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Long-term use and follow-up of autologous and homologous cartilage graft in rhinoplasty
Ghasemali Khorasani , Siamak Rakei , Amirhosein Tavakoli ,
Volume 74, Issue 2 (5-2016)
Abstract

Background: Cartilage grafting is used in rhinoplasty and reconstructive surgeries. Autologous rib and nasal septum cartilage (auto graft) is the preferred source of graft material in rhinoplasty, however, homologous cartilage (allograft) has been extensively used to correct the nasal framework in nasal deformities. Autologous cartilage graft usage is restricted with complication of operation and limiting availability of tissue for extensive deformities. Alternatively, preserved costal cartilage allograft represents a readily available and easily contoured material. The current study was a formal systematic review of complications associated with autologous versus homologous cartilage grafting in rhinoplasty patients.

Methods: In this cohort retrospective study, a total of 124 patients undergone primary or revision rhinoplasty using homologous or autologus grafts with postoperative follow-up ranging from 6 to 60 months were studied. The types of grafts and complications related to the grafts were evaluated. This included evaluation for warping, infection, resorption, mobility and fracture.

Results: The total complications related to the cartilage grafts were 7 cases, which included 1 warped in auto graft group, three cases of graft displacement (two in allograft group and one in auto graft group) and three fractures in allograft group. No infection and resorption was recorded. Complication rate (confidence interval 0.95) in autologous and homologous group were 1.25(0.4-3.88) and 2.08(0.78-5.55) in 1000 months follow up. There was no statistically significant difference between autologous and homologous group complications. Onset of complication in autologous and homologous group were 51.23(49.27-53.19) and 58.7(54.51-62.91) month respectively (P=0.81).

Conclusion: The allograft cartilage has the advantage of avoiding donor-site scar. Moreover, it provides the same benefits as autologous costal cartilage with comparable complication rate. Therefore, it can be a reliable alternative material for rhinoplasty surgeries. A longer follow-up may be necessary to confirm the structural stability of the allograft cartilage grafts.


The comparison between the absorption rate of rib cartilage graft with conchal cartilage graft in rabbit
Soraya Shahrokh , Seyed Abolhasan Emami , Mohammad Javad Fatemi , Mir Sepehr Pedram , Saeid Farzad Mohajeri , Seyed Jaber Mousavi , Seyed Aboozar Hoseini , Tooran Bagheri , Shirin Araghi ,
Volume 75, Issue 1 (4-2017)
Abstract

Background: Cartilage grafts is one integral component in the various fields of plastic surgery particular rhinoplasty. Surgeons usually use from various sources, including the septum of the nose, ears and rib. Complications such deformity and reabsorbtion may be created with use of the cartilage. Area of the removal of cartilage can prevent these complications. The aim of this study was to compare the absorption rate and viability of cartilage autograft between two common donor site, the rib and the concha.

Methods: This experimental study was performed on October 2014 in animal laboratory of Hazrat Fatima Hospital, Tehran, Iran. In this study, 15 New Zealand white male rabbits, weighing 2000-2500 g, approximately 12 to 16 weeks of age were used. In each rabbit, a piece of one ear and one cartilage was excised. After careful weighting of grafts, we implanted the rib cartilage graft into the left pocket and the conchal cartilage graft into the right one. After 8 weeks, the grafts were removed and weighed precisely and photography was carried out. The specimens were fixed in 10% formalin solution for histologic examination was. An example of hematoxylin and eosin staining and cut (H&E) were performed and samples of live chondrocytes and fibrosis were examined by a pathologist.

Results: We lost 3 rabbits during our study. The results showed that the average weight of a graft from the ear within 2 months, but this increase was not statistically significant (P= 0.152). In the rib graft weight loss over 2 months, and this reduction was statistically significant (P= 0.009). The resorption between two group was not significant but the amount of fibrosis was more in conchal cartilage graft.

Conclusion: According to the study it can be concluded that absorption rib cartilage is somewhat better results than the cartilage of the ear. More studies, in addition to cartilage implants longer human studies can contribute to more accurate conclusions.

Assessment of cognitive impairments following coronary artery bypass surgery with emphasis on working memory performance
Mohadeseh Mozafari , Seyyed Abolghasem Mehri Nejad , Jamshid Bagheri , Mehrangiz Peyvstegar , Masoud Saghafinia ,
Volume 78, Issue 3 (6-2020)
Abstract
Background: Previous researches have provided contradictory results about on working memory performance after the coronary artery bypass graft (CABG). In addition, studies have focused on the elderly community. For this reason and with regard to the importance and direct effects of working memory on the quality of life human. This study was designed to compare working memory of young CABG patients with age range of 30-55 years one year postoperatively with healthy subjects.
Methods: In this Case-control study, which was conducted from February 2017 to October 2018, two groups of people, 40 patient men with coronary artery bypass graft that admitted to the heart center of Tehran in last year and 64 healthy males were selected with using available sampling method. Both groups were tested with Wechsler's working memory scale.
Results: The results of the study showed that the mean and standard deviation of the age of coronary artery bypass graft patients were 52.65 and 5.559, respectively, and the mean and standard deviation of healthy subjects were 41.81 and 8.619, respectively. The results showed that The two group had significantly difference (P<0.01), in the sub scales of the working memory including of the forward auditory memory and reverse auditory memory, total score of auditory memory, reverse visual memory and auditory memory span and the two groups had significantly difference (P<0.05), in the total score of visual memory. But the two group had not significantly difference (P>0.05) in the forward visual memory (CABG [mean=5.40 & standard deviation=1.41] Healty people [mean=6.13 & standard deviation=3]) and visual memory span (CABG [mean=5.35 & standard deviation=1.12] Healty people [mean=5.56 & standard deviation=1.97]). The results showed that Patients with CABG than healthy people have overall poorer results for all sub scales the of working memory test.
Conclusion: The results of this study confirm the prevalence of relatively high cognitive decline, especially in working memory after CABG, and provide a pattern of persistence of cognitive decline after one year of coronary artery bypass surgery in young patients aged 30 to 55 years.

