Successful plastic procedures of the perineum.
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Biomedical subjects
Publications and source records attributed to J S Silverton.
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A patient who developed clostridial infection of the abdominal wall following laparotomy for small bowel perforation is described. Immediate debridement resulted in the loss of the entire abdominal wall. Dressing of the exposed viscera during the period of stabilization and prior to reconstruction was achieved using amniotic membranes.
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The tensor fascia lata (TFL) muscle, together with the overlying skin of the anterolateral thigh, makes a reliable musculocutaneous unit. It can be lengthened safely by taking the fascia lata and the skin of the anterolateral mid and lower thigh to within 8 cm of the knee. The skin of the longer flap is supplied by large perforating musculocutaneous arteries, the terminal branches of the vascular pedicle of the muscle. The shorter flap can easily be transposed over the trochanteric area, while the larger flap will cover not only the trochanter but also the ischial and sacral areas. The flap serves equally well as a transposition, island, or free flap. The anatomical and vascular basis of the flap is presented, together with its application in 21 patients. Possible further applications of the flap, including anterior rotation, are discussed.
The transmaxillary K-wire is a simple, fast, safe, and effective technique for the fixation of unstable tractured malar bones. Combined with other techniques such as interdental fixation it simplifies and provides the fixation of the Le Fort II fracture or osteotomy and certain osteotomies used for facial advancement. The technique of insertion is described and illustrated.
A method of pharyngoplasty based on the orticochea principle of using lateral pharyngeal flaps which contain the palaptopharyngeus muscle, is described. The results of this procedure, and its advantages over other methods, are presented.