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Zama D, Zanaroli A, Corbelli A, Lo Vecchio A, Del Bene M, Colombini A, Compagno F, Barone A, Fontanili I, Rosaria D'Amico M, Papa MR, Petris MG, Calore E, Montalto S, Meneghello L, Brescia L, Mura R, La Spina M, Muggeo P, Rinieri S, Meazza C, Perruccio K, Cellini M, Spadea M, Mercolini F, Petroni V, De Santis R, Soncini E, Provenzi M, Giurici N, Ziino O, Tridello G, Cesaro S. SARS-CoV-2 Infection in the Pediatric Oncology Population: The Definitive Comprehensive Report of the Infectious Diseases Working Group of AIEOP. J Infect Dis 2024; 229:1050-1058. [PMID: 37962869 DOI: 10.1093/infdis/jiad496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/20/2023] [Accepted: 11/11/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE The objective of this study was to assess the clinical impact and outcome of the SARS-CoV-2 infection on children with cancer or those who received a hematopoietic stem cell transplantation. METHODS AIEOP (Italian Association of Pediatric Hematology and Oncology) performed a nationwide multicenter observational cohort study, including consecutive patients between April 2020 and November 2022. RESULTS Twenty-five Italian centers participated and 455 patients were enrolled. We reported a significant increasing trend of symptomatic cases over the years, while the number of nonmild infections remained stable. Early infection after oncologic diagnosis (<60 days) and severe neutropenia were identified as independent risk factors for developing moderate, severe, or critical infections. The percentage of patients who were asymptomatic and mildly symptomatic and who stopped chemotherapy reduced over the years of the pandemic. Nine patients died, but no death was attributed to SARS-CoV-2 infection. CONCLUSIONS SARS-CoV-2 infection presented a self-limiting benign course in the Italian pediatric oncohematology population during the pandemic, and its main consequence has been the discontinuation of cancer-directed therapies. The rate of patients who were asymptomatic and stopped chemotherapy reduced over the years, suggesting that the continuation of chemotherapy is a feasible option.
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Affiliation(s)
- Daniele Zama
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
| | - Andrea Zanaroli
- Pediatric Oncology and Hematology Department, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliero-Universitaria di Bologna
| | - Agnese Corbelli
- Pediatric Hematology and Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples
| | - Margherita Del Bene
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples
| | - Antonella Colombini
- Antonella Colombini, Fondazione IRCCS, Ospedale San Gerardo dei Tintori, Monza
| | - Francesca Compagno
- Pediatric Hematology/Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Angelica Barone
- Pediatric Onco-hematology Unit, Ospedale dei Bambini, Azienda Ospedaliero-Universitaria di Parma
| | - Ilaria Fontanili
- Pediatric Onco-hematology Unit, Ospedale dei Bambini, Azienda Ospedaliero-Universitaria di Parma
| | | | | | - Maria Grazia Petris
- Women's and Children's Health, Clinic of Pediatric Hemato-oncology, University of Padua
| | - Elisabetta Calore
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Department of Women's and Children's Health
- European Reference Network for Paediatric Transplantation Member for Hematopoietic Stem Cell Transplantation, University Hospital of Padova
| | - Shana Montalto
- Pediatric Infectious Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa
| | | | | | - Rosamaria Mura
- Pediatric Oncology Unit, Azienda Ospedaliera Brotzu, Cagliari
| | - Milena La Spina
- Pediatric Hematology and Oncology Unit, AOU Policlinico "Rodolico-San Marco," University of Catania
| | - Paola Muggeo
- Pediatric Oncology-Hematology Unit, Department of Pediatrics, Azienda Ospedaliero Universitaria Policlinico, Bari
| | - Simona Rinieri
- Pediatric Unit, Onco-hematology Day Hospital, Sant'Anna Hospital, Ferrara
| | - Cristina Meazza
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
| | - Katia Perruccio
- Pediatric Oncology-Hematology, Santa Maria della Misericordia Hospital, Perugia
| | - Monica Cellini
