8 research outputs found
A systematic approach to the failed plastic surgical reconstruction of the diabetic foot
Plastic reconstruction for diabetic foot wounds must be approached carefully and follow sound micro-surgical principles as it relates to the anatomy of the designated flap chosen for coverage. First, the surgeon always needs to evaluate the local and general conditions of the presenting pathology and patient, respectively when considering a flap for reconstruction. The flap that is chosen is based on the vascularity, location, and size of the defect. Salvage of the failed flap and revisional reconstructive procedures are very challenging. Often, adjunctive therapies such as hyperbaric oxygen, negative pressure wound therapy, vasodilators, and/or vascular surgery is required. In certain case scenarios, such as patients with poor general health and compromised local vascularity in which revisional flap coverage cannot be performed, the above mentioned adjunctive therapies could be used as a primary treatment to potentially salvage a failing flap
Seventh cervical vertebral body solitary osteochondroma. Report of a case and review of the literature
Solitary osteochondroma of the cervical spine is a rare manifestation of
a common bony tumour. It can create symptoms, depending on the adjacent
compressed structures. In this report, a patient suffering solitary
osteochondroma on the anterolateral aspect of the C7 vertebral body is
presented and the literature is reviewed. A 46-year-old female presented
with dysphagia and pain at the anterolateral surface of her neck during
cervical movements or application of local pressure. The clinical and
imaging assessment ascertained that the above complaints were due to a
local tumour in the neck firmly attached to the spine at the
anterolateral aspect of the C7 and which resembled an osteochondroma.
Surgical treatment was chosen due to the persistence of the symptoms.
The lump was resected using an anterolateral cervical approach and it
was sent to the pathology department for confirmation of the lesion’s
histological character. The patient was completely relieved of her
symptoms. Resection of the osteochondroma seems to be the only reliable
solution for definitive relief from the clinical complaints. This
surgical treatment, as it is reported, has no major complications and
gives good functional results. One to four per cent of the
osteochondromas are located at the spine. At the cervical spine, they
can cause neurological symptoms and more rarely, dysphagia. Reviewing
the literature, no case of solitary osteochondroma located in the
anterior aspect of the C7 body was found. Two cases suffering from
dysphagia were reported due to external compression by anterior
hyperostosis of the cervical spine, but not due to osteochondroma