RESUMEN
We present the case of a 5-year-old boy with no personal or family history of bleeding disorders, who suffered from recurrent post-tonsillectomy bleeds. The patient required multiple separate emergency visits to theatre in the 2-week postoperative period to achieve haemostasis. Initial baseline coagulation tests were found to be normal. However more extensive clotting studies revealed that the patient had an undiagnosed 'mild' haemophilia A.
Asunto(s)
Hemofilia A/complicaciones , Hemorragia Posoperatoria/etiología , Tonsilectomía , Preescolar , Hemofilia A/diagnóstico , Humanos , Hallazgos Incidentales , Masculino , Recurrencia , Reoperación , Tonsilitis/cirugíaRESUMEN
INTRODUCTION: Reconstruction of complex head and neck cases involving bony and dural defects poses many issues. The primary aims of reconstruction are to provide a tight dural seal with good cranial support while also achieving a satisfactory cosmetic result. AIMS: This study describes the use of combined radial forearm cutaneous flap and radial forearm fascial flaps for reconstruction of complex skull defects where each component is used for a distinct reconstructive purpose. The benefits of this technique are illustrated in the cases of three patients requiring reconstruction following tumor resection. METHODS: The fascial component was used as a seal for dural defects. The cutaneous flap was then used to reconstruct the concomitant cutaneous defect. CONCLUSION: The combined use of the fascial and cutaneous components of the radial forearm flap, where each is used for a distinct reconstructive purpose, increased the reconstructive versatility of this commonly used flap. The fascial flap was a thin, pliable, and highly vascularized piece of tissue that was effectively used to provide a watertight seal for the dural defect. The simultaneous use of the cutaneous flap gave support to the bony defect while providing a good cosmetic result.
Asunto(s)
Carcinoma Adenoide Quístico/cirugía , Carcinoma Basocelular/cirugía , Carcinoma de Células Escamosas/cirugía , Fasciotomía , Antebrazo/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Procedimientos de Cirugía Plástica/métodos , Trasplante de Piel/métodos , Colgajos Quirúrgicos/irrigación sanguínea , Anciano , Femenino , Humanos , Masculino , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
With an ageing UK population people are living longer and enjoying longer periods of retirement. The number of people over the age of 65 years in the UK is projected rise to 20% by 2051 (Office of National Statistics, 2004). The fastest growing section of the population is those aged over 85 years - this sector is projected to reach 3.2 million in the UK by 2033. These figures also reflect trends seen across European countries. The 2008-based national population projections, EuroPop2008, predicted an increase to 30% of people aged 65 years and over by 2060 (Eurostat, 2008). Similarly the number of people aged 80 years or over is projected to treble.