n 1984 and 1985, a total of eleven Iranian patients were transferred to hospitals in Munich, Germany, after a reported gas attack in the Iran-Iraq war. The initial symptoms and pretreatment in Teheran, Iran, as well as the admittance examination data, the clinical courses of the patients, and the clinical laboratory data in Germany, are reported. The main injuries were to the skin, the eyes, and the respiratory tract. One patient stopped breathing suddenly on the third day of treatment (eight days after the exposure). A large piece of mucous membrane blocking a bronchus was removed during an immediate bronchoscopy, but attempts at resuscitation failed. The most important autopsy findings in this case were severe pseudomembranous inflammation of the trachea and the bronchial tubes. The histological findings are reported. Chemical proof of the poison (mustard gas) was established. A review of the history of chemical warfare, the physical and chemical properties of mustard gas, and a literature survey of clinical findings (including, especially, experiences from World Wars I and II) contribute to the understanding of the actual cases.

Verglichen werden freie myocutane Lappenplastiken, wie der

Latissimus dorsi-Lappen, der Gracilis-Lappen und der untere Gluteallappen, sowie

fasciocutane Lappen, wie der Scapularlappen in ihrer Anwendung zur Defektdeckung

an Unterschenkel und Fuß.

Es zeigte sich, daß myocutane Lappen eher geeignet sind tiefe Defekte mit Knochenverlusten

zu füllen, sie stellen ein gutes Lager für eine Spongiosaplastik dar. Fasciocutane

Lappen eignen sich eher zur Deckung flächiger Defekte. Sie zeigen auch ohne

Muskulatur eine gute Durchblutung durch das epifasciale Gefäßnetz. Sie sind dünner

als myocutane Lappen und benötigen bei großen Defekten an der Empfängerzone

keine zusätzliche Spalthauttransplantation.

The authors report their experience with the autogenous microsurgical

lymphvessel transplantation for the treatment of upper

(n = 60, 55 females and 5 males) and lower (n = 35, 10 females

and 25 males, primary lyphredemas = 11, secondary lymphredemas

= 24) limb edemas.

Regarding the volume measurements before and after lymphvessel

- transplantation in 58 patients there was a reduction of

volume differences between healthy and affected arms of more

than the half in 76 % of the patients after a mean follow-up

period of 2 1/2 years.

In 28 patients with unilateral redemas of the lower extremities

the volume reduction after a mean follow-up period of I 1/2

year compared to the healthy legs was more than 50 % in

20 patients.

As complications in the early period 2 postoperative erysipelas

were seen. One patient developed a Iymph cyst in the groin and

one patient had a postthrombotic lower leg rederna.

The authors conclude that lymphvessel transplantations therefore

seem to be a method to enhance significantly the lymphatic

transport if by conservation me ans alone no long term success

is seen.