1,720,986 research outputs found
Exploring the role of surgical margins and reoperation in basal cell carcinoma recurrence: a study of 3036 cases
Full text linkIntroduction: Basal cell carcinoma (BCC) is the most common type of skin cancer globally, with its prevalence increasing due to chronic ultraviolet (UV) radiation exposure. Although surgical excision remains the cornerstone of treatment, achieving optimal outcomes requires a careful balance between complete tumor removal and the preservation of cosmetic appearance. Objective: This study aims to investigate the relationship between excision margins, reoperation rates, and BCC recurrence through a retrospective analysis of 3036 surgical excisions. Methods: Conducted at the Department of Plastic Surgery in Trieste, Italy, this study includes data from 2037 patients treated between 2014 and 2018. Excision procedures adhered to standardized hospital protocols. Tumor characteristics, excision margins, and involved anatomical sites were analyzed. Results: The study demonstrated an equal gender distribution (51.02% women), with the nodular subtype (45.85%) being the most common. The head was the most frequently affected site (54.74%). A complete excision rate of 93.3% was achieved, but incomplete excisions were more common in head and neck locations and certain histological subtypes. Surgical reinterventions were primarily performed for high-risk BCCs, significantly reducing recurrence rates (0.52%). Conclusion: Reoperation, especially for high-risk BCCs, should be prioritized over conservative management to minimize recurrence. Narrow excision margins were associated with higher recurrence rates, highlighting the importance of adequate margin clearance. This study enhances understanding of the complex interplay between excision techniques, reoperation, and long-term outcomes in BCC management
Suture anchors to fix free flaps in oral and oropharyngeal reconstruction
No full textThe Mitek® suture anchors (Depuy Mitek Surgical Products,Inc.Raynham, Massachusetts) are produced in a number of differentsizes(micro, mini, GII, and Super) but we use the mini. It is composed of a body and two wings, the body being made oftitaniumalloy, and the wings of nickel-titaniumalloy, which benefits from superelasticity and its memory of shape. The packaging includes both the anchor and the insertion device, in which the anchor is already preloaded. The bottom of the anchor has a loop that contains the suture, which is charged on to the insertion device
Five years of experience using a dermal substitute: indications, histologic studies, and first results using a new single-layer tool.
No full textBACKGROUND: Dermal substitutes have been used in Europe since 1996 as a mean of reconstructing the dermal layer.
OBJECTIVES: To introduce the dermal substitute as a dual-stage reconstructing procedure using the dual-layer version and as a single-stage procedure, combining the single layer with a skin graft to achieve immediate closure. Our further objective was to evaluate the persistence of a commercial dermal substitute in the host's dermal layer using serial histologic studies.
MATERIALS AND METHODS: The dermal substitute used was a membrane made using a porous coprecipitate of type I bovine collagen and glycosaminoglycan organized in a three-dimensional structure that allows the host's cell to migrate into it. It is available in a double-layer structure, covered by a silicone sheet, and in a single-layer structure without silicon.
RESULTS AND CONCLUSION: We describe the dermal substitute indications in dermatologic surgery and our first results with the single layer as a single-stage procedure with an 80% to 100% take rate. Our histological studies of both products show their perfect integration and the persistence of the peculiar three-dimensional structure (neodermis) 5 years from implantation of the dual-layer dermal substitute
Macrovascular arteriovenous shunt (MAS) between ulnar artery and its venae comitantes: The cause of arterial thrombosis and insufficiency in a distally based ulnar forearm perforator (UAP) flap used for intraoral reconstruction
No full textMacrovascular arteriovenous shunt (MAS) between ulnar artery and its venae comitantes: The cause of arterial thrombosis and insufficiency in a distally based ulnar forearm perforator (UAP) flap used for intraoral reconstruction
Surgical Therapy: mastoplasty.
No full textThis book is especially focused on the surgical aspect on Gender Dysphoria. Male to female surgery is widely discussed as well as the female to male conversion. Full information on hormone administration and surgical procedures are provided. Mental health issues are also described, as well as ethics, the law and psychosocial issues. The text is extensively referenced and includes numerous photos, tables and figures to clearly illustrate information. Based on collaboration between international experts in transgender health, this book is an essential guide for health care professionals, educators, students, patients and patients’ families concerning the psychological, hormonal, surgical and social support of transgender individuals
Flexor hallucis longus transfer and composite anterolateral thigh fascio-cutaneous flap for reconstruction of massive chronic and infected Achilles tendon lesion. A case report and review of the literature
Full text linkAchilles tendon reconstruction with substance loss and infection in the overlying soft tissues is a challenge. There is no standardized treatment in literature for these cases. We describe a one-stage tendon reconstruction, using flexor hallucis longus (FHL) tendon transfer and an anterolateral thigh flap with vascularized fascia lata in a patient with re-rupture of the Achilles tendon, soft tissue infection and a tendon defect of 10 cm in length. The surgical procedure has had a successful outcome; patient has recovered normal gait, has recovered complete ankle range of motion with only a partial loss in plantar flexion of the big toe, without any loss in strength. No complications have emerged at follow-up. This technique is promising in treating large Achilles tendon defects with overlying soft tissue infection in a one-stage procedure. (www.actabiomedica.it
Reconstruction after wide excision in medial canthal region: The extended bilobed glabellar-palpebral flap
No full textReconstruction after excision of non-melanoma skin cancer involving the medial canthal region is a functional and aesthetic challenge. Several important anatomical structures (the lacrimal duct, the medial canthal ligaments and the superior and inferior eyelids with anterior and posterior lamellae) that the surgeon must preserve or has to reconstruct may be involved in the excision.
Several techniques for reconstructing this region have been described in the literature but all of them present several limits
Total Phallic reconstruction in female-to-male transsexual by the pedicle anterolateral (ALT) flap
No full textTotal Phallic reconstruction in female-to-male transsexual by the pedicle anterolateral (ALT) fla
Assisted Healing-Selective Delayed Reconstruction for Subacute Traumatic Wounds of the Lower Limb
Full text linkPatients often are being referred to plastic surgery for reconstruction of complex wounds in the subacute phase of healing. According to Godina,1 the time interval for the acute reconstruction (early free flaps) is less than 72 hours.2 Byrd et al,3 however, believe that the acute period of the wound lasts 1 week. Only after that, the wound enters in the subacute phase in which treatment of complex wounds becomes more prone to complications (bone and soft-tissue infection, free flap failure)
Clinical use of semiliquid dermal substitute: A case report
No full textNowadays IntegraTM is an integral part of the "reconstructive ladder", recently the new IntegraTM Flowable Dermal Regeneration has appeared on the market. This is a semiliquid compound, malleable and those characteristics widen the indication for its use. In this report we describe two cases in which we used this product to repair undermined and tunnelled wounds. We believe that this product can be useful for treatment of tunnelled wounds of small dimensions reducing the need for major procedures
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