Quality of Life Indicators in Patients Operated on for Breast Cancer in Relation to the Type of Surgery-A Retrospective Cohort Study of Women in Serbia.

Quality of life (QoL) after breast cancer surgery is an important public health issue. The aim of this study was to determine the relationship between the levels of perceived quality of life in patients operated on for breast cancer in relation to the type of surgery, using the standardized questionnaires. We assessed 425 women after surgery for breast cancer.

Platelet gel in wound treatment in patient with pemphigus vulgaris and Type 2 diabetes mellitus: Case report.

Treatment of wounds, especially in patients with systemic diseases, is very difficult and time consuming, and it represents great challenge. Complications like infections and impaired healing are regularly seen in these patients, sometimes leaving almost no other treating option, but amputation surgery. In wound healing process, platelets play one of key roles, both in hemostasis, and, by releasing many growth factors, in reepithelization and tissue remodeling.

Validity of ultrasound-guided aspiration needle biopsy in the diagnosis of micrometastases in sentinel lymph nodes in patients with cutaneous melanoma.

Background/aim: Cutaneous melanoma is one of the most aggressive solid cancers, that develops local, regional and distant metastases. The presence of metastases in lymph nodes is in correlation with Breslow tumor thickness. According to various researches, in melanoma with more than 4 mm Breslow thickness, lymph node micrometastases can be found in 60-70% of cases.

Surface enlargement of a new arterialised venous flap by the surgical delay method.

Background/aim: The delay method is a surgical, pharmacological and combined method that includes two or more time separated phases, which gives bigger flap surface. In our research we explored the possibility of flap surface enlargement in a new arterialised venous flap (AVF) on an experimental rabbit ear model by the delay surgical method. The aim of this research was to establish vitality surface of our AVF and to maintain the difference in flap vital surface between AVF flaps, with or without performing the delay surgery method.

Surgical treatment of hand vascular anomalies--a case report.

Background: Vascular anomalies in the hand do not occur frequently. Their presence in the metacarpal region can cause different functional disorders. The extent of such disorders directly depends on the localization and size of vascular anomalies, duration and the nature of the anomaly growth as well as on eventual secondary complications such as ulceration or bleeding.

[Using vacuum in the treatment of surgical wounds complications].

Background/aim: Using vacuum in medicine has been known from long ago, however, it has not been used for the treatment of wounds. The first experiments in this field were performed by Wagner Fleischmann, University of Ulm, Ulm, West Germany, in 1993. The aim of this study was to present our clinical experience with the treatment of surgical wounds complications in vascular patients by the use of controled vacuum.

Epidemiology of nosocomial colonization/infection caused by Acinetobacter spp. in patients of six surgical clinics in war and peacetime.

Background/aim: Acinetobacter spp. has emerged as nosocomial pathogen during the past few decades in hospitals all over the world, but it has increasingly been implicated as a serious nosocomial pathogen in military hospitals. The aim of this study was to analyse and compare the surveillance data on Acinetobacter nosocomial colonization/infection (NCI) collected during the wartime with the data collected in peacetime.

Principles of surgical treatment of congenital, developmental and acquired female breast asymmetries.

Background/aim: There is a natural asymmetry in normal female brests. When the difference in the shape, size or position of the breast and nipple-areola complex is visible, surgical correction is the only treatment option and presents one of the greatest challenges for a plastic surgeon. Based on the Nahai classification presented in details, the aim of the study was to present the possibilities of plastic surgery to correct primary (congenital), secondary (developmental) and tertiary (acquired) brest asymmetries.

[Ultrasonographic findings validity in the identification of metastatic regional lymph nodes in patients with cutaneous melanoma].

Unlabelled: BACKGROUND/AIM. Early identification of lymph node (LN) metastases has both therapeutic and prognostic significance in patients with cutaneous melanoma. Ultrasonographic (US) examination of LN morphological characteristics and US of LN morphological and vascular characteristics are diagnostic methods used in identification of regional LN metastases, thus rendering a base for lymphonododisection indication.

