Abstract:
:The use of diced cartilage grafts in rhinoplasty surgery was recently revived by Erol with the publication of his technique for "Turkish delight" grafts (i.e., diced cartilage grafts wrapped in Surgicel). The present study details the authors' experience with 50 consecutive diced cartilage grafts used in three configurations during a prospective study of 50 primary and secondary aesthetic rhinoplasty procedures performed by the senior author (Daniel). Part I consists of 22 diced cartilage grafts wrapped in Surgicel and placed in the radix (n = 14), radix/upper dorsum (n = 4), and full-length dorsum (n = 4). All grafts were performed adhering meticulously to Erol's technique without modification. This portion of the study was halted abruptly at 4 months because of the unexpected absorption and clinical failure of all diced cartilage grafts wrapped in Surgicel. Subsequently, five patients had revision surgery, and biopsy specimens were taken at the prior grafting site and analyzed histologically. After this clinical failure, part II of the study began, consisting of 20 patients who had diced cartilage grafts wrapped in fascia. The range of applications was comparable: radix (n = 12), radix/dorsum (n = 3), and full-length dorsum (n = 5). Because of our prior practice of overcorrecting by 20 percent with diced cartilage grafts wrapped in Surgicel, we had excessive amounts of material in six of our initial diced cartilage wrapped in fascia radix grafts, but no subsequent grafts. The overcorrections were easily reduced at 6 weeks to 11 months postoperatively using a pituitary rongeur under local anesthesia, and the material was sent for histologic analysis. Minimum 1-year follow-up of all 20 cases has shown maintenance of the grafts without evidence of absorption. Part III of this study comprised eight patients who had diced cartilage grafts without a fascial covering placed throughout the nose, including on the sides of osseocartilaginous rib grafts to the dorsum. At 14 months, there was no evidence that any of these grafts had been absorbed. Histologic analysis of the biopsy specimens from the diced cartilage grafts wrapped in Surgicel showed evidence of fibrosis and lymphocytic infiltrates with small amounts of Surgicel visible on birefringent microscopy. Remnants of cartilage were present but were metabolically inactive on the basis of negative glial fibrillary acidic protein staining. Control specimens of fresh septal cartilage and banked septal cartilage were remarkably similar to each other and demonstrated normal cartilage architecture and cellular activity. The diced cartilage grafts wrapped in fascia showed coalescence of the diced cartilage into a single cartilage mass, with viable cartilage cells and normal metabolic activity on the basis of glial fibrillary acidic protein staining. All of the diced cartilage grafts wrapped in Surgicel absorbed and failed to correct the clinical problem for which they were performed. All of the diced cartilage grafts wrapped in fascia and pure diced cartilage grafts did correct the clinical deformities and appear to have survived completely. The diced cartilage grafts wrapped in fascia placed along the dorsum were distinctly palpable throughout the postoperative period, as was one prior case with a 6-year follow-up. The authors' clinical experience confirms the experimental studies of Yilmaz et al. that question the use of Surgicel for wrapping diced cartilage grafts in clinical rhinoplasty surgery.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Daniel RK,Calvert JWdoi
10.1097/01.prs.0000122544.87086.b9subject
Has Abstractpub_date
2004-06-01 00:00:00pages
2156-71issue
7eissn
0032-1052issn
1529-4242journal_volume
113pub_type
杂志文章abstract::A major difficulty in understanding rare craniofacial clefts arises from the fact that previous reports have focused on a single case or have grouped together different types of rare clefts. Less than 50 Tessier no. 4 clefts have been reported. This paper examines our experience with eight patients treated primarily o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199006000-00001
更新日期:1990-06-01 00:00:00
abstract::A case is reported of bilateral rupture of inflatable implants from a closed capsulotomy, with ingrowth of fibrous tissue through the inflation valves. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197706000-00023
更新日期:1977-06-01 00:00:00
abstract:BACKGROUND:In extended upper-type lesions of the brachial plexus, nerve transfers and root grafting have improved the results of shoulder and elbow reconstruction. However, wrist extension reconstruction has received little attention. METHODS:In 20 cadaveric upper limbs, we dissected the anterior interosseous nerve an...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31826d16cf
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abstract:BACKGROUND:Histology remains the standard form to analyze cranial suture in murine models, but this technique provides only limited "snapshots" of the entire suture and requires animal euthanasia with tissue destruction. Because of the bone complex microarchitecture, better methods are required to study the behavior of...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000232979.78132.b2
更新日期:2006-09-01 00:00:00
