scholarly journals The effectiveness of local surgical technique in treatment of axillary bromhidrosis

2019 ◽  
Vol 7 (2) ◽  
pp. 187-191
Author(s):  
Thuong Nguyen Van ◽  
Tan Nguyen Manh ◽  
Phuong Pham Thi Minh ◽  
Trang Trinh Minh ◽  
Nghi Dinh Huu ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Skin Necrosis ◽  
Subcutaneous Tissue ◽  
Skin Flap ◽  
Life Quality ◽  
Arm Movement ◽  
Surgical Excision ◽  
Heart Valve Disease ◽  
Apocrine Glands ◽  
Thickness Skin

BACKGROUND: Up to now, surgical excision of apocrine glands still has been a method that yields high treatment results and low rate of odour recurrent for patients, but many people worry about some serious complications that have been observed postoperatively, such as hematoma and skin necrosis. These prolong wound healing, leading to unsightly scars in the axillary fossae. AIM: We conducted this research to investigate the effects and complications of our surgical technique for axillary bromhidrosis. METHODS: Forty-three patients with axillary bromhidrosis were treated. An elliptical incision was made at a central portion of the area marked, with both tips of the ellipse along the axillary crease. The elliptical skin with the subcutaneous tissue was removed en lock. The adjacent skin was undermined to the periphery of the hair-bearing area with straight scissors. The undermined subcutaneous tissue was removed with curved scissors, and the skin was defatted to become a full-thickness skin flap. Any suspected hemorrhagic spots were immediately coagulated electrosurgically. Appropriate drains were placed, and the treated area was covered with thick gauze to each axilla. Arm movement was strictly controlled in the first 3 days post-operatively. RESULTS: Thirty-one patients have been followed up and evaluated for 6 months. 56 out of 62 axillae (90.3%) showed good to excellent results for malodor elimination. All patients reported a reduction in axillary sweating. There were two axillae of skin necrosis and three axillae of hematoma, with one patient receiving an anticoagulant from a cardiologist after the first day of surgery, to treat heart valve disease. The Dermatology Life Quality Index (DLQI) score decreased significantly, and the quality of life improved after the operation. CONCLUSION: Our technique is a simple surgical procedure and easy to perform helping to achieve results for high malodor elimination, with almost no serious complications. Patient’s life quality improved significantly after the operation.

Comparison of a new hydro-surgical technique to traditional methods for the preparation of full-thickness skin grafts from canine cadaveric skin and report of a single clinical case

2012 ◽  
Vol 25 (01) ◽  
pp. 42-48 ◽  
Author(s):  
S. C. Ralphs ◽  
G Coronado ◽  
D. C. Sweet ◽  
J. Ward ◽  
C. P. Bloch ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Skin Graft ◽  
Clinical Case ◽  
Subcutaneous Tissue ◽  
Skin Grafts ◽  
Full Thickness ◽  
Preparation Methods ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Significant Difference

SummaryObjective: To compare the hydro-surgical technique to traditional techniques for removal of subcutaneous tissue in the preparation of full-thickness skin grafts.Study design: Ex vivo experimental study and a single clinical case report.Sample population: Four canine cadavers and a single clinical case.Methods: Four sections of skin were harvested from the lateral flank of recently euthanatized dogs. Traditional preparation methods used included both a blade or scissors technique, each of which were compared to the hydro-surgical technique individually. Preparation methods were compared based on length of time for removal of the subcutaneous tissue from the graft, histologic grading, and measurable thickness as compared to an untreated sample.Results: The hydro-surgical technique had the shortest skin graft preparation time as compared to traditional techniques (p = 0.002). There was no significant difference in the histological grading or measurable subcutaneous thickness between skin specimens.Clinical significance: The hydro-surgical technique provides a rapid, effective debridement of subcutaneous tissue in the preparation of full-thickness skin grafts. There were not any significant changes in histological grade and subcutaneous tissue remaining among all treatment types. Additionally the hydro-surgical technique was successfully used to prepare a full-thickness meshed free skin graft in the reconstruction of a traumatic medial tarsal wound in a dog.Presented at the ACVS symposium during the resident seminar, Seattle, Washington,USA on October 22, 2010.

