scholarly journals Plastic surgery in the treatment of primary melanoma of the skin

2003 ◽  
Vol 60 (4) ◽  
pp. 427-433 ◽  
Author(s):  
Ljubomir Panajotovic ◽  
Jefta Kozarski ◽  
Snezana Krtinic ◽  
Bojan Stanojevic
Keyword(s):  
Plastic Surgery ◽  
Primary Tumor ◽  
Size Structure ◽  
Primary Melanoma ◽  
Radical Excision ◽  
Reconstructive Procedures ◽  
Military Medical Academy ◽  
Margins Of Excision ◽  
Surgical Methods ◽  
Melanoma Classification

Surgery is still the most effective treatment modality of skin melanoma. The margins of excision are determined by the thickness of primary tumor. From January 1999 to December 2001, 99 patients (57 male and 42 female, of the average age 55), were surgically treated at the Clinic for Plastic Surgery and Burns of the Military Medical Academy. The most usual localization of the primary tumor was the back (23.23%), followed by the forearm, and the lower leg. Regarding the clinical type of the melanoma, nodular melanoma dominated (62.62%). Microscopic staging of the melanoma (classification according to Clark and Breslow), showed that the majority of patients already suffered from the advanced primary disease, which called for radical excision and the choice of reconstructive methods in the closure of post-excision defects. The reconstructive plastic surgical methods enabled the closure of post-excision tissue defects, regardless of their size, structure, and localization. During the closure of post-excision defects, direct wound closure or split skin draft was performed in 76.76% of patients. Flaps were applied in 19.19% of patients with the primary melanoma of the head, face foot, and hand. The sufficiency of the available reconstructive procedures makes plastic surgery irreplaceable in the surgical treatment of the primary melanoma of the skin.

scholarly journals Scalp Reconstruction Following High Voltage Electric Burn

2014 ◽  
Vol 3 (2) ◽  
pp. 49-52 ◽  
Author(s):  
Md Zakir Hossain ◽  
Bidhan Sarker ◽  
Lutfar Kader Lenin ◽  
Ayesha Hanna ◽  
Limon Kumar Dhar
Keyword(s):  
Plastic Surgery ◽  
High Voltage ◽  
Skin Grafting ◽  
College Hospital ◽  
Transposition Flap ◽  
Reconstructive Procedures ◽  
Rotation Flap ◽  
Medical College ◽  
Scalp Reconstruction ◽  
Scalp Defects

Background: Scalp reconstruction following high voltage electric burn can be challenging. A useful Reconstructive algorithm is lacking. The purpose of this study was to evaluate our experience and to identify an appropriate reconstructive strategy. Methodology: This was a prospective observational study, conducted in the Burn unit of Dhaka Medical College Hospital & Department of Burn & Plastic Surgery,Sir Salimullah Medical College & Mitford Hospital over a period of five years. Reconstructive procedures, independent factors and outcomes were evaluated. A total of 7 procedures were performed in 30 patients. Techniques for reconstruction included skin grafting, outer table drilling & skin grafting, Bipedicle flap, Single rotation flap, Double opposing rotation flap, Transposition flap, Tissue expansion & primary closure. Conclusion: Important tenets for successful management of scalp defects are durable coverage, adequate debridement, preservation of blood supply, and proper wound drainage. Local scalp flaps with skin grafts remain the mainstay of reconstruction in most instances. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18251 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 49-52

scholarly journals Treatment of Facial Nevi with Ideal Design and Splitting Technique

2021 ◽  
Author(s):  
Qiang Sun ◽  
Jiayan Guo ◽  
Siyu Liu ◽  
Mengru Zhu ◽  
Jingyi Feng ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Plastic Surgery ◽  
Surgical Excision ◽  
Added Value ◽  
Complete Excision ◽  
Splitting Technique ◽  
Surgical Methods ◽  
Serial Excision ◽  
Non Surgical Treatment

