Secondary osteoplasty by means of autogenic spongy bone grafting is the most common procedure used in the reconstruction of the continuity of the maxillary alveolar process. The aim of the study was to analyze retrospectively the effect of certain factors on the course of the bone graft healing process in patients with unilateral complete clefts of the lip, alveolar process, and palate. The investigations involved 62 children aged 8 to 14 years (mean age, 11 years) with unilateral complete cleft of the lip, alveolar process, and palate operated on at the Clinic of Plastic Surgery in Polanica Zdrój from November 2007 to April 2009. All the procedures consisted in the reconstruction of the maxillary alveolar process by means of autogenic spongy bone grafting from the iliac bone. The analysis was performed on the basis of computed tomography scans presenting maxillary alveolar processes in the horizontal cross-sectional planes performed on the second or third postoperative day and after 6 months. They were used as the basis for the measurement of the volume and density (condensation) of the bone graft, the surface of its adhesion to the maxillary alveolar bone, and the volume and density of the healed bone. The following correlation coefficients were determined: between the adhesion surface of the bone to the alveolar bone and the volume of the healed bone, between the adhesion surface of the bone to the alveolar bone and the density of the healed bone, and between the density of the graft and the volume of the healed bone. Increasing the surface of the graft adhesion to the bone ridges of the alveolar cleft contributes to increased volume of the healed bone and slows down the increase in its density (on 6-month follow-up). Crushing of the bone graft increases its resorption and reduces volume of the healed bone.

The aim of the study was to evaluate respectively the effectiveness of therapy of late complications of neck burns in the form of scars and contractures in the material of one clinical centre in the past 31 years . Material and methods. 321 patients aged from 1 to 69 (mean age: 8 years) years with late complications of neck burns were treated in the Plastic Surgery Hospital in Polanica Zdrój in the years 1976-2007. The majority of patients were children aged from 1 to 14 years -276. In total 589 surgical procedures were performed. The following therapeutic modalities were applied: scar excision followed by local reconstructive flap surgery -434 cases; full thickness and split-thickness skin grafting -124 cases; local flap reconstruction with the use of expander -18 cases; transferred pedicle flap from adjacent tissues -3 cases, flap from other body regions on microvascular anastomosis -11 cases; and dermabrasion -19 cases. Results. 285 (89%) patients were satisfied with the treatment outcome and accepted the appearance of scars without complaints. The remaining 36 patients did not find their esthetic appearance after reconstructive surgery satisfactory and did not accept the deformities. Conclusions. Deciding on the management and choosing a surgical modality in patients with postburn skin scarring, a plastic surgeon must take into consideration the kind and severity of the deformity. Surgical treatment of severe scarring is a complex and multi-stage procedure.