[Reconstructed breast burns following black clothes wearing and short sun exposure]. / Brûlures du sein reconstruit après port de vêtements noirs et exposition solaire modérée.

Breast reconstructions are plastic surgeries that female patients, who have undergone mastectomies, are increasingly using. While the morphological results are appreciated by patients themselves as being more and more satisfactory, results in terms of sensitivity remain uncertain and depend on type of reconstruction used. The chest wall skin already desensitized by mastectomy and exposed to radiotherapy presents disturbance of blood supply and innervation, likely responsible for impaired local thermoregulation that can easily lead to thermal burn injuries. Our paper presents a rare ethiopathological burn entity on the reconstructed breast: the association between short sun exposure and wearing black clothes. This aetiology of burns must be known by patients and by plastic surgeons in order to prevent dramatic clinical situations leading up to the loss of the reconstruction.

[Pyoderma gangrenosum: spontaneous healing after early diagnosis. Three cases and general review]. / Pyoderma gangrenosum : cicatrisation spontanée à la suite d'un diagnostic précoce. À propos de trois cas et revue générale.

INTRODUCTION: Pyoderma gangrenosum (PG) is a rare chronic inflammatory skin disease characterized by the recurring development of necrotizing and painful ulcers and therefore, often misinterpreted. This condition can simulate fulminant infection, particularly after surgery. The presentation is often impressive in extensive ulcerations and scarring and lead to significant sequelae. A rapid initial management avoids a dramatic evolution. PATIENTS AND METHODS: We report the case of three PG for patients followed for breast reconstruction after breast cancer. DISCUSSION: PG is a neutrophilic dermatosis that can occur after injuries of varying intensity. Its shape after surgery is a rare disease whose presentation loud and fast pace "infectious" contrasts with the absence of inflammatory lymphangitis or lymphadenopathy. Be aware of prescribing high doses of corticosteroids. CONCLUSION: These three cases illustrate the importance for early diagnosis and treatment of PG, who can allow spontaneous healing without complex surgery, always feared in this context.

[Complex breast reconstruction after severe chest trauma by firearm]. / Reconstruction complexe de la région mammaire après traumatisme thoracique grave par arme à feu.

This case report is of a 47-year-old woman who suffered a ballistic chest trauma with severe left hemothorax and heart wound. She was treated in emergency for the collapse by heart surgery. Then the coverage for her soft thorax tissue loss was done by an ipsilateral musculocutaneous latissimus dorsi pedicled flap. The patient was subsequently addressed to our team for a repair, especially for reconstruction of the left breast. Initially, rehabilitation of aesthetics units breast was achieved through the realization of an abdominal advancement flap, and breast volume was restored by several sessions of lipomodeling. The surgical alternatives were very limited for this post-traumatic complex breast reconstruction. Due to ballistic trauma, no reliable recipient vessels allowed a microsurgical solution, and the ipsilateral latissimus dorsi was used for the coverage. In conclusion, the restoration of the aesthetics units with lipomodeling has achieved a very good result in this extreme thoracomammary region repair.

[Breast rupture: presentation, diagnosis and treatment of two cases]. / Fracture du sein : présentation, diagnostic et prise en charge chirurgicale de deux cas.

INTRODUCTION: Breast rupture is an uncommon event that has become more frequent from the 1980s, with the generalisation of the seat belt, so that we can now speak of seat belt related injuries. The trauma is often forgotten and leaves a fibrous band in the breast as only mark. In this way, the breast can be deformed by the scar as much as the retraction is important. The clinical presentation can mime that of a breast cancer, so it is really important to do an echography and a mammography of the lesion. If some dilemma remains, IRM or core biopsy can be helpful. PATIENTS AND METHODS: We report two cases of breast rupture. A breast cancer has been excluded with echography and mammography. We performed a reduction mammoplasty, with inverted T scars, conserving a posterior glandular flap. We will present the observations in the article. DISCUSSION: A breast trauma often leads to haematomas, necrosis of fat and lipid cyst formation. Typically, these lesions are located in regard to the passage of the seat belt on the thorax. The surgical treatment should correct an oblique deformation. It is important to excise all the fibrous tissue and to reharmonize the glandular content. Moreover, in the accidentally discovered forms, one should take in mind the vascular damage determined by the lesions and be able to recognise its presentation before the operation. CONCLUSIONS: Breast rupture is a rare situation that should be known. The treatment is simple and consists in excising the fibrous tissue and replacing it with a well-vascularised tissue. The posterior glandular flap is a helpful tool in these situations.