Serban Arghir Popescu

Serban Arghir Popescu

Hydrofluoric Acid Burn Management – Case Presentation

Background: Hydrofluoric acid (HF) is an extremely dangerous weak inorganic acid, which can produce extensive burn lesions, depending especially on the solution concentration and exposure time, systemic toxicity occurring in patients with large burn areas, high concentration of acid or an extensive time of exposure. The subcutaneous infiltration and intravenous administration of calcium gluconate is essential for preventing dyselectrolytemia and severe pain appearance. Case summary: A 26-year-old man patient presented to our hospital after a hydrofluoric burn, secondary to an occupational accident. At the scene, the wound was irrigated with fresh water and topical calcium gluconate was applied. In the Emergency Department, we started the intravenous calcium gluconate administration, and in the Burn Unit it was injected subcutaneously and the pain was thus diminished. A prolonged QT interval was identified upon admission that has been corrected over the next few days. Particularly, the serum pseudocholinesterase levels were within normal range. The local treatment involved repeated copious lavage with sterile water and Betadine solution, the evolution being rapidly favorable with the burn lesions completely healed in the next week. Conclusion: HF burns are a very special type of chemical burn taking into account that exposure to a small quantity of solution can be life threatening and that the immediate treatment is mandatory in order to maximize the outcome. It is of vital importance that any medical facility had a chemical burn protocol.

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Negative Prognostic Factors in Severe Burns - Implication for Clinical Outcome

Burn injuries are a major public health problem all over the world and despite significant improvements in critical care and surgical treatment, major burns are associated with high morbidity and mortality and poor recovery outcome. Patients with severe burns need immediate intervention and rapid initiation of speci-alized treatment in a dedicated critical care burn unit in order to minimize morbidity and mortality. The complex nature of burn injuries requires an integrative approach, by a multidisciplinary team in order to obta-in an optimal care. [...]

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Single-Stage Reconstruction of Distal Third of the Dorsum Nasi Using a Nasolabial Flap after Removal of Basal Cell Carcinoma

The nose represents a common site for skin cancer, especially for Basal Cell Carcinoma (BCC) which is the most common malignant tumor in humans[1-3]. The removal of the tumor will lead to a defect that can involve skin, cartilage and even nasal mucosa. Therefore, reconstruction of this tridimensional structure can be a challenge even for the most experienced surgeons[4]. There are many techniques described in the literature for restoring the lining and skeletal framework[1-8], but all of these techniques should be adapted to the patient’s needs. In this paper we described our preferred surgical method to cover a medium defect of the distal third of the dorsum nasi after tumor excision using a nasolabial flap. In order to perform a single-stage reconstruction, we pushed the limits of the flap measurements and did some tricks so as the pedicle to be well fitted, leading to good aesthetic results. [...]

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Is Vascularized Composite Allotransplantation a Suitable Reconstructive Option for Extensive Defects in Burned Patients?...

Vascularized composite tissue allotransplantation (VCA) is a recent reconstructive entity that bases on the restoration of deformity by the allotransplantation of a vascularised tissue unit with more components (skin, muscle, bone, cartilage, bone marrow, tendon, nerve). Since the field emerged with the first hand transplant performed in France in 1998, VCA showed a huge potential in replacement of extensive tissue defects and disfigurements (after burns, severe high energy trauma like gunshots, congenital facial malformations), offering a viable treatment option for injuries that involve multiple layers of functional tissue, impossible to repair using conventional surgical techniques, permitting restoration of extensive defects in just one stage procedure with good functional and aesthetic results. A significant number of those procedures have been reported worldwide for various anatomic locations including upper and lower extremities, face, tongue, trachea, larynx, abdominal wall, uterus and penis. These procedures are offered for quality of life and functional indications rather than life-saving indications [1-7]. [...]

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Total Lower Lip Reconstruction - What Techniques Should We Choose

While the incidence of lip cancers incidence in the central Europe is low 0.7% of all malignant tumors compared to the 1-2% generally considered (2-5), they are extremely important from a clinical and surgical point of view because of the morphological and functional changes involved. More than 90% of these tumours are squamous cell carcinomas (SCCs) and, in lesser numbers, basal-cell tumours (BCCs) however, some adenocarcinomas deriving from the minor salivary glands can be observed and, even more rarely, melanomas, sarcomas and lymphomas. BCCs generally occur in the upper lip and do not usually present lymph node metastases (4, 6). In contrast, SCCs develop most often in the lower lip, with a possibility of neck metastases. Lip carcinomas frequently appear on top of precancerous lesions, such as radiodermitis, chronic chelitis and xeroderma pigmentosum. The diagnosis and treatment of these pre-cancerous lesions, facilitated by a direct view of the lesions, is, therefore, crucially important in order to avoid their evolving into actual tumours. The subjects most at risk of this type of tumour are fair-skinned elderly people who work in the open air. Men are more at risk than women, (1.3% men and 0.3% women) (1) probably because the latter use lipstick or lip-salve (2, 7-9).

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