Jacek Rapeła’s scientific contributions

p>A negative pressure dressing system enables effective dressing of traumatic wounds. Extensive injuries and tissue defects that accompany bone fractures and articular surface injuries require special management. In case of compound fractures, the risk of bone, joint and soft tissue infection significantly increases, so the appropriate healing process of traumatic wound is limited. Undisturbed healing process of traumatic wound is conditioned only by the proper wound dressing process by the removal of necrotic and ischemic tissues and elimination of the sources of infection and infections themselves. The article shows a case report of a patient with a traumatic subcapital humerus fracture complicated by a haematoma and then by a periarticular abscess. After the incision and drainage of a reservoir of blood and pus, a chronic infected fistula of glenohumeral joint was formed. During a prolonged therapeutic process an aggressive surgical management was implemented, by the removal of the infected bone, what eliminated the actively secreting fistula of glenohumeral joint. Following the appropriate wound preparation, the negative pressure therapy was successfully applied. In the described case the application of negative pressure dressing system enabled a gradual decrease of total wound depth and surface area and consequently, a restriction of tissue defects.</p

Gastrointestinal stromal tumor is a rare pathology. GISTs account for 0.3-1% of all tumors of the gastrointestinal tract. At the same time, this type of cancer is the most common, malignant, non-epithelial tumor of the gastrointestinal tube. Over 90% of GISTs are found in the stomach and small intestine. This cancer usually develops without characteristic clinical symptoms and is diagnosed incidentally. This clinical situation, in which the first symptom of a GIST-pattern tumor includes a fully-symptomatic, non-complicated umbilical hernia, is an unprecedented anomaly. This work presents a case report of a 77-year old female patient undergoing elective surgery, in which the contents of the hernial sac included a stromal tumor. Disseminated, multi-focal progression of the disease was found intraoperatively. Postoperative histopathology and immunohistochemistry revealed a gastrointestinal stromal tumor GIST of the spindle cell type, showing a CD-117, CD-34, SMA expression with possible starting point in the small intestine.

The content of the hernial sac may comprise peritoneal cavity elements, such as small and large bowel loops, visceral adipose tissue, the greater omentum, appendix (amyand hernia), and Meckel's diverticulum. The sliding of part of the urinary bladder wall to the inguinal canal is rare, being observed in 1%-4% (0.5%-3%) of inguinal hernia cases. Complete migration of the urinary bladder to the scrotum is considered a rare anomaly. As of today, 100 such cases have been described.