abstract::The microsurgical second toe wrap-around technique is an ideal treatment option for reconstruction of the distal half of the finger with circumferential loss of skin and nail associated with an uninjured proximal interphalangeal joint and an intact insertion of the flexor digitorum superficialis tendon. Follow-up of 1...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199111000-00016
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:This study was undertaken to determine contemporary surgical management of bilateral cleft lip. METHODS:A survey was sent to North American cleft surgeons. Variables included number of bilateral cleft lip repairs per year, surgical specialty, and methods of nasolabial correction. The authors analyzed possib...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/PRS.0b013e31824ecbd3
更新日期:2012-06-01 00:00:00
abstract::The purpose of this article is to present the authors' experience with the use of porous polyethylene ultrathin sheets for orbital floor reconstruction. Thirty-two patients with orbital floor fractures were treated with porous polyethylene ultrathin sheets. Sixteen cases corresponded to orbitozygomatic fractures, 11 c...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200203000-00007
更新日期:2002-03-01 00:00:00
abstract::Cartilage structures from the head and neck possess a certain but limited capacity to heal after injury. This capacity is accredited to the perichondrium. In this study, the role of the inner (cambium) and the outer (fibrous) layers of the perichondrium in cartilage wound healing in vitro is investigated. For the firs...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000020991.10201.6C
更新日期:2002-09-15 00:00:00
abstract::In contrast to adult cutaneous wounds, early fetal wounds heal scarlessly. Fetal rat skin transitions from scarless repair to healing, with scar formation between days 16.5 (E16) and 18.5 (E18) of gestation. Term gestation is 21.5 days. The composition of the extracellular matrix in fetal skin and wounds differs from ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000060102.57809.DA
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:At Great Ormond Street Hospital for Children, patients with periocular hemangiomas are assessed in a multidisciplinary team setting using a protocol developed in 1999. As part of this protocol, surgery is indicated for lesions that continue to cause amblyopia despite treatment with systemic or intralesional ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000256068.52183.f5
更新日期:2007-04-15 00:00:00
abstract::The authors describe the techniques that use the principles of fat grafting to allow them to successfully graft megavolumes (250-ml range) of autologous fat into breasts. The Brava external volume expansion device preoperatively increases the volume and vascularity of the recipient site. Low-pressure liposuction and m...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000179
更新日期:2014-06-01 00:00:00
abstract::This experimental study demonstrates that iontophoresis can be used to transport biologically active gentamicin into auricular cartilage. Fifty female New Zealand White rabbits were divided into three groups: live controls with unburned ears, live animals with burn-injured ears (deep or partial-thickness), and euthani...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::Costochondral grafts have gained increasing popularity in reconstruction of the temporomandibular joint and condyle in children. This is a report on the long-term follow-up of eight adolescent patients who underwent reconstruction of the temporomandibular joint and ramus for correction of hemifacial microsomia or trau...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Treatment of keloid scars poses a significant challenge. Assessment of treatment response and research in this area depend on the availability of objective, accurate, and reproducible outcome measures. At present, scars are assessed using subjective grading systems, or with cumbersome investigations such as ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000252505.52821.76
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:In the spring of 2000, the U.S. Food and Drug Administration issued a ban on the use of Betadine (povidone-iodine; Purdue Frederick, Stamford, Conn.) in association with saline breast implants, because data seemed to indicate a higher rate of implant deflation in association with Betadine. Betadine has been ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000251088.51675.a8
更新日期:2007-01-01 00:00:00
abstract::This study of suction lipectomy aspirates from 15 consecutive patients was undertaken to biochemically quantitate the blood-to-fat ratios of the aspirates. A wide variation in the blood-to-fat ratios (8 to 54 percent) was noted, but the authors failed to demonstrate any relationship between the blood-to-fat ratios and...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198678060-00009
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:Brachioplasty has increased 4059 percent from 2000 to 2008 in the United States, with 14,059 upper arm lift procedures performed in 2008. Numerous variations in the evolution of brachioplasty have been described to improve on complications and outcomes. Liposuction-assisted posterior brachioplasty is the nex...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181ebe23c