scholarly journals Vulvar Lymphangiosarcoma in a Bitch

2017 ◽  
Vol 45 ◽  
pp. 6
Author(s):  
Isabella De Almeida Fabris ◽  
Marconi Rodrigues De Farias ◽  
Juliana Werner ◽  
Vinicius Gonzales Peres Albernaz ◽  
Taíse Fuchs ◽  
...  
Keyword(s):  
Survival Time ◽  
Subcutaneous Tissue ◽  
Skin Flap ◽  
Young Animal ◽  
Single Agent ◽  
Soft Tissue Sarcomas ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Histological Lesion ◽  
Lesion Pattern

Background: Lymphangiosarcoma (LSA) is a rare, highly malignant and infiltrative neoplasm of the lymphatic endothelium of dogs and cats. It is mostly reported in medium to large breed dogs, over 5-year-old, with no sexual predisposition. Affected animals present fluctuating and diffuse swelling, covering both dermis and subcutaneous tissue, spreading through lymphatic and haematic vessels. Histologically, LSA is characterized by connected channels devoid of conspicuous haematic elements. Treatment depends on location of the neoplasm, staging, and possibility of curative surgical excision. Chemotherapy and radiotherapy can increase survival time. In this report, we describe a rare case of vulvar LSA in a dog. This is the first Brazilian report of LSA in dogs so far.Case: A 3-year-old, female, mixed breed dog was presented for evaluation of vesicle-bullous lesions in the vulvar and perivulvar region with progressive growth along 6 month. Histopathology revealed neoplastic proliferation in the superficial dermis, advancing through the profound dermis. The histological lesion pattern was consistent with angiosarcoma, which united along with macroscopic pattern of the tumor, and the presence of multiple anastomosed vascular structures without erythrocytes within it at microscopy, was compatible with LSA. No evidence of metastasis or lymphadenopathy was found on survey radiography and ultrasound. We performed a surgical excision, and remaining wound was reconstructed with an advancement skin flap. Despite wide surgical resection, neoplastic cells could be found in surgical borders, as well as a metastatic inguinal lymph node. Postoperative chemotherapy based on doxorubicin as a single agent was administrated. Disease free interval (DFI) was one month after surgery, when small bullous lesions were observed near the surgical site, and histopathological exam confirmed LSA. Three months after the surgical procedure, the patient presented with worsening of the lesions, anorexia, and apathy. The owner opted for euthanasia. Total survival time was five months.Discussion: The LSA occurs often in dogs above five years old, unlike this case, in which the patient was 3 years old. Several anatomic locations were cited in other reports. In this case, the lesion was in both the vulvar and perivulvar regions, which is an uncommon location of LSA, described as secondarily affected region in one report only. Despite absence of metastasis in this case, lungs, kidneys, bone marrow, and spleen can be affected. Histopathologic exam is the golden standard for a definitive diagnose of LSA. Diagnosing LSA may be challenging due to its resemblance to hemangiosarcoma, and confirmation is only possible if histopathology detects an absence of red blood cells in the lymphatic channels. Prognosis is poor due to LSA aggressive and infiltrative features. Doxorubicin demonstrated good clinical response in other dogs. Chemotherapy protocols, whether alone or in combination with cyclophosphamide, have been proving to be promising in dogs with soft tissue sarcomas, such as LSA. Surgical approach is the most appropriate and it may be associated with radiotherapy or chemotherapy, especially if complete resection of the tumor is not possible. In this report, even though it was a young animal, the location and extension of the lesion did not contribute to the good prognosis, even after adding adjuvant chemotherapy to the treatment.

scholarly journals Modified Suction-Assisted Cartilage Shaver for Axillary Osmidrosis