Comparison of the thickening of donor skin graft with conventional method (using vaseline gas) and platelet-rich plasma topical application
Vahid Hatami, Hamed Tavan, Sajad Hatami , Ali Delpisheh, Mina Mamizadeh,
Volume 79, Issue 10 (1-2022)
Abstract
Background: Healing involves complex processes that are not yet fully known. The wound healing process consists of three stages. In all these stages, normal wound healing requires platelet activation, release of cytokines and growth hormones, and chemotaxis and cell differentiation. Platelets play a key role in homeostasis and wound healing and growth factor production of more than 30 carried out by them. Platelets regulate the healing process with their chemotactic effect. Antilogous PRP platelet count in about 3 to 5 times increase and consequently also increases the number of growth factors, for this reason, they are being used in surgical procedures and clinical therapy.
Methods: At Ilam Medical Center in Imam Khomeini Hospital, 20 patients with two similar donor graft sites were gradually selected to participate in a clinical trial from January to March 2017. The two regions have the same skin graft patients, an area of Honor conventional and other areas with the topical administration of platelet-rich plasma That immediately after surgery and in the days after the fifth and eleventh, eightieth and after washing the wound with a topical serum Physiology rubbed on the wound and thus treated The rate of wound healing clinically and using X-ray photo-checked and compared.
Results: Seven are male and thirteen are female and the age range of patients is between 17 and 67 years. After collecting wound healing times in two groups, we used the means comparison method to evaluate the effect of PRP on wound healing rate and analyzed the results (T-Test). Because the data followed a normal distribution, we used the Independent T-test method, which resulted in 0.416, which was higher than the alpha level equal to 0.05.
Conclusion: In this study, we found that PRP had a positive effect on wound healing time and increased the speed of wound healing. It is suggested that the effect of the PRP method on various organs that have not been tested before, be discussed in future studies.
 

Evaluation of risk factors for cognitive disorders indication in patients undergoing coronary artery bypass graft surgery: a cross-sectional study
Mohammad Parsa Mahjoub , Naser Kechuian, Mohammad Haji Aghajani , Hossein Aghamiri , Ainaz Samadi, Fateme Omidi ,
Volume 82, Issue 7 (10-2024)
Abstract
Background: Cardiovascular surgery is sometimes associated with brain consequences such as cognitive disorders. Diagnosis of cognitive disorders risk factors in cardiovascular patients is important for increasing patient satisfaction and success after (CABG). In the present study, the frequency of cognitive disorders in cardiovascular patients and its effective factors were investigated.
Methods: In the current cross-sectional study that was conducted from September 2019 to the February 2022, 60 cardiovascular patients undergoing CABG surgery were selected by convenience sampling method. Demographic, clinical, and intraoperative information was recorded for participants in the data collection form. Mini–Mental State Examination quesionary.
Results: The results showed that 15% of participants had cognitive impairment. Gender and age were the actual variables on the incidence of cognitive disorders after CABG surgery. The frequency of cognitive disorders in women was 14 times higher than men and 6.5 times higher in the elderly. Elderely population was considered as 65 years old or above. The clinical variables such as blood transfusion under surgery and ejection fraction<40% were effective factor for incidence of cognitive disorders in cardiovascular patients.
Conclusion: The CABG surgery may be associated with cognitive disorders in cardiovascular patients, which is more common in women and the elderly. Further studies are recommended to confirm the results of the present study and identify the related risk factors.

Evaluation of reduction mammoplasty outcomes in patients with severe gigantomastia using vertical design and free nipple areola graft: a case series
Ali Yavari, Hojjat Molaie, Hesam Amini ,
Volume 82, Issue 9 (12-2024)
Abstract
Background: Macromastia can have a significant impact on patients’ quality of life by causing physical discomfort and psychological distress. Reduction mammoplasty can provide both aesthetic and therapeutic benefits. In cases of gigantomastia, where extreme breast hypertrophy prevents the use of traditional pedicled techniques, breast amputation with a free nipple graft is always a considered surgical option. There are different presented methods and designs for this procedure. This surgery is highly beneficial for patients, and most of them report significant improvements in their quality of life and overall satisfaction with the final results.
Case Presentation: In this study, we employed reduction mammoplasty and a free nipple graft with a vertical design and superior pedicle preservation in patients with gigantomastia who were referred to Tehran Imam Khomeini Hospital Clinic during a period of five years (February 2020–February 2025). The patients were out of the range of fertility and were in the range of obesity (most of them had a BMI of over 35(kg/m2)). Then, patient satisfaction and quality of life improvement were evaluated with a standard questionnaire. Finally, complications during and after surgery were recorded. The surgery was performed on 17 patients. The distance from the sternal notch to the nipple was more than 40 cm, and the distance from the nipple to the inframammary fold (IMF) was more than 20 cm in all patients (confirming gigantomastia). Therefore, they were not candidates for pedicled mammoplasty. All the patients were satisfied with the results. Their quality of life, posture, back pain, neck pain, and other symptoms improved significantly. We recorded no cardiovascular complications during or after surgery.
Conclusion: Breast amputation with a free nipple graft is an efficient method for treating gigantomastia and is very safe for patients with diabetes mellitus, cardiovascular diseases, high BMI, and those at infertile ages. A vertical design with superior pedicle preservation can provide both aesthetic and therapeutic benefits, leading to high patient satisfaction and improved quality of life.

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