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Ultrastructural Pathology Jan 2020Tissue expansion has been widely used for plastic, reconstructive, and esthetic surgeries. A mouse scalp expansion model can effectively mimic the characteristics of...
Tissue expansion has been widely used for plastic, reconstructive, and esthetic surgeries. A mouse scalp expansion model can effectively mimic the characteristics of human skin expansion. However, a detailed study of the histological features and ultrastructural characteristics of expanded scalp is lacking, especially early ultrastructural changes. Here, a mouse scalp expansion model was established and the expanded scalp samples were obtained on day 2 (group I) and 4 (group II) post final injection. Histological analysis revealed epidermal thickening, dermal thinning, subcutaneous fat thinning, and capsule formation in the expanded samples. Ultrastructural evaluation showed the presence of keratinocytes with numerous tonofibrils and damaged mitochondria, and several ruptured collagen fibers and increased number of active fibroblasts and myofibroblasts were observed in the dermis and capsules. Adipocyte dedifferentiation was detected in the expanded samples of both groups, but formation of autophagosomes was only detected in the dermal fibroblasts of group I. Thus, early changes in expanded tissue should be carefully monitored, as it may help avoid dermal thinning and promote expanded tissue regeneration.
Topics: Animals; Cell Dedifferentiation; Fibroblasts; Male; Mice; Mice, Inbred C57BL; Scalp; Skin; Subcutaneous Fat; Tissue Expansion
PubMed: 31989853
DOI: 10.1080/01913123.2020.1720876 -
The Journal of Craniofacial SurgeryThe scalp defect was a clinical common constructive challenge. This research verified the efficacy of the skin-stretching device in the treatment of scalp defect and...
BACKGROUND
The scalp defect was a clinical common constructive challenge. This research verified the efficacy of the skin-stretching device in the treatment of scalp defect and assessed the associated complications.
METHODS
The clinical data of 12 patients with scalp defect treated with skin-stretching device from January 2020 to January 2021 were collected. We used EASApprox skin-stretching device for the treatment of scalp defect. We described a detailed reconstruction procedure for this treatment. We collected the site, distance from wound edge and other characteristics of the wound, and recorded the number of stretching cycles, operation time, closed state, healing time, and observed postoperative complications and wound healing status.
RESULTS
In this research, the scalp defect was mainly caused by pressure ulcer, and mainly located in the parietooccipital site. The average distance from wound edge was 3.2 cm, the average stretching cycles was 4.2 times during the operation, and the average operation time was 43.5 minutes. Ten patients were directly sutured after stretching, and 2 patients underwent first-stage stretching to reduce the wound. The average time of wound healing was 13.5 days. Postoperative follow-up of 3 months, no patients had wound tear, necrosis, 1 patient suffered from wound exudation and infection due to poor nutrition. Skin function and final scar was acceptable.
CONCLUSION
The treatment of skin-stretching device was effective for scalp defect and has the advantages of convenient operation, acceptable functional results, without severe complications. In addition to traditional treatment, this was a promising treatment. However, more clinical and preclinical research of the skin-stretching device were required.
Topics: Humans; Scalp; Skin Transplantation; Treatment Outcome; Skin; Plastic Surgery Procedures
PubMed: 36214652
DOI: 10.1097/SCS.0000000000008856 -
Identifying Factors Affecting Outcomes in Scalp Replantation: A Systematic Review of the Literature.Journal of Reconstructive Microsurgery Jan 2022Replantation is the ideal treatment in traumatic scalp defects to provide immediate coverage with restoration of hair-bearing skin. However, data are limited to case...
BACKGROUND
Replantation is the ideal treatment in traumatic scalp defects to provide immediate coverage with restoration of hair-bearing skin. However, data are limited to case reports and small case series. Comprehensive analysis of techniques and outcomes is not available. Our aim was to systematically analyze the available literature to better understand management and postoperative outcomes of patients undergoing scalp replantation.
METHODS
A systematic review of the PubMed, Cochrane, and EBSCO databases was performed in October 2019. Search terms included "replantation," "replant," "revascularized," "revascularization," "avulsion," and "scalp." Only papers reporting microvascular replantation of completely avulsed scalps, including case reports, were included. Review articles, non-English language articles, articles discussing nonreplant coverage, incomplete scalp avulsions, and articles discussing delayed scalp replantation were excluded. Data extracted included demographics, percent of scalp affected, mechanism, operative technique, and postoperative outcomes. Statistical analysis was performed using Mann-Whitney U tests, Kruskal-Wallis, and chi-squared tests.
