Objective: To study the frequency of application of various types of skin flaps in patients with consequences of extensive burns of the neck and chest area. Methods: The experience of surgical treatment of the consequences of burns in the neck and chest area was studied in 17 patients with extensive lesions. All patients underwent excision of scar-modified tissue, with the subsequent covering of the formed defect with free or non-free flaps from other anatomical zones. Surgical treatment was performed only with hypertrophic scars; the presence of keloid scars was the criterion for excluding the patient from the study group. Results: The use of non-free flaps yielded the best results due to aesthetic acceptability and coverage of large defects in the covering tissues of the neck and chest region. Full-thickness dermal grafts taken from the inguinal region, as well as from various areas of the upper limb, showed themselves to be more aesthetically justified, but their use allowed them to cover only defects of small and medium size. Despite the fact that the use of different types of non-free flaps allowed to cover defects of large sizes, the aesthetic result of their application in seven patients (41.2%) was relatively satisfactory, in view of the extensive lesions and residual consequences. Conclusion: With defects in the neck of small and medium sizes, the use of free and non-free flaps is justified and has an optimal aesthetic result. Further research should be aimed at finding new varieties of flaps with minimal donor damage or other means of cover in cases of extensive post-burn defects in other anatomical areas involving potential donor zones Keywords: Full-thickness flaps, vascularized flaps on the leg, post-burn scars of the neck and chest.
Objective: To analyze the results of application of the two surgical techniques in the treatment of the consequences of urethral injuries (CUI). Methods: 38 patients aged 16.4±1.9 years with CUI were examined. CUI were localized in the area of the scaphoid fossa (n=3), the penile part (n=9), the bulbous region (n=6). Multi-site and panurethral lesions were noted in 8 and 12 cases, respectively. Additional research methods included ultrasound examination of the bladder, uroflowmetry, residual urine measurement, and, if necessary, retrograde and voiding urethrography. The patients underwent two types of surgical intervention: one-stage (16 patients, 1st group) and two-stage (22 patients, 2nd group) urethroplasty using a buccal mucosal flap. The results of surgery were assessed by ascending urethrography and uroflowmetry. The follow-up period ranged from 6 to 24 months. Results: The immediate and long-term results between the two groups showed significant difference. According to uroflowmetry data, the main indicator of the effectiveness of surgical intervention was a stable retention of maximum urine flow rate at least 15 ml/sec. In the 1st group, there was one case of early wound dehiscence with the formation of a fistula. In the 2nd group, early divergence was observed in 8 cases, it was also accompanied by formation of fistulas. These complications required additional surgical intervention; their correction was deferred. Conclusion: One-stage urethroplasty using a buccal mucosal flap for CUI proved to be safer and more effective compared to the two-stage technique Keywords: Consequences of urethral injury, urethrography, uroflowmetry, buccal flap.
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