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Cutaneous Surgery

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https://www.readbyqxmd.com/read/27920067/injectable-diphenhydramine-used-as-anaesthetic-for-wide-local-excision-with-flap-closure
#1
Laura E Pickett, Jillian Macdonald
BACKGROUND: Lidocaine-allergic patients pose a challenge for cutaneous surgical procedures. We present a case of a successful wide local excision with flap closures on the face using topical tetracaine followed by infiltration with 1% diphenhydramine. CASE SUMMARY: An 84-year-old woman, with a lidocaine intolerance, presented to the Mohs surgery clinic for wide local excision of a nodular basal cell carcinoma on her right medial cheek. Successful anaesthesia was achieved using topical 4% tetracaine followed by intradermal and subcutaneous injection of 1% diphenhydramine...
December 5, 2016: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/27911468/radical-cystectomy-and-cutaneous-ureterostomy-in-4-dogs-with-trigonal-transitional-cell-carcinoma-description-of-technique-and-case-series
#2
Rafael Ricardo Huppes, Leandro Z Crivellenti, Andrigo Barboza De Nardi, Bruno Roque Lima, Cristiane Alves Cintra, Jorge Luiz Costa Castro, Christopher A Adin
OBJECTIVE: To describe radical cystectomy followed by cutaneous ureterostomy as a treatment of invasive bladder neoplasia in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs with transitional cell carcinoma of the bladder trigone (n=4). METHODS: Perioperative complications and long-term outcomes of dogs that underwent cutaneous ureterostomy following radical cystectomy and lymphadenectomy for transitional cell carcinoma of the urinary bladder trigone were reviewed...
December 1, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27910800/routine-x-ray-of-the-chest-is-not-justified-in-staging-of-cutaneous-melanoma-patients
#3
Caroline Asirvatham Gjørup, Helle Westergren Hendel, Rita Kaae Pilegaard, Cecilie Balslev Willert, Lisbet Rosenkrantz Hölmich
INTRODUCTION: The incidence of cutaneous melanoma is increasing in Denmark and worldwide. However, the prevalence of distant metastases at the time of diagnosis has decreased to 1%. We therefore questioned the value of routine preoperative chest X-ray (CXR) for staging asymptomatic melanoma patients and hypothesised that routine CXR is not justified. METHODS: A retrospective study was conducted on patients undergoing wide local excision and sentinel lymph node biopsy for cutaneous melanoma in the period from 2010 to 2014...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27909895/invasive-cutaneous-infection-due-to-scopulariopsis-brevicaulis-unsuccessfully-treated-with-high-dose-micafungin-in-a-neutropenic-patient
#4
Daniela Gavril, Paul-Louis Woerther, Aicha Ben Lakhdar, Linda Mahjoubi, Emilie Routier, Elisabeth Chachaty, Bertrand Gachot, Stephane De Botton, Jean-Baptiste Micol, Christophe Willekens
Scopulariopsis brevicaulis onychomycosis with local cutaneous invasion was diagnosed in an acute leukemia patient and unsuccessfully treated with high-dose micafungin, based on antifungal susceptibility testing. This case should alert clinicians to the possible severe evolution of onychomycosis in neutropenic patients and suggests that surgery should be preferred in such a situation.
December 1, 2016: Infection
https://www.readbyqxmd.com/read/27909818/presto-lift-a-facelift-that-preserves-the-retaining-ligaments-and-smas-tethering
#5
Wolfgang Funk
BACKGROUND: Producing youthful facial appearance by face-lifting often comes along with an undesired loss of patient's individual phenotype. This may result from insufficient preservation of retaining ligaments, the "guardians of facial identify," and from severance of the intersegmental connections of the superficial musculo-aponeurotic system (SMAS), which tether, structure, and compartmentalize facial soft tissue into defined, relevant anatomical zones. METHODS: The technique reported here preserves most retaining ligaments...
