ABSTRACT
Tuberculosis remains a public health problem and its rare extrapulmonary forms persist with late diagnosis, which delays the diagnosis and favors the dissemination of the disease. The perianal manifestation occurs in approximately 0.7% of tuberculosis cases and usually manifests as fistulizing disease, but may also present with ulcerated lesions, with necrotic and quite painful clinical picture. Initial treatment should be carried out aimed at controlling perineal and perianal sepsis, with subsequent establishment of specific drug therapy provided by the Health Ministry. (AU)
A tuberculose ainda hoje se mantém como um problema de saúde pública e suas raras formas extrapulmonares persistem com diagnóstico tardio, o que retarda o diagnóstico e propicia a propagação do bacilo. A manifestação perianal ocorre em cerca de 0,7% dos casos de tuberculose e manifesta-se geralmente como doença fistulizante, mas que pode também apresentar-se com lesão ulcerada, de fundo necrótico e bastante dolorosa. O tratamento inicial deve ser realizado objetivando o controle da sepse perineal e perianal com posterior instituição de terapia medicamentosa específica fornecida pelo ministério da saúde. (AU)
Subject(s)
Humans , Male , Middle Aged , Perineum/injuries , Tuberculosis/diagnosis , Tuberculosis/drug therapyABSTRACT
Ulcer in buttock is mainly a pressure sore, which is frequently occurred at the sacral region in Korea and its surgical treatment is chiefly the operation using gluteus maximus myocutaneons flaps. For the treatment of ulcerated lesion in gluteal area, various methods using gluteus maximus muscle have been developed. We reviewed and analyzed the 100 cases using gluteus maximus myocutaneous flaps in our department since 1980. The results were summarized as follows ; 1) The ratio between male and female was 3:1. 2) The prevalent age groups were between third and fifth decades. 3) The main cause was the trauma. 4) The wound culture showed the pattern of mixed infections in most cases, consisting of Staphylociccus, Pseudomonas, Enterococcus, Streptococcus, and others. 5) The postoperative complications were noted in about thirty percent of the cases. The complications were flap tip necrosis, wound infection, wound disruption, and others. 6) For the treatment of small ulcers, a pure skin flap or myoplasty may be used, but for the treatment of large one, a kind of myocutaneous flap should be selected. 7) Gluteus maximus myocutaneous flaps can be used as variable methods, but of which the island flap is ideal in deep and large ulcerated lesion.