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mohs reconstruction

Min Seok Kang, Eun Jung Lee, Ji Seop Kim, In Sik Yun, Hyung Kwon Byeon
Microcystic adnexal carcinoma (MAC) is a rare malignant cutaneous adenocarcinoma that typically occurs in the head and neck, particularly at the central face. There are only slightly more than 300 patients reported worldwide, and most patients occur in Caucasians. A 72-year-old man was referred to our hospital for definitive treatment of known MAC from previous biopsy. Wide excision of nasal tip and reconstruction of nasal defect with paramedian forehead flap and nasolabial flap transposition were performed rather than conventional Mohs surgery, due to grossly evident disease...
October 14, 2016: Journal of Craniofacial Surgery
Michael Bickell, Jonathan Beilan, Jared Wallen, Lucas Wiegand, Rafael Carrion
This article reviews the most up-to-date surgical treatment options for the reconstructive management of patients with penile, urethral, and scrotal cancer. Each organ system is examined individually. Techniques and discussion for penile cancer reconstruction include Mohs surgery, glans resurfacing, partial and total glansectomy, and phalloplasty. Included in the penile cancer reconstruction section is the use of penile prosthesis in phalloplasty patients after penectomy, tissue engineering in phallic regeneration, and penile transplantation...
November 2016: Urologic Clinics of North America
C Blake Perry, Richard C Allen
INTRODUCTION: Repair of large defects of the lower eyelid can be difficult. A common procedure performed to address these defects is a Hughes flap. This procedure has a number of disadvantages: The eye is closed postoperatively, a second stage is required, and the edge of the flap is often erythematous. The purpose of this paper is to describe a one-stage procedure for the repair of large full-thickness defects of the lower lid as an alternative to a Hughes flap. MATERIALS AND METHODS: This is a retrospective study of patients who underwent the described procedure...
August 2016: Indian Journal of Ophthalmology
Ani Tajirian, Michelle Tsui
OBJECTIVE: Following Mohs surgery, medium-to-large defects on the central forehead can often be complicated to surgically reconstruct. In this paper, the authors discuss possible central forehead reconstructions and report their successful experience employing a simple primary vertical linear closure with a special technique to demarcate forehead rhytides rather than performing an overly complicated flap or graft. CASE REPORT: The patient was a 57-year-old man who presented with a broad superficial basal cell carcinoma that required treatment with Mohs surgery...
August 2016: Journal of Clinical and Aesthetic Dermatology
Junqian Zhang, Christopher J Miller, Joseph F Sobanko, Thuzar M Shin, Jeremy R Etzkorn
BACKGROUND: No evidence-based surgical guidelines exist for atypical intraepidermal melanocytic proliferation (AIMP), a descriptive histopathologic diagnosis with uncertain malignant potential. OBJECTIVE: We sought to identify the frequency of and risk factors associated with positive or equivocal margins after conventional excision. METHODS: We conducted a retrospective cross-sectional study of 413 AIMPs treated by conventional excision. RESULTS: Positive or equivocal margins were seen in 2...
October 2016: Journal of the American Academy of Dermatology
Julio Magliano, Sofia Falco, Caroline Agorio, Carlos Bazzano
BACKGROUND: When possible, surgery is the treatment of choice for cutaneous carcinomas, as it allows to us perform the anatomopathological study and control the surgical margins. Mohs micrographic surgery (MMS) controls 100% of the margins, maintains a larger amount of healthy tissue, and a fewer number of recurrences are seen. Large limb surgical defects after MMS are a challenge. Within the different kind of flaps, the keystone flap, which is a fasciocutaneous island advancement flap, is an option...
July 15, 2016: International Journal of Dermatology
Helen A Moses, Charles R Woodard
PURPOSE OF REVIEW: The article reviews the current literature to provide an overview on contemporary reconstructive options for closure of Mohs defects of the nose that are 1.5 cm or less. RECENT FINDINGS: Although some of the techniques described in the literature are of historical importance only, others have undergone modification and metamorphosis to be broadly used in their contemporary form. Others are implemented in their original design, irrespective of relative age or multiple attempted adaptations...
