KARAPANDZIC FLAP FOR RECONSTRUCTION OF LOWER LIP IN A 18-MONTH OLD BOY WITH CONGENITAL AGAMMAGLOBULINEMIA AND ECTHYMA GANGRENOSUM. CASE REPORT

The reconstruction of lower lip in children is extremely rare and challenging procedure. The etiology in literature reveals trauma and infection. An 18-month boy was admitted with sepsis and pneumonia. Laboratory tests revealed congenital agammaglobulinemia. Necrosis of lower lip developed and was diagnosed as ecthyma gangrenosum. Blood culture was positive for Pseudomonas aeruginosa. Multiple abscess formations were found in abdominal wall and gluteal region and were treated by incisions. After spontaneous demarcation of necrotic tissue in lower lip the Karapandzic flap technique was used for reconstruction. Karapandzic flap can be used as optimal method for reconstruction of lower lip in children with satisfactory functional and aesthetic results.Key words: Karapandzic flap, ecthyma gangrenosum, reconstructio

Application of Sentinel Lymph Node Biopsy in Cutaneous Basosquamous Carcinoma

Basosquamous carcinoma of the skin is a relatively rare cutaneous neoplasm that has significant metastatic potential and a metastatic rate greater than that of basal cell and squamous cell carcinoma. We describe the use of lymphatic mapping and sentinel lymph node biopsy in a 63-year-old man after identification of basosquamous carcinoma. Sentinel lymph node biopsy, which is a standard tool to detect regional lymphatic metastasis in cutaneous melanoma, has been rarely employed to detect lymphatic metastasis of basosquamous carcinoma. The approach was successful in detecting a regional lymphatic metastasis of two nodal basins with minor morbidity. Sentinel lymph node biopsy may be useful for certain high-risk lesions of basosquamous carcinoma

APPLICATION OF THE PECTORALIS MAJOR LOBE IN THE CLINIC PRACTICE

In the period from 1985 to 1998 at the Surgery Clinic, Niš, the pectoralis majorlobe was applied to 40 patients with a large skin defect that could hardly bereconstructed by the traditional methods. The myocutaneous lobe was used with 38patients (95%), the osteomyocutaneous lobe in one patient (2,5%) and the muscularpectoralis major lobe in one patient (2,5%). In all the patients, the defect was aconsenquence of the operative treatment of the skin or the subcutaneous tissue tumor,namely, in the orbit area (2 patients), in the face (14 patients - one patient had anosteomyocutaneous lobe applied), in the neck (11 patients), in the thoracic cavity (8patients - one patient had a muscular lobe with the skin transplant applied) and in theshoulders (5 patients). The secondary defect is directly sutured in all of them. Tn onepatient the necrosis of the whole lobe due to a hematoma is registered, while in 3patients a partial lobe necrosis (due to infection) has been taken care of by necrectomyand a secondary suture. In all the other patients the lobe has been completely accepted.The island-like pectoralis major muscular-cutaneous lobe can be successfully used for reconstructing great skin defect in the area of the face, neck, thoracic cavity andshoulders. The technique of lifting the lobe is relatively simple while the complicationsare rare