Fibrous dysplasia is an uncommon genetic disorder in which bone is replaced by immature bone and fibrous tissue, manifesting as slowgrowing lesions. Sporadic post-zygotic activating mutations in GNAS gene result in dysregulated GαS-protein signaling and elevation of cyclic adenosine monophosphate in affected tissues. This condition has a broad clinical spectrum, ranging from insignificant solitary lesions to severe disease. The craniofacial area is the most common site of fibrous dysplasia, and nine out of 10 patients with fibrous dysplasia affecting the craniofacial bones present before the age of 5. Surgery is the mainstay of treatment, but the technique varies according to the location and severity of the lesion and associated symptoms. The timing and indications of surgery should be carefully chosen with multidisciplinary consultations and a patient-specific approach.
Scar formation is a natural, physiological response to the healing of damaged tissue. However, abnormal or disturbed collagen synthesis can cause skin texture irregularities, such as depression. Scar treatments should improve both functional and aesthetic aspects of the scarred area to optimize patient satisfaction. Plastic surgeons use surgical, nonsurgical, and multimodal strategies to treat scars, which begin with an accurate understanding of the characteristics of the scar, as well as the patient's needs. Depressed scars may occur when the injured tissue is replaced by scar tissue, which causes adhesion and tethering between the overlying skin and the underlying tissues, such as muscle or fascia. The main technique used to resolve depressed scars is to disrupt the connection between the skin and underlying tissue and to prevent re-adhesion [1,2]. However, many patients present with combined scar problems. In such cases, making an additional skin incision over a depression site is considered to be uneconomical. Therefore, we used de-epithelialized scar tissue of the widened scar portion as a transposition flap to fill under the depressed area for volume augmentation and to prevent re-adhesion.
Background: Chronic wounds of the lower extremities are challenging to treat. Recently, honey-based dressings have been shown beneficial effects in diabetic foot ulcers and venous ulcers. Here, we compared Medihoney alginate with a standard alginate dressing in lower extremity chronic wounds.Methods: We performed retrospective chart reviews of 37 patients between January 2019 and January 2021 with chronic lower extremity wounds who were treated with an Algisite M dressing (group A) or a Medihoney alginate dressing (group B). Microorganisms isolated from wound cultures, weekly decrease in wound area over 4 weeks, the number of patients who achieved complete wound closure, and the amount of time required for wound closure were compared between the two groups. Results: Sixteen patients were assigned to group A and 21 to group B. The isolated microorganisms were confirmed as methicillin-susceptible Staphylococcus aureus most commonly, followed by methicillin-resistant S. aureus. Wound area decreased from 12.71 to 2.34 cm<sup>2</sup> in group A and from 14.07 to 1.71 cm<sup>2</sup> in group B (P<0.05). Seven patients achieved complete wound closure in group A (43.75%) and 15 patients in group B (71.43%). Mean duration of wound closure was 36.31 days in group A and 34.62 days in group B.Conclusion: Considering the more rapid decrease in wound area in group B, application of a honey-containing alginate dressing to lower extremity chronic wounds, especially those infected with antibiotic-resistant bacteria, was proved to be a good treatment option.
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