Zeitschrift fur plastische Chirurgie最新文献

A method for subcutaneous mastectomy and reconstruction is described. To the patients the results of this method are pleasing. A specific advantage of this method is, that only in 20, 15% of these cases in recent years, we used silicone prosthesis for augmentation. An analysis of 333 cases showed some frightening facts: in 9,26% an invasive carcinoma was found. Furthermore, in 4,44% a lobular carcinoma in situ was found. A preoperative diagnosis was made, only in four of these fourty patients. Therefore, it can be stated that - as reconstruction possibilities by plastic surgery standards are good - a generally restrictive point of view towards the indications to subcutaneous mastectomy should be given up.

There is a considerable rate of complications in face lift procedures. Especially those examiners who have included the dissatisfaction of patients found a rate of complications up to 40%. The article brings a conclusion of the most in the literature described complications and also hints from different authors to avoid them.

In a group of 174 children with clefts lip and palate the articulation-connected (sprachgebundene) and non-articulation-connected (nicht sprachgebundene) intelligence have been inquired by the HAWIE- and HAWIK-intelligence test. For this group a general average IQ of 106,6 resulted, that means 6,6 IQ points above a normal 100 level found out for this test. There is a significant difference between the verbal and the action-part, the action-part prevailing in nearly all IQ fields. With due restraint the qualitative interpretation of the subtests discovers a surprising high ability in respect of the verbal forming of conception, the verbal knowledge and the ability to adapt to social norms.

To achieve a re-contouring of the lower extremities the conservative methods of the local slide plasty, the Z-plasty and the slide swing plasty in combination with subcutaneously pedicled fat flaps as single or combined measures proofed satisfying. As far as the general extend and the localization of the defect admits, those measures may be superior to the free and musculo-cutaneous flaps in respect to esthetically good results. Several cases may demonstrate those possible methods. Besides the technical know-how, a well based planning in connection with a specific valuation of the different operative methods are the fundamental necessities for a satisfying result.

Regarding the usual procedures for closure of defects of the lower extremity, the author prefers the primary procedure, if possible. Skin closure should be achieved by scarification. In cases with larger defects, the cross leg flap procedure is the way of treatment.

A basic aim of photographic documentation of clinical cases is to compare these cases with each other. Some examples illustrate possible misinterpretations due to inadequate or variable photographic conditions. To assess postoperative results is possible only in exact comparative photography. Depending upon specific problems, the required conditions are variable. Nevertheless, some general rules can be formulated. They should be applied in a photographic documentation of clinical cases.

The Urea production (PU) of three severe burned patients is presented as an example for calculating protein loss. Burn injuries are accompanied by an extensive catabolism more then any other disease, operation or trauma. The operative stress caused a further increase of PU. The highest values are measured in electric burns. Alimentation is considered as an important therapeutic mean to diminish catabolism. Urea production rate is presented as a simple method to control protein loss and can be done in every hospital.