Wound healing re-provides the morphological integrity after trauma. We investigated the effects of Metoclopramide and Ranitidine on survival of flat template McFarlane skin flaps in an experimental wound healing model.Rats (n:32) were randomly allocated in following groups: Flap control (Control), Metoclopramide(MET), Ranitidine(RAN) and Metoclopramide+Ranitidine (MET+RAN). After flap elevation, ip 10 mg/kg Ranitidin or 5 mg/kg Metoclopramide or the combination of both drugs were administered for 3 days. Next analgesia was maintained. No additional drugs were used for controls. On 10th day, whole cut skin flaps were excised, fixed in buffered formaldehyde and processed with histological techniques. Paraffine sections were stained with Hematoxylen-Eosin, Mallory-Azan and immunohistochemically with Desmin and Fibronectin and then evaluated with light microscopy.Experimental groups showed differences for epidermal degeneration, edema, hypertrophy of the hair follicles, neutrophil infiltration and areolar degeneration. Metoclopramide or Ranitidine administration positively impacts wound healing.This unique study emphasizes the importance of considering Metoclopramide or Ranitidine for possible adverse effects on flap survival in surgical clinics, therefore the combination of both drugs is not more effective.

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The aesthetic and functional role of the human face can not be overemphasized. It is keystone in perception of self-identity and represents the most striking features of an individual's being. Being a place of concentration of major perceptive organs, like eyes, ears and nose, the face also has direct involvement in emotional and social communication. Facial disfigurements may present in different forms, varying from minor nuisances to severe debilitating problems. The main goals in reconstruction of severely deformed face include restoration of function, comfort and appearance. Nowadays we have plenty of surgical modalities to fulfill these tasks, including cadaveric face transplantation. However, neither of the procedures can be considered as fully consistent in terms of achievable results. Here we describe reconstruction of face by expanded supraclavicular flap. Two clinical cases are presented. We performed a three-stage reconstruction, which included implantation of tissue expander in supraclavicular area, subsequent transfer of a fasciocutanous flap onto the face, and finally, pedicle division of the flap with additional scar revision. A satisfactory fascial shape has been achieved. We believe that supraclavicular flap, prefabricated by expansion is a powerful tool for autologous reconstruction of face and can be successfully used in selected cases.

No abstract

Meier-Gorlin syndrome (MGS) is a very rare autosomal recessive primordial dwarfism disorder, characterized by microtia, patellar aplasia/hypoplasia, and a proportionate short stature. Typical facial characteristics during childhood comprise a small mouth with full lips and micro-retrognathia. Presence of cleft palate in these patients is usual condition. Due to associated congenital pulmonary emphysema and sudden cardiac death during anesthesia these patients present major perioperative challenges to anesthesiologist. We report successful anesthetic care in a 4-year-old male child diagnosed with Meier-Gorlin syndrome and admitted for repair of cleft palate. Because of dysmorphic features, we faced difficulties during intubation. Being a multisystem disorder, each patient of Meier-Gorlin syndrome requires meticulous preoperative evaluation and high level of intraoperative and postoperative continuous monitoring regardless of any surgical procedure. Presented case report highlights the significance of aggressive perioperative management in MGS which can result in successful outcome. As for additional features, it is worth to note that in our patient we didn't reveal short stature and patellar anomalies.