• Title/Summary/Keyword: Wound closure techniques

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The superior lateral genicular artery flap for reconstruction of knee and proximal leg defects

  • Low, O-Wern;Loh, Tian Fu;Lee, Hanjing;Yap, Yan Lin;Lim, Jane;Lim, Thiam Chye;Nallathamby, Vigneswaran
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.108-114
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    • 2022
  • Reconstruction of defects around the knee region requires thin and pliable skin. The superior lateral genicular artery (SLGA) flap provides an excellent alternative to muscle-based flaps. The anatomy and the surgical techniques of the SLGA flap were reviewed and the results of cases using the SLGA flap for coverage of knee and proximal leg defects were analyzed. SLGA flaps were performed in two cases and followed up for at least 6 months. Twelve articles on the use of the SLGA flap were also identified. A review of 39 cases showed that the mean diameter of the perforator supplying the skin of the flap was 1.04 mm, while the mean diameter of the SLGA at its origin was 1.78 mm. The mean length of the pedicle measured from the origin of the popliteal artery was 7.44 cm. The average dimensions of the flap were 14.8×6.6 cm with primary closure of the donor site in 61.5% of cases. Of these cases, 38.5% were due to trauma, 23.1% were post-burn complications, 12.8% were defects after resection of tumors, and 10.3% were for ulcers post-bursectomy. The most common complication was flap tip necrosis. All studies reported favorable outcomes with complete wound healing.

Biocompatibility study of lithium disilicate and zirconium oxide ceramics for esthetic dental abutments

  • Brunot-Gohin, Celine;Duval, Jean-Luc;Verbeke, Sandra;Belanger, Kayla;Pezron, Isabelle;Kugel, Gerard;Laurent-Maquin, Dominique;Gangloff, Sophie;Egles, Christophe
    • Journal of Periodontal and Implant Science
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    • v.46 no.6
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    • pp.362-371
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    • 2016
  • Purpose: The increasing demand for esthetically pleasing results has contributed to the use of ceramics for dental implant abutments. The aim of this study was to compare the biological response of epithelial tissue cultivated on lithium disilicate ($LS_2$) and zirconium oxide ($ZrO_2$) ceramics. Understanding the relevant physicochemical and mechanical properties of these ceramics will help identify the optimal material for facilitating gingival wound closure. Methods: Both biomaterials were prepared with 2 different surface treatments: raw and polished. Their physicochemical characteristics were analyzed by contact angle measurements, scanning white-light interferometry, and scanning electron microscopy. An organotypic culture was then performed using a chicken epithelium model to simulate peri-implant soft tissue. We measured the contact angle, hydrophobicity, and roughness of the materials as well as the tissue behavior at their surfaces (cell migration and cell adhesion). Results: The best cell migration was observed on $ZrO_2$ ceramic. Cell adhesion was also drastically lower on the polished $ZrO_2$ ceramic than on both the raw and polished $LS_2$. Evaluating various surface topographies of $LS_2$ showed that increasing surface roughness improved cell adhesion, leading to an increase of up to 13%. Conclusions: Our results demonstrate that a biomaterial, here $LS_2$, can be modified using simple surface changes in order to finely modulate soft tissue adhesion. Strong adhesion at the abutment associated with weak migration assists in gingival wound healing. On the same material, polishing can reduce cell adhesion without drastically modifying cell migration. A comparison of $LS_2$ and $ZrO_2$ ceramic showed that $LS_2$ was more conducive to creating varying tissue reactions. Our results can help dental surgeons to choose, especially for esthetic implant abutments, the most appropriate biomaterial as well as the most appropriate surface treatment to use in accordance with specific clinical dental applications.

Arthroscopic Cannulated Screw Fixation Technique for Avulsion Fracture of the Intercondylar Eminence of the Tibia (삽관 나사못(Cannulated screw)을 사용한 경골 과간 융기부 견열 골절의 관절경적 치료 기법)

  • Lee, Kee-Byoung;Chang, Ho-Guen;Lee, Seok-Beom;Moon, Young-Wan;Kang, Ki-Hoon;Lee, Wook-Hyung
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.127-131
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    • 1999
  • Avulsion fractures of the intercondylar eminence of the tibia are not uncommon. In the displaced avulsion fracture, anatomical reduction and firm fixation of fracture fragments are needed but the most of the conventional operative techniques including arthroscopic technique are relatively complex and need. The results were not always satisfactory due to the risk of postoperative complications such as wound infection, premature epiphyseal closure and loss of fixation after early motion etc. So we describe a simple and safe modified method of arthroscopic reduction and fixation for avulsion fractures of the intercondylar eminence of the tibia. In our thirteen cases, we achieved anatomical reduction and secure fixation using cannulated screw through the three arthroscopic portals (anterolateral, medial mid-patellar and central). Postoperatively, immediate limited range of motion of the knee and partial weight bearing were possible. Additional use of the washer afforded safe fixation of comminuted avulsion fracture. The advantage of this technique includes its technical simplicity, easy removal of hardware, ability to treat comminuted type IV fracture with washer, no additional skin incision, no damage to growing plate in growth children and less morbidity.

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