The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Mats Bjellerup - One of the best experts on this subject based on the ideXlab platform.
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Novel method for training Skin flap Surgery: polyurethane foam dressing used as a Skin equivalent.
Dermatologic Surgery, 2006Co-Authors: Mats BjellerupAbstract:BACKGROUND. With a substantial rise in the incidence of Skin cancer, Skin Surgery has become an increasingly large part of dermatology. Skin Surgery is best performed by dermatologists. This demands effective training in dermatologic Surgery, including flap Surgery. OBJECTIVE. To find a modern alternative to traditional training on pig's feet Skin in teaching flap Surgery to residents in dermatology. MATERIALS AND METHODS. A face with expression lines printed on a nonadhesive hydrocellular polyurethane dressing (Allevyn, #66007638, 20 x 20 cm, Smith & Nephew Medical Limited, Hull, England). Tumors were marked in suitable locations,necessitating the use of transposition, advancement, and rotation flaps. Twenty-two residents were trained in flap construction, excision, and closure. RESULTS. Training on Allevyn was rated high by participants. CONCLUSION. Allevyn has unlimited storing qualities and Skinlike qualities when incised, extended, and sutured. Sutures stay tight without the help of an assistant. Training on Allevyn gives students a good understanding of the mechanics of Skin flaps, including transposition, advancement, and rotational flaps. The Allevyn is kept by the student after the course and can be studied afterward. Skin Surgery training on Allevyn is superior to traditional training in pig's feet Skin. (Less)
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Novel method for training Skin flap Surgery: polyurethane foam dressing used as a Skin equivalent.
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2005Co-Authors: Mats BjellerupAbstract:With a substantial rise in the incidence of Skin cancer, Skin Surgery has become an increasingly large part of dermatology. Skin Surgery is best performed by dermatologists. This demands effective training in dermatologic Surgery, including flap Surgery. To find a modern alternative to traditional training on pig's feet Skin in teaching flap Surgery to residents in dermatology. A face with expression lines printed on a nonadhesive hydrocellular polyurethane dressing (Allevyn, #66007638, 20 x 20 cm, Smith & Nephew Medical Limited, Hull, England). Tumors were marked in suitable locations, necessitating the use of transposition, advancement, and rotation flaps. Twenty-two residents were trained in flap construction, excision, and closure. Training on Allevyn was rated high by participants. Allevyn has unlimited storing qualities and Skinlike qualities when incised, extended, and sutured. Sutures stay tight without the help of an assistant. Training on Allevyn gives students a good understanding of the mechanics of Skin flaps, including transposition, advancement, and rotational flaps. The Allevyn is kept by the student after the course and can be studied afterward. Skin Surgery training on Allevyn is superior to traditional training in pig's feet Skin.
Anthony Dixon - One of the best experts on this subject based on the ideXlab platform.
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Post procedural pain with photodynamic therapy is more severe than Skin Surgery
Journal of plastic reconstructive & aesthetic surgery : JPRAS, 2013Co-Authors: Anthony Dixon, Mary P. Dixon, Stuart Anderson, John DixonAbstract:Summary Objective To compare prospective data on pain experienced by patients undergoing large facial Skin cancer Surgery with pain experienced with novel face photodynamic therapy (PDT). Design A comparison of pain data sets from two prospective trials in the same centre. Setting Referral Skin cancer centre in Australia. Protocol 34 PDT patients had two aminolevulinate treatments to the face two weeks apart. 68 Surgery patients, matched 2:1 for gender and age, had large Skin cancer excisional Surgery to the face and closure with flap, graft or wedge reconstruction. Main outcome measure(s) Severity of pain during and following procedure. Results The only patients describing their experience as the worst pain of their life were 4 PDT patients (12%). The median and mean pain scores for PDT patients were significantly higher than for extensive facial large face Surgery, ( p Discussion and conclusions Clinicians should consider explaining the relative likelihood of more severe pain whenever PDT is considered over Surgery. The pain experienced with this PDT product may not reflect the pain experienced with other PDT products.
