Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 11 de 11
Filtrar
1.
Ann Plast Surg ; 78(1): 46-48, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27505448

RESUMO

Myxofibrosarcoma is a rare cause of swelling in the upper extremities. The rarer form arising in the deep tissues can present a diagnostic difficulty. The treatment of high-grade myxofibrosarcoma in the extremity requires tissue diagnosis, accurate staging, careful multidisciplinary agreement on treatment, accurate execution of that treatment, and finally regular specialist surveillance. The treatment must be planned on an individual basis, weighing the risk of distant metastasis against the potential for severe functional impairment should radical excision or amputation be performed. The grade of tumor, clinical stage as well as the site, local extent, and the comorbidity of the patient influence the decision.We present the case of an elderly woman with an expanding high-grade myxofibrosarcoma within the thenar musculature of the nondominant hand. She presented with early signs of complex regional pain syndrome, leading to a treatment dilemma. We feel this case has important learning points on assessing objectives, risks, and outcomes in the management of these types of cases, and it highlights the role of multidisciplinary involvement in sarcoma management.


Assuntos
Fibrossarcoma/diagnóstico , Mãos/patologia , Neoplasias Musculares/diagnóstico , Idoso , Feminino , Fibrossarcoma/patologia , Fibrossarcoma/cirurgia , Mãos/cirurgia , Humanos , Neoplasias Musculares/patologia , Neoplasias Musculares/cirurgia , Gradação de Tumores
2.
J Plast Reconstr Aesthet Surg ; 98: 339-341, 2024 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-39332160

RESUMO

INTRODUCTION: Aesthetic surgery tourism is a flourishing trend, and challenges often arise when patients return home with post-operative complications, necessitating follow-up care. METHODS: Between July 2021 and June 2023, we conducted a retrospective analysis of patients who presented with complications from aesthetic surgery tourism in two major teaching hospitals in Ireland. RESULTS: Thirty-three patients with a mean age of 41 years were identified. Procedures were predominantly performed in Turkey (67%), followed by Lithuania (24%). Complications included wound dehiscence (n = 22), infections (n = 9), seroma (n = 9), haematoma (n = 2) and skin necrosis (n = 1). A total of 27 operations were performed, with an average hospital stay of four days and a per-patient cost of €5 486. CONCLUSION: Complications from aesthetic surgery abroad not only have a psychological and financial impact on the individuals involved but also strain our public healthcare system. Therefore, it is important for us, as medical professionals to advocate for our patients in order for them to make informed and safe decisions before seeking healthcare abroad.

3.
Br J Sports Med ; 46(16): 1134-6, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22976908

RESUMO

Hurling is an Irish national game of stick and ball known for its ferocity, played by 190 000 players. Facial injuries were common but have been significantly reduced by legislation enforcing compulsory helmet wearing. Current standard helmets worn by hurlers do not offer protection to the external ear. Here we describe an emerging pattern of ear injuries and demonstrate the risk of external ear injuries in hurlers complying with current helmet safety standards. A 6-month retrospective analysis was carried out of patients attending Cork University Hospital (CUH) with ear lacerations sustained while hurling. Patient notes were reviewed and helmet manufacturers were interviewed. Seven patients were identified, all of whom sustained complex through ear lacerations while wearing helmets complying with current safety standards. Current helmet design fails to protect the external ear placing it at an increased risk of injury, a potential solution is to include ear protection in the helmet design.


Assuntos
Orelha Externa/lesões , Dispositivos de Proteção da Cabeça/normas , Equipamentos Esportivos/normas , Atletismo/lesões , Adolescente , Adulto , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/prevenção & controle , Humanos , Lacerações/etiologia , Lacerações/prevenção & controle , Masculino , Estudos Retrospectivos , Adulto Jovem
4.
JPRAS Open ; 32: 161-165, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35402681

RESUMO

Nodal metastasis is an independent prognostic factor in patients with melanoma. Sentinel lymph node biopsy (SNB) is a recommended component of the management of patients with AJCC stage T1b or above. The dermal scar is injected with a Technetium-99 m (99MTc) Nanocolloid, a radiotracer that drains into sentinel nodes to be identified on a preoperative SPECT/CT scan. Intraoperatively the sentinel nodes are located using a gamma probe and patent blue dye. A 79-year-old male was referred to the Plastics Outpatient Department for management of a biopsy proven pT4b melanoma on the right flank and a suspicious lesion on the right shoulder. He was scheduled for a SNB and wide local excision of the flank melanoma and excisional biopsy of the shoulder lesion. He received injections of 99MTc Nanocolloid around the flank biopsy scar, however, preoperative, and intraoperative attempts to locate a node using radiological and surgical techniques were unsuccessful. The biopsy of the shoulder lesion sent for histopathology revealed a pT1b melanoma. A subsequent second SNB on the shoulder melanoma was unsuccessful, as 99MTc Nanocolloid failed to drain into a sentinel node for a second time. The drainage function of lymphatic vessels declines with age however the complete failure of nodal uptake is exceptionally rare. Novel radiotracers such as 99MTc Tilmanocept have shown superior lymph node tracking in recent tracers.

