We describe an unusual case of an aggressively invasive, recurrent xanthelasma palpebrarum which was unilateral in its occurrence. Despite characteristics that appeared malignantly invasive clinically, the lesion was benign. The surgical treatment consisted of wide excision and resurfacing of the eyelids with full-thickness skin grafts.

Eyelid Diseases↗

PubMed1987

Correction of enophthalmos and superior sulcus depression in the anophthalmic orbit: a long-term follow-up.

The purpose of this study was to review the long-term results in anophthalmic patients treated for enophthalmos. The patients in our series had augmentation of the volume of their orbital contents by subperiosteal placement of room-temperature vulcanized silicone. From 1972 to 1985, sixty-three patients received subperiosteal placement of room-temperature vulcanized silicone for their enophthalmos. Twenty-four of these patients were seen in long-term follow-up 1 to 13 years postoperatively. Indepth follow-up evaluation showed that room-temperature vulcanized silicone subperiosteal implantation for the treatment of enophthalmos and superior sulcus depression in the anophthalmic orbit is a reliable, safe procedure that is without serious complications and has excellent long-term results.

Adult↗

PubMed1986

A concentration gradient of bacteria within wound tissues and scab.

This investigation was designed to evaluate the effect of a synthetic moisture vapor permeable dressing on the size of the bacterial population of superficial wounds. Split-thickness donor sites were created in pig skin and were treated with a synthetic occlusive dressing (Tegaderm), with fine mesh gauze, or with nothing. All wounds became spontaneously infected with a variety of bacteria, predominantly with Staphylococcus epidermidis. The population of the Tegaderm wounds was always greater than that of the untreated controls, while that of the gauze treated wounds was equal to or less than that of the controls. Tegaderm dressed wounds healed more quickly than did the others. A gradient in the concentration of bacteria within the wounds was seen, with a very high concentration in the scab (10(8) cells/g), an intermediate concentration (10(6) cells/g) in the dermal layer, and the lowest concentration (10(4) cells/g) in the hypodermal level of the wound tissue. Such a gradient has not previously been reported. No evidence was seen that the level of infection declined over time for any of the dressings. Apparent bacterial clearing in earlier investigations may be due to the progressive loss of superficial wound tissues with the corresponding exclusion of the high concentration of bacteria within these layers from the tissue sampled.

Animals↗

PubMed1986

Your computer as your library.

Explore the source record for details and available documents.

Information Systems↗

PubMed1986

Surgical reconstruction of a difficult orbital cleft.

The natural history of an untreated coloboma with an orbital cleft in a 14-year-old girl is presented. The method of the surgical reconstruction of this defect is presented in detail: in a single operation the bony cleft was repaired and grafted, the globe was enucleated, and the lids and sockets were reconstituted.

Adolescent↗

PubMed1985

The incidence of experimental contracture varies with the source of the prosthesis.

Nominally equivalent gel-filled miniprostheses supplied by three different manufacturers were placed subcutaneously in rats under identical conditions in a double-blind comparison. The incidence of experimental contracture, defined by grossly visibly asymmetrical distortion of the implant, was 0, 9, and 91 percent for the different manufacturers, consistent with previous observations. Differences among the different implants with respect to the density of the fibrillar capsule structure, the cellularity, and the amount of extruded gel did not correlate with the incidence of contracture. Contracture rate was inversely proportional to the relative degree of filling of the prostheses, as reflected in deviations from the nominal hemispherical shape, and to the viscosity of the gel filling. For implants of the same type, the incidence of contracture was higher when the prosthesis was underfilled. Contracted capsules were more fibrous and contained more cells with microfilament bundles. It is concluded that the physical and geometric properties of silicone implants are critical in the expression of contracture and that these properties vary significantly among prosthesis manufacturers.

Animals↗

PubMed1985

The augmentation of soft tissue with injectable collagen.

