PLASTIC SURGERY OF WOUND DEFECTS WITH FREE GRAFTS AFTER MALIGNANT SKIN TUMORS EXCISION: A PILOT STUDY.

AIM: To evaluate the effectiveness of applying negative pressure bandages (VAC bandage) in patients with malignant skin tumors after closing defects with free skin grafts and to compare it with fixation of skin grafts by the ordinary ointment bandages. MATERIALS AND METHODS: 61 patients with malignant skin tumors who underwent surgical treatment at the National Cancer Institute from 2019 to 2023 were included in the study. For the wound defects closure, the split skin grafts were applied in all patients. At the time of surgery, after closing a wound defect by a split skin graft, a negative pressure dressing (VAC bandage) was applied in 41 patients for 7 days (group 1). In 20 patients, a transplanted skin graft was fixed after surgery by an ordinary ointment pressure bandage (group 2). The immediate results were evaluated one week after surgery. RESULTS: Complete engraftment of the flap in group 1 was observed in 53.7 ± 7.8% cases, in group 2 this result was achieved in 5.0 ± 4.8% patients (p = 0.002). The complete graft necrosis occurred in 1 case in group 1 vs. 2 cases in group 2 (p = 0.496). CONCLUSION: The results of the engraftment in postoperative wounds were significantly better in the VAC-bandage group in terms of the number of the complete engraftments compared to the conventional pressure ointment bandage group.

Non-linear dynamics theory and malignant melanoma.

Chaos theory (nonlinear dynamics) defines cancer as a complex adaptive system in which each cyclic point corresponds to the bifurcation at which changes in signaling pathways emerge. Quantitative assessment of chaos in digital medical images such as electron microscopy, histology and cytology sections collected from patients with malignant cutaneous melanoma employed the following calculation parameters: the irregularity of external contours, internal heterogeneity based on brightness distribution of macromo-lecules, chromosomes, organelles, inclusion bodies, cells and tissues, kurtosis, entropy and the asymmetry coefficient. The present study undertook a nonlinear analysis of the chaotic hierarchy of malignant melanoma. However, considerably more studies will need to be carried out to determine the exact interrelationship between different levels of the hierarchy in the biological system. Multidisciplinary collaborations are therefore essential to find evidence to answer questions that remain open to researchers and oncologists.

[Recombinant α-2 interferon in preventing the progression of melanoma].

A brief history of interferon application in the treatment of cutaneous melanoma is represented.

[Primary multiple malignant neoplasms in patients with skin melanoma].

The problem of primary multiple malignant tumor (PMMT) of skin melanoma in Ukraine is analyzed. During the period from 2000 to 2006, 16760 cases of skin melanoma have been diagnosed, and in 873 patients from them PMMT has been registered. So, the part of the patients with multiple tumors among all patients with skin melanoma was 5.2%. Most often PMMT appears in the case of skin melanoma of head and neck (6.6 +/- 0.4%). Most commonly skin melanoma is accompanied by other skin malignant neoplasms (40.9 +/- 1.6% of all PMMT cases). Upon malignant skin melanoma, PMMT occurs more often in males (5.7 +/- 0.7%) than in females (4.9 +/- 0.7%). Most often the diagnosis of skin melanoma at PMMT is detected synchronously (48.3 +/- 1.6%), and simultaneous detection of PMMT predominates in all polyneoplasms and in all age groups. The most favourable course of skin melanoma is characteristic for metachronous cancer of II type when melanoma is diagnosed after manifestation of other malignant tumor.

[Cases of primary multiple metachronous skin melanoma].

The article presents medical cases of primary multiple metachronous skin melanoma, which is rarely come across in oncological practice and presents interest for oncologists.

[Recombinant interleukin-2 (roncoleukin) in therapy of the patients with skin melanoma].

