En-Bloc Kidney Transplant Using an Aortic Extension from a Paediatric Multi-Visceral Donor to a Paediatric Recipient

Abstract

Aim: To analyze the results of surgical treatment of cicatricial post-traumatic deformities of the breasts. Methods: There has been presented treatment experience of 149 patients with cosmetic and post-traumatic changes of the breasts in the clinical base of the Department of Surgery, Endoscopy and Reconstructive Surgery of DNMU. The number of the patients treated for post-traumatic cicatricial deformity was 34 patients (22.8%) aged 7 to 62 years. There were 27 injured of them (79.4%) with the consequences of burns, 2 (5.9%) after the complications of cosmetic surgeries, 5 patients (14.7%) were operated on for the consequences of cancer treatment and three of them (8,8%) were hospitalized for radiation ulcers. The patients underwent 54 surgical interventions: Free autodermoplasty 13 (24.1%); local flaps grafting 14 (25.9%); combined plastic surgery and endoprosthetics 13 (24.1%); expander dermatotension 5 (9.3%); plastic surgery with complex composite flaps 9 (16.7%). Results: The article gives a historical overview of breast reconstructive operations and the classification of their post-traumatic injuries. Depending on the anatomy of cicatricial damage to the chest wall and the breast an algorithm for reconstructive mammoplasty is generalized. When performing surgical interventions in patients with the consequences of any type of the injury the main task was to eliminate scar-modified skin, correct the elevation of the breast, functional disorders such as contractures and make normal development of breast tissue possible. In any case, the operation is aimed at releasing the breasts from scars and creating the conditions for their normal development in adolescents, as well as restoring the shape, size and the appearance of already formed breasts in case of the patients’ late appointment with a doctor. When eliminating breast deformities in women of mature age it is often rational to separate the nipple-areolar complex from cicatricial tissue and transpose it to its usual location. Conclusion: Good cosmetic results, stable restoration of the shape, position and the skin of the breasts deformed by scars were obtained during all surveys. Reconstructive operations contribute to a significant regression of psychological and social disorders in patients with cicatricial deformities after a burn injury, and therefore they improve their overall rehabilitation result. If it’s possible surgical treatment of cicatricial deformities of the anterior surface of the chest wall should be started before breast development in adolescent girls and they should be followed-up.