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    Platelet-rich plasma as a promising bioscaffold for enhancing peripheral nerve regeneration: An experimental study in a rat sciatic nerve model
    (Journal of Biological Methods, 2025)
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    Aleksovski, Boris
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    Tusheva, Sofija
    Despite advancements in surgical treatments, impairments persist after peripheral nerve injuries, prompting a shift in research toward the microenvironment of injured axons. Platelet-rich plasma (PRP), rich in growth factors and derived from autologous blood, emerges as a potential candidate to accelerate nerve healing.
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    High energy trauma of the upper extremity with traction injury of the brachial plexus
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University Skopje, R.N.Macedonia, 2021-10)
    Gordana Georgieva
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    Gjorgje Dzokic
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    Tomislav Jovanoski
    As a severe peripheral nerve injury, brachial plexus lesion can cause limitation in every- day home and workplace activities. Hereby, we present a patient with high-energy trauma of the upper extremity. The examination showed motor weakness of the upper extremity and no flexion and extension in the wrist and fingers with sensibility impairment. The examination and mechanism of injury indicated traction lesion of the brachial plexus. MRI showed postganglionic stretch injury. Treatment of choice was physical therapy. To evaluate the function of the upper extremity after the injury, we used the DASH score. Four months post injury, the patient has flexion and extension in the wrist and fingers. The mechanism of injury and the magnitude of forces that caused the injury can guide as to the extent of the brachial plexus lesion. Analyzing the acquired information, a plan for initial treatment can be established. On point treatment can increase patient’s quality of life with better outcome.
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    Surgical treatment of scalp skin cancer with endocranial invasion
    (Macedonian Association of Orthopedics and Traumatology, 2016)
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    Radical skin-sparing mastectomy with primary prosthetic reconstruction as treatment of early breast cancer: a case report
    (Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2015)
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    WALANT as an Optimal Approach in Hand Surgery during Pandemics
    (Charles University in Prague, Karolinum Press, 2022-01)
    Georgieva, Gordana
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    Srbov, Blagoja
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    Tusheva, Sofija
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    Jovanovska, Katerina
    The emergence of the COVID-19 pandemic imposed fundamental changes in the field of surgery. Reorganization was made in order to adequately treat the patients during the pandemic. WALANT (Wide Awake Local Anesthesia No Tourniquet) approach was found to be a very convenient method in facilitating continuity in hand surgery with limited staff. A retrospective comparative study was performed between period of April 2020 till September 2021 at our clinic to evaluate advantages of WALANT approach. This study included 136 patients, from which 72 (53%) were operated with WALANT, compared to the control group of 64 (47%) patients without WALANT. Average hospital stay for the WALANT group was 2.2 days vs. 4.7 days for the control group. Average operating room personnel were 3.8 for WALANT and 6.2 for the control non-WALANT group. Intraoperative and postoperative VAS (visual analogue scale) score was evaluated. Due to its diversity, low cost and low complication rate, we recommend WALANT approach in acute and elective hand surgery.
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    ESPRAS Survey on Continuing Education in Plastic, Reconstructive and Aesthetic Surgery in Europe
    (Georg Thieme Verlag KG, 2022-08)
    Moellhoff, Nicholas
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    Arnez, Tine
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    Athanasopoulos, Elias
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    Costa, Horacio
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    De Santis, Giorgio
    Background Specialty training in plastic, reconstructive and aesthetic surgery is a prerequisite for safe and effective provision of care. The aim of this study was to assess and portray similarities and differences in the continuing education and specialization in plastic surgery in Europe. Material and Methods A detailed questionnaire was designed and distributed utilizing an online survey administration software. Questions addressed core items regarding continuing education and specialization in plastic surgery in Europe. Participants were addressed directly via the European Leadership Forum (ELF) of the European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS). All participants had detailed knowledge of the organization and management of plastic surgical training in their respective country. Results The survey was completed by 29 participants from 23 European countries. During specialization, plastic surgeons in Europe are trained in advanced tissue transfer and repair and aesthetic principles in all parts of the human body and within several subspecialties. Moreover, rotations in intensive as well as emergency care are compulsory in most European countries. Board certification is only provided for surgeons who have had multiple years of training regulated by a national board, who provide evidence of individually performed operative procedures in several anatomical regions and subspecialties, and who pass a final oral and/or written examination. Conclusion Board certified plastic surgeons meet the highest degree of qualification, are trained in all parts of the body and in the management of complications. The standard of continuing education and qualification of European plastic surgeons is high, providing an excellent level of plastic surgical care throughout Europe.
