Direct repair of canalicular lacerations

Injury and disruption of the canaliculi of the lacrimal excretory system commonly occur from laceration or shearing trauma. This type of injury will likely lead to dysfunction of tear flow from the palpebral sulcus and chronic epiphora. The goal of this article is to give a step-by-step review of canalicular repair.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

The pigtail ureteral stent in the cancer patient.

Nephrostomy has been the standard procedure for urinary diversion when ureters are obstructed by cancer. However, recent reports have revealed significant problems related directly to the nephrostomy. The indwelling, internal ureteral stent eliminates many of these problems. We herein describe the course and survival of 20 patients in whom the pigtail ureteral stent was used to relieve ureteral obstruction caused by cancer. In these cases an over-all prolonged longevity, better quality of life and fewer complications have been noted when compared to cases of nephrostomy diversions.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

Clinical effects of three types of silicone intubations in repairing lacerations of canaliculus

To evaluate the clinical effects of one-passage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: A total of 109 eyes in 109 cases of canalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average fol-low-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rapture incidence of the one-passage group was significantly higher than that of the other two groups ( x2=9.416, P<0.01). During the intubation, canaliculifs was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( x2=6.095, P<0.05). After extubation 6 months after laceration repair, the lacri-mal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicu-lar patency in the one-passage group was significantly lower than that of the other two groups ( x2=7.390, P<0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the double-passage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.     

A method of repairing the no. 3 facial cleft.

A method of correction of an incomplete no. 3 facial cleft in an infant is presented. It is compared with previously described repairs, and its advantages are outlined.     

Efficiency and therapeutic effect of modified pigtail probe in anastomosing lacerated lacrimal canaliculus

Objective: To investigate the necessity of modification to the traditional pigtail probe and evaluate its efficiency and therapeutic effect in scarehing the hasal cut ends and anastomosing the lacerated lacrimal carlaliculus.Methods: Eighty-seven patients (including 87 eyes) suffering from canalicular laceration were randomized into two groups:41 patients treated with tradidonal pigtail probes (Group A) and 46 with modified pigtail probes (Group B).During the reconstruction of the lacerated canaliculi,the traditional pigtail probe and the modified pigtail probe were used respectively to seek for the nasal cut ends of lacerated lacrimal canaliculi.Peripherally inserted central catheter (PICCTM) silicone tube with diameter of 0.95 mm was intubated as a stent for 4-6 months.The surgical outcomes were retrospectively analyzed after stent removal.Results: In Group B,the primary Success rate of searching the hasal cut ends of lacerated lacdmal canaliculi was 93.48% (43/46) and the final success rate was 97.83% (45/46).No false passage formed in Group B.Statistical significance was found between Group Aand Group B as the primary success rates of searching the nasal cut ends (χ2=10.522,P＜0.01) and the false passage forming rates were concerned (χ2=4.704,P＜0.05),whereasno significance was found between the two groups as the final success rates were concerned (χ2=0.007,P＞0.05).The mean time of searching the nasal cut ends of lacerated lacrimal canaliculi in Group B was (5.02±2.73) minutes and the mean time of operation was (33.9±4.84) minutes,and both were significantly shorter than those of Group A (t1=9.779,t2=10.700,P＜0.01).The cure rate of Group B was 95.65%,though higher than that of Group A,no statistical significance was found (Z=-1.007,P＞0.05).Totally,2 patients (2.30%) were found to be absent of common canaliculus and underwent bicanalicular hasal intubation in the two groups.Conclusions: Pigtail probes arc efficient and convenient apparatus for searching the nasal cut ends of the lacerated lacrimal canaliculi in the reconstruction of canalicular laceration.Necessary or proper modifications to the pigtail probes can minimize the risk of iatrogenic damages or complications and enhance the efficiency and therapeutic effect of canalicular repair.     

Repair of flexor digitorum profundus lacerations: the Indiana method

The article reviews the current literature on flexor tendon healing and repair. It further describes the rationale andtechnique of a four-strand repair. The technique may allow the initiation of an active rehabilitation protocol, which is believed to decrease joint limiting adhesions and strengthen the repaired tendon.     

脐旁皮瓣修复四肢软组织缺损的疗效评价

1974年Taylor在进行腹直肌皮瓣的研究中,发现并设计了脐旁皮瓣,并于1983年首先报道临床应用2例成功,称之为扩大的腹壁下动脉皮瓣;1984-1986年范启申、刘增智等对该皮瓣进行了进一步的解剖学研究及临床应用,使其在国内逐渐被同行认识。本院于1996-1999年运用脐旁皮瓣修复四肢软组织缺损14例,现报告如下。     

Bilateral canalicular adenomas of the upper lip.

An unusual case of canalicular adenomas appearing bilaterally and simultaneously as separate nodules of the right and left upper lip is described. Upon histological examination, both nodules revealed tumor islands within their respective capsules, as well as outside their capsules and extending into normal salivary gland tissues. The article describes this unusual case and reviews the significance of the extracapsular tumor islands. The immunohistochemical profiles of canalicular adenoma and other salivary gland neoplasms with similar histology are compared and discussed.     

The tertiary management of pretibial lacerations

Pretibial lacerations remain one of the commonest yet most neglected conditions facing emergency departments and plastic surgeons alike. Furthermore, these injuries afflict the most vulnerable groups of adults - the elderly and the infirm. It is essential therefore to have an approach to pretibial lacerations based on best available evidence, in order to optimize wound outcomes, but perhaps more importantly, to safeguard the general health of the vulnerable individual. We present an evidence-based approach to the tertiary management of these injuries and propose a treatment algorithm that we have utilized in our unit to successfully manage 40% of tertiary referrals of pretibial lacerations in a conservative manner.