Use of Indermil tissue adhesive for closure of superficial skin lacerations in children.

BACKGROUND: The aim of this study was to assess the use of tissue adhesive for paediatric wound closure in a minor injuries environment. METHODS: A n-butyl 2-cyanoacrylate adhesive formulation was used for the closure of traumatic skin lacerations in 56 children. RESULTS: Tissue adhesive succeeded in approximating skin margins in all cases. No episodes of wound dehiscence were experienced. There were no incidences of wound infection. CONCLUSIONS: This study indicates that this form of tissue adhesive can safely and effectively be utilised for traumatic superficial skin closure in children.

[Laboratory model of a microvascular free flap in the rat: the epigastric flap]. / Modello sperimentale di lembo libero microchirurgico nel ratto: il lembo epigastrico.

BACKGROUND: Soft tissue defects are mostly managed surgically by free microvascular flaps. The progressive development of techniques and the availability and reliability of new different and free flaps encouraged this surgical approach. Thus, there is a constant need of free flap models to reproduce in laboratory. The experience with the use of the epigastric free flap in the rat as a laboratory model for microsurgical trainees is presented. In our microsurgical flap model the anastomoses were constantly performed on the femoral vessels. METHODS: The flap was used in 25 rats during the practical sessions of periodical experimental microsurgery courses. The main steps were: flap harvesting on the superficial epigastric vessels; flap anastomosis on the femoral vessels; pedicle section; microvascular anastomosis. RESULTS: The epigastric free flap showed to be an easy surgical model. The mean duration of the exercise was 2 hours and 11 minutes. These surgical times were considered acceptable to the requirement of a laboratory model. CONCLUSIONS: The epigastric free flap in the rat is a reproducible experimental model which is still up to date in microsurgical training.

A rare case of 'histiocytoid haemangioma' of the hand.

Histiocytoid haemangioma has been identified by Rosai in 1979 as a group of vascular tumour-like lesions. This lesion can occur in a wide variety of sites. Surgical excision is the treatment of choice. We present the case of a 35-year-old man with a swelling in the thenar region of his right hand. Preoperative X-rays, magnetic resonance imaging (MRI) and angio-computed tomography (angio-CT) demonstrated a lesion invading the radial digital artery to the index finger without any bone erosion. It was excised 'en bloc' with the artery itself. The radial digital nerve to the index finger and the main digital artery to the thumb were preserved. No local recurrence was observed at the 3-year follow-up. Histiocytoid haemangioma of the hand is a rare disease, and patients should undergo early surgical treatment to achieve complete excision of the lesion without any functional deficit.

Redefinition of the helical rim in cauliflower-ear surgery.

Cauliflower ear is a serious deformity of the auricle induced by single or repeated injury to the external ear. Few papers deal with surgical techniques for correcting this deformity. We describe the use of ipsilateral excess cartilage to restore the helical rim.

Ambulant vacuum-assisted closure of skin-graft dressing in the lower limbs using a portable mini-VAC device.

A skin graft may fail to adhere to the recipient site because of fluid collecting between the graft and the area being treated. We have devised a simple procedure, consisting of a vacuum-sealed dressing, to fix skin grafts on the lower limbs. A fully portable, battery-operated aspirator continuously draws secretions through a vacuum-sealed dressing, preventing accumulation of fluid underneath the graft. Patients are not confined to bed, thus reducing nursing time. The procedure was applied successfully in seven out of nine patients treated for ulcers of the lower limbs.