Abstract Background: The treatment of nevi includes surgical treatment and non-surgical treatment. Non-surgical treatment has many defects in the clinic, whereas surgical treatment is applicable to any type of nevi. However, there is no unified standard for surgical methods. Methods: Patients with facial nevi ( width ≤4 cm) and high requirements for beauty were included. Preoperatively, incision design and resection range based on the recommended wrinkles or folds of each region and principle of plastic surgery. Intraoperatively, a nevus flap was formed, and then equally divided by splitting technique. After the splitting nevus flap was resected, suture without tension was performed. Results: 21 patients underwent surgical excision. 14 patients underwent complete excision, while 7 patients underwent serial excision. The patients were satisfied with the appearance, local sensations were normal, and there were no secondary deformities of the surrounding facial organs without recurrence.Conclusion: This method is of added value, which achieved by the correct assessment of the size and location of facial nevi and designed according to the reference marks in each region and complete or serial excision.

scholarly journals Metastatic Malignant Melanoma of Parotid Gland with a Regressed Primary Tumor

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
M. Mustafa Kılıçkaya ◽  
Giray Aynali ◽  
Ali Murat Ceyhan ◽  
Metin Çiriş
Keyword(s):  
Malignant Melanoma ◽  
Parotid Gland ◽  
Head And Neck ◽  
Primary Tumor ◽  
Primary Melanoma ◽  
Metastatic Malignant Melanoma ◽  
Malignant Melanomas ◽  
Pigmented Lesions

Malignant melanoma of the parotid gland is often metastatic and mainly originates from malignant melanomas in the head and neck. Nevertheless, some malignant melanomas may metastasize and subsequently regress. Therefore, it may not be possible to observe a metastatic malignant melanoma and its primary melanoma simultaneously. The investigation of a patient’s old photographs may help in the detection of preexisting and regressed pigmented lesions in the facial and neck regions.

Prospective analysis of predictors of survival in melanoma patients with brain metastases

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9074-9074
Author(s):  
J. A. Zakrzewski ◽  
L. Geraghty ◽  
H. Hamilton ◽  
P. Christos ◽  
D. Krich ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Mitotic Index ◽  
Primary Tumor ◽  
Univariate Analysis ◽  
Primary Melanoma ◽  
Neurological Symptoms ◽  
Independent Effect ◽  
Exclusion Criterion ◽  
Clinical Variables ◽  
Melanoma Patients

9074 Background: Melanoma patients (pts) with brain metastases (BM) have limited survival, and BM remains an exclusion criterion in most clinical trials. A recent retrospective analysis at Memorial Sloan Kettering Cancer Center (MSKCC) identified 4 clinical variables that were associated with worse post BM survival (Raizer J et al, Neuro Oncol 2008). In this study, we investigated whether primary tumor features could improve the predictability of post BM survival and examined the reproducibility of the variables identified in MSKCC study. Methods: Melanoma pts with BM prospectively enrolled in an interdisciplinary database at NYU Medical Center from 2002 to 2008 were studied. Six primary tumor characteristics, 21 clinical variables, and treatments were examined. Univariate associations were analyzed using Kaplan Meier survival analysis and the independent effect of identified predictors was assessed by multivariate cox proportional hazards regression analysis. Results: Eighty-nine pts (36 F, 53 M, median age 57) were identified. Median post BM survival was 5.75 months. Median follow-up time based on survivors was 4.2 months. Ulceration and mitotic index ≥3/field were univariately associated with worse post BM survival (p=0.004, p=0.009 respectively). Age >65, ≥3 BM lesions, presence of neurological symptoms, and extracranial metastases were also univariately associated with worse post BM survival (the same 4 variables identified in MSKCC retrospective study). An additional 4 clinical parameters were significant by univariate analysis: frontal lobe location (p=0.01), bilateral lesions (p=0.01), ≥2 neurological symptoms (p=0.005), and weakness/fatigue (p<0.0001). After reproducing the significance of the 4 MSKCC variables in a multivariate model, ulceration of the primary tumor was also an independent predictor of post BM survival (hazard ratio [HR] = 2.75; 95% CI = 1.30, 5.83; p=0.008) whereas mitotic index ≥3/field was not (HR=1.24; 95% CI = 0.57, 2.71; p=0.59). Conclusions: Data suggest that ulceration of the primary melanoma might indicate an adverse biologic behavior that impacts post BM survival. Our data also lend independent support for the predictive model of post BM survival. No significant financial relationships to disclose.

