BACKGROUND: Specific toxic compounds, such as polycyclic aromatic hydrocarbons (PAHs) and their metabolites, may affect the inhalation injury (INHI) grade, patients' status, and prognosis for recovery. This pilot prospective study aimed to: i) evaluate the suitability of bronchoalveolar lavage (BAL) for determination of PAHs in the LRT and of urine for determination of hydroxylated metabolites (OH-PAHs) in patients with INHI, ii) describe the dynamic changes in the levels of these toxic compounds, and iii) correlate these findings with clinical variables of the patients with INHI. METHODS: The BAL and urine samples from 10 patients with INHI were obtained on Days 1, 3, 5, 7, and 14 of hospitalization, if possible, and PAHs (BAL) and OH-PAHs (urine) were analyzed using chromatographic methods (GC-MS and HPLC). RESULTS: Concentrations of analyzed PAHs were in most cases and time points below the limit of quantification in BAL samples. Nine OH-PAHs were detected in the urine samples; however, their concentrations sharply decreased within the first three days of the hospitalization. On Day 14, the total amount of OH-PAHs in urine was higher in surviving patients with High-grade INHI (≥3) than in those with Low-grade INHI (<3, p = 0.032). Finally, a significant correlation between certain OH-PAHs and clinical variables (AST/ALT, TBSA, ABSI) from Day 1 of the hospitalization was observed (p<0.05). CONCLUSIONS: BAL samples are not suitable for the analysis of PAHs. However, the OH-PAHs levels in urine can be measured reliably and were correlated with several clinical variables. Moreover, High-grade INHI was associated with higher total concentrations of OH-PAHs in urine.
- MeSH
- bronchoalveolární lavážní tekutina * chemie MeSH
- dospělí MeSH
- hospitalizace * MeSH
- lidé středního věku MeSH
- lidé MeSH
- pilotní projekty MeSH
- polycyklické aromatické uhlovodíky * moč analýza MeSH
- prospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Microsurgical reconstruction is currently considered a method of choice for the repair of soft tissue or bony defects in head and neck surgery. This technical note presents the use of a reverse flow technique in mandibular reconstruction with two segments of fibula free flap in a patient with bilateral pseudoarthrosis. In the standard procedure, both segments of the fibula are supplied by one donor vascular pedicle with normal antegrade blood flow. The approach presented here employs reverse flow in the distal segment of the fibula using a venous graft to create two vascular independent free fibula segments. Reverse flow in mandibular reconstruction represents an alternative option to support the success of microsurgical procedures in indicated cases.
- MeSH
- fibula transplantace MeSH
- lidé MeSH
- mandibula chirurgie MeSH
- mikrochirurgie MeSH
- rekonstrukce mandibuly * metody MeSH
- volné tkáňové laloky * krevní zásobení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- chirurgie s pomocí počítače přístrojové vybavení metody MeSH
- dospělí MeSH
- fibula krevní zásobení transplantace MeSH
- fraktury mandibuly diagnostické zobrazování etiologie chirurgie MeSH
- kostní destičky MeSH
- lidé MeSH
- mandibula krevní zásobení diagnostické zobrazování chirurgie MeSH
- počítačová simulace MeSH
- počítačové modelování podle konkrétního pacienta MeSH
- rekonstrukce mandibuly metody MeSH
- reoperace MeSH
- volné tkáňové laloky krevní zásobení MeSH
- zobrazování trojrozměrné MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- dopisy MeSH
- kazuistiky MeSH
