Megacystis Microcolon Intestinal Hypoperistalsis Syndrome (MMIHS) is a rare motility disorder with high mortality rate described by Berdon in 1976. We present the first case of Berdon’s syndrome (heterozygous pathogenic variant in the ACTG2 gene) reported in Romania, a female newborn admitted in NICU “Marie S. Curie” Emergency Children’s Hospital Bucharest for intestinal obstruction after birth. Total parenteral nutrition, ileostomy, gastrostomy, clean intermittent bladder catheterisation, evaluation for multivisceral transplantation were performed. She was discharged from our NICU ward at the age of 4 years and 2 months with home total parenteral nutrition administered by her mother in sterile condition, clean intermittent catheterisation for bladder evacuation performed by her mother, monitored monthly for about three years, with normal cardio-respiratory function, no signs of thrombosis, she maintained relatively low platelet count without positive blood culture, good liver and renal function test. Normal neurological and psychomotor development according to age. Her course was complicated by multiorgan failure with death ensuing at the age of 7 years and 10 months.

We present the first successful case of extracorporeal membrane oxygenation (ECMO) at „M.S. Curie” Emergency Clinical Hospital for Children, Newborn Intensive Care Unit: a term neonate with cardiorespiratory failure secondary to left sided congenital diaphragmatic hernia. The patient was placed on veno-venous ECMO at three days of life;
however, on the fourth day, due to unstable right ventricular function, conversion to veno-arterial ECMO was mandatory. At one week of life, the patient was operated on-site for diaphragmatic hernia without ECMO support and then reintroduced on ECMO immediately after the surgical procedure, being on ECMO support for a total of 8 days. Antithrombotic treatment was administered for significant occlusion of the right common carotid artery and right internal jugular vein (complication of the cannulation for ECMO) and also long term treatment for Persistent Pulmonary Hypertension was needed. The patient was discharged at the age of four months with moderate neurodevelopmental delay. The literature review indicates that neonatal ECMO procedure in Romania is still in its early stages. Despite this state, our current case proves that ECMO can be successfully performed with increased chances of survival for neonates with severe prognosis after failure of conventional therapy.

Limb amputation has a severe somatic and psychological impact, that can furthermore have complications, which lead to increased morbidity, mortality, hospitalization days, health care costs, delay prosthetic application, and social reintegration. Proper therapeutic management must be initiated in cases with amputation stump complications to ensure the best result. This paper aims to present the therapeutic management of a patient with sepsis after above–the–knee amputation, performed after acute limb ischemia. The patient presented in our clinic 10 days postoperatively with local infection, wound dehiscence, and sepsis.

This article comes as a presentation of the clinical experience in the plastic surgery department. Gather the experience of 3 clinical cases, more representative, with different histopathological tumors, of important dimensions that occupied a large part of the facial anatomical unit, the nose. The article is structured by presenting the risk factors that are the causes of malignant lesions and by recalling the therapeutic options and general principles of addressing large lesions. Malignant lesions that occur most frequently in the nose are reviewed. We consider that it is a serious health problem, with various consequences, of a functional nature, which can affect the airways and aesthetically that can lead to a reconsideration of self-respect and the perception of the affected person towards his peers. The approach of the cases was done sequentially. The first surgical stage involved the excision of the lesion with the oncological safety limit, the defect being larger than the lesion and the more elaborate therapeutic options on the reconstruction scale. The first operative stage ended each time with covering the defect with a graft to have the confirmation of the histopathological examination, free of the tumor. The second stage of the treatment involved lifting the flap and accommodating it. The last surgical stage involved the sectioning of the pedicle and its reintegration into the donor area.

Cutaneous leiomyomas are uncommon benign smooth muscle tumors that comprise of three distinct types such as piloleiomyoma, angioleiomyoma, and genital leiomyoma. The discovery in 2001 of the association between cutaneous leiomyomas, uterine leiomyomas in women, and an aggressive form of renal cell cancer (RCC) underscores the importance of accurate dermatologic diagnosis of CL so that appropriate cancer screening and counseling of patients and at-risk relatives can be instituted. The present case report will discuss the pathogenesis, clinical manifestations, diagnosis, and management of a piloleiomyoma.

Almost known in the literature and underdiagnosed even in the obvious cases, Wartenberg syndrome is most often treated, superficially and as a result, with direct consequences on its evolution. These elements ultimately lead to loss of cases and reporting in the literature as a rarity or other condition of the radial nerve, superficial branch. It must be understood at first that the radial nerve is susceptible to compression in different ways along the anatomical path. Causes are all common in the upper limb, compression and trauma. The two elements (compression and trauma) affect the superficial branch of the radial nerve at the time of its passage between the brachioradial muscle and the supinator muscle, as a result the patients complain of ‘’hand pain‘’. They describe only sensitive disorders but not motor disorders. The pain is described distally by the radial foramen and is accompanied by paresthesia on the dorsal side of the hand. The present case shows a female person working in a car parts factory where they have to pick up considerable parts to inspect them. The pieces are positioned on different side, as a result he must use the muscles of the forearm to turn them.

This article completes the problem of nerve regeneration on the allograft model harvested from the same type of individual (in this case the Wistar laboratory mouse).The approach to major trauma produced by various mechanisms and the development of a well-established algorithm, applied in a multidisciplinary team, results in a distinctly different result, both sensory and motor recovery, depending on the operative technique, the operative logistics and the type of graft. The article explains the experimental model, the subjects that were previously prepared for the operating time, the type of anesthesia that was administered, explaining why dosages and administered substances were used, the techniques used in the two batches that are totally different anatomic approach path, different as a bed of nerve regeneration but with operating technicians that do not differ in the two batches. The results are visibly different and are compared by the fi ngerprint sample. The regeneration times are different, the sensitive recurrence, the resumption of motor activity differs very little in the variables of each lot but are appreciable and different as the dynamics and value from one batch to the other.