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yu-Ju Tseng ◽  
Chih-Hung Lee ◽  
Shang-Hung Lin
Keyword(s):  
Clinical Efficacy ◽  
Skin Necrosis ◽  
Subcutaneous Tissue ◽  
Clinical Effectiveness ◽  
Chang Gung Memorial Hospital ◽  
Surgical Removal ◽  
Apocrine Glands ◽  
Registration Number ◽  
Axillary Osmidrosis

Apocrine osmidrosis (AO) is a chronic, recurrent, and disturbing disease characterized by malodorous secretion from apocrine glands. Despite various conservative and nonsurgical treatments, surgical removal of apocrine glands remains the cornerstone for AO treatment. Conventional suction-assisted cartilage shaver is effective; however, there are several risks and complications. Hence, we modified the conventional method to achieve better effectiveness and reduce complications. This paper aims to evaluate the clinical effectiveness and the complications arising from the modified suction-assisted cartilage shaver for AO. Thirty-nine patients (M/F=11/28, average age 26.3 years) received this surgical treatment for AO from 2013 to 2017 in the Department of Dermatology at Kaohsiung Chang Gung Memorial Hospital, Taiwan. A suction-assisted cartilage shaver was introduced for the ultimate removal of the subcutaneous tissue containing the apocrine glands. A 0.5 cm incision was made in the center of the identified elliptical surgical area at each axilla. After defatting, the incision was closed primarily. The defatting skin was anchored to the axillary fascia by using 4-0 sutures without drains. We then evaluated the clinical efficacy and complications. The mean duration of follow-up was 31.8 months (12–68 months). Among patients receiving the modified cartilage shaving for AO, 92.3% achieved excellent-to-good results, 5.1% had acceptable results, and 2.6% had fair results. None of them experienced poor clinical efficacy. There was no skin necrosis, hematoma, nor wound infection after the surgery. There were no recurrences in all these patients 2 years after the surgery. This modified suction-assisted cartilage shaver for AO results in good efficacy, a low complication rate, and a low recurrence rate. The method is superior to the conventional one due to tissue glue-free procedure, greater comfort in postoperative care, minimal wounds, less hematoma, and less skin necrosis. The clinical study registration number of this study is NCT03793374.

scholarly journals Dermatofibrosarcoma protuberans – a wolf in sheep’s clothing: a case report and review of the literature

2021 ◽  
Vol 11 (3) ◽  
pp. 246-249
Author(s):  
Mohammad Kamrul Ahsan ◽  
Md Rashedul Islam
Keyword(s):  
Subcutaneous Tissue ◽  
Skin Flap ◽  
Dermatofibrosarcoma Protuberans ◽  
Surgical Excision ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Diagnostic Work ◽  
Work Up ◽  
Slow Growing

Dermatofibrosarcoma protuberans (DFSP) is a locally invasive and slow growing tumor of the subcutaneous tissue. It rarely metastasizes but progressive and recurs frequently after surgical excision. The trunk and proximal extremities are the most common sites of the disease. A 53-year-old woman presented to dermatology outpatient department with a 3-cm, firm, violaceous and multinodular mass located on the left upper shoulder. Diagnostic work-up including magnetic resonance imaging and histopathological findings of biopsy were consistent with DFSP. The patient underwent wide local excision with skin flap reconstruction. No recurrence has been observed during ten months of follow-up. BIRDEM Med J 2021; 11(3): 246-249

scholarly journals Improvement of Therapy Outcomes after Negative Pressure Wound Therapy in a Patient with Acne inversa.