- Pediatric Oncology-Hematology Unit, Department of Mother and Child, Azienda Ospedaliero Universitaria Modena
| | - Manuela Spadea
- Department of Public Health and Pediatrics, University of Turin
- Pediatric Onco-hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Turin
| | - Federico Mercolini
- Pediatric Oncology and Hematology Department, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliero-Universitaria di Bologna
- Pediatric Onco-hematology Unit, Department of Pediatrics, Hospital of Bolzano
| | - Valeria Petroni
- Division of Pediatric Hematology and Oncology, Ospedale G Salesi, Ancona
| | - Raffaella De Santis
- Hemato-oncology Unit, Department of Pediatrics, "Casa Sollievo Della Sofferenza" Hospital, San Giovanni Rotondo
| | - Elena Soncini
- Pediatric Oncohematology and Bone Marrow Transplant Unit, Children's Hospital, Spedali Civili, Brescia
| | | | - Nagua Giurici
- Pediatric Hematology-Oncology, Institute for Maternal and Child Health IRCCS "Burlo Garofolo,"Trieste
| | - Ottavio Ziino
- Department of Pediatric Hemato-oncology, ARNAS Ospedali Civico, G Di Cristina, Palermo, Italy
| | - Gloria Tridello
- Pediatric Hematology and Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona
| | - Simone Cesaro
- Pediatric Hematology and Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona
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Scarano SM, Bruzzese E, Poeta M, Del Bene M, Guarino A, Lo Vecchio A. Dalbavancin for Acute Bacterial Skin and Skin Structure Infections in Pediatrics: Insights from Continuation Therapy Experience. Antibiotics (Basel) 2024; 13:327. [PMID: 38667003 PMCID: PMC11047506 DOI: 10.3390/antibiotics13040327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/29/2024] Open
Abstract
Acute Bacterial Skin and Skin Structure Infections (ABSSSI) are marked by substantial morbidity, frequent need for hospitalization, and long courses of intravenous antibiotic therapy. Herein, we report four cases of pediatric patients admitted for ABSSSI and managed with a combination antibiotic regimen incorporating dalbavancin: a second-generation lipoglycopeptide active against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus. In our experience, particularly in a setting with a high methicillin-resistance rate, dalbavancin demonstrated safety and efficacy, simplifying ABSSSI management in childhood. Its prolonged half-life enables a single-dose administration regimen, offering potential solutions to numerous challenges encountered in pediatric care, such as extended hospital stays, difficulties in securing and maintaining vascular access, lack of pediatric-specific drug indications, and limited availability of suitable oral formulations.
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Affiliation(s)
- Sara Maria Scarano
- Pediatric Infectious Disease Unit, Department of Maternal and Child Health, University Hospital “Federico II”, 80131 Naples, Italy; (S.M.S.); (E.B.); (M.P.); (M.D.B.); (A.G.)
| | - Eugenia Bruzzese
- Pediatric Infectious Disease Unit, Department of Maternal and Child Health, University Hospital “Federico II”, 80131 Naples, Italy; (S.M.S.); (E.B.); (M.P.); (M.D.B.); (A.G.)
- Department of Translational Medical Science, University of Naples “Federico II”, 80138 Naples, Italy
| | - Marco Poeta
- Pediatric Infectious Disease Unit, Department of Maternal and Child Health, University Hospital “Federico II”, 80131 Naples, Italy; (S.M.S.); (E.B.); (M.P.); (M.D.B.); (A.G.)
- Department of Translational Medical Science, University of Naples “Federico II”, 80138 Naples, Italy
| | - Margherita Del Bene
- Pediatric Infectious Disease Unit, Department of Maternal and Child Health, University Hospital “Federico II”, 80131 Naples, Italy; (S.M.S.); (E.B.); (M.P.); (M.D.B.); (A.G.)
| | - Alfredo Guarino
- Pediatric Infectious Disease Unit, Department of Maternal and Child Health, University Hospital “Federico II”, 80131 Naples, Italy; (S.M.S.); (E.B.); (M.P.); (M.D.B.); (A.G.)
- Department of Translational Medical Science, University of Naples “Federico II”, 80138 Naples, Italy
| | - Andrea Lo Vecchio
- Pediatric Infectious Disease Unit, Department of Maternal and Child Health, University Hospital “Federico II”, 80131 Naples, Italy; (S.M.S.); (E.B.); (M.P.); (M.D.B.); (A.G.)
