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Biomedical subjects

B Chrétien-Marquet

Publications and source records attributed to B Chrétien-Marquet.

12 recordsLinked to original sources
PubMed2000

[The importance of early surgery in preventing the esthetic sequelae of cervicofacial mucocutaneous hemangiomas in children].

Infants with cutaneous hemangiomas are classically managed medically, well-defined surgery being planned for esthetic correction at the age of 8 to 10 years. We present a series of 65 cases of early surgery in children with head and neck cutaneous or mucosal hemangiomas where irreversible and unesthetic scars were predictable. The surgical procedure was simple and the cosmetic result was better than could be expected after late surgery, limiting psychological consequences. In our opinion, the abstention rule should be changed. A multidisciplinary check-up at 2 years to identify cases with a predictably unesthetic scar after complete resolution of the angioma would help select cases where early surgical correction, taking advantage of the exceptional quality of skin in these young children, would be most beneficial.

Child, Preschool↗
PubMed1997

Surgical treatment of large cutaneous lesions of the back in children by concentric cutaneous mobilization.

Excision of large cutaneous lesions of the back, such as giant nevi in children, represents a major surgical challenge. Actually, many authors use tissue expanders. Recently, we have proposed, through a better evaluation of the biomechanical properties of the skin, a natural expansion mode using the postoperative tension. This expansion is natural and delayed. In the back the natural expansion can be created by concentric excision, which takes maximum advantage of the possibilities of cutaneous mobilization of the back. The concentric excision has been used in 12 children presenting with cutaneous lesions of the back involving more than 30 percent of the dorsal anatomic unit. Nine patients underwent total excision; two patients were treated in one stage, four patients in two stages, and three patients in three stages. Three patients could not have total excision. The follow-up was uneventful, except in one patient who presented with wound dehiscence. The follow-up was 1 to 2 years and showed a modest scar widening (< 4 mm) in three patients, moderate widening (> 4 min, < 7 mm) in three patients, and significant widening (> 10 mm) in three patients. The systematization of the cutaneous mobilization for each region of the back has allowed us to optimize the utilization of peripheral normal tissue in the surgical treatment of large cutaneous lesions of the back. In some circumstances, the gain in tissue has been superior to that we usually obtain with skin expanders and with lesser cost, lesser pain, and fewer risks.

Back↗
PubMed1997

Dog ear: true and false. A simple surgical management.

The rise of the utilization of tissue expanders and procedures like liposuction have brought us a better understanding of the biomechanical properties of the skin as a living organ. This understanding has helped us to appreciate better the etiopathology of a dog ear deformity and to utilize the same properties for its correction by simple methods and thus avoid complex plasties and additional scars.

Dermatologic Surgical Procedures↗
PubMed1997

[Congenital giant blue nevus. Apropos of a case].

A case of a three years old girl showing a congenital giant blue nevus, in the neck and the occipital region, is presented. The giant blue nevus was associated to an important cutaneous nevomatosis. The treatment has consisted of an surgical excision of an surgical excision of the main lesion, and operative continuations have been simple. The literature study showed 11 cases of congenital giant blue nevus and demonstrate the high risk of malignancy, and the importance of an early surgical treatment.

Child, Preschool↗
PubMed1997

[Complex facial nevus in children treated by combination of prosthetic and deferred natural expansions].

Congenital pigmented naevi of the face in children represent indications for early excision and the search for the best aesthetic result has led the authors to prefer the use of skin expansion techniques. The case presented here illustrates the combined use of two expansion techniques: prosthetic expansion and natural differed expansion. This procedure gives good cosmetic results at a moderate overall cost.

Face↗
PubMed1997

[Use of deformities in the treatment of facial skin defects in children: "deforming resections". Report of 35 cases].

