Reconstructive surgery following skin tumor resection can be challenging. Treatment options after removing the tumor are skin grafting, local pedicled and axial flaps, or microsurgery for complex and extensive wounds correction. Recently, the use of dermal substitutes has been extended to reconstructive surgery in cutaneous oncology. Objectives. To report both a single-center experience using dermal substitutes in reconstructive surgery for skin malignancies and reconstructive surgery's outcomes. Methods and Results. Among thirteen patients, seven (53.8%) were male with mean age of 62.6 years. Regarding diagnosis, there were five cases (38.5%) of basal cell carcinoma (BCC), two (15.4%) of melanoma in situ, two (15.4%) of dermatofibrosarcoma protuberans, one (7.7%) of squamous cell carcinoma (SCC), one (7.7%) of angiosarcoma, and one (7.7%) of eccrine carcinoma (EC). The most common site of injury was scalp (53.8%) and lower limbs (23.1%). Seven (53.8%) patients used NPWT and six (46.2%) patients underwent Brown's dressing. The most frequent complication of the first stage was wound contamination (38.5%). Average time to second-stage skin grafting was 43.9 days. Three (23%) patients developed tumor recurrence and one died. Conclusions. Use of dermal substitutes in oncology can be an option for reconstruction after extended resections, providing good aesthetical and functional results.

Background: Standard treatment for subungual melanoma is wide local excision including digit amputation in order to obtain safety margins. Level of amputation has been discussed in order to achieve appropriate oncological results along with preservation of limb function wherein local excision of

Objective: To report the experience of a routine follow-up program based on medical visits and chest CT. Methods: This was a retrospective study involving patients followed after complete surgical resection of non-small cell lung cancer between April of 2007 and December of 2015. The follow-up program consisted of clinical examination and chest CT. Each follow-up visit was classified as a routine or non-routine consultation, and patients were considered symptomatic or asymptomatic. The outcomes of the follow-up program were no evidence of cancer, recurrence, or second primary lung cancer. Results: The sample comprised 148 patients. The median time of follow-up was 40.1 months, and 74.3% of the patients underwent fewer chest CTs than those recommended in our follow-up program. Recurrence and second primary lung cancer were found in 17.6% and 11.5% of the patients, respectively. Recurrence was diagnosed in a routine medical consultation in 69.2% of the cases, 57.7% of the patients being asymptomatic. Second primary lung cancer was diagnosed in a routine medical appointment in 94.1% of the cases, 88.2% of the patients being asymptomatic. Of the 53 patients who presented with abnormalities on chest CT, 41 (77.3%) were diagnosed with cancer. Conclusion: Most of the cases of recurrence, especially those of second primary lung cancer, were confirmed by chest CT in asymptomatic patients, indicating the importance of a strict follow-up program that includes chest CTs after surgical resection of lung cancer.

Background: Chronic obstructive pulmonary disease (COPD) is related to the prognosis of patients with lung cancer, and one of risk factors of respiratory complications after surgical resections. This study aimed to investigate whether perioperative inhalations of long-acting beta-agonists (LABAs) or long-acting muscarinic antagonists (LAMAs) would decrease the postoperative complications in lung cancer patients with COPD. Methods:We retrospectively analyzed 108 patients with COPD who underwent pulmonary resections for primary lung cancer at our hospital between January 2013 and January 2016, in order to determine the association between the incidence of postoperative complications (e.g., prolonged air leakage and pneumonia) and the use of LABAs or LAMAs. Results: Among 108 patients with COPD patients, there were 86 men and 22 women, with a mean age of 69.3 years (range, 46e84). The mean Brinkman index was 1172.1(range, 50-3480). The mean FEV1.0/FVC was 61.4%(range, 26.8%-69.9%). The surgical procedures were partial resection in 11 patients, pulmonary segmentectomy in 3 patients, lobectomy in 92 patients, and pneumonectomy in 2 patients. The histological types showed adenocarcinoma in 53 patients, squamous cell carcinoma in 38 patients, adenosquamous carcinoma in 5 patients, large cell neuroendocrine carcinoma in 3 patients, large cell carcinoma in 4 patients, small cell carcinoma in one patient, and pleomorphic carcinoma in 4 patients. There were 29 postoperative complications in COPD (26.9%), prolonged air leak (more than 7 days) 14 cases, pneumonia 9 cases, arrhythmia 2 cases, chylothorax 2 cases, wound infection 2 cases. The frequency of postoperative pulmonary complications such as prolonged air leakage and pneumonia, was significant higher in COPD (23 cases, 21.3%) than in non COPD (15 cases,6.7%). Inhaled bronchodilators such as LAMA or LABA were prescribed to 34 cases in COPD, not to 74 cases. The pulmonary complications were significant lower in LAMA or LABA users (3 cases, 8.8%) than in no users (20 cases, 27.0%). Conclusion:For lung cancer patients with COPD, preoperative management using the inhalants with LABA or LAMA, and smoking cessation can reduce the frequency of the postoperative pulmonary complications after surgical lung resection. The inhalants with LAMA or LABA may be adapted for the management of not only perioperative care but also long-term survival of COPD patients after surgery.Background: There is no consensus about the best method to follow up patients after complete resection of lung cancer. This study was performed to identify how often follow-up chest-CT detected recurrence or a second primary lung cancer in asymptomatic patients.