plastische, reconstructieve en esthetische chirurgie - UZ Leuven
plastische, reconstructieve en esthetische chirurgie - UZ Leuven
plastische, reconstructieve en esthetische chirurgie - UZ Leuven
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Unilateral glottic cancer and lateralizedchondrosarcomas of the cricoid cartilage are resectedwith a hemilaryngectomy including one-half of the cricoidcartilage. After tumor resection, a radial forearm flap witha skin paddle and a fascial paddle are tak<strong>en</strong>. The skinpaddle restores the laryngeal defect temporarily, and thefascial paddle wraps the upper 4 cm of cervical trachea.A 'tracheostomy' is preserved in the area betwe<strong>en</strong> thereconstructed larynx and the fascia-wrapped trachea.The radial forearm vessels are sutured to the neckvessels. After 4 months, the skin island of the radialforearm flap is removed from the defect and therevascularized, fascial <strong>en</strong>wrapped trachea istransplanted to the laryngeal defect. The trachealcontinuity is re-established with preservation of atracheostoma. The tracheotomy can be closed after 6weeks. Two case reports are pres<strong>en</strong>ted: a unilateral T3glottic cancer and a chondrosarcoma of the cricoidcartilage. The two pati<strong>en</strong>ts showed normal oral feeding 1week after the operation. Hand-free speaking waspossible after closure of the tracheostomy. Trachealautotransplantation after vascular induction of thetrachea with the radial forearm flap leads to optimalrepair of ext<strong>en</strong>ded hemilaryngectomy defects.HIERNER R.: Operative treatm<strong>en</strong>t of pressure sores: howand wh<strong>en</strong>? J. Wound Healing, 2005; 10: 110-123.Pressure sores still pres<strong>en</strong>ts a chall<strong>en</strong>ging problem ofdiagnosis and choice of treatm<strong>en</strong>t. Nowadays defectclosure alone is not suffici<strong>en</strong>t to fulfil the criteria ofsuccessful defect reconstruction, which are as follows: 1)complete wound closure, 2) persist<strong>en</strong>t wound closure, 3)functional reconstruction allowing early mobilization, 4)acceptable l<strong>en</strong>gth of time for rehabilitation (and return tonormal life), and to a lesser degree 5) acceptableesthetic result. Successful treatm<strong>en</strong>t requires a globaltherapy concept based upon: 1) basic (plastic) surgicalprinciples, 2) defect-related factors, 3)- therapy relatedfactors, and 4) pati<strong>en</strong>t-related factors. The global therapyconcept is delivered by a multidisciplinary therapy-team(surgeon, nurse staff, physiotherapist, occupationaltherapist, social service...).HIERNER R., BECKER M., BERGER A.: Indications andresults of operative treatm<strong>en</strong>t in birth-related brachialplexus injuries. Handchir. Mikrochir. Plast. Chir., 2005; 37:323-331.Introduction: A review of the literature reveals that underconv<strong>en</strong>tional treatm<strong>en</strong>t alone or in combination withsecondary muscle/t<strong>en</strong>don transfer about 4 to 43% ofcases show incomplete recovery with severe functionaland/or aesthetic impairm<strong>en</strong>t. If those pati<strong>en</strong>ts underw<strong>en</strong>tearly microsurgical brachial plexus revision areg<strong>en</strong>eration without any significant functional and/or