In the last century, the breast reconstruction after mastectomy has become an important element of the multicentric treatment of the patients suffering from breast cancer. Breast reconstruction was initially developed to reduce the complications of mastectomy and the deformations of the thoracic wall. Currently, it is known the fact that reconstruction can improve the psychosocial state and the quality of life of the patients with breast cancer[1]. [...]

In the last decades, the approach manner of the defects of the soft parts post-mastectomy developed significantly together with the innovative surgical techniques of oncoplastic surgery.
Among these techniques, the reconstruction of the breast with LD flap and implant continues to be a reliable and easy to perform method, both by the experi-enced surgeons and also for the beginners[1]. [...]

It is well known that the thumb is responsible for 40% of the hand function. Th erefore, preserving its length and mobility represents the main objective of the plastic surgeon while choosing the most appropriate reconstruction technique[1]. When resurfacing of the fingers is needed after hand injuries, cross-finger flaps have proved themselves very useful[2]. Since its premier many years ago[3], this type of flap remains an elegant method in order to cover exposed bones or tendons of the fi n-ger, in order to ensure length preservation and function recovery. [...]

Rhinophyma is a benign tumor characterized by a pro-gressive hypertrophy of the nose soft tissues, with a re-ddish and bulky appearance, affecting most frequently elderly Caucasian males[1], which may also cause functional airway obstruction. It is believed to be the end stage of severe acne rosacea, but the real cause and the exact etiology remain unknown[1]. The male to female ratio of rhinophyma patient varies between 5 to 1 and 30 to 1 [2,3]. The diagnosis is based on the clinical features of this rare and disfiguring disease using Rhinophyma Severity Index Score (RHISI)[4]. The main differential diagnosis is the basal cell carcinoma (BCC), with an occult incidence of 3% to 10% in patients with rhinophyma[1]. [...]

Postmastectomy radiation therapy decreases the incidence of locoregional disease recurrence in patients with invasive breast cancer and has been proven to reflect a survival advantage for patients with node positive disease[1,2]. The optimal timing and technique of breast reconstruction procedures in patients requiring post-mastectomy radiation therapy are controversial[1] . Patients undergoing postmastectomy breast reconstruction, with a history of prior radiation therapy, present a particular clinical scenario. This is because of their well-documented higher complication rates, secondary to deleterious effects of irradiation on the soft tissue envelope of the remaining breast. [...]

Hand surgery is considered to be the biggest challenge for every plastic surgeon. The social value of the hand is appreciated by any individual, butmostly by plastic surgeons which are, par excellence, hand-working persons. When a hand injury is treated you must consider the Hippocratic concept which states that "healing is a matter of time but it is sometimes also a matter of opportunity". The hand forms a functional unit with the forearm which is a high-precision machine, with multiples levers, who has tactile intelligence that ensure its auto-mechanism, being able to grab and maintain, in any spatial position, large and small tools invented by human genius. The hand is both a motor and sensory organ, and in terms of society,it is an organ of defense, an organ of creation and expression. This is why hand surgery is very important, both in medical and social terms, and any research in this domain has one purpose: improving the treatment of hand injuriesin order to obtain functional results closer to the genetic scale of the divine creation. The purpose of this study was to assess different osteosynthesis techniques in order to establish which one is better in matters of functional results. [...]

Cutaneous flaps are usually utilized in covering skin defects in different parts of the body. Facial reconstruction is an important topic for plastic and reconstructive surgeons, facial defects having a serious impact on patient’s quality of life. [...]

Non-melanoma skin cancer (NMSC) ranks as the fifth most costly cancer to treat in the United States even though the mortality rate is not high [1].
In Romania, the dermatologist is the one who generally detects skin cancer, but any clinician, especially the primary care physician who has a constant connection with the patient, plays an important role in skin cancer detection. In the early detection stage, a good collaboration with the plastic surgeon permits the surgical excision of the tumour with oncologic safety margins and primary suture, resulting in minimal costs [2]. Unfortunately, a great number of patients involved in our study (>84%) showed up in more advanced stages which required a reconstructive method.

Located between the popliteal fossa and the midportion of the calf, centered over de midline raphe, between the medial and lateral heads of the gastrocnemius muscle, the sural flap is the best known neurocutaneous flap of the leg. [1,2]
The sural angiosome was first introduced in practice by Ponten in 1981, when he reported the use of 23 fasciocutaneous proximally based flaps for soft tissue defects.[3] Donski and Fogdestam described the anatomy of the distally based sural flap and presented three clinical cases in 1982. [4]

Basal cell carcinoma (BCC) is known as the most common type of skin cancer with a rapidly rising incidence, 90 % of the cases occurring in the head and neck region. (1) The eyelids are involved in 10% of these cases, making it the most prominent eyelid malignancy. (2) It predominantly affects fair-skin individuals, notably type I and II Fitzpatrick photo types, most of them presenting with a positive history of chronic sunlight exposure. Etiology may be multifactorial, but sun exposure has been involved in most of the cases. (3) Basal cell carcinomas arise from the basal layer of the epidermis, probably as a result of activating the proto-oncogenes and inactivating the suppressor genes in the keratinocytes. (4)