Keloids in male genitalia-Systematic review and illustrative case report.

Keloid is the maximum expression of pathological fibroproliferative skin wound healing, whose pathophysiology is not yet fully understood. Its occurrence in the perineum and genitalia is uncommon. A systematic review was carried out regarding the occurrence and treatment of keloids on the penis. An illustrative case was also reported. The review used the PRISMA checklist and was registered in PROSPERO. The entire literature period up to April 2023 was searched in the EMBASE/Elsevier, Cochrane, Scopus, Medline, BVS, SciELO, and Lilacs databases. The inclusion criteria embraced primary studies, clinical trials, prospective or retrospective cohorts, case series, case-control studies and case reports. Three hundred and sixty-one studies were found and 12 of them were included, consisting of 9 case reports and 3 case series. The most common triggering factor for keloid formation was circumcision, in 11 of the cases, of which more than half occurred in prepubescent children. Several therapies, associated or isolated, were used to treat the cases. Only one of the reported patients had scar recurrence after surgical treatment. Studies with better scientific evidence are needed to understand the involvement of keloids in male genitalia. However, keloid formation in this topography is rare, making it difficult to carry out more elaborate studies.

Aplicabilidade do retalho de Limberg: uma série de casos / Applicability of the Limberg Flap: a case series

Retalhos locais constituem uma excelente opção para o reparo da excisão de tumores cutâneos, em que o fechamento primário do defeito acarretaria prejuízos estético e funcional. O retalho romboidal (de Limberg) é um retalho de transposição simples e versátil, que pode ser aplicado amplamente com bons resultados cosméticos e de vascularização. A análise retrospectiva de uma série de casos em que o retalho de Limberg foi utilizado para reconstruir defeitos resultantes de ressecções de tumores demonstrou tratar-se de técnica de fácil execução, com ótima evolução e viabilidade vascular

Local flaps are an excellent option for repairing the excision of skin tumors, where the primary closure of the defect would cause aesthetic and functional impairment. The rhomboid (Limberg) flap is a simple and versatile transposition flap that can be applied widely with good cosmetic and vascularization results. The retrospective analysis of a case series using the Limberg flap to reconstruct defects resulting from tumor resections proved to be easy to perform, with excellent evolution and vascular viability

Case report: The use of three-dimensional biomodels for surgical planning of rib fixation.

BACKGROUND: Prosthetic titanium plates are frequently used in the stabilization of rib fractures and are typically contoured to the patient's anatomy at the time of implant in the operating room. Smith et al. [17] described the use of a 3D prototype biomodel of his patient's skeletal anatomy for preoperative customization of standard titanium plates for rib fractures. This process facilitated the preoperative planning and provided implants appropriate for a patient's unique anatomy. Further, the approach facilitated repair of complex fractures and may decrease operating time. Besides that, it provides idealized conditions for plate shaping and may facilitate implantation. METHODS: We performed rib fixation combined with 3D biomodels for surgical planning for the first time in Brazil, achieving reduced operating time with a good outcome for our patient. RESULTS: Surgical planning was conducted one day before the surgery using a 3D printer to make a patient-specific model. The printing time of the model was 16 h. The 3D biomodel was used for simulating the surgical procedure, pre-molding the titanium plates, and measuring the screw sizes that would be used in the procedure. All five fractures were fixed on the 3D biomodel and the total simulation time was 58 min. We used four pre-contoured titanium plates of 1.5 mm thickness and one straight 1.5 mm thickness titanium plate. We used the printed model to measure screw size, as we would do in the surgery. After planning, the material was processed and sterilized according to the hospital standards to be implanted in the patient the following day. CONCLUSION: This is the second reported case of surgical stabilization of rib fractures using a 3D model. Both cases demonstrated the advantages of this approach. More studies are needed to validate the safety and benefits for the patient, as well as the impact on cost savings.

Alternativas de retalhos cutâneos para lesões dermatológicas na perna / Skin flap alternatives for dermatological lesions on the leg

A utilização de retalhos de pele para a cobertura de lesões é melhor opção do que o enxerto de pele, considerando-se a heterogeneidade do leito receptor após a ressecção do tumor e a maior segurança oferecida. Para melhor resultado devem ser levados em consideração também o local e a extensão da lesão, além da segurança da vascularização. Foram realizadas três ressecções com diferentes técnicas de cobertura. Os pacientes apresentaram excelente evolução, sem necroses ou deiscências.

The use of skin flaps for covering lesions is a better option than skin grafts, due to the diversity of the receptor area after the tumor's resection and the greater degree of safety. For better results, the lesion's location and extent, as well as the safety of the vascularization, should also be taken into account. Three resections were performed, with different coverage techniques. The patients had excellent development, without necrosis or dehiscence.