Early and late operation of cleft lip and intelligence quotient and psychosocial development in 3-7 years.

Background: Early and late operations of the cleft lip represent exposure to general anesthesia during the first year of life. The early exposure to the anesthetics may influence long term neurological outcome. Timing of the operation may also influence the quality of life as babies with early repair might be accepted better by their families.

Reconstruction of eyelids with Washio flap in anophthalmia.

The authors present a case report of a patient with anophthalmia in whom retroauriculo-temporal flap (Washio flap) was used for reconstruction of eyelids. This flap, which is mostly used for reconstructions of nasal defects, was not used in this way according to available literature.

Extension of orofacial cleft size and gestational bleeding in early pregnancy.

Objective: The oronasal cavity in humans develops during embryonic day 30-60. There are three critical periods when this process can be affected, resulting in a specific type of orofacial cleft: cleft lip (CL), cleft palate (CP), or most serious, total cleft lip+palate (CLP). We assessed whether gestational bleeding during early pregnancy might act to produce a non-specific worsening of embryo status resulting in extension of the basic cleft type (CL or CP) into more serious CLP.

Mouse 3T3 fibroblasts under the influence of fibroblasts isolated from stroma of human basal cell carcinoma acquire properties of multipotent stem cells.

Background Information: Multipotent mesenchymal stem cells can participate in the formation of a microenvironment stimulating the aggressive behaviour of cancer cells. Moreover, cells exhibiting pluripotent ESC (embryonic stem cell) markers (Nanog and Oct4) have been observed in many tumours. Here, we investigate the role of cancer-associated fibroblasts in the formation of stem cell supporting properties of tumour stroma.

Diagnostic dilemmas of infantile sarcoma of the forearm.

The authors present an interesting case of a suckling baby treated for forearm tumour. All the preoperative examinations including the imaging methods are documented, as are the surgical procedures and the final results. The case report is interesting not only because such surgery is infrequent but also due to the unpredictable progress of the final diagnosis statement.

Nasal reconstruction in children with the combination of nasolabial and island flaps.

Background: The reconstruction of the nose is one of the most complicated aesthetic-reconstructive procedures. The difficulty of the procedure lies is in the necessity for reconstruction not only to capture the very complicated, various shapes of the nose but also to preserve the function of the nose: to allow the patient to breathe through the nose.

Materials And Methods: 12-year-old girl had loss injury of the part of left wing of the nostril.

Reconstruction of defect after radical vulvectomy by the use of four-flap local transfer--a case report.

Malignant vulvar tumors must be treated by radical removal of the tumor as well as a sufficient amount of surrounding healthy tissue. The resulting defects can be resolved by skin transplants, local transfers, skin flaps, muscle flaps or free tissue transfers. We describe the case history of a patient who underwent radical vulvectomy for a malignant tumor with immediate reconstruction by local flaps from the area of inner thighs and mons pubis.

Management of infected tibial fractures and chronic tibial osteomyelitis by muscle flap transfer: a comparison of two series of patients.

Objective: The goal of this work is to compare therapeutic results of two groups of patients with an infected fracture or chronic osteomyelitis of the lower leg and ankle joint treated by the method of radical debridement followed by free flap transfer or muscle transposition.

Patients: In the period between 1 January 2002 and 30 September 2007 the authors used this method in the treatment of 52 patients (10 females and 42 males) with the average age of 44 years (ages ranged from 10 to 67). The observed group of patients was divided into retrospective and prospective subgroups.

"Coagulum suction": a simple trick for the reduction of postoperative hematoma associated with facelift.

Background: Facelift is currently one of the most requested procedures among consumers of aesthetic plastic surgery. Like any operation, it is accompanied by a variety of potential complications, with postoperative bleeding probably the most frequent. Hematomas can cause hyperpigmentation,contour changes due to subcutaneous scarring, prolongation of healing, and necrosis of the skin flap.

Free latissimus dorsi muscle flap for chronic bronchopleural fistula.

The author presents experience with the treatment of chronic bronchopleural fistula in a patient who suffered a gunshot injury to his right chest. During the primary assessment the patient underwent resection of two lobes of the right lung, and the patient healed without complications. Four years later the patient presented with bronchopleural fistula with empyema.

[Plastic and reconstructive surgery and orthopaedics interdisciplinary cooperation in the management of extremity injuries. Review].

