RESUMO
The pharyngo-cutan defect is a frequent complication of oropharynx and larynx operations. The not frequent serious actinomycotic inflammation of the neck, and in its treatment the repeated surgical incision was in the background of the defect. The authors review the possibilities of closing these defects, and they describe the method used.
Assuntos
Actinomicose/complicações , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Fístula Cutânea/cirurgia , Diabetes Mellitus Tipo 1/complicações , Procedimentos Cirúrgicos Bucais/efeitos adversos , Doenças Faríngeas/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Lesões por Radiação/complicações , Fístula do Sistema Respiratório/cirurgia , Actinomicose/etiologia , Adulto , Fístula Cutânea/microbiologia , Diabetes Mellitus Tipo 1/induzido quimicamente , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/radioterapia , Humanos , Microcirurgia , Doenças Faríngeas/microbiologia , Faringe/cirurgia , Lesões por Radiação/etiologia , Fístula do Sistema Respiratório/microbiologia , Retalhos Cirúrgicos , Infecção da Ferida Cirúrgica/etiologia , Resultado do Tratamento , CicatrizaçãoRESUMO
The salivary excretion of cefoxitin (Mefoxin), a second-generation beta-lactam antibiotic of the cefalosporin group, which shows enhanced anti-anaerobic effect was investigated in oral surgery patients. In animal experiments the saliva levels of imipenem (Tienam) and meropenem (Meronem), which also belong to the betalactam carbapenem group were studied. The antibiotics were administered parenterally in single therapeutic doses, then blood samples were taken first after half an hour then hourly, and mixed saliva was collected for 6 hours. Cefoxitin was found to reach top level in the 1st hour, then this level decreased rapidly, and in the 4th hour it was no longer measurable. Out of the carbapenems imipenem showed highest level in the 2nd hour and in the 4th hour its concentration in the saliva was minimal. Meropenem reached a higher level in the saliva (1,5-2 times higher than the serum level) in the 2nd hour after administration, which persisted even in the 6th hour. The experimental results justify the administration of these antibiotics in dentistry and oral surgery.
Assuntos
Cefoxitina/metabolismo , Imipenem/metabolismo , Saliva/química , Tienamicinas/metabolismo , Adulto , Antibacterianos/metabolismo , Cefamicinas/metabolismo , Feminino , Humanos , Masculino , Meropeném , Pessoa de Meia-IdadeRESUMO
The perforating facial defects are often results of the removal of malignant tumours and less commonly are caused by accidents and shotgun injuries. The advent of musculocutan flaps and the microvascular tissue transplantation has made essential changes in the treatment of full thickness cheek defects during the last decade. The authors describe three cases, where the reconstruction has been made with free radial forearm flaps.