Mycobacterium ulcerans ulcers: a proposed surgical management algorithm.

Mycobacterium ulcerans (MU) is the third common mycobacterial infection after tuberculosis and leprosy. In endemic areas, MU ulcers should be considered in the differential diagnosis of any unusual or nonhealing lesion or ulcer. Diagnosis and treatment should be instigated promptly.

Fascial suspension mastopexy.

Background: The objective of this study was to assess a new procedure for breast mastopexy, fascial suspension mastopexy.

Methods: Between December of 2001 and July of 2004, 52 patients (102 breasts) underwent fascial suspension mastopexy. Sixteen women had grade 1 ptosis (30 percent), 31 had grade 2 ptosis (60 percent), two had grade 3 ptosis (4 percent), two (4 percent) had breast asymmetry and underwent unilateral mastopexy, and one had pseudoptosis (2 percent).

Can aesthetic facial reconstruction be judged in black and white?

Aesthetic considerations of the face need to be evaluated in real-life full color. Staged contouring and insetting of a transferred free flap is sometimes required. This consists of debulking, thinning, and reshaping the flap.

Simple technique for inverted nipple correction.

Several different techniques have been developed and currently are in use for correction of the inverted nipple. The diversity of techniques indicates the lack of a good, sustainable, and durable solution for this quite common problem. This report discusses a new technique in which two flaps are inserted beneath the nipple through a small tunnel.

Use of the SpaceMaker balloon dissector for repair of sacral pressure sores.

Most of the techniques that have been suggested for closure of sacral pressure sores use musculo-cutaneous flaps. We report our experience in three patients using the SpaceMaker balloon dissector. The dissector was inserted into the subgluteal maximus muscle plane to expand the muscle and overlying skin, thereby forming bilateral sliding and tension-free musculocutaneous flaps.

Palatal rotation-advancement flap for delayed repair of oroantral fistula: a retrospective evaluation of 63 cases.

Objective: To review our 17-year clinical experience with delayed oroantral fistula repair by palatal rotation-advancement flap, and to report its advantages, disadvantages, and complications.

Study Design: The records of 63 patients with late oroantral fistula treated by palatal rotation-advancement flap from 1984 to 2002 were reviewed. Eleven had undergone unsuccessful closure with a buccal flap.

[Diffuse lichen sclerosus et atrophicus involving the palms].

Lichen sclerosus et atrophicus (LSA) is an extremely rare condition which usually involves the genitalia. There are sporadic reports of diffuse LSA with hand involvement apparently the rarest. Although the clinical course of the disease is often benign, there may be widespread lesions, disabling joint contractures, and cutaneous malignancies.

Breast-areola-nipple proportion.

Studies of breast volume and size have failed to take into account the aesthetic value of the nipple-areola-breast proportion. These data are important to plastic surgeons in planning breast reduction, augmentation, and reconstruction. In the current study, the anatomic size of the nipple, areola, and breast was measured in 37 women aged 20 to 64 years, and their proportions were calculated.

Rotation flap of the anterior rectus abdominis sheath for hernia prevention in TRAM breast reconstruction.

Prevention of hernia or bulge of the abdominal wall after TRAM breast reconstruction has been a challenge for the reconstruction surgeon. Different techniques have been described to avoid this complication. The use of anterior rectus abdominis sheath (ARAS) for the repair of various abdominal wall hernias has been well described in the literature and is the basis of the authors' technique.

Role of physicians and patients in the diagnostic delay of cutaneous malignant melanoma.

The incidence of cutaneous malignant melanoma is increasing constantly. The most accurate prognostic factor of primary melanoma is thickness of the lesion according to Breslow. Information and screening campaigns for early diagnosis of melanoma are based on the assumption that tumor thickness is the consequence of a delay in diagnosis.

Subdermabrasion in the treatment of post-burn facial hypertrophic scars.

Hypertrophic scars cause great discomfort to the patient and pose a challenge for the reconstructive surgeon. This is particularly true in the facial area. Optimal function and aesthetic appearance are the main goals of reconstruction.