RESUMO
Free-tissue transfer is commonly used in micro-vascular head and neck reconstruction. In a significant proportion of cases, the reconstruction involves the placement of a conspicuous, colour-mismatched skin paddle on the face. This article presents our experience in resurfacing of free flaps on the face in seven patients, using split-thickness skin grafts harvested from the scalp. All patients had a noticeable improvement in colour match. This relatively minor procedure can significantly improve aesthetic outcome and merits consideration in appropriate patients.
Assuntos
Face/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Couro Cabeludo/cirurgia , Transplante de Pele/métodos , Retalhos Cirúrgicos/irrigação sanguínea , Adulto , Idoso , Estética , Feminino , Seguimentos , Sobrevivência de Enxerto , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Estudos de Amostragem , Pigmentação da Pele , Transplante Autólogo , Cicatrização/fisiologiaRESUMO
Cherubism is a rare hereditary condition characterised by progressive cystic proliferation of the mandible and maxilla in childhood, followed by post-pubertal involution of the process and jaw remodelling in adulthood. Its name is derived from the cherubic appearance that results from the jaw hypertrophy. Here, we present the case of a young boy with cherubism, in the context of his pedigree, to illustrate the clinical characteristics and their variable expression. We also seek to distinguish cherubism from central giant cell granuloma and giant cell tumour of the jaws, with which it holds a false synonymity.
Assuntos
Querubismo/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Calcitonina/uso terapêutico , Querubismo/diagnóstico , Querubismo/patologia , Criança , Diagnóstico Diferencial , Tumor de Células Gigantes do Osso/diagnóstico , Tumor de Células Gigantes do Osso/tratamento farmacológico , Granuloma de Células Gigantes/diagnóstico , Granuloma de Células Gigantes/tratamento farmacológico , Humanos , Doenças Maxilomandibulares/diagnóstico , Doenças Maxilomandibulares/tratamento farmacológico , Neoplasias Maxilomandibulares/diagnóstico , Neoplasias Maxilomandibulares/tratamento farmacológico , Masculino , LinhagemRESUMO
Many microsurgical training models exist. These can be broadly classified into living and non-living. The latter type can be further sub-classified into non-vital, prosthetic, and virtual reality models. We review each model within these sub-groups with reference to the ideal properties of a training model. The most important attribute of any model is that the skills acquired from it must translate efficiently into microsurgical skill in the clinical situation. We believe that non-vital and prosthetic models are an important complement to living ones in training and maintaining the skills of all microsurgeons. As virtual reality technology improves, virtual models may succeed the rat as the microsurgical training tool of choice.
Assuntos
Competência Clínica , Microcirurgia , Humanos , Técnicas de Sutura , Interface Usuário-ComputadorRESUMO
A previously fit and healthy 17-year-old male presented with the clinical symptoms and signs of an acute abdomen and with the secondary complaint of a rash. In view of the primary presenting complaint he was admitted to the surgical ward. The patient was initially booked for an emergency exploratory laparotomy, but after reassessment on the ward a clinical diagnosis of meningococcal septicaemia was made. The patient was treated medically with intravenous antibiotics and supportive therapy, and made a complete recovery. Medical causes of abdominal pain, as exemplified here, can be more life threatening than surgical causes and should be considered in all patients.
