Cleft Lip Surgery in Sudan: Clinical Presentations, Early Outcomes, and Patient and Professional Satisfaction: A sub-Saharan African experience.

Background: Cleft lip and palate are the most common congenital craniofacial anomalies. They account for approximately 13% of all congenital anomalies. Objectives: To study the presentation of cleft lip and the early results of surgical repair among patients who presented to our centers. Methods: This was a hospital-based prospective cohort study of 72 patients who underwent cleft lip repair in Sudan. Results: The commonest age group was between 10-18 months. The male-to-female ratio was 2:1, and a family history of cleft lip was found in 2.8% of patients. The cleft lip was complete in 81.9%, incomplete in 12.5%, and hybrid in 5.6% of patients. Associated cleft palate was observed in 54 patients. Associated syndromes were found in 10 patients. The surgery was carried out in most patients at 9 months or less; in 4 patients, it was more than 18 months. Achievement of reasonable lip repair was moderate (50% collectively). High achievement was observed for criteria, such as accurate union (90.3%), and sub-moderate achievement in even vermillion border and cupid's bow (44%), low nose symmetry (30.6%), and quality of scar (18.1%). Early complications were reported at the rate of 13.9%. Patient satisfaction was 59.7%; however, the professionals showed higher satisfaction levels (66.7%). The anthropometric measurements of normal infants were moderately similar to those of the infants who underwent surgery. Conclusion: The patients with cleft lip showed early presentation, with a predominance of the male gender and left side pattern. The preliminary outcome of cleft lip repair was moderate, with variations in different criteria. Patient and professional satisfaction were above average.

Staged penile reconstruction with pedicled groin flap for penile shaft necrosis following circumcision.

A 10-year-old boy was referred by urologist to plastic surgery department with penile shaft necrosis after debridement of necrotic tissue and dry eschar that extends from the glans to the penile root and was started to separate. Also, they managed to insert urethral catheter. He had traditional circumcision 2 weeks earlier performed at home by a traditional health practitioner, resulting in full-thickness tissue loss involving skin and corpora cavernosa with sparing of the glans which was attached by stalk of scared tissue enveloping the spongiosum. After assessment and analysis of the defect was done, two-stage pedicled groin flap reconstruction was performed with satisfactory results. In this report, we are demonstrating procedure steps and outcome.