Application of hairpin shaped incision combined with cover-lifting flap in plastic surgery of huge fat pad on nape and back / 中国修复重建外科杂志

OBJECTIVE@#To explore the effectiveness of hairpin shaped incision combined with cover-lifting flap in plastic surgery of huge fat pad on nape and back.@*METHODS@#Between March 2019 and March 2023, 10 patients with huge fat pad on the nape and back were treated. There was 1 male and 9 females with an average age of 52 years (range, 39-57 years). All patients had soft tissue bulge on the nape and back. Preoperative MRI showed the subcutaneous fat thickening. The length of the longitudinal axis of the fat pad ranged from 10.0 to 25.0 cm (mean, 14.1 cm), the length of the transverse axis ranged from 6.0 to 15.0 cm (mean, 10.8 cm); the thickness of the fat pad ranged from 2.5 to 5.1 cm (mean, 3.9 cm). Under general anesthesia, the patient was placed in a prone position and a hairpin shaped incision was made. The flap was lifted to remove the fat pad according to the marked area. The dressing was changed every 2 days after operation.@*RESULTS@#The operation time was 35-110 minutes (mean, 72 minutes). The intraoperative blood loss was 35-80 mL (mean, 49.5 mL). The drainage tube was removed at 2-5 days after operation (mean, 3.4 days). All incisions healed by first intention without incision dehiscence, infection, subcutaneous bruising, hematoma, or other related complications. All patients were followed up 2-24 months (mean, 12 months). All patients had a good shape of the nape and back and no noticeable scar on the incision. According to the Vancouver Scar Scale evaluation criteria, the incision scar score was 3-5 (mean, 3.7) at 2 months after operation. Patients had good neck movement with no recurrence.@*CONCLUSION@#For the huge fat pad on the nape and back, the plastic surgery using hairpin shaped incision and cover-lifting flap has the advantages of fully exposing the fat pad, concealed incision, simple operation, and natural shape of the nape and back after operation.

Clinical analysis of 19 cases of maxillary local tissue defects repaired by buccal fat pad flaps / 口腔疾病防治

Objective@# To investigate the clinical effect of buccal fat pad flaps on the restoration of maxillary defects.@*Methods@# Nineteen cases with oral-nasal communications and maxillary soft and hard tissue defects ranging from 3.0 cm×2.0 cm-5.0 cm×4.0 cm after resection of the primary tumor foci were repaired with a pedicled buccal fat pad flap, and the maxillary sinus cavity and oral-nasal communication were closed. The survival, healing and complications of the flap were observed during the 3-month follow-up. @*Results @#The buccal fat pad flaps of 19 patients all survived. Five days after the operation, the buccal fat pad flap was dark red with slight edema, and the maxillary defect area collapsed. Ten days after the operation, most of the buccal fat pad flap turned pink, and the collapse was alleviated. One month after the operation, the buccal fat pad flap had no obvious collapse, and its surface was epithelialized, with a shape and color close to those of the normal mucosa. The opening was slightly limited. Three months after the operation, the buccal fat pad flap was completely epithelialized, with no difference from the surrounding tissue, and the opening was approximately 3 transverse fingers. No complications, such as swelling and necrosis of the buccal fat pad flap, limitation of mouth opening, maxillary sinus fistulas, oral-nasal communications and facial changes occurred in 19 patients within 3 months after the operation.@*Conclusion @#The application of a buccal fat pad flap has a good effect to repair maxillary tissue defects and close oral maxillary sinus communication with diameters less than 5 cm, so it can be widely used in the clinic.

Suprapubic lipectomy with a "Ω" incision for buried penis in obese adult men / 中华男科学杂志

Objective@#To investigate the application of suprapubic lipectomy with a "Ω" incision to removal of the prepubic fat pad for the management of buried penis in obese adult patients.@*METHODS@#We retrospectively analyzed the clinical data on 20 obese adult patients with buried penis treated by suprapubic lipectomy via a "Ω" incision between August 2016 and September 2019.@*RESULTS@#The operations were successfully completed in all the cases, with a mean operation time of 3.7 ± 0.6 hours and an average hospital stay of 8.3 ± 3.3 days. There were no such severe surgery-related complications as hematoma, urethral injury, or fat embolism in any of the cases. Fat liquefaction-related superficial wound infection developed in 1 patient postoperatively, which was cured by combined topical and systemic antibiotic therapy. A 3-month follow-up showed a 95% satisfaction of the patients with the postoperative appearance of the penis and suprapubic incision, but no complications such as ED, abnormal penile sensation, or penile retraction.@*CONCLUSIONS@#Suprapubic lipectomy with a "Ω" incision to remove the prepubic fat pad is an effective surgical approach to the management of buried penis in obese adult males, which is an anatomy-based surgical correction and has the advantages of slight injury, rapid recovery and few complications./.

