Professor of Plastic Surgery
Sohag | Egypt
Main Specialties: Craniofacial Surgery, Plastic Surgery
Additional Specialties: Plastic Surgery
I am a professor and former head of plastic surgery department in Faculty of Medicine, Sohag University. I was graduated from Faculty of Medicine, Assiut University in 1991. I had 4-years residence in general surgery department in Sohag University Hospital after which I got my Master Degree in General Surgery and was assigned to be an assistant lecturer of Plastic Surgery.
I got training in plastic surgery for 6 months in plastic surgery department in Assiut University Hospital, then 12 months in Ain Shams University in Cairo. I was offered a two-year fellowship program from my University to complete my training in Plastic Surgery and get my MD degree of plastic surgery. I joined the UT-Southwestern Medical Center at Dallas and worked under supervision of Rod Rohrich from July 2001 till May 2003. Since then I work in department of Plastic Surgery in Sohag Faculty of Medicine.
Primary Affiliation: Sohag University - Sohag , Egypt
J Craniofac Surg 2019 May/Jun;30(3):e199-e202
Plastic Surgery Department, Faculty of Medicine, Sohag University, Sohag, Egypt.
Objective: This report presents an extremely rare case of heminasal aplasia or hemi-arhinia with only about 80 cases reported so far. The exact etiology and mechanism of development of heminasal aplasia are still unknown. Furthermore, the rarity of this anomaly makes its reconstruction a surgical challenge with a diversity and controversy on the timing and technique of such reconstructive procedures.
Method: Reconstruction was performed when the child was 3 months of age. The missing heminose was reconstructed by a superiorly based nasolabial flap.
Results: On early follow-up visits, there was retraction of the flap. However, the parents were satisfied by the result to the degree that the girl did not show for follow up after 3 years of surgery until she is 13 years and even now her parents do not want any further surgery.
Conclusion: Early surgical reconstruction is recommended even if revisions may be needed later.
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Journal of Craniofacial Surgery
Egyptian Journal of Plast. Reconstruct. Surg.
Background: Pressure sores are localized injury to the skin and/or the underlying tissue usually over bony prominences. Pressure sores affect significantly the patients' life especially those with limited mobility, 70 % of sores occur in persons older than 65 years. There is an inverse relationship exists between the amount of pressure and the length of time required to cause ulceration. Pressure sores usually occur due to combination of extrinsic and intrinsic factors. Surgical management include debridement and reconstruction by local or distant flap, the most commonly used are rotational, rhombic, V-Y advancement and tensor fascia lata flaps. Rarely skin graft is the adequate treatment. Patients and methods: This is a prospective study included 42 patients of different age and sex, having 57 pressure ulcers of variable etiology and severity. All patients were evaluated and managed in the plastic surgery department at Sohag university hospital. Results: Rotational flap was the most common type of surgical procedures followed by V-Y advancement flap then tensor fascia lata and rhombic flap. In most cases, the results were accepted. Conclusion: A person that is bedridden or cannot move, or who has diabetes, vascular disease (circulation problems), incontinence, or mental disabilities, should be frequently checked for pressure ulcers. Surgical treatment is the main treatment for pressure sores especially for 3rd and 4th degrees. Rotational flap is the most common flap used in the surgical. However protection is much better and cheaper than treatment.
Egyptian Journal of Plast. Reconstruct. Surg
Background: Foot trauma may have a major influence on life style in the form of chronic pain, ulcers and diminished function. These potential complications can be minimized by appropriate management of foot soft tissue injuries. Proper wound debridement and meticulous hemostasis are essential. The ultimate goal of reconstruction is to close the wound and to provide for bipedal ambulation. Methods: During the period from January 2010 to December 2014, 164 patients with soft tissue defects in the foot underwent reconstruction in the plastic surgery department of Sohag university hospital. Reconstructive method was chosen according to the local finding of each defect as well as the general clinical status of the patient. Skin grafts, fasciocutaneous and myocutaneous flaps, either pedicled or free, were utilized. The minimal post-operative follow up was 6 months. Results: 169 foot soft tissue defects in 164 consecutive patients were reconstructed. The etiology was acute trauma in 152 and chronic trauma in 12 cases. Modalities of reconstruction used were: 72 skin grafts, 51 cross-leg flaps, 15 flap repositioning and direct closure, 12 local flaps, 9 sural flaps, 5 dorsalis pedis flaps, 4 free flaps and 1 medial planter flap. Overall complication rate was 12%. Conclusion: Reconstruction of the foot should start by the simplest procedure that can accomplish the desired anatomical and functional outcome. Although microsurgical progress has improved and changed the quality of lower limb reconstruction, pedicled flaps remain good solution in selected cases.
