Background: Unintentional injuries are one of the most important public health problems among children in developed and some developing countries. Aim: Our purpose is to determine the prevalence of everyday life unintentional injuries among children admitted for at least 24 hours in the pediatric surgical emergencies (PSE) department, Children’s hospital of Rabat, Morocco. Methods: A cross-sectional study of unintentional injuries in children was undertaken over 4 years (2016- 2019) in the pediatric surgical emergencies (PSE) department, Children’s hospital of Rabat, Morocco. The data were analysed by statistical software Jamovi 1.6.23. Drownings and foreign bodies were excluded. Results: 1204 patients were screened, of which 545 files were studied. The median age was 8 years[4;12] with 36,5% were less than 6 years old, 70,4% were boys. The most injuries occurred mostly during winters and summers (41,6 vs 33,8%). The medical insurance plan was provided by compulsory medical insurance (AMO) and RAMED (Medical Assistance Scheme) (30,4% and 46.5% respectively). The main circumstances were accidents of everyday life (52%) with predominance of falls. For the public road accident, pedestrians were predominant. Hospital stay did not exceed 24 hours (73%) mainly in the surgical emergency department.
Neonatal testicular torsion (NTT) was first described by Taylor et al. in 1897 [1]. It can be unilateral or less frequently, bilateral. It’s a rare disease that occurs in neonate estimated at 1 in 7500 newborns [2]. Our case report is about a 9 days old male presented with a history of a swelling and irreducible inguinal hernia. Upon admission an ultrasonography was done and reported a right inguinoscrotal hernia. Surgical exploration was performed and the exploration found an extravaginally testicular torsion with a necrotic testicular associated with an inguinal hernia sac. Inside the sac we found a vermiform appendix non perforated known as amyand’s hernia.
The reverse sural artery flap (RSAF) was first described approximately four decades ago in 1983 by Donski and Fogdestam [1] and has since been used frequently for reconstruction of soft tissue defects in the distal part of the leg. Coverage of soft-tissue defects of the ankle and foot is often challenging. The distally based sural fascio-cutaneous flap is useful for reconstructing the lower leg, ankle, heel, and foot but has rarely been evaluated in paediatric patients. The objectives of this study were to assess the reliability of this flap in children, to get a global experience with the sural flap in our department of plastic and reconstructive pediatric surgery, and to describe the complications. Material and methods: A distally based sural fascio-cutaneous flap was used to cover soft-tissue defects of the ankle and foot in 5 paediatric patients between 2018 and 2021. The median age of patient at surgery was 6 years old. The most frequent mechanism of soft tissue defect was trauma caused by vehicular accident (open fractures) crush injuries, lacerated wound. Results: One of the 5 flaps was a cross leg sural flap, 4 recovered well without necrosis, only one developed partial necrosis requiring excision and skin grafting. The other complications where an early postoperative complications: partial or total necrosis of the flap late complications including impaired touch sensation over the flap and donorsite. Discussion: The distally based sural fascio-cutaneous flap is a method of choice for covering soft-tissue defects of the ankle and foot in paediatric patients. This reliable flap spares the major blood vessels and has a good blood supply. When there is exposure of a vital structure, distal sural flap is the best indication for coverage in a traumatic soft-tissue defect. The use of a distally based sural fascio cutaneous flap is not free from delayed complications most of them at the donor site.
Unintentional accidents are very common in children and are the main reason for consultation and hospitalization in paediatric surgery. Aim: To determine the factors associated with unintentional accidents resulting in hospitalization. Material and methods: This is a cross sectional study carried out in the Paediatric Surgical Emergency Department of the Children's Hospital of Rabat over a period of 4 years. We processed 1205 children's files; the data was collected and analysed by Jamovi. Results: for the 545 files selected, the median was 8 years [4; 12] and boys were predominant (70.4%). Sociodemographic factors were represented by low health insurance. In 95.1% of cases, the family lived in a house (50.1%) or an apartment (45%) compared to 4.9% who had insanitary house. For parents' level of education, fathers had a high school education (43.6%) or never attended school (16.9%), compared to 32.9% of mothers who did not attend school. No adult was present during the accident (54.6%). The accident occurred on weekdays (73.2%), especially on winter and summer (41.6% and 33.8%). The main lesions were fractures (53%). The lesions involved the limbs (52.5%) and the head (30.2%) and were multiple in 6.5% of cases. The outcome was simple in 96.1%.
Unintentional injuries (UI) correspond to “unplanned” events; they include everyday life injuries (EDL), road traffic accident (RTA) and work accidents. In our pediatric context, the latter are excluded. Aim: Draw up an epidemiological profile of UI in children hospitalized for at least 24 hours and make a comparison between EDL and RTA. Material and Methods: A cross-sectional study conducted during four years, about children hospitalized for UI, in the pediatric surgical emergency department (PSE) of the children's hospital of Rabat, Morocco. Sociodemographic and medical data were analyzed by statistical software (JAMOVI). Results: 545 files were retained. EDL represented 81.9 % with a male predominance (70.4%). The median age was 8 years [4; 12] with predominance of school children (63.5%). Infants predominated in EDL (15.1%). Spring has a predominance in RTA (33%), while there is a reversal of the trend for the other seasons (p<0.05). As regards the accident, the majority occurred on weekdays. The injured body parts were multiple for the RTA (39.1%) and affected the limbs (58.5%) for the EDL (p <0.05). Radiological abnormalities were found in 79.6% of cases in EDL. The 24-hour hospital stay was for EDL (66.7%) while RTA is hospitalized beyond 48 hours (53.7%).
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