ABSTRACT
Transposition flaps are some of the most commonly used flaps for reconstructing scalp defects. Limberg first described his rhomboid transposition flap in 1946. Dufourmentel flap was an improved version of the Limberg flap published in 1962 in which the base of the flap is widened to improve vascularisation. Transposition flaps are one of the best known and most widely used transposition flaps in reconstructive surgery. They have proven successful in different types of reconstructive and aesthetic situations as a full-thickness random transposition flap. Combination of three Dufourmentel flaps to reconstruct hexagonal defects has not been reported in the literature. It is a modification of the triple Limberg flap, in which, after removing a hexagonal defect, we reconstruct the primary defect with a triple Dufourmentel flap. This flap is very useful for reconstructing large scalp defects as it provides a large amount of skin tissue with high viability; however, given its versatility, it could be used in other anatomical areas. Ann Med Surg (Lond) 2021 7:102544; Plast Reconstr Surg 2015 136:163-164; Atlas Oral Maxillofac Surg Clin North Am 2020 28:17-22.
Subject(s)
Ectodermal Dysplasia , Plastic Surgery Procedures , Humans , Scalp , Surgical FlapsABSTRACT
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Subject(s)
Humans , Male , Infant , Skin Diseases/complications , Skin Diseases/diagnosis , Skin Diseases/prevention & control , Pediatrics/instrumentation , Pediatrics/methods , Skin Diseases, Vesiculobullous/complications , Skin Diseases, Vesiculobullous/diagnosis , Skin Diseases, Vesiculobullous/prevention & controlABSTRACT
Introducción: La biopsia selectiva del ganglio centinela representa la herramienta más importante para determinar el estatus ganglionar en el paciente con melanoma. Objetivos: Analizar la capacidad de detección y disección de la técnica de biopsia selectiva de ganglio centinela con la incorporación de una gammacámara portátil intraoperatoria, así como las morbilidades derivadas de la misma. Métodos: Estudio observacional sobre una serie de casos incluidos prospectivamente y de forma consecutiva de pacientes a los cuales se les realizó la técnica de biopsia selectiva de ganglio centinela radioguiada mediante gammacámara portátil. Se realizó un análisis de concordancia entre los ganglios detectados entre la linfografía prequirúrgica, la gammagrafía portátil y los ganglios disecados. Resultados: Durante el período de estudio se incluyeron 29 pacientes diagnosticados de melanoma cutáneo. Eran 17 mujeres (62,5%) y 12 varones (37,5%) y la edad media fue de 52,6 años (rango: 26-82). Se realizó disección del ganglio centinela en el 100% de los pacientes; además se obtuvieron en algunos casos ganglios secundarios. En el número detectado de ganglios mediante linfografía preoperatoria hubo concordancia con respecto a la gammagrafía portátil y a los ganglios disecados finalmente en 16 de los pacientes (55,2%). Respecto a las complicaciones se observaron solo seromas en un 3,64% de los casos, no presentando en ningún caso dehiscencia de la herida, infección, hematoma o hemorragia. Conclusiones: La biopsia selectiva de ganglio centinela radioguiada mediante gammacámara portátil es una técnica que podría colaborar en mejorar la capacidad de detección y disección del ganglio centinela, así como en una disminución en la morbilidad quirúrgica derivada de la técnica, aspectos que resultan esenciales en una técnica cuyo objetivo inicial es la estadificación del paciente con melanoma (AU)
Introduction: Sentinel lymph node biopsy is the most important tool available for node staging in patients with melanoma. Objectives: To analyze sentinel lymph node detection and dissection with radio guidance from a portable gamma camera. To assess the number of complications attributable to this biopsy technique. Methods: Prospective observational study of a consecutive series of patients undergoing radioguided sentinel lymph node biopsy. We analyzed agreement between nodes detected by presurgical lymphography, those detected by the gamma camera, and those finally dissected. Results: A total of 29 patients (17 women [62.5%] and 12 men [37.5%]) were enrolled. The mean age was 52.6 years (range, 26-82 years). The sentinel node was dissected from all patients; secondary nodes were dissected from some. In 16 cases (55.2%), there was agreement between the number of nodes detected by lymphography, those detected by the gamma camera, and those finally dissected. The only complications observed were seromas (3.64%). No cases of wound dehiscence, infection, hematoma, or hemorrhage were observed. Conclusions: Portable gamma-camera radio guidance may be of use in improving the detection and dissection of sentinel lymph nodes and may also reduce complications. These goals are essential in a procedure whose purpose is melanoma staging (AU)
