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Surgical skin closure

Syed Ali Raza Rizvi, Md Shahid Alam, Kafil Akhtar
PURPOSE: To analyze varying clinical presentations, histopathological features, and management outcome of sebaceous gland carcinoma (SGC) of the eyelid. MATERIALS AND METHODS: We retrospectively reviewed medical records of 30 patients with histologically proven cases of SGC of eyelid treated at tertiary care hospital. RESULTS: Patients were in the age group of 28-80 years, among which 18 (60%) were females and 12 (40%) were males. Mean follow-up period was 29...
January 2018: Oman Journal of Ophthalmology
Jonathan D Scrafford, Buvana Reddy, Colleen Rivard, Rachel Isaksson Vogel
PURPOSE: To compare the rates of wound-related complications among women undergoing a cesarean section when the surgical team used intra-operative glove changing versus usual care. METHODS: All women undergoing a cesarean section at a single, county hospital were randomized to usual care or intra-operative glove changing prior to abdominal closure. Participants were randomized at the time of decision for cesarean section; surgeons were not blinded to the randomization arm...
March 19, 2018: Archives of Gynecology and Obstetrics
Je Yeon Byeon, Hwan Jun Choi, Ji Hye Lee
Dermoid cysts are benign developmental anomalies that occurred as a result of the sequestration of the skin along the lines of embryonic closure. Those occurring in the cervicofacial region are uncommon, accounting for about 7% of all dermoids and its presence in postauricular region is further exceptionally rare. A healthy 19-year-old Asian boy presented with a unilateral postauricular cyst that had been present since childhood without any symptom. The computed tomography scan revealed an encapsulated tumor with no intracranial extension...
March 16, 2018: Journal of Craniofacial Surgery
S P Paul
Objective There remains confusion between Langer's lines and wrinkle lines with respect to the optimal orientation of elliptical excisions on the trunk. This study sought to determine the directions of wound closure that would result in least wound tension after skin lesion excisions. Materials and methods Some 1181 consecutive skin lesion excisions were investigated (age range 13-95 years, median 64 years) using a tensiometer to determine directions of least wound tension. These lines were mapped. Skin tension measurements were taken during the procedure and analysed...
March 15, 2018: Annals of the Royal College of Surgeons of England
Slavomir Kondoff, Atanas Drenchev, Torello Lotti, Uwe Wollina, Ilia Lozev, Ivan Pidakev, Ivan Terziev, Yavor Grigorov, Serena Gianfaldoni, Georgi Tchernev
BACKGROUND: Basal cell carcinomas (BCC) located in the sun-exposed regions are a serious therapeutic challenge. Therefore early diagnosis and adequate therapy should be of a high priority for every dermatologic surgeon. CASE PRESENTATION: We are presenting a patient with multiple BCCs, located on the area of the scalp, who had been treated several years ago with electrocautery and curettage after histopathological verification. However, the last few years the tumours have advanced, infiltrating firstly the tabula external and a year later the tabula interna of the cranium...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Maryam Rezapoor, Timothy L Tan, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Iodophor-impregnated adhesive incise drapes are widely used during surgeries for reducing surgical site contamination. There is little evidence to support the latter belief. This study evaluated the efficacy of iodophor-impregnated adhesive drapes for reducing bacterial contamination and counts at the incision site during hip surgery. METHODS: In this prospective, randomized clinical trial, we enrolled 101 patients undergoing open joint preservation procedure of the hip...
February 2, 2018: Journal of Arthroplasty
Mohammed A Almustafa, Alistair M Ewen, Angela H Deakin, Frederic Picard, Jon V Clarke, Fahd F Mahmood
BACKGROUND: Surgical site infection (SSI) is a debilitating complication of lower limb arthroplasty with significant morbidity and increased costs. Numerous risk factors are associated with SSI. METHODS: In an effort to identify novel risk factors for SSI, we undertook a retrospective cohort study of 1832 primary total hip arthroplasties and 2100 primary total knee arthroplasties performed in our high volume arthroplasty unit over a 2-year period. RESULTS: Two risk factors were identified for SSI following total hip arthroplasty: body mass index ≥30 and peri-operative blood transfusion...
