OBJECTIVES To eliminate the inconsistency in the nomenclature, to anatomically and definitively describe the topographic relationship of the temporal branch of the facial nerve to the fascial layers and the fat pads, and to create an effective algorithm to define the safest approaches and planes for surgical procedures in this area. METHODS The study was performed using 18 hemifacial cadaveri...

BACKGROUND Infected sternotomy wounds occur in 0.5 to 8.4 percent of open heart operations. They are complex problems, with a mortality rate of 8.1 to 14.8 percent despite flap closure. For closure, the pectoralis major flap has had considerable success. However, in providing coverage to the lower third of the sternum, it may be deficient. Modifications to improve closure have included a rectus...

BACKGROUND There is a limited evidence base to guide surgeons on the ideal thickness of skin flaps during mastectomy. Here the literature relevant to optimizing mastectomy skin flap thickness is reviewed, including anatomical studies, oncological considerations, factors affecting viability, and the impact of surgical technique and adjuvant therapies. METHODS A MEDLINE search was performed usi...

CONTEXT Although mathematical models have been developed for the bony movement occurring during chiropractic manipulation, such models are not available for soft tissue motion. OBJECTIVE To develop a three-dimensional mathematical model for exploring the relationship between mechanical forces and deformation of human fasciae in manual therapy using a finite deformation theory. METHODS The p...

OBJECTIVE To evaluate the effect of urethral coverage by a single- or double-layered dorsal dartos flap after tubularized incised-plate (TIP) repair of hypospadias on fistula formation. PATIENTS AND METHODS In this retrospective study we evaluated sequential patients with hypospadias who underwent TIP urethroplasty with a dorsal dartos interpositional flap between April 2008 and December 2009...

This paper examines the main characteristics of the human fascial system, considered in its three-dimensional continuity. To better understand the anatomy of the human fascial system, a simple diagram of the subcutaneous tissue must be borne in mind. From the skin to the deepest plane, we find the superficial fascia, dividing the subcutaneous tissue into two fibroadipose layers, superficial and...

INTRODUCTION The medial thighplasty is a procedure where patients may attain superior mobility, hygiene, and cosmesis. Most surgeons use attachment of the superficial fascial system (SFS) of the thigh flap to the Colles fascia, whereas others attach the SFS to the pubic ramus periosteum. Because of a high complication profile, we aim to elucidate the clinical, biomechanical, and anatomic qualit...

AIM Analysis of the pectoral fascia from a macroscopic and histological point of view. RESULTS The pectoral fascia appears as a thin collagen layer (mean thickness of 297 microm) formed by undulated collagen fibres and many elastic fibres, within which small nerves are highlighted. Numerous septa detach from its internal surface, creating an intimate connection between the fascia and the pect...

This very thin, delicate fascia is found just deep to the skin and envelopes the muscles of the head and neck including platysma and the muscles of facial expression. It is so thin that it may be difficult to identify when incising the neck. It extends from the epicranium above to the axillae and upper chest below and includes the superficial musculo-aponeurotic system/SMAS. The space deep to t...

A large full-thickness chest wall defect over 10 cm in diameter requires skeletal reconstruction and soft tissue coverage. Use of various flaps for soft tissue coverage was previously reported, but en bloc resection in each case affects these flap pedicles and sizes. We present a case of a 74-year-old man with a soft tissue tumor involving the left lateral chest wall. We performed an en block r...