Uso de bolsa adiposa de Bichat pediculada como recurso para el cierre de comunicaciones y fístulas bucoantrales: informe de caso / Use of pedicle Bichat fat pad as a resource for the closure of communications and oroantral fistulas: case report

Resumen Introducción: El uso de un colgajo de bolsa adiposa de Bichat en el cierre de comunicaciones buco sinusales y defectos óseos maxilares ha sido reportada en varios estudios con resultados positivos, al ser una técnica sencilla y bien tolerada, gracias a su riqueza vascular, volumen y versatilidad, mostrando una baja tasa de complicaciones. Objetivo: Reportar el caso clínico de un paciente que acudió a la clínica universitaria de la Universidad UTE con una comunicación buco sinusal y el tratamiento quirúrgico a través de un colgajo pediculado de la bolsa adiposa de Bichat, como alternativa satisfactoria en el cierre de la comunicación y corrección de los defectos óseos intraorales. Metodología: Se obtuvo un colgajo mucoperiostico trapezoidal de avance recto hasta el margen palatino, fue ejecutada una fistulectomía, y mediante una incisión horizontal se conseguió la exposición de la bolsa adiposa para obtener tejido suficiente para cerrar la comunicación. Conclusiones: El uso de un colgajo de bolsa adiposa de Bichat gracias a su riqueza vascular, volumen, versatilidad y capacidad para realizar una metaplasia a tejido epitelial, por la presencia de células madre, es muy confiable.

Abstract Introduction: The use of buccal fat pad flap in closure of oroantral communications and maxillary bone defects has been reported in several studies with positive results, being a simple and well-tolerated technique, thanks to its vascular richness, volume and versatility, showing a lower complication rate. Objective: Report the clinical case of a patient who went to university clinic of Universidad UTE with a sinus oral communication and surgical treatment through a pedicle flap of buccal fat pad, as a satisfactory alternative in the closure of the communication and correction of intraoral bone defects. Methods: A mucoperiosteal trapezoidal flap was made to reach the palatal margin, a fistulectomy was also performed, and using a horizontal incision the buccal fat pad was exposed in order to obtain enough tissue to close the oroantral communications. Conclusions: The use of the flap technique in the buccal fat pad seems reliable thanks to its vascular characteristics, volume, versatility and capacity to experience an epithelial metaplasia because of the presence of stem cells.

Evaluation of the Effectiveness of Pedicled Buccal Fat Pad Graft for Repair of Oro-Antral Communications.

Oro-antral communication is a complication associated with extraction of maxillary posterior teeth, surgeries of the maxillary sinus or pathologies associated with the sinus or the posterior maxilla. Such abnormal communications need to be repaired at the earliest, to maintain oral and nasal complex harmony and to prevent undue complications thereafter. These communications can be repaired by various methods, one of those being buccal fat pad pedicled graft technique which will be clinically evaluated and critically discussed in this paper. The pre-operative, immediate and post-operative measures followed, the eligibility criteria chosen, and the duration of follow up period, will formulate the outline for the study. A careful assessment of the criteria, clinical signs and healing is noted, to establish the outcome of the technique.METHODSAn observational study was undertaken to evaluate the effectiveness of a surgical technique to repair oro-antral communications wherein the pedicled buccal fat pad is used as a graft material. 20 patients with OAC, who were presented to the department of Oral & Maxillofacial Surgery, VS Dental College & Hospital, Bangalore, were recruited for the study. The clinical study was conducted in accordance with the protocol and the results were evaluated on the basis of patient’s comfort towards the procedure, ease of technique, healing time, post-operative complications and recurrence rate of the communication. Details of the technique and a review of the previous studies published were discussed in detail, to form a relevant summary.RESULTSThe clinical study utilised buccal pad of fat as a pedicled graft for the closure of oro-antral communication and the study was compared with previous studies published regarding the same. The technique was found to be more effective and convenient than the other methods to both the patient and operator, owing to its ease of performing, minimal risk of complications from the grafted site and the harvest site, and predictable healing.CONCLUSIONSThe technique is easiest among the various methods recommended so far, pertaining to the procedure and predictability. Although, the training and experience of a skilled operator is equally important in achieving the best results.

