Background: Since time immemorial, soft-tissue defects of face due to injuries have been documented in literature and even depicted in sculptures, reflecting the image of society. Facial injuries themselves are rarely life-threatening, but are indicators of the energy of injury. Soft-tissue defects of the face can arise out of various causes which may include simple or complex contused lacerations with loss of tissue, avulsions, bites and burns. Common etiologies are road traffic accidents, foreign bodies, defects secondary to tumor excision, homicidal trauma, thermal, chemical and electrical burn, suicidal injuries, human bites, animal bites, gunshot injuries and blast injuries. The management of acquired soft tissue defects of face requires precise planning and coverage by a modality which is functionally and aesthetically pleasant. Objectives: To study the epidemiology of acquired soft tissue defects of face. To restore the aesthetics of the face by resorting to appropriate modality of reconstruction. Materials & Methods: This study was conducted in the Department of Surgery, Govt. Medical College Jammu, J&K, India and included 40 patients having been diagnosed with acquired soft-tissue defects of the face admitted in surgery ward from November 2018 to October 2019 (Prospective study). All the defects were evaluated for size, depth, and status of the base of the defect (presence of gross contamination or infection, integrity, and viability of the wound edges) along with evaluation and documentation of cranial nerve function, particularly the facial and trigeminal nerves. The management depended upon the defect site, size, status and type. 52.5 % patients underwent flap coverage whereas 22.5% underwent skin grafting for coverage of defects. 25% of the patients underwent primary closure of the facial defects. Results: Majority of the patients had restoration of anatomy and normal function after reconstructive procedures with colour and contour matching of that of the recipient site. No major complication was encountered in any of the patients. Conclusion: Acquired soft tissue defects of the face can be reconstructed by a variety of modalities which should not only be functionally adequate but also aesthetically appealing. Flaps are a versatile modality of reconstruction with the choice of flap being governed by the site and size of the defect.

Background: Small bowel obstruction (SBO) is a common general surgical emergency usually caused by adhesions, bands or hernias. Food bolus impaction or bezoars remain an uncommon cause, albeit well reported in literature. The objective was to outline the frequency, demographic features, etiopathogenesis and management patterns of acute SBO due to ingested food bolus.Methods: An observational retrospective study was conducted whereby patients admitted to the surgical emergency of the associated hospital of Government Medical College, Jammu, Jammu and Kashmir, India as cases of acute SBO, who underwent laparotomy, over a period extending from August 2020 to June 2022 were selected and their records reviewed for history of ingestion/intra-operative finding of food bolus obstruction. Demographic, etiological and management patterns were noted. Descriptive analysis was done using Jamovi (version 1.6) (computer software).Results: A total of 100 patients of food bolus obstruction were admitted and operated upon during the study period with a median age of 14 years, with 40% patients belonging to 11 to 20 years age group, with a male to female ratio of 3:1. Majority belonged to rural areas (86%). 97% cases were due to ingestion of date plum or persimmons (vernacular: “amlook”). Ileum was the most common site of impaction (63%). 90% cases were managed by fragmentation of bolus and milking of gut, whereas enterotomy and resection-anastomosis were performed in 5 patients each.Conclusions: Food bolus obstruction especially due to phytobezoars of Diospyros lotus (date plum or “Amlook”) is often encountered in our setup, especially in rural populations, predominantly affecting male children and adolescents.

Background: The defects of the groin and the genitalia are complex and pose a challenge to the reconstructive surgeon. These defects may arise out of a variety of insults which include – extirpative oncologic surgeries, necrotizing fasciitis, post burn defects, post traumatic defects including road traffic accidents and animal bites etc. Objectives: To study the epidemiology of the acquired soft tissue defects of the groin and genitalia. To evaluate the role of various reconstructive modalities for the acquired soft tissue defects of groin and genitalia. Materials & Methods: This study was conducted in the Department of Surgery, Govt. Medical College Jammu, J&K, India and included 25 patients admitted with acquired soft-tissue defects of groin and genitalia over a period extending from November 2018 to October 2019 (Prospective study). Personal and demographic data of the patient was noted. A detailed history regarding the cause of the defect along with history of trauma, discharge and bleed from the site was taken. Any past history of surgery and irradiation of the region was noted. The patients having soft tissue defects of the groin and genitalia secondary to the release of post burn contracture were subjected to the detailed history as regards cause of burn, treatment taken and time taken for burn wounds to heal. Examination included general physical examination along with the local wound condition which included site, size, discharge, slough, granulation tissue and any exposed vital structures such as vessels/ nerves. A hemogram, assessment of blood sugar, renal function (blood urea nitrogen and serum creatinine), coagulation profile, blood grouping, viral markers, chest x-ray and ECG were done as a part of routine pre-operative investigations. Wound swab was sent for culture. Biopsy was taken wherever required. Analysis of report of any previously taken biopsy was done. Split thickness skin grafting was the modality of coverage utilized in 56% cases followed by flap coverage in 32% cases. 12% of the defects were closed primarily. Results: Majority of the patients had durable coverage of the defects of groin/genitalia and the coverage modality was acceptable to the patient as regards aesthesis and functional outcome. No major complication was encountered in any of the patients. Conclusion: The reconstruction of the soft tissue defects of groin and genitalia need a meticulous examination and planning of reconstructive modality which may include skin grafting or a flap coverage.