[The repair of the vermilion border with an orbicular musculocutaneous flap].
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Biomedical subjects
Publications and source records attributed to A Faga.
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The authors present the documents of plastic surgery preserved in the University of Pavia's History of the University Museum. They include clinical papers, drawings, surgical instruments, and anatomic preparations. Most of these documents relate to the activity of Luigi Porta, who was a general and plastic surgeon and professor in the Medical School of the University of Pavia from 1832 to 1875.
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This article describes a one-stage technique to reconstruct up to one-third of the vermilion after full-thickness excision of the lips. It is based on a mucosal elliptically shaped random island flap from the inner lip, combined with a conventional skin flap from the surrounding area. The procedure can be performed under local anesthesia. Healing is achieved in 8 days. The technique has been employed in 9 patients, both on lower and on upper lips and even on different sides of the same lip. The results are aesthetically and functionally good.
Some biochemical characteristics of collagen extracted from granulation tissue were studied and compared with those of normal skin and scar. By using electrophoretic techniques the type III collagen content was confirmed to be significantly greater in granulation tissue and lower in scar with respect to normal skin. The chromatographic determination of hydroxylysine (Hyl) glycosides in collagen extracted from granulation tissue showed a significant increase in both the degree of Hyl glycosylation and in the di-/monoglycoside ratio, while both parameters turned out to be lower in scar. These data suggest that the degree of Hyl glycosylation and the di-/monoglycoside ratio could represent an index of the degree of collagen fiber maturation.
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By the aid of radioimmunologic assay, the authors measured the cAMP content of the reactive capsules around solid dimethylpolysiloxane implants in mice at different times; they also measured the same substance in some human connective tissues (granulation tissue and normal dermis) and compared together all the values they obtained. Different concentrations of cAMP in different tissues seem to reflect correspondent histologic findings, since they vary according to them. These values also seem to indicate a close correspondence between the development of the process of wound healing and of the foreign-body reaction following the implantation of alloplastic materials. On the basis of these data, the authors suggest an experimental therapeutic trial to enhance peripheral cAMP synthesis in order to control the process of reactive capsule constitution.
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