[The value of the medial plantar flap in the repair of loss of soft tissue in the distal quarter of the leg]. / Intérêt du lambeau plantaire médial dans la réparation des pertes de substance du quart distal de la jambe.

OBJECTIVE: Soft tissue repair of the distal leg is a challenge for the surgeon. The objective of our work is to evaluate the interest of medial plantar flaps in the repair of soft tissue loss in the distal quarter of the leg, by highlighting the advantages and disadvantages of this technique. METHODS: We conducted a retrospective study over 4 years in the Department of Plastic, Reconstructive and Burn Surgery of the Mohammed V Military Teaching Hospital of Rabat, including 8 patients admitted for coverage of a distal quarter of the leg with a medial plantar flap. RESULTS: Eight patients were included, 5 men and 3 women with an average age of 45.5 years. All patients received coverage with a medial plantar flap. The functional and aesthetic results were very good with a low complication rate. CONCLUSION: The medial plantar flap should no longer be reserved for covering loss of substance of the foot only, but should be integrated into the therapeutic arsenal of reconstruction of the distal quarter of the leg.

[Necrotizing fasciitis of the thoracoabdominal wall complicating Dujarier's bandage: a case report]. / Fasciite nécrosante compliquant un bandage de Dujarier: à propos d'une observation.

The necrotizing fasciitis (NF) means a serious infection of the subcutis, the fascia and superficial dermis secondarily. We report the case of a patient with cellulitis NF of the thoracoabdominal wall complicating Dujarier's bandage. It was monobacterial NF caused by ß hemolytic streptococcus, whose development was supported through an appropriate medical and surgical care. The situation mentioned is the occurrence of secondary infection of skin necrosis occurred in the bandage too tight opposite the support zone of the elbow on the trunk. We point out, through this case, the importance of the medicosurgical and also the importance of making any thoracoabdominal bandage, which could lead, if it is tight, a pressure sore can be a door entry for any NF plus a late diagnosis.

[Rail plastic surgery technique in the treatment of popliteal contractures]. / La plastie en rail dans le traitement des brides rétractiles du creux poplite.

The case is presented of a patient aged 45 years suffering from thermal burns due to flame following the deflagration of a gas cylinder. The initial lesions involved the four limbs, in particular the knee, and the trunk. The initial taking in charge consisted in an early excision-graft of the limbs. The evolution of the burn was marked by the development of hypertrophic scars at the level of the non-transplanted zones and at the edge of the graft as also by the onset of contractures. Because of the functional problem caused by the contracture as a result of the considerably reduced extension, the patient was admitted for surgical treatment. Thanks to the rail technique described, the patient recovered normal knee function. Post-surgical treatment was straightforward with a hospitalization period of one month. The aesthetic results were satisfactory. The rail technique is part of the therapeutic arsenal for treating knee contractures. Its simplicity, easy technique, and satisfactory results, plus its easy follow-up, make it a highly appreciated technique in the treatment of this type of contracture.

[Burns and pregnancy: report on two cases and review of the literature]. / Brulure et Grossesse: A Propos de Deux Cas et Revue de la Litterature.

Les brûlures thermiques au cours de la grossesse sont rares, cependant elles requièrent une attention particulière du fait qu'elles engagent le pronostic maternel et foetal. Les Auteurs rapportent deux observations qui illustrent la gravité de cette association. Le traitement des brûlures pendant la grossesse connaît des particularités en rapport avec les modifications anatomiques et physiologiques de la gestation. Certains Auteurs ont préconisé des recommandations, comme en particulier le traitement précoce de la thrombose veineuse et la surveillance obstétricale avec un accouchement dirigé à l'approche du terme. La mortalité maternelle et périnatale augmente significativement à partir de 50% de la surface corporelle brûlée. De ce fait une prise en charge multidisciplinaire est indispensable. Le pronostic de brûlure chez la femme enceinte reste très réservé, d'où l'intérêt d'une prise en charge multidisciplinaire réunissant obstétricien, réanimateur et plasticien.

[Role of the aponeurotic variation of the posterior interosseous flap in the treatment of burns sequelae on the dorsum of the hand]. / Place du Lambeau Interosseux Posterieur dans sa Variante Aponevrotique dans le Traitement des Sequelles de Brulure de la Face Dorsale de la Main.

Le lambeau interosseux postérieur dans sa variante aponévrotique est un outil très intéressant dans le traitement des séquelles de brûlures de la face dorsale de la main. Les Auteurs cherchent, à travers un cas clinique et une revue de la littérature, à replacer cette variante dans l'arsenal thérapeutique.

[Burns by electric scalpel blade: four cases]. / Brulure par Plaque de Bistouri Electrique: a Propos de Quatre Cas.

A burn due to the plate of a diathermy knife is a rare but serious accident owing to the depth of the lesion and its localization, especially when it occurs in a surgical context that creates difficulties for both the patient and the surgeon. Such burns are unpredictable and also serious not only because of their location but also because they occur during a surgical operation in patients who are already ill. Such burns have to be dealt with by specialists. Prevention is the only way of avoiding this kind of accident.

[Not Available]. / Brulures par Bouillottes Chez les Diabetiques.

Diabetic neuropathy is a frequent complication of diabetes. The most frequent clinical form is known as "sock polyneuritis", with loss of sensitivity to pain in the feet. Hot water bottle burns are the prerogative of diabetic patients suffering from a form of sensitive polyneuropathy. Such burns are deep. It is difficult to take therapeutic responsibility and decisions must be multidisciplinary. We underline the importance of the education of diabetic patients and of arousing their awareness to the possible risks involved in the use of hot water bottles.