Head ; surgery ; Humans ; Neck ; surgery ; Skin Transplantation ; Subcutaneous Tissue ; transplantation ; Surgical Flaps

Subcutaneous dirofilariasis is a parasitic infestation found in endemic areas in Mediterranean countries such as Italy. It is occasionally reported in India, mostly from the state of Kerala. Presentation in an infant is extremely rare. We report a case of subcutaneous dirofilariasis in a child that was diagnosed by ultrasonography and confirmed by surgery.
Connective Tissue Diseases ; diagnosis ; diagnostic imaging ; parasitology ; surgery ; Dirofilariasis ; diagnosis ; diagnostic imaging ; surgery ; Female ; Humans ; Infant ; Subcutaneous Tissue ; Ultrasonography

OBJECTIVE: To explore the feasibility and effectiveness of plantar medial thin skin flaps preserving plantar fascia with its superficial fascia tissue to repair skin defects in hands and feet. METHODS: Between July 2017 and January 2023, 35 cases of hand and foot defects were repaired with plantar medial thin skin flaps preserving plantar fascia with its superficial fascia tissue (13 pedicled flaps and 22 free flaps). There were 18 males and 17 females, with an average age of 38.8 years (range, 8-56 years). Thirty cases of defects were caused by trauma, and the interval between injury and admission ranged from 2 to 6 hours (mean, 3.3 hours). Three cases were ulcer wounds with a course of 3.0, 3.8, and 7.0 months, respectively. Two cases were malignant melanoma. Eight cases of wounds located in the fingers, 13 cases in the palm, 12 cases in the heel, and 2 cases in the distal foot. The size of skin defects ranged from 4.0 cm×3.5 cm to 12.0 cm×10.0 cm, and the size of flap ranged from 5.0 cm×4.5 cm to 13.0 cm×11.0 cm. The donor sites were repaired with skin grafts. RESULTS: All flaps were survived and the wounds healed by first intention after operation. The partial necrosis at the edge of the skin graft occurred in 1 case, which healed after dressing change; the other skin grafts survived successfully. All patients were followed up 6-24 months (mean, 18 months). The flaps exhibited similar color and thickness to the surrounding hand and foot skin. Two-point discrimination ranged from 7 to 10 mm in the flaps with an average of 8 mm. The donor sites had no painful scars or sensory abnormalities. Foot and ankle functions were good and gaits were normal. CONCLUSION Application of plantar medial thin skin flaps preserving plantar fascia with its superficial fascia tissue to repair skin defects in hands and feet had good flap shape, high survival rate of skin graft at the donor site, and no obvious complications.
Male ; Female ; Humans ; Adult ; Plastic Surgery Procedures ; Subcutaneous Tissue/surgery* ; Soft Tissue Injuries/surgery* ; Skin Transplantation ; Fascia ; Free Tissue Flaps ; Treatment Outcome ; Perforator Flap

OBJECTIVETo report a method of repair facial skin defects with a skin flap of SMAS pedicle.

METHODSAccording to the size of defect of skin, design a skin flap with SMAS pedicle for repair of defect.

RESULTSThe method has been successfully applied for skin defects of eyelid and lip in 14 cases with satisfied results. The area of the largest flap was 5 cm x 3 cm.

CONCLUSIONRepairing facial defects such as eyelid skin defect or lip skin defect with skin flap of SMAS pedicle is a very good method. The flap has a good blood supporting and satisfactory color and flexibility.

Adolescent ; Adult ; Child ; Child, Preschool ; Facial Dermatoses ; surgery ; Facial Injuries ; surgery ; Humans ; Male ; Subcutaneous Tissue ; transplantation ; Surgical Flaps ; Young Adult

OBJECTIVETo investigate the clinical effect of penile augmentation with superficial fascia retrocession.

METHODSThe first annular incision line was designed, reserving the inner plate 0.5 -0.8 cm. The second annular incision line was determined, according to the length of penile erection. The skin tissue between the double loops was stripped, reserving the superficial fascia and the superficial dorsal veins. Before the closure of two annual incision with no tension, the superficial fascia tissue was pushed proximally and fixed sectionally to augment penis.

RESULTSFrom Jun 2009 to Jun 2011, 60 patients with redundant prepuce or phimosis were treated with this method. During 3 to 12 months follow-up, the postoperative penile perimeter increased significantly. The glans were exposed and the prepuce looked smooth. The function of the penis maintained undamaged.

CONCLUSIONSThe penile augmentation with superficial fascia retrocession can make full use of autologous tissue to augment penis, meanwhile, redundant prepuce can be resected. It is very practical for clinical application.

Adolescent ; Adult ; Circumcision, Male ; methods ; Humans ; Male ; Middle Aged ; Penis ; surgery ; Subcutaneous Tissue ; surgery ; Transplantation, Autologous ; Young Adult

OBJECTIVETo explore an ideal procedure with more lasting aesthetic results by covering the orbicularis oculi muscles with the superficial temporal fascia flap in rhytidectomy, which can help to correct the crow's feet successfully.

METHODSDuring rhytidectomy, dissection was performed subcutaneously and also under pericranium and superficial temporal fascia at temporal area. Then the superficial temporal fascia flap was formed by cutting between pericranium and superficial temporal fascia. The fascia flap was reversed to cover the lateral orbicularis oculi muscle with fixation.

RESULTSFrom May 2004 to May 2010, 18 cases were treated with a follow-up period of 6-12 months. The crow's feet was corrected better with long lasting results, compared with conventional rhytidectomy. No complication happened.

CONCLUSIONSThe crow's feet can be corrected markedly with long lasting results by covering the orbicularis oculi muscles with the superficial temporal fascia flap in rhytidectomy.

