ABSTRACT
ABSTRACT: Necrotizing fasciitis (NF) is an infection of the deeper tissues that results in progressive destruction of muscle fascia and overlying subcutaneous fat. It has a fast and destructive course. Moreover, it is related to immunosuppression and could be fatal. The aim of this study is to report a clinical case of a young patient, without immunosuppression, who developed NF evolution due to an erroneous diagnosis of abscess at the beginning of the disease. Patient was submitted to broad-spectrum antibiotic therapy and aggressive surgical treatment. Adequate treatment led to a satisfactory evolution in a short period of time. Early recognition and adequate treatment are essential for a favorable prognosis.
Subject(s)
Fasciitis, Necrotizing , Abscess , Adult , Anti-Bacterial Agents/therapeutic use , Face , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/surgery , Humans , Lip , MaleABSTRACT
OBJECTIVE: To perform an integrative review associating current literature with a clinical series regarding the use of Le Fort I osteotomy for the removal of tumors located in the midface and central region of the skull base. METHODS: A systematic review was performed through the PubMed, SCOPUS, and Cochrane databases. In addition, 4 different patients operated using the above-cited technique are described in this study. RESULTS: Initially, 123 articles were found. After the removal of duplicates, and title and abstract reading, 27 articles were selected for data extraction. The Le Fort I surgical approach of tumors was performed in 183 patients. CONCLUSION: The Le Fort I surgical approach allows lesion exeresis with good visualization, low rates of recurrences and complications, and without aesthetic compromises for the patient.
Subject(s)
Facial Bones/surgery , Osteotomy, Le Fort , Skull Fractures/surgery , Skull Neoplasms/surgery , Humans , Osteotomy, Le Fort/methods , Skull Base , Skull Fractures/etiology , Skull Neoplasms/complicationsABSTRACT
As fraturas que envolvem o assoalho da órbita e o rebordo infraorbitário podem provocar uma comunicação entre a cavidade orbitária e o seio maxilar, imprimindo o conteúdo destas para o interior desse seio, sendo denominadas de fraturas do tipo blow-out impuras. O diagnóstico dessas fraturas baseia-se em exames físicos, de palpação e avaliação dos sinais e sintomas, como equimose periorbitária, hematomas, enoftalmia, diplopia e restrição dos movimentos oculares, e de exames de imagem e tomografia computadorizada. No tratamento dessas fraturas, o acesso cirúrgico torna-se relevante para se obter visualização direta da fratura, favorecendo, assim, a realização da reconstrução dos segmentos fraturas com a implantação de biomateriais adequados. Este trabalho relata a reconstrução de um extenso defeito do assoalho orbitário com tela de titânio, considerando suas propriedades mecânicas e suas principais indicações... (AU)
Fractures involving the orbital floor, along with the infraorbital ridge, leading to a communication with the maxillary sinus and pushing its contents thereof into it, are called impure blow out fractures. The diagnosis of these fractures is based on palpation physical examination and evaluation of signs and symptoms such as periorbital ecchymosis, bruises, enophthalmos, diplopia and restriction of eye movements, x-rays and cat Scan.The treatment consists of surgical acess into the fracture site where the reconstruction can be done with the implantation of the appropriate biomaterial, according to size of the fracture and choice of the surgeon. This study reports the reconstruction of a large defect of the orbital floor with titanium plate system, considering their mechanical properties and main indications... (AU)
Subject(s)
Humans , Male , Adult , Orbit , Orbital Fractures , Biocompatible Materials , Eye Movements , Maxillary Sinus , Maxillofacial Injuries , Tomography, X-Ray ComputedABSTRACT
PURPOSE: To assess the evolution profile of the immunohistochemical expression of stromal constituents over the time-course of wound healing in a murine model. METHODS: Surgical wounds were performed in the back of 24 Wistar rats. After three, seven, 14 and 21 days, six rats were euthanized and the wounded histologically processed to assess the immunohistochemical expression of CD3, CD20, CD31, α-SMA and type-I collagen. Non-injured skin samples (NSS) were used as control. Data were subjected to statistical analysis using ANOVA and Tukey test. RESULTS: The mean of CD3 and CD20 positive cells in the wounds was significantly higher than in NSS at seven and 14 days (p<0.001). The blood vessels content was significantly lower than in NSS (p<0.05) at three days, but increased at seven and 14 days (p<0.01). The mean of α-SMA positive cells at seven, 14 and 21 days was higher than in NSS (p<0.05). The relative content of type I collagen increased from three to 21 days, but remained lower than in NSS (p<0.05). CONCLUSIONS: Lymphoid cells, myofibroblasts and microvessels contents varied over the time-course of wound healing, with peak at seven days and progressive reduction until 21 days. The type I collagen content increased over time.
Subject(s)
Actins/metabolism , Antigens, CD/metabolism , Collagen Type I/metabolism , Disease Models, Animal , Lymphocytes/pathology , Skin/injuries , Wound Healing/physiology , Animals , Antigens, CD20/metabolism , CD3 Complex/metabolism , Immunohistochemistry , Male , Myofibroblasts/pathology , Platelet Endothelial Cell Adhesion Molecule-1/metabolism , Rats, Wistar , Skin/metabolism , Stromal Cells/metabolism , Stromal Cells/pathology , Time FactorsABSTRACT
PURPOSE: To assess the evolution profile of the immunohistochemical expression of stromal constituents over the time-course of wound healing in a murine model. METHODS: Surgical wounds were performed in the back of 24 Wistar rats. After three, seven, 14 and 21 days, six rats were euthanized and the wounded histologically processed to assess the immunohistochemical expression of CD3, CD20, CD31, α-SMA and type-I collagen. Non-injured skin samples (NSS) were used as control. Data were subjected to statistical analysis using ANOVA and Tukey test. RESULTS: The mean of CD3 and CD20 positive cells in the wounds was significantly higher than in NSS at seven and 14 days (p<0.001). The blood vessels content was significantly lower than in NSS (p<0.05) at three days, but increased at seven and 14 days (p<0.01). The mean of α-SMA positive cells at seven, 14 and 21 days was higher than in NSS (p<0.05). The relative content of type I collagen increased from three to 21 days, but remained lower than in NSS (p<0.05). CONCLUSIONS: Lymphoid cells, myofibroblasts and microvessels contents varied over the time-course of wound healing, with peak at seven days and progressive reduction until 21 days. The type I collagen content increased over time. .
