Marjolin's ulcer is a rare and often aggressive cutaneous malignancy that arises in previously traumatized or chronically inflamed skin, particularly after burns. We reviewed 264 burns cases treated in our departments to assess the frequency and clinicopathological features of this malignant complication. We found 31 cases of Marjolin's ulcer and a further 14 cases of nonmalignant ulceration at previous burn sites. Eighteen Marjolin's ulcers were located on the extremities, six on the scalp, six on the trunk, and one on the nose. Most malignancies were squamous cell carcinomas. The average time lag between the burns and subsequent malignant ulceration was 19 years. Four of the malignant ulcers had spread to regional lymph nodes, but there were no distant metastases. This study emphasizes that Marjolin's ulcer should be considered as a significant postburn complication.

To increase the survival of proximally pedicled venous island flaps, which are known to be safe only when small, we used surgical and chemical delaying procedures both individually and in combination for 7, 14, and 21 days. Survival was 1% in those flaps designated as controls, in which there was neither surgical nor chemical delay. However, it was 3%, 31%, and 68% at 7, 14, and 21 days, respectively, when surgical delay was used and 16%, 56%, and 86%, at 7, 14, and 21 days, respectively, when chemical delay was used. Survival was 32%, 84%, and 87%, at 7, 14, and 21 days when both chemical and surgical delays were used. We conclude that chemical delay is more effective than surgical delay in increasing survival of proximally pedicled venous island flaps, but the use of combined chemical and surgical delay may reduce the time required for delay.

Background: The mandible is one of the most frequently fractured bones. The objective of this prospective study was to determine and illustrate fracture patterns of the mandible in relation to various etiologic factors. Patients and Methods: A total of 218 patients with mandibular fractures were included in this study. Data regarding age, gender, causes and anatomic sites of fractures and treatment modalities were collected. Conventional plain radiographs of the mandible were obtained in all patients. The plain radiographs included such projections as Towne and Waters in patients suspected of having subcondylar fractures or associated facial fractures. Radiographs were scanned using a high-resolution scanner, and fracture lines were marked. The lines were copied and pasted to a graphic image of the mandible. All fracture lines were confirmed on surgical explorations of the fractures when the patients were under general anesthesia. Results: Traffic accidents (67%) were the most frequent cause of mandibular fractures. 51% of the patients had multiple fractures including fractures of the parasymphysis and angle, which were the most commonly affected sites (33.3%). 49% of the patients had a single fracture. The body of the mandible was the most frequently affected site in these patients (26.2%). Conclusion: Weak points of the mandible and etiologic factors were the determinants of mandibular fracture sites. We speculate that the main determinants of fracture sites were characteristics of the mandible in those fractures caused by motor vehicle accidents, while the other etiologic factors themselves determined the fracture sites for the other types of trauma.

Background: Reconstruction of the defects after surgical resection of tumors is one of the important issues in surgical oncology. It is essential that the defect should be covered with a tissue quite similar to the original one and is best achieved by harvesting tissue from an area adjacent to the defect. Tissue expansion is one of the most frequently used reconstructive techniques. A number of studies evaluated blood circulation, capsule formation, tissue tolerance, histomorphological changes and complications of expander placement. However, only a few attempted to enhance tissue expansion. This study we aimed to evaluate verapamil, a calcium channel blocker, to enhance tissue expansion.