ABSTRACT
Les auteurs rapportent le cas d'une adolescente de 14 ans presentant une gigantomastie unilaterale droite; chez qui une chirurgie de reduction mammaire; recourant a un lambeau dermo-glandulaire a pedicule supero-interne; a ete realisee par l'Unite de Chirurgie Plastique des Cliniques Universitaires de Kinshasa. Les suites operatoires ont ete simples; avec conservation de la sensibilite et de la coloration de la plaque areolomamelonnaire; de la lactation; ainsi qu'une bonne morphologie du sein reconstruit
Subject(s)
Adolescent , Case Reports , Mammaplasty , Surgical FlapsABSTRACT
To assess the efficacy of an inner preputial skin flap as replacement for the tunica albuginea of the corpus cavernosum after excision of fibrous plaque. Patients and Methods In this retrospective study we evaluated 5 men who presented with impotence; chordee; painful erection and/or painful coitus after previously undiagnosed or untreated penile fracture. In two patients soft tissue X-rays suggested calcification of the plaque; while ultrasonography revealed extension of fibrosis in four cases. In all patients the plaque was excised and the defect in the tunica albuginea was closed with an inner preputial pedicle skin flap. Results The flaps had taken well in all cases at 3 months follow-up and all patients reported having normal sexual intercourse. Conclusion Surgical excision is the treatment of choice for management of symptomatic fibrous plaques occurring in undiagnosed; untreated or conservatively managed penile fracture. A defect of more than 1.5 cm after excision of the plaque requires tunica replacement; and an inner preputial flap is a good replacement
Subject(s)
Disease Management , Foreskin , Penile Induration/therapy , Surgical FlapsABSTRACT
Background: Although autogenous materials have been used in abdominal wall hernioplasty for a long time; the introduction of prosthetic materials diminished their popularity. However; these materials may be expensive; inappropriate or unavailable. The aim of this study is to determine the place of de-epithelialized dermal flap in the reconstruction of abdominal wall hernias. Materials and Methods: A five-year prospective; descriptive analysis of eligible patients with difficult abdominal wall hernias closed with de-epithelialized dermal flap in a Nigerian Tertiary Health Institution; from January 2001 to December 2005. Results: Over the five-year period; 37 patients were recruited into the study. There were 11 males and 26 females; giving a male: female ratio of 1: 2.4. The ages ranged from 8 months to 47 years (mean = 12.6 years). The defects consisted of 15 incisional hernias; 12 intermuscular/inferior lumbar hernias; nine healed exomphalos major and two giant umbilical hernias. The size of the hernia defects ranged from 4.5 cm to13cm (mean = 6.4 cm). Three patients had bowel resection and end-to-end anastomosis; in addition to the flap reconstruction. Morbidity was minimal and included skin dimpling in 11 patients; seroma in three; and wound infection in two patients. Neither recurrence of herniation nor mortality was recorded during the period of follow-up; which ranged from three months to 4.5 years (mean = nine months). Conclusion: The results suggest that this is a useful technique that can easily be applied in many centers with minimal resources. It is cheap; effective and associated with minimal morbidity
Subject(s)
Abdominal Wall , Surgical Flaps , Surgical Procedures, OperativeABSTRACT
Objective: To evaluate our experience with penile circular fasciocutaneous flap urethroplasty for the repair of long penile and bulbar strictures. Patients and Methods: Between February 2003 and April 2005; a total of 21 circumcised patients with a mean age of 39 (range 11 - 79) years underwent penile circular fasciocutaneous flap urethroplasty for urethral strictures involving the penile and bulbar tracts. The average stricture length was 7 cm. Follow-up included retrograde urethrography at 3 weeks; 3 months and 12 to 18 months; and thereafter when needed; and evaluation of the urinary flow. The mean follow-up was 25.6 months (range 7 to 44 months). The clinical outcome was defined as success when the patient had a good urinary stream; a post void residual urine 50 cc; a peak urinary flow speed 20 ml/sec; a normal and smooth caliber of the urethra as shown on retrograde urethrography and no urinary tract infection. Results: Our initial success rate was 86(18/21 patients). An immediate successful outcome was achieved in 15/21 (71) patients. Three patients had an unsatisfactory urinary stream in the immediate post-operative period which resolved after a single dilation or optical urethrotomy. With a mean follow-up of 26 months 2 patients developed a stricture at the proximal site of the repaired urethra necessitating resection and re-anastomosis. One patient with lichen sclerosus developed recurrence of the stricture and was subjected to suprapubic cystostomy; then further staged reconstruction was done. Immediate post-operative complications were encountered in 4 patients in the form of secondary hemorrhage; ischemia and sloughing of the penile skin; urethrocutaneous fistula which closed spontaneously and a decreased sensation at the lower limb in one patient each. Conclusion: Circular fasciocutaneous flap urethroplasty is a highly effective single-stage method of reconstructing long urethral strictures. It provides ample tissue for urethral substitution
Subject(s)
Egypt , Penis/anatomy & histology , Postoperative Period , Surgical Flaps , Urethral StrictureABSTRACT
Objective: This study was carried out to evaluate the cosmetic and functional results of this new technique for repair of hypospadias. Patients and technique: 28 patients (2-22 years) with distal penile hypospadias were included in the study. Eleven of them had had a failed previous repair. An unhealthy urethral plate and/or thin ventral penile skin were found in 17 patients. The technique follows the steps of the island onlay preputial flap or dorsal penile fasciocutanous flap except in that the length of the flap is; at least; 1 cm longer than the length of the urethral plate. The proximal part of the flap is used for urethral reconstruction. The distal free part of the flap is reflected back to be sutured to the edges of the glanular wings and the penile skin. The urethral stent is removed after 5 days. The patients were followed monthly up to 6 months. Results: In 26 patients an excellent cosmetic appearance of both the penile shaft and glans was achieved with a slit-like or elliptic neo-meatus resulting in a good urine stream satisfying both the patients and their parents. Partial disruption of one side of the suture line and urethrocutanous fistula was reported in one patient each. These two complications were corrected surgically with good results. Conclusion: We conclude that this new technique that we named distally folded onlay flap is easy and versatile with excellent cosmetic and functional results and a low rate of complications when used for the repair of distal and mid-shaft hypospadias in either virgin or redo cases. It should also be considered as a salvage procedure when other techniques are no feasible options
Subject(s)
Egypt , Hypospadias , Penis/surgery , Plastic Surgery Procedures/adverse effects , Surgical Flaps , Treatment OutcomeABSTRACT
Le noma; encore trop frequent dans les pays developpes; provoque des pertes de substance toujours difficile a corriger. Nous decrivons notre technique de reconstitution labiale par un lambeau d'avancement labial total
Subject(s)
Noma/rehabilitation , Surgical FlapsABSTRACT
Il s'agit d'une brulure de la main gauche au feu de bois ayant entraine une carbonisation de quatre doigts cubitaux et une escarre infectee au niveau dorsal de la main. Une couverture de la surface cruentee fut realisee par un lambeau inguinal homolateral de Mac Gregor apres une detersion chirurgico-chimique
Subject(s)
Burns/complications , General Surgery , General Surgery/methods , Hand/surgery , Surgical Flaps/methodsABSTRACT
Soft tissue loss is a frequent accompaniment to open fractures of the tibia and chronic osteomyelitis associated with pseudarthrosis. In Mozambique most of these problems follow war injuries. There are many methods of closing these soft tissue defects; but the best way is the use of a flap. This paper describes the use of a one stage de-epithelialised cutaneous turnover flap in three patients. It is applicable to many circumstances and is quick and easy to perform