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    ЗГРИЖУВАЊЕ НА ДЕФЕКТИТЕ НАСТАНАТИ ПО ЕКСЦИЗИЈА НА SINUS PILONIDALIS ВО САКРО-КОКЦИГЕАЛНАТА РЕГИЈА
    (Македонско лекарско друштво = Macedonian medical association, 2012)
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    Introduction. The pilonidal cyst is still an actual surgical problem due to the frequency of its appearance and high risk of post-operative recurrence. Radical excision and treatment of the defect is classic surgical technique when dealing with this clinical identity. Having in mind the frequency of post-operative recurrences, many surgical methods to treat the tissue defect have been developed. The tendency is to avoid the straight line in the inter-gluteal crease. The objective of our study is to evaluate the different available operative techniques that are used when treating this disease. Methods. This is a retrospective-prospective study that includes all 671 patients treated in a period of 10 years with various techniques employed. The techniques are analyzed and compared regarding their complications with a special attention paid to the recurrence and the rate of the disease. Results. Recurrences are seen after 6-12 months of follow up. There are 22 eases of recurrences (3,28%). Most of them, or 72% of the total number, are seen in the patients that were operated with the method of direct suture of the postexcisional defect (2,88%). In the open method, no recurrences are presented. In the other 93 cases where other techniques were utilized, there are only 2 recurrences (2.07%). Conclusions. There are no recurrences in cases of opened wound healing, but hospital stay is the longest one. Com-paring other methods. there is a smaller recurrence risk with this technique. and although patient and surgeon de-pended. it has insignificant differences concerning the risk of postoperative complications.
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    Surgical treatment of cancer on the eyelids and periorbital skin
    (Macedonian Surgical Association, 2003)
    Mostrov I
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    Naceska, A
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    Skin cancer of the eyelids and periorbital area produce cosmetical defects, and unlike other skin cancers they also have tendency to damage ocular and adnexal structures by direct invasion or as a result of the therapy. No matter which treatment is used the cancer should be eradicated in toto, without damaging structures and function of the eye, and as the final goal to achieve normal functional and cosmetical result.
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    COMPARATIVE ANALYSIS OF PREOPERATIVE AND POSTOPERATIVE DIAGNOSIS IN SKIN MELANOMA
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2021-12)
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    Gruev, Vladislav
    Introduction: Taking into account the increase in incidence and high mortality in advanced stages, early diagnosis is a prerequisite for successful treatment of melanoma. The aim of this study was to determine the concordance between dermatological (withdermoscopy), surgical and pathohistological diagnosis in patients with a suspicious finding of skin melanoma. Material and methods: A comparison between the clinical and pathohistological diagnosisof patients of both sexes, of all ages, with a referral diagnosis of skin melanoma was made. Results: Out of a total of 535 analyzed cases, 469 (87.5%) had preoperative dermato logical findings. In 329 of these patients the referral diagnosis was in favor of melanoma. In 140 cases with a dermatological finding other than melanoma, a pathohistological finding of melanoma was obtained, 30% with a dermatological finding.In addition to melanoma, in 289 cases out of 329 cases with dermatological findings a pathohistological finding for melanoma was obtained, and in 40 cases a pathohistological finding other than melanoma was obtained. Of 66 cases without dermatological findings, 27 patients with a surgical diagnosis other than melanoma were operated on, with a pathohistological finding for melanoma - 41%. With a diagnosis of melanoma without prior dermatological examination, 39 cases were operated on, of which in 12 cases the pathohistological finding was in support of melanoma. Of 58 patients who underwent dermoscopy, 78% had a matching dermoscopic and pa thohistological diagnosis. Conclusion: The results of this study showed a high percentage of erroneous preope rative diagnoses
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    COMPARATIVE STUDY OF ARTICLES ON DIFFERENT SURGICAL APPROACHES BY DIVERSE AUTHORS IN TREATMENT OF CUBITAL TUNNEL SYNDORME
    (Македонско Лекарско Друштво - Macedonian Medical Association/De Gruyter, 2019)
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    Introduction. Cubital tunnel syndrome is the second most common compressive neuropathy in the upper limb. The diagnosis of cubital tunnel syndrome is primarily clinical. A thorough history should include the onset of symptoms, presence of grip or pinch weakness, numbness and the chronicity of the condition. Methods. Depending on symptoms and clinical signs, the surgical methods of choice include in situ open decompression, submuscular transposition, intramuscular transposition, subcutaneous transposition and medial epicondylectomy. APubMed search was conducted and published articles were comparedusing predetermined criteria. Data collected showed the follow-up of patients’ surgical treatment with different surgical approaches. The percentage results are shown as combined good and excellent outcomes. Results. Despite the different scoring scales used and difficulty comparing studies directly, the bulk of single technique outcomes studies and multi-technique comparative studies demonstrate that all surgical techniques discussed are effective treatment methods for cubital tunnel syndrome, but fail to demonstrate one technique to be uniformly superior to another. Conclusion. The literature, articles and casereports, state that all of the techniques are generally effective. Comparative studies show no statistical difference in outcomes with any presentedtechnique. One conclusion is obvious that transposition should be performed only when subluxation of the nerve is present. In conclusion, there is no superior technique and no gold standard in treatment ofcubital tunnel syndrome.