Idiopathic scrotal calcinosis is a rare, painless and benign disease characterized by the presence of multiple painless calcified nodules of the scrotum with no abnormalities of phosphocalcic metabolism. The main reason for consult among patients is the aesthetic discomfort. Histology shows basophilic calcium deposits in the scrotal dermis and calcified fibroids surrounded by foreign body giant cell granulomas. Treatment is based on surgical removal of the nodules. We report the case of a 27-year-old patient with no notable pathological history who consulted for multiple cystic nodular lesions of the scrotum, painless and non- infected, with no notion of previous trauma, evolving for 12 years. The patient underwent surgical removal of the scrotal nodules under local anesthesia. No recurrence was noted; the follow-up was one year. After a review of the literature, we discuss the pathogenic, clinical and therapeutic aspects of this poorly understood pathology.

Introduction: superficial cutaneous angiomyxoma is a relatively recent individualization. It is a paucicellular, lobulated, poorly limited myxoid tumor containing numerous small blood vessels around which inflammatory elements, in particular neutrophils, are scattered. Case history: a 50-year-old patient with no previous medical history presented with an erythematous, ulcerated skin tumor on the left arm, measuring 5 cm long. A biopsy was performed, and the tumor was found to be a superficial angiomyxoma. The patient underwent surgical excision with 1 cm peripheral margins to avoid recurrence, and the loss of substance was closed in 2 planes. Postoperative follow-up was unremarkable. Conclusion: superficial angiomyxoma must be distinguished from other subcutaneous myxoid lesions. The sporadic form is characterized by its tendency to recur locally, especially in the case of associated epithelial components.

Introduction: Scalp defects are frequent in the daily practice of plastic surgeons. Their etiologies are multiple; they can be of tumoral origin, infectious, secondary to a burn, post-traumatic… The great vascular richness of the scalp explains the possibility of using local flaps. Clinical Case: This is an 80-year-old patient with ATCD: arterial hypertension under treatment. The onset of symptoms dates back 10 years when the patient was operated on by neurosurgeons for a frontal meningioma for which she underwent excision + cranioplasty. The patient presented after 10 years for cranioplasty rejection with signs of local infection. The decision to remove the prosthetic material and cover the loss of substance was taken. After removal of the cranioplasty material by the team of neurosurgeons, we decided to perform a bi-pedicled scalp flap vascularized by the occipital pedicle and the posterior auricular pedicle, the donor area was grafted. The postoperative course was unremarkable. The result was considered good without complications. Conclusion: The anatomical particularities of the scalp explain all the originality of the reconstructions of this region. In our patient, the advantage of using the bipediculated flap is its extreme reliability, especially when the cranial vault has to be sacrificed.

In this article, we will compare two surgical techniques most frequently used to treat scrotal defect, namely the thin skin graft and the superomedial fasciocutaneous thigh flap.

The causes of nasal defects are dominated by skin tumors; surgical excision of these tumors sometimes leaves a large skin defect, which represents a challenge to the plastic surgeon for reconstruction. In this article, we will describe from a clinical case, the particularities of the three-stage forehead flap in nasal reconstruction as described by F. Menick, and we compare it with the classic technique in terms of aesthetic result.

Beautifully shaped, “perky” breast is a symbol of youth and sexuality, and the lack of this trait can cause insecurity and self-esteem issues for many women. In this manuscript, we will describe the most frequently techniques used to manage breast ptosis, and the most common complications.

Covering the nasal defects represent a difficult challenge for the plastic surgeons, many techniques have been described in the literature but none has given good aesthetic results. In this article, we will describe the case of a patient who has a transfixing nasal defect, reconstructed by the 3-step forehead flap, as used in the department of reconstructive and plastic surgery of the Ibn Sina hospital in Rabat.

