CPR- Artigos
Permanent URI for this collection
Browse
Recent Submissions
- Eosinophilic cistitis. A rare cause of dysuriaPublication . Piedade, C; Ramos, M; Heitor, F; Castro, L; Ochoa de Castro, A
- A microcirurgia em reconstrução mamária: o retalho livre miocutâneo do recto anterior do abdoménPublication . Freire dos Santos, MJ
- Paralisia facial: técnicas de reconstrução neuro-muscularPublication . Gomez, MM; Pereira, H; Gomes da Silva, A; Rego, JM; Almeida, MASeveral surgical procedures have been proposed through the years for the treatment of facial paralysis. The multiplicity and diversity of techniques portray the complexity and challenge represented by this pathology. Two basic dynamic options are available: -Reconstruction of nerve continuity through direct micro suture, with interposition grafts or nerve transpositions. -Regional muscular transposition, most often using the temporalis. Facial reanimation with the temporalis transfer has withstood the test of time and still is a reference technique. In a few weeks, good results can be obtained with a single and rather simple surgical procedure. Functional free flaps have been used with increasing frequency in the last two decades, most often combining a cross-facial nerve graft followed by a gracilis free flap nine months later. With this method there is a potential for restoration of spontaneous facial mimetic function. Apparently there is a limit in microsurgical technique and expertise beyond which there is no clear improvement in nerve regeneration. Current research is now actively studying and identifying nerve growth factors and pharmacological agents that might have an important and complementary role in the near future.
- Necrólise Epidérmica Tóxica (Síndrome de Lyell): uma patologia para as Unidades de QueimadosPublication . Cabral, L; Diogo, C; Riobom, F; Teles, L; Cruzeiro, CToxic Epidermal Necrolysis (Lyell's syndrome) is a rare but very serious dermatological lesion, characterized by the sudden onset of high fever, signs of systemic toxicity and intense mucocutaneous exfoliation. Its pathophysiology is not yet well determined, although it is almost consensual the presence of an immunological basis. It appears usually as an answer to the taking of a given drug, and, in spite of being self-limited in the absence of complications, if not well managed it is associated with great morbidity and a high mortality, due, in most cases, to the developing of sepsis. Treatment includes mainly the immediate suspension of the inducing drug and the precocious admission of the patient in a hospital facility with the capacity to provide intensive support care and to minimize the infectious risk, having also the conditions for the execution of surgical debridement and covering of the affected areas, that is to say in Burn Units. There are in study several therapeutical measures designed to lower the morbidity and mortality of this syndrome, namely the use of plasmapheresis; the administration of high doses of N-acetylcysteine; immunosuppression; hyperbaric oxygen, etc. The authors present the treatment protocol in use at the Coimbra Burns Unit, in Portugal, illustrated with a clinical case from that Unit