Chemical burn in domestic setting with an uncommon agent: hydrofluoric acid.

Chemical burns, in particular because of hydrofluoric acid, are not common in the pediatric emergency department. Here, we describe an infant presenting with digital ischemic findings owing to late diagnosis of hydrofluoric acid splash in domestic setting.

[Distal phalanx metastasis in operated bronchial carcinoma]. / Opere brons karsinomlu hastada distal falanks metastazi.

A 54 years old man who admitted with thoracolomber pain and pain at left knee had history of left pneumonectomy four months ago for squamous cell lung carcinoma. At physical examination swelling and hotness at the left knee, swelling and redness of the distal phalanx of the right third finger were found. Distal phalanx was not observed at the X-ray which was taken for suspect of metastasis. Incision biopsy was performed from this lesion and microscopic findings of the material were evaluated as metastatic squamous cell carcinoma. Bone metastasis are seen frequently at bronchial carcinoma, but hand metastasis are seen in 0.2% of all cases. This case is represented because of the rare metastatic localisation of bronchial carcinoma.

Increasing the viability of fat grafts by vascular endothelial growth factor.

OBJECTIVE: To increase the viability of fat grafts using vascular endothelial growth factor (VEGF) in a calcium alginate microsphere controlled release system. DESIGN: Twenty-four rats were divided into 4 groups of 6 rats each. Group 1 was the preconditioning group in which VEGF was applied prior to the fat grafting. In group 2,VEGF was given at the time of the grafting. In group 3, an empty microsphere was added to the grafting material. The fourth group, which received the fat graft only, was the control group. At the 90th day, samples of the fat grafts were weighed and compared with preimplantation weights. RESULTS: The graft viability ratios of the first 3 groups were significantly higher than those of the control group. The relative adipocyte index was significantly higher in the first and second groups compared with the control group and group 3. Consistent with the literature, VEGF used both in the preconditioning procedure and simultaneously with the grafting procedure increased the graft viability ratio and relative adipocyte index. CONCLUSION: This study suggests that VEGF-induced preconditioning of the recipient bed improves fat graft viability via increased revascularization.

Follow-up form for patients undergoing orthognathic surgery.

Patients undergoing orthognathic surgery need quantitative follow-up of many parameters. Standardization and recording of data should be done with minimal paper work and time. The patient follow-up form presented enabled the authors' clinic to increase the quality of follow-up. The form consists of more than 20 variables that are routinely evaluated in all patients undergoing orthognathic surgery. It facilitates the cross-evaluation of many variables easily and more accurately. This type of accurate recording would also be beneficial in the event of medico-legal issues. The authors believe this form would be helpful to clinics that have a large number of patients undergoing orthognathic surgery.

Craniofacial reconstruction with high-density porous polyethylene implants.

Deformities of the facial skeleton may be reconstructed using autogenic or allogenic materials. Porous polyethylene is one of the few alloplastic materials currently in use having a well-documented history of reconstruction or augmentation in the maxillofacial region. High-density porous polyethylene, which is shown to be effective as a biomaterial, has additional advantages like tissue ingrowth, no capsule formation around it, and easy fixation. In this study, 83 implants in 71 patients were evaluated. Seven patients were in need of a second intervention. Three of the seven secondary interventions were for contour alignment, and four interventions were for extraction of the implants because of extrusion or infection. Placement of porous polyethylene implants directly under the skin without coverage of periosteum or another fascial envelope has an increased risk of early and especially late exposure. In cases like nasal dorsum or microtia reconstruction, we prefer autogenic grafts instead of allogenic materials.