[Tissue expanders in plastic surgery of the head and neck. Indications and use]. / Gewebeexpander in der plastischen Kopf- und Halschirurg. Indikation und Anwendung.

Tissue expansion allows a functional as well as an aesthetic reconstruction of local defects and thus corresponds to the actual state of the art in plastic surgery.-Tissue expansion provides tissue of the same quality for the repair of defects without leaving deformities on the donor site. It creates local flaps with skin of the same texture, colour and preserved sensitivity.-The use of tissue expanders has grown enormously during the last few years.-A higher rate of complications on the cheek and on the neck must be taken into account.

Iron, zinc, folate and vitamin B12 nutritional status and milk composition of low-income Brazilian mothers.

The purpose of this study was to assess the nutritional status of low-income Brazilian mothers, who were supplemented with iron and vitamin B12 during pregnancy, in terms of iron, zinc, folate and vitamin B12, in different stages of lactation and to determine the influence of the maternal nutritional status on milk composition. The effect of folate supplementation during pregnancy on folate status of the nursing mothers and milk composition was investigated. The effect of partial weaning on maternal status and milk composition was also studied. In general, the nutritional status of iron, zinc, folate and vitamin B12 of the mothers appears adequate. However, some of the mothers had indices of status lower than normal limits for non-pregnant women. These values, particularly after 30 d post-partum, indicate that these mothers might be at nutritional risk and that the nutrient supplementation received during pregnancy was insufficient to meet demands. There was an increase with the stage of lactation for haematocrit, serum vitamin B12, serum zinc, serum albumin, milk folate and saturation of its binding protein, but there was a decrease for milk protein, total and whey-bound iron and zinc, and lactoferrin. Mothers who took folate supplements during pregnancy had higher serum folate levels immediately after birth than those not taking the supplements but no differences were found at later stages of lactation. Milk composition was not affected. Partial weaning did not affect the maternal nutritional status or the milk composition except for iron which was higher in milk from mothers who were partially breastfeeding.(ABSTRACT TRUNCATED AT 250 WORDS)