For patients who present abroad treatment may be surgical excision or amputation.
Borderline (B3) core needle histology, however, has more significant implications in that most cases progress to surgical intervention, and debate continues on whether selected cases may be spared excision (Jacobs et al, 2002).
Long term recurrence may be reduced by excision of cords/nodules with the overlying skin and full thickness skin grafting (dermofasciectomy) [ 2].
With regards to clinical decision making, preoperative biopsy gains another function, and the future planning of the operation may be further influenced (excision range, resection margins).
▪ Cleaning: with tap water and mild soap [ 43- 45], followed by careful drying ▪ Debridement: if necrotic tissue or sloughing are observed, perform enzymatic debridement, which may be combined with excision debridement, if necessary ▪ Managing infection: if infection is suspected, take a sample and begin treatment with silver sulfadiazine for a maximum of 2 weeks.
The other 11, he concluded, "may be released with excisions".
Since random re-insertion is predicted to result in a higher rate of insertion on the correct chromosome, the majority of these false positive 'preliminary candidates' may be from non-excision events.
Surgical excision of FEA at our centre has resulted in a low rate of upgrade to malignancy supporting current thinking that some lesions may be managed by vacuum excision, thus reducing the surgical diagnostic excision rate.
Lesion size has a variable association with persistence[ 37] and the presence of disease at the excision margins may be related to lesion size or excision technique but we did not see any difference in rates of persistence between the two operators (data not shown).
These intrastrand lesions are repaired by the nucleotide excision repair (NER) pathway so the response of tumours to cisplatin and other platinum-based drugs may be affected by nucleotide excision repair capacity of the tumour cells [ 1].