The article deals with a problem of combined use of interferon (laferon) and interleukin in patients with skin melanoma. Recombinant interleukin-2 (rIL-2) was included into the worked-out scheme. Patients with primary-localized skin melanoma (T(2-4)N0M0) have been studied. Three groups were chosen. 901 patients of the control group underwent excision of tumor (e/t); 34 patients of the first study group (e/1) were given endolymphatic interferontherapy (ift); 35 patients of the second study group were subjected to excision of tumor followed by endolymphatic interferontherapy. One-year relapse-free survival among patients of the control group reached 57.6+/-1.6%, 1st study group--70.5+/-7.8% and 2nd study group--83.6+/-6.7%. Total one-year survival among patients of the control group was 92.1+/-0.9%, in the 1st study group--97.0+/-2.9%, in the 2nd study group--92.7+/-5.0%. Thus, the combined use of recombinant interferon (laferon and interleukin (ronkoleukin) in treatment schemes of malignant skin melanoma was proved to be perspective.

[Use of local magnitothermia in the treatment of patients with primary-confined skin melanoma]. / Opyt primeneniia lokal'noi magnitotermii pri lechenii bol'nykh s pervichno-ogranichennoi melanomoi kozhi.

We studied modifying potentialities of high temperatures in treatment regimens with adjuvant endolymphatic chemo- and interferontherapy of malignant melanoma of the skin. We had previously obtained enough evidence for expediency of adjuvant endolymphatic therapy of primary-localized melanoblastoma of the skin. Added to the preventive treatment regimens were sessions of local magnetothermia. The study was done in patients diagnosed as having primary-localized melanoma of the skin T(2-4) No Mo. A 3-year recurrence-free survival in the control group was (38.2 +/- 1.6)%, in the first study group--(54.2 +/- 5.8)%, in the second study group--(44.3 +/- 13.5)%. The general 3-year survival in the control group was (67.7 +/- 1.5)%, in the first study group--(70.8 +/- 5.5)%, in the second one--(91.7 +/- 5.7)%. In this way, the expediency has been proved of employment of local magnetothermia in treatment regimens to deal with malignant melanoma of the skin.

[Long-term results of treatment of patients with bone tumors using hydroxyapatite and calcium phosphate ceramic implants]. / Viddaleni rezul'taty likuvannia khvorykh z pukhlynamy kistok z vikorystanniam keramichnykh implantativ na osnovi gidroksylapatytu ta trykal'tsiifosfatu.

On the basis of experimental-and-clinical investigations it has been found out that the home-produced hydroxylapatite (HA)- and tricalciumphosphate(TCP)-based ceramic material is capable owing to specificities of its chemical structure and osteoinductive action of stimulating the reparative osteogenesis and is accompanied by angiogenesis. No ill effects have been noted in its use in bone plastic surgery. An apparent clinical effect has been shown to occur in postsurgical patients (n = 120) presenting with giant cell tumour, benign tumours and tumour-like affections of the bones, with the expediency having been ascertained of employment of the HA- and TCP-base ceramic material in the treatment of the above patients. The use of the above materials implants versus allotransplants promotes decline in the percentage of complications (1.66 vs 27.2), shortening of time of medical rehabilitation of patients by two to three months as compared to allotransplantation as well as hospital stay duration (by 10 to 12 days).

[Experimental studies on the effect of ceramic materials on cellular and humoral immunity]. / Eksperymental'ni doslidzhennia vplyvu keramichnogo materialu na reaktsiï klitynnogo ta gumoral'nogo imunitetu.

It has been established in an experimental setting in laboratory animals through testing a number of reactions such as active skin anaphylaxis reaction, mast cell degranulation reaction, specific leucocyte lysis reaction, delayed hypersensitivity reaction, and graft-versus-host reaction that ceramic preparations hydroxilapatite M and osteogel-7 have no sensitizing effects; osteogel-7 is not endowed with immunomodulating activity, which fact suggests to us its immunological inertness.

[Systemic enzymotherapy as a method of prophylaxis of postradiation complications in oncological patients]. / Systemna enzymoterapiia iak metod profilaktyky promenevykh uskladnen' u khvorykh na onkolohichni zakhvoriuvannia.

