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Biomedical subjects

G Dagregorio

Publications and source records attributed to G Dagregorio.

13 recordsLinked to original sources
PubMed2006

A retrospective review of 20 hypertensive leg ulcers treated with mesh skin grafts.

BACKGROUND: Few articles have been published about hypertensive leg ulcers and their surgical treatment. Since mid of the year 2000, it has been our policy to treat all hypertensive leg ulcers very early with mesh split-thickness skin grafts. The present series consists of 15 patients whose hypertensive leg ulcers, including five bilateral cases, were treated with 20 mesh grafts from 2000 to 2002. SUBJECTS AND METHODS: All patients, nine women and six men, had a long history of hypertension. The same surgical procedure was applied to all 15 patients: a complete mechanical debridement of all necrotic tissues, immediately followed by mesh skin grafting. RESULTS: Patients were discharged from the hospital after an average post-operative period of 16 days. Upon leaving the hospital, the patients had lesions completely healed in 14 of 20 cases. The graft take had been complete after an average period of 14 days. In six cases, one or two very small patches of skin graft had necrosed and complete healing required an additional period of 1 to 3 months. In all 20 cases, pain had disappeared within 1 week from surgery. DISCUSSION: All patients were on opioid therapy before surgery. With medical treatment only, hypertensive leg ulcers used to heal after a mean period of 15 months. After surgery, the average healing period was 2 weeks and opioids were stopped within 1 month after surgery. CONCLUSION: The review of the present series shows that early mesh grafting of hypertensive leg ulcers is beneficial, because healing is very quick and the pain will disappear quasi-instantly.

Aged↗
PubMed2005

Post-ablative reconstruction of the medial canthus and medial orbital wall using conchal cartilage graft with three illustrative cases.

When the medial third of the upper or lower eyelid has to be reconstructed after full-thickness tumour excision, we usually use Hübner tarsomarginal grafts, but when medial canthal lesions spread to the medial orbital wall without invading the orbital margin, conchal graft becomes our first surgical option. Previously reported solutions to this difficult problem are few and concern more directly medial orbital wall fractures. We found no article dealing specifically with the use of conchal graft in post-ablative reconstruction of the medial orbital wall. Nevertheless the concha presents great advantages over bone grafting or rib cartilage, because it is more flexible and malleable. And it is less prone to extrusion or infection as may be allografts implants. It is a very effective way to repair medial orbital defects, but graft reorientation must be perfect to match exactly the medial orbital wall concavity.

Aged↗
PubMed2005

Aesthetic surgery techniques after excision of dermatofibrosarcoma protuberans: a case report.

Dermatofibrosarcomata protuberans are rare locally aggressive tumours that have a very high recurrence rate in the absence of wide resection. Normally, when the area to be covered is exceptionally large or when skin grafting is not possible because of the location, pedicle or free flaps are used. We report one case of wide excision where the opportunity arose to apply aesthetic surgery techniques combining bilateral superiorly based mammaplasty and reverse abdominoplasty.

Abdominal Wall↗
PubMed2005

Reconstruction of seventeen full-thickness defects of the eyelids with twenty-two Hübner tarsomarginal grafts.

In 1976, Hübner described a new technique to repair full-thickness defects of the eyelids. In 1993, we decided to adopt this simple and easily reproducible technique that guarantees restoration of the normal aspect of the margin. Subsequently, 17 eyelid reconstructions were performed on 13 patients, requiring the harvesting of 22 tarsomarginal grafts. No cosmetic or functional sequelae in the donor eyelids were observed. One or several functional complications were present in seven out of 17 reconstructed eyelids, including two cases of epiphora, one case of lagophtalmos and two cases of lid notch. Loss of the eyelids was observed in three cases out of six upper eyelid reconstructions and in nine cases out of 11 lower eyelid reconstructions. In all cases, the margin integrity was otherwise preserved. Very few simple techniques achieve that level of quality in the eyelid reconstruction process.

Adult↗
PubMed2005

Seven reconstructions of the orbital and periorbital region with a contralateral orbitonasolabial flap.

Blasius designed the first orbitonasolabial flap in 1842, which has since, been reshaped by many other surgeons. Three years ago, we were confronted with a difficult reconstructive case where ipsilateral local flaps were insufficient to cover a huge defect of the periorbital region. We performed 11 cadaver dissections to determine the type of vascularisation of the orbitonasolabial flap and to define its arc of rotation prior to contralateral use. This contralateral orbitonasolabial flap was subsequently applied to seven cases with satisfactory results.

