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Introduction Lesion resulting from malignant transformation of a non-healing chronic wound of various etiology is referred to as Marjolin's ulcer. Histopathologically in most cases it is a squamous cell carcinoma, while basal cell carcinoma, melanoma malignum and sarcoma cases have been reported in the literature. Aim The aim of the work was to outline major characteristics of the entity and to focus on a variety of lesions which may evolve into this malignancy, based on literature review and patients operated on in the authors' department. Material and methods Four cases of malignant lesions which occurred in patients presenting chronic wounds in the period 2008–2012 were described. Results and discussion All patients presented squamous cell carcinomas which evolved in chronic post-burn wounds (two cases) and a chronic atheroma (one case). The time between the initial injury and malignant transformation was long (over 20 years in all cases). One patient died in the course of the disease. Conclusions Marjolin's ulcer is a non-frequent manifestation of a malignant neoplasm. It is an entity, which should be suspected and meticulously diagnosed and treated in all individuals presenting alerting symptoms such as chronic ulcerations of previously injured skin. It is a highly-virulent kind of malignant skin lesion in most cases due to late diagnosis and to histopathological characteristics of the entity. Surgical wide excision is a treatment of choice. In some cases, radiotherapy and limb amputation in some cases of acral localization are advocated. There is no agreement on prophylactic regional lymph node dissection.

Ichtyosis is an heterogeneous group of diseases characterized by formation of hyperkeratotic, squamous, tile-like scales virtually on the whole body. Depending on the severity and localization of the symptoms, the disease may lead to serious complications including ectropion of the eyelids, which may further lead to ocular disorders, including blindness. The aim of the work was to outline major characteristics of the entity and to focus on surgical methods of ichtyosis-related eyelid ectropion management. Four cases of ichtyosis-related eyelid ectropion, which occurred in patients presenting severe symptoms of the disease treated surgically in the clinic between 2003-2011, were described. In all patients the eyelid contractures were successfully released and relief of conjunctival inflammation was obtained. No postoperative complications occurred. In two patients, a secondary operation was necessary due to skin graft contracture and ectropion recurrence. In some cases, ichtyosis may lead to serious ocular complications. Surgical management of eyelid ectropion is challenging due to the shortage of available lesion-free skin for grafting and due to possible skin graft contracture leading to recurrence.

Parry-Romberg syndrome is an extremely rare disease characterized by the slow atrophy of the face involving the skin, subcutaneous tissue, fatty tissue, muscles, and even bones. The cause of the disease is unknown. The onset is slow and it begins usually during the first 2 decades of life, more often between the ages of 5 and 15. The purpose of the study was to present the principles of management and treatment outcomes in patients with Parry-Romberg syndrome.A total of 14 patients (12 females and 2 males) aged between 14 and 36 years (mean, 21.5 years), were treated at the Hospital of Plastic Surgery in Polanica Zdrój between 1970 and 2005. Hemifacial atrophy affected the left side in 7 patients, and the right side in the remaining 7. Altogether 45 operations were performed. Less severe changes were reconstructed by means of dermal grafts, galeal flaps; patients with more severe facial deformities were treated with free tissue transfer: parascapular and latissimus dorsi flaps (6 cases). The treatment was completed with facial modeling, dermal regrafting, and scars correction.The appearance was improved in all the patients. There was only 1 free flap loss reported during postoperative management.Dermal grafts are used in the treatment of milder forms of Romberg disease to improve facial symmetry. In severe cases of facial atrophy, the surgical management is based on free-tissue transfer.

Eyelid tumors constitute about 40% of all cancers located in the orbital region. Most commonly, they are basal cell carcinomas, in 90% of cases located in the lower eyelid and medial canthus. The purpose of our study was to present the management and to overview the results of surgical treatment of eyelid tumors.One hundred ninety-three patients, 89 men and 104 women, aged 16 to 87 years (mean, 63.5 years) with eyelid tumors were treated in Plastic Surgery Hospital in Polanica-Zdrój in the years 1985 to 2008. The patients were divided into 2 groups: group 1 (n = 148) was composed of patients operated on primarily in our hospital, and group 2 (n = 45) was composed of patients operated on in other hospitals, admitted for recurrence. All the patients underwent surgery involving resection of the tumor and simultaneous eyelid reconstruction. The preparations were evaluated histopathologically. Various surgical modalities were used, depending on the extent and location of the tumor.Recurrence developed in 13 patients in group 1 (8.7%; 5 women and 8 men) and in 9 patients in group 2 (20%; 5 women and 4 men).Tumors, usually basal cell carcinoma, originate mainly in the lower eyelid and medial canthus. Surgery should be performed as soon as possible after onset of the primary tumors and should include resection and reconstructive therapy. The highest risk of recurrence is in case of squamous cell and basospinocellular tumors, and especially in melanoma. The aim of reconstructive therapy is to reconstruct aesthetically and functionally effective eyelid.

Background Anterolateral thigh flap (ALTF) has gain popularity as a workhorse flap in the management of simple as well as complex tissue defects. The purpose of this study was to investigate the differences in ALTF’s perforators’ location in male and female human cadavers. Methods The study involved 30 fresh human cadavers of both sexes. A total of 60 flaps were examined. The flaps were raised as originally designed. After location of vessels, the distance from the anterior superior iliac spine (ASIS) to subsequent perforators was measured. Also, the kind of the perforator, its diameter and origin were marked. Perforators were designated according to Yu’s classification (A, B, and C). The perforators were divided into thin (1 mm). Ratio of the ASIS–patella distance to the distance of a given perforator from the ASIS (AP rate) was calculated. Results The mean AP rate (perforator location) was different in both sexes. Mean AP rate in men was calculated as 0.498 ± 0.117, and in women, 0.559 ± 0.114. Differences in AP rate between female and male were statistically significant (t = −3.144; p < 0.002). Mean flap thickness was 3.65 cm in women and 1.17 cm in men (t = −14.444; p < 0.00001). In men, 63 perforators originated from descending branch, and seven perforators originated from oblique branch. In women, there were 67 and one, respectively. Conclusions In men, perforators are located closer to the ASIS in comparison to women. Clinically significant perforators (Φ > 0.5 mm), in majority of cases, occur in A and B positions. Thickness of the flap was higher in women. The oblique branch was more common in men.