Granular cell tumor of the toe: a case report

Granular cell tumor is a rare tumor of unknown etiology that more commonly affects the oral cavity but can also occur at other sites. The majorities of granular cell tumors are benign and present as a singular dermal nodule. We discuss a case of granular cell tumor of the fourth toe in a 54-year-old patient that was treated with conservative surgery, instead of amputation, and reconstruction with a dermal regeneration template

A case of post–traumatic cervicogenic headache treated by cervical cord stimulation

The case of a 26–year–old woman suffering from cervical trauma with disc herniation presenting with arm and neck pain is presented. She underwent cervical discectomy with fusion because the pain did not improve with medical therapies; as the neck pain resumed after surgery, a cervical cord neurostimulator was implanted, with improvement for cervicogenic headache. This report underlines the presence of two pathologies and the relationship between C2 and trigeminal pathways

A novel method to medicate local cv flaps in nipple reconstruction

Besides surgical technique related variables, post-operative care after nipple reconstruction with CV flaps is important for an satisfactory final result. We present a novel method to prepare a protective and sealing medication in order to minimize traumas to the new nipple. We found the silicone cap plunger of a 50cc syringe suitable for our purpose. It was applied over a non-adherent dressing and TNT gauze to avoid decubitus and fixed it with a steri-strip before covering with a sticking plaster. Analyzing 118 nipples casistic, reconstructed with a CV flaps technique, between January 2011 and June 2012 and medicated with the presented technique in the last six months considered, we noticed a reduction in partial loss of flap vitality and nipple reabsorption. The main advantages of the dressing technique we propose are the ease and rapidity in the preparation and availability of all materials used in every operation room or outpatient clinic. We believe that our technique of medication may reduce traumas to delicate vascularization of the new nipple, avoiding the partial or total loss of vitality and reabsorption of the flaps

Reconstructive management of degloving trauma of male external genitalia using dermal regeneration template: A case report

Traumatic injuries of male external genitalia are rare and not usually life threatening; however, they can have psychological repercussions. The reconstructive management of these lesions is challenging and articulated. We report the case of a 38-year-old farmer suffering from a degloving wound on the external genitalia. The first reconstructive step used to treat the wound was the incorporation of a dermal regeneration template (Integra (R)) and accordingly partial-thickness skin grafts and local flaps. The follow-up 16 months after the first treatment was satisfying; sexual function had been restored. (C) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeon

Acellular Dermal Matrices and Radiotherapy in Breast Reconstruction: A Systematic Review and Meta-Analysis of the Literature

The increasing use of commercially available acellular dermis matrices for postmastectomy breast reconstruction seems to have simplified the surgical procedure and enhanced the outcome. These materials, generally considered to be highly safe or with only minor contraindications due to the necessary manipulation in preparatory phases, allow an easier one-phase surgical procedure, in comparison with autologous flaps, offering a high patient satisfaction. Unfortunately, the claim for a higher rate of complications associated with irradiation at the implant site, especially when the radiation therapy was given before the reconstructive surgery, suggested a careful behaviour when this technique is preferred. However, this hypothesis was never submitted to a crucial test, and data supporting it are often discordant or incomplete. To provide a comprehensive analysis of the field, we searched and systematically reviewed papers published after year 2005 and registered clinical trials. On the basis of a meta-analysis of data, we conclude that the negative effect of the radiotherapy on the breast reconstruction seems to be evident even in the case of acellular dermis matrices aided surgery. However, more trials are needed to make solid conclusions and clarify the poor comprehension of all the factors negatively influencing outcome

Massive de-gloving thigh injury treated by vacuum therapy, dermal regeneration matrix and lipografting

Frequently lower limb injuries are caused by road and work accidents. The young age of those affected coupled with the anatomical and functional peculiarities of this part of the body with regards to social life during adolescence make the treatment of the leg wound complex and challenging. We present two cases of young girls, victims of serious road accidents who were treated initially with frequent wound washings, vacuum therapy to stimulate granulation tissue, then dermal regeneration matrix (INTEGRA ® ) and split-thickness skin grafts. After one year, both patients treated with lipofilling have shown improved cosmetic results allowing a new social life