The thoracodorsal artery perforator flap in the treatment of axillary hidradenitis suppurativa: effect on preservation of arm abduction

Hidradenitis suppurativa is a chronic, recurrent inflammatory disease of the skin characterized by abscesses and scars. The axillary region is predominantly affected, leading to limited mobility of the arm due to scar retraction. This prospective study aimed to analyze the surgical treatment of severe lesions of axillary hidradenitis suppurativa by using the thoracodorsal artery perforator flap while focusing on the preservation of arm abduction. We enrolled 12 patients with severe axillary hidradenitis suppurativa who underwent bilateral surgical treatment of their lesions by radical excision, followed by immediate reconstruction with the thoracodorsal artery perforator flap. The amplitude of arm abduction was measured preoperatively and 6 months postoperatively by goniometry, and statistical analysis was performed using Student's t test. Preoperative and 6-month postoperative mean amplitude of arm abduction were 98.7 degrees and 152.7 degrees, respectively, with a significant mean increase of 54 degrees (p<0.0001). The thoracodorsal artery perforator flap can be used as a good option for axillary reconstruction after radical excision of severe lesions of hidradenitis suppurativa, and its use would allow a significant increase in the amplitude of arm abduction. It has several other advantages when compared with other types of coverage, including its anatomical proximity to the axilla, similar thickness, and high-quality skin. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.     

Hidradenitis suppurativa: patient satisfaction with wound healing by secondary intention

Ariyan and Krizek, in 1976, reported on three patients with perineal hidradenitis suppurativa who, following excision, achieved satisfactory closure allowing spontaneous wound healing by secondary intention. We have used this approach and have considered it very satisfactory from the surgeon's point of view. We now report from the point of view of patients and review the records of 20 consecutive patients with perineal hidradenitis treated by excision and secondary healing. Surgical results and patient satisfaction were assessed 1 year following complete wound closure. All patients reported minimal inconvenience and interruption of daily activities from this method of management. Analgesic requirements were minimal, and little reinforcement was necessary to maintain vigorous wound care. Uncomplicated wound closure was uniformly achieved with unrestrictive, stable scars providing long-term relief of this disabling disease. Two patients expressed dissatisfaction as a result of a new onset of disease in previously uninvolved and therefore unresected apocrine tissue. With this exception, patient satisfaction has been great and hospitalization time and costs reduced.     

Hidradenitis suppurativa of the breast areolae. Case report.

A case of hidradenitis suppurativa of the areolae of the breasts is presented. The treatment was excision and split-skin grafting, and this was successful.     

Cancer recurrence following Mohs micrographic surgery: a mechanism of tumor persistence.

Recurrence of basal cell carcinomas after Mohs micrographic surgery is rare but known to occur. This report describes the recurrence of a basal cell carcinoma of the forehead after Mohs surgery in order to illustrate a previously undescribed mechanism of tumor persistence and recurrence despite thorough microscopic evaluation of all surgical margins. The value of the surgeon's reviewing all prior histologic sections before performing micrographic surgery, the importance of resecting all scar tissue from a previous surgical site prior to determination of tumor-free margins, and the potential usefulness of a three-tiered closure after excision of a cutaneous malignancy that involves the muscular layer are discussed.     

Anaerobic axillary abscess.

Fifty-two patients with axillary abscesses were seen during two years. Staphylococcus aureus was isolated from 34, anaerobic bacteria from 12, and skin flora from five; in one case the pus was sterile. Seven patients with hidradenitis suppurativa had recurrent infection with abscess formation, which was bilateral in three. Anaerobes were isolated in five of these cases and skin flora alone in two. Anaerobes are secondary invaders in this condition, and histological examination shows that the primary abnormality is obstruction of pilosebaceous follicles and apocrine glands, associated with keratin plugging of the follicles. Chemotherapy offers little hope of cure, although metronidazole removes the offensive smell of the discharge. Radical surgery is usually indicated.     