Closure of oroantral fistula: a review of local flap techniques

Oroantral fistula (OAF), also termed oroantral communication, is an abnormal condition in which there is a communicating tract between the maxillary sinus and the oral cavity. The most common causes of this pathological communication are known to be dental implant surgery and extraction of posterior maxillary teeth. The purpose of this article is to describe OAF; introduce the approach algorithm for the treatment of OAF; and review the fundamental surgical techniques for fistula closure with their advantages and disadvantages. The author included a thorough review of the previous studies acquired from the PubMed database. Based on this review, this article presents cases of OAF patients treated with buccal flap, buccal fat pad (BFP), and palatal rotational flap techniques.

Importance of Hoffa’s Pad Sign in MRI evaluation of various knee pathologies: a study conducted at SGT Hospital of SGT University of Gurugram Haryana

Hoffa’s fat pad is intracapsular and extra synovial structure present behind the patella and Infrapatellar tendon. This is delineated nicely in magnetic resonance imaging(MRI) by which it has become a modality of choice for its evaluation .The evaluation is by disruption of the outline of this region due to injury or other underlying pathologies .The indirect signs of this fat pad corresponds to the grading of associated trauma or underlying disease. Methods: We had conducted the MRI knee studies of fifty three patients which included both the genders from March 2018 to July 2018 .They all were having complaints of knee pain because of different aetiologies This cross sectional study included from 7-70 years of age group and patients were evaluated for the characteristics of Hoffa’s pad in MRI .The morphological characters of the region were studied and correlated in relation to the corresponding pathology. Results: There was excellent delineation and intensity relationship of HFP in various MRI sequences. The most vulnerable group to the changes was in 21- 30 years age group .The trivial trauma was the most common cause. The left knee was affected more than the right. Conclusion: Hoffa’s fat pad sign is an excellent indicator in various knee pathologies during MR evaluation. This also helps to know the involvement of the associated surrounding structures .MRI evaluation is very helpful in the decision making for the line of management.

Lateral arthroplasty along with buccal fat pad inter-positioning in the management of Sawhney type III temporomandibular joint ankylosis

OBJECTIVES: The objective of this study was to highlight the role of lateral arthroplasty along with interposition of the buccal fat pad (BFP) in the management of Sawhney type III temporomandibular joint (TMJ) ankylosis. MATERIALS AND METHODS: Ten patients with TMJ ankylosis (7 unilateral and 3 bilateral, total of 13 joints) were treated with lateral arthroplasty and BFP interposition. The bony bridge of the ankylotic mass on the lateral aspect was resected, leaving a distance of 1.5 to 2.0 cm from the base of the skull to the neck of the condyle. The condyle was left intact. Coronoidectomy was performed on the ipsilateral side via the same approach in all cases. The inter-incisal opening was measured at that time, and if it was less than 35 mm, contralateral coronoidectomy was performed by using the intra-oral approach. After satisfactory inter-incisal mouth opening (≥35 mm) was achieved, the TMJ surgical site was revisited, and BFP was retrieved and used to cover the lateral aspect of the medially placed condyle. RESULTS: With lateral arthroplasty, the medially displaced condyle can be left in-situ to maintain the mandibular ramal height and function and to act as a growth center in children. Interposition of the BFP prevents reformation of the lateral bony bridge that was removed. CONCLUSION: Lateral arthroplasty along with interpositioning of the BFP is a novel technique for managing Sawhney type III ankylosis that achieves management goals while avoiding complex and advanced reconstructive surgical procedures.