Aged↗
PubMed2005

[Vulvar contact dermatitis due to seminal allergy: 3 cases].

BACKGROUND: Contact sensitivity deserves to be assessed in acute vulvitis as well as chronic vulvar dermatitis with a specific orientation toward semen allergy whenever the pathology is post-coital. OBSERVATIONS: Three observations of semen allergy are reported. Two women presented with post-coital vulvitis due to delayed hypersensitivity to semen proteins without associated specific IgE. The type 2 allergy was confirmed by positive patch-tests and disappearance of symptoms when using condoms. Another woman presented with oedematous vulvitis associated with asthma and malaise per and post-sexual intercourse. Positive prick-tests with husband's semen and blood tests for specific IgE led to the diagnosis of type 1 hypersensitivity to semen, with disappearance of both vulvar and systemic symptoms with the use of condoms. DISCUSSION: Immediate or delayed type hypersensitivity may be discovered using prick and patch tests respectively. The observation of vulvitis or vulvar discomfort should promote such investigations, whenever a post-coital chronology is suggested. The good clinical pertinence of positive skin tests must be emphasized. Although type I hypersensitivity to semen is documented in the literature, with easy detection of specific IgE, delayed type 2 allergy presents as an as yet under-diagnosed etiology of post-coital vulvitis. Patch tests may help to confirm that contact dermatitis may be due to seminal proteins.

Acute Disease↗
PubMed2005

Allergic contact dermatitis from natural rubber latex in atopic dermatitis and the risk of later Type I allergy.

The aims of the study were to assess whether contact dermatitis in children could be due to a delayed hypersensitivity reaction to natural rubber latex (NRL) and to define risk factors for later occurrence of Type I hypersensitivity to this allergen. Among 1800 children investigated for contact dermatitis, 55 were referred on suspicion of rubber allergy and had patch tests to NRL, as well as prick tests and blood tests for specific immunoglobulin E (IgE). A 2-year follow-up was then carried out. Delayed hypersensitivity to NRL was confirmed in 32 children. Patch testing with NRL proved to be positive, and clinical improvement confirmed the diagnosis and relevance of patch tests. 30 of these 32 patients had associated atopic dermatitis (AD). Prick tests and blood tests for specific IgE to latex were negative at the time of diagnosis. A 2-year follow-up showed that 10 of 27 patients presenting initially with a positive patch test without associated Type I sensitization later developed immediate hypersensitivity. Children with AD are at high risk for allergy to NRL protein. Exclusion of this allergen should be strongly advised in atopics because of the dual risk of dermatitis and later evolution into severe Type I hypersensitivity.

Allergens↗
PubMed2004

Simple neurolysis for failed anterior submuscular transposition of the ulnar nerve at the elbow.

From 1996 to 2000, we reoperated nine patients totally dissatisfied after previous surgery for cubital tunnel syndrome. All patients had simple external neurolysis in situ of the transposed ulnar nerve. Only the anterior aspect of the ulnar nerve was dissected and released. Dense scarring around the ulnar nerve was found to be the main cause of recurrence but could not explain the three initial cases of persistent symptoms. All patients were reviewed 2 years after the secondary neurolysis. The patients were asked to describe their remaining symptoms and examination included palpation of the ulnar nerve at the elbow, Tinel's sign, two-point discrimination, and palpation of the scar. Pinch and grip strength were measured. According to the Wilson and Krout classification, there were four good results with complete alleviation of symptoms, four fair results, and one poor result. Simple neurolysis proved to be effective after failed anterior submuscular transposition of the ulnar nerve at the elbow.

Adult↗
PubMed1995

[Eyelid repair using the Hübner technique].

Many methods have been proposed for the reconstruction of full thickness defects of the eyelid are numerous, but all are imperfect. The texture, colour, and functional role of the eyelid require the use of a ciliated composite transplant. Among the various techniques described, Hübner's transplants, free transfers of a segment composed of connective tissue of the tarsus and the ciliary margin of the contralateral eyelid, covered by a palpebral flap, can be used to reconstruct a hemi-eyelid, or even two-thirds of the eyelid with good aesthetic and functional results.

Adult↗