The emergence of vaccines for coronavirus disease 2019 (COVID-19) raises risk of possible adverse events from interaction between the vaccines and facial aesthetic care. A 47-year-old female with no medical comorbidities visited our emergency room due to midface painful swelling after 3 hours following receiving the second dose of the messenger RNA BNT162b2 COVID-19 vaccine. About 14 years ago, she underwent nonsurgical augmentation on the nasojugal groove with a calcium hydroxylapatite dermal filler. We performed incision and drainage under general anesthesia on the next day. During operation, yellowish pus-like materials bulged out. After an operation, we performed a combination therapy with antibiotics and methylprednisolone. Her symptoms improved day by day after surgery, and then a complete recovery was achieved at 3 weeks after the treatment. In conclusion, providers of aesthetic procedures are to be aware of the potential risks of such vaccines for patients who already had or seek to receive dermal filler injections.

Purpose While plastic surgeons have been historically indispensable in reconstruction of posttraumatic defects, their role in Level I trauma centers around the world has not yet been clearly approved. This study aims to assess the contribution of plastic surgeons in major trauma care by evaluating the characteristics of trauma patients underwent plastic surgery at a Level I trauma center. Method From November 2014 to October 2020, we conducted a retrospective review of our hospital’s Trauma Registry System for patients with an Injury Severity Score (ISS) of 9 or higher. Of all of 7174 patients, the plastic surgery (PS) department treated 870 patients; the 6304 patients not treated by the PS were classified as the Non-PS. Then, we performed propensity score matching to reduce the statistical bias, after the death in the emergency room and the missing value were considered exclusion criteria. Result The mean ISS showed no significant difference between two groups (16.29 ± 7.04 in the PS vs. 16.68 ± 9.16 in the Non-PS, p = 0.3221). According to investigate the Abbreviated Injury Scale, both head and neck (65.0%) and face (46.4%) categories showed significantly higher in the PS group than the Non-PS group (p < 0.0001), and its contribution ratio was 2.151 and 21.822 times, respectively. Conclusion This study revealed the specialty of plastic surgery was face area in trauma care. We thus argue that plastic surgical care is imperative for trauma patients, and expect to be implicated in trauma system planning.

Background: Treating panfacial fractures (PFFs) can be extremely difficult even for experienced surgeons. Although several authors have attempted to systemize the surgical approach, performing surgery by applying a unidirectional sequence is much more difficult in practice. The purpose of this study was to review the literature on PFF surgery sequence and to understand how different surgical specialists–plastic reconstructive surgery (PRS) and oral maxillofacial surgery (OMS)–chose sequence and review PFFs fixation sequence in clinical cases.Methods: The PubMed and Google Scholar databases were scoured for publications published up until May 2020. Data extracted from the studies using standard templates included fracture part, fixation sequence, originating specialist, and the countries. Bibliographic details like author and year of publication were also extracted. Also, we reviewed the data for PFFs patients in the Trauma Registry System of Dankook University Hospital from 2011 to 2021.Results: In total, 240 articles were identified. This study comprised 22 studies after screening and full-text analysis. Sixteen studies (12 OMS specialists and 4 PRS specialists) used a “bottom-top” approach, whereas three studies (1 OMS specialist and 2 PRS specialists) used a “top-bottom” method. However, three studies (only OMS specialists) reported on both sequences. In our hospital, there were a total of 124 patients with PFF who were treated during 2011 to 2021; 64 (51.6%) were in upper-middle parts, 52 (41.9%) were in mid-lower parts, and eight (6.5%) were in three parts.Conclusion: Bottom-top sequencing was mainly used in OMS specialists, and top-bottom sequencing was used at a similar rate by two specialists in literature review. In our experience, however, it was hard to consistently implement unidirectional sequence suggested by a literature review. We realigned the reliable and stable buttresses first with tailoring individually for each patient, rather than proceeding in the unidirectional sequence like bottom-top or top-bottom.

Degloving injuries over the entire lower extremities may result in significant complications such as infection and may even lead to death. Therefore, the establishment of an effective treatment strategy is important. In this study, we propose a treatment strategy after examining cases of patients with entire lower extremity degloving injuries. A retrospective analysis was conducted on three patients who were all treated according to the established strategy. We divided the strategy into three time sequences: initial treatment; intensive medical care and wound bed preparation for skin graft; and skin graft. The patients’ progress was assessed to demonstrate the efficacy of the strategy. Three female patients with no underlying diseases were included, and the mean age was 58.0±15.7 years (range, 44–75 years). The mean C-reactive protein level was the highest on day 3 after the injury and sharply reduced up to day 14.3 on average. After treatment, joint motion was limited in all cases, but it gradually improved with rehabilitation. Unfortunately, all patients suffered from post-traumatic stress disorders. We established a treatment strategy for patients with entire lower extremity degloving injury using a comprehensive approach and achieved satisfactory results.

Closed flexor tendon ruptures are uncommon, and most are avulsion ruptures from the tendon insertion. Such intratendinous ruptures are generally associated with an underlying pathological process such as inflammatory disease; purely spontaneous ruptures are very rare. A 66-year-old male patient presented with sudden loss of flexion in the left little finger distal interphalangeal joint (DIPJ) while rotating a steering wheel. Preoperative ultrasonography and magnetic resonance imaging (MRI) suggested a closed flexor digitorum profundus (FDP) injury in the substance of the tendon. Surgical exploration revealed a zone III rupture in the FDP tendon. After tenorrhaphy, early postoperative exercise using a dynamic splint was initiated. At 8 months’ follow-up, he had regained flexion of the DIPJ and was free of pain. We recommend that patients with suspected closed flexor tendon injuries promptly undergo preoperative imaging studies such as ultrasonography or MRI to determine the rupture site, facilitating preoperative planning and reducing surgical morbidity.