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Prospective study of Skin Surgery in patients with and without known diabetes.
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2009Co-Authors: Anthony Dixon, Mary P. Dixon, John DixonAbstract:To study the association between known diabetes and complications after Skin Surgery. In a 5-year prospective observational study, 7,224 lesions were excised on 4,197 patients in a referral center involving one surgeon in a southern Australian locale. One hundred ninety-six patients with known diabetes (4.7%) underwent 551 excision procedures (7.6%) 4,001 people without diabetes underwent 6,673 procedures. Patients with diabetes were older (72 +/- 13) than those without (64 +/- 17) (p<.001.) Infection incidence was significantly higher in patients with diabetes (4.2%, 23/551) than in those without (2.0%, 135/6,673) (p<.001). There were five bleeds in patients with diabetes (0.9%) versus 47 in those without (0.7%) (p=.58). The incidence of wound dehiscence in patients with diabetes (2) was not different from that in those without (22), (p=.90). Noninfective complications were 1.8% for patients both with diabetes (10/551) and those without (118/6,673). Two thousand three hundred seventy-one flaps resulted in 14 (0.6%) cases of end-flap necrosis, but no case occurred in patients with diabetes. Multivariate analysis using binary logistic regression demonstrated that known diabetes was predictive of infection (odds ratio=1.66, 95% confidence interval=1.05-2.65). Diabetes was not predictive of other complications. Patients with known diabetes suffer more postoperative Skin infections than those without. Noninfective complications are similar. Clinicians may consider antibiotic prophylaxis in their patients with diabetes facing high-risk Skin Surgery.
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prospective study of Skin Surgery in smokers vs nonsmokers
British Journal of Dermatology, 2009Co-Authors: Anthony Dixon, Mary P. Dixon, John Dixon, C. B. Del MarAbstract:Summary Background Smoking may increase complications following minor Surgery leading many clinicians to urge patients to refrain from smoking before and after Surgery. Objective To study the association between smoking and complications following Skin Surgery. Methods In a 5-year prospective observational study 7224 lesions were excised on 4197 patients. Patients were not instructed regarding smoking. All complications were recorded. Results A total of 439 smokers (10·5%) underwent 646 procedures (9%), 3758 nonsmokers (89·5%) underwent 6578 procedures (91%). Smokers were younger (55 ± 16 years) than nonsmokers (66 ± 17 years) (P < 0·001). Infection incidence was not significantly different, 1·9% (12/646) in smokers compared with 2·2% (146/6578) in nonsmokers (P = 0·55). There were two bleeds with smokers (0·3%) vs. 50 in nonsmokers (0·8%) (P = 0·2). The incidence of wound dehiscence in nonsmokers (three) was not different from nonsmokers (21) (P = 0·54). However, the incidence of scar contour distortion in smokers (three) was greater than in nonsmokers (two) (odds ratio 15·3; 95% confidence interval 2·5–92). Total complication incidence was similar, 3·6% in smokers vs. 4·0% in nonsmokers (P = 0·58). Out of 2371 flaps there were 14 (0·6%) cases of end-flap necrosis but smokers were not at increased risk. The case–control analysis compared each smoker with two nonsmokers matched for age, sex, postal code and outdoor occupational exposure. This again demonstrated no difference in infection, scar complication, bleed, dehiscence, end-flap necrosis or total complication incidence. Conclusions Smokers and nonsmokers suffer Skin Surgery complications similarly. The increased risk of contour distortion identified was difficult to interpret. Advice to cease smoking in the short term to improve outcomes with Skin cancer Surgery is not supported by these data.
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Prospective study of Skin Surgery in smokers vs. nonsmokers.
