Ali Mojallal

Prise en charge chirurgicale des nécroses cutanées dans le purpura fulminans : à propos de 2 cas cliniques

Resume Les auteurs rapportent leur experience dans la prise en charge de 2xa0patients atteints de purpura fulminans. Apres un rappel de l’epidemiologie, des methodes diagnostiques, de l’evolution naturelle et du pronostic de la maladie, les sequences therapeutiques sont decrites. L’urgence du traitement medical est soulignee et les specificites techniques de l’abord chirurgical axees sur le derme artificiel sont precisees. Les auteurs insistent sur la qualite de la prise en charge initiale et sur le fait que ces destructions cutanees etendues et profondes sont au mieux prises en charge dans les centres de traitement des brules.

Autologous Breast Reconstruction Using Muscle Sparing Latissimus Dorsi Flap and Fat Grafting

Autologous breast reconstruction using muscle sparing latissimus dorsi flap (MSLD) combined with fat grafting is a new surgical technique that minimizes consequences to the donor site as much as possible. Its main special feature is the harvest of an anterior 3 cm muscle band from the latissimus dorsi muscle, on the descending branch of the thoracodorsal pedicle, where reliability has been assessed through a prior anatomic and radiological study. Its main advantages are the morbidity reduction at the donor site, full function retention in the latissimus dorsi muscle, a better post-operative physical recovery for the patient and a greater freedom of movement in the skin paddle of the flap. Combining this technique with fat grafting means that breast reconstruction can be performed to a satisfactory size in a pure autologous manner without having to use an implant.

Lateral Intercostal Artery Perforator Flap: Use in the Treatment of Breast Tumorectomy Sequelae

Lateral breast defect after partial mastectomy is a difficult challenge. Pedicled perforator flap is a new indication for breast surgery. Perforator flaps and fat tissue transplant are new concepts in this kind of reconstruction. Lateral intercostal artery perforator (LICAP) flap has been used for a lot of indications. It can be used for lateral breast defect reconstruction. This flap provides several advantages: minimal donor site morbidity, advantages in flap shaping, better aesthetic results and higher patient satisfaction. The aim of this chapter is to present the technique of LICAP flap and discuss its indications and advantages and its limits in lateral breast reconstruction after partial mastectomy. LICAP flap provides a new solution instead of conventional flaps.