RESUMEN
INTRODUCTION: Skin and soft-tissue defects at the ischaemic lower extremity represent a challenging condition. Major amputations can be prevented by optimised surgical therapy. The aim of any intervention is the revascularisation and defect reconstruction of the extremity. METHODS: This article aims to provide a structured overview on up-to-date therapeutic strategies and differentiated indications for certain surgical flaps in combination with bypass surgery for the treatment of chronic "vascular" wounds. RESULTS: Optimised conservative wound therapy, skin grafts, pedicled or microsurgical free flaps in combination with vascular bypasses can be applied to salvage ischaemic extremities. These operations require an interdisciplinary cooperation between vascular surgeons and plastic surgeons. DISCUSSION: These procedures should accordingly only be performed in specialised high-volume centres with significant vascular surgical and microsurgical expertise.
Asunto(s)
Tejido Conectivo/irrigación sanguínea , Angiopatías Diabéticas/cirugía , Isquemia/cirugía , Traumatismos de la Pierna/cirugía , Pierna/irrigación sanguínea , Microcirugia/métodos , Procedimientos de Cirugía Plástica/métodos , Piel/irrigación sanguínea , Colgajos Quirúrgicos/irrigación sanguínea , Colgajos Quirúrgicos/cirugía , Anciano , Anciano de 80 o más Años , Anastomosis Quirúrgica/métodos , Arterias/cirugía , Terapia Combinada , Comorbilidad , Conducta Cooperativa , Femenino , Humanos , Comunicación Interdisciplinaria , Recuperación del Miembro/métodos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Factores de Riesgo , Piel/lesionesRESUMEN
Analyses using fluorescence in situ hybridization (FISH) were performed on cytogenetic slides of 25 human ovarian carcinomas. Biotinylated alphoid DNA probes were used for the monocolor and bicolor detection of chromosomes #1, #7, #8, #11, #12, #17 and #20 in interphase nuclei of the target cell material. Specific loss of chromosomes #17 and #20 was the most significant finding in aberrant cell populations of the tumors, as was gain of chromosomes #7, #1, #8 and #11. By the use of probe combinations, the presence of combined gains and losses of several chromosomes within the same cell subpopulations could be shown in a series of tumors, while in others the significant numerical chromosome abnormalities found characterized various different cell populations. In summary, FISH could be shown to be a powerful tool of interphase cytogenetics, provided that its limitations are considered conscientiously.