RESUMO
Objective To observe and evaluate the clinical effect of submental island myocutaneous flap(SIMF) and free skin graft(FSG) for the reconstruction of buccal defect resulted from the buccal carcinomas .Methods Forty-four aged aging patients di-agnosed with the buccal carcinomas were operated by the total dissection of primary tumor and selective neck dissection and recon-structed simultaneously with SIMF(19 cases) and FSG(25 cases) .The degree of postoperative cheek shape ,limitation of mouth o-pening ,speech sound ,and function of chewing were observed and analyzed .Results Eighteen SIMFs were completely survived .The residual muscle flap had a good blood supply after the debridement of skin island in one case ,the successful rate of flaps was 94 .7%(18/19) while 100% (25/25) .The donor site of SIMF was sutured directly .Follow-up was taken in 12 months for all patients .In SIMF group ,the degree of postoperative cheek shape ,limitation of mouth opening ,speech sound ,and function of chewing were bet-ter than those of FSG group in FSG group(P0 .05) .Conclusion The submental island flap is an excellent choice for the reconstruction of cheek defects in aging patients af-ter resection of buccal carcinoma .With acceptable cosmetic ,functional results and reasonable oncological saftety ,SIMF has a prom-ising prospect in head and neck surgery .
RESUMO
BACKGROUND: Full-thickness skin graft(FTSG) for deep skin defects often results in poor contour cosmetically due to insufficient thickness and does not take on defects with exposed bone or cartilage. These lesions may require more difficult methods such as skin flaps. OBJECTIVE: To describe the usefulness of free skin graft(FSG) with some fat and vascular network on the underside, and therefore thicker than FTSG, for repairing deep cutaneous defects on the nose. METHODS: Five patients, four with skin cancers and one with a combined nevus, were treated with FSG harvested from the postauricular area as the donor site. RESULTS: These grafts provided excellent cosmetic and functional results in all patients without complications. CONCLUSION: FSG with subcutaneous vascular network is useful in reconstruction of deep skin defects instead of complex, multistaged skin flaps. Moreover, its cosmetic outcome is superior to FTSG.
Assuntos
Humanos , Cartilagem , Nevo , Nariz , Neoplasias Cutâneas , Pele , Doadores de Tecidos , TransplantesRESUMO
BACKGROUND AND OBJECTIVES: Cholesteatoma in the middle ear is characterized by the presence of a keratinizing epithelium which is believed to have hyperproliferative properties. Among the various approaches for evaluating proliferative activity, proliferating cell nuclear antigen (PCNA) has been recently induced as an antigenic marker of cellular proliferation. In this study, we investigated the hyperproliferative characteristic of implanted skin in Mongolian gerbil middle ear cavity by comparing its mitotic activity with that of the retroauricular skin. A secondary purpose was to provide the morphological basis for future animal studies concerning cholesteatoma pathogenesis. MATERIALS AND METHODS: Using immunohistochemical technique with anti-monoclonal antibody, we investigated PCNA expressions of the implanted free skin and normal retroauricular skin of Mongolian gerbils. RESULTS: Experimental cholesteatoma induced by implanting free skin graft showed an average PCNA labeling index of 0.47+/-0.07 and normal retroauricular skin revealed 0.14+/-0.05. The labeling index of experimental cholesteatoma was 3.47 times higher than that of normal retroauricular skin. CONCLUSION: The epithelium of experimental cholesteatoma induced by implanting free skin graft in gerbil middle ear cavity proliferates at a higher rate than its normal retroauricular skin, suggesting that this animal model can be used for future study of epithelial proliferation of cholesteatoma.