Introduction In aesthetic surgery, we have a few evaluation tools that numerically and objectively measure the changes we make in patients. This article aimed to evaluate the nasal systematic analysis and compare findings between the three systems of nasal evaluation: photographs 2D, 3D surface imaging with the Kinect system, and 3D CT scan imaging. Methods We designed a longitudinal and descriptive prospective study with simple non-blind randomization. To compare the systematic nasal analysis between the three methods. If the findings are similar, all three methods would be useful in independent clinical scenarios. Results A total of 42 observations were included finding a minimum age of 21 with a mean of 28 years old. Also, 64% were female, 93% had adequate facial proportions, and 50% were Fitzpatrick III. For outcome statistics, we found differential nasal deviation between 3D images with a mean of 6.53 mm. While when comparing the nasal dorsum length, we found a statistical significance of p = 0.051. When comparing the nasal dorsum length index, we found no significant difference p = 0.32. Also, we did not find statistical significance when comparing the nasofrontal angle and tip rotation angle p = 1 for both. Conclusion We found that the population we serve has characteristics of Hispanic mestizo nose. The three methods seem to evaluate systematic nasal analysis in a very similar way, and any of them can be used depending on the scenario and the needs of plastic surgeons.
3D printing has been used for teaching purposes. Creating models for simulating surgeries. Gong et al presented a workflow for digital planning for surgery and Rendon et al previously presented a low-cost method with acceptable precision. This paper aims to present a case where 3D printing surgical planning was applied for bone graft shape and dimensions. A 16-year-old female patient with a history of bilateral cleft lip and palate has received 6 surgical interventions to treat her congenital pathology. She begins orthodontic management at the age of 6 years and is referred to the plastic surgery service 10 years later, presenting oral and nasal fistula on the nasal floor with mainly liquid leakage. A bone graft was taken and applied from the patient's left iliac crest. the iliac crest is taken and the bone graft is molded Assisted with 3D printed model which is fixed in the premaxilla with a 14-hole linear plate. We proposed a new application for low-cost 3D printed models. Patient specific models have applications in cleft palate bone grafting. We present a case and more studies are required to measure variables as time, graft integration, and patient satisfaction.
Introduction: Autografts are useful but unfortunately are limited in big dural defects, in such cases, synthetic implants have been recommended. Extensive evidence in the literature suggests that sometimes synthetic implants had high rates of complications like infections. This paper aims to present a novel dura matter graft based on capsule granulation tissue harvested from subcutaneous space as a dura substitute and its histological findings. Materials and Methods: Wistar rats between 240 and 430 grams of both genders were included. First stage procedure introducing silicon spheres in the subcutaneous tissue. Second stage procedure 4 weeks later harvested de capsule granulation tissue that contain them. Then a craniectomy was performed to create a dura mater defect. This defect was reconstructed with the granulation tissue was placed onlay the defect. After another 4 weeks the subjects were euthanized and sent to an external pathology unit for analysis with validated integration scales. Results: A total of 5 subjects were included (3 males and 2 females) with weight between 240 and 430 grams. Only 2 outcome out of 6 scales had significance difference between the samples: adhesions P ¼ 0.011 and integration P ¼ 0.006. Conclusions: The histological findings shown that capsule granulation graft is a compatible, autologous compatible substitute for dura mater. It has a great potential of full integration and an acceptable grade of adhesions.
Introduction: Zone I extensor tendon lesion accompanies an avulsion fracture of the bone insertion. A common complication of traditional pull-out is the necrosis of the site of the button in the finger pad. Zhang described an alternative way of anchoring the cerclage to the Kirschner Wire (K-wire) to relieve the pressure in the finger pad. He describes the use of wire cerclage, for fracture reduction. The objective of this paper is to perform a comparison between wire and nylon using Zhang pull-out technique. Material and methods: We performed a cohort study comparing Nylon versus Wire in Zhang technique. Comparing cosmetic satisfaction, stiffness, residual pain, and Crawford scale. Results: When comparing the outcomes between both groups, we found no statistical difference in cosmetic satisfaction (p = 0.285), stiffness (p = 0.460), and residual pain (p =1.000), overall complications (p = 1.000), or Crawford scale (p = 1.000). We only found a significant statistical difference in pain when removing the cerclage, being greater in Group B (p = 0.008). Conclusions: We found no significant outcome difference between nylon and wire cerclage. However, at the time of removing it, patients experience less pain.
Investigaciones recientes sugieren que el ambroxol se relaciona con el bloqueo de la entrada de sodio durante el potencial de acción en las neuronas nociceptivas. Este trabajo tiene como objetivo comparar el manejo del dolor sin analgésico, con paracetamol o con ambroxol, en pacientes con tenorrafia. Los pacientes fueron asignados a tres grupos. El grupo A no recibió ningún tratamiento analgésico, el grupo B se trató con ambroxol y el grupo C se trató con paracetamol. La evaluación del dolor se hizo mediante el protocolo Duran-Houser en cada articulación. Recolectamos 31 casos en un mes. El dolor se presentó en el grupo A en 3-4 de la escala visual analógica, 2-4 en el grupo B y 2-4 en el grupo C. No se encontró diferencia significativa entre los tres grupos en ninguna de las semanas evaluadas. Concluimos que nuestros hallazgos encontraron una falta de asociación y que el ambroxol no aumenta la tolerancia al dolor, en comparación con los que usan paracetamol o con los pacientes que no reciben analgésico. Además, no se encontraron diferencias en los resultados funcionales después de la rehabilitación, por lo que no fue necesario un análisis adicional.
Summary: The anatomic position of the auricle leaves it vulnerable to traumatic lesions. In most cases, the best reconstructive outcome is accomplished using a temporoparietal flap with a costal cartilage frame and a partial thickness skin graft. Exceptional cases may require different approaches because the reconstructive goals could be more structural than aesthetic. An important factor in this regard is the mechanical properties of the skin that will provide coverage. This study aimed to share a particular case of total auricular reconstruction assisted by 3D surface imaging and 3D printing in a radial forearm free flap. We present a 58-year-old man with a history of having tympanic barotrauma causing hearing loss, burdening him with the use of auricular devices for hearing assistance. Seven days before presenting for the initial treatment, he sustained ear trauma while performing mechanical reparations in a car. The wheel was activated, causing a total amputation of the right ear. He first went to another hospital‚ where they performed primary closure and then referred him to our unit. The team performed a prelaminated radial forearm free flap assisted by 3D scanning and planning. A detailed comparison between the left ear and the result of the reconstruction was measured and described. The radial forearm prelaminated free flap is a viable structural alternative with the disadvantage of poor auricular definition in some cases.
Summary: Free-flap monitoring is challenging to perform in some centers. It requires the availability of trained health care personnel for 24 hours a day and seven days a week. Many methods had been proposed for flap monitoring, and none of them are superior to clinical evaluation. This study aimed to present a murine model to evaluate the accuracy (sensitivity, specificity, and the positive or negative predictive values) of a device. Wistar rats weighing 240–490 g were included for intervention and data collection. A murine model of left inferior epigastric vessel flaps was implemented. Intermittent pedicle clamping was performed to calculate the accuracy of the device that detects flow obstruction. The general variables studied were age, weight, and gender. The sensitivity, specificity, and negative or predictive values were calculated. The results showed a sensitivity of 97%, a specificity of 95% with a positive predictive value of 95%, and negative predictive value of 97%. The sensitivity and specificity showed excellent results within the range of clinical security. We require more data to analyze the multiparameter monitoring to see if it is feasible and cost-effective.
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