[PRESSURE ULCER TREATMENT EXPERIENCE AT CLINICAL DEPARTMENT OF PLASTIC, RECONSTRUCTIVE AND AESTHETIC SURGERY, DUBRAVA UNIVERSITY HOSPITAL: COMPARISON OF RESULTS RECORDED IN THE 2011-2016 AND 2003-2008 PERIOD].

Results of this clinical study on surgical treatment of pressure ulcers at Department of Plastic, Reconstructive and Aesthetic Surgery, Dubrava University Hospital showed that there was no difference between the 2011-2016 and 2003-2008 periods, indicating continuation of good surgical treatment planning and appropriate postoperative care. Despite the smaller number of hospitalized patients in the 2011-2016 period (31 patients and 42 reconstructive procedures), the number of reconstructive procedure was similar to the recent 2003-2008 period (47 patients and 57 reconstructive procedures). The best results of reconstruction of sacral region pressure ulcer were achieved with fasciocutaneous and musculocutaneous flaps. Whenever possible, depending on the extent of the defect, musculocutaneous flaps should be preferred for reconstruction. It is especially suitable for pressure ulcer recurrence. For ischial region reconstruction, good results can be obtained by mobilizing the semimembranosus and/or semitendinosus in defect gap. For trochanteric region, the tensor fascia lata flap is a good choice. For maximal functional and reconstructive results, a multidisciplinary approach in pressure ulcer treatment has the leading role in the modern concept of wound healing. Surgical treatment should always include radical debridement, ostectomy and well planned defect reconstruction. Conservative treatment should be support to surgical treatment with a focus on patient health care and high hygiene measures. In recent years (2011-2016), the usage of better conservative treatment led to reduction of patient hospital stay and surgical treatment of pressure ulcer. Further 'wound care' nurses training in Croatia can lead the trend towards advanced practice nursing in pressure ulcer prevention and conservative treatment.

[Surgical treatment of irradiation-induced sarcoma after treatment for breast carcinoma, personal experience: 4 case reports] ]. / Kirursko lijecenje sarkoma induciranih iradijacijom poslije lijecenja karcinoma dojke, nase iskustvo: prikaz cetiriju bolesnica.

In the Department of Plastic Surgery of "Dubrava" University Hospital from 1993 to 1999 four patients were treated for radiation induced sarcoma. All of the patients were formerly operated for breast cancer and irradiated postoperatively. The mean time span between radiotherapy and development of sarcoma was 4.75 years. Four patients were treated with wide excision and immediate reconstruction with local flaps. One of the patients had fibrosarcoma, two patients had lymphangiosarcoma, and one patient had osteosarcoma. Two patients died within two years. Radiation induced sarcomas are therapy resistant, and the review of literature did not show large controlled investigations which would offer the most optimal treatment. Most frequently a rapid progression of the disease is seen.

[Silicone breast implants and risk of carcinoma]. / Silikonski implantati za dojku i rizik od karcinoma.

Breast reconstruction, i.e. enlargement of the breast by use of silicone implants, has been performed for almost 40 years. Due to its qualities silicone is being widely used in different branches of surgery. New scientific and technological knowledge have resulted in a variety of types of silicone implants (sheet, filling). There is a great interest, but also controversies concerning the development of breast cancer and connective tissue disease in implant bearing patients. There is no evidence on the influence of silicone implants on the breast cancer development. Regardless of the presence of the implant, standard mammography, additional tangential projections, Eklund's maneuver, ultrasonography in addition to a careful clinical examination are sufficient for an adequate follow-up and detection of even minimal changes within the breast tissue.

[The most frequent intrahospital infections in children with malignant diseases]. / Najcesce intrahospitalne infekcije u dece obolele od malignih oboljenja.

In 100 children, suffering from different malignant diseases, who were hospitalized on our ward, during the period of 5 years, we have performed the examination of bacterial, viral and fungias infections. The majority of our patients belonged to the group, suffering from acute leukaemias and malignant lymphomas, 94%. In our patients was the clear prevalence of bacterial infections in the 41%, of all our cases. Most of children had the mild clinical picture, as the consequence of infection, while less of them had the middle severe or very severe clinical picture. Our position in treatment, was due to the fact that appearance of every febril epizode is conected with the existence of infection. The therapy was combined, and was consisting from: hemio, haemo, support and Rö therapy, recommended from the Highes group in 1975. The succesful treatment of bacterial infections was in 96%, while in 2%, in spite of therapy the end was fatal.