Background: The management of acute surgical pathology implies not only the diagnosis–treatment sequence but also an important preventive component. In the surgical hospital department, wound infection is one of the most frequent complications which must be managed both in a preventive and a personalized manner. To achieve this goal, several factors of negative local evolution, contributing to the slowdown of the healing processes, such as the colonization and contamination of the wounds, need to be emphasized and controlled from the first moment. In this context, knowing the bacteriological status at admission ensures the distinction between the colonization and infection processes and could help to manage in an efficient way the fight against bacterial pathogen infections from the beginning. Methods: A prospective study was performed for 21 months on 973 patients hospitalized as emergencies in the Plastic and Reconstructive Surgery Department within the Emergency University County Hospital of Brasov, Romania. We analyzed the bacteriological profile of the patients from admission to discharge and the bidirectional and cyclic microorganism dynamics both in the hospital and the community microbial environment. Results: Of the 973 samples collected at admission, 702 were positive, with 17 bacterial species and one fungal, with a predominance of Gram-positive cocci at 74,85%. The most frequently isolated strains were Staphylococcus species (86.51% of the Gram-positive/64.7% of the total isolated strains), while Klebsiella at 8.16% and Pseudomonas aeruginosa species at 5.63% were mainly emphasized in the case of Gram-negative bacilli. Two to seven pathogens were introduced after admission, suggesting that the community microbial environment is in a process of evolution and enrichment with hospital pathogens. Conclusions: The high level of positive bacteriological samples and the complex associations of the pathogens found at the admission bacteriological screening sustain the new idea that the pathogenic microorganisms existing in the community microbial environment have started to increasingly influence the hospital microbial environment, in contrast with the previous consideration, which emphasized only the unidirectional relationship between hospital infections and the changing bacteriological characteristics of the community environment. This modified paradigm must become the basis of a new personalized approach to the management of nosocomial infections.

Background/Objective: Surgical treatment of extensive tumors of the lower lip generates important defects in its structure and functions. Over time, a multitude of reconstruction options for these defects have been imagined. Unfortunately, the majority involve the use of both local and regional flaps, which either lack labial structure or disorganize the oral commissures as nodal oral function points. We set out to design a new reconstruction method that is not burdened by any of the above disadvantages, starting from the necessity to reconstruct large lower lip defects by exclusively using local and/or regional labial flaps belonging only to the healthy upper lip and the remaining structures of the lower lip after surgical tumor removal. In this way, the tissues involved in lower lip reconstruction will have a 100% labial structure and, supplementarily, the remaining oral commissures will not be damaged. Method: This new reconstruction method is based on the original association of WY-plasty to reduce the size of the large primary defect until it becomes congruent with the Abbe–Sabattini cross-lip flap. Results: Applied in a personalized manner, impressive results were obtained in several patients with lip tumors affecting about one-half of the lower lip length and in whom oncological surgical ablation produced defects in more than two-thirds of it. Conclusions: This new method is characterized by functional oral advantages, and can be applied in a personalized way to only certain categories of patients. Other disadvantages are characteristic and specific of Abbe–Sabattini cross-lip flap plasty.