RESUMO
The results of 144 congenital syndactyly releases over a 12-year period by a single surgeon using a modified Flatt technique (dorsal hourglass flap, interdigitating zigzag flaps, and full-thickness skin grafts) are analyzed considering the association of skin grafts and web creep. The mean follow-up was 5 years. There were seven cases of graft failure, only one of which developed web creep. Web creep occurred in 4.2% of web releases. The results suggest that avoiding longitudinal straight-line scars across the web space may be an important factor in avoiding web creep when performing the modified Flatt technique described.
Assuntos
Dedos/anormalidades , Dedos/cirurgia , Complicações Pós-Operatórias/etiologia , Transplante de Pele , Retalhos Cirúrgicos/cirurgia , Sindactilia/cirurgia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Complicações Pós-Operatórias/cirurgia , Reoperação , Estudos Retrospectivos , Técnicas de SuturaAssuntos
Tendões/anormalidades , Tendões/cirurgia , Polegar/lesões , Polegar/cirurgia , Adulto , Feminino , Humanos , Ruptura , ContençõesRESUMO
We present the case of a patient with a 1.2mm Breslow thickness subungual melanoma of the thumb who refused the standard treatment of amputation. He underwent a 1cm wide local excision of the lesion down to bone and the defect was covered with Integra and later grafted. The evidence for increasingly conservative treatment of subungual melanoma is growing. He remains disease free and is left with a fully functional thumb and a good cosmetic result.
