ABSTRACT
In this study, the functional and aesthetic outcome of patients with nasolabial flaps in the floor of the mouth was examined. Sixteen patients underwent reconstruction of the floor of the mouth with 19 nasolabial flaps after resection of a squamous cell carcinoma. Eight patients received postoperative radiotherapy. The patients were questioned concerning oral disabilities. Speech, mastication, deglutition, oral continence and the aesthetic result were evaluated. Two-point discrimination, temperature sensation and blunt-sharp discrimination of the intraoral flaps were tested. Speech and the wearing of dentures were hardly affected. Consumption of solid foods caused moderate problems in half of the patients. No sensibility problems were found. The aesthetic deformity was minimal. The use of nasolabial flaps in patients with limited defects of the anterior floor of the mouth after tumor resection showed adequate functional and aesthetic results.
Subject(s)
Carcinoma, Squamous Cell/surgery , Mouth Neoplasms/surgery , Mouth/surgery , Plastic Surgery Procedures , Surgical Flaps , Adult , Aged , Carcinoma, Squamous Cell/physiopathology , Carcinoma, Squamous Cell/psychology , Esthetics , Female , Humans , Lip/surgery , Male , Middle Aged , Mouth/physiopathology , Mouth Neoplasms/physiopathology , Mouth Neoplasms/psychology , Nose/surgery , Sensory Thresholds , Treatment OutcomeABSTRACT
A new technique using vacuum-assisted closure was successfully applied in 3 patients with poststernotomy mediastinitis. After surgical debridement, this vacuum-assisted closure technique has made it possible to avoid the need for secondary surgical closure (including direct secondary surgical closure and secondary surgical closure by use of vascularized muscle flaps). A healed stable sternotomy wound can be achieved using this new technique.
Subject(s)
Mediastinitis/therapy , Sternum/surgery , Surgical Wound Infection , Vacuum , Aged , Coronary Artery Bypass/adverse effects , Humans , Male , Mediastinitis/etiology , Wound HealingABSTRACT
The Biocarbon vascular access device (DiaTAB) is a relatively new method in secondary access surgery. Punctures, often the cause of complications can be avoided because it is a no-needle method of dialysis. However thrombosis due to stenosis of the venous anastomosis or of the efferent vein is a continuing problem. A new experience is the fibrin flap formation under the plug of the device, which can be removed easily.
Subject(s)
Arteriovenous Shunt, Surgical/instrumentation , Renal Dialysis , Adult , Aged , Arteriovenous Shunt, Surgical/adverse effects , Evaluation Studies as Topic , Humans , Middle Aged , Thrombosis/etiologySubject(s)
Arteriovenous Shunt, Surgical , Bioprosthesis , Blood Vessel Prosthesis , Carbon , Renal Dialysis , Adult , Aged , Arm/blood supply , Female , Humans , Male , Middle AgedABSTRACT
In a consecutive series of 76 PTFE grafts (37 Impra and 39 Gore-Tex), 30 non-thrombotic complications were observed. Twenty-one (70%) of these grafts could be salvaged either by conservative means (2) or by an aggressive surgical approach (19). The median survival time of the salvaged grafts was 12 months. Only nine grafts (30%) were lost as a result of the complications. Lesions caused by punctures techniques seemed more frequent in Impra grafts than in Gore-Tex grafts. Apart from this observation it is concluded that an aggressive surgical approach to non-thrombotic complications in PTFE grafts is worthwhile.
