RESUMO
A preservação do desenho das margens cirúrgicas é essencial durante a realização da cirurgia micrográfica de Mohs. Contudo, a degermação cutânea no ato da antissepsia e o uso da gaze durante a anestesia local, com frequência, promovem a remoção dessas marcações. A utilização da película protetora Cavilon® 3M, ao fixar a tinta da caneta marcadora, mostrou-se eficaz na preservação do mapa cirúrgico, permitindo uma remoção precisa do espécime cirúrgico
The preservation of the surgical margins marking is essential during Mohs micrographic surgery. However, skin degermation during antisepsis and the use of gauze during local anesthesia often remove these markings. The use of the protective film Cavilon® 3M to fix the marking pen ink was effective in preserving the surgical map, allowing an accurate removal of the surgical specimen.
RESUMO
In some cases, keratoacanthomas can be indistinguishable from squamous cell carcinoma, making the gold standard treatment surgical excision with histopathological evaluation. The surgical defects created on the back of the hand can be challenging to repair. We describe the use of bilateral rotation flap as an option in this area, and discuss the indications and contraindications of some of the possible surgical techniques for reconstruction of the dorsum of the hand.
Assuntos
Dermatoses da Mão/cirurgia , Ceratoacantoma/cirurgia , Transplante de Pele/métodos , Retalhos Cirúrgicos , Idoso , Humanos , Masculino , Reprodutibilidade dos Testes , Resultado do TratamentoRESUMO
Mycetoma is caused by the subcutaneous inoculation of filamentous fungi or aerobic filamentous bacteria that form grains in the tissue. The purpose of this study is to describe the epidemiologic, clinic, laboratory, and therapeutic characteristics of patients with mycetoma at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil, between 1991 and 2014. Twenty-one cases of mycetoma were included in the study. There was a predominance of male patients (1.3:1) and the average patient age was 46 years. The majority of the cases were from the Southeast region of Brazil and the feet were the most affected anatomical region (80.95%). Eumycetoma prevailed over actinomycetoma (61.9% and 38.1% respectively). Eumycetoma patients had positive cultures in 8 of 13 cases, with isolation of Scedosporium apiospermum species complex (n = 3), Madurella mycetomatis (n = 2) and Acremonium spp. (n = 1). Two cases presented sterile mycelium and five were negative. Six of 8 actinomycetoma cases had cultures that were identified as Nocardia spp. (n = 3), Nocardia brasiliensis (n = 2), and Nocardia asteroides (n = 1). Imaging tests were performed on all but one patients, and bone destruction was identified in 9 cases (42.68%). All eumycetoma cases were treated with itraconazole monotherapy or combined with fluconazole, terbinafine, or amphotericin B. Actinomycetoma cases were treated with sulfamethoxazole plus trimethoprim or combined with cycles of amikacin sulphate. Surgical procedures were performed in 9 (69.2%) eumycetoma and in 3 (37.5%) actinomycetoma cases, with one amputation case in each group. Clinical cure occurred in 11 cases (7 for eumycetoma and 4 for actinomycetoma), and recurrence was documented in 4 of 21 cases. No deaths were recorded during the study. Despite of the scarcity of mycetoma in our institution the cases presented reflect the wide clinical spectrum and difficulties to take care of this neglected disease.
Assuntos
Fungos/isolamento & purificação , Micetoma/epidemiologia , Micetoma/patologia , Nocardia/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Brasil/epidemiologia , Criança , Pré-Escolar , Desbridamento , Feminino , Fungos/classificação , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Micetoma/microbiologia , Micetoma/terapia , Resultado do Tratamento , Adulto JovemRESUMO
Abstract In some cases, keratoacanthomas can be indistinguishable from squamous cell carcinoma, making the gold standard treatment surgical excision with histopathological evaluation. The surgical defects created on the back of the hand can be challenging to repair. We describe the use of bilateral rotation flap as an option in this area, and discuss the indications and contraindications of some of the possible surgical techniques for reconstruction of the dorsum of the hand.
Assuntos
Humanos , Masculino , Idoso , Retalhos Cirúrgicos , Transplante de Pele/métodos , Dermatoses da Mão/cirurgia , Ceratoacantoma/cirurgia , Reprodutibilidade dos Testes , Resultado do TratamentoRESUMO
We describe the use of modified Tripier flap for reconstruction of a surgical defect in the lower eyelid region, after excision of nodular basal cell carcinoma.
Assuntos
Blefaroplastia/métodos , Carcinoma Basocelular/cirurgia , Neoplasias Palpebrais/cirurgia , Retalho Miocutâneo , Neoplasias Cutâneas/cirurgia , Carcinoma Basocelular/patologia , Neoplasias Palpebrais/patologia , Pálpebras/cirurgia , Humanos , Masculino , Ilustração Médica , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
Knowledge of the inverted "T" incision--used in plastic, oncologic and orthopedic surgery--has allowed its adaptation for the diagnostic assessment and therapeutical approach of acral, nodular lesions. The authors describe the use of this technique for the surgical approach of a patient with a plantar nodular lesion, further diagnosed as a calcified angioleiomyoma.