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mohs reconstruction

Jeremy R Etzkorn, Scott D Tuttle, Ilya Lim, Elea M Feit, Joseph F Sobanko, Thuzar M Shin, Donald E Neal, Christopher J Miller
BACKGROUND: Surgical treatment options for facial melanomas include conventional excision with postoperative margin assessment (CE-POMA), Mohs micrographic surgery with immunostains (MMS-I) or slow Mohs. Patient preferences for these surgical options have not been studied. OBJECTIVES: To evaluate patient preferences for surgical treatment of facial melanoma and to determine how patients value the relative importance of different surgical attributes. METHODS: Participants completed a two-part study consisting of a stated preference survey and a choice-based conjoint analysis (CBCA) experiment...
March 2, 2018: Journal of the American Academy of Dermatology
Moh A Alkhamis, Carmina Gallardo, Cristina Jurado, Alejandro Soler, Marisa Arias, José M Sánchez-Vizcaíno
African swine fever (ASF) is a complex infectious disease of swine that constitutes devastating impacts on animal health and the world economy. Here, we investigated the evolutionary epidemiology of ASF virus (ASFV) in Eurasia and Africa using the concatenated gene sequences of the viral protein 72 and the central variable region of isolates collected between 1960 and 2015. We used Bayesian phylodynamic models to reconstruct the evolutionary history of the virus, to identify virus population demographics and to quantify dispersal patterns between host species...
2018: PloS One
Alberto Goldman, Uwe Wollina, Katlein França, Torello Lotti, Georgi Tchernev
Squamous cell carcinoma is the most common malignancy of the lower lip. Environmental factors such as ultraviolet light exposure, arsenic and smoking are contributing factors to the increasing incidence. Mohs surgery is the treatment of choice ensuring the lowest recurrence rates. The closure of the surgical defects, however, can be a challenge. Multiple and versatile methods of reconstructing vermilion defects have been described. Among these options, Goldstein developed the adjacent ipsilateral vermilion flap based on an arterialized myocutaneous flap...
January 25, 2018: Open Access Macedonian Journal of Medical Sciences
Ryan B Thorpe, Rajiv I Nijhawan, Divya Srivastava
BACKGROUND AND OBJECTIVE: The V-to-Y advancement flap, also known as the island pedicle flap, is a single-stage repair option that can be used for defects on the distal nose. We report our experience using this flap for nasal defects following Mohs micrographic surgery, as well as describe optimal patient selection and flap design. MATERIALS AND METHODS: A retrospective review was conducted of all patient charts and operative photographs of nasal V-to-Y advancement flaps performed over 6 years at the Universtiy of Texas Southwestern Medical Center...
February 1, 2018: Journal of Cutaneous Medicine and Surgery
Adam Tinklepaugh, Zain Husain, Tiffany J Libby, David Ciocon
No abstract text is available yet for this article.
January 29, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Payal M Patel, Judah N Greenberg, Kathryn L Kreicher, Nicole M Burkemper, Jeremy S Bordeaux, Ian A Maher
BACKGROUND: The paramedian forehead flap (PMFF) is the repair of choice for large nasal defects involving multiple cosmetic subunits. However, the PMFF may not be optimal for all patients. The combination of a melolabial interpolation flap (MLIF) and a nasal sidewall flap may serve as an alternative. OBJECTIVE: To present the surgical technique and aesthetic outcomes of the alternative reconstruction for surgical defects of the lower nose. MATERIALS AND METHODS: Fourteen patients with multisubunit nasal Mohs defects reconstructed alternatively were identified from 2 academic centers in this retrospective case series...
January 22, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Elizabeth A Insull, Varajini Joganathan, Jonathan H Norris
PURPOSE: The "reading man" flap (RMF), a double advancement transposition cutaneous flap named for its appearance, has been described in the reconstruction of various circular skin defects, particularly in the malar region. We describe two cases where this flap was used to reconstruct the lower eyelid/periorbital region. METHODS: Two oculoplastic patients with lower eyelid basal cell carcinomas underwent Mohs micrographic excision resulting in a large skin defects...