老年翼状胬肉患者翼状胬肉切除与角膜缘干细胞移植联合治疗的疗效观察

摘要 目的：分析评估老年翼状胬肉患者实施翼状胬肉切除与角膜缘干细胞移植联合治疗的临床效果。方法：回顾性纳入的本院2018年08月至2020年07月期间295例翼状胬肉患者（共442只眼）的临床资料,根据术式差异将患者分为联合组（150例,共224只眼）和参照组（145例,共218只眼）,参照组病患仅择取翼状胬肉切除手术,联合组病患于以上基础实施角膜缘干细胞移植术,比较两组病患术前及术后各时间点（1周、1个月、3个月）的BUT、SIt、UCVA、CAD、CAA,统计病患术后3个月的复发情况。结果：两组BUT在术后1周较术前显著缩短（P<0.05）,而在术后1月和3月较术前显著延长（P<0.05）,两组BUT在术后1周对比差别明显（P<0.05）,而其他时间点对比没有明显差别（P>0.05）。两组术前术后SIt对比没有明显差别（P>0.05）,术后1月和3月的两组UCVA均高于术前（P<0.05）,而两组在各时间点UCVA对比没有明显差别（P>0.05）,两组术后各时间点的角膜CAD较术前显著性降低（P<0.05）,而两组角膜CAD在各时间点无明显差别（P>0.05）。两组术后CAA术后3月与术前比较,WR比例显著降低,AR、OA比例显著增加（P<0.05）,而组间对比没有明显差别（P>0.05）。术后复发率联合组（6.67%）与参照组（32.26%）对比有明显差别（P<0.05）。结论：与翼状胬肉切除术比较 ,老年翼状胬肉病患实施翼状胬肉切除与角膜缘干细胞移植术联合治疗对患者早期眼表无较大影响,两种术式均不影响泪液分泌,且能够改善裸眼视力、散光度及轴向,但联合治疗在降低术后复发率方面优势明显。     

Predictors of Post-operative Mycetoma Recurrence Using Machine-Learning Algorithms: The Mycetoma Research Center Experience

Post-operative recurrence in mycetoma after adequate medical and surgical treatment is common and a serious problem. It has health, socio-economic and psychological detrimental effects on patients and families. It is with this in mind, we set out to determine the predictors of post-operative recurrence in mycetoma. The study included 1013 patients with Madurella mycetomatis causing eumycetoma who underwent surgical excision at the Mycetoma Research Centre, Khartoum, Sudan in the period 1991–2015. The clinical records of these patients were reviewed and relevant information was collected using a pre-designed data collection sheet. The study showed, 276 patients (27.2%) of the studied population developed post-operative recurrence, 217 were males (78.6%) and 59 were females (21.4%). Their age ranged between 5 to 70 years with a mean of 32 years. The disease duration at presentation ranged between 2 months and 17 years. The majority of the patients 118 (42.8%) had mycetoma of 1 year duration. In this study, students were the most affected; 105 (38%) followed by workers 70 (25.4%), then farmers 48(17.3%). The majority of the patients were from the Central Sudan 207 (75%), Western Sudan 53 (19.2%) while 11 patients (4%) were from the Northern part. Past history of surgical intervention performed elsewhere was reported in 196 patients (71.1%). Family history of mycetoma was reported in 50 patients (18.1%). The foot was the most affected site, 245 (88.7%), followed by the hand seen in 19 (6.8%) patients and 44 (4.5%) had different sites involvement. Most of the patients 258 (93.5%) had wide local surgical excisions while 18 had major amputation. The model predicted that the certain groups have a high risk of recurrence, and these include patients with disease duration greater than 10 years and extra-pedal mycetoma. Patients with disease duration between [5–10] years, with pedal mycetoma, who had previous surgery, with positive family history and underwent wide local surgical excision. Patients with disease duration [5–10] years, with pedal mycetoma, had previous surgery, with no family history but presented with a disease size (> 10 cm), were non- farmers and underwent wide local surgical excision. Other groups are patients with disease duration (≤5 years), with pedal mycetoma, age <59 years, living in the Western /Eastern / Southern regions of the Sudan and with positive family history and had wide local surgical excision. Also included patients with disease duration (≤5 years), with pedal mycetoma, aged <59 years, living in the northern or central region, with no family history but presented with a disease size >10 cm, working as farmers or students and underwent wide local surgical excision. In conclusion, these groups of patients need special care to reduce the incidence of post-operative recurrence with its morbidity and detrimental consequences. In depth studies for the other predisposing factors for post-operative recurrence such as genetic, immunological and environmental factors are needed.     