- Department of Translational Medical Science, University of Naples “Federico II”, 80138 Naples, Italy
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Lo Vecchio A, Scarano SM, Palladino R, Del Bene M, Trama U, Affinito G, Buono P, Guarino A. Co-administration with Men-B vaccine increases Rotavirus vaccination coverage: A 5-year regionwide retrospective cohort study (STORM study). Vaccine 2024; 42:287-294. [PMID: 38072758 DOI: 10.1016/j.vaccine.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 01/01/2024]
Abstract
INTRODUCTION In Italy Rotavirus vaccination (RVV) is provided free of charge from 2018, however, the coverage is scattered and suboptimal. The narrow time frame to complete the schedule is a barrier to uptake, and co-administration with other vaccines may potentially increase the coverage. Although the co-administration of RV vaccine and Meningococcal Group B vaccine (MenB) is not included in the product labels, we aimed at studying its impact on RVV coverage. METHODS This Surveillance study on Timing and cOverage of Rotavirus and MenB vaccine co-administration (STORM study) used the Regional Vaccination Registry to collect data about children born in Campania Region between January 2016 and December 2020, and receiving vaccines scheduled in the first year of life. RESULTS Among the 224,110 children enrolled, 60,614 (27.0%) completed the RVV schedule, with a vaccination rate that increased over time from 1.15% in 2016 to 56.92% in 2020. The first and last dose of RVV schedule were administered beyond the recommended time in 6% of the study population, respectively. Co-administration of RV vaccine with MenB vaccine increased from 0.7 % in 2016 to 46.85 % in 2020. Children receiving RV/MenB vaccines concomitantly had a significantly higher chance of completing the RV schedule compared to those receiving RVV alone during a specific appointment (94.78 % vs 72.26 %, Prevalence Ratio -PR- 1.275, 95 %CI 1.245-1.295p < 0.00001). The positive driving effect of RV/MenB co-administration was more evident for children receiving pentavalent (PR 1.288) than monovalent RVV (PR 1.115) which was confirmed when adjusted for confounding variables (i.e., year of vaccination, local district, gender). CONCLUSIONS Although still far from the target, RVV coverage has increased in recent years in Campania Region. Co-administration with MenB vaccine may aid in increasing RVV coverage, especially for pentavalent RVV. Further safety data are needed to support co-administration as a key tool to increase coverage.
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Affiliation(s)
- Andrea Lo Vecchio
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Naples, Italy.
| | - Sara Maria Scarano
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Margherita Del Bene
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Ugo Trama
- Drug Policy and Devices Unit, Regione Campania Health Department, Naples, Italy
| | - Giuseppina Affinito
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Pietro Buono
- Department of Maternal and Child Health, General Directorate for Health, Naples, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Naples, Italy
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Quitadamo P, Isoldi S, Mallardo S, Zenzeri L, Ceccanti S, Battagliere I, Del Bene M, Di Nardo G. Rectal Bleeding in Infants: Diagnostic Work-up and Management. Curr Pediatr Rev 2024; 20:286-295. [PMID: 36809947 DOI: 10.2174/1573396319666230210111048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/11/2022] [Accepted: 11/23/2022] [Indexed: 02/17/2023]
Abstract
Lower gastrointestinal bleeding is an alarming symptom in pediatrics, especially in infancy. However, it is commonly secondary to benign and self-limiting conditions, such as anal fissures, infections, and allergies; more rarely it is caused by more serious disorders, such as necrotizing enterocolitis, very early onset inflammatory bowel diseases, and vascular malformations. The present review aims at summarizing the different clinical conditions presenting with rectal bleeding in infancy and provides an evidence-based diagnostic work-up for the clinical management of patients with this occurrence.
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Affiliation(s)
- Paolo Quitadamo
- Pediatric Gastroenterology and Hepatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Sara Isoldi
- Pediatric Gastroenterology and Hepatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
- Maternal and Child Health Department, Sapienza - University of Rome, Santa Maria Goretti Hospital, Polo Pontino, Latina, Italy
| | - Saverio Mallardo
- Maternal and Child Health Department, Sapienza - University of Rome, Santa Maria Goretti Hospital, Polo Pontino, Latina, Italy
| | - Letizia Zenzeri
- Pediatric Emergency Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Silvia Ceccanti
- Pediatric Surgery Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Ilaria Battagliere
- Department of Translational Medical Science, Section of Pediatrics, University "Federico II", Naples, Italy
| | - Margherita Del Bene
- Department of Translational Medical Science, Section of Pediatrics, University "Federico II", Naples, Italy
| | - Giovanni Di Nardo
- Chair of Pediatrics, Pediatric Gastroenterology and Endoscopy Unit, NESMOS Department, Faculty School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
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Mosca C, Colucci A, Savoia F, Calì C, Del Bene M, Ranucci G, Maglione A, Pepe A, Morelli A, Vajro P, Mandato C. Vitamin D Levels in the Pre- and Post-COVID-19 Pandemic Periods and Related Confinement at Pediatric Age. Nutrients 2023; 15:2089. [PMCID: PMC10181113 DOI: 10.3390/nu15092089] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 06/01/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) restrictions have been correlated with vitamin D deficiency in children, but some uncertainties remain. We retrospectively studied vitamin 25-(OH) D blood levels in 2182 Italian children/adolescents hospitalized for various chronic diseases in the year before (n = 1052) and after (n = 1130) the nationwide lockdown. The type of underlying disease, gender, and mean age (91 ± 55 and 91 ± 61 months, respectively) of patients included in the two periods were comparable. Although mean levels were the same (p = 0.24), deficiency status affected a significantly higher number of subjects during the lockdown period than in the pre-COVID period (p = 0.03), particularly in summer (p = 0.02), and there was also a smoothing of seasonal variations in vitamin D levels. Particularly at risk were males (OR = 1.22; p = 0.03), the 1–5 year age group (OR = 1.57; p < 0.01) and the 6–12 year age group (OR = 1.30; p = 0.04). Infants appeared not to be affected (p = 1.00). In the post-COVID period, the risk of vitamin D deficiency was unchanged in disease-specific groups. However, the proportion of deficiency or severe deficiency differed significantly in the subgroup with endocrinopathy (higher; Chi-square p = 0.04), and with respiratory problems and obesity (lower; Chi-square p = 0.01 and p < 0.01, respectively). Conflicting/opposite literature results advocate for further studies to clearly indicate the need for supplementation during possible future periods of confinement.