January 31, 2018: Journal of Arthroplasty
Kenneth R Feehs, Jonathan T Maslan, Daniel J Kirse
OBJECTIVE: To present a novel superiorly-based turnover skin flap for the primary repair of pediatric tracheocutaneous fistula closure, and to determine the efficacy and safety of this tracheocutaneous fistula turnover flap primary closure technique. SUBJECT AND METHODS: This retrospective review analyzed one surgeon's (DJK) pediatric tracheostomy decannulation methods and results, specifically relating to the development of tracheocutaneous fistulas, over a fourteen-year period, from October 2002 through June 2016...
April 2018: International Journal of Pediatric Otorhinolaryngology
Uwe Wollina, Birgit Heinig, Christian Stelzner, Gesina Hansel, Jacqueline Schönlebe, Georgi Tchernev, Torello Lotti
BACKGROUND: Leg ulcers are a burden to patients, their families and society. The second most common cause of chronic leg ulcers is the mixed arterio-venous type. An 80-year-old female patient presented to our department due to painful enlarging chronic leg ulcer of mixed arteriovenous origin on her left lower leg. She suffered from peripheral arterial occlusive disease stage I and chronic venous insufficiency Widmer grade IIIa, and a number of comorbidities. AIM: The aim of our ulcer treatment was a complete and stable wound closure that was hampered by arterial occlusion, exposed tendon, and renal insiffuciency...
January 25, 2018: Open Access Macedonian Journal of Medical Sciences
Markus Pirlich, Iris-Susanne Horn, Christian Mozet, Mandy Pirlich, Andreas Dietz, Miloš Fischer
BACKGROUND: The use of the radial forearm-free flap is a well-established and reliable reconstruction method in head and neck surgery. Usually, the defect of the donor site is covered with full or split-thickness skin grafts. Since 09/2013, a direct closure of the radial forearm donor site has been performed at the ENT University Hospital Leipzig to avoid secondary donor site morbidity. However, few data are available in the literature on long-term cosmetic and functional results compared to the established indirect donor site defect coverage...
February 26, 2018: European Archives of Oto-rhino-laryngology
Fabio Rondelli, Laura Franco, Ruben Carlo Balzarotti Canger, Graziano Ceccarelli, Cecilia Becattini, Walter Bugiantella
PURPOSE: Surgical site infection (SSI) is one of the most frequent complications after stoma closure and the optimal skin closure technique is still not clear. The goal of this review was to compare outcomes with purse-string closure technique (PSC) versus conventional closure technique (CCT) for skin closure after stoma reversal. METHODS: We performed a systematic review and meta-analysis of available randomized controlled trials (RCTs) to compare SSI rate within 30 days, operative time, hospital stay, incisional hernia and intestinal obstruction rates between PSC and CCT...
February 20, 2018: International Journal of Surgery
Andy C Kiser, Thomas G Caranasos, Mark D Peterson, David M Holzhey, Philipp Kiefer, L Wiley Nifong, Michael A Borger
OBJECTIVE: Recently, the PARTNER 2A trial reported results of transcatheter aortic valve replacement versus surgical aortic valve replacement in 2032 intermediate-risk patients at 2 years. Two hundred thirty-six patients (24%) required an access route other than transfemoral. Compared with transfemoral and surgical aortic valve replacement, nontransfemoral transcatheter aortic valve replacement was associated with a numerically higher rate of death and disabling stroke at 30 days. This underscores the need for a better alternative surgical approach for patients with marginal femoral access...
February 17, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Eijiro Echizen, Kei Miyata, Ken Yamashita, Takeshi Mikami, Eichi Narimatsu, Nobuhiro Mikuni
BACKGROUND: Neurosurgical intervention for a patient with an extensive scalp burn is rare, but it might be associated with the high risk of surgical site infection. CASE DESCRIPTION: An 80-year-old man had a severe and extensive scalp burn. A chronic subdural hematoma (CSDH) was observed on a head CT for the assessment of bacteremia during treatment in the intensive care unit. To evaluate whether the CSDH might underlie his prolonged fever and sepsis pathology, we urgently evacuated the hematoma using one burr hole...
February 13, 2018: World Neurosurgery
Annika Senghaas, Thomas Kremer, Volker J Schmidt, Leila Harhaus, Christoph Hirche, Ulrich Kneser, Amir K Bigdeli
Despite considerable advances in reconstructive surgery, massive abdominal wall defects continue to pose a significant surgical challenge. We report the case of a 72-year-old morbidly obese female patient with Clostridium septicum-related gas gangrene of the abdominal wall. After multidisciplinary treatment and multiple extensive debridements, a massive full-thickness defect (40 cm × 35 cm) of the right abdominal wall was present. The abdominal contents were covered with a resorbable mesh to prevent evisceration...
