Objective: Electrosurgery is widely used in surgical procedures, but mainly for subcutaneous and deep layer dissections. The aim of this study was to clinically evaluate the results of routine use of electrosurgical microneedle in performing skin incisions in the facial regions. Material and methods: Eighty patients with both benign and malignant skin lesions in the facial regions undergoing surgery were enrolled in this study. In group A comprising 40 patients, cold steel surgical scalpel N° 15 was used for the surgical procedure. Electrosurgical microneedle with 0.06 mm tip radius and generator unit KLS Martin Electrosurgical Unit ME MB 2 set on cutting mode, power 12 W was used for performing the surgery in group B including the same number of patients. Differences between incision time, excision time, blood loss and the wound related complications were evaluated. Results: The two groups did not significantly differ in the speed of incision and speed of excision although both the speed of incision and the speed of excision were found to be slightly faster in the electrosurgery group. There was significantly less blood loss in the electrosurgery group compared with the scalpel group.Statistical analysis did not confirm as significant the difference in complications between the two groups although most of the complications were associated with the patients operated with scalpel. Conclusion: Electrosurgery presents safe and effective way of work. In that manner, it is very important to choose the right generator unit's settings and the right type of electrode.

Introduction: Postoperative pain presents a significant medical problem. It can create a considerable discomfort in the immediate postoperative period and thus increase patient’s morbidity. Multiple mechanisms are involved in its’ etiology, one of them being the method of tissue incision. The aim of this study is to compare the early postoperative pain following incision with two different methods, scalpel and electrosurgery in the facial regions. Material and methods: Eighty patients with both benign and malignant skin lesions in the facial regions undergoing surgery were enrolled in this study. Patients were randomized in two groups. In group A, comprising 40 patients, cold steel surgical scalpel №15 was used for the surgical procedure. Electrosurgical microneedle with 0.06mm tip radius and generator unit KLS Martin Electrosurgical Unit ME MB 2 set on cutting mode, power 12 W was used for performing the surgery in group B including the same number of patients. After the surgery patients were given analgesics on their demand. The total number of on demand analgesics requirements was calculated. The patients were also asked to note the oral analgesics they were taking after being released from the hospital. Results: Results of this study showed a statistically significant difference between the groups in the analgesics demand on the day of the operation (p=0.041). On the day of the operation 52.5% patients in the scalpel group and only 30% of the patents of the electrosurgery group received analgesics on demand. In all other analysed time points, the patients in the scalpel group received analgesics more often than the patients in the microneedle group, but with no statistically confirmed difference between the groups (p>0.05). Even more significant is the fact that patients treated with electrosurgery that needed analgesics, had significantly bigger excision area median 471 (rank 283-589) compared to the patients treated with the conventional method 289 (rank 177-432) (p=0.016). Conclusion: In accordance with previous studies our results suggested a significantly reduced postoperative pain in the electrosurgery group.

Introduction. Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders of adrenal steroidogenesis. In approximately 90-95% of the CAH cases, it is a deficiency of the enzyme steroid 21-hydroxylase. The degree of enzyme insufficiency determines the severity of the disease. In the simple virilizing type of CAH dominant symptoms are virilization in girls and precocious puberty in boys. Virilizing type of CAH is the most common etiology of ambiguous genitalia in women. There are several options for surgical reconstruction of such anomalies, which must always be optimized to the patient’s anatomy, to achieve a good esthetic and functional result. Detailed presentation of the case. The paper presents the case of a 36-year old woman with delayed pediatric diagnosis of simple virilizing type of CAH, due to deficiency of 21-hydroxylase, pronounced phenotypic virilization, clitoromegaly, hyperpigmentation of the external genitalia, vaginal hypoplasia and existence of low confluence of the urethra with the vagina in so called low type of urogenital sinus andbilateral micromastia, also called mammary hypoplasia. The patient underwent augmention mammoplasty, clitoroplasty, reduction of clitoral hood and proximal labioplasty. Discussion. CAH is a continuum of disorders, affecting patients throughout the life. Feminizing genitoplasty includes three parts: clitoroplasty, labioplasty and vaginoplasty. Clitorectomy in modern times is unacceptable option. Conclusion. Surgical management and reconstruction in women with simple virilizing type CAH and ambiguous genitalia remains still controversial and emotionally laden area in reconstructive surgical activity and requires a team approach.