ABSTRACT
[This corrects the article DOI: 10.1155/2018/4192657.].
ABSTRACT
Verrucous carcinoma (VC) is a rare, low-grade, and well-differentiated variant of squamous cell carcinoma. These tumors are slow-growing and exophytic and have a negligible incidence of metastasis. Treatment is complete surgical resection, ideally by Mohs micrographic surgery, to ensure adequate clear margins. Cutaneous VC predominantly occurs on the plantar surface of the foot and rarely occurs in multiple sites. This case study describes the fourth reported occurrence of bilateral VC of the feet in a woman with chronic diabetic foot ulcers. The case provides further support for persistent wounds contributing to the development of this lesion and describes their role in the characteristic delay in diagnosis of VC.
ABSTRACT
The Keystone Design Perforator Island Flap is a fasciocutaneous perforator flap resembling two end-to-end VY flaps. We used a modification of the original design to avoid extending the incision into an elliptical pattern, and maintained a trailing skin bridge whilst incising fascia in a tunneling fashion. Thirty patients underwent 32 flaps mainly on the lower leg to close defects that would traditionally require skin grafting. All flaps survived completely, with minor complications in four patients. All but five patients were allowed unrestricted ambulation after surgery. The modified design is straightforward to learn, has reliable perfusion, and provides a simpler recovery for patients. CLINICAL QUESTIONS/LEVEL OF EVIDENCE: Therapeutic, IV.
Subject(s)
Free Tissue Flaps/blood supply , Melanoma/surgery , Myocutaneous Flap/blood supply , Skin Neoplasms/surgery , Adolescent , Adult , Cohort Studies , Databases, Factual , Female , Follow-Up Studies , Free Tissue Flaps/transplantation , Graft Rejection , Graft Survival , Humans , Lower Extremity , Male , Melanoma/pathology , Middle Aged , Myocutaneous Flap/transplantation , Retrospective Studies , Risk Assessment , Skin Neoplasms/pathology , Skin Transplantation , Treatment Outcome , Wound Healing/physiology , Young AdultABSTRACT
Despite improved protective mechanisms, pacemakers and implanted cardioverter defibrillators are subject to interference from various sources. An effective means of hemostasis, electrocautery generates electromagnetic interference and may be problematic in this patient population. Reported complication rates are low, but the consequences can be serious. Recommendations regarding the management of patients with implanted cardiac devices become increasingly significant both as the number of patients with devices increases and the number of out-of-hospital/minor surgery procedures performed increases. This article provides surgeons and anesthetists with practical recommendations for use of electrocautery in patients with pacemakers or implantable cardiac defibrillators.
