ABSTRACT
BACKGROUND: Curettage mastectomy is indicated as a palliative treatment in locally advanced breast cancer. We present our experience with the use of a DIEP flap reconstruction following extensive mastectomy. METHODS: We report the case of a patient with very advanced local breast cancer that was subsidiary to aggressive palliative surgery after chemotherapy. RESULTS: It was considered that the closure that could be performed with the latissimus dorsi muscle was unsuitable, therefore a DIEP flap was performed. The patient was discharged uneventfully. CONCLUSION: The DIEP reconstruction offers great cutaneous extension. It can be a resource in highly selected cases of locally advanced breast cancer in which surgery becomes the main treatment.
Subject(s)
Breast Neoplasms/surgery , Mammaplasty/methods , Perforator Flap , Breast Neoplasms/pathology , Curettage , Epigastric Arteries , Female , Humans , Middle Aged , Neoplasm Staging , Palliative CareABSTRACT
Fundamento. La mastectomía de limpieza está indicada con carácter paliativo en el cáncer de mama localmente avanzado. Para cerrar el defecto cutáneo puede ser necesario el empleo de un injerto. Mostramos nuestra experiencia con el uso de un colgajo DIEP (Deep Inferior Epigastric artery Perforators) de cobertura tras la realización de una mastectomía de gran extensión. Material y métodos. Se muestra el caso de una paciente con un tumor de mama muy avanzado localmente, que era subsidiaria de un tratamiento quirúrgico agresivo tras la administración de quimioterapia. Resultados. Se consideró que el cierre que puede ofrecer un colgajo realizado con el músculo dorsal ancho esta insuficiente, por lo que se realizó un DIEP. La paciente presentó una evolución postoperatoria satisfactoria. Conclusiones. El colgajo DIEP de cobertura ofrece una gran extensión cutánea. Puede ser un recurso en casos muy seleccionados de tumores de mama localmente avanzados, en los que la cirugía se convierte en la principal arma terapéutica (AU)
Background. Curettage mastectomy is indicated as a palliative treatment in locally advanced breast cancer. We present our experience with the use of a DIEP flap reconstruction following extensive mastectomy. Methods. We report the case of a patient with very advanced local breast cancer that was subsidiary to aggressive palliative surgery after chemotherapy. Results. It was considered that the closure that could be performed with the latissimus dorsi muscle was unsuitable, therefore a DIEP flap was performed. The patient was discharged uneventfully. Conclusion. The DIEP reconstruction offers great cutaneous extension. It can be a resource in highly selected cases of locally advanced breast cancer in which surgery becomes the main treatment (AU)
Subject(s)
Humans , Mastectomy/methods , Breast Neoplasms/surgery , Mammaplasty/methods , Epigastric Arteries/transplantation , Surgical FlapsABSTRACT
The aim of this study is to present a new 3D capture system of facial movements called FACIAL CLIMA. It is an automatic optical motion system that involves placing special reflecting dots on the subject's face and video recording with three infrared-light cameras the subject performing several face movements such as smile, mouth puckering, eye closure and forehead elevation. Images from the cameras are automatically processed with a software program that generates customised information such as 3D data on velocities and areas. The study has been performed in 20 healthy volunteers. The accuracy of the measurement process and the intrarater and interrater reliabilities have been evaluated. Comparison of a known distance and angle with those obtained by FACIAL CLIMA shows that this system is accurate to within 0.13 mm and 0.41 degrees . In conclusion, the accuracy of the FACIAL CLIMA system for evaluation of facial movements is demonstrated and also the high intrarater and interrater reliability. It has advantages with respect to other systems that have been developed for evaluation of facial movements, such as short calibration time, short measuring time, easiness to use and it provides not only distances but also velocities and areas. Thus the FACIAL CLIMA system could be considered as an adequate tool to assess the outcome of facial paralysis reanimation surgery. Thus, patients with facial paralysis could be compared between surgical centres such that effectiveness of facial reanimation operations could be evaluated.
Subject(s)
Face/physiology , Facial Expression , Image Processing, Computer-Assisted/methods , Movement , Adult , Facial Paralysis/physiopathology , Female , Humans , Imaging, Three-Dimensional/methods , Middle Aged , Observer Variation , Video RecordingABSTRACT
The therapeutic approach to haemangiomas has changed slightly in recent years, moving from a generally conservative attitude to a more aggressive one in some cases. Chronic unaesthetic alterations that might be caused by haemangiomas, psychosocial traumas that can be caused during childhood, together with a better understanding of the behaviour of this type of lesions and advances in safer and more efficient surgical techniques are the basic factors behind this change of attitude. The present paper concentrates on the surgical treatment of haemangiomas, explaining their indications according to the stage of evolution at which they are found, and the surgical techniques employed to resect the lesion with the least morbidity. Similarly, a detailed treatment is given to those lesions that, because of their specific facial anatomical localization, require a special surgical treatment.
Subject(s)
Facial Neoplasms/surgery , Hemangioma/surgery , Algorithms , Child , Child, Preschool , Humans , Infant , Postoperative Complications/etiologyABSTRACT
El planteamiento terapéutico ante los hemangiomas ha cambiado ligeramente estos últimos años, pasando de mantener una actitud general conservadora a ser más agresivos en algunos casos. Las alteraciones inestéticas crónicas que pueden originar los hemangiomas, el trauma psicosocial que pueden desencadenar en la niñez, junto con un mejor conocimiento del comportamiento de este tipo de lesiones y el avance en técnicas quirúrgicas más seguras y eficaces, han sido los factores fundamentales de este cambio de actitud. El presente trabajo se centra en el tratamiento quirúrgico de los hemangiomas, explicando las indicaciones que tienen según la etapa de evolución en que se encuentren y las técnicas quirúrgicas empleadas para resecar la lesión con la mínima morbilidad. Así mismo, se tratan de forma detallada aquellas lesiones que, por presentar una localización anatómica facial concreta, requieren un tratamiento quirúrgico especial (AU)
Subject(s)
Child, Preschool , Infant , Child , Humans , Hemangioma/surgery , Clinical ProtocolsABSTRACT
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