The British journal of dermatology, 2008Co-Authors: Anthony Dixon, Mary P. Dixon, John Dixon, C. B. Del MarAbstract:Summary Background Smoking may increase complications following minor Surgery leading many clinicians to urge patients to refrain from smoking before and after Surgery. Objective To study the association between smoking and complications following Skin Surgery. Methods In a 5-year prospective observational study 7224 lesions were excised on 4197 patients. Patients were not instructed regarding smoking. All complications were recorded. Results A total of 439 smokers (10·5%) underwent 646 procedures (9%), 3758 nonsmokers (89·5%) underwent 6578 procedures (91%). Smokers were younger (55 ± 16 years) than nonsmokers (66 ± 17 years) (P
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Managing bleeding complications in Skin Surgery.
Australian Family Physician, 2007Co-Authors: Anthony DixonAbstract:CASE STUDY: Mr AB, aged 78 years, developed a lentigo maligna (LM) on his left cheek just below the orbital margin. Dermoscopy was typical for LM, with thickened variable peri-follicular pigmentation, some granular pigmentation, and an area of regressive depigmentation. Mr AB has a past history of aortic valve replacement and has been taking warfarin prophylaxis for many years. The tumour was excised with a 6 mm margin and effected a laterally based transposition flap. Warfarin was not ceased either before or after Surgery. A small bleed occurred from the wound 2 days postSurgery. Redressing was effected but no other intervention was required. Sutures were removed on day 8. Two days after removal of sutures, Mr AB bumped his left cheek in a stumble and the wound started bleeding again. He developed a haemorrhage under the flap resulting in significant haematoma, flap necrosis, and subsequent ulceration at the site. This required wound toileting and repeated dressings in a prolonged postoperative course. Over time, the wound healed with conservative management. (author abstract)
C. B. Del Mar - One of the best experts on this subject based on the ideXlab platform.
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prospective study of Skin Surgery in smokers vs nonsmokers
British Journal of Dermatology, 2009Co-Authors: Anthony Dixon, Mary P. Dixon, John Dixon, C. B. Del MarAbstract:Summary Background Smoking may increase complications following minor Surgery leading many clinicians to urge patients to refrain from smoking before and after Surgery. Objective To study the association between smoking and complications following Skin Surgery. Methods In a 5-year prospective observational study 7224 lesions were excised on 4197 patients. Patients were not instructed regarding smoking. All complications were recorded. Results A total of 439 smokers (10·5%) underwent 646 procedures (9%), 3758 nonsmokers (89·5%) underwent 6578 procedures (91%). Smokers were younger (55 ± 16 years) than nonsmokers (66 ± 17 years) (P < 0·001). Infection incidence was not significantly different, 1·9% (12/646) in smokers compared with 2·2% (146/6578) in nonsmokers (P = 0·55). There were two bleeds with smokers (0·3%) vs. 50 in nonsmokers (0·8%) (P = 0·2). The incidence of wound dehiscence in nonsmokers (three) was not different from nonsmokers (21) (P = 0·54). However, the incidence of scar contour distortion in smokers (three) was greater than in nonsmokers (two) (odds ratio 15·3; 95% confidence interval 2·5–92). Total complication incidence was similar, 3·6% in smokers vs. 4·0% in nonsmokers (P = 0·58). Out of 2371 flaps there were 14 (0·6%) cases of end-flap necrosis but smokers were not at increased risk. The case–control analysis compared each smoker with two nonsmokers matched for age, sex, postal code and outdoor occupational exposure. This again demonstrated no difference in infection, scar complication, bleed, dehiscence, end-flap necrosis or total complication incidence. Conclusions Smokers and nonsmokers suffer Skin Surgery complications similarly. The increased risk of contour distortion identified was difficult to interpret. Advice to cease smoking in the short term to improve outcomes with Skin cancer Surgery is not supported by these data.
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Prospective study of Skin Surgery in smokers vs. nonsmokers.
The British journal of dermatology, 2008Co-Authors: Anthony Dixon, Mary P. Dixon, John Dixon, C. B. Del MarAbstract:Summary Background Smoking may increase complications following minor Surgery leading many clinicians to urge patients to refrain from smoking before and after Surgery. Objective To study the association between smoking and complications following Skin Surgery. Methods In a 5-year prospective observational study 7224 lesions were excised on 4197 patients. Patients were not instructed regarding smoking. All complications were recorded. Results A total of 439 smokers (10·5%) underwent 646 procedures (9%), 3758 nonsmokers (89·5%) underwent 6578 procedures (91%). Smokers were younger (55 ± 16 years) than nonsmokers (66 ± 17 years) (P
John Dixon - One of the best experts on this subject based on the ideXlab platform.
