Cryopreserved fascia lata allograft use in surgical facial reanimation: a retrospective study of seven cases.

BACKGROUND: Facial palsy treatment comprises static and dynamic techniques. Among dynamic techniques, local temporalis transposition represents a reliable solution to achieve facial reanimation. The present study describes a modification of the temporalis tendon transfer using a cryopreserved fascia allograft. CASE PRESENTATION: Between March 2015 and September 2018, seven patients with facial palsy underwent facial reanimation with temporalis tendon transfer and fascia lata allograft. Patients with long-term palsy were considered, and both physical and social functions were evaluated. The mean follow-up time was 21.5 months. No immediate complications were observed. Patients reported improvement in facial symmetry both in static and dynamic. Improvement was noticed also in articulation, eating, drinking, and saliva control. The Facial Disability Index revealed an improvement both in physical function subscale and in the social/well-being function subscale. CONCLUSIONS: This modified orthodromic technique allows to reduce the operative time and the risk of complications connected to the use of autologous tissues. The use of the cryopreserved fascia allografts from cadaveric donors seems to provide promising and long-standing results in the treatment of facial palsy.

Suture With Resorbable Cones: Histology and Physico-Mechanical Features.

BACKGROUND: Silhouette Sutures (Kolster Methods, Inc., Corona, CA) exhibit different biological characteristics at various time points after their placement. OBJECTIVES: The goals of this study were to understand the biological reactions of Silhouette Sutures in human tissues at different time intervals and to determine the index of resistance of the sutures in subcutaneous tissue. METHODS: Histologic examination was performed on section soft tissue containing the sutures at 1 month, 3 months, 6 months, and 1 year after suture placement. The study comprised 8 patients, each of whom received 4 sutures in the lower abdomen under local anesthesia. The sutures were placed exactly 1 month, 3 months, 6 months, and 1 year before planned post-bariatric abdominal surgery. Dynamometric evaluation was performed on a never-used suture and on sutures removed from 1 year after placement. The scar process around the threads was also examined. RESULTS: A progressive increase in scar tissue around the sutures was observed. One year after placement, there was a reduction of 16.7% in yield and tensile strength and a reduction of 14.29% in elongation at break, relative to the never-used suture. By 1 year, the cones in polylactic and glycolic acids had been replaced by scar tissue. CONCLUSIONS: Fibrous tissue around the sutures increased progressively over time, and was most prominent at the level of the nodes. Cones were completely resorbed within 6 months. A reduction in the index of resistance of the suspension sutures occurred over 1 year.