A life-threatening multilocalized hidradenitis suppurativa case

The patient was a 38-year-old man. He had been suffering from hidradenitis suppurativa (HS) for approximately 20 years. He had active lesions at both axillas, hip, scrotum, and perineum, and inactive lesions located behind the ears, lower abdomen, and posterior neck. He was monitored and treated at different branches; he continuously used antibiotics and was given steroids at times. Antibiotic resistance developed subsequently. His general situation was bad; vital signs were poor; and he was in a state of sepsis and preshock, so this case was regarded as life-threatening. Total excision was performed first on the lesion at the right axilla, then on the lesion at the left axilla, and the parascapular fasciocutaneous flap was reversed. A skin graft was applied to the triangular defect on the scapula. No relapse occurred. Then the lesions at the hip were managed. Broad excision was used twice with the patient under general anesthesia; because the lesions spread to the retrococcygeal and gluteal muscles, coccyx resection and partial gluteal muscle resection were implemented. The defect was eliminated with a progressive flap. At the intergluteal sulcus, small lesions emerging at the median line were debrided with the patient under local anesthesia, and together with secondary recovery, the disease was completely managed. Lesions at the perineum and scrotum and at both inguinal areas were broadly excised and grafted. No lesion has relapsed so far. One year later, Hodgkin's lymphoma was diagnosed, and the patient was treated with chemoradiotherapy easily, because there was no infective focus. The disease is in remission now. The patient weighs 110 kg, is healthy, and is working again.     

The role of anaerobic bacteria in cutaneous and soft tissue abscesses and infected cysts

This review presents the aerobic and anaerobic microbiological aspects and management of cutaneous and soft tissue abscesses, paronychia, anorectal, pilonidal, and perirectal abscesses, infected epidermal cysts, hidradenitis suppurativa, and pustular acne lesions. These infections often occur in different body sites or in areas that have been compromised or injured by foreign body, trauma, ischemia, malignancy or surgery. In addition to group A beta-hemolytic streptococci and Staphylococcus aureus, the indigenous aerobic and anaerobic cutaneous and mucous membranes local microflora usually is responsible for these generally polymicrobial infections. These infections may occasionally lead to serious potentially life-threatening local and systemic complications. The infections can progress rapidly and early recognition and proper medical and surgical management is the cornerstone of therapy.     

Acid Secretion and Serum Gastrin Levels in the Zollinger-Ellison Syndrome

Thirteen cases of patients with the Zollinger-Ellison syndrome were reviewed. In two cases the diagnosis was made by incidental biopsy of small liver nodules at operation for peptic ulcer disease.Seven patients had gastric secretory tests which showed a basal acid output to maximum acid output ratio of more than 65 percent. Five patients had bao:mao ratios less than 50 percent.A 30-month interval between incidental discovery of tumor and clinically evident disease was observed in two patients. Recurrence of symptoms after excision of tumor was noted after a similar interval in another case.Serum gastrin levels, before total gastrectomy, were elevated in all cases. The lowest preoperative level in this series of patients was 550 picograms per ml (normal 100 to 150 picograms). They were diagnostic in two patients with normal gastric secretory studies. The levels fell to normal following total gastrectomy in six patients. Two patients still had elevated levels five years and 14 years after total gastrectomy. One was discovered to have a parathyroid adenoma with hypercalcemia.Total gastrectomy was curative in all the patients with the Zollinger-Ellison syndrome; lesser operations were not.     

解毒活血汤促进肛周脓肿术后创面愈合的效果分析

目的:研究解毒活血汤治疗肛周脓肿术后患者创面愈合的临床效果及可能机制。方法:选择2017年1月～2019年1月我院肛肠科三病区收治的300例肛周脓肿患者,根据其就诊的顺序,随机数字表法均分为两组,各150例,两组均采取一期肛周脓肿根治术治疗,对照组于术后采用高锰酸钾溶液坐浴疗法,观察组于术后联合服用解毒活血汤治疗。均治疗4 w后,比较两组创面愈合的有效率,肛周脓肿患者创面的愈合时间和视觉模拟评分(visual analogue scale,VAS)评分,治疗前后肉芽组织中的血红蛋白含量、羟脯氨酸含量、血管内皮生长因子水平以及组织微血管计数。结果:治疗后,观察组创面愈合的总有效率明显高于对照组(90.67 vs. 71.33%,P0.05);观察组肛周脓肿患者创面愈合的时间明显短于对照组(P0.05)。对照组治疗前后的肉芽组织中的血红蛋白含量、羟脯氨酸含量、血管内皮生长因子水平以及组织微血管计数无明显的差异(P0.05),观察组治疗后的肉芽组织中的血红蛋白含量、羟脯氨酸含量、血管内皮生长因子水平以及组织微血管计数明显高于治疗前和对照组(P0.05)。观察组术后3 d、1 w和2 w的VAS评分均明显低于对照组(P0.05)。结论:解毒活血汤可能通过提升肉芽组织中的血红蛋白含量、羟脯氨酸含量、血管内皮生长因子水平以及组织微血管计数有效促进肛周脓肿术后的创面愈合,减轻术后疼痛。     

