Marjolin's ulcer(MU) represents malignant degeneration that typically ensues over a period of time in the post-burned lesions and scars or any other chronic wound. This review highlights various facets of the pres...Marjolin's ulcer(MU) represents malignant degeneration that typically ensues over a period of time in the post-burned lesions and scars or any other chronic wound. This review highlights various facets of the presentation and management of MUs that originate from post-burned lesions. The incidence of MUs in such lesions is reported to be 0.77%-2%. This malignancy characteristically develops in the areas of full thickness skin burns that had been allowed for weeks to months to heal spontaneously by secondary intention, or burn wounds which never healed completely over years and the unstable post-burned scars. In the majority of cases, the MU is a squamous cell carcinoma(SCC). The MUs contribute to an overall 2% of all SCCs and 0.03% of all basal cell carcinomas of the skin. Clinically MUs present in two major morphologic forms. The commoner form is the flat, indurated, ulcerative variety while the less common form is the exophytic papillary variety. Lower limbs represent the most frequently affected body parts. Surgical resection of the primary tumor with 2-4 cm horizontal clearance margin, nodal clearance and radiotherapy constitute the cornerstones of effective oncologic management. Despite best efforts, the overall mortality is reported to be 21%.展开更多
Post-burn contractures are common entities seen in developing countries.There are multiple reasons for the development of contractures,most are preventable.In extensive contractures,a strategic plan is necessary to re...Post-burn contractures are common entities seen in developing countries.There are multiple reasons for the development of contractures,most are preventable.In extensive contractures,a strategic plan is necessary to release all contractures and yet not antagonize post-operative positions.It is also necessary to be cost-effective and minimize the number of surgeries needed.Conventionally the release sequence in extensive burn contractures is proximal to distal.In this case report,we discuss an unusual sequence where we released distal contractures before the proximal to achieve optimum results.A 3-year-old child with post-burn contracture of hand,wrist,elbow,and axilla was treated in 2 stages,with the release of wrist contracture and cover with pedicled abdominal flap in the first stage and division of pedicled flap with the release of axilla and elbow contracture in the second stage.Thus,the release of all contractures was achieved without antagonizing post-operative positions and minimized the number of surgeries.A case-based approach may be crucial in making a strategic surgical plan to minimize the rehabilitation phase,rather than following known dictums.展开更多
文摘Marjolin's ulcer(MU) represents malignant degeneration that typically ensues over a period of time in the post-burned lesions and scars or any other chronic wound. This review highlights various facets of the presentation and management of MUs that originate from post-burned lesions. The incidence of MUs in such lesions is reported to be 0.77%-2%. This malignancy characteristically develops in the areas of full thickness skin burns that had been allowed for weeks to months to heal spontaneously by secondary intention, or burn wounds which never healed completely over years and the unstable post-burned scars. In the majority of cases, the MU is a squamous cell carcinoma(SCC). The MUs contribute to an overall 2% of all SCCs and 0.03% of all basal cell carcinomas of the skin. Clinically MUs present in two major morphologic forms. The commoner form is the flat, indurated, ulcerative variety while the less common form is the exophytic papillary variety. Lower limbs represent the most frequently affected body parts. Surgical resection of the primary tumor with 2-4 cm horizontal clearance margin, nodal clearance and radiotherapy constitute the cornerstones of effective oncologic management. Despite best efforts, the overall mortality is reported to be 21%.
文摘Post-burn contractures are common entities seen in developing countries.There are multiple reasons for the development of contractures,most are preventable.In extensive contractures,a strategic plan is necessary to release all contractures and yet not antagonize post-operative positions.It is also necessary to be cost-effective and minimize the number of surgeries needed.Conventionally the release sequence in extensive burn contractures is proximal to distal.In this case report,we discuss an unusual sequence where we released distal contractures before the proximal to achieve optimum results.A 3-year-old child with post-burn contracture of hand,wrist,elbow,and axilla was treated in 2 stages,with the release of wrist contracture and cover with pedicled abdominal flap in the first stage and division of pedicled flap with the release of axilla and elbow contracture in the second stage.Thus,the release of all contractures was achieved without antagonizing post-operative positions and minimized the number of surgeries.A case-based approach may be crucial in making a strategic surgical plan to minimize the rehabilitation phase,rather than following known dictums.
