RESUMO
ABSTRACT: Langerhans cell histiocytosis (LCH) is a rare disease in which LCH cells derived from myeloid dendritic cells proliferate and invade single or multiple systems. We have encountered a case of short-term resorption of the grafted bone after split calvarial bone grafting for an occipital skull defect in a 6-year-old girl with multisystem LCH in remission who was referred to our department for reconstructive surgery. We performed cranioplasty using a split calvarial bone graft. Two months after surgery, computed tomography scans revealed that most of the grafted bone had been resorbed. To our knowledge, there have been no such reports previously. There are 2 possible explanations for the resorption of an autologous bone graft in this patient. The first possibility is that the recipient site contained an active lesion and the second is that the bone resorption occurred because the bone graft was placed on the periosteum.
Assuntos
Reabsorção Óssea , Histiocitose de Células de Langerhans , Procedimentos de Cirurgia Plástica , Transplante Ósseo/métodos , Criança , Feminino , Histiocitose de Células de Langerhans/diagnóstico por imagem , Histiocitose de Células de Langerhans/cirurgia , Humanos , Procedimentos de Cirurgia Plástica/métodos , Crânio/diagnóstico por imagem , Crânio/cirurgia , Tomografia Computadorizada por Raios X/métodosRESUMO
OBJECTIVE: According to previous reports, remote ischaemic preconditioning (RIPC) is a "delay" procedure that is highly likely to be useful for preventing skin flap necrosis. Differences in the extent of necrosis in rat dorsal skin flaps when different clamping times were used in RIPC were compared among the four groups described below. METHODS: Group A was a control group in which no prior ischaemic area was created, and both back legs were devascularised for 15 min in Group B, 30 min in Group C, and 60 min in Group D. The experiments were performed on 10 rats in each group, and the surviving area was measured. One-way analysis of variance (ANOVA) and Tukey's multiple comparison test were used for analysis, with p < 0.05 regarded as significant. RESULTS: The surviving area of the skin flap was 15.4 ± 1.8 cm(2) in Group A, 15.4 ± 2.0 cm(2) in Group B, 17.9 ± 2.0 cm(2) in Group C, and 19.2 ± 3.4 cm(2) in Group D, with significant differences between Groups A and D and between Groups B and D. CONCLUSIONS: RIPC consisting of 60 min of ischaemic preconditioning may be clinically useful as a method of preventing skin flap necrosis.