Comparative study on the donor site aesthetic outcome between epidermal graft and split-thickness skin graft

Donor site aesthetic outcomes of epidermal graft (EG) vs split‐thickness skin graft (SSG) have yet to be objectively compared. Here, we evaluate donor site healing using a validated scar assessment tool and digital colorimetric technique, which compares colour in a consistent and objective manner. Ten patients (SSG (n = 5) and EG (n = 5)) were included. Donor site scarring was evaluated using the Vancouver Scar Scale (VSS) at Week 6 and Month 3. Colorimetric measurement was performed at Weeks 3 and 6 and Month 3. The mean donor site healing time for EG was significantly shorter (EG: 4.6 days (95% c.i. 3.8‐5.3), SSG: 16.8 days (95% c.i. 13.3‐20.1) (P = 0.003)). The VSS scores of the EG donor site were lower at Week 6 and Month 3(P < 0.001). The colour match between the donor site and surrounding skin for EG was better compared with SSG at all time points and was almost identical to their surrounding healthy skin at Month 3. This study is the first to objectively measure the clinical appearance of the EG donor site against SSG. EG donor site has faster healing with excellent scarring and good colour match with its surrounding normal skin at all time points compared with SSG

New otoplasty approach: A laterally based postauricular dermal flap as an addition to mustarde and furnas to prevent suture extrusion and recurrence

Prominent ear is the most common deformity of the external ear. The major causes can be an underdeveloped antithetical fold, concha hypertrophy, and prominence of the ear lobule. Since Ely's first aesthetic correction of the prominent ear in 1881, more than 200 different techniques have been described, but the choice of procedure still remains the surgeon's preference. This report presents the laterally based posterior auricular dermal flap technique as an adjunct to the conventional cartilage-sparing otoplasty. An elliptical skin incision was planned according to the classic prominent ear correction technique. Instead of the excision, skin was deepithelialized. From the inferior border of the incision, the dermal flap was incised and elevated in a medial-to-lateral direction. The posterior auricular dermal flap was used to support and cover the suture material. This method was used in the treatment of 17 consecutive patients. After a follow-up period of 6-32 months (mean 16 months), the patients were evaluated in terms of the recurrence and suture line problems. No suture line problems or recurrences were observed at the end of the follow-up period. Use of the posterior auricular dermal flap both prevents suture extrusion and decreases recurrences. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

Increased iNOS gene expression in the granulosa layer of F1 follicle of over-fed and under-fed broiler breeder hens

To clarify the effects of high (20 and 40% more than normal) and low (20% less than normal) daily feed allowance on egg and body parameters, ovarian morphology and plasma glucose, cholesterol, triacylglycerol, leptin-like hormone, nitrite/nitrate and gene expression of inducible nitric oxide synthase (iNOS) in the granulosa layer of F1 follicle, broiler breeder hens (30-week-old) were fed for 30 days. Egg and body parameters significantly changed between treatments (p<0.05). Effect of different level of feed intake on ovarian morphology parameters was significant (p<0.05), except for white follicles. After 30 days of experiment, plasma nitrite/nitrate (as a index of plasma nitric oxide) and leptin-like hormone increased in FI+20% and FI+40% groups as compared to controls (p<0.05). Plasma level of leptin-like hormone also significantly (p<0.05) increased in FI+40% group. The relative amount of iNOS mRNA expression in the granulosa layer of F1 follicles was significantly higher in FI-20% and FI+40% groups than in control group only after 4 weeks of experiment. The amount of these elevations in the FI-20% and FI+40% groups were 32.4% and 60.9% respectively. It was concluded that iNOS gene is normally expressed in follicular granulosa cells of F1 follicle of broiler breeder hens 2-4 hours before ovulation. However, over- and underfeeding of hens increased iNOS expression in F1 follicle, which may be one of the atresia-inducing factors in hierarchical follicles as shown by the significant (p<0.05) increase of shrunken follicles in the ovary of over- and under-fed broiler breeder hens after 30 days of feeding