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:One of the most common complications of the use of foreign material, in both reconstructive and cosmetic breast surgery, is capsular contracture. Historically, research on capsular contracture has focused mainly on reducing bacterial contamination through antibiotic solutions. Only secondary studies have foc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006553
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Although studies have analyzed quality of life in children with nonsyndromic craniosynostosis, to date nobody has investigated long-term quality of life in adults with nonsyndromic craniosynostosis. The purpose of this study was to compare quality of life in adult nonsyndromic craniosynostosis patients with ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004408
更新日期:2018-06-01 00:00:00
abstract::In a postoperative wound infection study in plastic surgery, 315 patients were randomized to either outpatient wound control after 30 days (group I) or self-control by questionnaire (group II). We present a new definition of wound infection based on physiologic wound healing. The surveillance of postoperative wound in...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00006534-199509001-00028
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Acellular dermal matrix is used in most postmastectomy implant-based breast reconstructions in the United States. It is believed to be safe, despite a slightly increased complication rate. Although never established in a unifying study, the primary advantage of acellular dermal matrix is believed to be an en...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,meta分析
doi:10.1097/PRS.0000000000006212
更新日期:2019-12-01 00:00:00
abstract::This study was undertaken to understand the control mechanisms differentiating circulation to normal skin and acute skin flaps. The approach was to compare the effects of systemic vasoactive drugs on skin blood flow in rats in acute skin flaps and identical areas of control skin. With this model it was felt that syste...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198303000-00018
更新日期:1983-03-01 00:00:00
abstract:BACKGROUND:It is not easy to find a management-based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae that do not describe the fistula details comprehensively and guide toward its management. The authors have come across a wide variety of fistul...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005169
更新日期:2019-01-01 00:00:00
abstract::Pectus excavatum is the most common deformity of the chest wall. The overwhelming majority of patients with pectus excavatum have no physiologic compromise. Adolescents beyond their growth spurt and adults who are asymptomatic are best served by placement of a silicone implant to correct the chest-wall defect. We have...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198407000-00007
更新日期:1984-07-01 00:00:00
abstract::Despite advances in breast implant surgery, capsular contracture remains a challenging sequela of reconstructive and cosmetic breast implant surgery. Although there are established modalities for treatment, most recently, acellular dermal matrix products have been suggested to have a role in preventing or diminishing ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e318262df58
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Face transplantation has emerged as a viable option for certain patients in the treatment of devastating facial injuries. However, as with autologous free tissue transfer, the need for secondary revisions in face transplantation also exists. The authors' group has quantified the number of revision operations...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002605
更新日期:2016-10-01 00:00:00
abstract::The nasolabial flap remains the favored technique for alar and lateral nasal reconstruction. Results with currently popular techniques tend to be inartistic and aesthetically disappointing. Improved results can be achieved, however, by a technique using a medially based nasolabial turnover flap for lining with a dista...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198706000-00010
更新日期:1987-06-01 00:00:00
abstract::The pathologic cause of both rare craniofacial clefts and congenital limb ring constrictions is the subject of some debate. Uncommon though these two conditions are, they have often been anecdotally reported in association. This study sought to determine the frequency of congenital limb anomalies in general and limb r...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199803000-00010
更新日期:1998-03-01 00:00:00
abstract::Treatment options for the craniosynostoses vary from conservative observation until completion of growth to radical remodeling in infancy. To further define the timing and type of treatment necessary in these complex disorders, we have retrospectively analyzed all patients operated on for this deformity during the pas...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:Unilateral cleft lip revision may be necessary to address visible scars, unequal anatomical boundaries, vermillion inequities, or some combination thereof. In the setting of more than one stigma, a complete recreation of the defect and repair is necessary. This study anthropometrically evaluates the results ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001560
更新日期:2015-09-01 00:00:00