Egypt, J. Plast. Reconstr. Surg.,
Background: Oral and oropharyngeal cancers have a profound impact on the quality of life of patients and their families. Even with reconstructive procedures, the patient’s quality of life can be significantly altered by these functional problems. Although the primary intended outcome of head and neck cancer surgery is still the disease-free survival of the patient, quality of life is now considered as an essential goal and its assessment in head and neck cancer patients has become an important aspect of postoperative care. The aim of this study is to evaluate the functional outcomes of the three-dimensional template design free anterolateral thigh flap in reconstruction of intra-oral soft tissue defects that result after oral and oropharyngeal ablative surgery. Patients and Methods: 27 patients were classified into 3 groups according to the extent and geometry of the postresection defect. The resection involves oral tongue and floor of mouth in group I (n=10), while in group II, the resection involves tongue base, oral floor and lateral wall (n=6) and in group III, the resection involves oral tongue, tongue base, oral floor and lateral wall (n=11). Immediate reconstruction was performed with a three-dimensional anterolateral thigh tailored according to the defect. Functional outcome was evaluated using the University of Washington-Quality of Life Questionnaire. Results: The Postoperative functional evaluation showed no significant differences between the three groups for the pain, appearance, activity, recreation, chewing, taste, speech, and shoulder domains. However, there was a significant difference between the groups for the swallowing, anxiety and mood domains and very highly significant difference in the saliva domain with the worst results in group II. Conclusion: The four-lobed anterolateral thigh flap is reliable reconstructive technique for various complicated three-dimensional tongue and oropharyngeal defects and it can achieve reproducible good functional results. However, further refinement is required to deal with lower saliva production in group II patients.
Egypt, J. Plast. Reconstr. Surg.,
Background: Acute injury to extremities is a common surgical challenge. Road Traffic Accidents (RTA) are the most common etiology and are usually associated with soft tissue injuries and fracture patterns. Other injuries include gunshots, firework and burns. Negative-Pressure Wound Therapy (NPWT), also known as Vacuum-Assisted Closure (VAC), has revolutionized the wound care protocols. The use of NPWT has become quite common in chronic wounds, but only was reported in very few literatures as an immediate management in acute injuries. Objectives: To evaluate early use of NPWT compared to conventional dressings in the management of acute injuries in upper and lower limbs with tissue loss and/or open fracture. Methods: The study included 47 consecutive patients divided into 2 groups: The first group included patients who received NPWT after initial surgical debridement and fracture fixation if required. This group included 27 patients with age ranged from 3 to 73 years with average 38 years. The second group received conventional wound dressing and included 20 patients whose ages ranged from 15 to 46 with an average of 30.5 years. Results: NPWT reduced wound size of 1.7 times more compared to conventional dressings. It also reduced the average healing time to 18.5 days in the NPWT group compared to 28 days in conventional dressing group. Conclusion: NPWT is a safe, simple and cost-effective technique in the management of acute limb injuries.
Indian Journal of Plastic Surgery
pectoralis major myocutaneous (PMMC) in cases of cervicofacial defects following ablative oncological surgery. We performed a prospective analysis of patients in whom PMMC was used to reconstruct head and neck surgical defects during the period from April 2014 to September 2015. The study was carried out at plastic surgery department of Sohag University Hospital and involved 20 patients. Patients' age ranged from 47 to 78 years, 16 patients were males and 4 patients were females. PMMC was used in 14 cases of defects following cancer larynx surgery and 6 cases of defects following cancer check and mandible surgery. No failures were noted in the study; however one patient died two month post-operative due to carotid blow out as a result of over dose of radiotherapy. Despite the current emphasis in tissue replacement has shifted to microvascular free-tissue transfer, the pectoralis major myocutaneous flap is still a versatile and reliable flap with an excellent reach to cervico-facial region especially in patient with poor general condition and with limited expertise and resources required for microvascular free-tissue transfer.
