Extensive Convexity Flattening of a Synthetic Skull Implant the Overcome Major Scalp Deficiency After Multiple Craniotomies.

Multiple craniofacial surgeries and postoperative recalcitrant infections frequently can lead to secondary scalp tissue scarring and skin retraction. Although there are different methods of reducing and optimizing scalp skin tension, the authors describe a last resort treatment method of cranioplastic procedure, which despite of its unfavorable cosmetic outcome, relieves the skin tension through extensive flattening of the polyetheretherketone curvature. Thereby, a custom-made cranioplastic bone flap was extensively flattened in the curvature of the fronto-parietal area with consideration of the related brain hemisphere extension.

Infection of the Hand.

is an opportunistic, low-virulence pathogen occasionally associated with human infections and found largely in immunocompromised patients and those with intravascular devices. We report the case of a healthy 70-year-old man who presented with an infection of the hand, who had no history of trauma but had been gardening for 4 months. Despite surgical debridement and empirical antibiotics, the infection could not be controlled.

Endoscopic Carpal Tunnel Release Using Wide-Awake Anesthesia.

Purpose: We report on patient and surgeon experience after single-port endoscopic carpal tunnel release (CTR) using wide-awake local anesthesia no tourniquet (WALANT) technique.

Methods: From July to November 2018, patients undergoing endoscopic CTR with WALANT were prospectively included. Follow-up was 3 months.

Diffuse Dermal Angiomatosis of the Breast: A Distinct Entity in the Spectrum of Cutaneous Reactive Angiomatoses - Clinicopathologic Study of Two Cases and Comprehensive Review of the Literature.

Diffuse dermal angiomatosis (DDA) is a rare reactive angioproliferation in the skin and considered to be a subtype in the group of cutaneous reactive angiomatoses. DDA is clinically characterized by livedoid patches and plaques with tender ulceration. Its histologic features are a reactive diffuse proliferation of bland endothelial cells and pericytes within the dermis, forming small capillary vessels.

In utero Plastic Surgery in Zurich: Successful Use of Distally Pedicled Random Pattern Transposition Flaps for Definitive Skin Closure during Open Fetal Spina Bifida Repair.

Background: One of the intraoperative challenges of fetal spina bifida repair is skin closure when there is an extended skin defect. Thus, we examined whether distally pedicled random pattern transposition flaps (TFs) are a valid option to overcome this problem.

Subjects And Methods: All patients undergoing in utero repair of spina bifida with application of a TF for back skin closure were analyzed focusing on intraoperative flap characteristics and postoperative flap performance.

Human Adipose Mesenchymal Cells Inhibit Melanocyte Differentiation and the Pigmentation of Human Skin via Increased Expression of TGF-β1.

There is accumulating evidence that interactions between epidermal melanocytes and stromal cells play an important role in the regulation of skin pigmentation. In this study we established a pigmented dermo-epidermal skin model, melDESS, of human origin to investigate the effects of distinct stromal cells on melanogenesis. melDESS is a complex, clinically relevant skin equivalent composed of an epidermis containing both melanocytes and keratinocytes.

Characterization of vasculogenic potential of human adipose-derived endothelial cells in a three-dimensional vascularized skin substitute.

Purpose: The need for clinically applicable skin substitutes continues to be a matter of fact. Hypothetically, a laboratory grown autologous skin analog with near normal architecture might be a suitable approach to yield both satisfactory functional and cosmetic long-term results. In this study, we explored the use of human endothelial cells derived from freshly isolated adipose stromal vascular fraction (SVF) in a three-dimensional (3D) co-culture model of vascularized bio-engineered skin substitute.

Anterior spreader flap technique: A new minimally invasive method for stabilising and widening the nasal valve.

Background: The 'anterior spreader flap' is a new minimally invasive technique, for the treatment of nasal valve insufficiency or stenosis. The aim of this study was to present our experience with a series of patients with nasal valve dysfunction corrected by the minimally invasive spreader flap technique.

Methodology: We performed a retrospective review of our patients with nasal valve malfunction who underwent the anterior spreader flap between June 2010 and June 2013.

The Frontal View of the Nose: Lighting Effects and Photographic Bias.

Background: Most aesthetic rhinosurgeons rely on proper photographic documentation of the nose using several different views. The frontal view is probably the most important, but it is also the most demanding.

Objectives: In the frontal view, delicate, 3-dimensional (3D) anatomic structures require special photographic skills.

Assessment of long-term donor-site morbidity after harvesting the latissimus dorsi flap for neonatal myelomeningocele repair.

