[Case report: squamous cell carcinoma, radial forearm flap and Huriez syndrome. Focus on a rare pathology]. / Cas clinique : carcinome épidermoïde, lambeau antébrachial radial et syndrome d'Huriez. Mise au point sur une pathologie rare.

Huriez disease is a rare autosomal dominant pathology characterized by the triad hypoplastic nail, hyperkeratosis and scleroatrophy of distal extremities. One of its most principal complications is the development of an aggressive squamous cell carcinoma. We present a case of a 62-year old patient who had an acute two hands scleroatrophy associated with recurrent squamous cell carcinoma treated by large excision and covered by trophic and thick radial forearm flap. This flap allowed us to treat the wound and the sclerosis shrinkage with aim to give back the functional benefit to the patient. It also gave the patient an oncological treatment despite aggressive management in one step surgery. Furthermore, one year later we did not observe cutaneous flap histological modification that could have degenerated into cancer. A multidisciplinary approach with dermatologists, geneticists and plastic surgeons is essential in addition with close medical supervision because of high cancer risks.

[Study of the benefits after body contouring surgery at the university hospital in Lille]. / Étude du service rendu de la chirurgie des séquelles d'amaigrissement au CHU de Lille.

BACKGROUND: Cutting the excess of skin body contouring surgery in post-massive weight loss patients seems to only improve functional and aesthetic disorders. But other benefits can be determinated such as psychosocial effects. The first two are usually evaluated. The last two are rarely researched. The goal of this study is to evaluate the benefits of body contouring surgery by comparing patient satisfaction on these different aspects. METHODS: One hundred thirty-four patients with more that 30 kg's weight loss had body contouring surgery at the university hospital in Lille between June 2004 and June 2008. Seventy-eight patients agreed to respond to a study on quality-of-life improvements after body contouring surgery which evaluated aesthetic, functional, and psychosocial aspects. The data were compared before and after the surgery to assess the benefits of the surgery in these areas. RESULTS: All the aforementioned aspects were clearly improved with the body contouring surgery. However, the improvement in the physical aspects seems to be somehow disappointing, not living up to the patients expectations. Exactly 52.5 % of the patients wanted morphologic alteration, while the scars were well tolerated in 78.2 % of the cases. On the other hand, psychosocial discomfort was improved in ways not expected by the patients. Two new findings were remarkable: a decrease of 56.7 % in the sense of feeling depressed and an improvement in finding a job after body contouring surgery. CONCLUSION: The psychosocial improvements represent the true benefits of body contouring surgery.

[Retrospective study of 184 superior pedicle breast reductions without drainage]. / Étude rétrospective de 184 réductions mammaires bilatérales à pédicule supérieur et sans drainage postopératoire.

BACKGROUND: The safety of non-drainage has already been proven on inferior pedicle breast reduction techniques while other authors said that the superior pedicle breast reduction techniques increase the risk of postoperative drainage. We want to prove that non-drainage of superior pedicle breast reduction techniques is as safe as the non-drainage of inferior pedicle breast reduction techniques. METHODS: We made a retrospective study of 184 superior pedicle breast reductions in the last 5 years at the hospital of Lille. The complications were compared with the review of inferior pedicle breast reduction on the previous studies. RESULTS: We observed: 1.35% of hematomas, 0.54% of fat necrosis, 0.27% of infections, 4.1% of wounds dehisences, 0.81% of nipple loss and no seroma. No significant statistical difference between the complication rate of these two breast reductions techniques was found. CONCLUSION: Non-drainage in superior pedicle breast reduction techniques is as safe as the non-drainage in inferior pedicle breast reduction techniques and can be considered as reliable.