August 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Julia Dai, Jeremy S Bordeaux, Christopher J Miller, Joseph F Sobanko
BACKGROUND: Resident surgical education and technical skills may be enhanced with deliberate practice-based learning. Deliberate practice methods, such as simulation-based training and formal skills-based assessments, allow for trainees to repeatedly practice a defined task with expert supervision and feedback. OBJECTIVE: The authors sought to characterize how surgical skills are taught and assessed in dermatology residency, with an emphasis on whether deliberate practice methods are incorporated in the surgical curriculum...
August 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Nicola A Quatrano, Tamara B Dawli, Andrew J Park, Faramarz H Samie
The forehead is a unique facial region with distinct boundaries and variability in shape from patient to patient. When reconstructing the forehead, it is critical to take into account the regional boundaries as their distortion may result in noticeable facial asymmetry. We propose subdividing the forehead into newly defined zones and put forth a rational algorithm for forehead repair based on these divisions. We retrospectively reviewed a single surgeon's (F. H. S.) experience with Mohs excision and immediate reconstruction of the forehead over a 3-year period...
June 2016: Facial Plastic Surgery: FPS
Martijn A van Onna, Mona Haj, Jeroen M Smit, Maarten M Hoogbergen
BACKGROUND: Due to incidental occurrence of ectropion as a late complication of cheek advancement flaps, this study investigated the long-term effects of these flaps for post-Mohs' reconstruction of the cheek aesthetic. METHODS: All the patients who underwent a cheek advancement flap in the Catharina Hospital Eindhoven between January 2006 and January 2013 where included and assessed by means of a retrospective chart review and a survey about the long-term outcome and patient satisfaction...
May 31, 2016: Journal of Plastic Surgery and Hand Surgery
Sapna A Patel, Jack J Liu, Craig S Murakami, Daniel Berg, Sarah R Akkina, Amit D Bhrany
IMPORTANCE: Same-day Mohs reconstructive surgery is not always possible owing to patient factors, scheduling, and complexity of defect, but there is hesitancy in delaying closure of such defects. OBJECTIVE: To describe the frequency of and predictors of complications in patients undergoing delayed facial reconstruction after Mohs micrographic surgery (MMS). DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective, multi-institutional cohort study from February 1, 1989, to December 31, 2012...
September 1, 2016: JAMA Facial Plastic Surgery
Ahmed Hamroush, David Cheung
We present a case of an 84-year-old man with advanced glaucoma on multiple unilateral glaucoma medication. He had 2 years history of unilateral ocular irritation thought to be related to his medication. Patient was referred to an oculoplastic clinic and found to have segmental eyelash loss partially masked by hypertrichosis caused by glaucoma medications. His symptoms were initially thought to be related to drop-induced blepharitis. A clinical diagnosis of possible basal cell carcinoma (BCC) was made and the incisional biopsy showed infiltrative micronodular BCC...
2016: BMJ Case Reports
Bijnya Birajita Panda, Sucheta Parija, Susanta Pujahari, Jyotiranjan Mallick
Malignant tumours of the face are usually seen in the periocular region, mainly on eyelids most commonly in the inferior eyelid, medial canthus and superior eyelid, respectively. The prime treatment for eyelid malignant tumours is the total excision of the lesion with frozen section control or by Mohs Micrographic surgery. The postoperative defects should be reconstructed judicially taking care that the near normal anatomical and functional recovery is achieved. The Cutler-Beard flap procedure, a good alternative in the reconstruction of superior near-total eyelid defects resulted in good restoration of anatomy and function in our patient...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Jeremy R Etzkorn, Joseph F Sobanko, Thuzar M Shin, Rosalie Elenitsas, Emily Y Chu, Joel M Gelfand, David J Margolis, Jason G Newman, Hayley Goldbach, Christopher J Miller
BACKGROUND: Published appropriate use criteria (AUC) for Mohs micrographic surgery (MMS) for melanoma are based on consensus opinion. OBJECTIVE: To evaluate whether published AUC identify melanomas for which MMS may benefit patients by detecting subclinical spread or confirming clear microscopic margins before flap or graft reconstruction. MATERIALS AND METHODS: Retrospective cohort study of 591 melanomas in 556 patients evaluating the correlation between current AUC (anatomic location, recurrent status, and tumor stage) and subclinical spread or reconstruction with a flap or graft...