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Wojciech Francuzik ◽  
Tomasz Banasiewicz ◽  
Zygmunt Adamski
Keyword(s):  
Negative Pressure ◽  
Negative Impact ◽  
Life Quality ◽  
Skin Grafting ◽  
Surgical Excision ◽  
Visual Assessment ◽  
Acne Inversa ◽  
Pressure Therapy ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Treatment of acne inversa (also known as hidradenitis suppurativa) is complicated and chronic. This debilitating, inflammatory disease of the follicular sacks affects mostly young adults and has a strong negative impact on their quality of life. We present a case of a 28 year old woman with a history of acneinversa of Hurley grade 2 for 6 years. Patient underwent surgical excision of the skin of the left inguinum followed by negative pressure therapy dressings for 2 and a half weeks (5 dressing changes). This allowed a full closure of the wound after 12 weeks and formation of a well accepted scar. Patient’s paindecreased from 4.5 to 1.5 according to visual assessment scale. We also noted a 28 point decrease in disease severity score according to Sartorius scale and a 19 point decrease in Dermatology Life Quality Index. Two years prior admission patient had undergone surgical treatment of her right inguinum with split thickness skin grafting, which healed for 26 weeks and yielded less satisfactory results. Comparison photographs of both treatment results are presented.

scholarly journals Reconstruction of a secondary scalp defect using the crane principle and a split-thickness skin graft

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Lu ◽  
Ke-Chung Chang ◽  
Che-Ning Chang ◽  
Dun-Hao Chang
Keyword(s):  
Skin Graft ◽  
Subcutaneous Tissue ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Salvage Procedure ◽  
Primary Defect ◽  
Scalp Defects ◽  
Thickness Skin ◽  
Scalp Defect ◽  
Secondary Defect

Abstract Background Scalp reconstruction is a common challenge for surgeons, and there are many different treatment choices. The “crane principle” is a technique that temporarily transfers a scalp flap to the defect to deposit subcutaneous tissue. The flap is then returned to its original location, leaving behind a layer of soft tissue that is used to nourish a skin graft. Decades ago, it was commonly used for forehead scalp defects, but this useful technique has been seldom reported on in recent years due to the improvement of microsurgical techniques. Previous reports mainly used the crane principle for the primary defects, and here we present a case with its coincidental application to deal with a complication of a secondary defect. Case report We present a case of a 75-year-old female patient with a temporoparietal scalp squamous cell carcinoma (SCC). After tumor excision, the primary defect was reconstructed using a transposition flap and the donor site was covered by a split-thickness skin graft (STSG). Postoperatively, the occipital skin graft was partially lost resulting in skull bone exposure. For this secondary defect, we applied the crane principle to the previously rotated flap as a salvage procedure and skin grafting to the original tumor location covered by a viable galea fascia in 1.5 months. Both the flap and skin graft healed uneventfully. Conclusions Currently, the crane principle is a little-used technique because of the familiarity of microsurgery. Nevertheless, the concept is still useful in selected cases, especially for the management of previous flap complications.

Split-Thickness Skin Excision: Its Use for Immediate Wound Care in Crush Injuries of the Foot

Foot & Ankle ◽  
1989 ◽  
Vol 10 (2) ◽  
pp. 54-60 ◽  
Author(s):  
Mark Myerson
Keyword(s):  
Wound Care ◽  
Skin Flap ◽  
Free Flaps ◽  
Complete Coverage ◽  
Compartment Syndromes ◽  
Wound Debridement ◽  
Thickness Skin ◽  
Skin Excision ◽  
Crush Injuries ◽  
Skin Coverage

Split-thickness skin excision (STSE) was used as an adjunctive modality in the treatment of eight crush injuries of the foot. Compartment syndromes were present in four feet and were treated with fasciotomy. Wound debridement, internal fixation of fractures, and STSE followed. This technique accurately determined the viability of the skin flap, simultaneously providing skin for local wound coverage. All flaps treated in this manner survived and all (100%) of the degloved STSE grafts healed. Additional procedures were performed in four patients (two free flaps and two split-thickness skin grafts) adjacent to the debrided flap for complete coverage. STSE proved to be an effective modality for skin coverage in crush injuries of the foot associated with degloving of skin.