RESULTS
From a total of 704 initial results, 61 studies were included for analysis comprising 149 scalps. Complete survival was achieved in 54.7%, partial survival in 38.9%, and failure in 6.7%. Total ischemia time greater than 12 hours was associated with complete replant failure. Arterial anastomoses appeared to protect against complete loss. The number of venous repairs, proportion of venous-to-arterial repairs, use of vein grafts, thromboprophylaxis, or intraoperative complications did not affect outcomes. Patients required significant volumes of blood products, which was associated with partial success. Salvage rate after unplanned return to the operating room was 60.0%. Normal hair growth was achieved in all surviving native scalp tissue.
CONCLUSION
Scalp replantations, while technically challenging, are the ideal treatment for scalp avulsions. Fortunately, these have high rates of success. And as a focal point of a patient's appearance, this is invaluable in restoration of a sense of normalcy.
Topics: Anticoagulants; Humans; Microsurgery; Replantation; Scalp; Venous Thromboembolism
PubMed: 34010964
DOI: 10.1055/s-0041-1729876 -
Facial Plastic Surgery : FPS Apr 2018Hair restoration has become increasingly popular in recent years with both men and women. New technologies such as follicular unit extraction and grafting have made it... (Comparative Study)
Comparative Study Review
Hair restoration has become increasingly popular in recent years with both men and women. New technologies such as follicular unit extraction and grafting have made it possible for patients to get a natural looking result with minimal downtime. Men usually experience hairline recession as a result of androgenic alopecia, while women most commonly experience thinning of the crown and vertex, with the preservation of the hairline. However, there is a growing population of women who wish to advance their hairline forward because of congenital high hairline, traction alopecia, or previous facial cosmetic surgery. There are several key differences between the female and male hairline. Understanding such differences and following certain guidelines will help the facial plastic surgeon to obtain beautiful and natural appearing results.
Topics: Adult; Alopecia; Esthetics; Female; Hair; Humans; Male; Middle Aged; Scalp; Sex Factors; Surgery, Plastic
PubMed: 29631285
DOI: 10.1055/s-0038-1636905 -
Anais Brasileiros de Dermatologia 2017Trichoscopy has become an essential tool for the diagnosis of various diseases that affect the hair and scalp. Through dermatoscopy we identified a set of findings that...
Trichoscopy has become an essential tool for the diagnosis of various diseases that affect the hair and scalp. Through dermatoscopy we identified a set of findings that share a circular shape of hair shafts. The objective of this study is to distinguish among the various forms of circular hairs in order to identify their peculiarities and to describe in which skin disorders they can be found.
Topics: Dermoscopy; Diagnosis, Differential; Hair; Hair Diseases; Humans; Reproducibility of Results; Scalp; Scalp Dermatoses
PubMed: 29364454
DOI: 10.1590/abd1806-4841.20176487 -
Scientific Reports Apr 2019To estimate the neural generators of magnetoencephalographic (MEG) signals, MEG data have to be co-registered with an anatomical image, typically an MR image....
To estimate the neural generators of magnetoencephalographic (MEG) signals, MEG data have to be co-registered with an anatomical image, typically an MR image. Optically-pumped magnetometers (OPMs) enable the construction of on-scalp MEG systems providing higher sensitivity and spatial resolution than conventional SQUID-based MEG systems. We present a co-registration method that can be applied to on-scalp MEG systems, regardless of the number of sensors. We apply a structured-light scanner to create a surface mesh of the subject's head and the sensor array, which we fit to the MR image. We quantified the reproducibility of the mesh and localised current dipoles with a phantom. Additionally, we measured somatosensory evoked fields (SEFs) to median nerve stimulation and compared the dipole positions between on-scalp and SQUID-based systems. The scanner reproduced the head surface with <1 mm error. Phantom dipoles were localised with 2.1 mm mean error. SEF dipoles corresponding to the P35m response for OPMs were well localised to the somatosensory cortex, while SQUID dipoles for two subjects were erroneously localised to the motor cortex. The developed co-registration method is inexpensive, fast and can easily be applied to on-scalp MEG. It is more convenient than traditional co-registration methods while also being more accurate.
