Técnica com retalho muscular duplo e fasciocutâneo na correção de úlceras isquiáticas por pressão / Technique with double muscle and fasciocutaneous flap in the correction of sciatic pressure ulcers

Úlceras por pressão são lesões ocasionadas na pele e tecidos subjacentes devido à força de pressão local, geralmente em pontos de proeminências ósseas. Cita-se aqui o caso de uma paciente acamada devido à lesão medular por mielomeningocele que evoluiu com úlcera em região isquiática à direita, tratada com técnica de retalhos muscular e fasciocutâneo de face posterior da coxa. Por ser lesão rotineiramente encontrada nesses pacientes portadores de limitações funcionais, é fundamental a realização de tratamentos adequados que visem a melhora clínica do paciente e minimizar índice de recidivas. Além disso, é de suma importância a implementação de novas técnicas cirúrgicas, haja vista a enorme variedade de lesões por pressão

Pressure ulcers are injuries to the skin and underlying tissues due to local pressure force, usually at points of bony prominence. We mention here the case of a bedridden patient due to a spinal cord injury caused by myelomeningocele that evolved with an ulcer in the right sciatic region, treated with the muscle flap and fasciocutaneous flap technique of the posterior thigh. As it is a lesion routinely found in these patients with functional limitations, it is essential to carry out appropriate treatments aimed at improving the patients clinical condition and minimizing the rate of recurrences. In addition, the implementation of new surgical techniques is of utmost importance, given the enormous variety of pressure injuries

The clinical value of intracranial translucency (IT) in open spina bifida at 11-13 +6 weeks of gestation / 中国医师杂志

Objective To explore the clinical value of intracranial translucency (HT) in open spina bifida at 11-13 +6 weeks of gestation.Methods Abdominal ultrasound was performed in 200 cases of normal fetus and 6 cases of confirmed open spina bifida at 11-13 +6 weeks of gestation to compare the morphology of IT,diencephalon and midbrain.Results Fetal IT was readily recognized in all 200 normal cases,with diencephalons and midbrain showing number "8" shape.In 6 cases of open spina bifida,fetal IT cannot be identified,and the expected " 8" shape of diencephalon and midbrain was distorted.During 11-13 +6 weeks of pregnancy,the fetal brain is caused by intracranial negative pressure,resulting in morphological changes in the intracranial hyaline,diencephalon and mesencephalon.Conclusions Fetal brain characteristics including intracranial translucency and the shape of diencephalon and midbrain in 11-13 +6 weeks gestation are valuable ultrasound screening indicators for opens pina bifida.

A case of sacrococcygeal teratoma with spina bifida cystica in newborn

Sacrococcygeal teratoma is a rare tumor, it occurs once in every 40,000 live births. Most of the reported cases appear in female infant (M:F=1:4). They deserve clinical attention because they are potentially malignant and are curable if diagnosed and treated early. The patients may have associated congenital anomalies. This patient has spina bifida cystica in lower sacrum. Brief review of related literature is included in the report.

Clinical Study on Myelomeningocele

Myelomengocele is one of the most common congenital anomalies. The exact incidence of myelomeningocele is not known, but it is about one to three per 1000 live births. The long term results of treatment of infants born with myelomeningocele are disappointing. So many factors must be considered in deciding the treatment of the patients, such as clinical state of the patients, family's attitude, socioeconomic factors, and ethical and moral aspects. Authors performed clinical study of 71 cases of spina bifida cystica for past 10 years and the results are as follows : 1) Of the 71 cases, 51 cases(71.8%) were myelomeningocele and 20(28.2%) were meningocele. There was no sexual difference. 2) Admissions within 24 hours after birth were only 21 cases(29.5%). 3) Familial tendency and the relation to the number of childbearings were not observed. Majority of the cases were born in the families of low socioeconomic state. 4) Of the 71 cases, 17 cases(23.9%) were associated with hydrocephalus and 3(4.2%) with Arnold-Chiari malformation. 5) 39 cases(76.5%) of myelomeningocele showed definite neurological deficit but all cases of meningocele were quite normal neurologically. 6) Operation was performed in only 24 cases(47.1%) of 51 myelomeningocele.