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Objective@#To investigate the computer-aided design(CAD) of enblock porous silicone prosthesis for forehead and temporal augmentation with endoscope technique.@*Methods@#The 3-dimensional image of the enblock porous silicone prosthesis for forehead and temporal augmentation was designed with the aid of computer based on the 3-D images, the metal model and silicone prosthesis were made for surgery guided by endoscope technique.@*Results@#20 cases underwent frontal and temporal augmentation with enblock protheis with primary healing. No complication, like infection, effusion, nerve injury, prothesis displacement, happened. The patients were followed up for half a year with satisfactory result .@*Conclusions@#CAD for enblock porous silicone prosthesis for forehead and temporal augmentation has the advantages of individual design and good adaptation. Endoscope technique can be effective for reduction of the complication, like bleeding and protheis displacement.
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Objective To evaluate the causes of local masses found after periocular fat grafting,and the way of treatment in order to avoid the medical dispute.Methods In 37 patients with local mass being repaired,15 patients with superficial bulges were treated through surgical removal and as piration;10 patients with focal masses were treated with aspiration;12 patients with bulges close to eyelid margin and failure after the first two treatment methods were treated through incision.Results Histopathologic findings showed the characteristic features of lipogranuloma.Chronic inflammatory cells were infiltrated.Numerous,variable-sized lipid vacuoles were surrounded by histiocytes and for eign body-type giant cells.There were areas of fibrosis and fat necrosis.35 cases were followed-up for 3 months to 1 years.Both doctors and patients were satisfied with results in 27 cases,basically satisfied in 6 cases,but not satisfied in 2 cases.Two patients were lost to follow up.Conclusions The special complication of masses in the periocular fat grafting operation can be greatly improved with the personalized therapy.
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Objective To investigate the possibility of auricle reconstruction assisted by an expander using porous silicon auricle frame.Methods An adult male with average sized,normal ears was selected.The spiral CT scan was used to acquire primitive data of his external ear.Mimics 8.1 and Geomagic studio 12 were used for 3D reconstruction and image processing.Three-dimensional model of auricle 1.4 mm in thickness was created according to the anterior auricular surface data.Finally,a metal model was made according to the 3D model of auricle.By the extrusion method,silicon auricle frame was formed from the metal model.Multiple perforations,1 mm in diameter and 1 mm internal from each other,were then made by a puncher.50 ml kidney tissue expanders were implanted between the panniculus carnosus and the fascia through an incision on the backs of 10 New Zealand white rabbits.The expander was inflated with 20 ml saline weekly,to a total of 160 ml.Maintenance of expansion lasted for a month.The expander was then removed through an incision along the expander near the back.Silicon auricle frame was inserted into the pocket.The reconstructed ears were observed for 6 months postoperation.Whether there were deformations,contractures and extrusions were observed.Results The reconstructed ears were elastic and compressible.No deformation,contracture or extrusion were observed 6 months postoperation.Scaphoid fossa,triangular fossa,helix,antihelix were legible.Conclusions The silicon frame,1.4 mm in thickness manufacted by computer aided design,could stand up to contraction of the overlying expanded flap,and it thus is possible to be used for auricle reconstruction assisted by the expander.
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Objective To evaluate the efficacy of self-disigned long-thick silicone prothesis in the treatment of severe microgenia.Methods A long-thick silicone prothesis was designed according to the measurement results gained by a coordinate caliper.The designed long-thick silicone prothesis was sterilized by uperization.The procedure commenced under local anesthesia for all patients.The prothesis was placed through an intraoral incision.The digital photographs were taken at the pretreatment visits and 3 months and 12 months after treatment follow-up to observe the change of the chin projection.Results 20 cases of severe microgenia were treated with this technique.All wounds healed primarily.There was no infection,extrusion and rejective reaction.The profiles of chins were improved obviously and reached aesthetic standard.Only one implant required adjustment 3 months after first operation because of displacement.After 12 months follow-up the reshaping contour of the chins were satisfied.Locations of silicone prothesis were stable.No differences of the chin projection were observed.All patients were satisfied with their cosmetic results.Conclusions Implanting long-thick silicone prothesis to correct severe microgenia is safe,effective,simply,cheap and less invasive.
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Objective To explore the methodology of suturing the upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap to the levator aponeurosis,simulating the mechanism of fibers from the levator aponeurosis to the dermis in natural double-eyelid in blepharoplasty.Methods Pretarsal orbicularis myocutaneous flap was harvested.Dissection between the orbital septum and the levator aponeurosis was performed originating from the upper margin of the tarsi until to the levator muscle.The upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap was sutured to the levator aponeurosis.The lower skin margin to the orbital septum to the upper skin margin was sutured interruptedly.Patients with medial epicanthus were performed epicanthoplasty at the same time.Results 136 eyes in 68 patients were performed with double-eyelid blepharoplasty using this method.62 patients were followed-up for 1 month and 53 patients were followed-up for 3 months.They all reported satisfactory aesthetic results.Conclusions Double-eyelid blepharoplasty using this method accords with the physiological mechanism in natural double-eyelid.Postoperative double-eyelid is natural with little tumefaction.This method can avoid double-eyelid fold retraction and multi-fold occurrence.
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Objective To study the clinical efficacy of recombinant human epidermal growth factor (rhEGF) in the treatment of sacrococcygeal decubitus ulcers grade Ⅲ with direct polymerizing suture after appling rhEGF to reinforce wound bed preparation (WBP). Methods From January 2007 to October 2009, 60 patients with sacrococcygeal decubitus ulcers Grade Ⅲ, were divided into control group and treatment group. The ulcer size was 3 cm × 4 cm to 10 cm × 12 cm and all ulcers were infected for 15-70 d. Treatment group received traditional dressing change and appling rhEGF to reinforce wound bed preparation. Control group received traditional dressing change only. The operative technique that we used in two groups was direct polymerizing suture. Cure rate of stage Ⅰ and complication morbidities were analyzed. Results Cure rate of stage Ⅰ was 87% in treatment group and 70% in control group. Complication morbidities were 13% in treatment group and 30% in control group. The difference between these two groups was statistically significant (P ＜ 0.05). Conclusion Appling rhEGF to reinforce wound bed preparation before operation could make subsequent treatment more effective and improve the cure ratio of operation with decreasing complications and morbidities. And more, dissecting under fascia possesses the advantages of easiness to perform and rich blood supply.The method of appling rhEGF with direct polymerizing suture is a simple, high efficient approach for the first repairment of sacrococcygeal decubitus ulcers grade Ⅲ, especially desirable for the elderly.
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OBJECTIVE:To observe the amount of thoracic cavity drainage24h after using highdose reptilase during in?tracardiac surgery.METHODS:32patients undergoing operation were randomly divided into group R(reptilase group,n=17)and group C(control group,n=15).In group R,reptilase2KU was injected before opening the thoracic cavity,reptilase1KU was added to prefilling fluid of extracorporeal circulation machine and reptilase2KU was intravenoulsy dripped after stopping machine until the end of operation.RESULTS:Compared with group C,the amount of thoracic cavity drainage reduced by35%(P