The Development of Facial Prosthetics and Adhesives in Plastic and Reconstructive Surgery. A study in the application of prosthetic materials and devices used in plastic and reconstructive surgery together with tissue adhesives as an alternative to conventional ligation.

摘要

Various silicone elastomers have been evaluated for use in the prostheticudreconstruction of facial defects. Their strength, texture, flexibility,udhardness, ease of preparation, pigment receptivity and retention, andudtheir resistance to cleaning were compared and the data consulted when anudelastomer was chosen to restore defects, improve aesthetics and reestablishudthe confidence of a selection of patients. Detailed caseudreports are provided, together with information on the adhesives orudmechanical methods available for retaining the facial prosetheses. Cyanoacrylateudadhesives for use on skin surfaces and as tissue adhesivesudhave been studied in detail. A novel n-butyl 413 cyanoacrylate has beenuddeveloped with a viscosity, haemostatic property and stability to make itudparticularly suitable for use in skin grafting and tissue repair. It hasudalready been used with good results on patients with severe burns. Anudimproved formulation, containing a fluorescent dye, can be preciselyudapplied through a specially constructed foot-controlled dispenserudilluminated by a fibre-optic supplying UV-light. Cyanoacrylates are already being used as tissue adhesives in place of theudconventional but potentially disfiguring suture. The availability ofudimproved, imperceptible adhesives and a precision applicator, which canudbe used in a modern operating theatre, will extend their effectivenessudand satisfy some of the needs of Plastic, and Oral and Maxillo-FacialudSurgeons. Portable applicators have potential use in battlefield and inudveterinary surgery and overcome the imprecision characteristic ofudearlier methods.