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Biomedical subjects

S Brongo

Publications and source records attributed to S Brongo.

13 recordsLinked to original sources

Prevention and treatment of keloids with intralesional verapamil.

BACKGROUND: The current treatment of keloids is based on surgery, medical therapy and physical treatment. The optimal treatment remains undefined. OBJECTIVE: This clinical study determines the effectiveness of verapamil hydrochloride on the prevention and treatment of keloids. METHODS: Two groups of patients with keloids were divided according to lesion site and age. The first group was treated by perilesional surgical excision of keloids and topical silicone, combined with adjuvant treatment of intralesional 2.5 mg/ml verapamil hydrochloride injections administered at timed intervals. The second group served as control, receiving the same treatment except the verapamil hydrochloride. RESULTS: A periodical examination to check specific clinical parameters and an 18-month follow-up determined that keloids were cured in 54% of the cases in the first group, compared to 18% in the second group. Moreover, in the remaining 36% of patients in the first group in whom keloids recurred, there was an improvement in size and above all in consistence. CONCLUSION: These findings suggest that verapamil hydrochloride is an effective tool for the prevention and therapy of keloids.

Administration, Topical↗

Dermatofibrosarcoma protuberans: experience with 14 cases.

Dermatofibrosarcoma is a rare, low-grade malignant skin tumour that can be considered the equivalent of malignant non-cutaneous soft tissue fibrohistiocytoma. The high rate of recurrence of this tumour is correlated with poor surgical management because lesions, often smaller than 2 cm in diameter, may be confused with dermatofibroma or keloid. Our findings confirm the importance of accurate diagnosis of primary lesions and the need for aggressive surgical treatment (excision of 5 cm of surrounding tissue) to lower the incidence of local relapse.

Adult↗

Extracorporeal septoplasty with paramarginal incision.

To reconstruct the airways in the case of serious nasoseptal deviation it is preferable to remove the cartilaginous septum, reshape it, and put it back. This may be done through an open rhinoplasty approach with a transcolumellar scar resulting in wide visual access to the septal structures. As the transcolumellar scar may give problems in some cases, it might be helpful to use an extended paramarginal incision. A traditional open rhinoplasty approach was used in eight patients and the extended paramarginal incision technique in 19 patients. Two of the eight patients who had the open rhinoplasty technique developed unsatisfactory transcolumellar scars. Of the 19 patients who had paramarginal incisions no patient developed late problems. The paramarginal approach was superior to the traditional open rhinoplasty approach despite the slightly better visualisation with open rhinoplasty.

Adult↗

Skin island urethroplasty in deep urethral lesions--a long-term follow-up of 25 consecutive patients.

Strictures and ruptures of the bulbomembranous urethra have traditionally been treated by a two-stage scrotal skin inlay technique (Johanson B. Reconstruction of the male urethra in strictures. Acta Chir Scand 1953; Suppl 176). For the last 10 years we have treated the patients instead with a skin-dartos island flap pedicled on intertesticular septal vessels. The skin island has been taken from the scrotum, the penile base, or the penile shaft. Twenty-five consecutive patients were treated until 1993 and followed up for at least 5 years. Five of the patients had had open urethroplasty before. Fifteen of the patients had urethral strictures and 10 had complete ruptures. Of the 25 patients 6 had to have a further operation; in 4 patients this was because of restricture, in 1 patient a urethral pouch had to be reduced, and in the final patient the operation was both for restricture and pouch formation. At final follow-up impaired micturition occurred in three patients: two of them had had a ruptured urethra treated previously, and one had a chronic infectious stricture. Problems related to hirsutism were low. No obvious advantage was detected from using distal penile skin, so a skin-dartos island from the penile base is advocated. In conclusion, a one-stage skin-dartos island flap pedicled on the intertesticular septal vessels may be recommended in the treatment of both strictures and complete ruptures in the bulbomembranous urethra.

Adolescent↗

Nipple reconstruction with a modified S-flap technique.

A modified S-flap method for nipple reconstruction with two local opposing skin flaps, was used for a series of 21 women with a mean age of 50 years (range 30-64). Four patients had bilateral breast reconstructions, so the total number of reconstructed nipple areola complexes (NAC) was 25. The patients were examined 29-46 months (mean 36) after the reconstruction with particular reference paid to projection, size, sensation, and colour of the nipples. The patients also answered a questionnaire about their assessment of the final result. The mean projection of the nipples was 3.9 mm (range 0-9). Five patients had various degrees of necrosis of the skin flaps. One third of the women had some sensation in their reconstructed nipples. Two thirds of the nipples were pale. The patients estimated the final result as 8.2 (range 1-10) on a visual analogue scale.

Adult↗

Clinical experiences with the external tissue extender.

Forty one patients were operated on for different skin defects using the external tissue extender (ETE). The indications were similar to those in which ordinary tissue expanders were used with a prevalence of scars (n = 20, 46%) and previous skin grafts (n = 12, 28%). The ETE was used all over the body but mainly on the upper (n = 18, 42%) and lower (n = 12, 28%) extremities. The mean treatment time was eight days, and the complication rate was 8% compared with the reported 25% using ordinary tissue expanders. The advantages of the ETE compared to ordinary tissue expanders are that it saves time and money for doctors and patients, it is easy to handle, and it is almost always possible to operate under local anaesthesia.

Adolescent↗

[The use of polypropylene (Marlex) mesh in ambulatory care of inguinal hernia].

The use of Marlex mesh in the treatment of inguinal hernia produces a series of advantages, if compared with traditional techniques. According to the authors, these advantages can be identified with the ambulatorial treatment of this pathology, with the possibility to use the local anaesthetic, with a minimum postoperating pain, with a possible collaboration of the patients with the surgeon during the operation, and with a considerable reduction of relapses. The authors explain the different steps of their techniques.

Adolescent↗

[Use of dermo-adipose grafts in facial morphology restoration in cases of progressive partial lipodystrophy].

Two cases of partial progressive lipodystrophy syndrome with extensive soft tissue atrophy of the face and of the upper part of the trunk, with kidney and blood alteration, are presented. On the basis of the psysical examination and pathological history of the patients, blood and instrumental tests have been performed in both cases. The diagnosis of partial progressive lipodystrophy syndrome has been made and a surgical treatment with dermal fat graft from the inguinal region was proposed to the patients after several information and was performed to improve the facial contour. After a follow up of 18 months a resorption of 50% of dermal fat graft was found according to surgeons' expectations with a good esthetic improvement of the face.

Adipose Tissue↗

[Lip carcinoma. Various therapeutic options].

Lip carcinoma is a relatively unique malignant disease because the lip is a junctional structure. The lip is bounded externally by the facial skin and it is in continuity with the buccal mucosa of the oral cavity. The lymphatic drainage of the upper and lower lips is primarily directed to the mandibular group of lymph nodes. To a lesser extent, drainage may go to submental intraparotid, or internal jugular lymph nodes. Lip carcinoma is almost exclusively a squamous cell carcinoma, the major etiologic factor being prolonged iar exposure. Treatment for lip carcinoma is usually surgical, in the form of full-tickness excision. Neck dissection is also performed when clinically palpable lymph nodes are present.

Humans↗