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Plastische und rekonstruktive Mund-, Kiefer- und Gesichtschirurgie – Technische Aspekte

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Medizintechnik

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Zusammenfassung

Jede plastisch-rekonstruktive Maßnahme, die mit einer lokalen Verschiebung oder freien Verpflanzung von Haut verbunden ist, erfordert genaue Kenntnisse über ihren Aufbau und ihre Blutversorgung, die bereits 1893 durch Spateholz beschrieben wurde [56]. Man kann die Haut als ein zweilagiges Organ auffassen, wobei die äußere Lage von der Epidermis, die innere von der Dermis gebildet wird. Die Dicke der Epidermis ist vom Alter und der Körperregion abhängig und variiert zwischen 0,1 und 0,15 mm [19]. Die unterste Zellschicht der Epidermis bildet die Basalmembran, die einen festen mechanischen Verbund mit der Dermis ermöglicht und zugleich eine Barriere für chemische und andere Substanzen darstellt. Die Dermis, in der Hautanhangsgebilde wie Haarfollikel, Schweißdrüsen, Talgdrüsen, aber auch immunkompetente Zellen enthalten sind, ist mit dem subkutanen Fettgewebe und der darunter liegenden Muskulatur durch unterschiedlich straffe Bindegewebszüge verbunden. Man unterscheidet die dünne, oberflächliche papilläre von der dicken, tiefer gelegenen retikulären Dermis. Spalthauttransplantate können in unterschiedlichen Dicken aus Epidermis und Dermis entnommen werden, wobei das dünnste Transplantat, der sog. Thiersch-Lappen, der gesamten Dicke der Epidermis entspricht. Vollhauttransplantate reichen dagegen bis in die Übergangszone zum subkutanen Fettgewebe und beinhalten die gesamte Dermis, so dass es hier erneut zu Haarwuchs kommen kann.

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  1. Klinik für Mund-Kiefer-Gesichtschirurgie, Klinikum rechts der Isar der TU München, Ismaninger Straße 22, 81675, München, Deutschland

    Klaus-Dietrich Wolff & Thomas Mücke

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  1. Lehrstuhl für Medizintechnik, TU München, Boltzmannstr. 15, 85748, Garching, Deutschland

    Erich Wintermantel

  2. IVF Hartmann AG, Victor-von-Bruns-Str. 28, 8212, Neuhausen, Schweiz

    Suk-Woo Ha

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Wolff, KD., Mücke, T. (2009). Plastische und rekonstruktive Mund-, Kiefer- und Gesichtschirurgie – Technische Aspekte. In: Wintermantel, E., Ha, SW. (eds) Medizintechnik. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-93936-8_68

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