Soft tissue dehiscence coverage around endosseous implants: a prospective cohort study

AIM: To evaluate the healing outcome of soft tissue dehiscence coverage at implant sites. MATERIAL AND METHODS: Ten patients with one mucosal recession defect at an implant site and a contralateral unrestored clinical crown without recession were recruited. The soft tissue recessions were surgically covered using a coronally advanced flap in combination with a free connective tissue graft. Healing was studied at 1, 3 and 6 months post-operatively. RESULTS: Soft tissue dehiscences were covered with a coronal overcompensation of the flap margin up to 1.2 mm after the procedure. After 1 month, the coverage shrank to a mean of 75%, after 3 months to 70% and after 6 months to 66%. CONCLUSIONS: The implant sites revealed a substantial, clinically significant improvement following coronal mucosal displacement in combination with connective tissue grafting, but in none of the sites, a could complete implant soft tissue dehiscence coverage be achieved.

Femoral morphology differs between deficient and excessive acetabular coverage

Structural deformities of the femoral head occurring during skeletal development (eg, Legg-Calvé-Perthes disease) are associated with individual shapes of the acetabulum but it is unclear whether differences in acetabular shape are associated with differences in proximal femoral shape. We questioned whether the amount of acetabular coverage influences femoral morphology. We retrospectively compared the proximal femoral anatomy of 50 selected patients (50 hips) with developmental dysplasia of the hip (lateral center-edge angle [LCE] < or = 25 degrees ; acetabular index > or = 14 degrees ) with 45 selected patients (50 hips) with a deep acetabulum (LCE > or = 39 degrees ). Using MRI arthrography we measured head sphericity, epiphyseal shape, epiphyseal extension, and femoral head-neck offset. A deep acetabulum was associated with a more spherical head shape, increased epiphyseal height with a pronounced extension of the epiphysis towards the femoral neck, and an increased offset. In contrast, dysplastic hips showed an elliptical femoral head, decreased epiphyseal height with a less pronounced extension of the epiphysis, and decreased head-neck offset. Hips with different acetabular coverage are associated with different proximal femoral anatomy. A nonspherical head in dysplastic hips could lead to joint incongruity after an acetabular reorientation procedure. LEVEL OF EVIDENCE: Level IV, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence.

[Coverage of pressure sores with free flaps]

INTRODUCTION: The coverage of recurrent pressure sores with unstable scar in the surrounding tissue is still an unsolved problem in the literature. Local and regional transfer of tissue often does not meet the requirements of the tissue deficit. Especially in recurrent pressure sores, the adjacent skin has already been consumed due to multiple surgeries. As a good alternative, the microsurgical transfer of flaps offers viable tissue to cover even large pressure sores. METHODS: We performed a total of six free flaps in five patients who suffered from intractable pressure sores in the hip region. The age of the patients was between 41 and 63 years. The defect size varied between 6 x 6 cm and 25 x 30 cm. Two combined myocutaneous scapula-latissimus dorsi, two myocutaneous latissimus dorsi, one anteromedial thigh, and one rectus femoris flap were used to cover the defects. RESULTS: The average follow-up time was 29 months. Flaps provided stable coverage in four of five patients at 12-month follow-up. There was one subtotal flap necrosis that was subsequently treated with split-thickness skin grafting. CONCLUSION: In this series of five patients with six free flaps, we were able to show that the microsurgical transfer of tissue is a valuable option in the treatment of difficult pressure sores. Even in older and debilitated patients, this method is a good alternative to conventional local flaps.

“Beneath the Starry Flag”: the Flags and Songs of the 1913-14 Michigan Copper Strike as Image-making in the American Labor Movement

The 1913-14 Michigan copper strike is unlike many American labor actions of the period in that it did not include red flags or socialist anthems. Many of the most familiar photographs of the strike involve American flags, not red ones. Similarly, the songs mentioned in journalistic accounts of the strikers are American Civil War songs, not popular labor songs of the period. The few newly-written songs about the strike, published in the local newspapers, seem cautiously polite and espouse values such as patriotism, liberty and human rights. During a time when sections of the "friendly" press were concerned with labor presenting the correct image and avoiding unfavorable associations, the Copper Country strikers, and the W.F.M., seem to have been attempting to create a fresh narrative regarding what this strike was (and what it was not). This paper will consider elements of the Copper Country strike in the light of media coverage, prior to July 1913, of several American labor topics that might have influenced the way the strike was presented. Particular attention will be given to photographs, songs, and accounts from the 1912 Lawrence textile strike, as well as contemporaneous critiques of labor song lyrics. Most of this commentary will be drawn from the labor and socialist press, demonstrating that the 1913-14 Michigan copper strike occurred during a period in which the labor movement was struggling to craft and image that would display it as it wished to be seen. This paper has not yet been submitted.

Analytical Parametric Model Used to Study the Influence of Electrostatic Force on Surface Coverage During Electrospinning of Polymer Fibers

Electrospinning (ES) can readily produce polymer fibers with cross-sectional dimensions ranging from tens of nanometers to tens of microns. Qualitative estimates of surface area coverage are rather intuitive. However, quantitative analytical and numerical methods for predicting surface coverage during ES have not been covered in sufficient depth to be applied in the design of novel materials, surfaces, and devices from ES fibers. This article presents a modeling approach to ES surface coverage where an analytical model is derived for use in quantitative prediction of surface coverage of ES fibers. The analytical model is used to predict the diameter of circular deposition areas of constant field strength and constant electrostatic force. Experimental results of polyvinyl alcohol fibers are reported and compared to numerical models to supplement the analytical model derived. The analytical model provides scientists and engineers a method for estimating surface area coverage. Both applied voltage and capillary-to-collection-plate separation are treated as independent variables for the analysis. The electric field produced by the ES process was modeled using COMSOL Multiphysics software to determine a correlation between the applied field strength and the size of the deposition area of the ES fibers. MATLAB scripts were utilized to combine the numerical COMSOL results with derived analytical equations. Experimental results reinforce the parametric trends produced via modeling and lend credibility to the use of modeling techniques for the qualitative prediction of surface area coverage from ES. (Copyright: 2014 American Vacuum Society.)