No abstract available.
Polyurethanes* ; Transplants*

No abstract available.
Animals ; Rats* ; Transplants* ; Veins*

Todays, remnant split-thickness skin graft is stored for graft failure or for delayed grafting. Refrigerated skin is usually stored for 3 weeks, after which, cellular respiration ceaces. Even though the refrigerated skin can be used before 3 weeks after harvest, the success rate of the skin graft is usually lower than in case of fresh skin. One of the most reliable explanations is multiplication of microorganisms on the stored skin, that is, the more microorganisms on the refrigerated skin, the less the success rate of grafts. For this reasons, some kind of antibiotics have been used for storage of the split-thickness skin piece. But there is no report about the effect of antibiotics on stored skin. We want to know the effect of the antibiotics on stored skin. For this purpose, we did three experiments for qualititative bacteriology of refrigerated skin. Experiment 1 was qualititative identification of microorganisms colonizing split-thickness skin after 2 weeks storage in low temperature, and sensitivity tests for identified microorganisms. On the basis of experiment 1, the proper antibiotics were selected and samples of split-thickness skin were stored using this antibiotics. At 2 weeks after storage in low temperature, samples of split-thickness skin were cultured for identification of bacterial growth. This is experiment 2. Experiment 3 is histologic examination of the split-thickness skin involved in experiment 1 and 2.In the experiment 1, we found five kinds of microorganisms in 9 out of 30 split-thickness skin samples. The most common microorganism was coagulase negative Staphylococcus which was found in 4 samples. Through the antibiotics sensitivity test, teicoplanin was selected as the most proper antibiotics. In experiment 2, we could not find any microorganisms in 30 split-thickness skin samples. In experiment 3, there were no histologic differences in the split-thickness skin samples whether antibiotics were used or not. Through these results, we have confirms that split-thickness skin pieces are more safely stored using proper antibiotics.
Anti-Bacterial Agents* ; Bacteriology ; Cell Respiration ; Coagulase ; Colon ; Skin* ; Staphylococcus ; Teicoplanin ; Transplants

The purpose of this study was to investigate the functional recovery of end-to-side neurorrhaphy in rats. There have been several studies about the results of end-to-side neurorrhaphy from a histologic or eletrophysiologic view point. However, histologic or electrophysiologic parameters may not correlate with the actual nerve function. In this study we assessed the results of end-to-side neurorrhaphy functionally using walking track analysis. Forty-eight male Sprague-Dawley rats were randomly divided into 4 group, with 12 rats in each group. Group 1 was the sham-operation group. Group 2 was the peroneal nerve transection group. In group 3, the peroneal nerve was severed and end-to-end neurorrhaphy was carried out. In group 4, the peroneal nerve was severed and coapted end-to-side to the lateral face of the tibial nerve after removal of the epineurium arid perineurium. Walking track analysis was done every 2 weeks up to 16 weeks. Group 3 recovered 80.4% in peroneal function at postoperative 16 weeks, whereas group 4 recovered only 46.0%. In group 2, it was impossible to measure the peroneal function by walking track analysis because of plantar flexion contracture after 6 weeks. We concluded that the end-to-side neurorrhaphy group showed better results compared with the nerve transection group. However, the end-to-end neurorrhaphy group showed still better results in the walking track analysis of rats.
Animals ; Contracture ; Humans ; Male ; Peripheral Nerves ; Peroneal Nerve ; Rats* ; Rats, Sprague-Dawley ; Tibial Nerve ; Walking*

No abstract available.
Antibodies, Monoclonal* ; Skin*

No abstract available.
Melanoma* ; Proliferating Cell Nuclear Antigen*

No abstract available.
Scalp*

The clinical applications of free have been extended tremendously in head and neck reconstruction. In a nine-year period, 92 microvascular free flaps were performed to repair the defects following major head and neck ablative surgery. Twenty-one transverse rectus abdominis myocutaneous flaps, 18 radial foream flaps, 15 latissimus dorsi muscle flaps, 12 jejunal flaps, 8 fibular osteocutaneous flaps, 6 rectus abdominis muscle flaps, 6 iliac osteomyocutaneous flaps, 2 groin fasciocutaneous flaps, 1 scapular fasciocutaneous flap, 1 parascapular osteocutaneous flap, 1 tensor fascia lata muscle flap and 1 serratus anterior muscle flap were used for reconstruction. Twenty-five maxillary defects including the orbit or skull base, 16 pharyngoesophageal defects, 15 intraoral defects, 15 mandibular defects, 13 scalp defects, 1 cervical region and 7 other facial region were covered with various free flaps. The overall success rate of the flaps was 95.6%. The complications included total flap loss (3 cases), partial flap loss (1 case), recurrence of primary tumors (15 cases), cerebrospinal fluid leakage (3 cases), fistula formation (3 cases) and infection (5 cases). Superficial temporal artery, facial artery, superior thyroidal artery, lingual artery, occipital artery, transverse cervical artery were commonly used recipient arteries and 7 cases of vein grafts were used if indicated. End to end anastomosis was performed in 84 cases and end to side anastomosis in 8 cases. The average follow-up period was 42 months, ranging from 6 months to 8 years. One patent died during postoperative intensive care due to sepsis and 19 patients died because of recurrence of tumors and underlying medical diseases during the follow-up period. Although free flaps may appear to be riskier than traditional forms of reconstruction, they offer the surgeon a greater spectrum of reconstructive options. Free flap reconstruction also improves the quality of life and minimizes the loss of function. Limitations of the use of free flaps result only from a lack of technical skills and specialized equipment.
Arteries ; Cerebrospinal Fluid ; Fascia Lata ; Fistula ; Follow-Up Studies ; Free Tissue Flaps* ; Groin ; Head* ; Humans ; Critical Care ; Myocutaneous Flap ; Neck* ; Orbit ; Quality of Life ; Rectus Abdominis ; Recurrence ; Scalp ; Sepsis ; Skull Base ; Superficial Back Muscles ; Temporal Arteries ; Thyroid Gland ; Transplants ; Veins

Until recently, cranial base tumors or midfacial tumors were deemed unresectable due to an inability to accurately diagnose the extent of the involvement and to approach and excise the tumor safely. With refinements in CT and NMR scanning, as well as the development of craniofacial technique, reconstruction has become absolutely crucial in allowing successful resection of these tumors. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amendable to local tissue closure. In such cases, free tissue transfer was an effective alternative because it can provide a large amount of well-vascularized tissues arts reliable separation of the intracranial space from bacterial flora of the upper airway. Microvascular free tissue transfer was used in 15 patients at our center to reconstruct the cranial base and/or midfacial defects. Of these 12 were free rectus muscle flaps, 2 were free latissimus dorsi muscle flaps, 1 was a free scapular osteocutaneous flap and 1 was a free scapular fasciocutanegus flap. There were 2 cases of total flap loss. In those cases, revisions were performed using latissimus dorsi muscle free flap in one case and STSG in the other. One patient had a postoperative cerebrospinal fluid leak which was spontaneously resolved by conservative management. The large complex defects were successfully reconstructed by one-stage operation and the functional and esthetic results wee satisfactory with acceptable complication rates.
Cerebrospinal Fluid ; Free Tissue Flaps ; Humans ; Skull Base* ; Superficial Back Muscles

No abstract available.
Abdominal Wall*