Preliminary report

Preliminary report ing epicardial catheter during a prior change of the gen- Acknowledgement. The author acknowledges Dr. Enrique Bona- nad for his collaboration in the clinical case. erator. The previous attempt to place the implant be- tween the rectus abdominis muscle and its anterior sheath resulted in recurrent extrusion. Muscle wrapping References of the implant was not possible if capturing was to be avoided. 1. Elmqvist R, Senning A (1960) Implantable pacemaker for the The greater omentum is known to be the best tissue in heart. In: Smyth CN (ed) Medical electronics. Thomas. terms of space filling and bacterial control capability, the Springfield, Illinois, p 250 so called "biological activity" [6]. The greater omentum, 2. Goldsmith HS, Griffith AL, Kupferman A, Cantipoolas N besides the well known high density of vessels, has spe- (1984) Lipid angiogenic factor from the omentum. JAMA 252:2034-2037 cific angiogenic capability, the omental angiogenic lipid 3. Griffith MJ, Mounsey JR Bexton RS, Holden MP (1994) Me- factor [2, 7], and immunologic properties [4]. These chanical, but not infective erosion may be successfully man- facts, along with the need to isolate the active face of the aged by reimplantation of pacemakers. Br Heart J 71:202-204 generator with a non-excitable, highly "biologically ac- 4. Liebermann-Meffert D, White H (1983) Defense mechanisms. tive" flap made the greater omentum the most logical In: Liebermann-Meffert D, White H (eds) The greater omen- choice for this case. In the 21 month follow-up the pa- turn. Anatomy, physiology, pathology and surgery, with a his- torical survey. Springer, Berlin Heidelberg New York, pp tient has been well without recurrent exposure of the 90-92 system. The patient returned to his previous active life, 5. Rodriguez-Garcia J, Botella-Solana S, Coma-Samartin R, without abdominal wall problems or herniation, this in- Garcia-Calabozo R, Gascon-Lopez D, Novo-Valledor Let al. dicates that skeletonization of the pedicle of the omental (1995) Informe sobre el estado actual y nuevas tendencias en flap is an important step to permit the passage of the la electroestimulaci6n cardiaca. Rev Esp Cardiol 48:16-26 pedicle through a very narrow opening in the abdominal 6. Shilov BL, Milanov NO, Libermann-Meffert D (1995) Bio- wall, thus reducing the likelihood of herniation. logical activity of tissue flaps in the treatment of complicated irradiation wounds. Eur J Plast Surg 18:46-49 In conclusion, it is the authors' opinion that attempts 7. Williams R (1990) Angiogenesis and greater omentum. In: at salvaging exposed pacemakers are worthwhile in Goldsmith HS (ed) The omentum. Research and clinical appli- terms of economic savings and patient comfort. This cation. Springer, Berlin Heidelberg New York, pp 45-61 usually entails minor surgical maneuvers under local an- esthesia on an outpatient basis, although more complex procedures can be used in selected cases such as the greater omentum wrap-around flap in the case reported here. Eur J Plast Surg (1997) 20:222 Pitanguy, I., Sbrissa, R.A. (eds): Atlas de chirurgia palpebral Janbon, Ch., Cluzan, R.V. (eds): Lymphologie (in French). Par- (in Portuguese). Colina Livraria Editoria Ltd. 1994. US$ 125.00. is: Masson 1995. 200 pages, US$ 45.00. ISBN 2-225-84500-X. ISBN 85-7095-022-5. This book, certainly much looked for in the series published The atlas of ophthalmic plastic surgery, beautifully published, by Masson on vascular medicine, has been compiled by the two is written in Portuguese by a well-known plastic surgeon and an editors with the help of ten collaborators. It is an overview of to- ophthalmologist. The latter author produced all the excellent black day's diverse field of lymphology. One of the editors is head of and white drawings which profusely illustrate this book. In twen- the service for lymphatic diseases in Paris. Studying this book will ty-three chapters the basics of this surgical field is discussed: the probably stimulate the reader to consult with him on the more anatomy, local anesthesia, grafting procedures, lacrimal and complex problems in this field. The emphasis lies on the impor- canthal surgery, therapy for en- and ectropion, for blepharoptosis, tance, the physiology and the pathophysiology, including diagnos- paralytic lagophthalmos, for palpebral tumors. Further chapters tic approaches, of the lymphatic system. The most recent opinions deal with palpebraI tumors, reconstructive surgery of the eyelids, of the authors and from the literature are provided. A large section of the lacrimal system, and esthetic surgery of this area. This atlas is devoted to conservative methods of treatment of the various is certainly useful for all beginners in the field of ophthalmic plas- types of lymphedema. This handy and well produced book is rec- tic surgery, if they can read Portuguese. (L. Clodius, Ztirich) ommended, if you are fortunate enough to read French. (L. Clodius, Ztirich) European Journal of Plastic Surgery Springer Journals

Preliminary report

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