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https://www.readbyqxmd.com/read/28880987/association-of-mohs-reconstructive-surgery-timing-with-postoperative-complications
#1
Matthew Q Miller, Abel P David, James E McLean, Stephen S Park, Jared Christophel
Importance: Same-day Mohs reconstructive surgery is not always possible; moreover, a delay can offer benefits such as improved surgical planning and increased blood supply to the cauterized wound bed. However, recent work found that delaying reconstruction by more than 2 days increases the postoperative complication rate. Objective: To review the outcomes of Mohs micrographic surgery (MMS) reconstruction with respect to patient- and surgery-specific variables, especially timing of repair...
September 7, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28841628/aesthetic-facial-reconstruction-after-mohs-surgery
#2
William Dzwierzynski
No abstract text is available yet for this article.
September 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28802488/characterization-of-surgical-procedures-in-the-spanish-mohs-surgery-registry-regesmohs-for-2013-2015
#3
E de Eusebio Murillo, A Martín Fuentes, V Ruiz-Salas, J R Garcés, R Miñano Medrano, J L López-Estebaranz, T Alonso-Alonso, M Á Rodríguez-Prieto, Y Delgado Jiménez, V Morales, P Redondo Bellón, E Manubens-Mercadé, O Sanmartín-Jiménez, C Guillén Barona, R Cabeza, N Cano, A Toll-Abelló, R Navarro Tejedor, J L Artola Igarza, I Allende Markixana, A Alfaro Rubio, C Ciudad Blanco, H Vázquez-Veiga, L Barchino Ortiz, M A Descalzo, I García-Doval
INTRODUCTION: The Spanish Mohs Surgery Registry is used to collect data on the use and outcomes of Mohs micrographic surgery (MMS) in Spain. The aim of this study was to describe perioperative and intraoperative data recorded for MMS procedures performed between July 2013 (when the registry started) and January 2016. MATERIAL AND METHODS: Prospective cohort study of data from 18 hospitals. The data collected included type of anesthesia, surgical technique, hospital admission, number of Mohs stages, management of preoperative risk factors, additional treatments, previous treatments, type of tumor, operating time, and complications...
August 9, 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/28795284/dermatofibrosarcoma-protuberans
#4
REVIEW
Alvaro E Acosta, Catalina Santa Vélez
Dermatofibrosarcoma protuberans (DFSP) is a slow growing tumor with a very low metastatic potential but with significant subclinical extension and great capacity for local destruction. Thus, the first surgeon approached with such challenging tumor must attempt to cure the patient with a method that spares healthy tissue and ensures an optimal oncological, functional, and esthetic result. The treatment of DFSP often requires a multidisciplinary approach. Depending on location, dermatologic surgeons, surgical oncologists, head and neck surgeons, neurosurgeons, plastic surgeons, and occasionally medical oncologists may be involved with the management...
August 10, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28740787/costs-and-economics-of-skin-cancer-management-mohs-surgery-and-surgical-reconstruction
#5
Jonathan Kantor
No abstract text is available yet for this article.
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28728328/reconstruction-of-large-facial-defects-via-excision-of-skin-cancer-using-two-or-more-regional-flaps
#6
Dong Min Lee, Yong Chan Bae, Su Bong Nam, Seong Hwan Bae, June Seok Choi
BACKGROUND: Free-flap surgery and skin grafting can be used to reconstruct large facial defects that may result after skin cancer removal by Mohs micrographic surgery (MMS). However, these two methods may produce low postsurgical patient satisfaction with aesthetics, and free-flap surgery may produce an undue burden for the majority of skin cancer patients, who are of advanced age. Hence, the authors examined outcomes of large facial defect reconstruction using multiple flaps. METHODS: Among patients undergoing MMS for skin cancer at Pusan National University Hospital between January 2013 and December 2015, we evaluated 7 patients (2 males, 5 females; average age, 73...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28676169/scar-revision-and-recontouring-post-mohs-surgery
#7
REVIEW
Eric W Cerrati, J Regan Thomas
Following Mohs reconstruction, several options are available to improve the appearance of the resulting scars. It is critical that the patient has realistic goals before beginning any treatment because scars can be improved but never erased. The surgical and nonsurgical options aim to replace pre-existing scars with ones that are less conspicuous. This article addresses the different available options (listed in order of invasiveness) for improving scarring following Mohs reconstruction.