scholarly journals Cutaneous lymphoma in a cow - a case report

2019 ◽  
Vol 73 (1) ◽  
pp. 50-56
Author(s):  
Branislav Kureljusic ◽  
Slobodan Maksimovic ◽  
Slobodan Vujinovic ◽  
Bozidar Savic ◽  
Vesna Milicevic ◽  
...  
Keyword(s):  
Disease Virus ◽  
Skin Disease ◽  
Mononuclear Cells ◽  
Subcutaneous Tissue ◽  
Leukemia Virus ◽  
Surgical Excision ◽  
Cutaneous Lymphoma ◽  
Histopathological Analysis ◽  
Lumpy Skin Disease ◽  
Lumpy Skin Disease Virus

In this paper the case of a 2.5-year-old Simmental cow, with suspicion of lumpy skin disease in mid-2017 in Serbia will be presented. Clinical examination revealed numerous nodules of varied size from a few millimeters to approximately 10 centimeters disseminated predominantly on the skin of the udder and the perineum, some of which were coalescing and exulcerated. The general condition of the affected animal was unchanged. According to the results of laboratory analysis, the cow was negative for the presence of antibodies against the bovine leukemia virus, showed a negative reaction in tuberculinization and was vaccinated against lumpy skin disease virus. After the surgical excision of one skin node, the sample tested negative for the genome of lumpy skin disease virus. In order to establish the morphology of the skin lesion, a histopathological analysis was performed. Histopathological analysis showed the infiltration of the corium and subcutaneous tissue by numerous mononuclear cells showing cellular atypia. Suspicion of cutaneous lymphoma was established. Furthermore, the immunohistochemical examination confirmed that the infiltrate contained exclusively CD3-immunopositive cells, suggesting a T-cell origin nonepitheliotropic lymphoma.

scholarly journals Justification for preservation of the projected skin flap above the tumor during surgical treatment of primary resectable breast cancer

2019 ◽  
Vol 100 (4) ◽  
pp. 710-718
Author(s):  
A R Khamitov ◽  
K Kh Ismagilov
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Malignant Tumor ◽  
Subcutaneous Tissue ◽  
Skin Flap ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Superficial Fascia ◽  
Indirect Sign ◽  
The Aesthetic

Aim. Improvement of the aesthetic outcomes of reconstructive plastic surgery for nodular breast cancer due to the scientific rationale of conservation of the projected skin flap and moving the postoperative scar to aesthetically acceptable zones. Methods. Data of clinical and instrumental methods of investigation of 240 patients with primary resectable breast cancer were analyzed. The probability of involvement of the front layer of the superficial fascia in the projection of a malignant tumor depending on its clinical and topographic anatomical figures was estimated. Results. The study revealed that the fascia involvement does not depend on the skin flattening. The skin flatte­ning is an indirect sign of superficial tumors having a probability of intimate adherence of the tumor to the fascia of 31.8±0.401%. In turn, the intimate adherence of the tumor to the front layer of the superficial fascia with a pro­bability of its involvement of 39.3±0.41% is a significant risk factor for the projected skin flap involvement. It was also found that involvement of the fascia studied does not depend neither on the size of the tumor, nor on the nodal status, nor on the biological subtype. The key risk factor is the depth of the tumor. Conclusion. The indication for the projection skin flap preservation is the location of a malignant tumor at a depth of more than 1.05 cm, at which the probability of affecting the fascia is statistically insignificant and is 1.7±0.1%, which requires placing the subcutaneous tissue resection line in the tumor projection from the side of preserved skin flap.

scholarly journals Scrotal lymphangiomatosis: a case report

2013 ◽  
Vol 6 (1) ◽  
pp. 11 ◽  
Author(s):  
Rachel Wong ◽  
Megan Melnyk ◽  
Steven S. Tang ◽  
Chris Nguan
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Lymphatic System ◽  
Surgical Excision ◽  
Skin Grafts ◽  
Thickness Skin ◽  
Benign Tumours

Lymphangiomas are benign tumours of the lymphatic system, andthere are several reported cases of scrotal lymphangioma in theliterature to date. We report a rare case of multilocular cutaneouslymphangiomatosis treated with surgical excision (total scrotectomyand reconstruction using split-thickness skin grafts withvacuum-assisted closure dressing).

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