Background: Fournier's gangrene is a synergistic necrotizing fasciitis of the perineum and abdominal wall that develops in the scrotum and penis in men and the vulva and groin in women. This disease was initially believed to be idiopathic; however, recent studies have indicated that it is a serious condition caused by gram-positive, gram-negative, or anaerobic bacteria. It is often associated with severe and fatal systemic involvement. Methods: A retrospective study involving a chart review of 23 patients with Fournier's syndrome treated between January 2002 and January 2012 was conducted. Prompt treatment consisted of broad-spectrum antibiotic administration and serial debridement. The reconstruction techniques ranged from edge approximation via simple sutures to the use of flaps and grafts in cases with extensive lesions. Results: The skin and scrotal reconstruction techniques were effective in all cases, yielding satisfactory aesthetic results. Three (13%) patients died, including 2 patients who had previous illnesses and comorbidities. Conclusions: Although Fournier's syndrome is a serious disease, therapeutic measures such as prompt intervention, with early debridement and broad-spectrum antibiotic therapy, in a multidisciplinary approach is very effective for controlling the disease, enabling surgical reconstruction of the affected areas with a low mortality rate.Keywords: Fournier gangrene. Fasciitis, necrotizing. Reconstructive surgical procedures/ methods. RESUMO Introdução:A gangrena de Fournier é uma fasciite necrosante sinérgica do períneo e parede abdominal, que tem origem no escroto e pênis, no homem, e vulva e virilha, na mulher. O processo inicialmente foi descrito como idiopático, mas atualmente sabe-se que se trata de grave afecção causada por bactérias Gram positivas, Gram negativas ou anaeróbios, que pode levar a comprometimento sistêmico importante e, eventualmente, morte. Método: Foi realizado estudo retrospectivo, baseado na análise de prontuários médicos de 23 pacientes portadores de síndrome de Fournier, no período de janeiro de 2002 a janeiro de 2012. O tratamento dos pacientes incluiu intervenção precoce, com antibioticoterapia de largo espectro e desbridamentos consecutivos. O procedimento terapêutico empregado para a reconstrução variou desde a aproximação das bordas com sutura simples até uso de retalhos e enxertos, nas lesões extensas. Resultados: As técnicas de reparação cutânea foram eficientes e a reparação escrotal foi também efetiva em todos os casos, obtendo-se bons resultados estéticos. Houve 3 (13%) óbitos, 2 deles em pacientes com doenças pregressas This study was performed at the

Dornelas MT et al. Siliconomas Siliconomas RESUMO Introdução: O silicone líquido industrial tem sido introduzido no organismo humano de forma clandestina, com a finalidade de corrigir defeitos, depressões, irregularidades e para aumentar volumes, tanto em mulheres como em homens ou transgêneros. Com tal uso, podem ocorrer várias complicações, tais como infecções, necroses teciduais e, mais tardiamente, a migração do produto, pelo sistema linfático, venoso ou mesmo pela força da gravidade. Método: Foram avaliados 11 pacientes portadores de siliconomas, pertencentes ao ambulatório do Serviço

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Background: When the treatment of acquired immunodeficiency syndrome (AIDS) with highly active antiretroviral therapy (HAART) began in the 1990s, it considerably increased the life expectancy and quality of life of AIDS patients. However, the decrease in morbidity and mortality associated with opportunistic infectious and neoplastic diseases was accompanied by an increase in the prevalence of other diseases, including HIV-associated lipodystrophy. Lipodystrophy is due to the toxicity of drugs used in antiretroviral therapy, including protease inhibitors and nucleoside analog reverse transcriptase inhibitors. This article discusses the treatment of facial lipodystrophy, which confers an appearance of premature aging and brings back the old stigma of the "AIDS face," which negatively impacts the quality of life of HIV carriers. Methods: Forty-one patients with facial lipoatrophy received filling with polymethylmethacrylate (PMMA) at the Hospital Universitário da Universidade Federal de Juiz de Fora (HU-UFJF) and at the Plastic Center Clinic, Plastic Surgery Clinic in Juiz de Fora between January 2010 and February 2012. Results: Patients received 1 to 4 procedures with a minimum interval of 90 days between procedures. The amount of PMMA used ranged from 3 to 18 mL per procedure according to the degree and region to be corrected. The results were aesthetically favorable in all patients. Conclusions:The results obtained through bioplasty with PMMA are considered satisfactory by patients. The material used is highly adaptable to the receiving areas, requiring only modeling and an adequate amount in order to obtain good aesthetic results.