Introduction Inadequate professional and medical exposure and misconceptions about plastic surgery have not only been linked to students’ poor knowledge and attitude toward it, but also bias against the selection of plastic surgery as a specialty. This assertion is yet to be tested and confirmed in our setting. This study therefore aimed to determine the knowledge and attitude of medical students toward plastic surgery. Methods One hundred and eight (108) students between their 3rd and 4th year of study were randomly recruited and handed structured questionnaires on knowledge and attitude toward plastic surgery. Data were then analyzed using SPSS and represented in percentages, medians, and means. Mann-Whitney and Kruskal–Wallis tests were done to assess for significant statistical differences based on gender grouping and year of study, respectively. A p-value ≤ 0.05 was considered significant at a 95% confidence interval. Results Majority of the students had some awareness about plastic surgery since, a majority (88%) identified plastic surgery with cosmetics and identified trauma as the main condition handled by plastic surgeons. Sixty-four percent (64%) acknowledged the risks associated with plastic surgery and 79.6% noted the presence of the procedures in Kenya. When assessing attitude, 62% reported that they did not want to pursue plastic surgery in the future, 75% would not consider plastic surgery done on them and 77% of the respondents felt embarrassed to undergo the surgery if their family knew while another 77% felt embarrassed if their friends knew. It is worth noting that 55% had their initial exposure to plastic surgery through information from the media sources. Mann-Whitney test done to assess for gender differences only revealed significant difference (p-value = 0.009) on assessing for the availability of plastic surgery procedures in Kenya. Kruskal–Wallis test did not reveal any significant differences based on year of study. Conclusion Data from our study suggest that students have some awareness about plastic surgery but have a poor attitude toward it.

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Deep sacral wounds are best covered by flaps. Posterior thigh flaps have routinely been used to cover such wounds. The flap can however be modified as an island flap. Two patients with extensive sacral wounds were managed with island posterior thigh flaps. Both patients were admitted secondary to road traffic accident with subsequent soft tissue loss of the sacral area. The sacral defects in both patients were approximately 17 cm by 23 cm in dimensions. Unilateral island posterior thigh flap was raised and used to cover the wounds. Postoperatively both patients did well; the donor site and recipient sites healed without any complications. Island posterior thigh flap is thus an option in covering extensive defects of the sacral area. The flap is reliable and easy to raise and has minimal donor site morbidity. By raising it as an island flap the dog ear defect is avoided and the flap is able to be tunneled under the gluteal muscle. This maneuver enables the flap to be advanced further allowing it to cover more distal and extensive defects.

Penile replantation is uncommon, with most data being case reports or case series. In our setting, replantation is fairly new despite penile amputations being common as a result of marital disputes and assault. Replantation remains the most ideal option for managing these cases. We present a case of penile replantation in a 17-year-old male after traumatic amputation following an assault. Some of the challenges we encountered included loss of skin and the glans with formation of a hypospadias. Nevertheless, the outcome was satisfactory with return of sensation and erection.