Treatment of Epidermolysis Bullosa and Future Directions: A Review.

Epidermolysis bullosa (EB) comprises rare genetic disorders characterized by skin and mucosal membrane blistering induced by mechanical trauma. Molecularly, pathogenic variants affect genes encoding proteins crucial for epidermal-dermal adhesion and stability. Management of severe EB is multidisciplinary, focusing on wound healing support, ensuring that patients thrive, and complication treatment.

Mangled upper extremity: Our strategy of reconstruction and clinical results.

The management of mangled upper extremity is very challenging because the anatomical complexity of the region, the large number of possible involved anatomical elements, and the necessity of obtaining a good functionality. The impressive development of microsurgical techniques in the last decades contributed a lot to the salvage of several extreme injuries with mangled extremities considered untreatable in the past. Such injuries can nowadays be successfully managed by means of replantation/revascularization or complex reconstruction by using simple or complex microsurgical flaps.

Lower limb replantation: 27 years follow up.

Replantation of lower extremity is a very complex and difficult procedure. There are still a lot of controversies about indications, even numerous scoring systems are now available that can facilitate the surgeon's decision. We present the functional results of a replanted below-knee amputation in an elderly patient, 27 years after the injury and discuss the indication for replantation.

Why, when and how propeller perforator flaps in reconstructive surgery.

Purpose: The aim of this paper was to evaluate the outcomes of propeller perforator flaps used all over the body, and to appreciate their advantages and/or disadvantages over the free perforator flaps.

Method: Patients that required propeller perforator flaps used all over the body were eligible to participate in this study. A preoperative Doppler examination was performed for all the flaps in the trunk and thigh, but not regularly in the face, lower leg, foot, forearm and hand.

"Close-open-close free-flap technique" for the cover of severely injured limbs.

The treatment of severely injured extremities still presents a very difficult task for trauma orthopaedic surgeons. Despite improvements in technology and surgical/microsurgical techniques, sometimes a limb must be amputated, otherwise severe and potentially fatal complications may develop. There is a well-established belief that severe open fractures should be left open.

Propeller perforator flaps in forearm and hand reconstruction.

After a long history in flaps' surgery, the perforator flaps became the most used flaps nowadays. From the beginning, their use as free flaps diminished substantially the donor site morbidity. In the attempt to not only diminish the donor site morbidity, but also to achieve more similar reconstructions, a new concept appeared 20 years ago: local perforator flaps.

Carotid artery in-stent restenosis in a patient with contralateral total occlusion, resolved with drug-eluting stenting.

A 70-year-old male patient with 90% stenosis of the right carotid artery and total occlusion of the left carotid artery underwent right carotid stenting. Two weeks after the procedure, the patient experienced grand mal seizures, and had angioplasty after 6 and 11 months, respectively, for recurrent in-stent restenosis. During drug-eluting stent deployment, the patient developed acute stent thrombosis, but he recovered quickly and completely after local thrombolysis and balloon angioplasty.