Surgical treatment of hemangiomas and vascular malformations in functional areas.

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Het congenitale angiodysplasiesyndroom van het type Klippel-Trenaunay; medische en psychologische aspecten

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Donor-site complications in vascularized bone flap surgery.

Microvascular osteocutaneous free flaps have given reconstructive surgeons a powerful tool in the reconstruction of composite defects in head and neck surgery. Radial forearm, scapula, iliac crest, and fibula flaps have been used extensively in mandibular reconstruction. The inevitable donor-site morbidity of these osteocutaneous flaps has received less attention than the reconstructive advantages. We have reviewed the literature for each type of flap to determine the kind, incidence, and consequences of flap associated morbidity. In the future, tissue-engineered prefabricated free flaps might play an important role

Ectopic bone formation in rats: the importance of the carrier.

Contains fulltext : 48660.pdf (publisher's version ) (Closed access)Much research has been done to develop the ideal bone graft substitute (BGS). One approach to develop this ideal BGS is the use of growth factors, but for this approach osteoprogenitor cells are needed at the site of reconstruction. An alternative is a cell-based approach, where enough cells are provided to form bone in a carrier material. In previous studies of our group, titanium (Ti) carriers have been used, because of the excellent mechanical properties and the bone-compatibility of this material. On the other hand, calcium phosphate (CaP) ceramics are known for their excellent osteoconductivity. The aim of this study is to investigate the influence of the carrier in a cell-based bone regeneration approach, whereby we hypothesize that CaP-ceramic implants will induce more bone formation than Ti-fiber implants, in the same animal model as our previous experiment. Ti-fiber mesh implants and ceramic implants were seeded with rat bone marrow cells (RBM) and implanted subcutaneously. Histological analysis after one, three and six weeks showed differences in the way of bone formation in the two groups: bone appeared to grow from the center to the periphery of the implant in the titanium group, while bone formation in the ceramic group occurred through the whole implant. Histomorphometrical analysis after one week showed very limited bone formation for both the titanium and ceramic group. At three weeks, the amount of bone formation was increased till about 10% for the titanium group and 18% for the ceramic group. No significant difference between the two groups could be observed. In the six week group, the bone formation was 6% (Ti) and 23% (CaP), respectively (P < 0.001). Further, bone formation started earlier in the CaP-ceramic scaffolds than in the Ti scaffolds. Our hypothesis could be confirmed: ceramic implants induce more bone formation than titanium implants

Ectopic bone formation in rats: comparison of biphasic ceramic implants seeded with cultured red bone-marrow cells in a pedicled and a revascularized muscle flap.

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Prevention of wound dehiscence in palatal surgery by preoperative identification of group A Streptococcus and Staphylococcus aureus.

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Formation of a reliable capsular flap in a rat model.

Contains fulltext : 53549.pdf (publisher's version ) (Closed access)Prefabrication can be used to produce capsular flaps; other researchers have confirmed the feasibility of such flaps. Before the possibilities of capsular flaps can be explored, a reliable method to create these flaps has to be established first. METHODS: To produce capsular flaps in a rat model, the femoral vascular bundle was sandwiched between two silicone sheets. Three different methods were used and described. The capsule that formed between the two silicone sheets receives its main blood supply from that vascular pedicle. In this way pedicled capsular flaps were created. These flaps were used as a carrier for a skin graft, thus pre-laminating them, to test their ability for reconstructive surgery. The results of the three different methods of creating capsular flaps in a rat model were described and their results were evaluated. Especially the amount of capsule formation and the viability of the skin grafts was observed and compared. The feasibility of pre-laminated capsular flaps is confirmed and the most reliable method of creating them is described

Pedicled prelaminated capsular flaps for coverage of skin defect in a rat model.

Contains fulltext : 80523.pdf (publisher's version ) (Closed access)SUMMARY: In reconstructive surgery defects are closed using pedicled or free flaps. By raising these flaps the reconstructive surgeon creates new defects, which in turn are closed primarily or with the use of skin grafts. Inevitably, this results in extra scars that may be visible and may also lead to diminished function. In an attempt to avoid full-thickness donor site skin defects in reconstructive surgery, the principle of prefabrication has been modified to produce capsular flaps. In a rat model, we created prefabricated and prelaminated pedicled capsular flaps to fill a full-thickness skin defect. Both femoral vascular bundles in 10 Wistar rats were sandwiched between two silicone sheets. The capsule formed between the two sheets received its main blood supply from this vascular pedicle, and was used as carrier for a skin graft. After ligation of the distal femoral vessels a pedicled prelaminated capsular flap was raised on the proximal femoral vessels. The flap was brought to the surface for closure of an experimentally created abdominal skin defect. All 20 flaps survived, and there were no surgery-related complications. Comparison with controls indicated that flap survival was attributable to the blood supply from the vascular axis. Pedicled prelaminated capsular flaps can be created reliably and reproducibly, confirming the results of earlier studies, and are of value in reconstructive surgery