Arthroscopic Treatment of Infrapatellar Fat Pad Impingement between the Patella and Femoral Trochlea: Comparison of the Clinical Outcomes of Partial and Subtotal Resection

PURPOSE: To compare the clinical outcomes of arthroscopic partial and subtotal resection of the impinged infrapatellar fat pad (IFP). MATERIALS AND METHODS: This study enrolled 55 patients with IFP impingement who underwent partial resection (n=29, P group) or subtotal resection (n=26, S group). Clinical outcomes at least 2 years postoperatively were evaluated using a visual analog scale (VAS) for pain, the International Knee Documentation Committee (IKDC) 2000 subjective knee score, and the Lysholm score. RESULTS: In the P group, the preoperative mean VAS, IKDC 2000, and Lysholm scores were 5.6±0.61, 47.5±7.41, and 42.5±7.17, respectively, which improved significantly to 1.4±0.63, 70.9±6.15, and 82.2±7.61, respectively (all, p≤0.001). In the S group, the preoperative mean VAS, IKDC 2000, and Lysholm scores were 5.7±0.43, 47.7±9.09, and 45.2±4.18, respectively, which improved significantly to 1.8±0.77, 71.9±9.33, and 82.3±6.01, respectively (all, p≤0.001). There were no significant differences in any outcome measure between the groups at the final follow-up. CONCLUSIONS: Arthroscopic resection of the impinged IFP between the patella and femoral trochlea resulted in favorable clinical outcomes regardless of whether the resection was partial or subtotal. Thus, partial resection can be an appropriate treatment option, considering partial resection was as effective as subtotal resection and retained more of the IFP.

Descripción de las Diferentes Indicaciones del Cuerpo Adiposo de la Mejilla como Colgajo e Injerto Autólogo en Cirugía Maxilofacial. Revisión Narrativa / Buccal Fat Pad Indications as a Flap and Autologous Graft in Maxillofacial Surgery. Narrative Review

RESUMEN: Uno de los objetivos de la cirugía maxilofacial es devolver anatomía, función y estética a través de distintas técnicas quirúrgicas. Dentro de los tejidos utilizados para esto se encuentra el cuerpo adiposo de la mejilla (CAM). La gran evidencia clínica existente y el conocimiento que se tiene acerca de este tejido ha permitido poder utilizarlo como injerto o colgajo para el tratamiento de una serie de condiciones que afectan al territorio maxilofacial con buenos resultados tanto estéticos como funcionales. Describir las diferentes indicaciones que tiene el CAM como colgajo e injerto autólogo para el tratamiento de las distintas anomalías que afectan al territorio maxilofacial. Se realizó una búsqueda entre abril y junio de 2018 utilizando 3 bases de datos electrónicas: PubMed, EBSCO y Cochrane. Las palabras clave utilizadas fueron buccal fat pad, bichat's fat pad y oral surgery con la selección del término booleano AND y OR. Se seleccionaron aquellos estudios publicados entre los 2014 y 2018, de texto completo. Se seleccionaron 17 artículos de que cumplieron con los criterios de inclusión; 2 revisiones sistemáticas, 8 ensayos clínicos, 6 estudios observacionales y una serie de casos. El uso del CAM como injerto y colgajo para la corrección de anomalías en el territorio maxilofacial es una técnica versátil y predecible. La totalidad de los estudios analizados avalan su uso en dicho campo. Se necesitan más estudios clínicos aleatorizados, con un mayor número de casos, seguimiento a largo plazo y parámetros a evaluar para establecer una conclusión final sobre el uso del CAM en las diversas aplicaciones de la cirugía maxilofacial.

ABSTRACT: One of the main objectives of maxillofacial surgery is to restore patient normal anatomy, function and esthetic. Among the various tissues used to achieve the above, is the buccal fat pad. Currently, there is sufficient clinical evidence and knowledge regarding this tissue type, to approve its use as graft or flap, in order to treat a number of conditions that affect the maxillofacial area. Furthermore, it has shown various esthetical as well as functional results. The purpose of this narrative review is to describe different indications of the buccal fat pad, as a flap and autologous graft in treating various maxillofacial abnormalities. A search was conducted between april and june 2018 using 3 electronic data bases: PubMed, EBSCO and Cochrane library. Key words used were buccal fat pad, Bichat's fat pad y oral surgery using Boolean terms AND/ OR. Studies published between 2014 and 2018 were selected. For the study, 17 complete text studies that met the inclusion criteria were selected; two systematic reviews, eight randomized clinical trials, six observational studies and one case series. The use of the buccal fat pad as flap and graft for correcting maxillofacial abnormalities, is a predictable and versatile technique. The total number of studies analyzed, support its use in this surgical field. In conclusion and despite these results however, there is a need for further randomized clinical trials with a greater number of cases, long term follow up, and greater parameter assessment to support the use of the buccal fat pad in maxillofacial surgery.

