Cranioplasties by means of diced cartilage and split rib grafts.
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Biomedical subjects
Publications and source records attributed to P Wilflingseder.
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Three distinct methods have proved practicable: The dermafat-transposition (DeCholnoky), the skin flap procedures, and the retromammary implants. The motivation of the patient must be carefully balanced against various complications. Frequently a constrictive fibrosis impairs the primary pleasant shape, position, and consistency of the breasts soon or many years after implantation of soft polydimethylsiloxane material, due to phagocytosis and decomposition of plastic particles. Capsulotomy, capsulectomy, or squeezing of the implants can regain approximately the original good appearance, but does not solve the problem of continuous foreign body reaction. The malignancy risks require close follow-up examinations.
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From personal experience in the treatment of 655 patients with malignant epitheliomas of the skin, treated from 1966 to 1973 at the Department of Plastic and Reconstructive Surgery at the University Hospital, Innsbruck, the basic principles, methods, and results of treatment are reported. An adequate resection and a primary reconstruction is the method of choice. The clinical data and follow-up observations are analyzed and special types of treatment and indications are discussed. With it the 5-year-cure-rate of basal-cell carcinomas was 92%, of squamous-cell carcinomas 83%.
In the primary treatment of skin and soft tissue defects of the lower leg, after injuries or tumor excision, split skin grafting is the method of choice. But in respect to the late results, frequently additional plastic reconstructive measures, preferrably skin flap procedures, must be considered. Follow-up over decades and if necessary, skin transplantation, are mandatory to prevent interference of growth and function of the leg, as well as malignant degeneration of the scars.
Of the various methods of lining the vaginal canal with skin, i.e. split-skin, corium, and mesh grafts, the mesh graft offers the best results in terms of both take and shrinkage. The plastic surgeon's principle of performing construction or reconstruction work with similar or neighboring tissue is best met by the use of small-bowel composite grafts in the case of the vagina. Mucosa-muscularis grafts of sufficient size can be taken from the small bowel with relatively low risk; they take very well and the results also appear most appropriate from the anato-mical and physiological aspect.
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