Introduction to Flap Movement: Reconstruction of Five Similar Nasal Defects Using Different Flaps

There are several options for closure of a given surgical defect after tumor extirpation is confirmed. Flap reconstruction is one of these options. Objective . The purpose of this article is to introduce the three basic types of flap movement: advancement, rotation, and transposition. Methods . Five similar defects located on the nasal sidewall were repaired, each using a different flap design. Results . The optimal flap design for a given defect on a particular patient is based on the answers to a series of questions: Where is the available tissue reservoir? How can tissue be mobilized from the reservoir to cover the defect? How do the resulting tension vectors affect critical structures? Where are the final incision lines? Conclusion . Many factors must be evaluated before determining a method of reconstruction. Flap reconstruction requires a thorough understanding of anatomy and tissue movement.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72091/1/j.1524-4725.2005.31822.pd

Reply to: Metformin use and keratinocyte carcinoma risk.

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Anti-tumor necrosis factor therapy is associated with increased in situ squamous cell carcinoma of the skin: A population-based case-control study.

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Metformin is associated with decreased risk of basal cell carcinoma: A whole-population case-control study from Iceland.

To access publisher's full text version of this article click on the hyperlink belowBackground: Metformin has anticarcinogenic properties and is also known to inhibit the sonic hedgehog pathway, but population-based studies analyzing the potential protective effect for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are needed. Objectives: To delineate the association between metformin use and invasive SCC, SCC in situ (SCCis), and BCC. Methods: A population-based case-control study design was employed using all 6880 patients diagnosed in Iceland between 2003-2017 with first-time BCC, SCCis, or invasive SCC, and 69,620 population controls. Multivariate odds ratios (ORs) were calculated using conditional logistic regression. Results: Metformin was associated with a lower risk of developing BCC (OR, 0.71; 95% confidence interval [CI], 0.61-0.83), even at low doses. No increased risk of developing SCC was observed. SCCis risk was mildly elevated in the 501-1500 daily dose unit category (OR, 1.40; 95% CI, 1.00-1.96). Limitations: This study was retrospective in nature with the inability to adjust for ultraviolet exposure, Fitzpatrick skin type, and comorbidities. Conclusion: Metformin is associated with decreased risk of BCC development, even at low doses. Metformin might have potential as a chemoprotective agent for patients at high risk of BCC, although this will need confirmation in future studies. Keywords: basal cell carcinoma; keratinocyte carcinoma; metformin; squamous cell carcinoma; squamous cell carcinoma in situ