Background And Aim: The latissimus dorsi flap (LDF) has been employed very successfully over decades to cover large soft-tissue defects. Its donor-site morbidity has been extensively investigated in adults - but not in children - and is considered to be nonrestrictive. The aim of this long-term study was to assess donor-site morbidity with the modified Constant score more than 8 years after coverage of large myelomeningocele (MMC) defects with a reverse latissimus dorsi flap.

Simultaneous proximal interphalangeal joint arthroplasty and extensor tendon reconstruction in adjacent fingers: case report.

We present a case of a young man with heavily injured proximal interphalangeal joints and deficits of the extensor mechanism in 2 fingers treated by silicone proximal interphalangeal joint arthroplasty and 2-stage reconstruction of the extensor mechanism. The postoperative result was satisfactory with a painless, if limited, active arc of motion of the proximal interphalangeal joints of 50° in the middle finger and 35° in the ring finger.

Tissue-engineered dermo-epidermal skin grafts prevascularized with adipose-derived cells.

The major problem in skin grafting is that tissue-engineered skin grafts after their transplantation are initially entirely dependent on diffusion. Since this process is slow and inefficient, nutrients, growth factors, and oxygen will insufficiently be supplied and the regenerating graft will undergo a physiological crisis, resulting in scar-like dermal structures and shrinkage. The tissue-engineering of a vascular network in human dermo-epidermal skin substitutes (DESS) is a promising approach to overcome this limitation.

De novo epidermal regeneration using human eccrine sweat gland cells: higher competence of secretory over absorptive cells.

In our previous work, we showed that human sweat gland-derived epithelial cells represent an alternative source of keratinocytes to grow a near normal autologous epidermis. The role of subtypes of sweat gland cells in epidermal regeneration and maintenance remained unclear. In this study, we compare the regenerative potential of both secretory and absorptive sweat gland cell subpopulations.

Premiere use of Integra™ artificial skin to close an extensive fetal skin defect during open in utero repair of myelomeningocele.

Background: There are fetuses demonstrating very large myelomeningocele lesion which can not be covered with autochothonous skin.

Material And Methods: We use Integra™ artificial skin for intrauterine coverage of the back lesion. A reverse latissimus dorsi flap was used postnatally to reinforce the repair site.

"Trooping the color": restoring the original donor skin color by addition of melanocytes to bioengineered skin analogs.

Purpose: Autologous skin substitutes to cover large skin defects are used since several years. Melanocytes, although essential for solar protection and pigmentation of skin, are not yet systematically added to such substitutes. In this experimental study, we reconstructed melanocyte-containing dermo-epidermal skin substitutes from donor skins of different skin pigmentation types and studied them in an animal model.

Rebuild, restore, reinnervate: do human tissue engineered dermo-epidermal skin analogs attract host nerve fibers for innervation?

Purpose: Tissue engineered skin substitutes are a promising tool to cover large skin defects, but little is known about reinnervation of transplants. In this experimental study, we analyzed the ingrowth of host peripheral nerve fibers into human tissue engineered dermo-epidermal skin substitutes in a rat model. Using varying cell types in the epidermal compartment, we wanted to assess the influence of epidermal cell types on reinnervation of the substitute.

[Photography in Hand Surgery. Basic knowledge and standards].

Photo documentation plays an important role in hand surgery. Pre- and postoperative documentation, planning of interventions, patient information as well as publications and presentations all require high quality images. Last but not least an accurate documentation is necessary for legal reasons.

Human eccrine sweat gland cells turn into melanin-uptaking keratinocytes in dermo-epidermal skin substitutes.

Recently, Biedermann et al. (2010) have demonstrated that human eccrine sweat gland cells can develop a multilayered epidermis. The question still remains whether these cells can fulfill exclusive and very specific functional properties of epidermal keratinocytes, such as the incorporation of melanin, a feature absent in sweat gland cells.

[A case of nerve angiomatosis associated with neurofibromatosis type I].

We present the case of a patient suffering from Neurofibromatosis type I (NF-1) with acute, very painful neuropathy of the right lower extremity. The preoperative electro neuro- physiological study showed an impaired function of the peroneal nerve. The MRI revealed an extended diffuse plexiform tumour of the sciatic nerve and at thigh level.

Painful nodules and cords in Dupuytren disease.

Purpose: The etiology of Dupuytren disease is unclear. Pain is seldom described in the literature. Patients are more often disturbed by impaired extension of the fingers.

Subdivision of the sural nerve: step towards individual facial reanimation.

Long term facial paralysis is a serious affliction and upsetting for the patient. Dynamic facial reanimation has become the treatment of choice. Various techniques that use different donor muscles have been developed since the first functional muscle transplant for facial paralysis more than 30 years ago.