[Microsurgical replantation of traumatic amputated lip].

This is a case report of two patients with traumatic amputated lip due to respectively human bite and bicycle head-on-car collision. Both patients were successfully treated by microsurgical replantation within 24 hours and with post-operative leech treatment. Furthermore, a MEDLINE/PubMed search was performed for all scientific English articles of lip amputation and replantation using microsurgery. We want to address the importance of preserving amputated parts and the necessity of 24-hour access to plastic surgery and microsurgery in trauma if needed.

Reconstruction of massive full-thickness abdominal wall defect: successful treatment with nonabsorbable mesh, negative pressure wound therapy, and split-skin grafting.

We demonstrate that it is possible to use a nonabsorbable mesh for abdominal wall reconstruction after total wound rupture and successfully split-skin graft directly on the mesh. Sufficient granulation tissue formation prior to skin grafting was obtained with long-term use of negative pressure wound therapy (NPWT).

[Pyogenic granuloma].

Pyogenic granuloma is a common benign, rapidly growing vascular papule or polyp. The tumour is very vulnerable and bleeds easily after minor trauma. It can occur in the skin or mucosa and is typically localized within the gingiva, the lips, the mucosa of the nose and the face. It can occur at any age but is often seen on children and young adults. The diagnosis pyogenic granuloma is often straightforward, but several differential diagnoses should be considered, including malignant tumour.

[Burn wounds caused by a hair-dryer].

Burn wounds (ambustio) in children are frequent and occur in about 5% of all children and in about half of these before the age of three. The majority of the burn wounds in children occur at home, most frequently in the kitchen or the bathroom. This case describes an accidental ambustio caused by a hair dryer in a 3-month-old baby. Hair-dryers have become widely used in drying soar baby buttoms. Therefore, professionals as well as parents should be better informed about the potential risks of using hair-dryers for this purpose.

Tumour response after hyperthermic isolated limb perfusion for locally advanced melanoma.

INTRODUCTION: The aim was to describe tumour response, complications, recurrence and survival after hyperthermic isolated limb perfusion (ILP) with melphalan or melphalan in combination with tumour necrosis factor-alpha in patients with melanoma metastases confined to an extremity. MATERIAL AND METHODS: A total of 84 perfusions were performed (53 women, 31 men, median age 63 years) from 1993 to 2010. 95% of the perfusions were administered to the lower limbs and 5% to the upper limbs. The inclusion criteria were recurrent and/or clinically apparent cutaneous/subcutaneous extremity in-transit melanoma metastases. RESULTS: The response rate after ILP was 85%; 42% had complete response (CR), 43% partial response (PR), 12% no change (NC) and 3% progression. Two- and five-year survival rates were 57% and 31%, respectively, and they were higher for patients with than without lymph node metastases. Time from ILP to recurrence was a median of seven months (range 1-37 months) for patients with CR or PR. Survival was longer for patients with CR or PR than for patients showing NC or progression. Several patients had mild or moderate local toxicity reactions, two patients developed severe local toxicity. CONCLUSION: ILP induces tumour regression in the vast majority of patients. One patient, i.e. 1% of the group, died from surgical complications. Otherwise, ILP treatment had an acceptable morbidity in this group of very sick patients. We are convinced that the treatment should be offered to improve local disease control in patients with multiple and/or recurrent melanoma confined to an extremity if surgical excision is not possible. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.