In this ongoing experience of application, ADM has been shown to be a simple, safe, and helpful tool to reduce fistula rate mainly in relatively wide and high tension tenuous cleft palate repairs but less favorable in challenging fistula closure attempts particularly along with poorly vascularized surrounding tissues. However, study design and its results are yet far from strongly recommending routine ADM use in cleft palate surgery.
The nose anatomy is a functional and aesthetically important organ because of its three-dimensional structure, visible location in the face region, and its connection with the respiratory tract. Aesthetic and reconstructive nasal surgery requires correction of deformations in cartilage and bone structures as well as preservation of the natural connections between all subunits. The minimal mistake made can result in functional or aesthetically bad results. In this study, the authors aimed to create an experimental nose model that help aesthetic and reconstructive nose surgery operations.
Management of an exposed tissue expander in breast reconstruction patients remains a challenging problem. For large defects that cannot be repaired primarily, local flap options are limited. In this case report, we describe the use of lateral intercostal artery perforator (LICAP) flap in salvage of an exposed tissue expander of a patient who had delayed immediate breast reconstruction after mastectomy. The postoperative recovery was uneventful and tissue expansion followed by radiotherapy was well tolerated by the flap. We believe this is the first article to describe the use of LICAP flap in salvage of an exposed tissue expander of the breast due to mastectomy flap necrosis in the early postoperative period.
The principal aim of skin expansion is to provide additional donor tissue without extra donor-site morbidity. Most of the reports about tissue expansion are focused on the properties of expander. Donor-site decision is usually underestimated. Here, we offer to use the defect area and surrounding healthy tissue as the donor site.In 4 cases, expanders were placed just under the defect in a fashion to extend 1 to 2 cm more laterally toward the encircling healthy tissue. The expanded tissue was not mobilized for longer distances; thus, there was no loss in flap gain. The resulting final scar was linear or crescentic. In the Alagoz technique, tissue gain similar in size to the defect is sufficient for reconstruction. The simpler the flap, the best the resulting scar.
Background
The palmaris longus (PL) is one of the most anatomically variable muscles in the body. Although these variations are often asymptomatic, symptoms related to nerve compression can sometimes be encountered. If treatment is indicated, correct diagnosis is important for successful management. In cases of upper extremity nerve compression, variations of the PL should be included in the differential diagnosis. We report a case of reversed PL (RPL) with symptoms of median nerve compression and review the literature, emphasizing the rare and challenging character of these lesions.
Methods
The literature review was performed using Google Scholar and PubMed databases. Keywords were “reversed palmaris longus,” “reversed palmaris longus median nerve compression,” “anomolous palmaris longus muscle,” and “symptomatic palmaris longus.” Only clinical RPL muscle cases with at least one of the symptoms of paresthesia and pain in the median nerve sensory area or swelling on the wrist were included.
Results
In the literature review, 21 publications including 30 patients, matched the search criteria between 1973 and 2018 and were evaluated.
Conclusion
In carpal tunnel syndrome, in cases with atypical presentation, RPL should be considered in the differential diagnosis.
As the authors have shown in the present study, ADSCs have favorable effects on the viability of composite grafts. They have increased the survival rate of the grafts to a considerable extent. As a clinical implication of this experimental study, the authors think that in the patient of auricular and nasal defects involving the cartilage and the skin, injection of the ADSC and the adaptation of composite grafts 4 days after the preparation of the receiving bed may increase the composite graft viability rates. Thus, it has been found that if the composite grafts are implanted 4 days after stem cell injection, the injection of adipose tissue-derived mesenchymal stem cells is useful in enhancing the survival of composite grafts.
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