OBJECTIVEThe closure of the skin defect in myelomeningocele (MMC) repair is an essential step that determines the quality of the surgical result. The success of surgical results is related to the decision to use the most suitable techniques, namely flaps or primary closure. The aim of this study was to evaluate the effectiveness of a decision-making guide to determine whether to use primary repair or a flap for the closure of skin defects that occur in MMC.METHODSFifty patients underwent surgery after neurosurgical repair and closure of the placode. A simple guide was generated according to the defect height/width and posterior axillary lines/defect width ratio. These 2 ratios were considered to determine which closure technique (with or without primary repair) should be used for the MMC defect reconstruction.RESULTSBy using this decision-making guide, 20 of the defects were repaired with various flaps, and those of the remaining 30 patients were repaired with primary closure. In all patients, a successful tension-free 1-stage closure was obtained. Except for 4 patients who had flap reconstruction with partial flap necrosis or minimal flap tip necrosis, healing was uneventful without any complications. There were no additional wound complications during the mean follow-up of 6.8 years (range 5 months to 14 years).CONCLUSIONSBecause of various defect sizes and patient characteristics, no single protocol exists for the reconstruction of MMC defects. The guide suggested here might be effective in deciding which method is suitable for closure of MMC skin defects.
OBJECTIVE
The primary aim of treatment of basal cell carcinoma (BCC) is the complete excision of the tumor. Reconstruction of the defect after surgical excision varies, depending on the location and size of the defect and the skin to be used in the reconstruction. In this study, investigators compared the rates of tumor positivity at the edges of BCC specimens excised with 3- or 5-mm surgical margins.
METHODS
Researchers analyzed data related to 113 patients with a preliminary diagnosis of BCC between August 2016 and June 2018. In total, 99 lesions from 91 patients not exceeding 2 cm in size excised with 3-mm (n = 53) or 5-mm (n = 46) surgical margins were included. Statistical analysis was performed using the χ
2 test.
RESULTS
After histopathologic assessment, 3 of 53 lesions that were excised with 3-mm surgical margins had a positive surgical margin, whereas none of the 46 lesions excised with 5-mm margins indicated a positive tumor presence. However, there was no statistical difference between the groups.
CONCLUSIONS
A 3-mm surgical margin may be sufficient and safe for BCC excision.
Basal cell carcinoma (BCC) is the most common skin cancer type in humans. Various factors play a role in BCC occurrence, but sunlight exposure is the most common etiologic factor. This case series presents three patients who had scarring after severe traumas (a deep abrasion, burn, and puncture injury); a long time after the respective traumatic events, a BCC occurred in the scar tissue. The lesions were excised, and BCCs were diagnosed based on histopathology. Although several etiologic factors may play a role in trauma-related BCC, the main mechanism remains unclear. A correct diagnosis with biopsy and an assessment of the lymphatic system are crucial to prevent aggressive procedures, and BCC should be kept in mind when lesions are found in scar tissue.
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