Versatility of cervicofacial flap in management of cutaneous cheek defects post tumour excision: a report of two cases.

Reconstructing a large cutaneous cheek defect post tumour excision poses a great challenge to the reconstructive surgeon. The surgical options are limited for a functional and aesthetically acceptable outcome. The microvascular free flap which is currently the gold standard is still not a common place in our practice in Nigeria. Cervicofacial flap, a single stage procedure, offers an excellent alternative as it can be done for patients who are not fit for prolonged anesthesia and can even be undertaken under local anesthesia. We presented two cases of patients with cheek tumors who had wide local excision after histological diagnosis of Basal Cell Carcinoma and Basaloid Squamous Cell Carcinoma. Both defects were closed with cervicofacial flap under general anesthesia. The flaps survived with no loss. Cheek defect reconstruction with cervicofacial flap is simple, reliable and with similar favourable aesthetic outcome when compared with free flap procedure. It should be an important part of a reconstructive surgeon armamentarium.

Low Grade Fibromyxoid Sarcoma of the Parotid in a 5-year-old Child.

Low-grade fibromyxoid sarcoma (LGFMS) is a rare slow-growing malignant tumour with a deceptively benign histologic appearance. It typically involves young or middle-aged adults. These tumours usually occur in the proximal extremities and trunk. Sporadically they may be found in unusual locations leading to diagnostic dilemma. We report a 5year old boy that presented with painless right parotid swelling of 6 weeks duration. There was a 12-week presentation-to-diagnosis delay, due to the initial misdiagnosis as Burkitt's lymphoma that was entertained because of the region involved, rate of progression and endemicity of Burkitt's in our setting. Compromise of the aerodigestive tract was a major challenge, in addition to early recurrence and metastasis. We advocate for high index of suspicion, prompt tissue diagnosis and multidisciplinary intervention for better outcome.

Haematological indices of sickle cell patients with chronic leg ulcers on compression therapy.

BACKGROUND: Recurrent chronic leg ulcers and its are morbidities associated with sickle cell anaemia (SCA). Compression therapy increases the rate of healing of these ulcers and also decreases the rate of recurrence. OBJECTIVE: This study evaluated the haematological parameters of patients with SCA and chronic leg ulcers placed on high compression bandaging to provide data for improved ulcer management and prevention. METHODS: Eighteen patients with SCA and chronic leg ulcers were recruited for treatment by compression therapy in Ibadan, Nigeria, from March to June 2015. Eighteen SCA patients with no history of chronic leg ulcers were age and sex matched and recruited as controls. Blood samples, wound biopsies and swabs were collected at different time points for full blood count, microbiology, culture and antimicrobial susceptibility tests. Haemoglobin variants were quantified by high performance liquid chromatography. Fasting blood sugar was tested for leg ulcer patients to determine diabetic status. RESULTS: Ulcers ranged from 0.5 cm2 to 416 cm2 (median: 38.4 cm2). Post-intervention ulcer size ranged from 0.0 cm2 to 272 cm2 (median: 18.6 cm2, p < 0.001); four ulcers completely healed. Compared to the control group, haematological indices at commencement of treatment were more severe in leg ulcer patients (p = 0.02). No patients with chronic leg ulcer was diabetic. Microorganisms isolated from the leg ulcers include Pseudomonas aeruginosa, Staphylococcus aureus, Proteus sp., Escherichia coli and Klebsiella oxytoca. CONCLUSION: Measures to improve haematological parameters during leg ulcer treatment in SCA patients should be taken to aid wound healing.