[Anatomic and histological characteristics of vagina reconstructed by McIndoe method].

Background/aim: Congenital absence of vagina is known from ancient times of Greek. According to the literature data, incidence is 1/4 000 to 1/20 000. Treatment of this anomaly includes non-operative and operative procedures.

Some biological characteristics of transferred free flaps.

At the Clinic for plastic surgery and burns of the MMA, we examined 33 patients with transferred 5 cutaneous, 18 myocutaneous, and 10 osteocutaneous free flaps out of which 10 were done on foot, 13 on the lower leg, and 10 on the face. We analyzed the blood circulation (patency of arterial microanastomosis and perfusion) of transferred free flaps, recovery of sensitivity, functioning of the sebaceous and sweat glands as well as histomorphologic changes in the skin of the transferred free flaps during the period of 6 up to 36 months after the free flap transfer and compared with the same characteristics of the skin and tissue of the surrounding area of the recipient region.

[Microvascular osteoseptocutaneous radial flap in reconstruction of mandible following war injury].

Background: Vascularized osteoseptocutaneous radial flap is commonly used in the reconstruction of composite bony and soft tissue defects of the lower third of the face due to the outstanding quality of its cutaneous component. The aim was to evaluate the primary and overall success in the reconstruction of mandibular defects, following war injuries, with vascularized osteoseptocutaneous radial flap.

Methods: At the Department of Maxillofacial Surgery of the Military Medical Academy Belgrade, there were eight patients with this kind of defect following war injury, and the mandible was reconstructed with a vascularized osteoseptocutaneous radial flap.

[Breast reconstruction by pedicled transverse rectus abdominis myocutaneous flap].

Reconstruction of the amputated breast in female patients after surgical management of breast carcinoma is possible with the use of autologous tissue, synthetic implants, or by combining autologous tissue and synthetic materials. Autologous tissue provides soft and sufficiently elastic tissue, which is usable for breast reconstruction and eventually obtains original characteristics of the surrounding tissue on the chest wall. The use of the TRAM flap for breast reconstruction was introduced in 1982 by Hartrampf, Scheflan, and Black.

[Management of war burns of the lower leg using free flaps].

Free flaps are used in the surgical treatment of burns for wound closure where the burn is too deep, and in case, when after necrotic tissue excision, the bones, tendons, nerves, and blood vessels remain bare. Covering of the exposed structures is commonly performed in the primary delayed, or in the secondary wound treatment. The possibilities of covering the defects of the lower leg with local flaps are limited.

[Microvascular free flaps and care of war injuries with tissue defects].

Background: War wounds caused by modern infantry weapons or explosive devices are very often associated with the defects of soft and bone tissue. According to their structure, tissue defects can be simple or complex. In accordance with war surgical doctrine, at the Clinic for Plastic Surgery and Burns of the Military Medical Academy, free flaps were used in the treatment of 108 patients with large tissue defects.

[Plastic surgery in the treatment of primary cutaneous melanoma].

Surgery is still the most effective treatment modality of skin melanoma. The margins of excision are determined by the thickness of primary tumor. From January 1999 to December 2001, 99 patients (57 male and 42 female, of the average age 55), were surgically treated at the Clinic for Plastic Surgery and Burns of the Military Medical Academy.

[Surgical treatment of hand deformities in hereditary dystrophic bullous epidermolysis].

In the period 1996-2001 in the Clinic for Plastic Surgery and Burns of the Military Medical Academy, 18 patients. 12 male and 6 female, with hereditary dystrophic epidermolysis bullosa (HDEB) and hand deformities were surgically treated, to achieve the complete separation of fingers, correction of the thumb adduction contracture and flexion or extension contracture of finger joints. The period of wound healing on flat surfaces after surgery, and the period between two operations was estimated.

[Complications in the use of vascularized fibular grafts: classification and treatment].