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676168/reconstruction-of-cheek-defects-secondary-to-mohs-microsurgery-or-wide-local-excision
#8
REVIEW
John E Hanks, Jeffrey S Moyer, Michael J Brenner
Successful reconstruction of the cheek following excision for cutaneous malignancy requires careful consideration of defect location, size, and depth in relation to the anatomic properties of the affected cheek unit. Various reconstructive options are available to the surgeon, ranging from simple excisions to complex cervicofacial advancements to meet the needs for functional and aesthetically pleasing reconstructive outcomes. The surgeon must prevent distortion of mobile structures, such as the eyelid, nose, and lips; respect aesthetic subunits; and avoid blunting natural creases...
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676167/reconstruction-of-mohs-defects-of-the-lips-and-chin
#9
REVIEW
Yuna C Larrabee, Jeffrey S Moyer
Reconstruction of defects of the lips after Mohs micrographic surgery should encompass functional and aesthetic concerns. The lower lip and chin compose two-thirds of the lower portion of the face. The focus of this article is local tissue transfer for primarily cutaneous defects after Mohs surgery. Various flaps exist for repair. For small defects, elliptical excision with primary closure is a viable option. During reconstruction of the lip, all of the involved layers need to be addressed, including mucosa, muscle, and the vermillion or cutaneous lip...
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676166/reconstruction-of-cutaneous-nasal-defects
#10
REVIEW
Gregory S Dibelius, Dean M Toriumi
Mohs micrographic surgery has become the standard of care for the treatment of cutaneous malignancies. Reconstructing cutaneous defects of the nose can be challenging, as form and function must be respected to the greatest extent possible. A wide range of reconstructive techniques are used. Secondary intent, primary closure, skin grafts, local flaps, and the interpolated workhorse flaps represent the spectrum of options, each with specific advantages and disadvantages. Vigilant postoperative care, including judicious use of adjunctive procedures, can improve outcomes...
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676163/scalp-and-forehead-defects-in-the-post-mohs-surgery-patient
#11
REVIEW
Michael D Olson, Grant S Hamilton
Scalp and forehead reconstruction after Mohs micrographic surgery can encompass subcentimeter defects to entire scalp reconstruction. Knowledge of anatomy, flap design, and execution will prepare surgeons who operate in the head and neck area to confidently approach a variety of reconstructive challenges in this area.
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676162/skin-and-composite-grafting-techniques-in-facial-reconstruction-for-skin-cancer
#12
REVIEW
Michael J Brenner, Jeffrey S Moyer
Skin and composite grafting provide effective resurfacing and reconstruction for cutaneous defects after excision of the malignancy. The goal is to restore a natural appearance and function while preventing distortion of the eyelid, nose, or lips. With careful planning and attention to aesthetic subunits, the surgeon can camouflage incisions and avoid blunting aesthetically sensitive sulci. The surgical plan is also informed by the pathology, as basal or squamous cell carcinomas removed by Mohs micrographic excision have different prognostic and logistical considerations from melanoma...
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676161/flap-basics-iii-interpolated-flaps
#13
REVIEW
Lauren K Reckley, Jessica J Peck, Scottie B Roofe
Paramedian forehead and melolabial flaps are the most common examples of interpolated flaps used by facial plastic surgeons and are excellent options for reconstruction of the midface after Mohs surgery. They provide superior tissue match in terms of thickness, texture, and color, while leaving minimal defects at the tissue donor sites. The main advantage of interpolated flaps is the robust blood supply, which can be either axial of randomly based, and the maintenance of the integrity of facial landmarks. The main disadvantage is the frequent need for a multistage procedure, which eliminates some patients from consideration...
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676159/flap-basics-i-rotation-and-transposition-flaps
#14
REVIEW
Sidney J Starkman, Carson T Williams, David A Sherris
In many cases of complex facial defects, because of advanced cutaneous malignancies, primary wound closure is impossible. In these instances, ideal results can be obtained through recruitment of adjacent tissue with the use of local flaps. Advances in local flap techniques have raised the bar in facial reconstruction; however, acceptable results to the surgeon and patient require high levels of planning and surgical technique. Defects resulting from Mohs surgery and other traumatic injuries can typically be repaired with local flaps...