Bichectomia, a simple and fast surgery: case report / Bichectomia, uma cirurgia simples e rápida: relato de caso

Bichectomy is an intra oral surgical procedure, which is the excision of Bichat's fat pad, in order to make the patient's face thinner and bring to him/her greater harmony in the facial contour. The surgery is simple, fast, has a low rate of postoperative complications and can be performed by dental surgeons or plastic surgeons. This article will present a case report of a bichectomy procedure conducted by a dental surgeon on a female patient. The aesthetic results of this procedure can be effectively observed after a period of 4 to 6 months, when the swelling of the subcutaneous tissue is completely resorbed

Bichectomia é um procedimento cirúrgico, intraoral, no qual ocorre a excisão das bolas de Bichat, com o objetivo de afinar o rosto do paciente e conferir maior harmonia do contorno facial. A cirurgia é simples, rápida, e apresenta baixo índice de complicações pós cirúrgicas, podendo ser realizada por cirurgiões dentistas ou cirurgiões plásticos. Neste artigo, será apresentado um relato de caso clínico de um procedimento de bichectomia em uma paciente do sexo feminino, realizado por cirurgião dentista. Os resultados estéticos desse procedimento podem ser efetivamente observados após um período de 4 a 6 meses, quando o edema do tecido subcutâneo é completamente reabsorvido.

Reconstruction of large oroantral defects using a pedicled buccal fat pad / 대한악안면성형재건외과학회지

BACKGROUND: Oroantral communicating defects, characterized by a connection between the maxillary sinus and the oral cavity, are often induced by tooth extraction, removal of cysts and benign tumors, and resection of malignant tumors. The surgical defect may develop into an oroantral fistula, with resultant patient discomfort and chronic maxillary sinusitis. Small defects may close spontaneously; however, large oroantral defects generally require reconstruction. These large defects can be reconstructed with skin grafts and vascularized free flaps with or without bone graft. However, such surgical techniques are complex and technically difficult. A buccal fat pad is an effective, reliable, and straightforward material for reconstruction. CASE PRESENTATION: This report describes three cases of reconstruction of large oroantral defects, all of which were covered by a pedicled buccal fat pad. Follow-up photography and radiologic imaging showed successful closure of the oroantral defects. Furthermore, there were no operative site complications, and no patient reported postsurgical discomfort. CONCLUSION: In conclusion, the use of the pedicled buccal fat pad is a reliable, safe, and successful method for the reconstruction of large oroantral defects.

Reconstruction of cheek mucosal defect with a buccal fat pad flap in a squamous cell carcinoma patient: a case report and literature review / 대한악안면성형재건외과학회지

BACKGROUND: Squamous cell carcinoma (SCC) is the most commonly occurring malignant tumor in the oral cavity. In South Korea, it occurs most frequently in the mandible, tongue, maxilla, buccal mucosa, other areas of the oral cavity, and lips. Radial forearm free flap (RFFF) is the most widely used reconstruction method for the buccal mucosal defect. The scar of the forearm donor, however, is highly visible and unsightly, and a secondary surgical site is needed when such technique is applied. For these reasons, buccal fat pad (BFP) flap has been commonly used for closing post-surgical excision sites since the recent decades because of its reliability, ease of harvest, and low complication rate. CASE PRESENTATION: In the case reported herein, BFP flap was used to reconstruct a cheek mucosal defect after excision. The defect was completely covered by the BFP flap, without any complications. CONCLUSION: Discussed herein is the usefulness of BFP flap for the repair of the cheek mucosal defect. Also, further studies are needed to determine the possibility of using BFP flap when the defect is deep, and the maximum volume that can be harvested considering the changes in volume with age.

