1/4. Reverse flow instep island flap.The retrogradely perfused medial plantar artery flap was used in a leprosy patient with a plantar ulcer over the heads of the second and third metatarsals. The flap is based on the anastomosis of the medial plantar artery with the branch of the first plantar metatarsal artery, which supplies the medial side of the great toe. This design provides reconstruction with like local tissues while not distorting the weight-bearing pattern of the foot.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
2/4. Chance, the prepared mind and children with Hansen's disease.1. Hansen's Disease is a chronic disease found in every continent in the world and among all ethnic groups. 2. hawaii is neither a "hotbed" of the disease nor a place where the disease is absent. 3. Hansen's Disease is endemic in these islands, but we also have problems and resources for coping with it. 4. Current treatment approaches to clinical and public health aspects of the disease now offer hope. 5. There is a continuing need to educate patients, families, communities and professional workers in the many aspects of this disease. 6. Opportunity exists for hawaii to become the training nucleus for medical and public health approaches to Hansen's Disease among the populations of the Pacific Basin.- - - - - - - - - - ranking = 0.25keywords = island (Clic here for more details about this article) |
3/4. Sparing of leprosy macule in ampicillin hypersensitivity rash.A case of tuberculoid leprosy is reported in a middle aged female, who presented with generalised erythematous maculopapular rash which followed ampicillin therapy. In spite of extensive and severe involvement of the skin all over the body by erythema and rash, the hypopigmented patch of leprosy on the face did not show any erythema or rash and stood out more clearly as an island of pale area in the midst of large area of erythema on the face. The possible mechanism of non development of erythema and rash in the patch is discussed.- - - - - - - - - - ranking = 0.25keywords = island (Clic here for more details about this article) |
4/4. The distally based posterior interosseous fasciocutaneous island flap in reconstruction of the hand in leprosy.In leprosy a functionally useless hand can be the sequelae of resorption of the sensation-impaired thumb and fingers resulting from repeated trauma and infection. When this process shortens the thumb to the level of the proximal phalanx or metacarpal, the effect is to produce a relatively shallow first web space which together with the shortening, can prevent the most basic hand manoeuvre of a pincer or pinch grip. The reconstructive procedure commonly used in this situation is to widen and deepen the web space with a z-plasty combined with excision of the second metacarpal but the result can be inadequate. We have used the posterior interosseous fasciocutaneous island flap, both as a simple and a compound flap, to solve this challenging problem and we report here our experience with four patients.- - - - - - - - - - ranking = 1.25keywords = island (Clic here for more details about this article) |