Gradual particularization of medicine, as witnessed during the second half of the 20th century, resulted in a detailed development of individual subspecializations. Association of therapeutic options resulting from enormous development of these subspecialization brought a new dimension to the treatment of formerly unmanageable conditions. The closest cooperation between a plastic surgeon and a traumatologist is required in the management of patients with serious extremitiy injuries.

Our first experience with primary lip repair in newborns with cleft lip and palate.

The article summarizes the results of early primary lip repair in 44 newborns with cleft lip and palate. We present a study of the first 44 patients to undergo the surgery before the age of 1 week as performed by a surgeon who used a modified method according to Tennison with a nasal correction. Early lip surgeries started in 2005.

Primary reconstruction of arterial supply in the palm after an injury: a case study.

The authors present a case study of a patient with ischemic subtotal hand amputation in the palm. They describe an option to primarily reconstruct the arcus palmaris superficialis and common digital arteries by using a venous graft from the vena saphena magna with its several branches.

[Muscle flap transfer of the treatment of infected tibial and malleolar fractures and chronic osteomyelitis of the tibia].

Purpose Of The Study: The aim of the study was to evaluate the results of treatment in patients with infected fractures or chronic osteomyelitis in the tibial and ankle regions by radical debridement of skeletal and soft tissues and coverage of the defect, using free flap transfer or muscle flap transposition.

Material: Between January 1, 2002 and December 31, 2004, 26 patients were treated by this method; 13 had infected tibial or ankle fractures and 13 showed osteomyelitis of the tibia. All patients, in the case of failure, would have been indicated for below-knee amputation.

Clinical anatomy of the dorsal venous network in fingers with regard to replantation.

The arterial system of fingers is anatomically well described, and so, usually no difficulties arise during its preparation and the making of anastomoses in replantation surgery. Difficulties may occur, however, during manipulation in the dorsal vascular bed of fingers, known only as a random venous network. There are minimal references to its existence and the location of its valvular apparatus.

Degloving injury--the use of a combination of free fasciocutaneous sensitive flap and pedicle flaps for reconstruction.

The authors present a case report of reconstruction after a degloving injury to hand by a combination of microsurgery and standard pedicle flaps. Degloving injury high on the hand was solved by free sensitive fasciocutaneous flap transfer from the radial forearm (Chinese flap), which covered the defect in the palm, while finger defects were covered by pedicle flaps from the abdomen. Dorsum of the hand was treated with a mesh skin graft.

The primary use of venous grafts in thumb replantation.

The authors describe modified thumb replantation technique. With this technique it is possible to avoid extensive mobilization of the digital arteries as well as incisions, particularly at the distal thumb phalanx, and therefore reduce further damage of the amputated part. Prior to the osteosynthesis a venous graft is harvested from the distal forearm or from the thenar area.

Local pharmacological preconditioning increases the survival of experimental skin flaps in rats.

Skin flap survival is dependent on an adequate blood supply and on the resistance to ischemia. Experimentally we tested the effect of pharmacological preconditioning on the survival of skin flaps. The survival of an ischemic skin flap (McFarlane flap) was tested using the local application of cobalt gel in three groups of Wistar rats.

History of upper extremity replantation in the Czech Republic and worldwide.

Replantation surgery is a specialization in plastic surgery which, in comparison with other disciplines, has a relatively short history of only forty years. Replantation surgery developed due to experience with macrovascular anastomosis and to the evolution of the operative microscope, special micro-instruments and ultra delicate suturing material. Due to these advances, it is possible to implement anastomosis of blood vessels with a diameter smaller than 1-2 mm.

Types of vascular reconstructions in replantations of distal parts of the fingers.

The authors present the case of a 17-year-old patient with amputation of the distal portions of three-phalangeal fingers. During replantation of each finger a different method of revascularization of the amputate was used. In one finger the classical replantation pattern was used: anastomosis of the digital artery and dorsal vein.

Bioactive glass-ceramics in facial skeleton contouring.

The removal of certain facial-bone defects is a prerequisite to restoration of function, stability, and appearance. Synthetic bone substitutes are beneficial in cases where other operative techniques would be an unacceptable burden for a patient. Satisfactory results can be achieved in one surgical intervention with low costs and low demand on technical equipment.