5.
BMC Surg ; 9: 20, 2009 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-20030856

RESUMO

BACKGROUND: The development of a fistula between the tracheobronchial tree and the gastric conduit post esophagectomy is a rare and often fatal complication. CASE PRESENTATION: A 68 year old man underwent radical esophagectomy for esophageal adenocarcinoma. On postoperative day 14 the nasogastric drainage bag dramatically filled with air, without deterioration in respiratory function or progressive sepsis. A fiberoptic bronchoscopy was performed which demonstrated a gastro-bronchial fistula in the posterior aspect of the left main bronchus. He was managed conservatively with antibiotics, enteral nutrition via jejunostomy, and non-invasive respiratory support. A follow- up bronchoscopy 60 days after the diagnostic bronchoscopy, confirmed spontaneous closure of the fistula CONCLUSIONS: This is the first such case where a conservative approach with no surgery or endoprosthesis resulted in a successful outcome, with fistula closure confirmed at subsequent bronchoscopy. Our experience would suggest that in very carefully selected cases where bronchopulmonary contamination from the fistula is minimal or absent, there is no associated inflammation of the tracheobronchial tree and the patient is stable from a respiratory point of view without evidence of sepsis, there may be a role for a trial of conservative management.


Assuntos
Adenocarcinoma/cirurgia , Fístula Brônquica/terapia , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Fístula Gástrica/terapia , Idoso , Fístula Brônquica/etiologia , Fístula Gástrica/etiologia , Humanos , Masculino , Resultado do Tratamento
8.
J Plast Reconstr Aesthet Surg ; 70(6): 828-832, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28343783

RESUMO

Hard palate closure with a vomer flap at the time of lip repair has been widely adopted. A recent study by Deshpande et al. showed a high rate of failure of the vomer flap and led the authors to abandon the technique. We conducted a retrospective study of vomer flap healing in a consecutive series of cases performed by the senior author (D.O.). The case records of 71 patients who underwent repair of unilateral cleft lip and palate with a vomer flap at the time of lip repair were studied. Vomer flap healing was assessed and documented by the senior author at the time of definitive palate closure, and this was recorded. Adequate records were available for 66 cases. Twelve patients (18%) had associated syndromes and were included in the analysis. The median age at the time of lip and vomer flap repair was 3.5 months, and that at the time of palate repair was 8 months. At definitive palatoplasty, the vomer flap was intact in 62 patients (94%). Four patients (6%) had partial or complete failure of the vomer flap. All failures occurred in cases where the vomer flap was sutured directly to the nasal mucosa, a technique since abandoned in favour of double-breasting the flap to the raw surface of the oral mucosa. Five patients had incomplete healing of the palate following definitive palatoplasty, two of whom had a previous vomer flap failure. Contrary to Deshpande et al., we found the vomer flap to be highly reliable in closing the hard palate at the time of primary lip repair.


Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Palato Duro/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Feminino , Humanos , Lactente , Masculino , Complicações Pós-Operatórias , Procedimentos de Cirurgia Plástica/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Vômer , Cicatrização
9.
Plast Reconstr Surg ; 131(3): 380e-387e, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23446588

RESUMO

BACKGROUND: Cleft palate fistulas of the anterior hard palate following previous repair are a challenging surgical problem. In addition to nasal regurgitation and potential adverse effects on speech, these fistulas may necessitate obturation with a removable dental prosthesis and can mitigate a fixed prosthodontic dental reconstruction. The authors present a method of repair using cancellous bone graft and only native palatal mucosa. METHODS: The authors carried out a retrospective review of 27 consecutive patients who underwent anterior palate fistula repair performed by a single surgeon over an 8-year period. RESULTS: The authors performed 29 fistula closure procedures using cancellous bone on 27 consecutive patients. Twenty-three (85 percent) of the initial 27 palatal fistula repairs in this study resulted in complete closure of the fistula. Two of the four patients who had incomplete closure went on to have a second operation using exactly the same technique, and complete closure was achieved. The remaining two patients in whom only partial closure was achieved were asymptomatic and no further treatment was necessary. All patients had an improvement in fistula symptoms after surgery. All patients who were using removable dentures/obturators were restored with fixed dental restorations supported by osseointegrated implants or fixed conventional bridges. CONCLUSIONS: This relatively simple method achieves reliable closure of most anterior hard palate fistulas and can be repeated if necessary. This technique removes the necessity of obturation of the defect with a removable prosthesis and in some cases facilitates the placement of dental implants.


Assuntos
Transplante Ósseo , Fissura Palatina/cirurgia , Fístula/cirurgia , Doenças Maxilomandibulares/cirurgia , Palato Duro , Procedimentos de Cirurgia Plástica/métodos , Complicações Pós-Operatórias/cirurgia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais , Estudos Retrospectivos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA