No abstract

The plastic surgeon played an important role in the treatment of complex wounds by adopting early surgical treatment, contributing to the effective resolution of cases.

CONTEXT AND OBJECTIVE:Use of topical negative pressure over diffi cult-to-heal wounds has been studied. The objective of this study was to analyze the effects from negative pressure in the treatment of complex wounds. DESIGN AND SETTING:Case series developed at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS:Twenty-nine patients with complex wounds were treated with the vacuum system and then underwent a surgical procedure to close the wound. RESULTS: 85% of the skin grafts took well, and 87.5% of the local fl aps were successful, thus demonstrating adequate wound preparation. The wounds were closed within shorter times than observed using other conventional treatments In two cases, the vacuum system was also used to stabilize the skin grafts over the wounds. CONCLUSIONS:Use of the vacuum method is safe and effi cient for preparing wounds for surgical closure. It allows for an improvement of local wound conditions, and healthy granulation tissue develops with control over local infection.

Rev Med (São Paulo

O tratamento atual das leucemias mielóides agudas (LMA) obedece principalmente aos seguintes critérios: precisa caracterização clínica e biológica, adequada e agressiva quimioterapia, intensa terapia de suporte e possível indicação precoce de transplante de medula óssea. Neste artigo, envolvendo crianças tratadas entre 1986 e 1996, são apresentados os resultados passíveis de obtenção com tratamento quimioterápico convencional e discutidas as bases de implantação de um programa terapêutico moderno e de maior eficácia. Quarenta e três pacientes com LMA "de novo", idades entre 6 meses e 14,5 anos, foram tratados conforme programa terapêutico que incluiu indução e consolidação com quatro drogas: DAUNO, ARA-C, VCR e DEXA e 60 semanas de manutenção com os seguintes ciclos administrados