Surgical management of subcutaneous fat necrosis of the newborn required due to a lack of improvement: a very rare case.

Subcutaneous fat necrosis of the newborn (ScFN) is an uncommon and transient disease characterized by defined areas of fat necrosis and overlying cutaneous nodule lesions. It usually becomes apparent within the first 6 weeks of life in full-term or post-term infants. It is caused by generalized and/or local tissue hypoperfusion. The skin lesions of ScFN tend generally to improve spontaneously in a few weeks. We present a full-term newborn with birth distress. After therapeutic hypothermia, she presented voluminous and numerous subcutaneous fat necrosis with extensive calcifications. Surgical management was decided at her ninth month because of a total lack of regression. Hypercalcaemia, the most threatening complication, appeared only after this delayed surgery.

[Alteration of general state in a woman with polyethylene breast implants since 1967. About an exceptional clinical case]. / Altération de l'état général chez une patiente porteuse d'implants mammaires en polyéthylène depuis 1967. À propos d'un cas clinique exceptionnel.

We report the case of a patient with mammary implants for 42 years. She presented for three years a change of the general state with clinicobiological demonstrations of indefinite origin, and a progressive bilateral increase of her mammary volume until it became exceptional. The surgery of explantation allowed the retreat of two masses of almost 6kg. The analysis did not put in evidence any malignant process but confirmed that it was about prostheses in polyethylene. In one year of recession, a considerable improvement of her general state was observed.

[Hyalomatrix PA(®) in skin substitutes. About 10 cases]. / Place du Hyalomatrix PA(®) au sein des substituts cutanés. À propos de dix cas.

During the surgical treatment of burns and reconstructive surgery, we can use autografts, allografts, xenografts or dermal substitutes. Acellular dermal substitutes, implantable medical devices of class III are composed mostly of collagen but also, more recently, derivatives of hyaluronic acid (Hyalomatrix PA(®)). Their mechanism of action is based on revascularization and colonization by fibroblasts of the patient. They are then used to screen for delayed epidermal grafting (2-stage procedure for Integra(®), Matriderm(®) 2mm, Renoskin(®), Hyalomatrix PA(®)) or simultaneous (1-time procedure for IntegraSL(®), Matriderm(®) 1mm). We report 10 cases of clinical use of Hyalomatrix PA(®) in the service of burns and plastic surgery of Nantes.

Surgical anatomy of calvarial skin and bones--with particular reference to neurosurgical approaches.

This chapter on surgical anatomy is addressed to young neurosurgeons and could be used as an introduction to basic neurosurgical technique. It aims to cover the basic anatomy relevant to making incisions in the scalp and creating bone flaps, an essential preliminary to any form of intracranial surgery. We will examine the anatomy of the scalp, its arterial and venous supply and its nervous system, as well as providing some technical points related to the cranial vault and the base of the skull. It will be explained how a well-grounded knowledge of the anatomical details makes it possible to execute correctly two of the most common approaches in neurosurgical practice, namely the pterional approach and an approach around the sinuso-jugular axis.