Acta chirurgiae plasticae最新文献

Objective: Limberg flap, is a rotational rhomboid flap. A procedure done for people who have either complex or recurrent pilonidal disease. This study has been performed to determine effects of the Limberg flap for sacrococcygeal pilonidal sinus, regarding the wound infection rate, seroma formation, postoperative pain relief, recurrence rates, return to work, its cosmetic final result and patients' satisfaction.

Methods: A total of 10 patients were operated from January 2022 to March 2023. Patients were selected according to the disease complexity and recurrence, so that the patients selected were classified as complex and at least of a second recurrence of the disease.

Results: Patients successfully underwent surgery, with mild to moderate postoperative pain, stayed in hospital for 3 days in average, returned to work after 6 weeks, with 5 patients having flap oedema, 1 patient had wound infection, no one had flap necrosis, and there were no recurrences so far for an average follow-up time of about 3 months. Patients with flap oedema took 2-3 weeks to heal with regular dressing only. Patient satisfaction and final cosmetic result were well accepted. Limberg flap for sacrococcygeal pilonidal sinus was found very useful in terms of recurrences.

Conclusion: Better patients' acceptance and satisfaction despite the increased risk in postoperative pain, infection rates, and longer return to work in comparison to the open procedures.

Reconstruction of large soft tissue foot defects were considered a difficult issue due to weight-bearing function of the foot. The reconstruction becomes more difficult when both plantar and dorsal soft tissues are involved. The options for the reconstruction were variable, in 2016 Hao Wu et al. presented a combined flap for coverage of combined fore-foot plantar and dorsal soft tissue defects. We used combined flaps in two cases and present our experience in this article.

Breast reduction mammaplasty is the only effective therapeutic intervention for patients with symptomatic breast hypertrophy. In this procedure, closed suction drains have become a standard of care, while the literature supporting use of drains is lacking. In fact, with emerging data we found out that drains might not be so necessary. This review aimed to systematically compare the number of complications in drained and undrained breasts and to evaluate the safety of omitting drains in reduction mammaplasty in clinical practice. A systematic review of literature was conducted identifying all studies on drainage in reduction mammaplasty. The analysed databases revealed 13 eligible studies to be included in this review. There were 308 drained breasts and 859 undrained breasts in total in patients from 16 to 73 years of age. The resected tissue weight per side fluctuated from 108 to 1,296 grams. In total, there was only 2.4% incidence of haematoma complications in undrained breasts and 3.9% in drained breasts. Closed suction drains are still being routinely used in reduction mammaplasty, although aborting drain use is proven to be not only safe, but advantageous. The clear benefit is increased patient comfort, shortened hospital stay, decreased cost of the procedure and nurse care, and decreased rate of complications.

Juvenile xanthogranuloma (JXG) is a rare, benign non-Langerhans cell histiocytosis that primarily affects the skin, with infrequent extracutaneous manifestations. Lesions typically emerge during early childhood and often resolve spontaneously, obviating the need for treatment. This paper details the case of a child diagnosed with a solitary JXG on the sole, necessitating surgical excision due to its functional impairment, specifically a delay in walking and weight bearing.

The hand is a unique structure in human body performing complex activities of daily life making it prone to injuries. While operating on zone VI extensor tendon injury, a surprising entity was observed. The extensor digitorum to the right index finger was absent. This is an extremely rare entity in the literature. Also, all previous studies on the extensor digitorum are cadaveric. Our findings are first of its kind intraoperative, incidental, and confirmed on MRI. Thus, it becomes a case report of special worth mentioning in literature.

Full-thickness skin grafts are essential tools for reconstructive surgery. Rectangular or square secondary defect usually occurs after performing a cross-finger flap or homodigital island flap. With the traditional fusiform ellipse design, trimming out excess graft tissue is necessary. Double right triangular shape full-thickness skin grafts are designed to correct the problem.

Background: We report a successful wound treatment of a chronic ulcer with bone exposure using a somehow forgotten technique of creating burr holes into the bone. Most clinics would promote flap surgery to cover wounds with bone exposure, however, in some cases invasive surgery is not mandatory. We bring up an alternative treatment for such cases.

Case: We report a case of chronic ulcers on both lower extremities in a 43-year-old Caucasian male. He suffers from a leukocytoclastic vasculitis and sarcoidosis which is medicated by immunosuppressive medication. The patient's wounds were initially treated with mechanical debridement and split-thickness skin grafts, however, his wounds tended to worsen the more they were manipulated and finally resulted in tibial bone exposure. After levelling up his immune suppressive drugs, the wounds finally stabilized but didn't heal after several weeks of follow-up. The wound was ultimately treated by placing burr holes in the underlying cortical bone.

Conclusion: Chronic ulcers with bone exposure at the lower leg are challenging to treat. They often require local or free flap surgery. In some cases, because of underlying systemic disease, it is mandatory to stay away from invasive flap surgery. With this case, we like to put under attention an old technique of decorticating the exposed bone to promote secondary wound healing. It has been described mainly for scalp injuries, however, we have proven the viability of this technique for pretibial wounds as well.

Indwelling intravascular catheters are important tools in the care of critically ill patients; however, they have an inherent risk of infection or thromboembolic events. Reports on catheter associated thromboembolic events in burn units are rare, despite being well recognized that burn patients bear an increased baseline risk for thromboembolic events. We describe two catheter-associated thromboembolic complications in burn patients in a burn unit and the morbidity associated with these events. Patients with endovascular catheters in burn units may be at increased risk for severe thromboembolic events associated with intravascular catheters, but specific guidelines for prevention and management of these patients are still missing.