Effect of micro-fracture and comminution of fat pad on meniscal tear healing under arthroscopy / 中国内镜杂志

Objective To analyze the curative effect of fossa intercondyloidea of micro-fracture and comminution of subcutaneous fat pad on meniscal tear healing under arthroscopy. Methods During the clinical operation, the samples of the micro-fracture and fat pad comminution were attracted to the outside of the joint. The source and properties of cells were identified based on preclinical medicine experiment in vitro. In clinical research, 75 cases of the simple meniscus injury were selected from January 2014 to January 2016 and divided into three groups refer to treatment: Group A, B and C. Different treatments were used in the three groups. Group A - micro-fracture group; Group B - fat pad group; Group C - blank group. All patients' conditions were assessed with Lysholm, VAS score and adverse event (Swelling, anterior knee pain). Results In the preclinical medicine experiment, cells released by micro fracture were fibroblast-like cells which tend to grow more rapidly in vortex shape. Cells released by comminution of fat pad contained a small amount of impurities and necrotic cells and are mostly similar to fibroblast in long spindle shape. Besides, the Human MSC Analysis Kit was used to authenticate two cells which were considered to be as BMSCs and IPFPSCs. In clinical research, all patients received an average of 10 (8 ～ 11) months follow-up visit. No severe complication, such as blood-vessel and nerve injury, infection occurred after operations in the patients followed. Before receiving the treatment, difference in Lysholm, VAS score and general condition of joint of Group A and B, C showed no statistical difference (P > 0.05). Compared with those before operation and after operation in both of four groups, the Lysholm and VAS score were improved (P < 0.05). Besides, there had significantly difference between group A and C, B and C after post treatment in Lysholm and VAS score (P < 0.05), however, group A and B did not. Compared group A and C, the early prevalence of adverse event of group B was higher, but last follow-up show no difference between three groups. Conclusion Combined with basic experimental and clinical studies, our research suggest that micro-fracture and comminution of fat pad have good effect on the repair of meniscus injuries. Nevertheless, it should be concerned that early prevalence of increased swelling amd anterior knee pain of comminution of fat pad.

Effect of total knee replacement with preservation of the patellar fat pad on short-term clinical outcomes / 新乡医学院学报

Objective To explore the effect of total knee replacement with preservation of the patellar fat pad on shorterm clinical outcomes.Methods Eighty two patients with end-stage osteoarthritis were treated by total knee arthroplasty in the Central Hospital of Zhumadian City from May 2012 to May 2016 were randomly divided into resection group and reservation group,with 41 patients in each group.Patients in the two groups were given total knee replacement after general anesthesia,the patients in the resection group underwent a complete resection of the patellar fat pad during exposure to the field,while the patellar fat pad was retained partly or completely during the operation in the preservation group.Patients in the two groups were followed up for one year.The knee function score,knee mobility and anterior knee pain score before operation and one year after surgery were evaluated.Patellar tendon shortening and incidence of anterior knee pain of patients in the two groups were analyzed at one year after surgery.Results There was no significant difference in the knee score,functional score,anterior knee pain score and knee mobility before operation between the two group (P ＞ 0.05).At one year after operation,the knee score,functional score and knee flexion degree were higher,while the anterior knee pain score and flexion contracture were lower than those before operation in the two groups (P ＜ 0.05).There was no significant difference in the knee score,functional score,knee flexion degree and flexion contracture at one year after operation between the two groups (P ＞ 0.05),but the anterior knee pain score in the preservation group at one year after operation was lower than that in the resection group (P ＜ 0.05).There was no significant difference in the length of patellar tendon at one week after operation between the two groups (P ＞ 0.05).The length of patellar tendon was longer and the length of patellar tendon shortening in the preservation group at one year after operation was lower than that in the resection group(P ＜0.05).The incidence of anterior knee pain at one year after operation in the resection group and the preservation group was 22.0％ (9/41) and 2.4％ (1/41),respectively.The incidence of anterior knee pain at one year after operation in the preservation group was lower than that in the resection group (x2 =7.29,P ＜0.01).Conclusion To remain the patellar fat pad in the total knee replacement can improve the condition of anterior knee pain and decrease the degree of patellar tendon shortening after operation.

