RESUMEN
This is an individual case report on envenoming caused by the cnidarian Portuguese man-of-war. The reported local reactions and the clinical symptoms are similar to those already known for Portuguese man-of-war envenoming. As far as we know it is the first clinical case documented for the Brazilian shores.
Asunto(s)
Mordeduras y Picaduras/etiología , Venenos de Cnidarios/envenenamiento , Adulto , Mordeduras y Picaduras/patología , Brasil , Humanos , MasculinoRESUMEN
In patients with extensive deep burns and scarce donor sites autogenic cultured epithelial grafts (auto-CEG) have become a real alternative. In deep burns the 'take' rate of auto-CEG applied directly on subcutaneous fat, fascia or muscle is unreliable and frequently disappointing. The auto-CEG seems to need a dermal base. Improved results have been reported when auto-CEG were applied to the dermal base of a viable cryopreserved donor skin. We extended this principle by using the dermal layer of non-viable glycerol-preserved donor skin (GPDS). We report on two patients with deep burns of 55 and 80 per cent TBSA in whom we used the composite grafting of auto-CEG on non-viable allogeneic dermis from GPDS. The estimated 'take' rates were 70 and 77 per cent. The grafted areas remained stable for 4 and 8 months respectively. The two-layer skin substitute gave a permanent cover for full thickness burn wounds of higher quality and better 'take' rate than previous results, where the auto-CEG had been grafted directly onto the debrided wounds.
Asunto(s)
Quemaduras/cirugía , Células Epidérmicas , Trasplante de Piel , Adulto , Quemaduras Químicas/cirugía , Células Cultivadas , Glicerol , Supervivencia de Injerto , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Trasplante de Piel/métodos , Trasplante de Piel/patología , Conservación de TejidoRESUMEN
O retalho da arteria calcanea lateral tem padrao axial e em seu pediculo esta incluido o nervo sural e a veia safena parva. E utilizado para cobertura cutanea de defeitos da regiao do tornozelo; e de simples execucao e seguro. A area doadora do retalho e fechada com enxerto de pele de espessura parcial. No presente trabalho, relatamos experiencia com oito pacientes que foram submetidos a reconstrucao da regiao calcanea com retalho da arteria calcanea lateral. E, sete casos o retalho foi utilizado em ilha, com diametro de ate 4 cm. No presente, o retalho foi realizado em sua forma original, como descrito por Grabb e Argenta. A etiologia da perda de substancia foi o trauma em cinco casos e ulceras de pressao em tres pacientes paraplegicos. Os resultados mostraram que o retalho foi adequado para promover a cobertura de lesoes da regiao calcanea, pois e resistente a marcha normal e nao foram observadas ulceracoes.
Asunto(s)
Humanos , Masculino , Niño , Adulto , Persona de Mediana Edad , Talón/cirugía , Trasplante de Piel/métodos , Colgajos Quirúrgicos/métodos , Talón/irrigación sanguíneaRESUMEN
The lateral calcaneal artery flap is an axial flap which comprises also the saphenous vein and the sural nerve. Its use has been reported for coverage of skin loss of the malleolus and calcaneal area. The donor area should be closed by a split thickness skin graft. In the present report, eight patients who had skin loss on the foot were submitted to reconstruction with the lateral calcaneal flap. In seven there were island flaps and in one a bridge of skin similar to that described by Grabb and Argenta. The etiology was trauma in five patients and decubitus ulcer in three. The results were good. The flap was adequate for the cover on the posterior foot area even after submitted to the strain of normal walking. The advantages were simpler technique and consistency of the anatomical landmarks.