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EN
The aim of the study was clinical evaluation of the results following reconstruction with the Indian flap in patients with partial nasal defects, and estimation of their postoperative life quality in functional and aesthetic aspects. Material and methods. We analyzed results in 38 patients who underwent reconstructions with the Indian flap in the Department of Plastic, Reconstructive and Aesthetic Surgery between years 2000‑2013. The patients were followed-up for at least 2 years. We estimated their life quality in aesthetic and functional aspects after surgery. Results. Observed complications of nasal reconstruction were alar asymmetry in 6 patients (15.8%), nasal obstruction in 6 persons (15.8%), wide postoperative scar in 4 (10.5%), and non-aesthetic appearance of the donor site in two cases (5.3%). Estimation of life quality post surgery in the examined group of patients revealed significant postoperative improvement in both functional and aesthetic aspects. Conclusions. 1. Reconstructions of nasal defects with the Indian flap resulted in satisfactory longterm postoperative results, which confirms the efficiency of the applied technique. 2. Reconstructive surgery with Indian flap of individuals with partial nasal defects contributed to significant postoperative improvement in both functional and aesthetic aspects and their life quality.
EN
Aims. Presenting our clinical experience with the postauricular island flap (pif) and estimation of the results following partial external auditory canal (eac) and/or auricular conchal bowl reconstructions with pif in patients after carcinoma resections. Methods. We have analyzed postoperative results of 19 patients after auricular conchal bowl (11), or auricular conchal bowl and eac (8) reconstructions with pif, following malignant tumor resections, between 2000-2015. The patients were reexamined and evaluated in respect of early and long-term results after surgical treatment considering both the plastic surgeon’s and the patient’s opinion. Results. The cancers were completely excised in all patients, and there were no recurrences within at least 2 years of follow-up. The observed complications after reconstructions comprised venous congestion in five cases (26.3%), pinning of the operated ear in four patients (21%), prominent earlobe in three (15.8%), and eac constriction in three cases (15.8%). The postoperative result was very good in all cases (both in the opinion of the plastic surgeon and the patients), except for patients with pinning of the operated ear, with a prominent earlobe (moderately satisfied). Conclusions. 1. Combined operations involving postauricular island flap reconstructions after partial (external auditory meatus and/or auricular conchal bowl) resections allowed for complete removal of malignant tumors with no evidence of recurrence, and for the preservation of a proper conchal shape in the reconstructed ear. 2. A retroauricular approach in cases with cancer involvement of the external auditory meatus allowed for proper visualization and estimation of lesions extent, as well as adequate surgical access.
EN
Dehiscence of a median sternotomy wound is a potentially devastating and life-threatening complication of cardiac procedures.Depending on the localization, extensiveness, and profoundness of the defect a variety of muscle flaps may be used to cover the frontal mediastinum, in particular: pectoralis major, rectus abdominisor latissimus dorsi. In spite of several options for restoration of sternal integrity we cannot avoid following serious local complications increasing patients morbidity. The aim of this paper is to report a method of sternal dehiscence management. Surgical technique and its results are presented on the example of two patients treated in Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University in Łódź because of sternal dehiscence after cardiovascular procedure with sternotomy. Our experience indicates that modified bilateral pectoralis major flap seems to be effective surgical method of sternal dehiscence treatment. Also it is worth to remember that surgical procedure in this complication should be performed as soon as possible to decrease patient’s disability and to avoid following complications
PL
Cel: Przedstawienie klinicznego doświadczenia z zastosowania wyspowego płata zamałżowinowego (Postauricular Island Flap; PIF) oraz ocena wyników rekonstrukcji przewodu słuchowego zewnętrznego (External Auditory Canal; EAC) i/lub muszli małżowiny usznej tą metodą u pacjentów po wycięciu złośliwej zmiany nowotworowej tej okolicy. Materiał i metody: Analizie poddano łącznie 19 chorych po wycięciu raka z zastosowaniem PIF (2000–2015) – 11 pacjentów po rekonstrukcji muszli małżowiny usznej, 8 pacjentów po rekonstrukcji muszli wraz z EAC. Oceniono wczesne i odległe wyniki leczenia operacyjnego. Porównano opinie chirurga i pacjenta. Wyniki: U wszystkich badanych zmiany wycięto w całości, nie stwierdzając wznowy w ciągu min. 2 lat obserwacji. Przekrwienie bierne wystąpiło u 5 chorych (26,3%), nadmierne przyleganie małżowiny usznej u 4 pacjentów (21%), u 3 chorych (15,8 %) zauważono odstawanie płatka, a u 3 osób (15,8%) zwężenie EAC. Wyniki pooperacyjne były bardzo dobre u wszystkich pacjentów (tak w ocenie chirurga, jak i chorych), za wyjątkiem pacjentów z nadmiernym przyleganiem małżowiny usznej i z odstawaniem płatka, u których oceny były satysfakcjonujące. Wnioski: 1) Operacje po wycięciu guza przewodu słuchowego zewnętrznego i/lub muszli małżowiny usznej połączone z rekonstrukcją wyspowym płatem zza małżowiny usznej pozwoliły na doszczętne wycięcie zmian (bez oznak wznów) oraz zachowanie właściwego konturu muszli operowanej małżowiny usznej. 2) Zastosowanie dostępu w okolicy zamałżowinowej u chorych z rakiem umiejscowionym w obrębie przewodu słuchowego zewnętrznego pozwoliło nie tylko na właściwą wizualizację i ocenę rozległości tych zmian, ale także stworzyło dobre dojście do pola operacyjnego.
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