Gynecomastia is a benign enlargement of male breast; many techniques have been described for management but none have gained universal acceptance. In this article, we have described a challenging case of gynecomastia, which benefited from mastectomy, mastopexy and nipple reduction surgery, and we compare it with other therapeutic options in terms of complications and aesthetic outcome.

In this article, we have described two cases of Verneuil’s disease (H.S) which benefited from radical surgical excision, and followed by reconstruction of the axillary region with a TDAP perforator flap, and we carried out a literature review to highlight the interest of this technique and compare it with other therapeutic options in terms of complications, and also the functional and aesthetic outcome.

Psychiatric disorders in burn victims are well known and studied, but few articles treat the impact of pre-existing psychiatric pathologies on the evolution of burns. The aim of our study is to compare the evolution in terms of complications, length of stay and survival between patients with and without pre-existing mental disorders. This is a bi-centric case-control study (N = 92), conducted at the Plastic Surgery Department of Rabat University Hospital, and the Plastic Surgery Department of the Tangier-Morocco Regional Hospital, between January 2012 and February 2018. Characteristics of the patients were collected and two groups of patients were identified and compared (n = 67): a preexisting mental disorder group (n = 22) and a control group (n = 45). TBSA (total body surface area) burned and 2nd and 3rd degree burned TBSA were significantly greater in the group with a history of mental disorders compared to the control group (p = 0.012, p <0.001, p = 0.014). Mean length of stay before discharge was greater (p = 0.005). Finally, mortality in the group with pre-existing mental illness was 31.8% versus 6.7% in the control group (p = 0.011). Patients with pre-existing mental disorders seem to present worse burns and need more time to recover from them, resulting in higher morbidity and mortality and a higher cost of care. The systematic screening of burned patients in search of a psychiatric diagnosis and early management of these disorders could improve the prognosis and quality of life of these patients.

Massive influx of burns (thermal, chemical or electrical) is a potential crisis situation in the world in peacetime. In fact, burn is one of the most frequently encountered injuries following natural or human disasters. The management of a massive influx of burn victims is considered to be a real challenge, not only from a medical point of view but also from a logistical and organizational point of view. It is an exceptional event requiring exceptional organization and planning in advance, including systematically training medical and paramedical personnel, without forgetting ambulance and fire workers as they will be the first to arrive at the scene. Planning must necessarily include equipment for fast and effective support. We will present our experience in managing a massive influx of burns from a juvenile detention centre. We share it in order to help establish a better plan to deal with these rare but challenging situations.

15Oct 2019 RARE ANATOMIC VARIANT IN THE POLYGON OF WILLIS J. Hafidi , M. A. Mokfi , J. Oumerzouk , S. El Mazouz , N. Gharib , A. Abbassi , S. El Khloufi , M. L Bouchikhi , M. Jiddane and Y. Bjijou Laboratoire danatomie, de microchirurgie et chirurgie experimentale, faculte de medecine et de pharmacie de Rabat. Service de chirurgie plastique et des brules, hopital Ibn-Sina, Rabat. Service de neurologie, hopital militaire dinstruction Mohamed V.

J. Hafidi12, M.A. Mokfi2, M. Raboune2, S. El Mazouz2, N. Gharib2, A. Abbassi2, S. El Khloufi1, M.L Bouchikhi1, M. Jiddane1 and Y. Bjijou1. 1. Laboratoire d’anatomie, de microchirurgie et chirurgie expérimentale, faculté de médecine et de pharmacie de Rabat. 2. Service de chirurgie plastique et des brûlés, hôpital Ibn-Sina, Rabat. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 14 August 2019 Final Accepted: 16 September 2019 Published: October 2019

The traditional brazier remains a means of cooking and warming for thousands of families in isolated rural areas in Morocco. From simple burns due to accidental contact to limb carbonizations, these burns are all the more serious when they are secondary to epileptic seizures or carbon monoxide poisoning. The sequelae are important in the associated forms, mainly because of delay in management and non-adherence to therapeutic protocols by patients of low socioeconomic status.

