O uso da fotografia digital na evolução de ferida cirúrgica neoplásica: relato de caso / The use of digital photography in the follow-up of surgical neoplastic wound: a case report

Introdução: As feridas oncológicas apresentam características peculiares, muitas vezes difíceis de expressar no texto escrito. A fotografia digital pode contribuir na descrição e na assistência destas feridas. Relato do Caso: Relatar o caso de paciente do sexo feminino, jovem, com lesão recidivada medindo 20x 18x13,7cm na coxa esquerda e diagnóstico de sarcoma sinovial. Utilizou-se a fotografia digital como facilitador na avaliação e tratamento de ferida oncológica complexa. A paciente foi submetida à exérese do tumor, curativos e enxertia de pele; o acompanhamento foi realizado com registros fotográficos com câmera do telefone celular, inserido no prontuário eletrônico e proporcionou a fotointerpretação pela equipe de saúde. Conclusão: O uso da fotografia foi importante, pois permitiu a avaliação rápida da ferida, pôde ser transmitida à equipe para avaliação do plano de tratamento e foram importantes ferramentas legais e para o ensino.

Introduction: The characteristics of cancer wounds are unusual and are often difficult to describe in writing. Therefore, digital photography may be used to describe and manage these wounds. Case Report: A young female patient with a recurring lesion measuring 20 × 18 × 13.7 cm in the left thigh was diagnosed with synovial sarcoma. Digital photography was used to facilitate evaluation and treatment of her complex cancer wound. The patient underwent tumor excision, dressings, and skin grafting; the follow-up was carried out with photographic records using a cell phone camera, which were inputted into the electronic medical record and interpreted by the medical team. Conclusion: The use of photographs was important because it allowed rapid wound evaluation, could be shared with the team to evaluate the treatment plan, and was an important tool for legal purposes and teaching.

Kyphectomy in meningomyelocele children: surgical technique, risk analysis, and improvement of kyphosis.

PURPOSE: Kyphosis is a major complication of spina bifida, causing skin ulcers and osteomyelitis. This study examined the clinical and surgical characteristics of eight patients who underwent surgery, as well as improvement of their postoperative kyphosis angulations. METHOD: The authors reviewed eight cases submitted to surgery between 2006 and 2010. Surgical intervention was indicated for osteomyelitis and recurrent ulcers at the curvature apex. Osteotomies and spine stabilization were performed. The patients' clinical characteristics were analyzed, as were the surgical techniques employed, variables of surgical complications, and angle range of the kyphosis deformity postcorrection. RESULTS: There were no deaths. The average age at the time of surgery was 11 years old. The level of neurological injury was T10 in four patients and T12 in four. Average amount of bleeding during surgery was 1,442 ml, (range, 340 to 3,200 ml). Improvement of kyphosis angle was evident in all patients. The average difference between preoperative and postoperative kyphosis angle was 63.2. CONCLUSIONS: Surgery performed by a multidisciplinary team minimizes risks. Despite the high number of complications published in the literature, the results found in this study were excellent with regards to improving kyphosis angle, as well as facilitating rehabilitation and daily care of children.

Biópsia do nervo sural: técnica, indicações e resultados / Sural nerve biopsy: technique, indications and results

A biópsia de nervo pode ser útil no diagnóstico de neuropatias periféricas quando não forpossível determinar a causa por métodos convencionais como eletromiografia ou testes desensibilidade. Nós revisamos as indicações desse procedimento, descrevemos a técnica ediscutimos os resultados.

A sural nerve biopsy may be useful to enable the clinician to diagnose of peripheral neuropathy,when no clear underlying cause has been determined with conventional assessmentsuch as electrophysiology or quantitative sensory testing. We review the indications of thisprocedure, describe the technique, and discuss the results.