Iatrogenic deep musculocutaneous radiation injury following percutaneous coronary intervention.

Radiation-induced skin injury has been reported for multiple fluoroscopic procedures. Previous studies have indicated that prolonged fluoroscopic exposure during even a single percutaneous coronary intervention (PCI) may lead to cutaneous radiation injury. We document a novel case of deep muscle damage requiring wide local debridement and muscle flap reconstruction in a 59-year-old man with a large radiation-induced wound to the lower thoracic region following 1 prolonged PCI procedure. The deep muscular iatrogenic injury described in this report may be the source of significant morbidity. Recommendations to reduce radiation-induced damage include careful examination of the skin site before each procedure, minimized fluoroscopy time, utilization of pulse fluoroscopy, employment of radiation filters, and collimator s and rotation of the location of the image intensifier.

Surgical management of acquired (cicatricial) buried penis in an adult patient.

The pathological entity of the buried penis occurs most commonly in children and is usually managed by urologists. Its presentation in the adult population may invoke plastic surgery expertise. The pathophysiology of buried penis in the adult is entirely distinct from that in children, and management principles may be complicated. Many plastic surgeons are unaware of the entity, even though they may be called to assist urology specialists in the management of complications in an adult patient. Not surprisingly, precious little information is available in the plastic surgical literature to provide management guidelines for this condition. This report highlights evaluation and management principles in an unusual case of adult (acquired, cicatricial) buried penis, and helps define the role of the plastic surgeon in such cases.