Letter to the editor: Should the subcutaneous tissue be plicated in a face lift?
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Soft-tissue thickness modifications were evaluated by high-resolution ultrasound sonography in six patients undergoing skin expansion, with the aim of investigating the possible use of this noninvasive method in the routine monitoring of soft tissues during and after skin expansion. Both during expansion (decrease) and in the postoperative period (increases up to 100 percent or more of the baseline preoperative value), changes in fat thickness occurred faster and were greater in magnitude than those in dermal tissue, overall gradual and limited. In our series, the values of fat thickness ranged between 44 (at full-expansion time) and 140 percent (2 months after expander removal), with a highly significant difference (p = 0.0003), while dermis thickness values ranged between 83 and 114 percent, respectively, showing no significant difference (p = 0.71). Some echo-structural dermal modifications were found by the 20-MHz probe at full skin expansion only. High-resolution ultrasound sonography may be proposed as a noninvasive method in the routine monitoring of soft tissues during and after skin expansion.
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We have developed a new skin transplantation method, called the skin fenestrating transplantation method, in which the nude mouse skin covering the lesion was removed one week after the transplant was embedded. One week later, transplanted psoriatic skin was biopsied and specimens were examined by electron microscopy. The basal cells and the nuclei of transplanted psoriatic epidermis were long and slender. Projections of basal cells extended to the dermis. Erythrocytes and lymphocytes were seen in the intercellular space. In the spinous cell layer, the cytoplasm and the nuclei were round. In the cytoplasm, mitochondria and endoplasmic reticuli were abundant, and tonofibrillar formation was poor. In the upper part of the epidermis, the cells were horizontally elliptic and, in the cytoplasm, short tonofibril bundles were formed. In the uppermost layers, in the cytoplasm of flat cells, degenerated flat nuclei, low dense lipid droplets and clumps of ribosomes were observed. These findings resembled the findings of intact psoriasis lesions more closely than those obtained by the skin embedding transplantation method.
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In the interests of producing an improved periodontal dressing material, adhesive cements are under consideration. A new glass ionomer system--aluminoborates--shows some potential in this respect, and a relatively soluble formulation was chosen for a simple biological test in rats, by means of implantation in polypropylene tubes. As a positive control, the widely used aluminosilicate cement Aspa was employed, and empty tubes were used as negative controls. A simple scoring system using interval measurements was employed, and showed no difference at the 5% level between the experimental cement and either control, although slight differences were discernible between controls. The study also indicated that the side of a filled tube is not the best control for assessment of reaction at tube ends.
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This article deals with the treatment of extensive avulsion injuries. Five out of twenty-eight cases of extensive avulsion injuries are presented and illustrated. All of these injuries were caused by machinery or automobile accidents and were encountered in the three-year period from 1972 to 1975. Etiology, pathology, and treatment with mechanical and chemical debridement, porcine skin grafts, fasciotomy, delayed primary closure, stamp or mesh skin grafts, and skin flaps are detailed and discussed.
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The present work studied the reaction caused in the connective tissue of rats by implantation of two brands of gutta-percha cones, and thermoplasticized gutta-percha cylinders. Thirty-six rats were used, in groups of 12, for periods of 15, 30, and 60 days. Each animal received one test implant of each material, and one implant of Teflon as control. The cylinders, and one of the brands of gutta-percha cones, were well tolerated by the connective tissue. The cones of the other brand elicited different reactions, of which the possible causes are herein discussed.
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