A literature search focusing on flap knee reconstruction revealed much controversy regarding the optimal management of around the knee defects. Muscle flaps are the preferred option, mainly in infected wounds. Perfora...A literature search focusing on flap knee reconstruction revealed much controversy regarding the optimal management of around the knee defects. Muscle flaps are the preferred option, mainly in infected wounds. Perforator flaps have recently been introduced in knee coverage with significant advantages due to low donor morbidity and long pedicles with wide arc of rotation. In the case of free flap the choice of recipient vessels is the key point to the reconstruction. Taking the published experience into account, a reconstructive algorithm is proposed according to the size and location of the wound, the presence of infection and/or 3-dimensional defect.展开更多
Introduction: The Sentinel Lymph Node Biopsy (SLNB) in melanoma is an important tool of staging. The impact on overall survival still remains unclear. The guidelines in regard to depth, taking in mind where SLNB stagi...Introduction: The Sentinel Lymph Node Biopsy (SLNB) in melanoma is an important tool of staging. The impact on overall survival still remains unclear. The guidelines in regard to depth, taking in mind where SLNB staging benefits do not outweigh the risks of the procedure, are constantly reviewed and modified. Patients and Methods: From 2010 to 2015, 104 patients with thin melanoma Stage IA with presence of adverse or high risk features and from IB only TIb, N0, M0 (American Joint Committee on Cancer, AJCC Melanoma Staging and Classification 7<sup>th</sup> Edition 2009) were included and divided into 2 groups: Group A: 68 patients with Breslow ≤ 0.75 mm and Group B: 36 patients with Breslow 0.76 - 1.0 mm. Initially all patients underwent excision of the primary site and subsequently wide local excision and SLNB. We analyzed the histopathology reports of SLNB procedures in both groups. Results: There was no positive SLN in group A (0%). 4 patients from group B had positive SLN (11.1%) and underwent Completion Lymph Node Dissection (CLND). The total percentage of positive SLNs from both groups was 3.8%. Conclusions: Our findings justify the SLNB procedure in thin melanomas of 0.76 - 1.0 mm. In melanomas ≤ 0.75 mm, SLNB should be considered on an individual basis when “high-risk features” are present. More comparable studies should be evaluated in order to accurately define the threshold value of Breslow thickness where SLNB is safely deemed unnecessary.展开更多
文摘A literature search focusing on flap knee reconstruction revealed much controversy regarding the optimal management of around the knee defects. Muscle flaps are the preferred option, mainly in infected wounds. Perforator flaps have recently been introduced in knee coverage with significant advantages due to low donor morbidity and long pedicles with wide arc of rotation. In the case of free flap the choice of recipient vessels is the key point to the reconstruction. Taking the published experience into account, a reconstructive algorithm is proposed according to the size and location of the wound, the presence of infection and/or 3-dimensional defect.
文摘Introduction: The Sentinel Lymph Node Biopsy (SLNB) in melanoma is an important tool of staging. The impact on overall survival still remains unclear. The guidelines in regard to depth, taking in mind where SLNB staging benefits do not outweigh the risks of the procedure, are constantly reviewed and modified. Patients and Methods: From 2010 to 2015, 104 patients with thin melanoma Stage IA with presence of adverse or high risk features and from IB only TIb, N0, M0 (American Joint Committee on Cancer, AJCC Melanoma Staging and Classification 7<sup>th</sup> Edition 2009) were included and divided into 2 groups: Group A: 68 patients with Breslow ≤ 0.75 mm and Group B: 36 patients with Breslow 0.76 - 1.0 mm. Initially all patients underwent excision of the primary site and subsequently wide local excision and SLNB. We analyzed the histopathology reports of SLNB procedures in both groups. Results: There was no positive SLN in group A (0%). 4 patients from group B had positive SLN (11.1%) and underwent Completion Lymph Node Dissection (CLND). The total percentage of positive SLNs from both groups was 3.8%. Conclusions: Our findings justify the SLNB procedure in thin melanomas of 0.76 - 1.0 mm. In melanomas ≤ 0.75 mm, SLNB should be considered on an individual basis when “high-risk features” are present. More comparable studies should be evaluated in order to accurately define the threshold value of Breslow thickness where SLNB is safely deemed unnecessary.
