External ear carcinoma: evaluation of surgical and reconstructive management with postauricular island flap.

Introduction: Cancers of the auricle and the external auditory canal (EAC) remain a relevant oncological problem. Aim: Presentation of the results after resections of conchal bowl and EAC carcinoma (with or without radical mastoid surgery) and after reconstructions (postauricular island flap - PIF). Material and methods: We analysed results of 37 patients with cancers of the auricular conchal bowl and EAC after tumour resection and reconstruction (2000-2017). Results: The cancers were completely excised in all patients, with no recurrences within at least 5 years after surgery. We noted venous congestion in 22 (59.4%) cases, pinning of the operated ear in 18 (48.6%), prominent earlobe in 14 (37.8%), and EAC constriction in 6 (16.2%) cases treated without radical mastoid surgery. Conclusions: Retroauricular approach in cancer of the auricular concha and EAC allowed for accurate evaluation of the tumour extent and proper surgical access, which facilitated complete removal of the tumour. Use of radical mastoid operation with conchal bowl resection and PIF reconstruction in patients with aquamous cell carcinoma or infiltrating basal cell carcinoma of auricular concha and osseous EAC resulted in cancer extirpation and good aesthetic outcomes, despite minor functional consequences. In these cancers mastoidectomy offered a wider access to determine the radicality of oncological resection.

Degloving lower leg injury - the importance of additional treatment: negative pressure and hyperbaric oxygen therapy.

Degloving injury poses a severe therapeutic challenge concerning both trauma and plastic surgery. The injury involves separation of skin and subcutaneous tissue from fascia and muscles. Treatment is often long-lasting and brings unsatisfying results due to the extent of damage, risk of infection and massive blood loss. In this article, we present the management and therapeutic outcomes of a patient admitted due to the degloving injury of the lower extremity caused by workplace accident. We described the complexity of treatment including surgical intervention as well as additional treatment, which combined brought good esthetic outcome.

Digit ratio (2D:4D) and postoperative pain perception.

BACKGROUNDS: It has not been established whether sex differences in pain perception are influenced by prenatal sex hormones. Digit ratio as an indicator of prenatal hormone exposure can be used as a simple measure of the influence of prenatal hormones on pain sensitivity or perception in adulthood. OBJECTIVE: The aim of this study was to determine a correlation between the 2D:4D ratio and pain perception in the postoperative period after rhinoplasty. METHOD: A prospective cohort study of 100 patients (50 women of the mean age of 30.74±8.09years and 50 men of the mean age of 30.98±10.86years) who underwent posttraumatic rhinoplasty due to the nose trauma in Plastic, Reconstructive and Aesthetic Surgery Clinic. The following measurements were taken the day before a surgery: body height, waist and hip circumference, II and IV digits' lengths and body weight. All subjects filled in a questionnaire including 0-10-point VAS scales to assess postoperative pain 1h after an operation (AO), 6h AO, 12h AO, 24h AO and 48h AO. RESULTS: Women with low 2D:4D reported significantly more pain 1h after an operation than women with high 2D:4D. Similar correlation was observed for low 2D:4D in women 48h AO. In men, low 2D:4D was associated with lower postoperative pain 12h AO (p=0.029). CONCLUSION: In conclusion, we showed that low 2D:4D in women was associated with high postoperative pain, and low right 2D:4D in men was associated with low postoperative pain. This may suggest that intrauterine estrogen exposure makes women more resistant to pain.

CAN BODY PROPORTIONS SERVE AS A PREDICTOR OF RISK-TAKING BEHAVIOURS IN WOMEN AND MEN?

The second to fourth digit ratio (2D:4D) is claimed to be a biomarker of prenatal sex steroids. This study compared 2D:4D and waist-hip ratio (WHR) in men and women with nose deformity caused by injuries suggesting risky behaviour with those of unaffected controls. This kind of facial trauma was accepted as an indicator of risk-taking behaviour. The study involved 100 patients (50 women aged 30.74±8.09 years and 50 men aged 30.98±10.86 years) who underwent rhinoplasty due to nose trauma in a hospital in Lódz, Poland, in 2015. For comparison purposes, a control sample of 70 women (aged 23.03±3.36 years) and 70 men (aged 22.87±3.46 years) was recruited. In both groups the following measurements were taken: body height, waist and hip circumferences, II and IV digit lengths and body weight. The results showed that women and men who had suffered nose injury had significantly higher values of WHR than controls. The 2D:4D in women with post-traumatic nose deformity was significantly different than the ratio in control women (p<0.0001) and presented the male pattern. It is concluded that in women risky behaviours seem to be associated with prenatal sex hormone influence, while differences in WHR suggest that this tendency is also related to postnatal hormonal factors. Risky behaviours in men should be linked to postnatal hormonal changes rather than to increased prenatal androgen exposure.

Dermatoscopy as a Helpful Tool in Plastic Surgeon's Practice - A Preliminary Study.

UNLABELLED: The aim of the study was to examine the utility of dermatoscopy in plastic surgeons' practice in pigmented and non-pigmented skin lesions management. MATERIAL AND METHODS: The examined group consisted of 68 patients with 132 lesions (50 women and 18 men) aged from 12 to 75 years (the mean: 47.2 years ± 16.9 years), who underwent dermatoscopy. Dermatoscopic photographs were analysed according to the ABCD and 7-point scales and then, a further treatment (surgical excision, electro resection or regular follow-up and observations) was planned. RESULTS: The mean score of all lesions according to ABCD scale was 2.34 while in 7-point scale it was 0.62. In male and female groups the number of lesions and their ABCD and 7-point scale scores were similar (p>0.05). Histopathological examination revealed that all excised lesions were benign (compound melanocytic nevi) which corresponded with dermatoscopic evaluation. CONCLUSIONS: Dermatoscopy seems to be helpful in surgeons' dealing with skin lesions practise and in many cases it enables to choose less invasive technique of lesions' removal (electro resection), which gives better aesthetic results.