CONTEXT: Anthrax is a very rare disease in Europe and the United States. AIM: A case of cutaneous anthrax of the hand with a wide skin defect is presented and some clinical observations highlighted. CASE REPORT: A 56-year-old male patient with cutaneous anthrax attended our infectious diseases department with a swelling up to the upper arm. An urgent fasciotomy was undertaken with a diagnosis of compartment syndrome. A black eschar had formed on the dorsal surface of the hand. A superficial tangential escharectomy was performed. RESULTS: Viable fibrous tissue, about 4 to 5 mm in thickness over the extensor tendons, was found under the eschar. At the postoperative 2-year follow-up, remarkable healing was observed via skin grafting. CONCLUSIONS: Hand surgeons should be cautious against the compartment syndrome that may accompany cutaneous anthrax of the hand. A consistent viable fibrous tissue can be found below the eschar. The mechanism for the involvement of the hand dorsum needs further concern.
Defects in the soft tissues of the nose are usually reconstructed with skin grafts or frontal flaps. However, skin grafts may cause scar tissue and changes in colour. Frontal flaps, however, may be thicker than normal skin and may give unsatisfactory results. Nasalis musculocutaneous V-Y advancement flaps avoid these disadvantages. We suggest an algorithmic approach for the use of these flaps in the reconstruction of small to medium defects in the soft tissues of various regions of the nose. The pedicles of these flaps are the dorsal and lateral nasal arteries. This approach provides a simple, safe, and reliable reconstruction for small and medium defects in the soft tissues of the nose.
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