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KMID : 1144920170130010013
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Journal of Wound Management and Research
2017 Volume.13 No. 1 p.13 ~ p.17
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Life Threatening Complications following Excision of Giant Neurofibroma
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Choi Jae-Ik
Ha Yoo-Seok
Kyung Hyun-Woo
Song Seung-Han
Kang Nak-Heon
Oh Sang-Ha
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Abstract
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Neurofibroma is a common benign tumor, occurs anywhere in the body, grows continuously, and often becomes very large. 5-10% of neurofibromas undergo malignant change. Surgical excision is the most effective method to control this tumor. However, it is hard to excise the tumor completely, and even partial excision is difficult due to the risk of hemorrhage. A 40-year-old female presented to our clinic with a huge neurofibroma on the back and posterior neck, and underwent surgical excision. She had uncontrolled bleeding during and after the operation, so she stayed in the intensive care unit for airway maintenance and hemodynamic stability (massive transfusion). After resuscitation, she had an extensive wound, repeated surgery nine times, and was hospitalized for fifty-four days. The lessons from this case when we excise huge neurofibromas are the following. 1) It is undesirable to excise tissues around the vital organs. 2) A careful preoperative design considering postoperative swelling and hemorrhage is necessary. A high tension in different directions after removal of the tumor may cause wound problems. 3) It is helpful to ligate feeding vessels via preoperative computed tomography angiography or angiogram.
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KEYWORD
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Neurofibroma, Hemorrhage, Excision
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