Various surgical techniques have been reported for the treatment of the pilonidal sinus; however, the most effective technique remains to be elucidated. We performed an open surgery technique and compared our findings with other methods. Between 2017 and 2022, we treated 17 patients who were diagnosed with sacrococcygeal pilonidal sinus using an open surgery technique. The average time for wound healing was 35.4 days. Delayed wound healing was observed in one case, which was successfully treated by removing an embedded body hair in the subcutaneous tissue. No recurrence was reported after a mean follow-up of 38.0 weeks. The open technique for the pilonidal sinus has a longer healing time; however, our findings suggest that it is effective and has a low patient burden, because of the low postoperative recurrence rate and shortened hospitalization period, compared to the primary closure technique.

 Congenital Lipomatous Overgrowth, Vascular malformations, Epidermal nevi, and Scoliosis/Skeletal and Spinal anomalies (CLOVES) syndrome is a rare disease in which systemic overgrowth and vascular malformations are observed due to abnormalities of the PIK3CA gene. Treatment for intractable vascular malformations has been focused on symptomatic treatment; however, molecular-targeted drugs were recently found to be effective.
 CLOVES syndrome was not widely known initially. In the present case, a definitive diagnosis was not made, and it was difficult to control the patient's condition. However, with the subsequent cooperation of other departments, we initiated oral administration of sirolimus. Based on clinical findings and genetic testing results, a definitive diagnosis of CLOVES syndrome was eventually made. Our findings suggest the importance of cooperation among multiple departments from an early stage to diagnose and treat cases of intractable vascular malformations.

 Recently, digital technologies have been used in medical research and clinical practice. With the popularity of smartphones, applications (apps) are now commonly used in everyday life. Specifically designed apps, such as those for medication management, offer simplicity, portability, and easy integration into clinical workflows. There have been reports of the use of apps for evaluating and managing pressure ulcers in plastic surgery; however, reports on apps pertaining to plastic surgery in Japan remain limited. Furthermore, although there have been scattered overseas reports on simulation software for local flaps, there are currently no reports on a user-friendly app for this purpose. Although local flap reconstruction is a crucial technique for plastic surgeons, it can be challenging for novice plastic surgeons, non-plastic surgeons, and patients to visualize the procedure. We aimed to develop a medical app that helps novice plastic surgeons understand flap creation techniques, facilitates surgical explanations to patients, and serves as a communication tool with non-plastic surgeons. Herein, we report details on the app, including its conceptual foundation.

 We report a rare case of desmoid fibromatosis developing after inguinal hernia repair. A 72-year-old man detected a tumor at the left lower abdomen. He had undergone the mesh plug method for bilateral inguinal hernia three years earlier. Computed tomography revealed a tumor had developed from the muscular layer of the abdominal wall, just outside the mesh plug. Biopsy suggested desmoid fibromatosis, myxofibrosarcoma, or low-grade fibrous myxosarcoma. We collaborated with a gastrointestinal surgeon to resect the tumor, including the mesh plug, and reconstruct the defect with mesh and a tensor fascia lata flap. The histopathological diagnosis was desmoid fibromatosis. The patient continues to be observed periodically on an outpatient basis, and no recurrence has occurred.

 An 80-year-old female patient presented to our hospital because of pain in her dorsal right foot that did not improve after treatment at a local hospital. The patient displayed increased inflammatory responses, hypotension, and organ damage. Fascial necrosis was observed on the dorsal right foot by test incision. Group A Streptococcus was detected in blood culture, and a diagnosis of necrotizing fasciitis due to streptococcal toxic shock syndrome was made. This disease has a high mortality rate and often requires amputation of the affected limb. The patient was successfully treated with negative pressure wound therapy and skin grafting. Amputation was avoided, and the patient regained the ability to walk. The patient had fewer than three risk factors for amputation, and the removal of the fascia to the normal extent was performed to achieve a high possibility of avoiding amputation.