https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(06)68935-6.pdf

First human face allograft: early report

Aim. This paper discusses the critical determinants of pressure ulcer development and proposes a new pressure ulcer conceptual framework. Background. Recent work to develop and validate a new evidence-based pressure ulcer risk assessment framework was undertaken. This formed part of a Pressure UlceR Programme Of reSEarch (RP-PG-0407-10056), funded by the National Institute for Health Research. The foundation for the risk assessment component incorporated a systematic review and a consensus study that highlighted the need to propose a new conceptual framework. Design. Discussion Paper. Data Sources. The new conceptual framework links evidence from biomechanical, physiological and epidemiological evidence, through use of data from a systematic review (search conducted March 2010), a consensus study (conducted December 2010–2011) and an international expert group meeting (conducted December 2011). Implications for Nursing. A new pressure ulcer conceptual framework incorporating key physiological and biomechanical components and their impact on internal strains, stresses and damage thresholds is proposed. Direct and key indirect causal factors suggested in a theoretical causal pathway are mapped to the physiological and biomechanical components of the framework. The new proposed conceptual framework provides the basis for understanding the critical determinants of pressure ulcer development and has the potential to influence risk assessment guidance and practice. It could also be used to underpin future research to explore the role of individual risk factors conceptually and operationally.

/pdf/a-new-pressure-ulcer-conceptual-framework-21ecxax4x4.pdf

A new pressure ulcer conceptual framework

Excellent book is always being the best friend for spending little time in your office, night time, bus, and everywhere. It will be a good way to just look, open, and read the book while in that time. As known, experience and skill don't always come with the much money to acquire them. Reading this book with the PDF oral and maxillofacial pathology a rationale for diagnosis and treatment will let you know more things.

/pdf/oral-and-maxillofacial-pathology-a-rationale-for-diagnosis-d76gmlp6cr.pdf

Oral and maxillofacial pathology: a rationale for diagnosis and treatment

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(09)61155-7.pdf

Near-total human face transplantation for a severely disfigured patient in the USA

Learning Objectives:After studying this article, the participant should: 1. Understand scalp anatomy, hair physiology, and skin viscoelastic properties as they relate to scalp reconstruction. 2. Understand the principles that allow for aesthetic reconstruction of scalp defects. 3. Understand the use

Reconstruction of Acquired Scalp Defects: An Algorithmic Approach

Background
Macromastia usually is associated with the physical and psychological symptoms reported comprehensively by many studies. Reduction mammoplasty seems to be the most reasonable solution for these symptoms, and many articles have reported improvement of these complaints after surgery. Some authors have postulated that the anatomic mechanisms of postural aberrations are heavy breasts and related pain symptoms. However, limited numbers of studies have tried to explain the effect of the heavy breasts on the vertebral column.

The Impact of Breast Size on the Vertebral Column: A Radiologic Study

Background:  The present study analyses the results of wide excision with primary closure (PC), wide excision with classical Limberg flap reconstruction (LF) and wide excision with modified Limberg flap reconstruction (MLF) in the surgical treatment of sacrococcygeal pilonidal disease.



Methods:  One hundred and sixty-two well-documented patients who were operated on for pilonidal disease and followed for more than 1 year were analysed retrospectively. Group 1 was composed of patients with excision plus PC (n = 78) while group 2 included those with excision plus a LF reconstruction (n = 40), and group 3 included those with excision plus a MLF reconstruction (n = 44).



Results:  There were no significant differences among the three groups with respect to age, sex distribution, frequency of recurrent disease, or follow-up periods (P > 0.05 for all comparisons). Significant disadvantages regarding postoperative infection rate, mobilization time, discharge from hospital, and time off work were noted for primary closure, compared with both LF and MLF reconstructions. Following a median follow-up period of 4.2 years, 14 recurrences (17.9%) developed in the PC group, three (7.5%) in the LF group, and none (0%) in the MLF group. The zero recurrence rate in the MLF group was significantly lower than that in the PC group (P = 0.003). On the other hand, the recurrence rate in the LF was not found to differ significantly from that in the PC group (P = 0.126). Comparing the LF and MLF groups, none of the surgical end points reached a statistically significant difference (P > 0.05 for all comparisons).



Conclusions:  For the surgical treatment of sacrococcygeal pilonidal disease, excision plus a classical or modified Limberg flap reconstruction proved to be superior to excision plus primary closure in terms of infection, mobilization time, discharge from hospital and time off work. Additionally, MLF reconstruction resulted in a statistically lower recurrence rate when compared with PC.

Modified Limberg flap reconstruction compares favourably with primary repair for pilonidal sinus surgery.

Functional tolerance following face transplantation in the rat.

Although fat grafts are considered the ideal soft-tissue fillers, the main concern dealing with this technique is not being able to predict long-term graft survival due to high absorption rates. The purpose of this study was to investigate the angiogenic effects of preconditioning the recipient area with micro-needling and to determine its overall impact on fat graft survival. The study consisted of a sham, control and study group. The source of fat was the Wistar albino rat inguinal fat pad while the recipient area was a dorsal subcutaneous pouch. The dorsal area was preconditioned with standard technique micro-needling 1-week prior to fat graft transfer in the study group while the control group did not undergo micro-needling. At the end of 15 weeks, morphological, biochemical, histological and immunohistochemical evaluation was carried out. Fat grafts in the study group had better integrity and a higher level of vascularity compared to the control group. Volume analysis demonstrated higher graft survival in the study group in comparison to the control group. Histomorphometric and immunohistochemical evaluation showed better graft integrity and uniform adipocytes, less fibrosis, less vacuolisation and inflammation and better vascularisation in the study group. Although higher triglyceride concentrations were measured for the study group, the difference between the two groups was statistically insignificant. In conclusion, fat grafting performed in an area preconditioned with micro-needling results in higher graft volume, better integrity and vascularisation and an overall higher graft survival rate.

https://www.jprasurg.com/article/S1748-6815(14)00025-4/pdf

Improving fat graft survival through preconditioning of the recipient site with microneedling

The face is a functional as well as an esthetic part of the body. It is the window through which we interact with others: two thirds of our communication is through nonverbal facial expressions. Reconstructing partial or full facial deformities caused by burns, trauma, or tumors still challenges most reconstructive surgeons. The ideal reconstructive procedure should address both the functional and esthetic units of the face.

Prospects for facial allograft transplantation in humans.

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