Airbag-induced thumb avulsion: two case reports.

Although airbags are designed to save lives and protect victims from serious injuries, airbag deployment can cause unwanted lesions. In this case report, two cases are presented of young women who sustained an important fracture dislocation of the first carpometacarpal joint (CMC I joint) caused by airbag deployment during a car collision.

Superior epigastric artery perforator flap: anatomy, clinical applications, and review of literature.

INTRODUCTION: To reduce donor site morbidity in anterior chest wall reconstruction, a flap based on perforators of the superior epigastric artery (SEA) was developed and successfully applied in a pedicled fashion for locoregional soft-tissue reconstruction. MATERIALS AND METHODS: We combined our anatomical and clinical experience with superior epigastric artery perforator (SEAP) flap with a PubMed search of the English language literature for articles published on "SEAP flap". Reference lists of the articles found were then checked for other related articles of interest. Articles were compared looking at flap indication, preoperative imaging, perforator morphology, SEA integument area, surgical approach, and outcome of the flaps. RESULTS: The four best perforators were most frequently encountered in an area 2 to 6 cm from the midline and 0 to 10 cm below the xiphoid process. The territory of the SEAPs depends on the location of the perforator. Controversy exists in the current literature concerning preferable SEAP flap orientation. Although tip necrosis is the major complication, this can often be treated conservatively without affecting outcomes or can even be avoided by limiting flap length to the anterior axillary line and the zone below the midpoint between the xiphisternum and the umbilicus. CONCLUSION: The SEAP flap provides a useful approach for reconstruction of defects of the anterior chest, or of the abdominal wall. As a perforator or adipocutaneous flap, the flap is reliable and easy to raise, and spares donor site morbidity.

Salvage reconstructive surgery in an adult patient with failed previous repair of an extrophy-epispadias complex: an operation with a functional and aesthetic purpose

Salvage surgical procedures after failed reconstruction for an extrophy-epispadias complex are extremely challenging. The goals are to restore continence and improve aesthetic appearance in order to provide quality of life and an improved body image to the patient. We describe the surgical steps in an adult patient who presented anal urinary incontinence and a poor body image due to the absence of an umbilicus and the presence of hypertrophic scars. He underwent a modified Mainz II reconstruction of the lower urinary tract at childhood for an extrophy-epispadias complex. Restoration of continence was achieved by the construction of a modified Mainz I pouch with a continent stoma in a neo-umbilicus. Body image improved dramatically by the construction of a neo-umbilicus, a surgical revision of the hypertrophic abdominal scars and an abdominoplasty. It is mandatory that such demanding surgery should only be attempted as a combined multidisciplinary effort with urologists and plastic/reconstructive surgeons.

Salvage reconstructive surgery in an adult patient with failed previous repair of an extrophy-epispadias complex. An operation with a functional and aesthetic purpose.

Salvage surgical procedures after failed reconstruction for an extrophy-epispadias complex are extremely challenging. The goals are to restore continence and improve aesthetic appearance in order to provide quality of life and an improved body image to the patient. We describe the surgical steps in an adult patient who presented anal urinary incontinence and a poor body image due to the absence of an umbilicus and the presence of hypertrophic scars. He underwent a modified Mainz II reconstruction of the lower urinary tract at childhood for an extrophy-epispadias complex. Restoration of continence was achieved by the construction of a modified Mainz I pouch with a continent stoma in a neo-umbilicus. Body image improved dramatically by the construction of a neo-umbilicus, a surgical revision of the hypertrophic abdominal scars and an abdominoplasty. It is mandatory that such demanding surgery should only be attempted as a combined multidisciplinary effort with urologists and plastic/reconstructive surgeons.