RESUMO
The reversed radial forearm free flap is described and patient histories are presented to illustrate its unique reconstructive versatility. The valvular orientation of the deep and superficial forearm veins should theoretically oppose the reversed flow in this flap, but the venous flow is not compromised. In comparison to the anterograde forearm free flap the vascular pedicle is longer and the donor defect generates less functional and cosmetic complications because it is located on the proximal forearm. In a review of the literature anatomical details of the venous drainage are presented. Different opinions on reverse flow in forearm flaps are discussed and a new theory is proposed.
Assuntos
Microcirurgia , Retalhos Cirúrgicos , Adolescente , Adulto , Feminino , Antebraço/irrigação sanguínea , Humanos , Masculino , Microcirurgia/métodos , Retalhos Cirúrgicos/métodos , Veias/anatomia & histologiaRESUMO
Hypertrophic scars and keloids still present problems in both white and pigmented skin. A treatment protocol is proposed: Hypertrophic scars are primarily treated with intralesional injections of corticosteroids or with compression therapy. Surgical scar revision is only secondarily indicated. Recurrent and resistant hypertrophic scars are surgically excised and postoperatively irradiated (twice with 400-cGy 7-MeV electron irradiation).
Assuntos
Cicatriz/terapia , Queloide/terapia , Corticosteroides/uso terapêutico , Cicatriz/patologia , Terapia Combinada , Humanos , Hipertrofia/terapia , Pressão , Dosagem RadioterapêuticaRESUMO
Hereditary congenital facial paralysis is rare. This paper presents a pedigree of four generations of a family of about 100 members, nine of whom suffer from congenital facial paresis, three with impaired hearing, and three with both facial paresis and impaired hearing. Heredity is dominant with reduced penetrance.
Assuntos
Paralisia Facial/congênito , Adulto , Paralisia Facial/genética , Feminino , Transtornos da Audição/congênito , Humanos , Masculino , LinhagemRESUMO
A study of 275 cases of cutaneous malignant melanoma treated in one centre at Nottingham has shown no significant changes in survival rates since Bodenham published his figures 13 years ago. Early excision of a suspicious tumour followed by immediate frozen section is still the best approach and was found to be reliable way of confirming the diagnosis of malignancy in a pigmented lesion. A large percentage of patients with malignant melanoma develop their first metastases 5 years after the initial treatment. Therefore, the routine follow-up of patients with cutaneous malignant melanoma should be continued for at least 10 years.
