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Background: The first report about the use of water-jet dissection in surgery dates 1982. The advantage compared to conventional cutting is the preservation of vessels and nerves, thus facilitating the precise coagulation thereafter. Devices of the new generation with coherent jet are used in liver surgery in order to reduce blood loss. The use of water-jet dissectors in other fields of surgery is currently under investigation. The preparation of vessels in fatty tissue is of special interest for plastic surgeons. The technical parameters of the hydro- or water-jet device have to be optimised., Method: Abdominal fat tissue of fresh cadavers was cut under standardised conditions with different parameters of the dissector. The depth of the cuts and the morphology of the blood vessels were analysed., Results: Between 20 and 60 Bar cutting pressure of the water-jet and one single pass the cuts are 8 mm deep. Deeper cuts can be achieved by repeated application on the same cut. When using 40 Bar and 5 passes the cutting depth is 1.7 cm. Higher pressure as 50 or 60 Bar do not lead to deeper cuts. The water-jet dissection leads to a water uptake of the cut tissue. Morphologically all the vessels, lying in the cut are undamaged if the pressure doesn't exceed 40 Bar pressure range., Conclusion: The optimal pressure for water-jet dissection of fatty tissue lies between 30 and 40 Bar. Higher pressure does not lead to deeper cuts, but increases the risk of vessel damage. The vessels in the remain morphologically intact if he cutting pressure lies below 50 Bar. The effect of the mechanical irritation of the vessels has to be investigated in vivo, before using the water-jet dissector for preparation of blood vessels in humans e.g. for flap dissection.

The article describes an older, simple, and effective method of postoperative fixation of the palatal flaps using celluloid-acetone dressing (CAD). Veau pedicle flaps and the construction of two nasal meatuses are used for the palatoplasty. After the surgery, a wire is round around teeth IV and V on each side: a prolene mattress suture, instead of wire, is used for infants without teeth. A celluloid-acetone paste is applied to the wire or suture over a layer of gauze and petroleum jelly. The CAD mixture hardens in less than 1 hour and is removed after 4 days by cutting the wire or suture. This method prevents the palatal flaps from descending; scar tissue is minimal, and assists in the formation of a high-arched roof of the palate. In addition, the patient feeds normally after the operation.

Within this study patients with mandibular prognathism were studied as to their psychological situation pre- and postoperatively with the help of the Freiburg Personality Evaluation Sheet. Since it was our special interest, whether psychologically it makes a big difference whether the patients were operated during the time of adolescence or after the age of twenty, the postoperative investigation was carried out with special reference to this point. Without any doubt, the correction of prognathism improved the psychological situation of the patients. It was obvious that for those patients in between fourteen and seventeen the improvement was more helpful than for those patients after the age of twenty. On the other hand the rate of recurrence was much higher within the group of those patients operated in between fourteen and seventeen (29.8%) than for those patients which were operated later than at age twenty (8%). The ideal age for the correction of mandibular prognathism must be found individually. While the operation at an early time is more helpful for the psychological situation of the patients, it must on the other hand be seen that for this age-group the danger of recurrence is higher.

The result of cleft lip operations is judged after the external image, the complet function of circular muscle system and the unfoldable vestibulum oris. The MILLARD-plastic for wide cleft lips and the REICHERT-plastic with the own modification for narrow cleft lips are for the time the optimal methods of operation.