Subject(s)
Female , Humans , Male , Adult , Aged , Middle Aged , Aged, 80 and over , Melanoma/diagnostic imaging , Sentinel Lymph Node Biopsy/methods , Gamma Cameras , Image-Guided Biopsy/methods , Lymphoscintigraphy/methods , Lymphatic Metastasis/diagnostic imaging , Equipment Design , Intraoperative Care , Observational Study , Prospective Studies , Neoplasm Staging/methodsABSTRACT
INTRODUCTION: Sentinel lymph node biopsy is the most important tool available for node staging in patients with melanoma. OBJECTIVES: To analyze sentinel lymph node detection and dissection with radio guidance from a portable gamma camera. To assess the number of complications attributable to this biopsy technique. METHODS: Prospective observational study of a consecutive series of patients undergoing radioguided sentinel lymph node biopsy. We analyzed agreement between nodes detected by presurgical lymphography, those detected by the gamma camera, and those finally dissected. RESULTS: A total of 29 patients (17 women [62.5%] and 12 men [37.5%]) were enrolled. The mean age was 52.6 years (range, 26-82 years). The sentinel node was dissected from all patients; secondary nodes were dissected from some. In 16 cases (55.2%), there was agreement between the number of nodes detected by lymphography, those detected by the gamma camera, and those finally dissected. The only complications observed were seromas (3.64%). No cases of wound dehiscence, infection, hematoma, or hemorrhage were observed. CONCLUSIONS: Portable gamma-camera radio guidance may be of use in improving the detection and dissection of sentinel lymph nodes and may also reduce complications. These goals are essential in a procedure whose purpose is melanoma staging.
Subject(s)
Gamma Cameras , Image-Guided Biopsy/methods , Lymphatic Metastasis/diagnostic imaging , Lymphoscintigraphy/methods , Melanoma/diagnostic imaging , Sentinel Lymph Node Biopsy/methods , Skin Neoplasms/diagnostic imaging , Adult , Aged , Aged, 80 and over , Equipment Design , Female , Humans , Intraoperative Care , Lymphoscintigraphy/instrumentation , Male , Melanoma/pathology , Middle Aged , Neoplasm Staging/methods , Prospective Studies , Sentinel Lymph Node Biopsy/adverse effects , Seroma/etiology , Skin Neoplasms/pathologyABSTRACT
La lepra (enfermedad de Hansen) es una enfermedad granulomatosa crónica que afecta a la piel y a los nervios, fundamentalmente, producida por Mycobacterium leprae. Se considera un proceso preerradicado en España, con una prevalencia de 0,1 casos por 10.000 habitantes. Se ha visto un discreto incremento debido al fenómeno de inmigración desde países con mayor prevalencia de este proceso. El tratamiento que se emplea es una combinación de fármacos como rifampicina, dapsona y clofazimina (AU)
Leprosy (Hansen's disease) is a chronic granulomatous disease affecting the skin and nerves that is mainly produced by Mycobacterium leprae. It is considered a pre-eradicated condition in Spain, with a prevalence rate of 0.1 cases per 10,000 inhabitants. A slight increase has been observed due to the phenomenon of immigration from countries with higher prevalence of this condition. Current treatments used share a common base made up of several combined drugs, particularly rifampicin, dapsone, and clofazimin (AU)
Subject(s)
Humans , Leprosy/diagnosis , Mycobacterium leprae/isolation & purification , Leprosy/drug therapy , Emigrants and Immigrants , Anti-Bacterial Agents/therapeutic useABSTRACT
La lepra (enfermedad de Hansen) es una enfermedad granulomatosa crónica que afecta a la piel y a los nervios, fundamentalmente, producida por Mycobacterium leprae. Se considera un proceso preerradicado en España, con una prevalencia de 0,1 casos por 10.000 habitantes. Se ha visto un discreto incremento debido al fenómeno de inmigración desde países con mayor prevalencia de este proceso. El tratamiento que se emplea es una combinación de fármacos como rifampicina, dapsona y clofazimina (AU)
Leprosy (Hansen's disease) is a chronic granulomatous disease affecting the skin and nerves that is mainly produced by Mycobacterium leprae. It is considered a pre-eradicated condition in Spain, with a prevalence rate of 0.1 cases per 10,000 inhabitants. A slight increase has been observed due to the phenomenon of immigration from countries with higher prevalence of this condition. Current treatments used share a common base made up of several combined drugs, particularly rifampicin, dapsone, and clofazimin (AU)