Primary sinonasal mucosal melanoma simulated as cystic lesions: a case report

Sinonasal mucosal melanoma (SNMM) in the maxillary sinus is a rare disease condition. Compared to oral mucosal melanoma, SNMM has a bulky, exophytic, and polypoid appearance, is weakly pigmented, and associated with unspecific symptoms. Due to these features, SNMM in the maxillary sinus has been misdiagnosed as nasal polyps and chronic sinusitis. In this case report, we described SNMM occurring in the right maxillary sinus simulated as a cystic or benign lesion. Cortical bone thinning and expansion were observed around the mass. The excised soft mass was encapsulated and weakly pigmented. The mass was clearly excised and covered with a pedicled buccal fat pad graft. Diagnosis using immunohistochemistry with S-100 and homatropine methylbromide-45 (HMB-45) is critical for proper treatment.

Infrapatellar Fat Pad-Derived Stem Cell-Based Regenerative Strategies in Orthopedic Surgery

Infrapatellar fat pad is a densely vascularized and innervated extrasynovial tissue that fills the anterior knee compartment. It plays a role in knee biomechanics as well as constitutes a source of stem cells for regeneration after knee injury. Infrapatellar fat pad-derived stem cells (IPFP-ASCs) possess enhanced and age-independent differentiation capacity as compared to other stem cells, which makes them a very promising candidate in stem cell-based regenerative therapy. The aims of this review are to outline the latest advances and potential trends in using IPFP-ASCs and to emphasize the advantages over other sources of stem cells for applications in orthopedic surgery.

Role of vitamin D in the development of obesity / Rol de la vitamina D en el desarrollo de la obesidad

SUMMARY: Antecedents in the literature suggest that vitamin D (VD) play a role in overweigh/obesity. The present study evaluated the effect of VD deficiency diet intake and fat hight on overweight/obesity about white adipose tissue (WAT) and body mass (BM) gain. Animals were divided into four experimental groups according to the lipid and VD content of their diets; G1: CVD+ (C: control diet with VD+; n=5), G2: CVD- (control diet without VD-; n=5), G3: HFVD+ (high fat diet, with VD+; n=5), G4: HFVD- (HF diet without VD-; n=5). The diets were administered for three months and BW was monitored weekly. At the end of this period all animals were euthanized. Epididymal (EFM), retroperitoneal (RFM) and subcutaneous (SFM) fat mass were removed, weighted. At 12 weeks the body mass of the animals that were fed without VD- diets; G2: 507.60±17.31 g, and G4: 528.50±13.50 g were significantly higher (p < 0.05), than the counterparts G1: 485.0±11.29 g and G3: 521.20±26.20 g respectively. Similarly, the animals fed with VDdiets had a greater EFM and SFM (p < 0.05) compared with the respective controls (VD+). Nevertheless, the animals fed with high fat diet had equal RFM (G3: 12.2±4.10 g, G4: 12.88±2.3 g, p > 0.05). The results demonstrate that the nutrition of rats with diet deficient in VD and high fat, promotes overweight by increasing fat deposits, suggestion a cause-effect relationship between VD deficiency and overweight. These results suggest that VD deficiency increases the risk of visceral fat obesity in males.

RESUMEN: Los antecedentes de la literatura sugieren una relación entre la vitamina D (VD) y el sobrepeso/obesidad, sin embargo, causalidad de la relación no está clara. El presente estudio evaluó el efecto de la ingesta dietética deficiente de VD y alta en grasa sobre el tejido adiposo (TA) y la masa corporal (MC). Los animales se dividieron en cuatro grupos experimentales de acuerdo con el contenido de VD y lípido en la dieta; G1: CVD+ (C: dieta control con VD+; n = 5), G2: CVD- (dieta control sin VD-; n = 5), G3: HFVD+ (dieta alta en grasa, con VD+; n = 5), G4: HFVD- (dieta HF sin VD-; n = 5). Las dietas se administraron durante tres meses y MC se controló semanalmente. Al final de este período, los animales fueron sacrificados. La masa grasa epididimaria (MGE), subcutánea abdominal (MGS) y retroperitoneal (MGR) fueron diseccionadas y pesadas individualmente. A las 12 semanas, la MC de los animales alimentados con dietas sin VD-; G2: 507,60 ± 17,31 g, y G4: 528,50 ± 13,50 g fue significativamente mayor (p < 0,05), que sus homólogos G1: 485,0 ± 11,29 g y G3: 521,20 ± 26,20 g respectivamente. De forma similar, los G2 y G4 tuvieron una mayor MGE y MGS (p < 0,05) en comparación con los controles respectivos (VD+). Sin embargo, los animales alimentados con dieta alta en grasas tuvieron igual MGR (G3: 12,2 ± 4,10 g; G4: 12,88 ± 2,3 g, p > 0,05). Los resultados demuestran que la nutrición de ratas con dieta deficiente en VD y alta en grasa, promueve el sobrepeso/obesidad al exacerbar la ganancia de masa grasa en los diferentes depósitos de grasa, sugiriendo una relación causa-efecto entre la deficiencia de VD y el sobrepeso/obesidad. Estos resultados sugieren que la deficiencia de VD aumenta el riesgo de obesidad de grasa visceral en machos.

