Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Mar 1993
Cosmetic reconstruction of the mons veneris and lower abdominal wall by skin expansion as the last stage of the surgical treatment of bladder exstrophy: a report of three cases.
The results of the correction of the medial scar depression and diastasis of the pubic hair of the mons veneris in three postpuberal female patients operated on for bladder exstrophy are reported. The reconstructive surgery is carried out using skin expanders. The expanded skin is utilized to create two dermoadipose flaps to fill the medial depression, to outline again the public hair areas, and to allow sutures without tension.
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Plast. Reconstr. Surg. · Mar 1993
Case ReportsIntraoperative rapid expansion in cleft palate repair.
Intraoperative rapid expansion in cleft palate repair increases surface area by distension of the palate and recruitment of the surrounding palate tissue. A 5-cc Foley catheter with the distal tip trimmed is employed as the tissue expander. Intraoperative rapid palate expansion is proposed for closure with less tension of large gaps between cleft borders. This procedure has not demonstrated any deleterious clinical effects in cleft palate repair.
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Plast. Reconstr. Surg. · Mar 1993
Combined tissue expansion: clinical attempt to decrease pain and shorten placement time.
Tissue expansion can be characterized as a unique reconstructive procedure that takes advantage of the intrinsic ability of tissues to stretch and, in some instances, to grow in response to expansive forces. The efficacy of combined intraoperative expansion to obtain sufficient expanded tissue more rapidly was tested in reconstructions of the extremities, and the comparison between conventional and combined expansion was performed observing five parameters: initial injected volume, pain score, duration of pain, total period of expansion, and histologic findings. We treated 22 patients with conventional expansion and 29 with combined expansions. ⋯ Histologically, only minor differences were seen between groups. In this study, intraoperative expansion combined with subsequent rapid overinflated expansion proved to be superior to conventional expansion not only in reducing expansion time but also in decreasing pain. We consider the following effects to contribute to this result: (1) increased skin elasticity due to repeated intraoperative load cycling, which leads to easier expansion of the skin and less irritation of the sensory nerves, (2) improved survival and vascularization of skin flaps due to the "delayed-flap" phenomenon, and (3) prevention of shrinkage of the expanded skin and widening of scars due to overinflated expansion.(ABSTRACT TRUNCATED AT 250 WORDS)