scholarly journals EP.WE.741Management of a giant extraocular sebaceous carcinoma during the COVID-19 Pandemic: a case report

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Angelos Mantelakis ◽  
Rebecca Nicholas ◽  
Jenny Geh
Keyword(s):  
Case Report ◽  
Local Anaesthetic ◽  
Length Of Hospital Stay ◽  
Day Surgery ◽  
Sebaceous Carcinoma ◽  
Resection Margins ◽  
Split Thickness Skin Graft ◽  
Rare Presentation ◽  
Thickness Skin ◽  
Malignant Skin

Abstract Introduction Sebaceous carcinoma is a rare malignant skin tumour of the sebaceous glands which is most frequently located in the ocular region (75% of cases). Prompt recognition and treatment is vital, as it bears a high mortality rate ranging from 9 – 50%. We present a rare case of a giant sebaceous carcinoma of the upper back, managed as a day-surgery case because of resource and safety restrictions due to the COVID-19 pandemic. Case report We present a case of a 58-year-old male patient with a giant lesion on his upper back measuring 13 x 13cm in size. Due to the COVID-19 pandemic, this was resected under local anaesthetic. The histology and immunohistochemistry confirmed the diagnosis of a giant sebaceous carcinoma. Resection margins were clear and subsequent investigations confirmed there were no metastases. The defect was reconstructed with Matriderm © and a split-thickness skin graft, achieving a satisfactory cosmetic outcome at 3 months follow-up. Conclusion This is the first report which demonstrates the wide local excision under local anaesthetic for a rare presentation of a giant sebaceous carcinoma. This approach may be more widely utilised in the extraocular manifestation of this tumour, reducing the morbidity and length of hospital stay for such patients.

scholarly journals Use of negative-pressure wound therapy and split-thickness skin autograft to cover an exposed renal transplant

2019 ◽  
Vol 12 (9) ◽  
pp. e231197
Author(s):  
Victoria Elizabeth McKinnon ◽  
Jouseph Barkho ◽  
Mark H McRae
Keyword(s):  
Case Report ◽  
Renal Transplant ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Rare Event ◽  
Split Thickness Skin Graft ◽  
Flap Surgery ◽  
Wound Therapy ◽  
Thickness Skin ◽  
Reconstructive Option

Exposure of a renal transplant through the abdominal wall is a rare event. A search of the literature reveals only six documented cases which used skin autograft for coverage, with none reported since 1981, and none which used negative-pressure wound therapy (NPWT) to prepare the recipient bed. This case report demonstrates that NPWT followed by split thickness skin graft is a reconstructive option which is feasible in patients who are at high risk for surgical complications in prolonged flap surgery.

scholarly journals 465 Split-thickness Skin Graft Harvest under Local Anaesthetic: A Single Pass Technique

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Begaj ◽  
C Asher ◽  
A Hamilton
Keyword(s):  
Skin Graft ◽  
Local Anaesthetic ◽  
Donor Site ◽  
Patient Comfort ◽  
Split Thickness Skin Graft ◽  
Uniform Thickness ◽  
Thickness Skin ◽  
Improve Patient Comfort ◽  
Anaesthetic Mixture ◽  
Improve Patient

Abstract Adequate local anaesthetic, in harvesting a split thickness skin graft (SSG), involves multiple passes of a needle across the length and width of the marked donor site. We describe a technique using hyaluronidase to uniformly anaesthetise an SSG donor site with one injection, in one pass of one needle. Mix 10mls 1% Lidocaine solution with Adrenaline 1:200,000 with 1 vial Hyaluronidase 1 Unit/ml solution. The mixture is buffered with 1 ml NaHCO3 to neutralise acidity and minimise pain. Mark out the SSG donor site Using a 27G long needle (sterican), enter perpendicular to the skin in the middle of the proximal aspect of the donor site. Inject some local anaesthetic subdermally, creating a mound. Change the angle of the needle to 180 degrees and continue to inject the remaining anaesthetic along one half of the width of the donor site. Using a rolled 4x4 swab, apply firm advancing pressure to distribute the mound across the remaining width and length of marked donor site. As the mound advances, the hyluronidase/anaesthetic mixture will distribute uniformly across the donor site within the same plane. The skin blanches secondary to the adrenaline during its distribution. The technique described is a fast, reproducible way to improve patient comfort through the elimination of repeated passes of a needle, distribute the anaesthetic uniformly across the donor site, and facilitate the acquisition of an SSG of uniform thickness The technique described is a fast, reproducible way to improve patient comfort through the elimination of repeated passes of a needle, distribute the anaesthetic uniformly across the donor site, and facilitate the acquisition of an SSG of uniform thickness

Radiation ulcer treatment with hyperbaric oxygen therapy and haemoglobin spray: case report and literature review

2020 ◽  
Vol 29 (8) ◽  
pp. 452-456
Author(s):  
Kengkart Winaikosol ◽  
Pattama Punyavong ◽  
Kamonwan Jenwitheesuk ◽  
Palakorn Surakunprapha ◽  
Ajanee Mahakkanukrauh
Keyword(s):  
Case Report ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Split Thickness Skin Graft ◽  
Radiation Ulcer ◽  
Short Course ◽  
Thickness Skin ◽  
Radiation Ulcers ◽  
Ulcer Treatment

Objective: To explore the effectiveness of a combination of hyperbaric oxygen therapy and haemoglobin spray in radiation ulcer treatment. Method: We reviewed the available literature and present a case report in which radiation ulcer was treated with a combination of hyperbaric oxygen therapy and haemoglobin spray. Results: After 30 sessions of hyperbaric oxygen therapy (2.4 ATA; 90 minutes each session) and administration of haemoglobin spray, the wounds showed gradual progress towards healing and a good granulating base was achieved. The wounds were closed after two months using a small split thickness skin graft. Conclusion: A combination of hyperbaric oxygen therapy and haemoglobin spray was effective as a short course of treatment for radiation ulcers.

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