THE NASOLABIAL FLAP: THE MOST VERSATILE METHOD IN FACIAL RECONSTRUCTION.

The nasolabial flap was described 170 years ago and still remains one of the most frequently used methods in facial reconstruction. This technically easy and maximally effective procedure has become a real workhorse and an integral instrument for every plastic surgeon. Over time multiple modifications of this technique have been described. In this article, authors present an overview of nasolabial flap modalities and discuss advantages and disadvantages of these techniques.

CURRENT TREATMENT OPTIONS OF DUPUYTREN´S DISEASE.

Dupuytren's disease (fibromatosis of the palmar fascia, benign neoplastic fibromatosis, Dupuytren's contracture) is a disease characterized by growth and successive contracture of single parts of the palmar aponeurosis. This condition is known and has been treated for several centuries. In the advanced stages of the disease, it leads to significant limitation of hand function, resulting in reduced quality of life of the patient. Dupuytren's disease (DD) is a life-long disease with a variable course and a heterogeneous clinical presentation. Therapy focuses on the clinical manifestations of the disease as well as on reduction of the functional limitation of the hand caused by the disease. In addition to conservative and surgical procedures, there are also some mini-invasive methods available. Treatment should be reserved for centres and experienced surgeons specialized in hand surgery.

SURGICAL TREATMENT OF MELANOMA.

Malignant melanoma is a serious disease, the incidence of which rises. Since the most important treatment method is sufficient wide skin and subcutaneous tissue excision, plastic surgeon is often the only specialist who is able to close the resulting defect. This paper deals with recommendations and treatment options for malignant melanoma from the point of a plastic surgeon. The primary width of excised safety rim of healthy tissue with regards to the depth of melanoma invasion differs. Safety margin is 0.5 cm for melanoma in situ, 1 cm in Breslow up to 2 mm and 2 cm in Breslow over 2 mm. Furthermore, there is indication for sentinel lymph node biopsy, which should be performed in melanoma with Breslow over 1 mm, and in risky melanoma in Breslow above 0.75 mm. Every patient with stage IIB malignant melanoma and above according to TNM classification should undergo adjuvant therapy in a specialized centre. Ideal condition for the patient is a permanent and close cooperation between a dermatologist, oncologist and plastic surgeon, who supplement each other in diagnostics, therapy and follow up of the patients.

Superficial brachioradial artery (radial artery originating from the axillary artery): a case-report and its embryological background.

A case of anomalous terminal branching of the axillary artery, concerning the variant called superficial brachioradial artery (arteria brachioradialis superficialis) was described, with special regard to its embryological origin. The left upper limb of a male cadaver was dissected in successive steps from the axillary fossa distally to the palmar region. A variant artery, stemming from the end of the third segment of the axillary artery, followed a superficial course distally. It skipped the cubital fossa, ran on the lateral side of the forearm, crossed ventrally to the palm, and terminated in the deep palmar arch. This vessel is a case of so-called "brachioradial artery" (inexactly called a "radial artery with a high origin"). The origin of the brachioradial artery directly from the axillary artery belongs to the rare variants of the arterial pattern of the upper limb. Its incidence is approximately 3%. Moreover, this vascular variant was associated with another one concerning the brachial plexus. The medial cutaneous nerve of the forearm joined the median nerve in the middle third of the arm and ran further distally as a common trunk, as the normal median nerve does. Anatomical knowledge of the axillary region is crucial for radiodiagnostic and surgical procedures, especially in cases of trauma. The superficially located artery brings an elevated risk of bleeding complications in unexpected situations.