February 16, 2018: Microsurgery
Chengliang Deng, Hai Li, Zairong Wei, Wenhu Jin, Kaiyu Nie, Shujun Li, Bihua Wu, Dali Wang
RATIONALE: Reducing the morbidity associated with anterolateral thigh (ALT) donor sites by performing aesthetic restoration has become a popular research topic. Various surgical techniques have been developed allowing for direct closure of the donor site. However, closure techniques for ALT donor sites based on the oblique branch have not been systematically reported. PATIENT CONCERNS: Data from 21 patients (18 males, 3 females) undergoing operative reconstruction with an ALT free flap between January 2016 and December 2016...
February 2018: Medicine (Baltimore)
Kenan Çetin, Hasan Ediz Sikar, Aytaç Emre Kocaoğlu, Muhammet Fikri Kündeş, Mehmet Karahan, Levent Kaptanoğlu
Purpose: We aimed to compare skin closure techniques, standard (intermittent mattress) and continuous subcuticular sutures, following Limberg flap procedure. Methods: From July 2013 to July 2015, 92 patients with sacrococcygeal pilonidal disease were prospectively randomized into 2 groups consisting of 46 patients for both. Patients underwent sinus excision and closure with Limberg flap; continuous subcuticular suture was used in subcuticular group (SG) and intermittent mattress sutures were used in mattress group (MG) for skin closure...
February 2018: Annals of Surgical Treatment and Research
Yazan N AlJamal, Raaj K Ruparel, Steven R Jacobson, David R Farley
While minimally invasive parathyroidectomy is an advantage to many properly selected patients, longer incisions and even wide skin resection may be optimal in a select few. We present an 80-year-old woman with primary hyperparathyroidism and bothersome excess neck skin and subcutaneous fat. The parathyroid adenoma was easily excised through a vertically-oriented cervical excision that removed an ellipse of fat and skin. Midline wound closure with a small Z-plasty to avoid wound tethering facilitated a cosmetic closure well within the surgical capabilities of endocrine surgeons...
October 2017: Journal of Surgical Case Reports
T Waldow, T Ghazy, T Madej, K Plötze, C Birkner, A Mahlmann, K Matschke
BACKGROUND: Reducing post-sternotomy mediastinitis (PSM) requires incorporating multiple methods. However, the independent effects of these measures are not well studied. AIM: To evaluate the independent effect of preoperative disinfection using isopropyl alcohol (IPA)-chlorhexidine gluconate (CHG) and the topical application of a retrosternal gentamicin collagen sponge at wound closure on reducing PSM. METHODS: From October 2012 to August 2014, 2340 patients were included in this prospective, controlled registry...
January 30, 2018: Journal of Hospital Infection
Zhenmi Liu, Jo C Dumville, Gill Norman, Maggie J Westby, Jane Blazeby, Emma McFarlane, Nicky J Welton, Louise O'Connor, Julie Cawthorne, Ryan P George, Emma J Crosbie, Amber D Rithalia, Hung-Yuan Cheng
BACKGROUND: Surgical site infection (SSI) rates vary from 1% to 5% in the month following surgery. Due to the large number of surgical procedures conducted annually, the costs of these SSIs can be considerable in financial and social terms. Many interventions are used with the aim of reducing the risk of SSI in people undergoing surgery. These interventions can be broadly delivered at three stages: preoperatively, intraoperatively and postoperatively. The intraoperative interventions are largely focused on decontamination of skin using soap and antiseptics; the use of barriers to prevent movement of micro-organisms into incisions; and optimising the patient's own bodily functions to promote best recovery...
February 6, 2018: Cochrane Database of Systematic Reviews
İsa Kaya, Mustafa Uslu, Fazıl Apaydın
Objective: This study aimed to investigate reconstruction methods according to nasal subunits in patients who were surgically treated with diagnosis of non-melanoma skin cancer of the nose. Methods: All patients were retrospectively investigated. This study was conducted between April 2004 and December 2010; 180 patients who were surgically treated with diagnoses of skin basal cell carcinoma, squamous cell carcinoma, cancer of skin appendages, and precancerous lesions and 194 lesions were included...
September 2017: Turkish Archives of Otorhinolaryngology
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