Long-term consequences of surgical excision of cortisol producing adrenocortical adenoma

INTRODUCTION: Surgical excision of adrenocortical tumour in patients with ACTH-independent Cushing syndrome gives a chance for their entire cure. However in some patients after adrenalectomy persistent arterial hypertension, obesity and diabetes mellitus is observed. The aim of the study was to analyse long term consequences of surgical excision of cortisol producing adrenocortical adenoma with a special attention on the influence of adrenalectomy on arterial blood pressure. MATERIAL AND METHODS: 15 patients (mean age 54 years) suffering from arterial hypertension (n = 15), obesity or overweight (n = 12) and diabetes mellitus (n = 7) were subjected to analysis. Mean follow up time was 45 months. RESULTS: Improvement of blood pressure control after unilateral adrenalectomy was observed in 66.7% of patients. The risk factor of no improvement of blood pressure control was BMI > 30.5 kg/m(2) (RR = 4.0 [1.07-14.90]). During the follow up period decrease of maximal values of systolic and diastolic blood pressure was observed (34 [17-50] and 25 [16-35] mm Hg respectively; p < 0.01). In the entire group of patients a 3.4 kg/m(2) decrease of BMI was observed p = 0.01. BMI decreased significantly (more than 1 kg/m(2)) in 66.7% of patients. Only in 2 patients a complete regression of diabetes was observed. 46.7% of patients required supplementation with adrenal steroids. 40% of patients reported a subjective withdrawal of all symptoms of the disease after surgery and 46.7% only partial remission. CONCLUSION: Surgical excision of cortisol producing adrenocortical adenoma results in improvement of blood pressure control and body weight reduction in a large percentage of patients with Cushing syndrome. Obesity before adrenalectomy is the factor that reduces a chance for improvement of blood pressure control after surgery.     

Perianal Crohn’s disease and hidradenitis suppurativa: a possible common immunological scenario

Background

Crohn’s disease (CD) and Hidradenitis suppurativa (HS) are both chronic inflammatory diseases. The pathogenesis of these diseases is multifactorial, due to the interaction of genetic and environmental factors leading to a deregulated local immune response where T lymphocytes play a major role. To the best of our knowledge, no previous study has clarified whether the pathogenetic mechanism of perianal CD and HS is the same. We therefore analyzed the cellular expression pattern and the cytokine repertoire in three patients suffering from both perianal CD and HS.

Methods

We evaluated three patients affected by concurrent HS and CD with fistulizing perianal disease. Surgical specimens have been fixed and embedded in paraffin prior to sectioning for histological examination. Inflammatory tissue curettages have been recovered during intervention from perianal fistulas and HS lesions in order to analyze the phenotypic and functional characteristics of infiltrating T cells. In particular we evaluated T cells, by flow cytometry, for cytokine production profile and expression of surface markers. Moreover, analysis of the T cell repertoire was performed by means of spectratyping, in only one patient.

Results

A higher frequency of CD4+ CD161+ T lymphocytes has been detected in CD fistulas and in HS lesions than in peripheral blood (PB) samples. In the patient in whom we derived enough cells from the three sources, we found higher frequency of CD4+ IL-17- producing cells in HS lesion and fistula lesion compared to PB. It is noteworthy that the same clonotypes were expanded in this patient in T cells derived from both HS lesion and fistula lesion.

Conclusion

The presence of numerous CD4+ CD161+ lymphocytes in fistula and HS lesion curettages suggests that these cells may play a pathogenic role, and candidates CD161 as a possible biological target for medical treatment.     

Treatment of Congenital Pseudarthrosis with Endomedullary Nail and Low Frequency Pulsing Electromagnetic Fields: A Controlled Study

We report our experience in the treatment of congenital pseudarthrosis with pulsing electromagnetic fields in a controlled study. Both the stimulated and control groups received the same surgical procedure: excision of the pseudarthrosis site, reduction and fixation by intramedullary nail. Stimulation with electromagnetic fields was begun within 3 days after surgery. The orthopaedic treatment was the same for all patients. The stimulation lasted up to 12 months. All patients were followed at least 24 months after the surgery. The data showed that the surgical approach in association with pulsing electromagnetic-field stimulation gave significantly better results than surgery alone.     

