Tissue Reaction and Morphologic Change of Gore-Tex Implant in the Rabbit Model

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.

Penile Resurfacing after Removal of Penile Foreign Body Granuloma

The loss of penile skin, either traumatic or iatrogenic, is sometimes difficult to treat. Especially, treatment of the penile foreign body granuloma is very difficult. Surgical treatment of penile skin defect are a skin graft, flap-to-graft conversion method, and various scrotal flap. But these have many problems such as wound disruption, skin necrosis, skin contracture, and hypertrophic scar. We present our technique for penile resurfacing using apronlike scrotal flap and groin flap. Apron-like scrotal flap has several advantages: one stage operation, short operation time, avoidance of dorsal scar and flap necrosis, maintenance of erectile capacity. Also we think that groin flap is a proper method for the patients who suffer from a large penile skin defect and whose scrotal skin is not available. We did the research in patients with the penile foreign body granuloma who were used the techniques of groin flap and apron like scrotal flap in the operation from March 2000 to February 2002. All the 15 cases showed excellent outcome. Especially, apron like scrotal flap was very beneficial in patients whose scrotal skin was available.

Intraoral Compressive Dressing for Prevention of Palatal Fistula after Cleft Palate Repair

The rate of postoperative cleft palate fistula is influenced by palatal repair methods. High incidence of cleft palate fistula is associated with pushback palatoplasty, because wide elevation of mucoperiosteal flaps can cause hematoma and exudate, which make flaps thinner so necrotise. Thus, the authors tried to reduce the wound disruption, hematoma, and dead space while performing pushback palatoplasty in complete cleft palate by applying compressive dressing over mucoperiosteal flaps. As a result, the incidence of cleft palate fistula was statistically reduced after compressive dressing. Three fistulas occurred in 14 patients treated by pushback palatoplasty without compressive dressing, but no fistula occurred in 25 patients treated by pushback palatoplasty with compressive dressing. By applying the compressive dressing after Pushback palatoplasty, it is expected not only reduced short-term complication, but also better results in the long-term follow up of maxillary growth and speech development.

Congenital Constriction Band of the Face: A Case Report

The congenital constriction band syndrome(which is analogous to amniotic band syndrome and Streeter dysplasia), which consist of constriction bands, peripheral lymphedema, acrosyndactyly, club foot, congenital amputation, is thought to be arised as a result of external factors affecting the fetus after early developmental period is completed. Congenital constriction band is rare congenital malformation and has rarely been reported about its occurrence on the adult face. We report a case of constriction band developed in the face and head of a 35-year-old female. Excision and W-plasty was performed for the surgical treatment of this band.