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Aim of the study The aim of this study is to emphasize the principles of face burn management based on our personal experience correlated with published literature data. We aim to illustrate different possible approaches of treatment in order to obtain good functional and aesthetic outcomes. Material and methods The study group included 342 patients (144 females and 198 males), with ages ranging between 18 and 92 years old, hospitalized and treated in the Burn Unit from the “Sf. Spiridon” Emergency County Hospital from Iași, Romania, during december 2020 – october 2023. The inclusion criteria for the study were: patients over 18 years old, isolated burn lesions only of the face or in association with burn lesions distributed on various anatomical regions, burns of all degrees. Results The group included 144 females (42,1%) and 198 males (57,89%). The etiologies of the burns were represented by flame (123 cases) – 35,96%, scald (103 cases) – 30,11%, contact (52) – 15,20%, electrocutions (31) – 9,06% or ultraviolet exposure (33) – 9,64%. 134 patients (39,18%) had isolated lesions of the face and 208 patients (60,81%) associated other localisations as well. Out of the total number of cases, the majority (276 cases) – 69% were treated conservatory, while 31% required different forms of surgical interventions. Conclusions The management of facial burns must be multidisciplinary and early in the face of serious complications that may endanger the vital, functional and aesthetic prognosis. Periodic evaluations must be constant and involve the physical and mental status of the patient. Social, family and professional integration takes a significant place in the overall management of facial burns to limit the difficulty of reintegration of a person affected by burns.

Aim of the study The aim of the study was to confirm the effectiveness and safety of wide awake local anesthesia no tourniquet (WALANT) technique in hand surgery, as well as its necessity and importance during the COVID-19 pandemics. Material and methods A retrospective study was performed between March 2020 and September 2021 to evaluate advantages of WALANT, taking into consideration the rules imposed by the pandemic context. This study included 360 patients, treated for acute and chronic hand diseases. A statistical investigation was performed using SPSS 20.0 version software and applying the ANOVA regression, evaluating demographic, anatomical and surgical variables. Results: 234 males and 126 females, treated for acute hand trauma (metacarpal and phalanx fractures, tendon and nerves lesions) and chronic hand diseases such as carpal tunnel syndrome (CTS) dupuytren’s disease (DD), trigger finger (TF), soft tissue and bone tumors. The average patient waiting time from admission in the operating room was 13.95 minutes, while the mean time of onset of local anesthesia was 12.15 minutes. No complications such as distal digital bleeding, hematoma, the necessity of using the antidote, or necrosis occurred, the outcomes were very good and the patient satisfaction high. Conclusions: The WALANT technique can be considered the “gold standard” in hand surgery anesthesia during the COVID-19 pandemic, ensuring a correct and safe surgical treatment in the restrictive conditions imposed by the epidemiological context.

Background: The broad spectrum of diagnoses and clinical features of hand tumors and the absence of pathognomonic signs often lead to an inaccurate or delayed diagnosis. However, only a few reports have comprehensively referenced the diagnosis and clinical features of hand tumors. This study intends to highlight the clinical, imaging and histological characteristics of uncommon hand tumors or tumor-like lesions. Methods: In this retrospective study, we report a series of 80 patients diagnosed with rare hand tumors and tumor-like lesions without skin damage. Age, gender, tumor location, imaging examinations and clinical and laboratory findings were analyzed. The histopathological exam established the final diagnosis. Surgery was indicated and performed in all cases. Results: This study included: neurofibroma, glomus tumor, lipoma, schwannoma, epidermal inclusion cyst and idiopathic tenosynovitis with “rice bodies.” We have described the clinical, imagistic and histopathological particularities of these tumors. Surgical management included the complete removal of tumors, with no recurrence recorded within two years and overall high patient satisfaction. The most common findings were lipomas and the rarest neurofibromas. Conclusions: To optimize the care of hand tumors and reduce diagnostic and treatment errors, knowledge of hand tumor types and their clinical and laboratory characteristics is necessary for every surgeon.

Background: Lipomas are the most frequent benign soft tissue tumor that are rarely found in the hand and are exceptionally rare on the fingers. The aim of this study was to investigate lipomas of atypical locations, so that they can be taken into account when making a differential diagnosis of a tumor of the hand or fingers. Methods: We studied a group of 27 patients diagnosed with lipoma of the wrist, palm, and fingers. The diagnosis was made by clinical and imaging examinations. Surgical treatment was established based on symptoms of pain, paresthesias, functional impairment, or aesthetic concerns. Treatment outcomes were assessed clinically at 1.5 years post-intervention. Results: Sizes over 5 cm were recorded in five cases, with the largest lipoma being 8 by 5 by 3.5 cm in size and weighing 125 g, located in the palm. There was one case of spontaneous tendon rupture and one case of carpal tunnel syndrome. There was no recurrence recorded at 1.5-year follow-up. Conclusions: Lipomas in the palm and fingers are rare entities (with more men affected), and surgical treatment consists of complete removal of the tumor and providing definitive healing. Despite their rarity, clinicians should consider lipomas when making differential diagnoses of soft tissue tumors of the hand.

Background: Although schwannoma (neurilemmoma) is the most common tumor of the peripheral nerve, its low incidence, slow growth and vague symptoms often lead to misdiagnosis or delayed diagnosis. The aim of the study is to present a series with a large number of schwannomas in the upper limbs, some with very rare occurrence. Methods: We report 17 patients with a mean age of 58.5 years and upper limb schwannomas, located on the median, ulnar and radial nerves, but also on the posterior interosseous nerve and digital collateral nerves. The diagnosis was made by clinical examination and imaging tests, and in no case was a preoperative biopsy performed. Surgical treatment was established based on symptoms or aesthetic concerns. In all cases, a diagnosis of schwannoma was confirmed through histopathological and immunohistochemical examinations. Results: For all patients, a complete tumor enucleation was performed under a surgical microscope. No recurrence was recorded at 2 years after surgery. Patient satisfaction was good, with complete socio-professional integration in all cases. Conclusions: Although more frequently present on the main nerve trunks, schwannoma may be present on the collateral digital nerves in rare cases. A correct technique with complete tumor excision offers excellent postoperative outcomes and avoids recurrences.