title: The Use of Double-Layer Collagen Membrane for the Improvement of Nasal Dorsum Skin Thickness and Texture in Primary Nose Surgery.
abstract: OBJECTIVE
  To place a collagen membrane containing crushed nasal septal cartilage over the nasal dorsum to see how this graft can improve the results of visible postsurgical irregularities in thin skinned patients.
  
  
  METHODS
  Fifty-seven patients were treated between 2006 and 2010 (26 males and 31 females) whose ages ranged between 31 and 55 years old. They were divided into group a, defect <1 mm, group b defect between 1 and 2 mm, group c defect >3 mm. These patients presented intraoperative nasal dorsum irregularities that were corrected with 57 cartilage grafts in conjunction with collagen membrane.
  
  
  RESULTS
  All of our patients showed an initial over-correction. A dense network of collagen fiber bundles was observed running parallel to the surface of the membrane at the connective tissue-membrane interface. The clinical percentage of volume reabsorption was about 5% after 6 months, measured with clinical pictures and a clinical follow-up. No infection was noted, only 1 patient of dislocation was observed, and 5 patients required some refinements at the long-term follow-up.
  
  
  CONCLUSIONS
  In the authors' experience the use of bilayered combined cartilage and collagen membrane grafts gives the best aesthetic results with balanced tip projection and dorsum fullness, and avoids thickness and texture modification of the skin above the graft. The use of Bio-gide membrane avoids all problems related to the donor site and shortens surgical time.
authors.affiliation: Maxillo-Facial Department, University of Verona, Policlinico G. B. Rossi, Verona, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Bertossi
authors.forename: Andrea
authors.initials: A
authors.lastname: Sbarbati
authors.forename: Pasquale
authors.initials: P
authors.lastname: Procacci
authors.forename: Pietro
authors.initials: P
authors.lastname: Palma
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Nocini
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D048091:Guided Tissue Regeneration / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007558:Italy; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D055171:Nasal Cartilages / Q000637:transplantation*; D009666:Nose / Q000473:pathology / Q000601:surgery; D009667:Nose Deformities, Acquired / Q000175:diagnosis / Q000601:surgery; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control*; D012225:Rhinoplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
chemical_list: C106416:Bio-Gide; D001672:Biocompatible Materials; D008567:Membranes, Artificial; D003094:Collagen