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676158/the-physiology-and-biomechanics-of-skin-flaps
#15
REVIEW
James B Lucas
Facial skin defects created by Mohs micrographic surgery are commonly reconstructed using local cutaneous flaps from surrounding skin. To provide optimal survival and aesthetic outcomes, the cutaneous surgeon must command a thorough understanding of the complex vascular anatomy and physiology of the skin as well as the imperative physiologic and biomechanical considerations when elevating and transferring tissue via local skin flaps.
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28659596/novel-approaches-for-spatial-and-molecular-surveillance-of-porcine-reproductive-and-respiratory-syndrome-virus-prrsv-in-the-united-states
#16
Moh A Alkhamis, Andreia G Arruda, Robert B Morrison, Andres M Perez
The US swine industry has been impaired over the last 25 years by the far-reaching financial losses caused by the porcine reproductive and respiratory syndrome (PRRS). Here, we explored the relations between the spatial risk of PRRS outbreaks and its phylodynamic history in the U.S during 1998-2016 using ORF5 sequences collected from swine farms in the Midwest region. We used maximum entropy and Bayesian phylodynamic models to generate risk maps for PRRS outbreaks and reconstructed the evolutionary history of three selected phylogenetic clades (A, B and C)...
June 28, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28538028/unnecessary-cost-of-post-mohs-permanent-pathology
#17
Kelly M MacArthur, Nikki Tang, George J Hruza, Timothy S Wang, Robert G Egbers
BACKGROUND: By providing tumor-free margins, Mohs micrographic surgery (MMS) results in high cure rates in the treatment of nonmelanoma skin cancers (NMSCs). However, when closure of the post-MMS defect is coordinated with reconstructive surgery, redundant tissue is sometimes submitted for permanent section evaluation. OBJECTIVE: The purpose of our study was to investigate the frequency and effect of this practice. MATERIALS AND METHODS: Patients (12 years and older) with NMSCs cleared by MMS with coordinated closures from 2014 to 2016 were identified...
May 22, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28537859/combined-closures-in-reconstructive-surgery
#18
Nita Kohli, Kathleen Kwedar, Nicholas Golda
It is common for dermatology surgery patients to present on the day of surgery with more than one skin cancer needing Mohs micrographic surgery. When these carcinomas are located near one another, it may be more practical to treat both at the same time as the reconstruction for one defect may involve or otherwise affect the treatment or reconstruction for the other carcinoma. Treating both cancers on the same day creates an opportunity for efficient repairs where a creative single reconstruction may minimize the amount of tissue wasted during reconstruction,and minimize morbidity for the patient...
May 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28510021/molecular-assembly-and-structure-of-the-bacteriophage-t4-tail
#19
REVIEW
Fumio Arisaka, Moh Lan Yap, Shuji Kanamaru, Michael G Rossmann
The tail of bacteriophage T4 undergoes large structural changes upon infection while delivering the phage genome into the host cell. The baseplate is located at the distal end of the contractile tail and plays a central role in transmitting the signal to the tail sheath that the tailfibers have been adsorbed by a host bacterium. This then triggers the sheath contraction. In order to understand the mechanism of assembly and conformational changes of the baseplate upon infection, we have determined the structure of an in vitro assembled baseplate through the three-dimensional reconstruction of cryo-electron microscopy images to a resolution of 3...
December 2016: Biophysical Reviews
https://www.readbyqxmd.com/read/28509671/complications-in-facial-mohs-defect-reconstruction
#20
Angelique M Berens, Sarah R Akkina, Sapna A Patel
PURPOSE OF REVIEW: To review the recent literature in regards to complications after reconstruction of Mohs defects, outline common pitfalls and to discuss the literature on avoiding complications as outlined per aesthetic subunit. RECENT FINDINGS: Complications in facial Mohs reconstruction commonly consist of infection, wound necrosis and dehiscence, hematoma and suboptimal scarring. However, site-specific complications such as hairline or eyebrow distortion, eyelid retraction or ectropion, nasal contour abnormality, alar retraction, nasal valve compromise, significant facial asymmetry or even oral incompetence must also be considered...
August 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
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