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1.
Artículo en Francés | MEDLINE | ID: mdl-39003220

RESUMEN

Necrotizing fasciitis is a rapidly progressive soft tissue infection extending from the skin to the fascia, resulting in extensive necrosis. It is a very rare but serious complication, with mortality ranging from 10 to 15%. Optimal management involves early diagnosis followed by treatment combining antibiotic therapy and wide surgical removal as soon as possible. Localisation in the breast is uncommon. Although most cases are primary necrotizing fasciitis of the breast, several cases of necrotizing fasciitis have been reported in the post-operative aftermath of breast surgery. We present a case of necrotizing fasciitis of the breast following submammary mastectomy with immediate reconstruction using a pre-pectoral silicone implant, which resulted in multiple organ failure and the death of the patient despite optimal medical and surgical management. This is the first case to occur after immediate breast reconstruction.

2.
Ann Chir Plast Esthet ; 69(4): 301-306, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38866680

RESUMEN

BACKGROUND: Reconstruction of nasal defects is a challenging task due to the complex nasal geometry and the need for aesthetic considerations. The bilobe flap has emerged as a reliable technique for nasal reconstruction, particularly for defects involving the nasal tip, alae, and inferior dorsum. OBJECTIVE: This study presents a review of 31 patients who underwent bilobe flap reconstruction for nasal defects after tumor resection. MATERIALS AND METHODS: The surgical technique, short- and long-term aesthetic outcomes, patient satisfaction, and complications were evaluated. Aesthetic outcomes were assessed using a qualitative ordinal scale, and long-term patient satisfaction was obtained through follow-up notes and phone interviews. RESULTS: Bilobe flap reconstruction yielded good aesthetic outcomes in the majority of cases, with high patient satisfaction. Complications were minimal, and revision surgeries were performed in a small number of cases to address aesthetic concerns. CONCLUSION: Overall, the bilobe flap technique proved to be an effective and reliable option for nasal reconstruction, providing stable and long-lasting results.


Asunto(s)
Neoplasias Nasales , Satisfacción del Paciente , Rinoplastia , Colgajos Quirúrgicos , Humanos , Estudios Retrospectivos , Rinoplastia/métodos , Femenino , Masculino , Persona de Mediana Edad , Estudios de Seguimiento , Anciano , Neoplasias Nasales/cirugía , Adulto , Estética , Anciano de 80 o más Años , Nariz/cirugía , Nariz/anomalías , Factores de Tiempo
3.
Ann Chir Plast Esthet ; 69(2): 194-199, 2024 Mar.
Artículo en Francés | MEDLINE | ID: mdl-37429803

RESUMEN

3D printing has been used in the medical field since the beginning of the 21st century. Over the years, it has been democratized and has become an accessible tool at almost no cost, provided that a 3D printer is available. The surgeon can thus easily integrate it into his practice and techniques in the operating room, provided that he learns to use 3D image processing software. In order to illustrate the whole process, from the genesis and processing of the 3D image to its application in the operating room, we describe the case of a patient with a left auricle amputation, whose reconstruction was guided by a 3D model printed from his right ear.


Asunto(s)
Pabellón Auricular , Procedimientos de Cirugía Plástica , Cirugía Plástica , Masculino , Humanos , Impresión Tridimensional , Pabellón Auricular/cirugía , Imagenología Tridimensional
4.
Rev Med Interne ; 44(12): 646-655, 2023 Dec.
Artículo en Francés | MEDLINE | ID: mdl-37344292

RESUMEN

Scleritis and episcleritis are rare ocular inflammatory diseases but deserve to be known by internists because of their frequent association with systemic autoimmune diseases. It is important to distinguish them between because their prognosis, therapeutic management and potential complications are very different. Episcleritis represents a superficial ocular inflammation with usually benign visual prognosis, no complication with local treatment, and is associated with a systemic autoimmune disease in rare cases. In contrast, scleritis is a potentially serious ophthalmological condition that can threaten the visual prognosis in the absence of appropriate systemic treatment. It is associated with an underlying disease in 40-50% of cases, in particular a systemic autoimmune disease (25-35% of cases) or an infectious cause (5-10% of cases). Rheumatoid arthritis and systemic vasculitides, particularly antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides, are the main autoimmune causes of scleritis and episcleritis. Scleritis can reveal the underlying autoimmune disease and requires systematic etiological investigations. Aggressive, complicated, refractory forms or those associated with a systemic autoimmune disease require glucocorticoids or even immunosuppressants, and close collaboration between ophthalmologists and internists is required. The development of biologic agents offers new effective therapeutic tools in the management of these difficult cases.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos , Artritis Reumatoide , Enfermedades Autoinmunes , Escleritis , Humanos , Escleritis/diagnóstico , Escleritis/etiología , Escleritis/terapia , Inflamación/complicaciones , Artritis Reumatoide/complicaciones , Pronóstico , Enfermedades Autoinmunes/complicaciones , Enfermedades Autoinmunes/diagnóstico , Enfermedades Autoinmunes/terapia , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones
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