Equine Sarcoids. A Clinical and Epidemiological Study in Relation to Equine Leucocyte Antigens (ELA)

Associations between clinical parameters of sarcoids and the equine leucocyte antigen system (ELA) were analysed for 120 Swedish horses. Median age of affected horses was 5.2 years, and the majority presented with solitary tumors between 2 and 5 cm in diameter and ventral abdomen was a predilection site. Clinical signs first appeared at a median age of 3.5 years, and sarcoids at different locations first appeared at different ages. Lesions at different sites differed in size, and multiple tumors, early onset, long duration, and older age all had an association with large size. Clinical manifestations of sarcoids and the association between certain ELA-specificities and early onset (A5) and increased recurrence rates after surgery (W13), in addition to increased prevalence (A3W13), strengthen further that some horses are inherently predisposed to sarcoid growth. Unassociated with any clinical parameters, one third of the untreated horses became free of sarcoids due to “spontaneous” regression, perhaps as a result of immune responses against the tumors. Seventy percent of the horses were treated (mostly by excision), and large size was the main parameter promoting treatment. Excision had no significant effect on possibly remaining sarcoids. Recurrence rate after first treatment was about 35%, with the majority of tumors recurring within 4 months. Early onset, long duration, large size, and localization to distal limbs all appeared to increase risk of recurrence. Early treatment, performed under general anesthesia in recumbency which permits wide excision and measures to avoid autoinoculation, significantly reduced recurrence rates.     

The vertical mammaplasty: a reappraisal of the technique and its complications

Since 1989, superior pedicle vertical scar mammaplasty as described by Lejour has been used in the authors' department as the only technique for breast reduction. From 1991 through 1994, a series of 170 consecutive patients (330 breasts) underwent an operation. In these patients, minor complications were observed in 30 percent of the patients and major complications in 15 percent. Surgical revision for scar or volume corrections was necessary in 28 percent of the breasts, which seemed unacceptable. Therefore, the original technique was modified by decreasing the skin undermining and avoiding liposuction in the breast. Primary skin excision was performed in the submammary fold at the end of the operation if the skin could not be puckered adequately. This modified technique was used from 1996 through 1999 in 138 consecutive patients (227 breasts). In the second series, minor complications were observed in 15 percent of the patients and major complications in 5 percent. However, the technical modifications did not significantly change the rate of secondary scar and volume corrections, which were still necessary in 22 percent of the breasts. In large breasts, the addition of a horizontal scar at the end of the operation did not change the rate of secondary revision, which however compares favorably with the figures obtained with the inverted T, superior pedicle mammaplasty.     

Isolated colostomy site recurrence in rectal cancer-two cases with review of literature

Background

Colostomy site carcinomas are rare with only eight cases reported in the world literature. Various etiological factors like adenoma-cancer sequence, bile acids, recurrent and persistent physical damage at the colostomy site by faecal matter due to associated stomal stenosis have been considered responsible. Two such cases are being reported and in both cases there was no evidence of any local recurrence in the pelvis or liver and distant metastasis. Both patients had received adjuvant chemotherapy following surgery.

Case presentation

First case was a 30-year-old male that had reported with large bowel obstruction due to an obstructing ulcero-proliferative growth (poorly differentiated adenocarcinoma) at the colostomy site after abdomino-perineal resection, performed for low rectal cancer six years previously. Wide local excision with microscopically free margins was performed with a satisfactory outcome. Four years later he presented with massive malignant ascites, cachexia and multiple liver metastasis and succumbed to his disease.Second case was a 47-year-old male that presented with acute large bowel obstruction due to an annular growth (well differentiated adenocarcinoma) in the upper rectum. He was managed by Hartmann's operation and the sigmoid colostomy was closed six months later. Five years following closure of colostomy, he presented with two parietal masses at the previous colostomy site scar, which, on fine needle aspiration cytology were found to be well-differentiated adenocarcinomas of colorectal type. Surgery in the form of wide local resection with free margins was performed. He presented again after five years with recurrence along the previous surgery scar and an incisional hernia and was managed by wide local excision along with hernioplasty. Follow-up of nine years following first surgery is satisfactory.

