A novel protective barrier for extremity surgeries during the COVID-19 pandemic

Aim: To present a novel protective barrier for COVID-19 transmission and investigate its effectiveness in protection against spreading aerosols and droplets during extremity surgery. Methods: We enrolled 436 patients who underwent urgent and essential surgery on the upper and lower extremity using a novel protective barrier under wide-awake local anesthesia. All patients were investigated in detail for COVID-19 infection with anamnesis, symptom questionnaires, and the required tests before surgery. Patient satisfaction regarding comfort during the surgery behind the protective barrier was analyzed using a five-point Likert scale. The protective effect of the transparent barrier was quantitatively and experimentally analyzed using smoke and saline transmission tests in different clinic scenarios with and without the protective barrier. Results: A total of 345 patients with no signs of COVID-19 infection underwent surgery. Ninety-one suspected patients who had positive COVID-19 symptoms or close contact with a COVID-19 infected patient underwent COVID-19 tests before surgery. All patients underwent urgent surgical treatment on the upper and lower extremities, and easily tolerated and were satisfied with the protective barrier. There was a statistically significant reduction in smoke and saline particles when using the protective barrier (p<0.001). The addition of negative suction and oxygen to the protective barrier potentiated the protective effect (p<0. 001). Conclusions: Extremity surgeries, especially hand surgeries, are one of the most common surgical procedures during the COVID-19 pandemic. Our protective barrier significantly reduced aerosol particles in our experimental model and was successfully used in clinical practice during extremity surgery. &nbsp

Surgical Management of Scarring Alopecia

Cicatricial alopecia presents a heterogeneous group of disorders, which are characterized by the destruction of hair follicles, and resulting in scarring and irreversible hair loss. Cicatricial alopecia is classified into two categories depending on the target pathological process. In primary cicatricial alopecia (PCA), the hair follicle is the sole target of a progressive inflammatory process in various skin or systemic diseases. In secondary cicatricial alopecia (SCA), non-specific and generalized disruption of the skin and skin appendages results in fibrotic scarring of the skin and permanent loss of hair follicles due to underlying disease or an external agent. The aim of the treatment of PCA is to reduce inflammation and prevent progression to irreversible alopecia by using immunosuppressive and antimicrobial agents at the earliest phase of the disease. When permanent hair loss occurs in PCA and SCA, scar tissue should be removed or camouflaged by surgical treatment. However, it is difficult to remove the existing scar and treat alopecia. Follicular unit extraction technique hair transplantation is a minimally invasive and alternative treatment with a high success and satisfaction rate in the treatment of cicatricial alopecia

A rare cause of squamous cell carcinoma which develops at an early age: Epidermodysplasia verruciformis

Epidermodysplasia verruciformis (EV) (Lewandowsky–Lutz syndrome) is a genodermatosis that accommodates premalignant skin lesions extensively infected with human papillomavirus with underlying cellular and humoral immune disorders. Localized especially in regions extensively exposed to the sun such as the forehead, these skin lesions may turn into malignant lesions with the mutation-inducing effect of ultraviolet lights. The skin lesions that may emerge as a result of this transformation include actinic keratosis, Bowen's disease, squamous cell carcinoma (SCC), and more rarely basal cell carcinoma. The SCC that develops in patients with EV may act aggressively and can become locally invasive. This article aims at presenting the underlying EV as a rare etiological cause in patients with SCC at an early age