RESUMO
Viper snake bite is, by far, the most common ophidian accident in Spain. It is responsible for between 100 and 150 hospitalizations per year in this country, although it is difficult to determine the frequency of emergency admissions due to this cause. The cornerstone to their approach rests on the correct evaluation of the possible effects derived from envenomation and the use of anti-venoms. In spite of all the controversies surrounding the use of anti-venoms, they have become a powerful therapeutic weapon ever since the serum has been highly purified and the great decrease of related anaphylactic reactions. The aim of this article is to update the emergency room procedures when viper bites are suspected, and to clarify the main therapeutic recommendations.
Assuntos
Antivenenos/uso terapêutico , Serviços Médicos de Emergência/métodos , Mordeduras de Serpentes/terapia , Venenos de Víboras , Viperidae , Animais , Humanos , Índice de Gravidade de Doença , Mordeduras de Serpentes/diagnóstico , EspanhaRESUMO
Mucormycosis is a highly aggressive fungal infection caused by Zygomycetes, from the order of Mucorales. This infection commonly presents an aggressive and rapid course and typically affects immunocompromised patients. Mucormycosis can manifest in different clinical patterns and locations. Although the correct diagnosis is often difficult, an early identification is essential for patient survival. Several clinical forms of mucormycosis are recognised. Cutaneous mucormycosis is less common than other clinical forms, but potentially lethal if treatment is not rapid. Tissue examination by histopathology and culture confirms the fungal infection. Standard treatment includes antifungal therapies associated with surgical debridement. We report five different cases of cutaneous mucormycosis treated in our institution and the management carried out in each case.
Assuntos
Dermatomicoses/diagnóstico , Dermatomicoses/terapia , Hospedeiro Imunocomprometido , Mucormicose/diagnóstico , Mucormicose/terapia , Adulto , Idoso , Antifúngicos/uso terapêutico , Terapia Combinada , Desbridamento/métodos , Dermatomicoses/imunologia , Seguimentos , Humanos , Oxigenoterapia Hiperbárica/métodos , Imuno-Histoquímica , Masculino , Mucormicose/imunologia , Medição de Risco , Estudos de Amostragem , Índice de Gravidade de Doença , Transplante de Pele/métodos , Resultado do Tratamento , Cicatrização/fisiologia , Adulto JovemRESUMO
We present a case of dorsoradial skin loss over the middle phalanx of the middle finger with section of the central slip of the extensor tendon and loss of one lateral band following mechanical injury. Successful primary reconstruction of the central slip was performed by retrograde flap from the central slip of the extensor tendon tied with barb-wire over a padded button, splinted for 2 weeks with a K-wire, and skin cover with a dorsocommissural flap based on the second web space. Other reconstructive options are discussed.