The impact of elastic chest belt on chest wall deformity after costal cartilage harvesting / 中华整形外科杂志

Objective@#To evaluate whether restricted breathing movement by wearing elastic chest belt within half a year postoperatively could decrease the incidence of chest wall deformity after costal cartilage harvesting.@*Methods@#The contour of chests of the patients receiving the third-stage operation of auricular reconstruction was assessed 1 year after costal cartilage harvesting with history collection and physical examination. The incidence of costal wall deformity was summarized and compared by wearing elastic chest belt or not within half a year postoperatively. Logistic regression was used to analyze the significance of results.@*Results@#Thirty-eight eligible patients were enrolled in the study. The incidence of chest wall deformity in patients wearing chest elastic chest belt as requested for half a year was lower (64.7% vs. 95.2%), and the difference was statistically significant, OR 10.9, 95%CI[1.16, 102.60], P=0.037.@*Conclusions@#Restricted breathing movement by wearing elastic chest belt within half a year postoperatively could decrease the incidence of chest wall deformity following costal cartilage harvesting through decreasing the traction force caused by respiratory muscles and intrathoracic negative pressure.

Treatment and outcome of postoperative infection of rib cartilage framework in ear reconstruction / 中华整形外科杂志

Objective@#To investigate treatment and outcome of rib cartilage framework in ear reconstruction.@*Methods@#12 cases of rib cartilage framework infection in ear reconstruction were retrospectively analysed in the latest four years. Lab examination results showed that staphylococcus aureus were found in 5 cases, coagulase negative staphylococcus in 3 cases, Klebsiella pneumonia in 2 cases, aeromonas hydrophila in 1 case and no bacteria were found in 1 case with regular culture. Debridement, systemic antibiotic therapy, saline irrigations and unobstructed drainage were utilized to treat the infection.@*Results@#The average duration of dressing change was 35 days in 12 cases (12-67 days), of which six cases were cured leaving no obvious or mild change of cartilage framework. Cartilage framework was totally damaged by infection in one case, so the framework had to be removed and debridement was then carried out to control infection. Secondary repair should be taken at least 6 months later. In the rest 5 cases, frameworks were taken out in the early stage of infection. The infected portion of the cartilage was removed and the healthy part was buried subcutaneously in the chest. The expanded postauricular flap and fascia were smoothened. Secondary repair should be performed after 6 months.@*Conclusions@#Effective debridement, irrigations and drainage can be used to control infection of cartilage framework and maintain normal contour and structure of reconstructed auricle. With regards to severe infection, framework should be removed as early as possible and infected portion of cartilage should be cleared out, while healthy part could be used for secondary reconstruction of auricular contour after complete control of infection.

Reconstruction of large vermilion defects with buccinator myomucosal flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate a novel method for the reconstruction of large vermilion defects.</p><p><b>METHODS</b>Based on the size and shape of the defects, a buccinator myomucosal flap pedicled with the junction of buccinator and orbicularis oris in the oral commisure was designed and rotated to reconstruct the large vermilion defects. The upper bound of the flap is at least 1 cm away from the stensen's duct. The width is about 2.5-3.0 cm, and the length is as far as to arrive the raphe pterygomancibularis. The donate site is directly closed primarily. There is no need for secondary pedicle division.</p><p><b>RESULTS</b>From July 2003 to April 2013, 14 cases with large vermilion defects was reconstructed with this method. No flap necrosis occurred with primary healing. 5 cases were followed up with an average follow up period of 1 year (0.5-3 years). The apprearance and function of the reconstructed vermilion were satisfactory without any apparent donor site defect. The patients were satisfied with both the functional and cosmetic results.</p><p><b>CONCLUSION</b>The buccinator myomucosal flap is a simple and ideal method for reconstruction of large vermilion defects, especially for the defects closed to the commisure.</p>