December 2, 2016: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27903471/bovine-pericardium-as-new-technical-option-for-in-situ-reconstruction-of-aortic-graft-infection
#6
Brigitta Lutz, Christian Reeps, Gabor Biro, Christoph Knappich, Alexander Zimmermann, Hans-Henning Eckstein
OBJECTIVE: Alloplastic aortic graft infection is a devastating complication following aortic surgery. It is associated with excessively high mortality and morbidity caused by anastomotic rupture or septicemia. Many authors consider in situ replacement after complete surgical graft removal as the method of choice. However, there is an ongoing debate about the most suitable material for reconstruction. We present our first experiences with replacing the descending and infra-renal aorta using custom-made bovine pericardium grafts...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27895450/dermatofibrosarcoma-protuberans-a-case-report-and-review-of-the-literature
#7
D Paramythiotis, G Stavrou, D Panagiotou, G Petrakis, A Michalopoulos
BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) represents less than 0.1% of all tumors, but it is considered the most common skin sarcoma. Wide local excision (=5 cm) has been largely replaced by Mohs micrographic surgery; however, recurrence is not rare. Description of the case: A 35-year-old man presented with a large tumor on the upper side of his back and underwent local excision with the possible preoperative diagnosis of lipoma. Upon histological examination, the diagnosis of DFSP was made, and the patient underwent wide local excision with skin flap reconstruction and was referred for adjuvant radiotherapy...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27894880/lymphoma-of-the-eyelid
#8
REVIEW
Frederik Holm Svendsen, Steffen Heegaard
Lymphoma of the eyelid constitutes 5% of ocular adnexal lymphoma. In previously published cases, 56% of lymphomas of the eyelid are of B-cell origin and 44% are of T-cell origin. The most frequent B-cell lymphomas are extranodal marginal zone lymphoma (27 cases--14%) and diffuse large B-cell lymphoma (18 cases--9%). T-cell lymphomas are most frequently mycosis fungoides (25 cases--13%), extranodal NK/T-cell, nasal type lymphoma (12 cases--6%) and primary cutaneous anaplastic large cell lymphoma (12 cases--6%)...
November 25, 2016: Survey of Ophthalmology
https://www.readbyqxmd.com/read/27894385/-effect-of-expanded-lateral-thoracic-abdominal-flap-transferred-with-pedicle-on-repairing-large-area-of-hypertrophic-scar-after-burn-of-the-upper-extremity
#9
C D Xia, J D Xue, H P Di, J L Niu, X L Li, D Y Cao, Q Li, X H Niu
Objective: To observe the effect of expanded lateral thoracic abdominal flap transferred with pedicle on repairing large area of hypertrophic scar after burn of the upper extremity. Methods: Twelve patients with large area of secondary hypertrophic scar 8 month to 3 years after healing of burn wound on the upper extremity were hospitalized in Zhengzhou First People's Hospital from October 2008 to October 2015, with scar area ranging from 11 cm×7 cm to 20 cm×10 cm. Five patients were with limited straightening and bending of elbow...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27893551/mid-face-degloving-an-alternate-approach-to-extended-osteotomies-of-the-midface
#10
Anantanarayanan Parameswaran, Naveen Kumar Jayakumar, Manikandhan Ramanathan, Hermann F Sailer
Extended osteotomies for mid-face advancement require generous exposure of the anterior maxilla, nasal bones, infraorbital rims, orbital floor, zygoma, and the anterior third of the zygomatic arches. This cannot be obtained with an exclusive transoral approach. Hence, the surgeon is usually compelled to utilize supplemental cutaneous incisions that are a compromise on the purpose behind a cosmetic surgery. In order to alleviate the need for such compromise, the authors advocate the mid face degloving approach for extended osteotomies at Lefort II and Lefort III levels...
November 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27889195/metastasectomy-in-cutaneous-melanoma
#11
REVIEW
K Lasithiotakis, O Zoras
Metastectomy remains the only treatment in malignant melanoma to offer complete pathologic response within a few days of in-hospital stay. It has been historically associated with the highest survival rates in the literature reported for patients of this stage. However, only a minority of patients are amenable to curative resection of distant metastatic disease. This patient group exhibit slow growing oligometastases as indicated by: a. Long disease free interval after treatment of their primary tumours and b...
November 13, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27884329/saphenous-artery-based-flap-models-in-rats-new-flap-designs-for-experimental-studies
#12
Ersin Aksam, Berrak Aksam, Mustafa Erol Demirseren, Huban Sibel Orhun Yavuz
BACKGROUND: Experimental research using laboratory animals provides substantial data about reconstructive surgery. However, the literature does not include any experimental studies that have used flap models on the hind limbs of rats. To gain an understanding of the physiology of lower-extremity flaps and of flap failures, this study assessed the cutaneous perforators of the saphenous artery, and new flap models were designed for the hind limbs of rats. MATERIALS AND METHODS: The experiment was designed to include three stages and used 35 rats...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27879139/-liver-metastases-of-malignant-melanoma-utility-of-resection-or-radiofrequency-ablation
#13
V Třeška, T Skalický, I Třešková, V Liška, J Fichtl, J Brůha, E Korčáková
INTRODUCTION: Incidence of cutaneous and uveal forms of malignant melanoma (MM) has increased significantly in the population in the last years. Biological behavior of both these forms of MM is different and is associated with the development of liver metastases. The prognosis of patients with MM liver metastases is generally poor. The authors seek to consider the sense and the possibilities of surgical treatment of MM liver metastases. METHOD: Seven patients with liver metastases of MM were operated on in the Hepatobiliary Center of the Department of Surgery, University Hospital in Pilsen during the last ten years...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/27873142/university-hospital-waterford-5-year-experience-of-cutaneous-melanoma
#14
R Sehgal, C X Cheung, R Alradadi, D A Healy, R Landers, G T O'Donoghue
INTRODUCTION: The incidence of cutaneous melanoma (CM) continues to rise in Ireland. Despite significant advances in melanoma molecular therapy, surgery remains the mainstay of treatment for CM. The University Hospital Waterford (UHW) prospectively maintained CM registry was established in 2010. AIM: To summarize 5-year experience (2010-2015) of primary CM presenting to UHW. METHODS: Data were retrospectively obtained from a central electronic pathology and radiology repository augmented by HIPE data and theatre logs...
