Objective: Hemangioma is the most common benign cutaneous vascular tumor in infants and children. Oral propranolol hydrochloride is a safe and effective medication for treating infantile hemangioma (IH), with decreases in IH volume, color, and elevation. This study reviews propranolol use in IH. Materials and Methods: We conducted a prospective study of IHs treated with oral propranolol between January 2009 and June 2015. We included 300 children between the ages of 3 months and 5 years with fast-growing IHs in the proliferative phase, ulcerated IHs, and IHs that could cause functional or esthetic problems after the proliferative phase. They received propranolol 2 mg/kg/day, divided 3–4 times daily for 6–12 months and monitored in an outpatient basis. Response to treatment, time of initial, and peak response as well as side effects and sequelae were recorded. Results: We analyzed 300 IH cases. All the IHs responded to treatment; response was excellent in 45% of the cases, good in 30%, minimal in 15%, and none in 10%. No serious side effects were observed. Conclusion: In our study, we concluded that oral propranolol is efficacious and safe, with a careful dosing and monitoring regimen for IH.

Background: The management of lower limb soft tissue defects is still a challenge in our setting. Aims: This study aimed to review the clinical and socio-demographic characteristics of the patients with traumatic lower limbs defect and evaluate the results of surgical management in our setting. Settings and Design: Retrospective descriptive study. Materials and Methods: The charts of 30 adults patients treated surgically for lower limb soft tissue defects in the period from 1 January to 31 December 2014 were reviewed. Socio-demographic, clinical and therapeutic characteristics were documented. Statistical Analysis Used: The results were as general descriptive statistics, presented as medians, percentages and ranges. Results: The mean age was 34 years (range 18–60 years). The sex ratio was 3.28 for men. In 83% of the cases (20/30), injuries were due to collision between motorcycle and other vehicles. Soft tissue defects were type III B (50%, 15/30) and III A (47%, 14/30) of Gustilo-Anderson classification. The mean time between injury and reconstructive surgery was 48 days (range 14–118 days). Reconstruction techniques were mostly split skin graft (53%, 16/30) and neuro-sural distal pedicled flaps (20%, 6/30). Five cases of persistent osteomyelitis were observed. Conclusion: The non-availability of microsurgery limited our practice to regional and local flaps that gave good results and protected bone fractures that mainly healed in acceptable time.

Aims and Objective: This study was carried out to show modified Mathieu’s procedure to reduce the rate of complications of Mathieu’s procedure for the repair of primary distal hypospadias. Settings and Design: Prospective study. Materials and Methods: This study was carried out in the Department of Paediatric Surgery from March 2012 to March 2016. Children between 3 and 12 years were included in the study. We managed 40 patients with primary distal hypospadias. Those who had previous repair, chordee were excluded from the study. After a detailed history, local examination was performed with reference to the site and shape of meatus, glandular groove, penile size, and presence of chordee. Modified Mathieu’s was performed in 40 patients. On follow-up, the patients were examined for the position and the shape of the meatus, urinary stream, urethrocutaneous fistula, and stricture formation. Statistical Analysis Used: Done. Results: The mean age of the presentation was 7.5 ± 2.68 years (range 3–12 years). The mean operative time was 52.37 ± 5.42 min in modified Mathieu’s repair. Complications after surgery were urethrocutaneous fistula in one (2.5%), glandular disruption in 2 (5%), meatal stenosis in zero, wound infection in zero cases in modified Mathieu’s repair. The shape of meatus was near to rounded in all patients who had undergone modified Mathieu’s repair, which was accepted by parents cosmetically and with urinary stream in our study. Conclusion: The modified Mathieu’s repair is significantly faster with less complication in spite of having round-shaped meatus, which was cosmetically and with good urinary stream accepted by parents in our study.

Objective: To study the determinants of hospital length of stay among skin cancer patients in a teaching hospital in North-Central, Nigeria. Patients and Methods: A 3-year retrospective study of patients with histologically confirmed skin cancers presenting to our institution from April 1, 2012 to March 31, 2015 was conducted. Relevant data were extracted from the patients’ records and subjected to statistical analysis (frequencies, cross tabulation and χ² tests). Results: Records were available for 43 patients with a mean age of 46 ± 18 years. There were 21 males and 22 females with a M:F ratio of approximately 1:1. The length of hospital stay (LOS) ranged from 0 to 63 days with a mean of 14 ± 15 days. Most (51.2%) patients spent <8 days in hospital with the 20–29 years age group spending the least time. Married patients had longer LOS than unmarried patients. Patients who are human immunodeficiency virus (HIV)-positive, artisans and students along with patients with facial and multifocal lesions had shorter LOS. Patients who delayed their presentation, underwent major surgery, had complications and had melanomas had longer LOS. Conclusion: The study found the patients’ marital status, occupation, location of the lesion, type of surgery performed, histologic diagnosis and complications were significant factors in determining the patients’ LOS.

The reconstruction of extensive lower lip defects is challenging. Various options have been described for reconstructing limited extent of full thickness defects of the lower lip; however, the reconstructive options get narrower as the defect approaches 100%. Local flaps play the prominent roles in smaller defects but regional and distant flaps become the preferred choices in total and near total defects. We present the use of an in-folded extended pedicled deltopectoral flap for the reconstruction of complete lower lip defect. A 58-year-old woman presented with complete lower lip defect following failed local flaps previously employed to reconstruct the lower lip after excision of squamous cell carcinoma at another facility. She had extensive perioral scaring with complete exposure of the lower dentition. She had scar excision and two staged lower lip reconstruction with in-folded extended deltopectoral flap with satisfactory outcome. We report the successful restoration of oral competence and satisfactory esthetic outcome with the use of a simple deltopectoral flap for complete lower lip defect.

The calcaneus has a fundamental role in weight bearing and gait. Open fractures of the calcaneus with complex soft tissue and bone defects represent a reconstructive challenge. Such fractures require specialized care and demand attention despite its low incidence. We report our experience in the management of a 50-year-old man with a Gustilo-Anderson type IIIB fracture of the right calcaneus complicated with extensive soft tissue defect and chronic osteomyelitis. He had a two-stage reconstruction. The soft tissue defect was reconstructed with an anterolateral thigh flap and the bone defect with a vascularized fibula osteocutaneous flap.