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Post procedural pain with photodynamic therapy is more severe than Skin Surgery
Journal of plastic reconstructive & aesthetic surgery : JPRAS, 2013Co-Authors: Anthony Dixon, Mary P. Dixon, Stuart Anderson, John DixonAbstract:Summary Objective To compare prospective data on pain experienced by patients undergoing large facial Skin cancer Surgery with pain experienced with novel face photodynamic therapy (PDT). Design A comparison of pain data sets from two prospective trials in the same centre. Setting Referral Skin cancer centre in Australia. Protocol 34 PDT patients had two aminolevulinate treatments to the face two weeks apart. 68 Surgery patients, matched 2:1 for gender and age, had large Skin cancer excisional Surgery to the face and closure with flap, graft or wedge reconstruction. Main outcome measure(s) Severity of pain during and following procedure. Results The only patients describing their experience as the worst pain of their life were 4 PDT patients (12%). The median and mean pain scores for PDT patients were significantly higher than for extensive facial large face Surgery, ( p Discussion and conclusions Clinicians should consider explaining the relative likelihood of more severe pain whenever PDT is considered over Surgery. The pain experienced with this PDT product may not reflect the pain experienced with other PDT products.
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Prospective study of Skin Surgery in patients with and without known diabetes.
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2009Co-Authors: Anthony Dixon, Mary P. Dixon, John DixonAbstract:To study the association between known diabetes and complications after Skin Surgery. In a 5-year prospective observational study, 7,224 lesions were excised on 4,197 patients in a referral center involving one surgeon in a southern Australian locale. One hundred ninety-six patients with known diabetes (4.7%) underwent 551 excision procedures (7.6%) 4,001 people without diabetes underwent 6,673 procedures. Patients with diabetes were older (72 +/- 13) than those without (64 +/- 17) (p<.001.) Infection incidence was significantly higher in patients with diabetes (4.2%, 23/551) than in those without (2.0%, 135/6,673) (p<.001). There were five bleeds in patients with diabetes (0.9%) versus 47 in those without (0.7%) (p=.58). The incidence of wound dehiscence in patients with diabetes (2) was not different from that in those without (22), (p=.90). Noninfective complications were 1.8% for patients both with diabetes (10/551) and those without (118/6,673). Two thousand three hundred seventy-one flaps resulted in 14 (0.6%) cases of end-flap necrosis, but no case occurred in patients with diabetes. Multivariate analysis using binary logistic regression demonstrated that known diabetes was predictive of infection (odds ratio=1.66, 95% confidence interval=1.05-2.65). Diabetes was not predictive of other complications. Patients with known diabetes suffer more postoperative Skin infections than those without. Noninfective complications are similar. Clinicians may consider antibiotic prophylaxis in their patients with diabetes facing high-risk Skin Surgery.
