The effects of botulinum toxin A on the wound and skin graft contraction.

OBJECTIVE: In the current study, we investigated the efficiency of botulinum toxin-A (BTX-A) on wound and skin graft contractions. METHODS: Thirty adult female Wistar rats weighing 150 to 200 g were used. The rats were divided into 2 groups. As each rat in these groups underwent 2 different procedures, those groups also were divided into 2 subgroups. Group 1 (n = 15) was assigned as the control group. Pair of full-thickness skin grafts of 40 × 20 mm was harvested from the 2 sides of the dorsal regions of the rats. The full-thickness skin graft harvested from the left side was readapted (Group 1A), and the right side was left as an open wound (Group 1B). The rats in the second group (n = 15) underwent the same procedures and botulinum toxin-A (BTX-A) 0.5-international unit injection to the graft area (Group 2A) and open wound area (Group 2B). RESULTS: A decrease in the amount of the contraction was observed in the groups, which underwent BTX-A injection. In the histologic examination, it was observed that inflammation and collagen amount was higher, and the arrangement of the collagen was different in the groups, which underwent BTX-A injection. CONCLUSIONS: It has been determined that BTX-A injection reduces wound and graft contraction, and also, it is effective on reducing the amount of sebaceous cells and hair follicles.

Using bilaterally fascioperichondrial flaps with a distal and a proximal base combined with conventional otoplasty.

Prominent ears are the most common aesthetic abnormality of the external ear. Mustardè sutures and conchal setback are usually used for otoplasty, additional various cartilage-manipulation methods are also presented. One adjunctive technique that is often used involves the elevation of a fascial flap beneath which is sutured for additional cover, potentially reducing the risk of complications and recurrence. In the literature, this flap is traditionally raised with a proximal or distal base but it can be raised both distally and proximally with a number of advantages as we demonstrate. This article presents a technique to raise the fascioperichondrial flap with both a proximal and a distal base as an addition to conventional otoplasty. One hundred consecutive patients, followed up for at least 12 months, have been reviewed. One hundred ninety otoplasties were performed in 100 patients (10 unilateral), 65 women and 35 men. The mean age was 20.6 years, and the mean follow-up time was 16.3 months, respectively. No patient has developed skin necrosis or suture extrusion. In two patients (One bilateral and one unilateral for a total of three ears) a further procedure has been required to improve symmetry (1.5%). Using the retro auricular fascioperichondrial flap combined with other techniques offers good results and can be used as a standard procedure in the surgical treatment of prominent ears.