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Affiliation(s)
- Caterina Mosca
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, 80131 Naples, Italy
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Fabio Savoia
- Epidemiology, Biostatistic and Childhood Cancer Registry of Campania, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - Camilla Calì
- Epidemiology, Biostatistic and Childhood Cancer Registry of Campania, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - Margherita Del Bene
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, 80131 Naples, Italy
| | - Giusy Ranucci
- Pediatric Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), University of Pittsburgh Medical Center, 90127 Palermo, Italy
| | - Antonio Maglione
- Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - Angela Pepe
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Annalisa Morelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Claudia Mandato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
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Poeta M, Nunziata F, Del Bene M, Morlino F, Salatto A, Scarano SM, Cioffi V, Amitrano M, Bruzzese E, Guarino A, Lo Vecchio A. Diarrhea Is a Hallmark of Inflammation in Pediatric COVID-19. Viruses 2022; 14:v14122723. [PMID: 36560726 PMCID: PMC9783993 DOI: 10.3390/v14122723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/28/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a pathogen with enteric tropism. We compared the clinical, biochemical and radiological features of children hospitalized for acute SARS-CoV-2 infection, classified in two groups based on the presence of diarrhea. Logistic regression analyses were used to investigate the variables associated with diarrhea. Overall, 407 children were included in the study (226 males, 55.5%, mean age 3.9 ± 5.0 years), of whom 77 (18.9%) presented with diarrhea, which was mild in most cases. Diarrhea prevalence was higher during the Alpha (23.6%) and Delta waves (21.9%), and in children aged 5-11 y (23.8%). Other gastrointestinal symptoms were most commonly reported in children with diarrhea (p < 0.05). Children with diarrhea showed an increased systemic inflammatory state (higher C-reactive protein, procalcitonin and ferritin levels, p < 0.005), higher local inflammation as judged by mesenteric fat hyperechogenicity (adjusted Odds Ratio 3.31, 95%CI 1.13-9.70) and a lower chance of previous immunosuppressive state (adjusted Odds Ratio 0.19, 95%CI 0.05-0.70). Diarrhea is a frequent feature of pediatric COVID-19 and is associated with increased systemic inflammation, which is related to the local mesenteric fat inflammatory response, confirming the implication of the gut not only in multisystem inflammatory syndrome but also in the acute phase of the infection.
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Affiliation(s)
- Marco Poeta
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy
| | - Francesco Nunziata
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy
| | - Margherita Del Bene
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy
| | - Francesca Morlino
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy
| | - Alessia Salatto
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy
| | - Sara Maria Scarano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy
| | - Valentina Cioffi
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy
| | - Michele Amitrano
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Eugenia Bruzzese
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy
| | - Alfredo Guarino
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-746-4232
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Bene MD, Petrolati M, Raimondi P, Tremolada C, Muset A. Reverse dorsal digital island flap. Plast Reconstr Surg 1994; 93:552-7. [PMID: 8115510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The anatomic and clinical bases for a reliable and versatile homodigital flap for covering difficult distal dorsal and dorsolateral wounds of the long fingers are presented. This one-step procedure, which uses the dorsal skin of the first or second phalanx transposed as a reverse island flap, preserving the collateral nerve and artery to the fingertip, has proved valuable in salvaging the severely injured digits of nine patients (for a total of 12 flaps). It would seem to be a relatively simple way of achieving early recovery because it does not require distant flap reconstruction, the immobilization of adjacent digits, or homodigital flaps that might jeopardize an already injured finger. Furthermore, it reduces the time of hospitalization and improves patient welfare.
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Affiliation(s)
- M D Bene
- Hand and Plastic Surgery Department, Legnano Hospital, Italy
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