Clinical experience has demonstrated the value of injectable collagen in treating small soft-tissue defects. Among the lesions that respond best to injectable collagen therapy are nasolabial and glabellar lines as well as areas of atrophy and soft scars. This material is a useful adjunct to surgical procedures and can correct contour irregularities that may follow rhinoplasty or rhytidectomy. The safety of injectable collagen has also been well demonstrated. The nature and incidence of treatment reactions (less than 3 per cent) remains unchanged since the close of clinical trials. Reactions have been localized, and although some have been cosmetically undesirable, none has been health-threatening. All ultimately resolve without therapeutic intervention. Immunologic studies have confirmed the benign nature and specificity of reactions to injectable collagen. The importance of proper injection technique cannot be overstated. Immediately upon injection, tissue blanching followed by whealing and overcorrection should be evident. These indicate the desired superficial placement of the material. The overcorrection helps to compensate for the loss of carrier saline, and it quickly dissipates. When properly injected, injectable collagen can be used safely and effectively to correct an array of soft-tissue contour irregularities.

Antigens↗

PubMed1979

The anatomical basis for common cosmetic anterior neck deformities.

The anatomical basis for some common anterior neck deformities, the key to which is the presence or absence of decussation of the platysma muscles at the midline, is described. A plea is made to be specific in describing these deformities, and to approach corrective surgery anatomically.

Adipose Tissue↗

PubMed1979

Experience with the Fasanella-Servat operation for ptosis of the upper eyelid.

A quick, simple, and reliable operation for the correction of mild to moderate ptosis in the presence of fair to good levator function was described by Fasanella and Servat nearly two decades ago. This operation consists of resection of the conjunctiva, tarsus, and müller's muscle using a conjunctival approach. We have performed this operation in 39 patients with good to excellent results in 38. Our criteria and experience are described.

Blepharoptosis↗

PubMed1979

Supportive therapy in burn care. Methods of excision.

Explore the source record for details and available documents.

Burns↗

PubMed1978

A microarchitectural model of regional variations in hypodermal mobility in porcine and human skin.

In this paper, we focus on the hypodermal component of the integument and its functional contribution to properties of skin mobility. A specially designed mechanical apparatus was used to measure hypodermal extensibility in vivo of 6-mm "island" punches at selected anatomical sites in anesthetized pigs. Representative regional hypodermal force displacement curves were found to differ statistically in magnitude of acceleration, slope, and extensions at breaking point. A vertically oriented "lattice network" of hypodermal fibrous elements arranged in geometric subunits is consistently seen in sample specimens. Microarchitectural differences in network configuration, geometric unit size, fat infiltration, and intrinsic collagen fiber length can be correlated directly to the biomechanical data. These findings are corroborated by light microscopy, scanning electron microscopy, and quantitative hydroxyproline concentrations. A similar network is confirmed in human cadaver biopsies. Clinically, our data suggest that skin mobility is at least partially allowed by unfolding and stretching of the hypodermal vertical collagen network, and that regional variations in fibrous network architecture satisfy specific functional requisites (e.g., joint mobility, skin stabilization), as well as serving as an expansile retractile reservoir for the deposition and absorption of fat.

Adipose Tissue↗

PubMed1978

Orbital blowout fractures: an approach to management.

Cadaver studies and clinical evidence are presented to suggest that medial wall fractures are often concomitant with orbital floor fractures. The medial wall fractures are located in the ethmoid bone midway between the medial canthus and the lesser wing of the sphenoid. These fractures may be the etiology of late enophthalmus. The discrepancy between the high frequency of occurrence of medial wall fractures in this study and the rarity of clinical diagnosis derives from the limitations of standard radiography. Computed tomography (CT scan) is useful in delineating these fractures. The operative approach is through an incision above the medial canthus. Surgical treatment includes reduction of the herniated periorbital fat and coverage of the defect with autogenous, homologous, or alloplastic materials.

Adult↗

PubMed1978

Study of encapsulation of silicone rubber implants in animals. A foreign-body reaction.

It has long been known that the formation of a fibrous capsule around an implant is a general phenomenon in nature, an inevitable result of the tissue defense mechanism called the foreign body reaction. We have investigated this reaction in animals and find it consists of a series of interrelated processes in which the final result may vary, depending on the susceptibility of the foreign material to phagocytosis, incorporation by giant cells, or isolation by fibrosis. This susceptibility depends, in turn, on the physical and chemical properties of the implant. The process of capsule formation, as well as the structure of the final capsule, is similar in animal models and in humans--so that investigations of human encapsulation may be done in animals. The cause of abnormal induration around human breast implants is still unknown, and the question of whether normal induration in the animal model can be used to elucidate abnormal clinical induration depends on further investigation of both phenomena.

Animals↗