Efectividad del uso de la bolsa adiposa de bichat para la reconstrucción de defectos en el paladar: reporte de un caso / Effectiveness of the use of the bichats fat pad for the reconstructionof defects in the palate. report a case

La bolsa adiposa de Bichat está constituida por un cuerpo y tres extensiones de tejido adiposo, se localiza dentro del espacio bucal y seextiende siguiendo el borde anterosuperior del músculo masetero. En la actualidad su uso como colgajo pediculado ha demostrado excelentesresultados en el tratamiento de reconstrucción de defectos postumorales de tejido blando en el paladar. Lo anterior se debe a su gran aporte vascular, composición histológica y a la presencia de células madre en tejido adiposo que fomentan una metaplasia del tejido, convirtiéndose en tejido fibroso y superfi cialmente con epitelio en tan sólo cinco semanas. La técnica de abordaje y reposicionamiento del colgajo pediculado en paladar fue modifi cada con la extirpación de la tuberosidad del maxilar para corregir el defecto ocasionado por un adenoma pleomorfo en el paladar. Se destacan las características y cualidades de la bolsa adiposa de Bichat para su uso en reconstrucción de defectos tumorales.

Bichat’s buccal fat pad is constituted by a body and three extensions ofadipose tissue within the buccal space and extending to the anteriorsuperiorborder of the masseter muscle. To this days, the use of thebuccal fat pad as a pedicled graft has shown excellent results onoral post tumoral reconstruction treatment. This is due to its greatvascularity, histological composition and perhaps to the presenceof stem cells that promotes a metaplasia, turning adipose tissue intofi brous and superfi cially epithelized tissue within fi ve week aftersurgery. Surgical approach and repositioning technique of the pedicledgraft was modifi ed, extirpating part of the maxillary tuberosity, topreserve vascularity and cover up a hard-soft tissue defect caused by apleomorphic adenoma on a patient’s palate. Buccal fat pad’s qualitiesand characteristics are taken into consideration to demonstrate theeff ectiveness on its surgical reconstructive uses.

Use the technique of three layers suspension to lift the mid-low face / 中华医学美学美容杂志

Objective To explore an ideal surgical method for mid-low face lifting.Methods In this procedure,the first surgical step was subcutaneous undermining that was performed through the incision along temporal hairline,anteriorear,and mastoideae.It extended distally beyond the furthest skin fold and along the mandibular border or the midline of the neck if nacessary.Then three layers suspension were performed,which included three procedures:first,SMAS was purse string sutured in certain direction;secondly,the malar fat pad was suspended to tow directions backward and upward and anchored in the periosteum of zygoma and SMAS too;lastly,through traction suture of reducing tension step-by-step,lots of the tension was relieved from the incision;at the same time,new retaining ligaments between flap and SMAS were reestablished.And redundant skin was removed in incision at the end of the procedure.Results A total of 22 cases received this operation.16 cases were followed up from 3 months to 24 months after operation.The results of operation were divided into three degrees:excellent,acceptable and poor;and those were evaluated by patients themselves.14 cases obtained excellent result (87.5 ％),2 cases regarded that their results were acceptable (12.5 ％).The total satisfactory rate was 100 ％.None serious complication occurred in those eases except some slight complications,such as local edema,skin numbness and small hematoma which relieved in 3 to 6 months after operation.Scar was inconspicuous.Conclusions This technique can correct the posies of lower tow-third face better,especially for mitigating the nasolabial fold and enhancing the elastic of face skin.Simultaneously,it is an effective,safe and simple technique.