Can the plasma PD-1 levels predict the presence and efficiency of tumor-infiltrating lymphocytes in metastatic melanoma patients?

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14035-e14035
Author(s):  
Daniele Fanale ◽  
Lorena Incorvaia ◽  
Gaetana Rinaldi ◽  
Lidia Terruso ◽  
Giuseppe Badalamenti ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Primary Tumor ◽  
Primary Melanoma ◽  
Tumor Infiltrating Lymphocytes ◽  
Rank Test ◽  
Expression Levels ◽  
Kaplan Meier ◽  
Melanoma Patients ◽  
Infiltrating Lymphocytes ◽  
First Time

e14035 Background: The immune response to melanoma has been shown to be locally affected by presence of tumor-infiltrating lymphocytes (TILs), generally divided into brisk (infiltrating the entire base of the invasive tumor), non-brisk (infiltrating only focally) and absent. Several studies showed that greater presence of TILs, especially brisk, in primary melanoma is associated with a better prognosis and a higher survival rate. Since recent studies revealed an association between PD-1/PD-L1 expression levels and tumor response, the aim of our study was to investigate the correlation between plasma PD-1 and presence/absence/class of TILs in metastatic melanoma patients. Methods: The plasma PD-1 levels were analyzed in 28 patients with metastatic melanoma using a specific ELISA assay. The characterization of TILs in tumor tissue was performed by immunohistochemistry. Statistical analysis was assessed using t-Student and ANOVA tests. Survival curves were estimated by using the Kaplan-Meier method and log-rank test to evaluate significant differences among them. Results: 16 out of 28 patients showed the presence of TILs in primary tumor, 10 of which brisk and 6 nonbrisk. The plasma PD-1 levels were analyzed in relation to the presence/absence of TILs (p = 0.022), brisk TILs versus nonbrisk/absent TILs (p = 0.014), and brisk vs nonbrisk vs absent TILs (p = 0.032). In particular, low plasma PD-1 levels have been shown to be associated with brisk TILs in primary melanoma, intermediate values with nonbrisk TILs, and high expression with absent TILs. Although the low number of samples did not allow us to obtain a statistically significant association between the plasma PD-1 expression levels and overall survival (OS) depending on the absence or presence of TILs (brisk/nonbrisk), however the median survival of patients having brisk TILs was five months higher than other 2 groups of patients with absent and nonbrisk TILs, respectively. Conclusions: This work highlights, for the first time, the potential ability of using the plasma PD-1 levels to predict prognosis also in patients with metastatic melanoma at diagnosis for which it is not possible to identify the primary tumor.

scholarly journals Possibility of management of lower leg war burns with free flaps

2003 ◽  
Vol 60 (6) ◽  
pp. 741-745 ◽  
Author(s):  
Ljubomir Panajotovic ◽  
Jefta Kozarski ◽  
Snezana Krtinic-Rapaic ◽  
Bojan Stanojevic
Keyword(s):  
Wound Closure ◽  
Free Flaps ◽  
Lower Leg ◽  
The Other ◽  
Wound Treatment ◽  
Necrotic Tissue ◽  
Local Flaps ◽  
Reconstructive Procedures ◽  
Military Medical Academy ◽  
Medical Academy

Free flaps are used in the surgical treatment of burns for wound closure where the burn is too deep, and in case, when after necrotic tissue excision, the bones, tendons, nerves, and blood vessels remain bare. Covering of the exposed structures is commonly performed in the primary delayed, or in the secondary wound treatment. The possibilities of covering the defects of the lower leg with local flaps are limited. Free flaps are used when all the possibilities of the other reconstructive procedures have been exhausted. The defect of the soft tissue of the lower leg was covered with free flaps in the injured soldiers with deep burns, treated at the Clinic for Plastic Surgery and Burns, Military Medical Academy, Belgrade. In one patient the wound closing was performed immediately after excision of necrotic tissues, and in the other two in the secondary management. The application of free microvascular flaps enabled the closure of large post excision defects of the lower leg in one operation. Our experience in the treatment of these soldiers point to the possibility of coverage of the exposed deep structures with free flaps as early as possible.