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prospective study of Skin Surgery in smokers vs nonsmokers
British Journal of Dermatology, 2009Co-Authors: Anthony Dixon, Mary P. Dixon, John Dixon, C. B. Del MarAbstract:Summary Background Smoking may increase complications following minor Surgery leading many clinicians to urge patients to refrain from smoking before and after Surgery. Objective To study the association between smoking and complications following Skin Surgery. Methods In a 5-year prospective observational study 7224 lesions were excised on 4197 patients. Patients were not instructed regarding smoking. All complications were recorded. Results A total of 439 smokers (10·5%) underwent 646 procedures (9%), 3758 nonsmokers (89·5%) underwent 6578 procedures (91%). Smokers were younger (55 ± 16 years) than nonsmokers (66 ± 17 years) (P < 0·001). Infection incidence was not significantly different, 1·9% (12/646) in smokers compared with 2·2% (146/6578) in nonsmokers (P = 0·55). There were two bleeds with smokers (0·3%) vs. 50 in nonsmokers (0·8%) (P = 0·2). The incidence of wound dehiscence in nonsmokers (three) was not different from nonsmokers (21) (P = 0·54). However, the incidence of scar contour distortion in smokers (three) was greater than in nonsmokers (two) (odds ratio 15·3; 95% confidence interval 2·5–92). Total complication incidence was similar, 3·6% in smokers vs. 4·0% in nonsmokers (P = 0·58). Out of 2371 flaps there were 14 (0·6%) cases of end-flap necrosis but smokers were not at increased risk. The case–control analysis compared each smoker with two nonsmokers matched for age, sex, postal code and outdoor occupational exposure. This again demonstrated no difference in infection, scar complication, bleed, dehiscence, end-flap necrosis or total complication incidence. Conclusions Smokers and nonsmokers suffer Skin Surgery complications similarly. The increased risk of contour distortion identified was difficult to interpret. Advice to cease smoking in the short term to improve outcomes with Skin cancer Surgery is not supported by these data.
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Prospective study of Skin Surgery in smokers vs. nonsmokers.
The British journal of dermatology, 2008Co-Authors: Anthony Dixon, Mary P. Dixon, John Dixon, C. B. Del MarAbstract:Summary Background Smoking may increase complications following minor Surgery leading many clinicians to urge patients to refrain from smoking before and after Surgery. Objective To study the association between smoking and complications following Skin Surgery. Methods In a 5-year prospective observational study 7224 lesions were excised on 4197 patients. Patients were not instructed regarding smoking. All complications were recorded. Results A total of 439 smokers (10·5%) underwent 646 procedures (9%), 3758 nonsmokers (89·5%) underwent 6578 procedures (91%). Smokers were younger (55 ± 16 years) than nonsmokers (66 ± 17 years) (P
Laurenz Schmitt - One of the best experts on this subject based on the ideXlab platform.
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Surgical site infections after microscopically controlled Skin Surgery in immunocompromised patients: a retrospective two-center cohort study
Archives of Dermatological Research, 2020Co-Authors: Galina Balakirski, Christoph R. Löser, Edgar Dippel, Amir S. Yazdi, Inga Artamonova, Mosaad Megahed, Laurenz SchmittAbstract:The data on the risk of surgical site infections (SSI) after Skin Surgery in patients undergoing immunosuppressive treatment are limited and the results of the existing single-center studies are controversial. At the same time, perioperative antibiotic prophylaxis (PAP) for immunocompromised patients seems to be overused. We performed a retrospective analysis of the SSI rates after extensive dermatosurgical procedures performed from January 2017 to December 2017 in patients with impaired immune status due to a hematological disorder or immunosuppressive treatment at two German dermatosurgical centers. The SSI rate in immunocompromised patients was 6.7%. The independent risk factors for SSI found in the studied population were the occurrence of bleeding after one of the surgical stages and the use of oral anticoagulation with two different agents (the combination of acetylsalicylic acid and a direct oral anticoagulant). 44.4% (4/9) of the procedures complicated with an SSI involved wound closure with a Skin flap, which was statistically significant ( p = 0.041). Other risk factors identified were older age of the patients and increased duration of hospitalization ( p
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Surgical Site Infections After Dermatologic Surgery in Immunocompromised Patients: A Single-Center Experience.
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2018Co-Authors: Galina Balakirski, Konstantin Kotliar, Karolin Juliane Pauly, Laura K. Krings, Albert Rübben, Jens M. Baron, Laurenz SchmittAbstract:Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing Skin Surgery. However, the data on the risk of developing SSI after dermatologic Surgery in immunosuppressed patients are limited. All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic Surgery between June 2016 and January 2017 (6 months), were followed up after Surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records. The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the Skin Surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma Skin cancer and malignant melanomas. Surgical site infections occurred in 6.7% (19/284) of the cases. In 95% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients. According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic Surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing Skin Surgery in these patients.