April 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Meredith S Baker, Vivian T Yin, Doina Ivan, Richard C Allen, Keith D Carter, Bita Esmaeli, Erin M Shriver
PURPOSE: To characterize the clinical presentation, management, and outcomes of patients with sweat gland carcinoma of the periocular region. To review the pathologic classification scheme, compare the clinical behavior between subtypes, and discuss treatment recommendations for periocular sweat gland carcinomas. METHODS: Retrospective study from 2 tertiary centers, which are part of the American Society of Ophthalmic Plastic and Reconstructive Surgery Oncology Database...
March 11, 2016: Ophthalmic Plastic and Reconstructive Surgery
Matthew Q Miller, Shefali R Rikhi, Stephen S Park, John J Christophel
OBJECTIVES/HYPOTHESIS: To construct an easy-to-use server-based database that stores photographs of patients undergoing reconstructive surgery for cutaneous facial defects and organizes them in a manner best suited for rapid search and education. STUDY DESIGN: An institutional review board-approved user-modifiable database was designed using OnBase software (Hyland Software Inc., Westlake, OH) to store both the photographs of patients undergoing reconstructive surgery and the pertinent clinical data...
March 12, 2016: Laryngoscope
Joshua W Trufant, Sean Marzolf, Brian C Leach, Joel Cook
BACKGROUND: Full-thickness skin grafts (FTSGs) are a common repair option on the external ear, but there are few large case series examining graft sublocations, dimensions, and outcomes. OBJECTIVE: We sought to report our experience with FTSGs for repair of postsurgical defects of the external ear. METHODS: We conducted a retrospective review of all FTSGs on the ear performed by 2 surgeons (J. C., 2000-2014; B. C. L., 2007-2014) after clearance by Mohs micrographic surgery at a single institution...
July 2016: Journal of the American Academy of Dermatology
Charlotte L Thomas, Alvin Lam, Janice Lam, Robert Paver, Leslie Storey, Pablo Fernandez-Peñas
BACKGROUND/OBJECTIVES: In Mohs micrographic surgery (MMS) the dermatologist serves as surgeon, pathologist and reconstructive surgeon. Analysis of the factors that play a part in determining defect size and closure type may result in better patient outcomes. The objective was to identify factors contributing to the defect size and closure method employed in MMS. METHODS: Retrospective analysis of all MMS performed for non-melanoma skin cancers (NMSC) of the head at the Skin and Cancer Foundation Australia, Westmead, between 1 January and 31 December 2007...
February 24, 2016: Australasian Journal of Dermatology
Rajshree Jayarajan
The use of the nasocheek sulcus flap with a cartilage strut provides an aesthetically pleasing result in total columella reconstruction. This provides thin hairless skin appropriate for the subunit. Mohs surgery aids in limiting the excision to the tumor involved area, providing a complete clearance and conserving precious units, which have an impact on the reconstructive options. The method of reconstruction described here is simple and easily reproducible, providing an optimal result with almost no donor site morbidity...
November 2015: Plastic and Reconstructive Surgery. Global Open
Zachary R Jergensen, Ronnie A Pezeshk, James F Thornton
BACKGROUND: Optimal aesthetic results are achieved when nasal defects after Mohs micrographic surgery (MMS) are reconstructed as entire nasal subunits. OBJECTIVE: To illustrate the importance of reconstructing the nose in entire subunits and explore the possibilities of expanding the principles of subunit reconstruction to the concept of subunit Mohs excision. METHODS: An 83-year-old man presented for MMS to excise 3 lesions on the nasal ala...
July 2016: Journal of Cutaneous Medicine and Surgery
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