RESUMEN
AIM: Genital burns are rare injuries. Reconstruction of penile skin defects should consider cosmetic and functional outcomes. Skin grafts can develop scar contractures and carry hair follicles, causing unwanted results. These downsides remain unsolved issues. This work aimed to describe a new foreskin advancement flap method for completely reconstructing penile shaft skin defects in severely burned patients. MATERIALS AND METHODS: From 2021 to 2023, four patients with third-degree burns in the genital area were enrolled in this investigation. We describe a series of cases with deep burns to the penile shaft and surrounding area that needed debridement and reconstruction using a novel technique called "reverse circumcision," which consists of tangential excision of the penis and a foreskin advancement flap without longitudinal cuts with less morbidity, preservation of function, and a better aesthetic appearance. The patients had an average follow-up of nine months. RESULTS: The reverse circumcision technique was established for patients with severe burns in the genital area. The four patients were satisfied with the postoperative results and the aesthetic results of the procedure without reporting any complications. No scarring or contractures were observed on the glans or penile shaft after surgery. CONCLUSIONS: Compared with other flap methods, the use of a reverse circumcision foreskin advancement flap was more straightforward, feasible, and effective. In adults, the foreskin tissue completely covers the penile shaft skin defect. It is a viable reconstructive surgical technique that is easily reproducible and has excellent aesthetic and functional results. For this surgical technique, tissue transfers, bulky regional flaps, or skin grafts were not needed.
RESUMEN
Background: Traumatic herniation of the buccal fat pad can be treated with repositioning or excision. This report describes a case of a child with traumatic herniation of the buccal fat pad treated with excision. A comprehensive review of the literature was performed with the objective of establishing treatment criteria for the decision-making involved in choosing between repositioning versus excision. Methods: A systematic review of the literature was performed through searches of PubMed, Ovid, Elsevier, Cochrane, ResearchGate and Google Scholar for reports published from 1968 through May 2021. The search keywords used were traumatic herniation of the buccal fat pad, buccal fat pad herniation, traumatic pseudolipoma, and traumatic lipoma. We included only those studies that included patients with intraoral buccal fat pad herniation. Results: We found and included 39 articles (44 patients). Time since trauma, size of the fat pad herniated, and presence of necrosis were the most important characteristics considered for treatment decision; on the basis of these factors, we created a treatment algorithm. We present a case report of a 2-year-old boy diagnosed with traumatic herniation of buccal fat pad and, according to our algorithm, the appropriate treatment was to perform excision. A follow-up examination at 11 months showed no complications. Conclusions: Because traumatic herniation of buccal fat pad is very rare, this algorithm can be an easy and effective tool to guide decision-making when choosing between repositioning versus excision.
RESUMEN
INTRODUCTION: The traumatic injuries to the tongue can go form section to partial or complete amputation, the latter being a rare presentation in the setting of facial trauma or even in patients with mental illness. CASE REPORT: We present 25-year-old patient with traumatic partial amputation of the tongue who presented to the emergency department with successful surgical repair with good functional and esthetic outcome. DISCUSSION: The tongue can suffer a broad type of traumatic injuries, in the setting of active bleeding, the muscular planes must be closed with absorbable sutures to stop the hemorrhage and prevent hematoma formation. Tongue surgical repair in the setting of a total section requires integrity of arterial and venous flow, so anastomosis must be executed. CONCLUSION: Amputation of the tongue can put the patient's life at risk and its management needs to be mastered by the surgeons treating polytraumatized patients.