Topics: Adult; Evoked Potentials, Somatosensory; Humans; Magnetic Resonance Imaging; Magnetoencephalography; Male; Phantoms, Imaging; Scalp
PubMed: 30940844
DOI: 10.1038/s41598-019-41763-4 -
Der Hautarzt; Zeitschrift Fur... Jun 2017Non-melanoma skin cancer and its precursor lesions are common diagnoses in dermatological practice, due to rising incidence and prevalence. Diagnosis is often clinical... (Review)
Review
Non-melanoma skin cancer and its precursor lesions are common diagnoses in dermatological practice, due to rising incidence and prevalence. Diagnosis is often clinical with subsequent histological confirmation. First-choice treatment for invasive carcinomas is complete surgical excision. Other therapeutic options, such as radiation or systemic therapies, should only be considered when excision is impossible. Mostly located on parts of the scalp that are poorly visible and accessible, particularly for elderly patients, these lesions are a challenge for physicians and patients alike. Especially regarding precursor lesions, the therapeutic options are numerous and should be adapted to the individual patient. The main risk factor for development of non-melanoma skin cancer and its precursor lesions is chronic UV exposure. A possible occupational context should always be considered. Preventative methods based on patient education and adequate sun protection behavior are particularly important. The prognosis of non-melanoma skin cancer improves significantly with early diagnosis, as well as with guideline-compatible treatment and follow-up.
Topics: Aging; Antineoplastic Agents; Combined Modality Therapy; Dermatologic Surgical Procedures; Evidence-Based Medicine; Head and Neck Neoplasms; Humans; Scalp; Skin Neoplasms; Treatment Outcome
PubMed: 28516187
DOI: 10.1007/s00105-017-3988-2 -
Anais Brasileiros de Dermatologia 2016Leprosy is a chronic infectious disease caused by Mycobacterium leprae. This bacillus has a high predilection for skin and peripheral nerves. The scalp's anatomical...
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. This bacillus has a high predilection for skin and peripheral nerves. The scalp's anatomical properties do not favor the development of such mycobacterium. We report a case of leprosy with scalp involvement, a rare occurrence in our literature.
Topics: Adolescent; Alopecia; Biopsy; Humans; Leprosy, Multibacillary; Male; Scalp; Scalp Dermatoses
PubMed: 28300899
DOI: 10.1590/abd1806-4841.20164391 -
BMC Anesthesiology Aug 2023Analgesia is very important for children with craniosynostosis who are undergoing cranial suture reconstruction. This study investigated the effectiveness and safety of... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Analgesia is very important for children with craniosynostosis who are undergoing cranial suture reconstruction. This study investigated the effectiveness and safety of an analgesic technique based on scalp nerve block combined with general anesthesia versus general anesthesia alone.
METHODS
This was a single-center, prospective, randomized, controlled study. A total of 60 children aged 6-24 months who underwent cranial suture reconstruction were randomly divided into two groups: Group A (general anesthesia combined with scalp nerve block) and Group N (general anesthesia). The hemodynamics were recorded preoperatively, at 5 min after incision and at 1, 6 and 12 h after surgery; the pain was scored at 1, 6 and 12 h after surgery, and blood glucose was detected at 1 h after surgery.
RESULTS
The mean arterial pressure and heart rate at 5 min after incision and 1 h after surgery in Group N were higher than those in Group A; the blood glucose and FLACC score in Group N were higher than those in Group A; and the number of postoperative analgesic pump presses were also significantly increased in Group N.
CONCLUSION
Preoperative scalp nerve block can reduce hemodynamic fluctuation and postoperative pain in children undergoing cranial suture reconstruction for craniosynostosis. Thus, it can be safely and effectively applied in the anesthesia of these children.
Topics: Humans; Child; Cranial Sutures; Scalp; Prospective Studies; Blood Glucose; Nerve Block; Pain, Postoperative; Analgesics; Craniosynostoses; Ultrasonography, Interventional
PubMed: 37528335
DOI: 10.1186/s12871-023-02223-9 -
Annales de Dermatologie Et de... Nov 2015
Topics: Adult; Diagnosis, Differential; Folliculitis; Humans; Scalp
PubMed: 26428395
DOI: 10.1016/j.annder.2015.08.009