RESUMO
Reconstruction of the burned thumb is a challenge to the plastic surgeon and the goal of the surgery is to achieve a functionally and aesthetically acceptable hand. We report a case of a patient who presented with extensive scarring of the upper limb and atrophic thumb due to severe burns and multiple surgical procedures. The patient had limited reconstructive options, and had a free toe-to-thumb transfer with successful outcome in a technically challenging situation 37 years after the injury.
Assuntos
Queimaduras/complicações , Traumatismos dos Dedos/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Polegar/cirurgia , Dedos do Pé/transplante , Feminino , Traumatismos dos Dedos/etiologia , Seguimentos , Sobrevivência de Enxerto , Humanos , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Medição de Risco , Fatores de Tempo , Cicatrização/fisiologiaRESUMO
Attaining symmetry is indispensable for a successful aesthetic outcome of plastic surgical procedures. In this paper we propose a simple technique for accurate placement of markings during surgery. This technique is simple, quick and does not require any special instruments. The method is easily reproducible and can be used intraoperatively to position the symmetrical points accurately.
Assuntos
Estética , Procedimentos de Cirurgia Plástica/métodos , Abdome/anatomia & histologia , Abdome/cirurgia , Mama/anatomia & histologia , Feminino , Humanos , Cuidados Intraoperatórios/métodos , Mamoplastia/métodos , SuturasRESUMO
BACKGROUND: Infection of a median sternotomy wound is a rare albeit potentially fatal complication because of the risk of mediastinitis and deep sternal wound infection. Current treatment of deep sternal wound infection comprises antibiotics, debridement and transposition of muscle or omental flaps to fill the anterior mediastinal dead space. METHODS: A retrospective analysis of the deep sternal wound infections treated in our unit over a nine-year period was performed. RESULTS: Out of the 11 903 consecutive coronary artery bypass graft procedures performed, 27 patients were referred to plastic surgery for management of deep sternal wound infection with flaps. Wounds were classified based on their location on the sternum as type A (upper (1/2)), B (lower (1/2)) or C (whole of sternum). Five patients had type A wounds, 12 type B wounds and 10 type C wounds. The mean age was 68 years and the M:F ratio was 20:7. We describe guidelines for the choice of flap for sternal wound reconstruction, according to the anatomical site of the wound dehiscence.