Bilateral ligation of external carotids and ethmoidal arteries proved successful in controlling severe recurring epistaxis in a 13-year-old patient with Bernard-Soulier syndrome. In this child, epistaxis was the major bleeding symptom. Despite massive substitutive therapy, the patient suffered several life-threatening episodes of hypovolaemic shock. Although epistaxis is not reported as a cause of death in patients with haemostasis defect, our case might suggest that in selected cases with inherited platelet defect and intractable epistaxis so severe as to make normal or near-normal life impossible, surgical treatment could be considered.

Burns are an important public health problem. [1] In Brazil, it is estimated that they are the cause of approximately 1,000,000 accidents per year. Of these, 100,000 patients will require hospital care, and about 2,500 will die directly or indirectly as a result of their injuries. [2] One of the best ways to treat burn patients is by the use of allografts, which remain the biological dressing of choice and are an important tool. In many cases they can be used for the effective reconstruction of the dermal component. [3] Although allografts are primarily used in the treatment of severe burns, they can also be used for many indications, including extensive skin loss, surgical wounds, lower limb ulcers, pyoderma gangrenosum of diabetic feet and bullous diseases. In addition to serving as a barrier against infection, allografts serve as a temporary biological dressing to help control pain, protect deep structures, promote re-epithelialization and restore the important functions of the skin such as thermal regulation and

-Background -Insulinoma is a pancreatic neuroendocrine tumor originated from pancreatic islet beta cells. Although rare, is the most common pancreatic endocrine tumor, with about four cases per million people.

OBJETIVO: Avaliar a cicatrização da ferida incisional da parede abdominal de ratos hepatectomizados quanto à concentração de colágeno, reação inflamatória e angiogênese. MÉTODOS: Utilizaram-se 48 ratos distribuídos aleatoriamente para laparotomia com e sem hepatectomia. As cicatrizes foram estudadas no 3º, 7º e 14º dia de pós-operatório. Analisou-se a densidade do colágeno por método histoquímico e a angiogênese por método imunohistoquímico. RESULTADOS: A análise do colágeno total mostrou menor concentração no plano da pele e da tela subcutânea, nas cicatrizes abdominais do grupo experimento (p3=0,011; p7=0,004 e p14=0,008). A densidade de colágeno I foi inferior no grupo hepatectomizado, principalmente no 3º dia, tanto na pele e tela subcutânea (p=0,038) quanto no plano aponeurótico (p=0,026). Houve menor concentração de colágeno III nos dois planos estudados, embora não significante. A resposta inflamatória foi semelhante em todos os tempos, nos dois grupos. Verificou-se que a angiogênese desenvolveu-se mais precocemente no grupo controle (p3=0,005 e p7=0,012) e mais tardiamente no grupo experimento (p14=0,048). CONCLUSÃO: A hepatectomia leva ao atraso do processo cicatricial, interferindo na síntese do colágeno e na angiogênese.

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