Immediate and delayed two-stage post-mastectomy breast reconstruction with implants. Our experience of general surgeons.

BACKGROUND: Breast reconstruction after a mastectomy, today is considered the best choice to improve the quality of life for the patient. The aim of the procedure is to consider the aesthetic results obtained and the various involvements, comparing them with those already reported in literature. METHODS. There is no certain data of the number of breast reconstructions performed in Italy in the few years. In 1999, in Veneto, reconstruction surgery after total breast removal, represented only 16% of the operations. In our surgery Division, from 1996 to 2000, there were breast reconstructions performed, either immediately or delayed on 87 patients out of 118 after mastectomy. 73.7% none over the age of 60 (range 27-60). The breast removal technique used is the Madden, while, for the reconstruction we have put into effect the submuscle prosthetic implant; 63 patients were subject to follow-up treatment during the period of 10 to 36 months. RESULTS: Seventy-eight percent of the women have judged the final aesthetic results the same or better than expected. Based on reconstruction with prosthesis, is the preferred procedure, even with serious complications which do not always influence the final results. This preference is because of the reduced operation time and the psychological and physical benefits due to immediate restoral of the mammary volume and shape. CONCLUSIONS: Some problems (Garavaglia Law) have slowed down the diffusion in Italy of this type of treatment which is now receiving more and more request and approval by the women affected with breast cancer.

[Gas gangrene. Clinical considerations, prognosis and therapeutic prospects in our experience]. / La gangrène gazeuse. Considérations cliniques, pronostic et perspective thérapeutiques selon notre expérience.

The prognosis of gas gangrene is changing as the means of treatment become more accurate and are implemented earlier. The authors, in their work referring to 10 cases of gas gangrene, point out to the extreme fastness of debridement and immediate exeresis, of wide-spectrum antibiotic protection and of caloric balance, associated to a treatment using trace elements. The importance of hyperbaric oxygen therapy seems to be increasingly proven with time. Lastly, in their general experience of treatment, the authors suggest the use of a specific frequency soft laser therapy, which might speed up the process of tissue repair.