This article is reproduced from: People’s Daily Online – Anhui Channel
Recently, the plastic surgery body surface tumor team of the First Affiliated Hospital of China University of Science and Technology (Anhui Provincial Hospital) successfully removed the forehead for the 104-year-old grandmother Tang (pseudonym). The malignant tumor was freed from the annoying tumor. Grandma Tang held the hand of the attending physician Lang Zhongliang and praised her.
A few years ago, Grandma Tang, who lives in Hefei, developed a “pimple” on her forehead. The tumor grew bigger and bigger, almost the size of an egg. Because of the itching, Grandma Tang couldn’t help scratching, and often scratched the tumor to bleed.
A few days ago, Grandma Tang’s family brought the elderly to the plastic surgery clinic of the First Affiliated Hospital of China University of Science and Technology. The attending physician, Lang Zhongliang, found that the tumor had reached 5*6cm, and the protruding body surface was about 2cm, occupying a Half of the forehead, which seriously affects the appearance, is recommended to undergo surgery as soon as possible.
Considering Grandma Tang’s advanced age and combined cardiopulmonary insufficiency, the risks of anesthesia and surgery are extremely high. Zhao Liping, director of plastic surgery, organized general medical staff to conduct group rounds and discussions with Grandma Tang, comprehensively and meticulously assessed her condition, improved relevant preoperative examinations, formulated specific surgical plans, and invited related disciplines such as cardiovascular medicine and anesthesiology. A consultation assessment was performed.
For elderly patients with complex systemic conditions like Grandma Tang, the tumor needs to be enlarged and removed, and the operation will face multiple problems: Comprehensive assessment of surgical hazards; the tumor on the other side must be completely resected, functional requirements must be preserved, and facial aesthetics must be considered.
On the third day after admission, under the guidance of the chief physician of plastic surgery Wang Hongyuan, Lang Zhongliang was the chief surgeon. Expansion and radical resection of the tumor were performed, and abdominal skin harvesting and free facial full-thickness skin grafting were performed to restore the appearance of Grandma Tang. Intraoperative pathological findings: the tumor has become malignant.
During the operation, the two groups of medical staff performed tumor resection and skin extraction at the same time, which greatly shortened the operation time and reduced bleeding. After Grandma Tang returned to the ward, the medical staff paid close attention to the changes in the old man’s consciousness, breathing and various vital signs, and adjusted the treatment plan in time according to the changes in his condition. Grandma Tang recovered well and was discharged home to recuperate on the 4th day after the operation.
On the 20th day after the operation, Grandma Tang came to Dr. Lang Zhongliang’s clinic to review the suture removal. The facial appearance was good, and Grandma Tang was very satisfied with the operation.
Clinically, the principle of treatment for malignant body surface tumors is extended radical resection, and the surgical damage is relatively large, especially for skin tumors on the head and face. Various repair methods such as skin flap transfer or skin graft to repair secondary defects can minimize postoperative appearance and functional loss and achieve better repair results. The Plastic Surgery Department of the First Affiliated Hospital of China University of Science and Technology performs surface tumor or chronic wound surgery for many elderly people like Grandma Tang every year.
Dr. Lang Zhongliang also reminded the elderly and their children: with the increase of age, the physiological structure of the elderly’s skin undergoes degenerative changes, and various physiological functions such as the skin’s barrier defense are also gradually declining. As a result, various skin diseases such as age spots, seborrheic keratosis, keratoacanthoma, and solar keratosis may occur. These diseases are generally benign, but if accompanied by itching, pain, etc., the elderly often scratch and squeeze involuntarily, which may become malignant in the long run. Therefore, the following conditions of skin lesions, such as rapid enlargement, ulceration and bleeding, hyperplasia and discoloration, unhealed ulcers, etc., may be signs of malignant transformation, and attention should be paid to and timely medical treatment. (Fang Wen)