No abstract available.

We present our experience with calvarial bone framework insertion through an intraoral approach for a patient who was at risk for columellar necrosis due to a previous open rhinoplasty. A 58-year-old woman exhibited severe columellar contracture, so that the columellar tissue was too fragile to be touched. We could not incise the columella and insert a new nasal implant through the bilateral rim incision. Moreover, the patient had septal cartilage perforation and collapse. The patient needed columellar support as well as nasal dorsum reconstruction. The authors decided to graft an autogenous L-strut bone framework through an intraoral approach. Two pieces of 5-cm × 1-cm sized split calvarial bone were harvested and trimmed to fit the width and length of the nasal dorsum and columella. The right-angle-shaped bone framework was made with an absorbable plate and screws. Through a gingivobuccal incision, the bone framework graft was inserted and the graft was fixed with absorbable screws. The patient did not experience complications such as skin necrosis or inflammation. A bone framework grafted through an intraoral approach can be a good choice for patients who have experienced scar contracture in the columella, septal cartilage perforation, and collapse.
Cartilage ; Cicatrix* ; Contracture* ; Female ; Humans ; Inflammation ; Middle Aged ; Necrosis ; Oral Surgical Procedures ; Rhinoplasty ; Skin ; Transplants*

This study aimed to examine the positive effects of polydeoxyribonucleotide (PDRN) on the wound-healing process in pressure ulcers. In this randomized controlled trial, the effects of PDRN were compared over time between an experimental group (n=11) and a control group (n=12). The former was administered the same dose of PDRN intramuscularly (1 ampule, 3 mL, 5.625 mg, for 5 days) for 2 weeks and perilesionally (1 ampule, 3 mL, 5.625 mg, twice a week) for 4 weeks. The primary endpoint for determining efficacy was wound healing in the pressure ulcers, which was reflected by the wound surface area determined using VISITRAK Digital (Smith & Nephew, Largo, FL). The secondary endpoint was the pressure ulcer scale for healing score, determined using pressure ulcer scale for healing (PUSH Tool 3.0 developed by the National Pressure Ulcer Advisory Panel). After the 4-week treatment period, PDRN therapy was found to significantly reduce the wound size and PUSH score, without adverse effect during the treatment. The findings indicate that PDRN can positively modify the wound healing process in pressure ulcers, and its use could improve the clinical outcomes of patients and lower the need for additional therapies or hospital stay.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Injections, Intramuscular ; Male ; Middle Aged ; Polydeoxyribonucleotides/*therapeutic use ; Pressure Ulcer/*drug therapy ; Treatment Outcome ; Wound Healing/*drug effects ; Young Adult

Repeated or chronic pressure on the eminent part of the body will cause circulation disorder to the affected part of the body. The lack of circulation will result in damage and necrosis of the tissue. This phenomenon is defined as pressure sore. Due to growth of aging population and chronic disease, incidence and prevalence rate is in-creasing rapidly. This leads to increased duration of hospital stay, and medical expenditure. Hence, prevention of pressure sore and appropriate treatment is essential in order to diminish distress of the patient and health care provider. Prevention of pressure sore can be accomplished by frequent position change of the patient, skin care, and appropriate nutrition care. Frequent position change is known to be the most important and effective method to prevent pressure sore. Skin care can be achieved by choosing proper dressing material, management of exu-date, and protection of the tissue around the wound. In addition, appropriate nutrition care in order to correct protein-calorie imbalance should also be performed. Necrotic tissue can cause inflammation, and it can also be a good source of bacterial growth. Therefore, debridement of necrotic tissue is most fundamental and essential part in the treatment of pressure sore. Meanwhile, when the patient is not a candidate for surgical treatment due to poor general condition, many methods of dressing can be performed. Recently, dressing material with silver component, and vacuum assisted closure dressing is being performed frequently. In case of surgical treatment, after debridement of necrotic tissue, reconstruction can be performed by split-thickness skin grafting, full-thickness skin grafting, or primary closure. However, majority of reconstruction is performed by flap surgery. Rotation or advancement flap is usually performed.
Aging ; Bandages ; Chronic Disease ; Debridement ; Health Expenditures ; Health Personnel ; Humans ; Incidence ; Inflammation ; Length of Stay ; Necrosis ; Negative-Pressure Wound Therapy ; Pressure Ulcer* ; Prevalence ; Silver ; Skin Care ; Skin Transplantation ; Wounds and Injuries

