Matriderm for Management of Scalp Necrosis Following Surgical Treatment of Giant Parietal Encephalocele.

BACKGROUND: Management of encephaloceles is challenging when massive brain herniation is present. In such instances, an expansile cranioplasty may be attempted so as to preserve some herniated brain tissue. Complications such as wound dehiscence, cerebrospinal fluid leak, and scalp necrosis are postoperative concerns. The treatment of scalp necrosis with dural and brain exposure is certainly a challenge due to the complexity of flap techniques in such a young age. Herein we describe the use of a novel technique for the management of a scalp necrosis and dehiscence in an infant. CASE DESCRIPTION: A patient with a giant parietal encephalocele and massive brain herniation underwent an expansile cranioplasty. A large scalp necrosis ensued as a complication and later progressed to a suture dehiscence despite a new surgical intervention, with resultant brain exposure. A scalp reconstruction was subsequently performed using an artificial dermal substitute, laid directly onto the brain, followed by a split-thickness skin graft. We observed a rapid engraftment, without any further complications, with an acceptable cosmetic result in the long-term follow-up. CONCLUSION: A simple technique, such as the use of an artificial dermal matrix with simultaneous split-thickness skin graft, may be an effective treatment for the repair of scalp defects, even when coverage of exposed brain tissue is necessary, when no other techniques are found to be suitable.

A promising alternative for mature skin: the effects of phytoestrogens on human skin and its topical use / Alternativa promissora para peles maduras: os efeitos dos fitoestrógenos na pele humana e seu uso tópico

Skin quality deteriorates with age for various reasons, including hormone deficiencies. In women, the decline in estrogen levels during menopause plays an important role in skin degeneration, with consequent atrophy, collagen reduction, loss of elasticity, and impaired wound healing. Research has demonstrated the beneficial effects of topical phytoestrogen in preventing and repairing skin aging, with localized action and without side effects. The objective of this study was to review the relevant literature, demonstrating that this can be a safe and effective alternative for treating the skin of perimenopausal women.

A qualidade da pele deteriora-se com a idade por vários motivos, incluindo as deficiências hormonais. Nas mulheres, o declínio dos níveis de estrógeno, durante a menopausa, tem papel importante na degeneração cutânea, com consequente atrofia, redução do colágeno, perda de elasticidade e deficiência da cicatrização de feridas. Pesquisas têm demonstrado efeitos benéficos do fitoestrogênio tópico na prevenção e reparação do envelhecimento cutâneo, com ação localizada e sem efeitos colaterais. O objetivo deste estudo foi revisar a literatura pertinente ao assunto, demonstrando que esta pode ser uma alternativa segura e eficaz para o tratamento da pele de mulheres na perimenopausa.

Os efeitos dos estrogênios e fitoestrogênios na pele humana e seu uso tópico para prevenção do envelhecimento cutâneo: revisão da literatura / The effects of estrogens and phytoestrogens on human skin and its topical use for prevention of skin aging - Literature Review

A qualidade e a função da pele reduzem-se drasticamente com a idade devido ao envelhecimento cronológico, ao fotoenvelhecimento, aos fatores ambientais e às deficiências hormonais. O declínio dos níveis de estrógeno na menopausa tem papel importante na atrofia cutânea, redução do colágeno, perda de elasticidade e deficiência da cicatrização de feridas. Pesquisas têm demonstrado os efeitos benéficos do estrogênio tópico, que teria ação mais localizada na pele sem efeitos colaterais sistêmicos. O objetivo deste estudo foi revisar a literatura pertinente ao assunto, demonstrando que o uso do estrogênio tópico pode ser uma alternativa segura e eficaz para o tratamento da pele de mulheres na perimenopausa.

Skin quality and function drastically reduces with age due to chronological aging, photoaging, environmental factors and hormonal deficiencies. Decreased menopausal estrogen levels play a role in cutaneous atrophy, collagen and water content, loss of elasticity, skin wrinkling and deficiency of wound healing. Much research has been done to elucidate the beneficial effects of topical estrogen, which would have a more localized action on the skin without systemic side effects. The objective of this study was to review the relevant literature, demonstrating that this may be a safe and effective alternative for the treatment of women's skin in perimenopause

[Human bone fragment acting as a secondary projectile set off by an explosion]. / Fragmento de osso humano atuando como projétil secundário decorrente de explosão.

We report a case of a secondary projectile emanated from a fractured human bone from a victim of a bomb explosion. We also refer to the potential of transmition of blood-borne or body fluid pathogens by this mechanism of injury.

Fragmento de osso humano atuando como projétil secundário decorrente de explosão / Human bone fragment acting as a secondary projectile set off by an explosion

We report a case of a secondary projectile emanated from a fractured human bone from a victim of a bomb explosion. We also refer to the potential of transmition of blood-borne or body fluid pathogens by this mechanism of injury.