Annales de chirurgie plastique et esthétique
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Ann Chir Plast Esthet · Feb 1999
Case Reports[Humanitarian surgery of the hand. Our experience in Vietnam].
After a general presentation of the geographical and social aspects of Vietnam, the authors describe the conditions of their surgical work during short time humanitarian hand surgery missions. These missions, lasting 7 to 10 days are dedicated to the care of children, and a half-day of teaching for Vietnamese corresponding surgeons. The technical and material limits, the constraints for the patients to travel to the hospital, to pay for care and the difficulties of follow-up, require the selection of patients in whom the disease can be treated in a single stage procedure. ⋯ For reason of complexity and unreliability of electromyographic examination, brachial plexus injuries cannot be treated, except the simplest cases needing one or two tendon transfers. Concerning skin coverage and reconstructive surgery, our experience has shown that pedicled local and locoregional flaps, and even microsurgical transfers are adapted and reliable techniques due to the imperative of single stage procedure. The education and teaching of young surgeons in European teams and regular relation-ships with corresponding surgeons from developing countries are certainly the best way to promote humanitarian hand surgery.
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Merkel cell carcinoma (MCC) is a malignant cutaneous neuroendocrine tumor which may be difficult to diagnose. It mostly occurs in old patients and the commonest sites are the skin of the head and neck and the extremities. MCC appears as a solitary violaceous dome-shaped nodule or indurated plaque. ⋯ Local recurrence and regional lymph node metastases occur in 40 to 75% of cases. Long-term prognosis is unfavorable (3-year survival rate is 55%). Wide surgical excision associated with radiotherapy is the treatment of choice, regional lymph node metastases should be treated by lymph node excision and radiotherapy; chemotherapy should be used in systemic disease.
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Ann Chir Plast Esthet · Aug 1997
Case Reports Comparative Study[Complex facial nevus in children treated by combination of prosthetic and deferred natural expansions].
Congenital pigmented naevi of the face in children represent indications for early excision and the search for the best aesthetic result has led the authors to prefer the use of skin expansion techniques. The case presented here illustrates the combined use of two expansion techniques: prosthetic expansion and natural differed expansion. This procedure gives good cosmetic results at a moderate overall cost.
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Skin expansion material has progressed and now covers all needs in plastic and reconstructive surgery. Breast reconstruction occupies a special place among expansion techniques and requires specific material. ⋯ The skin expansion protocol is rigorous with no room for improvisation. It is only in this way that the quality of the result justifies the use of this technique.