January 15, 2018: Orbit
Shruti Aggarwal, Christopher T Shah, Maria Kirzhner
To describe a novel technique utilizing an amniotic membrane graft (AMT) to create the mucocutaneous portion of the lower eyelid margin in a modified Hughes eyelid reconstruction for secondary revision or prevention of a hyperemic, hypertrophic conjunctival margin with excessive discharge. This was a retrospective, non-comparative interventional study. Thirty consecutive patients who underwent a modified Hughes reconstruction were included. The first step of the reconstruction was performed in a standard fashion using a tarsoconjunctival flap from the ipsilateral upper eyelid...
January 15, 2018: Orbit
J Navarrete, J Magliano, M Martínez, C Bazzano
BACKGROUND AND OBJECTIVES: The primary goal of Mohs micrographic surgery (MMS) is to completely excise a cancerous lesion and a wide range of reconstructive techniques of varying complexity are used to close the resulting wound. In this study, we performed a descriptive analysis of patients who underwent MMS, with a focus on wound closure methods. MATERIAL AND METHODS: We conducted a bidirectional descriptive cohort analysis of all MMS procedures performed by a single surgeon between November 2013 and April 2016...
December 14, 2017: Actas Dermo-sifiliográficas
V Chaussade
This "What's new in instrumental dermatology" dedicated skin surgeryis based upon a 2015-2017 literature analysis. The excision of skin cancers is an important part of surgical dermatology. Will artificial intelligence and new drug be able to face the increasing need for therapy? Wrong-site surgery is due to multiple factors. Photographs of biopsy site and short time between biopsy and surgery decrease postponement of surgery and wrong-site surgery. Noninvasive imaging technologies are improving and help to delineate skin tumors and increase the probability of complete tumor removal...
December 2017: Annales de Dermatologie et de Vénéréologie
Michael Kelly-Sell, S Tyler Hollmig, Joel Cook
BACKGROUND: The laterally based bilobed flap is commonly used for the reconstruction of small- to medium-sized defects of the distal portion of the nose; However, when this flap is used to repair defects that are larger, more cephalic, or more lateral on the nose, there is a risk for lower nasal distortion. Reorienting the base superiorly preserves the advantages of the traditional design while minimizing this risk. OBJECTIVE: To demonstrate the design, execution, and efficacy of the superiorly based bilobed flap...
October 19, 2017: Journal of the American Academy of Dermatology
Mehul Bhatt, Zain Husain, Adam Jon Tinklepaugh, David Hermogenes Ciocon
A recent national survey suggests that up to one-third of facial reconstructive and plastic surgeons do not adhere to the classical principle of subunit reconstruction. While single-stage flaps and grafts may be easier and less time consuming, they can also lead to a poor cosmetic outcome. Here, the authors describe how the authors repaired a complex post-Mohs surgery facial defect involving multiple cosmetic subunits and how adherence to the subunit principle was essential to obtaining the most optimal functional and esthetic outcome...
November 2017: Journal of Craniofacial Surgery
Ansley M Roche, Martha Griffin, Ron Shelton, Mark L Urken
Extensive subtotal full-thickness auriculectomy defects pose a challenge for the reconstructive surgeon. The posterior island flap (PIF), based on the posterior auricular artery, has been described as a reconstructive option for auricular defects, with reports describing a "pull-through" or "revolving door" technique to reconstruct subtotal partial thickness and full thickness auricular defects. These techniques may result in posterior "pinning" of the auricle. This patient is an 87-year-old male who presented after Mohs excision of squamous cell carcinoma of the conchal bowl, which resulted in a 4x4cm subtotal auriculectomy defect...
November 2017: American Journal of Otolaryngology
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
William Dzwierzynski
No abstract text is available yet for this article.
September 2017: Plastic and Reconstructive Surgery
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...
November 2017: Actas Dermo-sifiliográficas
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
Jonathan Kantor
No abstract text is available yet for this article.
June 2017: Plastic and Reconstructive Surgery. Global Open
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
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
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