Handy locoregional flaps for nasal reconstruction

Background Skin lesions on the nose are common.Multiple surgical techniques have been used for nasal reconstruction.These options may be autogenous or alloplastic and can be performed in single or multiple stages.The choice of coverage depends on the nature of the lesion,location on the nose,and available donor sites.This study aimed to evaluate the surgical outcomes of using locoregional flaps for nasal reconstruction.Methods A total of 27 patients underwent surgery.There were 9 men and 18 women,aged 7 months to 93 years.Four patients presented with involuting hemangioma,five patients with ischemic necrosis of the columella,and five patients with congenital nevus;the remaining 13 patients were previously diagnosed with basal cell carcinoma.Six techniques have been described for nasal reconstruction at our institution from 2016 to 2020.Most patients had basal cell carcinoma(n=13).Locoregional flaps and primary sutures were used for nasal reconstruction.Results The complications were minimal.One patient had a superficial infection and one experienced postoperative bleeding.No recurrence was observed,and none of the patients asked for a second opinion.Conclusion Radical excision of tumors combined with analysis of nasal defects and nearby donor sites is essential for nasal reconstruction.The use of locoregional flaps leads to consistent and good aesthetic outcomes.

Oral Propranolol: A Useful Treatment for Infantile Hemangioma

Background: Infantile haemangioma is the commonest childhood tumor. Several lines of treatment are available. Recent reports have focused on the value of propranolol in treating rapidly proliferating haemangioma. The aim of this study was to assess oral propranolol in treatment for facial haemangioma. Patients and Methods: Fifteen patients with rapidly proliferating infantile facial haemangioma with cosmetic disfigurement were treated with oral propranolol. All patients had cardiovascular pre-treatment work-up and commenced on oral propranolol at 3 mg/kg/day. Results: A rapid decrease in hemangioma proliferation was seen in 100% of patients and significant regressions occuring in all patients. This treatment was well tolerated and had little side effects. Conclusions: Oral propranolol is a reliable and easily reproducible method for treatment of facial hemangioma.

Assessment and management of immature facial scars by non-surgical methods

Background:Scar quality is affected by patients’wound healing conditions,trauma type,and skin features that differ due to ethnicity.Despite tremendous improvements in scar remodeling techniques,conspicuous scars can still remain postoperatively.Non-surgical methods used for handling scars include the use of topical corticosteroids,pressure therapy,lasers,and platelet-rich plasma(PRP).This study aimed to assess and evaluate different non-surgical modalities for treating immature facial scars.Methods:Fifteen patients with scars were included for non-surgical management.They received one or more of 5 treatments:corticosteroid injection,topical silicone gel application with or without bandage,pressure therapy,lasers,or PRP injection.Scars were assessed using the Patient and Observer Scar Assessment Scale(POSAS)and serial photographs.Results:There were no significant differences in the results obtained using POSAS.None of the patients required a secondary intervention or sought a second opinion.The rate of complications associated with the treatments were very minor.Conclusion:Good assessment of patient characteristics,proper planning,and appropriate treatment lead to favorable outcomes.

A multidisciplinary approach to sphincter pharyngoplasty for correction of velopharyngeal dysfunction following repair of cleft palate

Background:Management of severe velopharyngeal dysfunction is best performed by a multispecialty team.This team could include a speech-language pathologist,otolaryngologist,prosthodontist,and a plastic surgeon.The most commonly performed surgical procedures in complicated cases with scarred soft palate are sphincter pharyngoplasty and pharyngeal flaps.In this study,a multidisciplinary approach was applied for proper assessment and surgical intervention using sphincter pharyngoplasty for velopharyngeal insufficiency after cleft palate repair.Methods:Twenty patients underwent sphincter pharyngoplasty.Preoperative diagnosis was performed using auditory perceptual assessment,nasoendoscopy assessment,nasometry,and videofluoroscopy.Results:There were statistically significant differences between the preoperative and postoperative assessments.Bleeding occurred in two patients.Obstructive sleep apnea occurred in three patients and was resolved spontaneously within three months,and one patient experienced slight wound dehiscence.Conclusion:Velopharyngeal dysfunction after cleft palate repair is best treated by a multidisciplinary team through speech therapy together with sphincter pharyngoplasty.

Micropunch grafting for healing of refractory chronic venous leg ulcers

Background: Chronic venous ulcers are a serious problem for both patients and physicians. The CEAP classification(clinical manifestations(C), etiologic factors(E), anatomic distribution of disease(A), and underlying pathophysiologic findings(P)) for chronic venous disorders(CVD) was developed in 1994. Published papers on CVD use all or part of the CEAP. Micropunch grafts, which are a variation of skin grafts, have been used with great success in plastic surgery for both esthetic and reconstructive purposes. This study aimed to assess the outcomes of micropunch grafting in the treatment of chronic refractory venous ulcers.Methods: Patients with chronic venous ulcers who did not respond to conservative treatment for more than 6months were included in the study. All patients underwent ulcer coverage by micropunch skin grafts using a micrometer. The patients were discharged on the same day as the surgery. Micropunch skin grafts were manually counted per square centimeter intraoperatively and during follow-up using Dermlite DermatoschopeTM II Pro HR.Patient satisfaction was assessed by using a questionnaire.Results: Twenty patients underwent the surgery. Most of the patients were middle-aged males. The ulcers were predominantly small-and medium-sized. The mean operation time was 167.00 ± 86.01 min. After 6 months, the survival rate of the planted micrografts was 84%. Three ulcers had graft loss and two patients had an infection at the ulcer site, which was managed conservatively. The patients were followed-up for 14 months.Conclusion: Micropunch grafting is a useful and convenient method for the treatment of difficult venous ulcers and can be performed on an outpatient basis.

Negative pressure wound therapy： An update

PurposeTo 没有滥用或 misuse.MethodsFourty 弊病，在尖锐、长期的创伤的管理得到帮助真空的闭合(休假) 的最大的利益病人们在学习被包括。在他们之中， 9 个病人有长期的创伤和剩余的 32 个病人有的尖锐创伤。在尖锐创伤， 19 个病人有 co 疾病的条件。有的 gaped 伤害的七个病人， 4 个病人有 necrotizing fasciitis， 2 个病人有住院时期从 1 ～ 6 个星期改变了的 enterocutaneous fistula.ResultsThe。后续时期直到 6 个月。没有死亡在这研究期间被记录。所有皮肤接枝显示出完全的愈合。Necrotizing fasciitis 与好结果被管理。有 enterocutaneous 管的创伤改善了。在长期的创伤，好愈合和优秀结果是 obtained.ConclusionThe 休假治疗是为有问题的尖锐、长期的创伤的管理的一个必要元素。