The open finger technique for the release of syndactyly.

A new technique of syndactyly release is described. The technique differs from the standard methods in that more digital flaps are used, and these are longer and are not defatted. A single stitch is applied to secure the tip of the flap and the defects between the flaps are not closed or grafted, hence the term "open" technique.

Nerve and blood vessel growth in response to grafted dermis and cultured keratinocytes.

The aim of this study was to study innervation and angiogenesis in response to grafts of dermis and cultured keratinocytes using immunohistochemical techniques. In a porcine model, fresh autologous de-epidermalized dermis and cultured autologous keratinocytes were combined using a two-stage technique, to produce keratodermal grafts. Wounds were encased within skin graft chambers that prevented the influence of the surrounding skin.

Regeneration pattern of blood vessels and nerves in cultured keratinocyte grafts assessed by confocal laser scanning microscopy.

The aim of this study was to investigate the pattern of both neovascularization and reinnervation, and the relationship between the two processes, in keratodermal grafts, using confocal laser scanning microscopy, at different time points during the healing process. Keratodermal grafts were prepared in pigs by combining autologous dermis with cultured autologous keratinocytes. Immunohistochemistry was carried out on thick cryostat sections (100-150 microns), using antisera to the endothelial marker von Willebrand factor (vWf) and the pan-neuronal marker protein gene product 9.

An animal model to study the significance of dermis for grafting cultured keratinocytes on full thickness wounds.

Autologous cultured keratinocytes grafted onto full thickness wounds take poorly, and any epidermal cover that is produced is unstable. However, a more stable epidermis has been reported when keratinocytes are grafted onto a dermal surface. We have developed a skin grafting model using a polytetrafluoroethylene (PTFE) skin graft chamber in the domestic pig.

Do babies require arm splints after cleft palate repair?

Traditionally, arm restraints are used in children after cleft surgery to prevent traumatic disruption of the repair. A questionnaire amongst consultant plastic surgeons in the UK that restraints are in common use. However, a prospective randomised trial of 46 children having primary cleft palate repair showed that arm splints did not decrease the incidence of oronasal fistulae.

Kerato-dermal grafts: the importance of dermis for the in vivo growth of cultured keratinocytes.

In a porcine model, we studied the benefit of dermis for the growth of cultured autologous keratinocytes (CAK) on full-thickness wounds isolated within skin graft chambers. Kerato-dermal grafts were prepared in a two stage process using autologous de-epidermalised dermis (DED) and CAK (Group 1). Control wounds were prepared by grafting either CAK only (Group 2) or DED only (Group 3).

A porcine model using skin graft chambers for studies on cultured keratinocytes.

In wound healing research, animal models permit an extensive tissue analysis which is not normally possible in clinical studies. A morphological comparison of human and porcine skin was made in order to identify those aspects of the wound healing process where a porcine model may help our understanding of clinical problems. We describe a porcine model for evaluating the growth of cultured keratinocytes on a variety of wound beds.

Yersinia enterocolitica infection of a prosthetic knee joint.

Yersinia enterocolitica is a very common organism which is mainly associated with gastrointestinal symptoms. It has not previously been associated with early or late infection of a prosthetic joint replacement. We report a case of late infection, seven years after an uncomplicated knee replacement.

Cystic hygroma of the breast in childhood.

Cystic hygromata are rare tumours of infancy. They usually occur at sites related to the embryological origins of the lymphatic system. A case is presented of a six-year-old boy with a cystic hygroma of the left breast.