Annals of plastic surgery
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Annals of plastic surgery · Nov 2000
Sentinel node biopsy in melanoma using technetium-99m rhenium colloid: the London experience.
Nodal metastases in patients with melanoma identify a reduction of survival by 50%; however, elective lymph node dissection (ELND) has not been shown clearly to improve survival. Morton's technique of sentinel node biopsy, using preoperative lymphoscintigraphy and intraoperative blue dye, addresses elegantly the controversy regarding ELND. Sentinel node biopsy has been shown to stage the patient accurately because metastases from melanoma follow an orderly progression from the sentinel node to the remainder of the basin. ⋯ Complications occurred at a substantially higher rate (45%) after completion lymphadenectomy than after sentinel node biopsy alone (9%). Sentinel node biopsy is a feasible technique with a high success rate (98%), but it requires a multidisciplinary approach. This study validates the clinical usefulness of 99mTc rhenium colloid for lymphoscintigraphy.
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Annals of plastic surgery · Oct 2000
Case ReportsDocetaxel (taxotere) extravasation: a report of five cases with treatment recommendations.
Docetaxel (Taxotere) is a relatively new antineoplastic agent that is proving to be clinically useful in the treatment of a number of major solid tumors, including breast, ovarian, lung, and prostate carcinoma. Common systemic toxicities include neutropenia, alopecia, nausea, and vomiting. ⋯ The authors did not find any other reported series of docetaxel extravasation in an extensive literature review. They present these 5 patients and provide treatment recommendations.
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Annals of plastic surgery · Oct 2000
Reliability of island flaps raised after superficial and deep burn injury.
In select cases, to prevent any functional loss and to initiate early function during the early burn period, the reconstructive procedure of choice may be flap coverage. In these circumstances, when the ideal flap donor site is burned, the clinician may be hesitant to raise this flap because of questionable flap survival. The authors conducted this study to determine whether a superficially or deeply burned skin island flap would survive when elevated during the early postburn period. ⋯ In addition, all the superficially burned flaps survived in group 1 (100%), and 21 of the deeply burned flaps survived in group 2 (84%). There was no significant difference between superficially and deeply burned flaps with regard to survival, and the burned flaps were as successful as the unburned control flaps in both groups (p = 0.11). Skin island flaps elevated after superficial or deep burn injury are reliable in this animal model.
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Annals of plastic surgery · Feb 2000
Case ReportsCorrection of axillary burn scar contracture with the thoracodorsal perforator-based cutaneous island flap.
Axillary scar contracture is observed frequently after severe burn insult and is usually accompanied by injuries to the adjacent area. Although many therapeutic methods, including skin grafting, Z-plasties, local flaps, island flaps, and free flaps, have been established, each technique has its own advantages and disadvantages in specific situations. The decision regarding which technique to use can only be made after consideration is given to the merits of the individual case. ⋯ In 2 patients, release was incomplete with only 110 deg shoulder abduction, but neither one required a second release. The range of motion in terms of shoulder abduction was improved preoperatively (30-90 deg) to postoperatively (110-170 deg). The thoracodorsal perforator-based cutaneous flap presents a very useful reconstructive method for the treatment of axillary defects.