Basal Cell Carcinoma in a Full-Thickness Skin Graft in the Upper Eyelid

Latar belakang: Penutupan defek wajah yang luas dengan jabir bebas forearm dan jabir foreheadparamedian merupakan salah satu pilihan pada pasien pasca eksisi luas dan pemberian radioterapi akibatkeganasan kepala leher. Tetapi cara ini bukan merupakan pilihan yang utama, meskipun memiliki tingkatkeberhasilan yang baik, khususnya pasca radioterapi.Tujuan: Kasus ini diajukan untuk memperlihatkankeberhasilan penutupan defek wajah yang luas dengan jabir bebas forearm, jabir forehead paramedianpasca eksisi luas dan radioterapi pada kasus karsinoma sel basal.Laporan kasus: Dilaporkan seorangperempuan 68 tahun dengan karsinoma sel basal yang dilakukan tindakan eksisi luas dan radioterapi.Penatalaksanaan: Setelah 6 bulan pasca radioterapi, dilakukan penutupan defek dengan menggunakanjabir bebas forearm, dan jabir forehead paramedian yang digunakan sebagai pengganti mukosa hidung sertadilakukan anastomosis radial forearm. Bagian dahi ditutup dengan full thickness skin graft (FTSG) yangdiambil dari regio abdominal pasien.Kesimpulan: Jabir bebas forearm dan jabir forehead paramedianmerupakan salah satu alternatif untuk rekonstruksi defek luas pada daerah kepala leher sesudah radioterapi. Kata kunci: Jabir bebas forearm, jabir forehead paramedian, karsinoma sel basal, radioterapi, eksisi luas ABSTRACTBackground: Paramedian forehead flap and radial forearm free flap is one option for reformationof excessive defect caused by tumor extirpation and radiotherapy in head and neck cancer, but not themain option in head neck reconstruction. In some certain condition, it has a better success rate thanother flap techniques, especially in postradiation patients on facial region. Purpose: To present evidencebased case report in order to show the result of reconstruction in a patient with basal cell carcinomawho underwent wide excision with paramedian forehead flap, radial forearm free flap and radiotherapy.Case report: We reported one case, a 68 years old woman who had basal cell carcinoma and underwentwide excision and radiotherapy. Management: Six months later, we performed reconstructive surgeryto close the forehead defect by reverse paramedian forehead flap, and replacing the nasal mucosa withradial forearm anastomosis, on the forehead covered with a full thickness skin graft (FTSG) taken fromabdominal region of the patient. Conclusion: Radial forearm and paramedian forehead flap can beconsidered as an alternative for reconstruction of wide defect of the head pasca radiotherapy. Keywords: Radial forearm flap, and paramedian forehead flap, basal cell carcinoma, radiotherapy, wideexcision Alamat korespondensi: Lina Marlina, Departemen Ilmu Kesehatan Telinga Hidung Tenggorok-BedahKepala Leher, Fakultas Kedokteran Universitas Padjadjaran/RumahSakit Hasan Sadikin, Bandung,e-mail: [email protected].

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Early wound repair versus later scar repair in children with treadmill hand friction burns

Journal of Burn Care & Research ◽

10.1093/jbcr/irab083 ◽

2021 ◽

Author(s):

Rong Zhou ◽

Lin Qiu ◽

Jun Xiao ◽

Xiaobo Mao ◽

Xingang Yuan

Keyword(s):

Skin Graft ◽

Wound Repair ◽

Full Thickness ◽

Full Thickness Skin Graft ◽

Vacuum Sealing ◽

Full Thickness Skin ◽

Thickness Skin ◽

Vacuum Sealing Drainage ◽

Repair Group ◽

Hand Friction

Abstract The incidence of pediatric treadmill hand friction burns has been increasing every year. The injuries are deeper than thermal hand burns, the optimal treatment remains unclear. This was a retrospective study of children who received surgery for treadmill hand friction burns from January 1, 2015, to December 31, 2019, in a single burn center. A total of 22 children were surveyed. The patients were naturally divided into two groups: the wound repair group (13 patients), which was admitted early to the hospital after injury and received debridement and vacuum sealing drainage initially, and a full-thickness skin graft later; and the scar repair group (9 patients), in which a scar contracture developed as a result of wound healing and received scar release and skin grafting later. The Modified Michigan Hand Questionnaire score in the wound repair group was 116.31 ± 10.55, and the corresponding score in the scar repair group was 117.56 ± 8.85 (P>0.05), no statistically significant difference. The Vancouver Scar Scale score in the wound repair group was 4.15 ± 1.21, and the corresponding score in the scar repair group was 7.22 ± 1.09 (P<0.05). Parents were satisfied with the postoperative appearance and function of the hand. None in the two groups required secondary surgery. If the burns are deep second degree, third degree, or infected, early debridement, vacuum sealing drainage initially, and a full-thickness skin graft can obviously relieve pediatric pain, shorten the course of the disease, and restore the function of the hand as soon as possible.

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