PURPOSE: Because of traffic accidents and many criminal violences, the incidence of facial trauma has been increasing not only in adults but also in children. We planed this study to introduce our experience about pediatric blow out fracture and provide more information. METHODS: We made retrospective study in 76 children with blow out fracture from January 2001 to September 2005 by retrospective chart review including detailed preoperative and postoperative evaluations, age, sex, cause, symptom and sign, and their post-operative complications. RESULTS: Among our patients, 69 were male and 7 were female. The ages ranged from 7 to 18 years, which shows the greatest incidence of blow out fracture. Physical violence(46%) was the most common cause in this group and was followed by vehicle accident(28%), and fall down accident(17%). Left side(64%) showed slightly more incidence than right side(36%), but there were no statistical importance. Ecchymosis(88%) was the most common symptom and followed by periorbital swelling(68%) and diplopia(30%). 30 patients was diagnosed with another facial bone fracture and nasal bone(51%) was the most common associated facial bone fracture. Fourty four Patients(60%) got an orbital wall reconstruction in 7 days after trauma. After the operation, only 3 patients(4%) suffered from diplopia postoperative 3 month, and resolved in 4 years. CONCLUSION: The incidence of blow out fracture in children has been increasing every year, and violence has become more important etiology of pediatric blow out fracture and public and private education institutions were the most common place that blow out fracture originated. Accurate diagnosis and careful treatment plans are important in pediatric blow out fracture.
Accidents, Traffic ; Adult ; Child ; Criminals ; Diplopia ; Facial Bones ; Female ; Humans ; Hypogonadism ; Incidence ; Male ; Mitochondrial Diseases ; Ophthalmoplegia ; Orbit ; Orbital Fractures ; Retrospective Studies ; Violence

To determine the efficacy of the 585nm pulsed dye laser in the treatment of traumatic or surgical scar. We made retrospective study with 26 patients and used 585nm pulsed dye laser (V-Star(R), 7mm spot size, mean 9.3J/cm2)in the treatment of traumatic or surgical scar. Scar were evaluated before and after the laser therapy by photo graph and Vancouver Scar Scale and Color Chart Manual and Visual Analogue Scale. Three month later after the last laser therapy, final scar analysis by the blinded examiner revealed a improved patient's satisfaction by visual analogue scale and much improvement on VSS parameter(vascularity and pigmentation) and Color Chart Manual. 585nm pulsed dye laser is effective and safe in improving the quality and cosmetic appearance of erythematous and hypertrophic scar.
Cicatrix* ; Cicatrix, Hypertrophic ; Humans ; Laser Therapy ; Lasers, Dye* ; Retrospective Studies

BACKGROUND: Facial rejuvenation can be achieved using a variety of techniques. Since minimally invasive procedures for face lifting have become popular because of their convenience and short operating time, numerous minimally invasive surgical procedures have been developed. In this study, a nonabsorbable polypropylene mesh is introduced as a new face lifting instrument, with the nasolabial fold as the main target area. In this paper, we report the efficacy and safety of a polypropylene mesh in midface rejuvenation. METHODS: Thirty-three subjects with moderate-to-severe nasolabial folds were enrolled from two medical institutions for a noncomparative single-sample study. A mesh was inserted above the superficial muscular aponeurotic system layer, reaching the nasolabial folds through a temporal scalp incision. After 3 weeks, the temporal end of the mesh was pulled to provide a lifting effect. Then, the mesh was fixed to the deep temporal fascia using nonabsorbable sutures. To evaluate efficacy, we compared the scores on the Wrinkle Severity Rating Scale and a visual analog scale for patient satisfaction between the baseline and 7 weeks postoperatively. In addition, we evaluated safety based on the incidence of adverse events. RESULTS: The treatment was deemed effective at improving wrinkles in 23 of 28 cases, and patient satisfaction improved significantly during the study period. There were seven cases of skin or subcutaneous tissue complications, including edema and erythema, but there were no suspected serious adverse events. CONCLUSIONS: Face lifting using a nonabsorbable mesh can improve nasolabial folds without serious adverse effects. Thus, this technique is safe and effective for midface rejuvenation.
Edema ; Erythema ; Fascia ; Incidence ; Lifting ; Nasolabial Fold ; Patient Satisfaction ; Polypropylenes* ; Rejuvenation* ; Rhytidoplasty ; Scalp ; Skin ; Subcutaneous Tissue ; Surgical Procedures, Minimally Invasive ; Sutures ; Visual Analog Scale

