaps was calculated to be 6.160 +/- 0.936, and nonnecrotic flap area was found to be 1859.1 +/- 269.3. In the group treated with pentoxifylline and nitroglycerin (n = 15), the mean viable length of the flap was calculated to be 6.907 +/- 0.617, and the mean nonnecrotic flap area was found to be 2078.5 +/- 172.7. In this study results showed that the use of parenteral pentoxifylline and topical nitroglycerin is effective on skin flap survival.

Reconstruction of postburn scar contracture of the neck by expanded skin flaps.

Flexion contracture of the neck after burns can produce severe functional deformity. Excision and split or full thickness skin grafts, local or distant flaps, and free flaps have been used for reconstruction. Recently, tissue expansion has been introduced as an additional reconstructive procedure. We have used tissue expansion for reconstruction of postburn neck contractures. Twelve patients with ages that ranged from 9 to 34 years were treated with expanded fasciocutaneous supraclavicular and shoulder flaps. No flap necrosis has been seen. In two patients, reconstracture occurred between the expanded flap and uninvolved skin. To date we have not seen any problems with nerve neuropraxia and impression on blood vessels.

Use of seven-flap plasty for the treatment of axillary and groin postburn contractures.

Axillary and groin contracture with limitation of abduction of the arm and leg are one of the most common complications of burns. In this paper we report the technique of using seven-flap plasty for treating axillary and groin scar contractures. The advantages of using this technique are that it does not need prolonged splinting and intense and painful physical therapy.

Deep burns following epileptic seizures.

Epileptic seizure is a risk factor for deep burns. We report five seizure-related thermal injuries. All burns occurred in the home while the patients were performing everyday domestic tasks. Many burns resulting from epilepsy are avoidable.

One-stage repair of blepharophimosis: a new method.

Blepharophimosis is a congenital malformation involving the orbital region. It is associated with ptosis of the upper eyelids, epicanthal folds, telecanthus, and flattened and widened nasal bridge. We have surgically treated five cases of blepharophimosis by a procedure in which nasal bone graft, medial canthoplasty, and fascial suspension are performed in one stage. There is not any kind of operation for repair of the flattened and widened bridge of the nose in the literature. We have treated this anomaly using bone grafts. The follow-up period was 1 to 2 years, and good results have been obtained. A flattened and widened nasal bridge should be repaired by using bone grafts in addition to medial canthoplasty and fascial suspension in blepharophimosis.

Use of iliac bone graft for saddle nose deformity.

The reconstruction of the saddle nose deformity presents an arduous task for the reconstructive surgeon. A large variety of graft materials have been used for augmentation rhinoplasty. The modern trend is to prefer autologous material. Iliac bone grafts are extremely suitable for augmenting moderate to severe saddle nose deformity. In our study, autogenous iliac bone grafts were used in the nasal reconstruction of 14 patients. The follow up has been from 1-4 years, with no significant resorption noted during that time. Complication was limited to one hematoma on the donor side.

The seven flap-plasty.

A method of releasing skin contracture crossing a joint by seven flap-plasty is presented. The seven flap-plasty consists of two half Z-plasties and one W-M plasty. We have obtained satisfactory results in the repair of postburn contractures at elbow, axilla, fingers and interdigital webs using the technique.

Reverse W-M plasty in the repair of congenital syndactyly: a new method.

A W-M plasty is described as a means of establishing an interdigital web in the repair of congenital syndactyly. 25 cases of congenital syndactyly were operated using this method. The web created did not advance distally, nor cause a transverse scar-band.