[Role of microvascular free flaps in the treatment of amputation stumps]. / Ruolo dei lembi liberi microvascolari nel trattamento dei monconi di amputazione degli arti.

The authors report the importance of plastic surgery in rehabilitation of the amputated stump. After having referred the tight dependence between amputated stump and prosthesis, they underline the importance of a trophic and painless stump characterized by a satisfactory "useful length". They report two cases in which these priorities have been satisfied by using latissimus dorsi free flap. The authors believe that better rehabilitative results can be achieved by applying the most recent techniques utilized in plastic surgery and particularly microvascular free flaps.

A multidisciplinary approach for the treatment of metastatic brachial plexus neuropathy from breast cancer: neurosurgical, plastic, and radiotherapeutic.

A new approach for the treatment of metastatic brachial plexus neuropathy at the axillary level is described. This may be used in patients previously submitted to radical mastectomy followed by radiotherapy for breast cancer. The method consists of external neurolysis of the cords of the plexus, dissection and excision of the pathological axillary contents along with the overlying atrophic cutaneous and subcutaneous tissues, reconstruction of the axilla by the latissimus dorsi musculocutaneous flap, and finally early radiotherapy by high-dose radiation delivered to the entire area. The advantages of the procedure are briefly discussed.

An unusual vascular pedicle in a deltopectoral free flap.

An unusual vascular pedicle of a deltopectoral flap is reported and the case is discussed. We suggest noting any anomalies in the flap's vascularization during its dissection.

A rare case of absence of vagina with the presence of functioning uterus: surgical treatment.

A rare case of absence of vagina in presence of a functioning uterus is reported. The surgical treatment--McIndoe's operation--has permitted to obtain an artificial vagina connected to the uterine cavity.

Skin storage in liquid nitrogen. An ultrastructural investigation.

The problem of cell survival as well as the biochemical and histological effects on skin of low temperature storage in liquid nitrogen has already received attention. However, little is known of the submicroscopic alterations induced by such treatment. Our study shows that rapid or slow freezing, direct or mediate contact with the liquid nitrogen, pretreatment before freezing, type and concentration of cryoprotectants, all have various effects on the fine morphology of epidermal cells. Glycerol is shown as having better cryoprotective activity than DMSO at concentrations of 15% or less. Our data are examined taking into account all available reports on the problem of cryopreservation and the use of cryoprotectants.

Striae albae: a morphological study on the human skin.

Specimens of abdomen skin, comprising alternate areas of striae albae and healthy skin, were removed during surgical lipectomy from multiparous and obese women between the ages of 24 and 53 years. A flattening and thinning of the striae albae surface and the almost complete disappearance of dermal papillae was observed in paraffin and thin sections. The papillary dermis was found to be almost completely replaced by straight bundles of collagen fibres running parallel to the skin surface. Immunofluorescence data revealed in these bundles high positivity for type I collagen. The underlying reticular dermis was also found to contain large densely packed bundles of collagen fibres running parallel to the skin surface. Both papillary and reticular dermis collagen fibres were mainly arranged orthogonally to the main axis of the stria. Furthermore, the density of the collagen fibre bundles and the diameter of the collagen fibrils was found to be greater than that of the clinically healthy skin. A larger number of elastic fibres, which presented an abnormal ultrastructural appearance, were visible in pathological papillary and reticular dermis.