Egyptian Journal of Plast. Reconstruct. Surg.
Thirty patients suffering from peripheral nerve injuries in the upper limb have been managed by secondary nerve repair. Clinical assessment was the same in all cases as well as surgical exploration and preparation of both ends of the injured nerves. Before coaptation of both ends, cases were divided randomly into two groups. Group 1: Fifteen patients where coaptation of both nerve ends were performed by conventional microsurgical repair using 8/0 and 9/0 ethilon sutures. Group 2: Fifteen patients where coaptation of both nerve ends were performed by the use of fibrin glue. The limb was splinted for four weeks and physiotherapy started later. Follow-up was performed according to a planned protocol until 18 months postoperatively, and both motor and sensory recovery was evaluated and recorded according to standard scores. The final outcome showed that the use of fibrin glue is easier, faster and more reliable for coaptation of nerve ends and gives similar results or slightly better outcome than the conventional suturing techniques.
The Egyptian journal of plastic and reconstructive surgery
ABSTRACT Small lower jaw may be a reason of upper respiratory obstruction in neonates. Neonatal upper airway obstruction is a life threatening condition often requiring urgent interference. Typically, the treating neonatologist first stabilizes the patient’s airway via intubation, a nasal airway or proper patient positioning. Although the tracheostomy is a life-saving procedure in these circumstances, it is associated with numerous complications. Distraction osteogenesis (DOG) offers an alternative to a tracheostomy for newborns with Pierre Robin sequence, Stickler syndrome, Treacher Collins syndrome, Nager syndrome, and other craniofacial deformities. The study included 9 patients had micrognathia and upper respiratory obstruction who were managed at Mattel’s children hospital at UCLA over the period from 2006 to 2010, 4 males and 5 females, all were full term babies except for one who was born at 33 weeks. All patients had distraction done in the first two months of life. The diagnosis of airway obstruction was based on oxygen desaturations and duskiness and apnea on feeding. Tongue base collapse was confirmed as the primary site of obstruction by flexible nasolaryngoscopy and direct laryngobronchoscopy and other airway lesions were excluded. In summary, bilateral distraction osteogenesis is an effective technique of elongating the micrognathic mandibles. Additional studies are indicated to study the long-term outcomes in different diagnostic subgroups of micrognathia with respiratory obstruction
Indian J Plast Surg 2009 Jul;42(2):261-4
Department of Plastic Surgery, Faculty of Medicine, Sohag University, Sohag, Egypt.
Aplasia cutis congenita (ACC) is a rare condition characterized by a localized absence of skin and in some cases, the subcutaneous tissues. The majority of cases occur in the scalp; however, the lesion may occur anywhere in the trunk and extremities. ACC is most often an isolated defect, but it can be associated with other anomalies. Most reported cases are sporadic with a few reports of familial occurrence. Neither the pathogenesis nor the aetiology is clarified. Healing is spontaneous in most cases, and apart from keeping the lesion clean, no specific treatment is required. In this report, two cases of non-scalp ACC occurring in the lower limbs are presented and a brief review of the literature is conducted.
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Rhinology 2008 Jun;46(2):151-2
Department of Plastic Surgery, Faculty of Medicine, Sohag University, Egypt.
Objective: We report an extremely rare case of subcutaneous lipoma of the nasal vestibule.
Method: A case report and a review of the literature concerning lipomatous growths in the nose and paranasal cavities are presented.
Results: A 34-year-old male presented with a swelling protruding from the dome of the right nasal vestibule. The swelling was excised and histological examination revealed it to be a subcutaneous lipoma.
Conclusion: Lipomas of the nasal cavity and paranasal sinuses have previously been reported, however, to our knowledge, this is the first report of such a lipoma developing subcutaneously under the nasal skin.
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Plast Reconstr Surg 2006 Nov;118(6):1338-48
Department of Plastic and Reconstructive Surgery, Jikei University School of Medicine, Tokyo, Japan.
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