Introduction/Objective. A pressure ulcer is a localized injury to the skin and/or underlying tissue, usually over a bony prominence. It appears as a result of pressure or combination of pressure and shear. Pressure ulcers can be identified within a wide variety of patient subpopulations and a major role in their treatment plays epidemiological and etiological aspects. Methods. A retrospective study of data analysis included 72 patients with pressure ulcers that were hospitalized and surgically treated during a five-year period at the Clinic for Burns, Plastic and Reconstructive Surgery of the University Clinical Center of Serbia in Belgrade. Main data features used in the analysis were: gender, age, principal diseases, comorbidities and biochemical indicators of malnutrition. The patients' data was obtained from the existing patients? records. Additionally, the study analyzed the method of treating pressure ulcers, types of reconstructive methods in surgical treatment, as well as the incidence rate of partial osteotomy. Results. A total of 72 patients with pressure ulcers were included into this study with 54.7 ? 16.1 mean age. Three times more patients injured in traffic accidents were male (75% vs. 25%), while the most of the patients with multiple sclerosis were female (85.7%). More than 95% of patients who had pressure ulcers of III or IV stage were treated surgically with a reconstructive method of transposition or rotation myocutaneous flap. The patient with pressure ulcer of stage IV was usually treated with partial osteotomy. Conclusion. A surgical reconstructive treatment with fasciocutaneous and myocutanaeous flaps represents a gold standard for treating patients with pressure ulcers. These procedures provide reconstruction with adequate flap coverage and obliteration of dead space with well-vascularized tissue but with necessity of further implementation of antidecubitus measures.
1 Klinika za opekotine, plastičnu i rekonstruktivvnu hirurgiju KC Srbije 2 Medicinski fakultet Priština, Kosovska Mitrovica, Srbija Miksofibroliposarkom je miksoidni mekotkivni tumor. Za postavljanje tacne dijagnoze, potrebno je da se drzimo nekoliko kriterijuma, uglavnom patoloskih. Najvazniji je,svakako, pleomorfozam sa celijskom atipijom izrazenom u, najmanje,10% tkiva..Većina nastaje u površnim slojevima potkožnog tkiva ili u dermisu. Jasna razlika izmedju low grade MFLSa i high grade MFLSa nije jasna. Medjutim, rekurentni low grade miksofibroliposarkom je infiltrativan, a zna da bude vrlo agresivan.Tako metastatske tumore mozemo naci u mezenterijumu,plucima,bubrezima,pleuri i kostima,i drugim udaljenim organima. Ovakva vrsta tumora vrlo je cesta u donjim ekstremitetima starijih pacijenata.Prognoza i terapija varira od slučaja do slučaja. Lečenje je hirurško a ponekad podrazumeva i hemioterapiju i zračenje.Ključne reči: recidivantni tumor, mksofibroliposarkom UVODSarkom je maligni tumor koji se razvija u vezivnom tkivu (mast, hrskavica, mišić, kosti, tetive,nervi, krvni sudovi, vlaknasto tkivo oko zglobova). Može da se razvije bilo gde u telu, ali predilekciona mesta su ekstremiteti (najčešće se razvija duboko u ekstremitetima), trbušna ili grudna duplja. Često se pogrešno dijagnostikuju. Ponekad se pogrešno zamenjuju sa sportskim povredama. Kada se dijagnostikuju, često su već dosta veliki i teško se otklanjaju operacijom, a prisutni su i sekundarni depoziti. Mnog e podvrste sarkoma postanu otporne na terapiju. Postoji mnogo različitih vrsta sarkoma. Sarkomi mekog tkiva se klasifikuju histološki prema vrsti ćelija mekanog tkiva iz kojeg su nastali. Prema poreklu ćelija iz kojih nastaju ovi tumori, postoji puno podela: angiosarkomi, hemangiopericitomi i alveolarni sarkomi su porekla krvnih sudova, hondrosarkomi porekla hrskavice, fibrosarkomi su porekla fibroznog tkiva, GIST je tumor porekla gastrointestinalne strome, rabdo i leiomiosarkomi su porekla glatke ili poprečnoprugaste muskulature, mezenhimomi i epiteloidni sarkomi su nepoznatog porekla, Schwanomi i neurofibrosarkomi su neurogenog porekla. Dermatofibrosarkomi su maligni spororastući tumori porekla fibroznog tkiva kao i maligni fibrozni histiocitomi koji su agresivnijeg rasta. PRIKAZ SLUČAJA MIKSOFIBROLIPOSARKOMNaziv miksofibroliposarkom prvi put su koristili skandinavski naučnici da bi skrenuli pažnju na miksoidne i fibroblastne elemente tumora . Osnovna tumorska ćelija je porekla izmenjenog miofibroblasta. Neki istraživači smatraju ovaj tumor za miksoid varijantu malignog vlaknastog histiocitoma. Patolog pravilnom dijagnostikom ove retke tumore razlikuje od reaktivnog ili pseudosarkomatoznog tkiva. DIJAGNOZADijagnoza ovog tumora uspostavlja se biopsijom i histopatološkom analizom, imunohistološkom analizom pri kojoj se tkivo testira na određenu interakciju antigena i antitela koja je svojstvena svakom određenom tipu sarkoma mekog tkiva.То је sarkom koji se može poistovetiti sa drugim tumorima vretenastih ćelija mekih tkiva. U preciznoj dijagnostic...
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