ABSTRACT
OBJECTIVE: Reconstruction of lateral malleolar region defects with exposed implants is a problematic situation for the reconstructive surgeon because there are limited options. The objective of our study was to revise the management of these defects and point out the role of proximally based peroneus brevis muscle flap. METHOD: Patients with an implant exposed tissue defects of the lateral malleolar region were evaluated retrospectively. All defects reconstructed with proximally based peroneus brevis muscle flap were included in this study. RESULTS: Of the 17 patients identified the mean age was 37.1 years (range 16-58 years). The size of the defects were 2-9cm in length (mean: 4.9cm) and 2-4cm in width (mean: 2.6cm). All defects were successfully covered with proximally based peroneus brevis muscle flaps combined with split-thickness skin grafts. All flaps healed with no complication or need for secondary surgery. The mean follow-up was18.8 months (range 12-32 months). CONCLUSION: Proximally based peroneus brevis muscle flap is a good alternative for reconstruction of lateral malleolar region defects with reliable blood supply, short surgical time, and minimal donor site morbidity.
Subject(s)
Ankle Joint/surgery , Muscle, Skeletal/transplantation , Plastic Surgery Procedures/methods , Skin Transplantation , Soft Tissue Injuries/surgery , Surgical Flaps , Adolescent , Adult , Female , Humans , Joint Prosthesis/adverse effects , Male , Middle Aged , Retrospective Studies , Soft Tissue Injuries/etiology , Treatment Outcome , Wound Healing , Young AdultABSTRACT
A 5-month-old boy who had been operated for esophageal atresia and tracheoesophageal fistula was presented with recurrent life-threatening apneic spells, expiratory stridor and difficulty in feeding. Diagnosis of tracheomalacia was confirmed by bronchoscopy and pericardial flap aortopexy was performed. Pericardial flap aortopexy is a relatively simple procedure with minimal risk to the aorta. Minimal dissection is required and there are no sutures placed in the aortic wall, thus avoiding the risk of tears.
Subject(s)
Aorta/surgery , Cartilage Diseases/surgery , Esophageal Atresia/surgery , Trachea/abnormalities , Tracheal Diseases/surgery , Tracheoesophageal Fistula/surgery , Age Factors , Cartilage Diseases/diagnosis , Esophageal Atresia/complications , Gastroesophageal Reflux/surgery , Humans , Infant, Newborn , Magnetic Resonance Imaging , Male , Pericardium , Surgical Flaps , Tracheal Diseases/diagnosis , Tracheal Stenosis/diagnosis , Tracheoesophageal Fistula/complications , TracheostomyABSTRACT
PURPOSE: The aim of this study was to determine the effects of bilirubin in experimental small intestinal ischemia/reperfusion (I/R) injury in rats. METHODS: Thirty rats were divided into 5 groups (n = 6). In group S, saline and in group B, bilirubin, 20 mg/kg were infused via the jugular vein without an additional procedure. In groups S-IR, saline, B(1)-IR and B(2)-IR, 10 and 20 mg/kg/h of bilirubin were infused for 2 hours, respectively. In these groups, an I/R procedure was done after infusions by occluding the superior mesenteric artery for 45 minutes followed by 1 hour of reperfusion. After reperfusion, the small intestines were resected for histopathologic and malondialdehyde (MDA) assessments. Mucosal lesions were scored between 0 and 5. Malondialdehyde levels and histopathologic grades were analyzed statistically. RESULTS: Mucosal injury was severe in S-IR (grade 4 to 5), mild in B(1)-IR (grade 0 to 3) and none in B(2)-IR group (grade 0). Grades of group S-IR were higher than those of B(1)-IR and B(2)-IR statistically (P <.05). Tissue MDA levels of the S-IR group were significantly higher than those of B(1)-IR and B(2)-IR groups (U = 36, P <.05). Bilirubin levels correlated inversely with MDA levels (r = -0.94). CONCLUSIONS: Bilirubin effectively prevents intestinal I/R injury in rat. This observation is consistent with the hypotheses regarding bilirubin as an antioxidant, having a role in the body defense. J Pediatr Surg 36:1764-1767.
