Cells of the zona fasciculata and zona reticularis lack aldosterone synthase (CYP11B2) that converts corticosterone to aldosterone, and thus these tissues produce only the weak mineralocorticoid corticosterone. However, both these zones do contain the CYP17A1 missing in zona glomerulosa and thus produce the major glucocorticoid, cortisol. Zona fasciculata and zona reticularis cells also contain CYP17A1, whose 17,20-lyase activity is responsible for producing the androgens, dehydroepiandosterone (DHEA) and androstenedione. Thus, fasciculata and reticularis cells can make corticosteroids and the adrenal androgens, but not aldosterone.
The patient had incision lines dressed with Xeroform gauge, fluff and 4-inch Kling. The patient had the hand maximally elevated in a patient tolerated the procedure well and all sponge counts, needle counts and instrument counts were correct postoperatively. The patient is aware of possible post surgical sequelae, post traumatic complications including but not limited to hypertrophic scar, wound dehiscence, wound infection, retracted scar, contracted scar, nerve compression, nerve injury, tendon injury, further wasting and numbness of the hand and the possible need for further revisional surgery and/or occupation therapy.