scholarly journals Erratum: The article „Congenital upper eyelid coboloma with ipsilateral eyebrow hypoplasia” [Urodjeni defekt gornjeg kapka sa istostranom hipoplazijom obrve]. Vojnosanit pregl 2012; 69(9): 809-811. (DOI:10.2298/VSP1209809V).

2016 ◽  
Vol 73 (11) ◽  
pp. 1078-1078
Author(s):  
E Editorial
Keyword(s):  
Plastic Surgery ◽  
Medical Faculty ◽  
Upper Eyelid ◽  
Military Medical Academy ◽  
Medical Academy ◽  
Clinical Centre ◽  
The Military ◽  
Font Color

The authors and their affiliations were listed as follows: Dejan Vulovic+, Marijan Novakovic??, Tatjana Sarenac?, Mirjana Janicijevic-Petrovic?, Nenad Petrovic?, Suncica Sreckovic?, Sasa Milicevic?, Branislav Piscevic? +Centre for Plastic Surgery, ?Clinic for Ophthalmology, Clinical Centre Kragujevac, Kragujevac, Serbia; ?Clinic for Plastic Surgery and Burns, Military Medical Academy, Belgrade, Serbia; ?Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia Listed the authors and their affiliations should read as: Dejan Vulovic+, Marijan Novakovic??, Tatjana Sarenac?, Mirjana Janicijevic-Petrovic?, Nenad Petrovic?, Suncica Sreckovic?, Sasa Milicevic?, Branislav Piscevic? +Centre for Plastic Surgery, ?Clinic for Ophthalmology, Clinical Centre Kragujevac, Kragujevac, Serbia; ?Clinic for Plastic Surgery and Burns, Military Medical Academy, Belgrade, Serbia; ?Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia <br><br><font color="red"><b> Link to the corrected article <u><a href="http://dx.doi.org/10.2298/VSP1209809V ">10.2298/VSP1209809V</a></b></u>

scholarly journals Primary reconstruction of neck defect after excision of metastatic melanoma of unknown primary site with regional pectoral myocutaneous flap

2016 ◽  
Vol 144 (7-8) ◽  
pp. 436-439
Author(s):  
Asen Velickov ◽  
Predrag Kovacevic ◽  
Aleksandra Velickov ◽  
Shahram Ghanaati
Keyword(s):  
Metastatic Melanoma ◽  
Primary Tumor ◽  
Primary Melanoma ◽  
Muscle Flap ◽  
Neck Region ◽  
Unknown Primary ◽  
Large Tumor ◽  
Tumor Mass ◽  
Regional Flap ◽  
Tissue Defects

Introduction. Metastatic melanoma of unknown primary (MMUP) is already a well described oncologic phenomenon in the literature, whereas tissue defects? reconstructions on the neck region always present a challenge for the reconstructive surgeon. Two cases of giant metastatic, skin infiltrative neck tumor masses are presented. In both cases MMUP was diagnosed. Both intraoperative tissue defects were reconstructed using pectoralis major (PM) regional flap. Outline of cases. The first patient was admitted with giant tumor mass on the right side of the neck. The fast growing mass appeared two months prior to the admission. Thorough examination showed no signs of primary tumor. Removal surgery was performed and the defect was reconstructed using the PM musculocutaneous flap. The second patient was admitted with large tumor mass on the left side of the neck. Thorough examination displayed no signs of any primary tumor. After the excision, the tumor mass and subsequent neck dissection, reconstruction followed, using the pedicled PM muscle flap and partial thickness skin transplants. There were no major complications in either case. The histopathological examinations presented metastatic melanoma diagnoses. Conclusion. Clinical outcome of MMUP described in literature is rather variable. Different studies have shown that prognosis in patients with MMUP is better than that in patients with diagnosed primary melanoma with metastatic disease. Therefore, the best initial course of action in those cases would be surgery, according to oncological principles, if possible. Neck defects? reconstructions should fulfill both functional and esthetic demands. Due to the reliability and low cost of the procedure, PM regional flap presents a very good and trustworthy reconstruction modality.