Spontaneous resolution of deformities after excision of facial skin lesions has been known and used for a long time by plastic surgeons. The resorption mechanism of deformity is based on natural skin expansion, and seems to be directly related to the action of the muscles of facial expression and their skin relations. Natural expansion has been shown to be effective in children. Between 1990 and 1994 excision of skin lesions, including congenital nevi, leading to postoperative deformity of the cheek, labial commissure, nose, eyelid and forehead, was performed on 35 patients, aged from 3 month to 12 years. The average follow-up is 24 months. For 26 patients (74%), natural resorption was observed 4 or 6 weeks later with good aesthetic results. For 6 patients (17%), the deformity persisted 3 or 6 months later, but did not require any further surgery. For 3 patients (9%), a second operation was necessary. Using the skins natural capacity for expansion in the treatment of facial skin defects in children is a method of reconstruction which has already been used for excision in enforced position. The platysma and muscles of facial expression by their action on skin mobilisation, allow natural expansion. A better knowledge of cutaneous biomechanical properties enables plastic surgeons to find an alternative to other classical methods.

Child↗
PubMed1996

[Natural skin expansion. Applications to the surgery of nevus of the head and neck in children].

The surgical treatment of congenital naevi of the head and neck often require the use of expansion prostheses. The high risk of complications in children such as infection, necrosis, prosthetic exposure, has led the authors to propose a new therapeutic approach, consisting of deferred cutaneous expansion, which uses the skin tension as an expansion motor. This allows repair in one or several surgical phases, of large defect using the skin of the same anatomical unit, with good esthetic results. The authors describe the three main techniques applied to surgery of naevi of the head and neck: simple excision-suture, excision-unfolding and deforming excision.

Child↗
PubMed1996

[Deferred natural expansion].

Adaptation of the skin to the oriented and directed tension stresses can allow, under certain specific conditions, considerable expansion for the subsequent cover of large skin defects in children and adults. This paper describes the concept of natural deferred expansion, illustrated by two clinical examples. Its theoretical bases, as well as a computerized biological model are discussed. A classification of the various types of cutaneous mobility and the biomechanical properties of skin is proposed.

Adaptation, Physiological↗
PubMed1995

Use of distortions in the treatment of skin lesions of the face: the distorting excision.

Reconstruction after excision of a cutaneous lesion of the face is done by various complex old and new flaps to avoid any distortion. The distortions following primary closure of defects in the face are given undue importance. We have observed and used the capacity of self-correction of these distortions, which is partially due to the muscular actions. We show our experience in various distorting reconstructions of the face in 36 patients. Because of our partial presence in a children's hospital, most of our patients were children.

Adaptation, Physiological↗
PubMed1994

Cutaneous expansion using enforced position in the treatment of large skin defects.

This paper presents a new method of reconstruction of a large skin defect, e.g., following excision of a giant pigmented nevus. By taking advantage of the flexibility of the joints and the extensibility of skin in the children, the large defects were closed in one stage by an enforced position that allows an easy closure of the wound. The scar was protected against stretching for 6 weeks to obtain sufficient strength. Later, free movements across the joints were permitted to allow gradual tension to the skin surrounding the scar. The final result is a permanent gain of the tissue replacing the defect.

Adolescent↗
PubMedDate not supplied

[Melanotic neurofibroma].

BACKGROUND: Melanotic neurofibromas are rare tumours. The clinical and histological diagnosis is often difficult to make. CASE REPORT: A 41 year-old woman with type-1 neurofibromatosis presented with an old, large (16 cm by 6 cm) pigmented tumour on her left arm. It was initially considered to be a congenital naevus. Partial surgical resection was performed. Histological examination showed a loose proliferation of spindle-cells within the dermis and subcutaneous layers, with multiple foci of melanin-laden cells but no mitotic figures or atypical cells. There was no melanocytic theca. The tumour had immunoreactivity for the S-100 protein, neuron-specific-enolase, neurofilaments, synaptophysin, A-103 and HMB-45. The association of a benign pigmented tumour producing melanin and the presence of Schwann cells and nervous cells, led to the diagnosis of diffuse melanotic neurofibroma. DISCUSSION: Melanotic neurofibromas can occur on their own or be associated with neurofibromatosis. They must be distinguished from classical neurofibromas when pigmentation occurs in the latter. Melanotic neurofibromas usually appear in the second or third decade of life and rarely in childhood. It is worth noting that hairs may overlie a melanotic neurofibroma, mimicking a giant naevus or a neurocristic cutaneous hamartoma. These are the two main differential diagnoses among children. Among adults, the main difficulty is to distinguish melanotic neurofibroma from pigmented dermatofibrosarcoma, because of the clinical and histological similarities between these two.

Adult↗