Purpose. - To study the epidemiologic, clinical and histological aspects of eyelid carcinomas in our context, and to evaluate our surgical management on an oncological, functional and aesthetic level.Patients and methods. - This work is a retrospective bicentric study extended over a 5-year period between January 2009 and December 2013, including 64 patients with eyelid carcinoma undergoing surgery in the Plastic and Reconstructive Surgery Department at the Avicenne University Hospital of Rabat and in the ENT/Head and Neck Surgery Department at the Hassan II University Hospital of Fez.Results. - The study included 25 men and 39 women with a mean age of 60.6 +/- 15.33 years. Advanced age and chronic sun exposure were the most important risk factors. The most commonly involved site was the lower eyelid (53%). Histological examination emphasized the very high prevalence of basal cell carcinoma (90.62%). Surgical treatment was performed in all our patients followed by an extemporaneous and/or standard histological examination of the surgical specimen. Exenteration was performed in one patient with adjuvant radiation therapy. Reconstruction incorporated a variety of techniques, of which total skin graft and Mustarde flap were the most common in our series. Aside from a few complications, the postoperative results were satisfactory for the majority of our patients.Conclusion. - Malignant tumors of the eyelids, of which basal cell carcinoma is the most common, pose a therapeutic problem where surgery remains the most utilized treatment option. The best treatment is prevention and diagnosis of early lesions to improve prognosis and to avoid worse outcomes. (C) 2015 Elsevier Masson SAS. All rights reserved.

Les sourcils jouent un rôle important dans l'équilibre esthétique du visage. Leur reconstruction ou ophriopoïése, après séquelle de brûlure fait partie intégrante du programme de réhabilitation de la face brûlée. Plusieurs techniques ont été décrites. Nous insistons ici sur l'intérêt d'une technique simple, à la portée de tous les chirurgiens, et dont la méthode et les résultats peuvent être améliorés par un dessin bien planifié des zones donneuse et receveuse: la greffe composite prélevée au niveau du cuir chevelu dessinée à l'aide d'un calque du sourcil controlatéral.

Introduction: A missed or neglected foreign body (NFB) is not infrequent in surgical practice. It constitutes a common reason for consultation later; location and removal of foreign bodies can be difficult because of possible inflammation, induration, granulated tissue and fibrous scar. This paper describes a simple method for the quick localization and surgical removal of NFB using two 25 gauge needles. Materials and Methods: In this paper we report the experience of department of plastic and reconstructive surgery in Ibn Sina Teaching Hospital in Rabat, conducted on ten patients in terms of the use of two 25-gauge needles was used in 12 NFB in soft tissue in order to achieve proper localization and fixation of foreign bodies during surgery. Results: Results were satisfactory in most of our Patients, surgical removal was successful in 11 of 12 NFB. Conclusion: Needle guided technique allows the successful surgical removal of NFB using minimal soft tissue exploration and dissection via proper localization, fixation, and propulsion of the foreign body toward the surface of the skin.

Introduction: A missed or neglected foreign body (NFB) is not infrequent in surgical practice. It constitutes a common reason for consultation later. Location and removal of foreign bodies can be difficult because of possible inflammation, induration, granulated tissue and fibrous scar. This paper describes a simple method for the quick localization and surgical removal of NFB using two 25gauge needles. Materials and Methods: In this paper we report the experience of the department of plastic and reconstructive surgery in IbnSina Teaching Hospital in Rabat, conducted on twelve patients in terms of the use of two 25gauge needles in 12 NFB in soft tissue in order to achieve proper localization and fixation of foreign bodies during surgery. Results: Results were satisfactory in most of our patients; surgical removal was successful in 11 of 12 NFB. Conclusion: Needle guided technique allows the successful surgical removal of NFB using minimal soft tissue exploration and dissection via proper localization, fixation, and propulsion of the foreign body toward the surface of the skin.