Periorbital giant congenital melanocytic nevus.
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Female↗
Biomedical subjects
S Stal
Publications and source records attributed to S Stal.
Conjunctival prolapse following craniofacial surgery.
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Cerebellar Diseases↗
Reconstruction of calvarial defects.
We subdivide the calvarium into three zones, each with its special reconstructive requirements. Based on our experience with calvarial defects in 13 patients, we favor use of autogenous material, especially in the face of previous infection or a scarred recipient bed. Alloplasts give excellent forehead contour but alloplastic reconstruction should be delayed for 1 year after injury. Vascularized bone grafts maintain contour well. They are best suited to large periorbital defects. At other locations we favor split calvarial free bone grafts. Occasionally, the defect may be so large as to warrant grafts from multiple donor sites. Use of vascularized muscle helps eradicate infection, provides a vascularized bed for free bone grafts, and fills dead space. The frontal sinus is managed either by cranialization (if the posterior wall is involved) or by mucosal stripping with obliteration of the nasofrontal duct. Additional technical considerations include rigid bone fixation, surgical exposure through a bicoronal incision, and meticulous handling of bone grafts.
Adolescent↗
Management of residual cranial vault deformities.
The aims of calvarial reconstruction are to restore anesthetic contour and to provide protection for the underlying central nervous system structures. The authors present their algorithm of reconstructive options. Important considerations are the anatomic location of the defect and the duration since the original injury.
Adult↗
A critical analysis of coronal incisions.
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Humans↗
Aesthetic considerations and the pediatric population.
Aesthetic surgery is the natural evolution of reconstructive surgery done to improve a patient's form in addition to function. This becomes especially critical in the pediatric age group in which patients are constantly evolving and their concepts of self-esteem and body image are so fragile.
Adolescent↗
Early surgical management of coronal synostosis.
Craniofacial surgery aims to allow proper expansion of the brain and the creation of an acceptable appearance. Early surgery represents an important means to attain these goals, with the choice of surgical technique being as critical as timing.
Age Factors↗
Salvage of amputation stumps by secondary reconstruction utilizing microsurgical free-tissue transfer.
During a 2-year period, 15 lower and upper extremity amputees were treated by microsurgical free-tissue transfer in an effort to salvage their amputation stumps. Salvage of length and restoration of contour to aid in prosthetic rehabilitation were the two main indications for reconstruction. Included in the 15 transfers were 3 scapular free flaps, 11 latissimus dorsi musculocutaneous flaps, and 1 groin flap. Thirteen of the patients in this group were refitted with prostheses following reconstruction and did well with no pain or skin breakdown of the resurfaced stumps. The follow-up period on these patients averaged 16 months. One patient, in whom the flap succeeded, underwent stump soft-tissue revision and myodesis. One patient, in whom the flap failed, continued to develop recurrent ulceration in his stump. This clinical experience followed an extensive laboratory study of 12 above-knee amputation patients using noninvasive Doppler ultrasound measurements to determine weight-loading and interface-pressure distribution between the stump and the socket of the prostheses and their relation to stump length and circumference.
Adolescent↗
Surgical treatment of acne scars.
Dermatologists and their plastic surgical colleagues treating acne vulgaris and its sequelae have an effective arsenal of anti-acne preparations to inhibit and avoid many of the long-term, cosmetically deforming effects of severe inflammatory acne. It is incumbent upon the physician participating in the care of the early and late sequelae of acne vulgaris to provide timely surgical therapy for those lesions requiring surgical drainage, extraction, or scar revision, while maintaining appropriate medical therapy for those areas of the skin still at risk to develop active disease.
Acne Vulgaris↗
Skin morphology and function.
Proper understanding of the cause, nature, and treatment of diseases affecting the skin requires an intimate knowledge of the anatomy and physiology of normal as well as pathologic skin. This article thus lays the groundwork for the discussions of specific pathologic conditions that follow in this issue.
Adipose Tissue↗
Nonexcisional therapy for benign skin lesions.
Benign skin lesions are commonly seen and treated in the physician's office using standard equipment. These simple techniques may be easily learned and can and should be effectively employed by plastic surgeons.
Chemexfoliation↗
Keratoacanthoma.
Keratoacanthoma is a benign epithelial tumor with a close resemblance to squamous-cell carcinoma both clinically and histologically. Both the pathologic status and treatment of keratoacanthoma are controversial.
Humans↗
Adrenergic receptors in insensitive skin of spinal cord injured patients.
The factors responsible for the increased susceptibility to decubitus ulcers of the insensitive skin of spinal cord injury (SCI) patients are not known. Autonomic dysfunction leading to defective vascularity is a possibility. SCI removes cerebral control of the isolated nervous system which may mimic denervation hypersensitivity of autonomic neural synapses, where an increase in number and a scattering of the receptors on the postsynaptic membrane leads to abnormal responses. Since adrenergic receptors mediate vascular tone and regulate blood flow in the skin, it would be of great interest to determine whether the number and the concentration of receptors in the insensitive skin of SCI patients is modified as a function of time since injury. To achieve this aim, alpha and beta adrenergic receptors were measured in biopsies obtained from intact skin used to surgically repair decubitus ulcers in SCI patients admitted to The Institute for Rehabilitation and Research. Receptors were identified by competitive radioligand-binding assays in whole skin homogenates. Patients were divided into two groups: patients injured less than five years ("early") and patients injured more than five years ("late"). Alpha and beta adrenergic receptors in both cervical and thoracic SCI patients decreased in density in the "late" patients. The small sample size and the inherent large errors of the assay precluded achievement of statistically significant differences. Nevertheless, a definite trend is seen: Disconnection of the adrenergic neurons from brain integration may mimic denervation and lead to abnormal vascular responses in the insensitive skin.
Adult↗
Melanoma of the head and neck. Update and perspective.
The diagnosis and appropriate treatment of melanoma remains a controversial subject. A review of the literature as well as evaluation of our experience allows for a better understanding of this challenging problem and the development of some up-to-date guidelines in the treatment of this disease.
Biopsy↗
Hemangiomas, lymphangiomas, and vascular malformations of the head and neck.
The etiology, diagnosis, and treatment modalities of common and not so common vascular malformations of the head and neck are discussed in this article.
Adrenal Cortex Hormones↗
Mons pubis as a donor site for split-thickness skin grafts.
It is extremely important that a donor graft site be selected with attention to the type of graft needed as well as the specific patient's needs and lifestyle. While it is inevitable that any donor site heals with altered pigmentation and texture, we feel that by using a combination of several time-honored techniques in this well-concealed donor site, we have achieved long-term aesthetic results of the transfer of skin grafts from a hair-bearing area.
Female↗