scholarly journals Plastic surgery in India in the era of COVID-19 outbreak

2020 ◽  
Vol 6 (12) ◽  
pp. 543
Author(s):  
Naveen Kumar
Keyword(s):  
Plastic Surgery ◽  
International Health ◽  
Healthcare Services ◽  
Healthcare Personnel ◽  
Cochrane Library ◽  
Indian Government ◽  
Reconstructive Procedures ◽  
Pubmed Search ◽  
The Aesthetic ◽  
Google Search

<p>With rise in the number of cases of patients infected with the coronavirus and easing in the lockdown, there is a need to modify the practice of the plastic surgery in India that can ensure an effective patient care, minimum transmission of disease, better management of available resources and protection of health care personnel. A search was made on google search, pubmed search and cochrane library for the recommendations in the published literature using terms: plastic surgery, COVID-19, recommendations, guidelines, India. Guidelines were also searched and considered, provided by various Indian government agencies and international health organizations. There is a need to follow the set proposed guidelines and the recommendations in order to modify the clinical practice in the outpatient and preoperative settings along with the priority to be given to the emergent or traumatic conditions and reconstructive procedures in some malignant conditions. Otherwise it is judicious to postpone or delay the elective and the aesthetic procedure. With this article we can conclude that by modifying the current practices in plastic surgery and evidence based prioritization of cases we can ensure a balance between effective delivery of healthcare services and prevention of the exposure of healthcare personnel.</p>

Influence of Specialist Title On Perceived Surgical Ability

1994 ◽  
Vol 2 (4) ◽  
pp. 149-154 ◽  
Author(s):  
Michael L Kreidstein ◽  
Hugh G Thomson ◽  
Peter C Neligan
Keyword(s):  
Plastic Surgery ◽  
Plastic Surgeon ◽  
Reconstructive Procedures ◽  
Operative Results ◽  
Before And After ◽  
Facial Plastic ◽  
The Face ◽  
Operative Result ◽  
Surgery Resident ◽  
Nose And Throat

ML Kreidstein, HG Thomson, PC Neligan. Influence of specialist title on perceived surgical ability. Can J Plast Surg 1994;2(4):149-154. This study was conducted to test the hypothesis that patients associate specialist titles with superior surgical ability, and that operative results are viewed more favorably if believed to be the handiwork of a specialist. Subjects (n=130) were randomly selected from among patients at a medical walk-in clinic. All subjects were presented with an identical set of ‘before and after’ photographs depicting six unrelated facial operations. However, each set of photographs was attributed at random to one of the following surgeons: plastic surgeon, plastic surgery resident, aesthetic plastic surgeon, facial plastic surgeon, ear nose and throat/ head and neck surgeon, cosmetic surgeon. Subjects completed a questionnaire evaluating the quality of the result from each operation, and then for each operation indicated which of the above surgeons was likely to achieve the best operative result. The attribution of identical operative results to the different surgeons resulted in evaluations that were not statistically different (P>0.05). Cosmetic surgeons were chosen most frequently as the type of surgeon likely to perform the best quality rhytidectomy or rhinoplasty, and facial plastic surgeons were chosen most frequently as best for repairs of facial lacerations or removal of skin tumours on the face (P<0.00l). Plastic surgeons and ear nose and throat surgeons received intermediate ratings, and aesthetic plastic surgeons and plastic surgery residents received low ratings. As hypothesized, specialist titles were associated with superior surgical ability, with cosmetic surgeons thought to provide the best cosmetic procedures, and facial plastic surgeons thought to provide the best reconstructive procedures. Despite this bias, evaluations of the operative results were not influenced by the type of surgeon credited with the operation, refuting the hypothesis of a placebo-type effect.

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