A rotational technique to manipulate microsurgical instruments has several advantages. Tremor is suppressed, the hands remain relaxed for long periods of time, and the nondominant hand is able to play a more active role in the operation. The fundamentals of rotational technique are discussed.
The ring technique for end-to-side microvascular anastomosis employs a resorbable polyglycolic acid ring to prevent stenosis and spasm at the anastomotic site. In 20 rats, the ring technique was compared with the conventional technique for constructing end-to-side anastomoses between the femoral (0.9-1.1 mm) and superficial epigastric (0.3-0.4 mm) arteries. The ring technique proved superior to the conventional end-to-side technique both in speed of execution and in patency at 3-4 weeks (100% vs 70%). Grossly and microscopically, the ring was completely resorbed at 3 wk.
We investigate whether the application of liposuction to the nasolabial region is a useful adjunct to the rhytidectomy procedure. We have devised a system to grade the severity of the depth and the length of the nasolabial folds pre- and postoperatively. This grading system was used to evaluate the nasolabial region in 60 consecutive patients who underwent rhytidectomy. We compared two subgroups: those who underwent rhytidectomy alone (Group I) and those who underwent rhytidectomy augmented by liposuction in the region of the nasolabial folds (Group II). A change in the length of the fold occurred in 2% of Group I and in 30% of Group II. A change in depth of the fold occurred in 12% of Group I and in 70% of Group II. These results suggest that suction-assisted lipectomy consistently improves the results of rhytidectomy in the region of the nasolabial fold.
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