2006 - UZ Leuven

MASSAGE P., VANDENHOF B., VRANCKX J.J.: Full face resurfacing of3rd degree burns with artificial dermis: barriers & opportunities. J.Plast. Reconstr. & Aesth. Surg., 2006; 59: S7.The face is a visiting card for every individual human being, playing amajor role in his social and professional life. Scar formation in theface, its prevention and its reconstructive treatment has always been amajor concern for all surgeons. In this search for solutions cliniciansand research team up. At the extreme of the scope of facial scarring isthe deep dermal complete facial burn. We show the results obtainedwith a tissue engineered skin substitute in 2 immediate and 2 latemajor facial reconstructions. These results encourage the furthersearch for the ideal skin substitute and raise questions about the ideaof considering facial transplantation for treatment of facial burnsequellae.PEETERS W., HIERNER R., NIJS S., VAN DENKERCKHOVE E.: Cost ofreplantation injuries at the hand: replantation versus stump providing.J. Hand Surg., 2006. 31B: 53.Background: With increasing financial pressure in the health caresector the question arises if the costs of replantation do outweight thebenefit ?Patients and Methods: The financial costs for reconstruction andstump providing are calculated and compaired in case of a: 1) singlelong finger amputation, 2) thumb amputation, and 3) multiple fingeramputation involving the thumb. Financial costs are calculated for a 25year old and a 50 year old manual worker.Criterias for calculation are:medical costs (for primary and secondary surgery), costs for unfit ofwork, and costs for disability.Results: Costs of single finger replantation for a 25 year old manualworker are equal for reconstruction and primary amputation. From apure financial point of view reconstruction of a subtotal or total singlefinger amputation in a 50 year old manual worker is not justified. Forthumb amputation in a 25 year old manual worker, there is a cleardifference in costs in favour reconstruction, thus justifyingreplantation/revascularization in every case possible and reasonable.From a pure financial point of view reconstruction of a subtotal or totalthumb amputation even in a 50 year old manual worker is justified. Inmultiple finger amputation there is a clear difference in cost in favourof reconstruction for the 25 and 50 year old manual worker.Conclusion: From a pure financial point of view all replantations arejustified except for the single long finger replantation in a 50 year oldmanual worker. Although in each group the major part of costs iscreated by costs for disability, there is no worldwide accepted87