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Nail surgery complications
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
PreventionHigher concentrations of the anesthetic and long-acting anesthetics (ropivacaine, if not available bupivacaine) offer postoperative analgesia for up to 16 hours.Painkillers are prescribed according to the expected postoperative pain. Some procedures cause very little pain (chemical cautery, debulking), whereas some others are very painful (wedge excision, DuBois Z-plasty).The operated digit is very sensitive to touch post-surgery and should be judiciously protected against trauma with a bulky dressing.To prevent swelling that will promote pain and throbbing, elevate the limb for 48 hours (arm sling or footstool) and avoid too tight a dressing.
Malignant diseases of the skin
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
Anupam Das, Yasmeen Jabeen Bhat
This is a slowly progressive neoplastic disorder of fibroblasts. It looks quite similar to a dermatofibroma histologically and is an intracutaneous form of plaque clinically. These lesions often extend widely into the skin and subcutaneous tissues and the clinical margins may be difficult to detect. Wide surgical excision is necessary or Mohs’ microscopically controlled excision.
Central Nervous System
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
The outcome following surgery strongly depends on the extent of resection. Re-growth varies from less than 10% for patients with complete excision to over 40% for patients undergoing partial resection. It follows that patients with tumors in the most accessible regions have better prospects than patients with tumors in difficult areas such as the sphenoid ridge. A second operation for recurrence is possible in the majority of patients.
Treatment of basal cell carcinoma with intralesional interferon alfa-2b: an open-label clinical trial
Published in Expert Review of Anticancer Therapy, 2023
Masoud Maleki, Pouran Layegh, Bita Kiafar, Mehrdad Teimoorian, Emadodin Darchini-Maragheh, Mahdi Razmara
In our study, most of BCC lesions in both groups were located in the central regions of the face. In the absence of Moh’s surgical technique, the cosmetic outcome of simple excision surgery method may be severely impaired. Therefore, when there is no access to Moh’s surgical technique, it is recommended by the authors to use intralesinal IFN-α 2b, especially for multiple BCC lesions, which will lead to better aesthetic outcome. Certain cases of intralesional IFN therapy could be patients with fear of surgery (tomophobia), patients with hemorrhagic disorders, or with other contraindications of anesthesia and underlying medical conditions. IFN-α 2b adds an effective option to the treatment of BCC, but financially, it is expensive in many countries [31–33]. However, it cost lower in comparison of surgical methods in Iran.
Controversies in Pediatric Angle Surgery and Secondary Surgical Treatment
Published in Seminars in Ophthalmology, 2023
Alexander K. Young, Deborah K. Vanderveen
Even if many of the early postoperative complications of trabeculectomy are avoided, there always remains a risk of failure from encapsulation. Due to the strong inflammatory and fibrosis response in pediatric patients, bleb formation is at high risk of failure. Intraoperative MMC is often used to chemically reduce fibroblast formation. However, it is a toxic antimetabolite that has significant side effects, playing a role in delayed wound healing and bleb leakage.54 Mechanical excision by tenonectomy has also been shown to reduce scarring further potentially. One study by Awadein et al. demonstrated a reduction in postoperative glaucoma medication usage, and a longer survival time of the formed bleb, with a partial tenonectomy, which was attributed to reduced encapsulation.55 A novel modification to a trabeculectomy has been described, by performing a trim of the edges of the scleral bed of the scleral flap.56
A rare case of epithelial-myoepithelial carcinoma arising ex pleomorphic adenoma of the lacrimal gland: case report and review of the literature
Published in Orbit, 2022
Nicholas Van Rooij, Alexander R. Newman, Vipul Vyas, Timothy J. Sullivan
This is the second reported instance of EMC presenting with eye pain and headaches and the first case where the pain worsened for several months. In both instances, the pain resolved following lesion excision. This report also emphasises the imperative role of immunostaining in the evaluation of lacrimal neoplasms to facilitate accurate diagnosis and implementation of appropriate management strategies. Due to the inherent complexities of ensuring complete excision of infiltrating masses within the orbit, the majority of EMC is managed with adjuvant radiotherapy; however, there remains no consensus on optimal management of these rare tumours. Further observational data including long-term surveillance is required to characterise lacrimal EMC and determine prognostic biomarkers specific to lacrimal gland disease. Future studies are needed to develop an optimal management strategy, including clarification of the role of adjuvant radiotherapy in relation to patient survival and tumour recurrence rates. The high proportion of EMC ex pleomorphic adenoma in lacrimal compared with non-lacrimal tumours also requires further investigation to ascertain its pathophysiological basis and prognostic significance.