Urs Hug

Integra® zur einzeitigen Defektdeckung nach Tumorresektion im Gesichtsbereich

BACKGROUND In 2010 excellent aesthetic results after basal cell carcinoma excision and one-stage coverage with Integra without split thickness skin graft (STSG) were published in a series of 10 Asian patients. Our aim in this study was to verify these results in a series of Caucasian patients and evaluate this procedure as a possible new standard. PATIENTS AND METHODS 6 patients with facial basal cell carcinoma were treated by regular excision with 3 mm safety margins and one-stage coverage with Integra without STSG, followed by a clinical evaluation and fotodocumentation. RESULTS In 3 patients local infection occurred with a complete loss of the Integra. 2 out of these 3 patients showed an unaesthetic scar and are considering another surgical approach for correction. The other 3 patients had an uneventful course, unfortunately 2 out of these patients (67%) developed an unaesthetic scar as well and are also considering surgical correction. CONCLUSION Because of aesthetically unsatisfactory results and high infection rates we abandoned this procedure after 6 patients only. Our standard remains excision with 3 mm safety margins, histological analysis and one-stage repair with local facial flaps.

Der interessante Fall: einseitige Hypoplasie der Brust bei Becker Nävus Syndrom

The Becker nevus syndrome is defined by the association of a Beckers nevus with ipsilateral breast hypoplasia and/or musculoskeletal disorders. There are only a few dozen case reports in the literature. We here present the case of a 20-year-old female patient who was treated in our clinic due to a breast asymmetry.

The hand injury caused by cutting avocado in 18 patients

Adel E, Shahram N, Reza TD, Salim K. Spontaneous radial nerve palsy subsequent to non-traumatic neuroma. Trauma Monthly. 2013, 18: 98–100. Burns J, Lister GD. Localized constrictive radial neuropathy in the absence of extrinsic compression: three cases. J Hand Surg Am. 1984, 9: 99–103. Qi HT, Wang XM, Li SY et al. The role of ultrasonography and MRI in patients with non-traumatic nerve fascicle torsion of the upper extremity. Clin Radiol. 2013, 68: e479–83.

Becker nevus syndrome and ipsilateral breast hypoplasia: a systematic literature review

Although the Becker nevus syndrome (BNS) is primarily defined as a Becker nevus (BN) in association with ipsilateral breast hypoplasia or musculoskeletal malformation, there are case reports about various associated malformations. The purpose of this study was to identify and analyze the common manifestations of the BNS. We conducted a systematic literature research about BNS and reviewed all available literature. In order to get an overview of the clinical manifestation, we analyzed all case reports by descriptive statistics. The most common manifestation of a BNS is breast hypoplasia, followed by musculoskeletal malformation and scoliosis. The regional correspondance between the skin manifestation and the malformation was strong for breast hypoplasia, musculoskeletal malformation, maxillofacial dysplasia, and lipodystrophy. Not all of the reported malformations are likely to be a manifestation of the BNS. By far, the most commonly described malformation is ipsilateral breast hypoplasia. Therefore, we would like to enhance the awareness of this syndrome among plastic surgeons.Level of Evidence: Not ratable.

The Vilkki Procedure as an emergency treatment in an apocalyptical hand injury – a case report and first description

Abstract We describe a young man who suffered a severe mutilating injury of the hand and forearm while working as a cheesemaker. He underwent a complex reconstruction of his right adominant hand including a heterotopic thumb replantation into the distal radius and combined with an emergency flow-through anterolateral thigh flap.

Immobilisierendes malignes Cystosarcoma phylloides der Brust

Cystosarkome der Brust sind seltene Tumoren, die aber enorme Ausmasse erreichen konnen. Tumoren, die eine Grose erreichen, dass die betroffene Frau infolge des Cystosarkomes immobilisert ist, sind aber selbst bei diesem Tumor in der Literatur eine grose Ausnahme. Wir prasentieren einen Fall eines ausgedehnten, uber Jahre gewachsenen Cystosacoma phylloides, das eine Grose und ein Gewicht erreicht hat, sodass die Patientin uber ein halbes Jahr immobilisert das Krankenbett nicht mehr verlassen konnte.