Flaps versus skin grafts in neovagina creation for vaginal agenesis

Background: Women with congenital uterovaginal agenesis have normal development of all secondary sexual characteristics. They face the cruel fact of being unable to bear children and enjoy sexual satisfaction. Good neo vaginal reconstruction is important in improving functional and psycho social impacts to womanhood. The aim of the study was to compare the three commonly done surgical procedures for vaginal reconstruction.Methods: All the vaginal agenesis patients who attended Department of plastic surgery Madras Medical College, Chennai during the period from August 2004 to April 2007 were included in our study.Results: In Abbe McIndoe procedure, graft take was full in all 7 cases with good cosmetic appearance. Flaps survived in all 10 patients underwent pudendal thigh flap surgery. 2 patients underwent horse shoe shaped labia minora flaps. The cosmetic appearance was fair because of the distortion of the labia. The mean vaginal depth obtained was 8 cm and width was 2 cm.Conclusions: Cosmetic appearance was good in patients who underwent McIndoe procedure as the genitalia were not distorted. Contracture rate was more in patients who underwent McIndoe procedure especially who were irregular in using stents. Flap procedure especially pudendal thigh flaps which has the least contraction rate is the preferable treatment option for such patients.

Comparative Study of Thyroidectomy Wound Closure UsingSubcuticular Suture, Metal Clips and Steristrips

Background: Thyroid surgeries are most commonly done infemales. Most of the women are more worried about cosmeticscar and pain. Hence, we opted for the better methods ofwound closure to have less pain and esthetic scar.Aim: The study compared subcuticular suture, metal clips andsteristrips for wound closure after thyroid surgery. Results areanalysed based on Post-operative pain assessment, andCosmetic appearance.Methods: The prospective study was estimated to include aconsecutive series of 93 patients undergoing thyroidectomywho will be randomized to had their wound’s closed bysubcuticular sutures or steristrips or staples.Results: In our study wound closure by steristrips had lesspost-operative pain followed by subcuticular suture and metalclips. In our study cosmetic appearance after thyroid surgerywound closure with steristrips had excellent scar appearancefollowed by subcuticular suture and metal clips.Conclusion: To conclude steristrips had less pain, acceptableneck mobility, excellent scar appearance followed bysubcuticular suture and metal clips .

Medpor Craniotomy Gap Wedge Designed to Fill Small Bone Defects along Cranial Bone Flap

OBJECTIVE: Medpor porous polyethylene was used to reconstruct small bone defects (gaps and burr holes) along a craniotomy bone flap. The feasibility and cosmetic results were evaluated. METHODS: Medpor Craniotomy Gap Wedges, V and T, were designed. The V implant is a 10 cm-long wedge strip, the cross section of which is an isosceles triangle with a 4 mm-long base, making it suitable for gaps less than 4 mm after trimming. Meanwhile, the Medpor T wedge includes a 10 mm-wide thin plate on the top surface of the Medpor V Wedge, making it suitable for gaps wider than 4 mm and burr holes. Sixty-eight pterional craniotomies and 39 superciliary approaches were performed using the implants, and the operative results were evaluated with respect to the cosmetic results and pain or tenderness related to the cranial flap. RESULTS: The small bone defects were eliminated with less than 10 minutes additional operative time. In a physical examination, there were no considerable cosmetic problems regarding to the cranial bone defects, such as a linear depression or dimple in the forehead, anterior temporal hollow, preauricular depression, and parietal burr hole defect. Plus, no patient suffered from any infectious complications. CONCLUSION: The Medpor Craniotomy Gap Wedge is technically easy to work with for reconstructing small bone defects, such as the bone gaps and burr holes created by a craniotomy, and produces excellent cosmetic results.

The Function of the Next Generation of Polyphenol "Oligonol" / 日本補完代替医療学会誌

Polyphenols are natural substances distributed widely in nature. They have various functions as well as an antioxidant activity, and are raw materials used commonly in food industry. Proanthocyanidins consist of catechin units. It is considered that the bioavailability would be low when orally administered because naturally available proanthocyanidins are high molecular weight resulting from polymerization. We developed a method for production of oligomeric proanthocyanidins from polymeric proanthocyanidins in collaboration with Faculty of Pharmaceutical, Nagasaki University. The method can be applicable to food process. The product produced through this method is named as “Oligonol”, which is superior to currently distributed polyphenols in <i>in vivo</i> antioxidant activities.<br> Oligonol is produced by oligomerizing proanthocyanidins derived from lychee fruit. The oligomerization mechanism is nucleophilic substitution of catechin monomers at the C-4 position of proanthocyanidins fragmentated under acidic condition. Oligomeric proanthocyanidins are available to be produced from any polymeric proanthocyanidins according to this method.<br> The safety of Oligonol was confirmed by various safety assessments, and a Phase I safety study in human has been conducted. Oligonol is also certified as NDI (New Dietary Ingredient) by US FDA. Oligonol possesses a predominant bioavailability when orally administered, and a lot of researches about improvement of blood flow, anti-fatigue, reduction of adipose and cosmetic appearance are vigorously underway.<br>