The Rejuran(R) is a new filler product made from purified polynucleotides. Here we present data from an animal study and a clinical trial to examine the durability, efficacy and safety of the Rejuran(R) on crow's feet. For the animal study, 25 mice were divided into three groups: Group 1 received phosphate buffered saline (PBS); Group 2 were treated with Yvoire(R); and Group 3 were treated with Rejuran(R). The durability and efficacy of each treatment were assessed by microscopy and staining. In the clinical trial, 72 patients were randomized to receive Rejuran(R) treatment for crow's feet on one side and Yvoire-Hydro(R) on the contralateral side, at a ratio of 1:1. Repeated treatments were performed every two weeks for a total of three times, over a total of 12 weeks' observation. All injections and observations of efficacy and safety were performed by the same two investigators. In the animal study, the Rejuran(R) group showed similar durability and inflammatory response to the Yvoire(R) group. Upon efficacy assessment, the Rejuran(R) group showed the greatest elasticity and collagen composition, and a significant difference in skin surface roughness and wrinkle depth. In the clinical trial, the primary and secondary objective efficacy outcome measure showed no statistical significance between the two groups, and in safety outcomes there were no unexpected adverse effects. Our data suggest that the Rejuran(R), as a new regenerative filler, can be useful to reduce wrinkles, by showing evidence for its efficacy and safety.
Adult ; Animals ; Dermatologic Surgical Procedures/*methods ; Double-Blind Method ; Elasticity/drug effects ; Female ; Humans ; Hyaluronic Acid/adverse effects/*therapeutic use ; Injections, Intradermal ; Male ; Mice ; Middle Aged ; Polynucleotides/adverse effects/*therapeutic use ; Skin ; Skin Aging ; Surgery, Plastic/*methods ; Treatment Outcome ; Wound Healing

PURPOSE: To evaluate the usefulness of various radiographic imaging modalities in the diagnosis and characterization of melorheostosis. MATERIALS AND METHODS: We retrospectively evaluated the plain film (n=8), computed tomographic (CT) imaging (n=5) and magnetic resonance (MR) imaging (n=5) findings of eight patients with melorheostosis diagnosed by bone biopsy (n=4) and characteristic radiographic findings (n=8). MR images were obtained with a 1.5-T scanner focused on the region of maximal radiographic abnormality. Pulse sequences include T1-weighted SE, T2-weighted fast SE (n=5) and postcontrast imaging (n=4). In order to define subtle enhancement of the lesions, subtraction MR images were obtained in one case. Imaging findings were analyzed with particular emphasis on the distribution of lesions along the sclerotome, differential radiographic findings between diaphyseal and metaepiphyseal lesions of the long bones, as seen on plain radiographs, and the density and signal characteristics of hyperostotic, lesions, as seen on CT and MR images. RESULTS: Characteristic distribution along the sclerotome was identified in five of eight cases mainly along C6 and 7 (n=2) and L3, 4 and 5 (n=3) sclerotomes. In diaphyseal melorherostosis (8/8), a characteristic finding, i.e., a wax flowing down from the candle, was identified on plain radiographs. In all three patients with metaepiphyseal melorheostosis (3/8), multiple round or oval hyperostotic lesions were seen in the epiphysis and metaphysis of the long bones. On CT, the marrow cavity was partly obliterated by hyperostotic lesions in all five patients with endosteal hyperostosis. Among these, central ground glass opacity with a sclerotic rim was seen in three patients. Periosteal hyperostosis was seen in two of five cases, being visualized as irregular excrescences in the periosteal region and surrounding soft tissue. Individual hyperostosis was visualized as hypointense on T1-weighted images and as a hyperintense center with a surrounding hypointense rim on T2-weighted images (5/5). On postcontrast images, central enhancement was noted in all four cases. In one of these, in which the degree of central enhancement was subtle, subtraction images (postcontrast SE- precontrast SE) also revealed a central signal increment. Central enhancement corresponded to the hyperintense center seen on T2-weighted images (4/4) and the ground-glass opacity seen on CT (2/2). CONCLUSION: Radiographic imaging plays a crucial role in the diagnosis of melorheostosis. The future role of gadolinium-enhanced MR imaging in the characterization of the lesion may be important though further evaluation and pathologic correlation is required.
Biopsy ; Bone Marrow ; Diagnosis ; Epiphyses ; Glass ; Humans ; Hyperostosis ; Magnetic Resonance Imaging* ; Melorheostosis* ; Retrospective Studies