Adult ; Eyelids ; surgery ; Facial Muscles ; surgery ; Female ; Humans ; Male ; Middle Aged ; Rhytidoplasty ; methods ; Skin Aging ; Subcutaneous Tissue ; transplantation ; Surgical Flaps

We present a rare case report of foreign body of the nasal apex in a 22-year man who were hospitalized because of a bit of metal rebounded. There was slight bleeding at wound site with a feeling of pain and swelling. On physical examination, the apex lied in the median position with a bleeding cut about 3 millimeter in length. There was no visible stump on the cut or rupture in the nasal vestibular. Computed tomographic scan showed the abnormal high-density shadow in the nasal apex while the foreign body was located in the subcutaneous tissue of the antero-upper part of septal cartilage. The admitting diagnosis was foreign body in nasal apex. Endoscopic surgery was adopted to remove the foreign body.
Endoscopy ; Foreign Bodies ; surgery ; Humans ; Male ; Metals ; Nasal Cartilages ; pathology ; Nasal Cavity ; surgery ; Pain ; Subcutaneous Tissue ; pathology ; Young Adult

The patient, female, 27 years old. The scalp neoplasm had been found at her right temple 10 years ago. At first, the size of the tumor was just like a soybean, and did not grow obviously in the past nine and a half years. But the tumor increased fast in these six months, almost as large as the pigeon egg now. The physical examination showed that: A spherical tumor locates in the right temple near the right ear; the size of the tumor is 3 cm X 4 cm X 3 cm; the surface is smooth, no tenderness, no obvious mobile base, skull defect not touched. Primary diagnosis: the scalp cyst or lipoma. Under the local anesthesia we remove the neoplasm, during the operation we found the lesion located in the subcutaneous tissue layer, involved the galea aponeurosis layer, the skull surface are smooth and complete. The tumor was completely removed. We cut the mass and found a cystic cavity sized 3 cmX4 cm, which contained gray jerry-built materials, contained oil and a mass of hair, the capsule wall was complete. Postoperative pathological report: The tumor is cystic look throught the microscope, the capsule wall is squamous epithelium, containing keratinized material and hair. The pathological diagnosis is teratoma. The incision healed primarily, no recurrence found for about a year.
Female ; Humans ; Lipoma ; Neoplasm Recurrence, Local ; Scalp ; pathology ; Skin Neoplasms ; pathology ; surgery ; Skull ; Subcutaneous Tissue ; Teratoma ; pathology ; surgery

OBJECTIVETo investigate the feasibility and advantages of total auricular reconstruction with single big expander at dual plane through incision at remnant ear.

METHODS52 patients with microtia were treated. Through incision at remnant ear, one big expander (150 ml) was implanted in the post-auricular area beneath the superficial facial in the hairless area, and above the superficial fascia in the area with hair. In the second stage, total auricular was reconstructed with autologous cartilage framework and expanded skin. Skin graft was not necessary. Another 32 paitents with single big expander above the superficial fascia were used as control. The downward shift distance of expanders, the appearance of auriculocephalic sulcus and complication were recorded in order to assess the effect of these two methods.

RESULTSThe downward shift distance of expanders in the dual plane group (0.7 ± 0.3) cm were lower than that in the control group (1.3 ± 0.4) cm, showing significant difference (P < 0.05). After a follow-up period of 6-12 months, shallow auriculocephalic sulcus was presented in 5 patients of the dual plane group and 12 patient of the control group. The shallow auriculocephalic sulcus was cut to make it deeper and covered with full skin graft.

CONCLUSIONSDual plane skin expansion could reduce the downward shift distance of expander. Adequate skin on the upper part of expander could make satisfactory auriculocephalic sulcus.

Cartilage ; transplantation ; Congenital Microtia ; surgery ; Feasibility Studies ; Hair ; Humans ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Subcutaneous Tissue ; Surgical Flaps ; trends ; Tissue Expansion ; methods ; Tissue Expansion Devices

The surgical correction of postburn nose and lips deformities still remains a difficult task domain to be done by plastic surgery. Consequently, the performance of autogenous cartilage graft and ear cartilage graft to maintain a better philtral form were found to raise the problem of a defect in the unnatural form due to consecutive tension in the region. Recently, focus had been placed on composite graft, including auricular cartilage, to obtain a unique dimple in the philtrum, and concurrently with this, part of its natural form has been acknowledged. However, composite graft on scar beds with poor circulation on the recipient site dose not represent safe survival, has increased risk allotment, which laeds to difficult application. From Jan. 1992 to Dec. 1998, the authors have experienced auricular composite graft in 15 patients who had a defect on the philtrum due to postburn scar contractures. As types of this operation, in method I, the subcutaneous pocket is made at the midline of the upper lip. The next step is cartilage insertion into subcutaneous tissue. The cartilage graft is fixed to be overlying skin by the bolus sutures. In Method II, the recipient site is excavated by some excision of the soft tissue in the central upper lip after scar tissue excision. The obtained auricular skin composite graft is placed and fixed to the philtral area. In Method III the auricular skin composite graft is harvested, and 2 or more 2mm-sized multiple holes are made along the midline of cartilage. Then composite graft is fixed to the defects of philtrum. The elongated portion of the distal tip of cartilage is embedded into the vermilion tubercle for sprouting and fullness. The most effective method was Method III, which enhanced the survival of auricular cartilage graft and its overlying skin, by trimming the margin of grafts, and enhancement of the connecting vessels through fenestrated holes of cartilage between the recipient site and composite graft. The authors hereby report the results of the present study along with study findings based on literature surveys.
Burns* ; Cartilage ; Cicatrix* ; Congenital Abnormalities ; Contracture ; Ear Cartilage ; Humans ; Lip ; Nose ; Skin ; Subcutaneous Tissue ; Surgery, Plastic ; Sutures ; Transplants*