Efficacy Of Excision Research Articles

Retrospective Analysis of Postoperative Hemorrhage after Hemorrhoidectomy ―The Efficacy of Excision and ALTA (EA) Therapy―

Retrospective Analysis of Postoperative Hemorrhage after Hemorrhoidectomy ―The Efficacy of Excision and ALTA (EA) Therapy―

Efficacy of Excision, Cauterization, and Fungicides for Management of Apple Anthracnose Canker in Maritime Climate

This study was designed to determine the efficacy of canker excision (CE) followed by a subsequent application of cauterization (CAU) and/or fungicide treatment to the excised area for the management of anthracnose canker (caused by Neofabraea malicorticis) on cider apple (Malus ×domestica) trees. Three experiments were conducted from 2015 to 2017, with one experiment each year, in an experimental cider apple orchard in western Washington where trees were naturally infested with N. malicorticis. Treatments were applied once in December and data were collected January through March. Treatments in the 2015 experiment were CE + CAU, CE + CAU + copper hydroxide, CE + 0.5% sodium hypochlorite, Bordeaux mixture (BM) only, and CE + copper hydroxide (control). The 2016 experiment included the same treatments as in 2015 plus one additional treatment, CE + BM. In 2017, one additional treatment was added, CE only, and CAU treatments were removed as they caused significant injury to the trees. Canker size was measured pretreatment, and the treated canker or excised area was measured posttreatment every 2 weeks for 13–15 weeks. Compared with pretreatment, cankers treated with BM did not increase in size, while the excised area treated with CAU increased 28-fold in size on average, and the excised area treated with 0.5% sodium hypochlorite or copper hydroxide increased up to 4-fold in size. Each year new cankers developed in all treatments 13–15 weeks after treatment application, at a time of year when there should not be any spores present to cause new infections. Dark brown streaking, indicative of the disease, was observed in the tissue below the intact or excised cankers 15 months after treatment application all years. Although N. malicorticis was not isolated from symptomatic tissue, symptoms were observed in all treatments including where cankers had not been excised and there was no wounding of the cambium tissue. Findings from this study indicate that of the treatments evaluated, the application of copper hydroxide after CE was the most effective for limiting the number of new cankers, but it did not limit expansion of the excised area. Additional physical and fungicidal strategies need to be tested for effective management of anthracnose canker.

The efficacy of excision followed by intralesional 5-fluorouracil and triamcinolone acetonide versus excision followed by radiotherapy in the treatment of ear keloids: A randomized control trial

BackgroundThe ear is the common site for keloid formation especially in women after ear piercing. Surgery is the main stay of treatment in these lesions but there are large numbers of treatment failures in surgery alone. ObjectiveThe objective of this study was to compare the efficacy of post-excision intralesional 5-fluorouracil/triamcinolone acetonide (5-FU/TAC) and post-excision radiotherapy in the treatment of ear keloids. Study designA randomized controlled trial. SettingThe study was conducted from May 2014 to January 2015 at Jinnah Burn and Reconstructive Surgery Centre, Allama Iqbal Medical College, Lahore. Subject & methodologyAfter approval from the hospital ethical committee, 60 patients presented in the outpatient department fulfilling the inclusion criteria were selected and randomly assigned in two groups with the help of the random number table. Patients in group A had excision followed by intralesional 5-FU/TAC injections while patients of group B had excision followed by radiotherapy.Patients were assessed at 6 months after completion of treatment for efficacy (no recurrence within 6 months of treatment). ResultsIn our study total of 60 patients completed the study, with 30 patients in each group. 7 patients (23.34%) in Group-A and 9 patients (30%) in Group-B were males while 23 patients (76.67%) in Group-A and 21 patients (70%) in Group-B were females i.e. male to female ratio is 1:2.75. Mean age was 31.8+6.48years. The comparison of frequency of efficacy in both groups showed that 73.33% (n=22) in Group-A and 43.33% (n=13) in Group-B had efficacy, p value was calculated as 0.01, showing a significant statistical difference. ConclusionExcision and intralesional 5-FU/TAC is an effective treatment for keloids on the ears.

Safety and efficacy of excision and direct closure in acute burns surgery: Outcome analysis in a prospective series of 100 patients and a survey of UK burns surgeons’ attitudes

Many burns surgeons avoid excision and direct closure of acute burns owing to concerns over wound dehiscence, scarring and infection. There is no evidence in the literature to support this practice. We present outcomes of a prospective series of 100 patients who underwent excision and direct closure of 138 burns over a 2-year period, along with results from a survey sent to 33 senior burns surgeons to gauge attitudes towards direct closure in burns surgery. 47% of survey respondents never perform direct closure. Dehiscence was cited as the most common concern, followed by hypertrophic scarring (HTS). In our cohort, the superficial dehiscence rate was 12% and the HTS rate was 16%, with no scarring contractures. Patients with healing time greater than 14 days were more likely to develop HTS (p=0.008), as were those with wound dehiscence (p=0.014). Patients undergoing part-grafting in addition to direct closure took significantly longer to heal than those undergoing direct closure alone (p=0.0002), with the donor site or graft delaying healing in the majority. Excision and direct closure of acute burn wounds avoids donor site morbidity and has an acceptable complication rate. It is a safe and effective treatment for full thickness burns in selected cases.

Closed rhinoplasty approach for excision of nasal dermoids

To assess the efficacy of excision of nasal dermoids through a closed rhinoplasty incision. This is the first description of the use of this approach for excision of superficial nasal dermoids. Three boys aged five, nine and 12 years presented with midline nasal dermoids with minimal cutaneous involvement. Magnetic resonance imaging demonstrated distinct, cystic, superficial nasal masses. The cysts were excised through a closed rhinoplasty approach. In each case, completeness of extirpation was judged by histopathological examination of the excised specimen. Aesthetic outcome was recorded photographically. All three patients' cysts were completely excised, with excellent cosmetic results. The closed rhinoplasty incision is another approach in the surgeon's armamentarium for excision of small, superficial nasal dermoid cysts. In well selected cases, this approach gives optimal cosmetic results, provides adequate exposure with minimal dissection, and allows total extirpation.

Serial excision of congenital melanocytic nevi

Congenital melanocytic nevus needs to be excised for aesthetic reasons and concerns regarding its malignant potential. Many methods like surgical resection, dermabrasion, curettage, chemical peeling, laser resurfacing, etc., are available for treatment. We hereby report the efficacy of excision of nevi by serial excision.