No abstract

The aim of this study was to evaluate morphological characteristics of pressure ulcers, methods of surgical treatment and its effectiveness in the Clinic of Plastic and Reconstructive Surgery of Kaunas University of Medicine Hospital. Material and methods. A retrospective data analysis of 139 patients with pressure ulcers treated in the Clinic of Plastic and Reconstructive Surgery, Kaunas University of Medicine Hospital, from January 1996 to January 2007 was performed. Results. A total of 139 patients were surgically treated for pressure ulcers at the Clinic of Plastic and Reconstructive Surgery, Kaunas University of Medicine Hospital, from January 1996 to January 2007. Eighty-one patients were treated repeatedly (from 1 to 7 admissions; M=1). Pressure ulcers were healed completely in 94 patients who underwent surgery during the treatment in the hospital; in 45 patients who underwent surgical treatment, pressure ulcers were partially healed, and on discharge from hospital, only small wounds were left. Pressure ulcers most commonly occur in tuber ischii area (69 cases). The mean age of patients was 42±13.65 years (M=31); pressure ulcers were for 8.9±8.5 months on average (M=31). At admission to Kaunas University of Medicine Hospital, the mean size of pressure ulcers was 42.62±53.27 cm2 (M=10). The results showed that the size of pressure ulcers depends on the duration of paraplegia (P<0.05). In 93 cases, pressure ulcers were treated using myocutaneous flaps; 17 of them were closed with V-Y advancement technique over the sacral area, 35 were closed with m. gluteus rotation flap, and in 41 cases, V-Y advancement technique using hamstring flaps was used. Conclusions. In patients with paraplegia, the first pressure ulcer occurs after 74.79±61.34 months from the onset of the disease. Pressure ulcers most commonly occur over tuber ischii area. The most effective surgical treatment of pressure ulcers is closure of the wound using myocutaneous flaps (use of the hamstrings); fasciocutaneous flaps were the most commonly used method in patients who underwent surgery for the second time.

Hands actively participate in daily activities of a human; therefore, hands are the most vulnerable parts of the human body. People injure hands so often because namely hands are in the closest position to the dangerous equipment. According to the data of various authors, the injuries of hands and fingers make even 30–75% of all industrial traumas, and burns of hands account for about 6% of all traumas of hands. The aim of the study was to compare the effectiveness of active surgical treatment method with conservative treatment method, applied for the treatment of deep dermal partial skin thickness burns of the hands, wrists, and forearms of distal third. Materials and methods. A total of 49 patients with burned hands participated in the perspective study of random sample (totally 79 hands). All these patients were treated in the Department of Plastic and Reconstructive Surgery, Hospital of Kaunas University of Medicine, during the period of 2001–2005. The patients were assessed after 3, 6, and 12 months. Results. Applying conservative method of treatment of deep partial skin thickness burns, the frequency of infectious complications was increased. In order to evaluate the state of scar, we applied the scale of Vancouver and analyzed the pigmentation of a scar, its height, flexibility, and color. After statistical analysis had been performed, we determined that more changes of skin were seen in the group, which received active surgical treatment (P<0.05). Conclusions. Statistically significantly fewer complications were in the group of active surgical treatment in the early (fewer infectious complications, smaller area of unnaturalized autograft) and in the late (scars were less rough, with less changes of pigmentation) postoperative periods

No patient who had no micrometastases in sentinel lymph nodes developed local and distant CSCC metastases during the follow-up period. Our report supports the concept that SLNB can be applied for CSCC. It is obvious that larger prospective studies with longer follow-up period are needed to establish the efficacy of SLNB and define the optimal treatment of occult nodal metastasis for CSCC.

Using two different early-stage cutaneous melanoma management techniques significantly more sentinel lymph nodes (p = 0.006) were detected using the two-stage surgery approach. However, there was no significant difference between the two approaches regarding the number of sentinel lymph nodes with micrometastases that were detected and excised.