November 21, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#15
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867513/ultrasound-guided-alcohol-neurolysis-of-lateral-femoral-cutaneous-nerve-for-intractable-meralgia-paresthetica-a-case-series
#16
Arif Ahmed, Divesh Arora, Amit Kumar Kochhar
Meralgia paresthetica is a rare sensory entrapment neuropathy which leads to burning, tingling and numbness in the antero-lateral aspect of thigh. Mostly it runs a benign course, and responds to conservative measures. We present a case series of six patients with intractable meralgia paresthetica with severe pain over antero-lateral thigh along the distribution of lateral cutaneous nerve of thigh which was further confirmed by nerve conduction study. These patients did not respond to the oral anti-neuropathic medications...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27863028/utility-of-hybrid-spect-ct-in-primary-melanoma-lymphoscintigraphy-a-retrospective-case-series
#17
Khimling Tew, David Farlow
INTRODUCTION: Sentinel lymph node (SLN) biopsy is widely accepted as an important part of staging cutaneous malignant melanoma. Hybrid single photon emission computed tomography and computed tomography (SPECT/CT) may identify additional SLN and provide important information to the surgeon performing SLN biopsy. We report our experience at a major referral centre for melanoma surgery. METHODS: Retrospective case series of pre-operative sentinel node lymphoscintigraphy for primary melanoma over a consecutive 12-month period...
November 14, 2016: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/27862152/cutaneous-polyarteritis-nodosa-localized-to-a-region-of-lymphedema-secondary-to-streptococcus-viridans-cellulitis-and-multiple-surgeries
#18
Andrew Matsumoto, Rami N Al-Rohil, Marina Bravin, Lori Anderson, Danielle Wroblewski, J Andrew Carlson
Cutaneous polyarteritis nodosa (CPAN) is a chronic, indolent, single organ arteritis that generally presents with lower extremity nodules and/or livedo racemosa, accompanied by malaise and arthralgias. CPAN is often triggered by infection, commonly Group A streptococcal species, and is considered an autoimmune reaction. Scarring from surgery and obliterative lymphangiitis from bacterial cellulitis are causes of lymphedema. Lymphedematous skin is predisposed to autoimmune disorders. Herein we report a 53yo woman who developed CPAN restricted to a localized area of the right upper arm-shoulder that had undergone multiple surgeries, complicated by episodes of Streptococcus viridans cellulitis...
November 10, 2016: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/27857904/successful-pregnancy-after-excision-of-cesarean-scar-endometriosis-with-uterovesicocutaneous-fistula-a-rare-case-report
#19
Sunil Kumar Juneja, Pooja Tandon, Isha Chopra
Scar endometriosis is an infrequent type of extrapelvic endometriosis. The most common extrapelvic form of endometriosis is cutaneous endometriosis, involving scar tissues occurring after obstetric or gynecologic procedures such as episiotomy, hysterotomy, cesarean section, and even laparoscopic surgery. The clinical presentation of scar endometriosis, i.e., tender swellings, mimics other dermatological and/or surgical conditions and delays the diagnosis. Scar endometriosis very rarely can get complicated with uterocutaneous fistula with a reported incidence of very few cases in world literature...
October 2016: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/27856288/a-multicenter-randomized-controlled-trial-evaluating-a-connexin43-mimetic-peptide-in-cutaneous-scarring
#20
Christina L Grek, Jade Montgomery, Meenakshi Sharma, A Ravi, J S Rajkumar, Kurtis E Moyer, Robert G Gourdie, Gautam S Ghatnekar
BACKGROUND: The transmembrane protein, connexin43 (Cx43) has key roles in fibrogenic processes including inflammatory signaling and extracellular matrix composition. aCT1 is a Cx43 mimetic peptide that in preclinical studies accelerated wound closure, decreased inflammation and granulation tissue area and normalized mechanical properties following cutaneous injury. PURPOSE: We evaluated the efficacy and safety of aCT1 in the reduction of scar formation in human incisional wounds...
November 14, 2016: Journal of Investigative Dermatology
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