Conclusion

Colostomy site/scar recurrence of rectal carcinoma is rare and could be due to various etiological factors, although the exact causative mechanism is not known. Surgery with microscopically free margins is recommended in the absence of metastatic disease. Stenosis of the stoma is considered as one of the most important contributory factors and should be followed carefully.

     

Life events and breast cancer prognosis.

OBJECTIVE--To determine whether psychosocial stress, in the form of adverse life events and social difficulties, depressive illness, or lack of confiding relationships, shortens the postoperative disease free interval in breast cancer patients. DESIGN--Prospective follow up of a cohort of newly diagnosed breast cancer patients for 42 months after primary surgical treatment, using a life events and social difficulties schedule (LEDS) and assessment of depressive symptomatology (DSM-III). SETTING--Patients recruited from breast clinics in Southampton and Portsmouth were interviewed in their homes. PATIENTS--204 women (83% of 246 consecutive cases) treated either by mastectomy or wide excision followed by radiotherapy interviewed four, 24, and 42 months after operation. MAIN OUTCOME MEASURES--Hazard ratios for relapse of breast cancer in relation to various measures of psychosocial stress. Relapse was defined as local recurrence or distant metastasis, or both, with histological or radiological confirmation and timed from the month when clinical symptoms began. RESULTS--After adjustment for age and axillary lymph node involvement, the hazard ratio associated with severe life events or social difficulties (excluding "own health" ones), or both, during the year before breast cancer surgery was 0.43 (95% confidence interval 0.20 to 0.93); for those during the follow up period it was 0.88 (0.48 to 1.64). For prolonged major depression before surgery and during the follow up period, hazard ratios were 1.26 (0.49 to 3.26) and 0.85 (0.41 to 1.79) respectively. For absence of a full confidant the figures were 0.93 (0.42 to 2.09) and 0.86 (0.38 to 1.93). CONCLUSION--These results give no support to the theory that psychosocial stress contributes to relapse of breast cancer.     

CA-549 serum levels in breast cancer monitoring.

CA-549 serum levels were assessed in 288 patients, 156 with early breast cancer (after surgery) and 132 with advanced breast cancer. CA-549 was abnormal (> 12 U/ml) in 25/156 patients (16%) without clinical signs of disease after surgery (median 9 U/ml), in 49/60 patients (82%) with disease in progression (P) (median 50 U/ml), in 19/27 patients (70%) with stationary disease (NC) (median 14 U/ml), in 25/33 patients (76%) with partial remission (PR) (median 18 U/ml) and in 4/12 patients (33%) with complete remission (CR) (median 9 U/ml). CA-549 serum levels correlated mainly with the extent of disease and secondarily with the prevalent metastatic site, higher values being observed in patients with visceral involvement (median 32.5 U/ml). CA-549 serum levels were also assessed in 51 patients at the start of treatment and at the time of objective evaluation: the results underline the concordance of CA-549 behavior with the clinical outcome in 71% of the cases. We conclude that CA-549 is a useful marker for monitoring breast cancer patients during the advanced stages of the disease.     

The carbon dioxide laser: an alternative surgery technique for the treatment of common cutaneous tumors in dogs

Background

Tumors of the skin and subcutaneous tissue are the largest group of canine neoplasms. Total excision is still the most effective method for treatment of these skin tumors. For its universal properties the carbon dioxide (CO₂) laser appears to be an excellent surgical instrument in veterinary surgery. Laser techniques are alternatives to traditional methods for the surgical management of tumors. The aim of this study was to compare various types of laser techniques in skin oncologic surgery: excision, ablation and mixed technique and to suggest which technique of CO₂ laser procedure is the most useful in particular case of tumors in dogs.

Findings

The study was performed on 38 privately-owned dogs with total number of 40 skin tumors of different type removed by various CO₂ laser operation techniques from 2010–2013. The treatment effect was based on the surgical wound evaluation, the relative time of healing and possible local recurrence of the tumor after 3 months post surgery. Local recurrence was observed in two cases. The study showed that in 30 cases time needed for complete resection of lesions was less than 10 minutes. Time of healing was longer than 12 days in 6 cases (42.8%) with tumor excision and in 14 cases (87.5%) where excision with ablation technique was performed.

Conclusions

The advantages of the CO₂ laser surgery were better hemostasis, precision of working, non-contact dissection, less instruments at the site of operation and minimum traumatization of the surrounding tissues.