Set out in the paper are results of treatment of those patients with carcinoma of the lung, uterine cervix, hysterocarcinoma, breast cancer, malignant thymomas, malignant non-Hodgkin's lymphomas, and lymphogranulematosis having been administered combined, chemoradiation or radiation treatments against the background of a complex of accompanying therapy involving systemic enzymotherapy. Polyenzymic drugs were found to be capable of improving results of treatment of acute radiation reactions and preventing postradiation fibrous changes in the lungs, skin, fatty tissue, soft tissue, liver, kidneys. Thus, systemic enzymotherapy is capable of improving the quality of life and results of treatment of oncological patients.

[Adjuvant chemotherapy in the combined treatment of primary circumscribed malignant melanoma of the skin]. / Ad''iuvantnaia khimioterapiia v kombinirovannom lechenii pervichnoogranichennoi zlokachestvennoi melanomy kozhi.

Results are analyzed of employment of different methods of adjuvant chemotherapy in patients with melanoma of the skin of the extremities and trunk. The courses of systemic prophylactic chemotherapy failed to improve results of surgical treatment of primary circumscribed melanoma of the skin. Adjuvant systemic chemotherapy and the immunomodulating agent levomizole combined in treatment of the condition did not change indices for late results of the treatment. The postoperative endolymphatic chemotherapy appeared to be associated with statistically significant (11.4%) increase in indices for a 5-year survival of patients with melanoma of the skin of the extremities and trunk.

[Recombinant interferon alfa-2b in the treatment of patients with skin melanoma]. / Rekombinantnyi al'fa-2b interferon v lechenii bol'nykh melanomoi kozhi.

An analysis was performed of early and remote results of inauguration in patients with primary-circumscribed skin melanoma of extremities and trunk of adjuvant endolymphatic interferon therapy. The results showed a statistically insignificant tendency to improve as per comparison of indices for 3-yr survival. Comparative analysis of the above indices among male patients of the study group and controls revealed statistically significant augmentation of the survival index following postoperative interferon therapy.

[The surgical treatment of patients with skin melanoma of the extremities and trunk]. / Khirurgicheskoe lechenie bol'nykh s melanomoi kozhi konechnostei i tulovishcha.

The surgical method of treatment late follow-up results of 901 patient with body and extremities skin melanoma in stages T1-4 N0M0 were analyzed. It was established that melanoma is metastasizing into the regional lymphatic nodes. The metastases are occurring from 1 month up to 20 years. Only 67.7% of patients survive more that three year and 53.5%--5 years after the tumor excision.

[Endolymphatic therapy in the treatment of primary delimited melanoblastoma of the skin]. / Endolimfaticheskaia terapiia v lechenii pervichno-ogranichennoi melanoblastomy kozhi.

The results of treatment of 1128 patients with the body and extremities skin melanoma were analyzed. The increase of five-year survival index in patients with the tumor of T1-4 N0M0 stage by 11.4% was promoted by the postoperative adjuvant endolymphatic chemotherapy application. The dacarbasin endolymphatic infusion together with recombinant interferon laferon have permitted to increase the survival index of patients by 15.4%.

[Effects of primary focus of malignant cutaneous melanoblastoma on the outcome of surgical treatment of regional lymphogenic metastases]. / Vliianie pervichnogo ochaga zlokachestvennoi melanoblastomy kozhi na iskhod khirurgicheskogo lecheniia ee regionarnykh limfogennykh metastazov.

The indexes of the disease remission dynamics proved to be les favourable in patients with lymphogenic metastases revealed while the first visit to oncologist (stage T1-4N1M0) in comparison with those, in whom the metastases in regional lymph nodes have appeared after the primarily restricted cutaneous melanoma T1-4N1M0 excision. The survival indexes of the patients were similar.

[Use of adjuvant therapy in patients with metastasis of melanoma to regional lymph nodes]. / Primenenie ad"iuvantnoi terapii u bol'nykh s metastazami melanomy v regionarnykh limfaticheskikh uzlakh.

The results of treatment of 276 patients with cutaneous melanoma of T1-4N1M0 stage were analyzed. The irradiation therapy conduction did not influence the result of surgical treatment. The trustworthy improvement of three-year survival index of patients after the radical operation conduction was noted under the influence of the endolymphatic cytostatic therapy. The result of preoperative endolymphatic chemotherapy and interferon therapy conduction is quite similar.