The complications in the reconstruction of the diaphysed defects by the use of VFG or VOSKFG are not shown in the literature coherent so it is very difficult to compare and use showed results. For the compensation of the bone defects the specific complications could be differentiated according to the influence on the primary and overall efficiency of the reconstruction. The classification of the complications in the donors region and osteogenic and vascular complications in the recipients region was suggested in the analysis which encompassed all these divisions.

[Importance of adequate immobilization of the upper extremity in using the vascularized fibular graft].

The most complications in patients after the reconstruction of the bone defect of the upper extremities are the fractures of the bone graft and pseudoarthrosis on one of the graft suture with defects of humerus. These complications influence on the primary efficiency of the reconstruction and prolong the recovery period. We registered five fractures, four pseudoarthrosis and two graft angulations in the prospective study on 25 patients where the defect of humerus, radius and ulna was compensated by the vascularized fibular graft.

[Metastasis of malignant melanoma in the small intestine--case report].

Small bowel metastases of the malignant melanoma are usually discovered in 2-5% of the patients with malignant melanoma of the skin during the life. They are usually being diagnosed with a complication on the small bowel, such as occlusion, bleeding, anemia and perforation of the intestine. Authors show three patients with metastases of the malignant melanoma in the small bowel, which lead to invagination, subocclusion and anemia due to bleeding.

[Reconstruction of the long bones and mandible with vascularized fibular grafts].

In two prospective studies at the Clinic for Plastic Surgery and Burns and Clinic for Maxillofacial Surgery of the Military Medical Academy in the period from 1991 to 1996 we performed 47 transplantations of the vascularized fibular graft in order to compensate bone defects of the long bones and mandibular inflicted by war wounding. The importance of the length of the vascular pedicle preparation for the total success was pointed out as well as the immobilization of the elbow region for the compensation of the defects of the upper arm and forearm and total healing of the mandibular for the later functional rehabilitation. The realized primary efficiency of 70.

[Reconstructive methods in the treatment of soft tissue defects below the knee].

The specificity of the lower leg is in sparse collateral blood flow of the skin cover in the middle and distal part, reduced subcutaneous tissue and the prominence of the front side of tibia immediately under the skin. These characteristics of the lower leg make the application of the standard plastic reconstructive principles, which have been applied in the other regions of the body to a certain degree impossible. The progress of anatomical knowledge in relation to vascularization of the tissue territories--angiosoma, and the anatomy of the vascular skin system of the lower leg, along with the technological progress represented by the application of the surgical microscope, new surgical instruments and suture materials, provides the reconstructive surgeon, not only with classic but also with the modern surgical methods in this region: microvascular transplantation of the tissue and the application of the fasciocutaneous reversible flaps.

[Vascularized fibular grafts in the reconstruction of bone defects caused by war injuries].

The efficiency of the vascularized fibular graft application in the reconstruction of diaphyseal defects of the long bone of extremities caused by war injuries was prospectively investigated in the group of 33 patients in the period 1991-1996, during the war in the former Yugoslavia. The preoperative, intraoperative and postoperative procedures were systematized. Early and late complications in donor and recipient regions were shown.

[Sebaceous gland function in transplanted microvascular flaps].

Sebaceous glands produce sebum that contains: triglycerides, esters of cholesterol, and sometimes even pure cholesterol, squalene and esters of wax. Microvascular transplantation exposed the tissue of free flaps to the temporary ischemia and anaerobic metabolism, inflammatory, denervative and reinnervative processes. The sebaceous glands of the free flaps were also exposed to the action of physiopathologic processes during the micro vascular transfer.

[Frequency, etiology, localization and surgical treatment of war injuries with tissue defects].

The retrospective analysis of 1,514 cases treated at the Clinic for Plastic Surgery and Burns of the Military Medical Academy in the period between 1991 and 1995, established that the percentage of the injuries caused by gunshots and those caused by explosives during the conflict in former Yugoslavia, was more or less the same. The injuries caused by gunshot more often occurred on the head, neck, arms and trunk. The injuries of the legs caused by the explosives were more frequent, and they occurred in 83% of the cases.