Carboxymethylchitosan, alginate and tulle gauze wound dressings: a comparative study in the treatment of partial-thickness wounds.

Background: Carboxymethylchitosan is a chitosan-derivative obtained from the carboxymethylation of chitin with chloroacetic acid in alkaline solution. It has shown its potential in animal model studies as an accelerator of wound healing. Materials and methods: Prospective, comparative clinical trials of traditional tulle gauze, alginate membrane, and carboxymethylchitosan sponge were carried out in the treatment of partial- thickness skin graft donor sites. Between June 2005 and March 2006, 70 donor sites from 44 patients were randomly treated by these three different wound dressing materials. Each wound was treated until it was completely healed, and a visual analogue scale was used for the pain evaluation. Results: The results showed that the donor sites dressed with carboxymethylchitosan or alginate healed more rapidly than those treated with tulle gauze. There was no significant difference in the healing rate between carboxymethylchitosan and alginate. The pain scores evaluated among these three dressing groups did not significantly differ. Conclusion: Carboxymethylchitosan is as efficacious as traditional tulle gauze or alginate membrain in the treatment of partial thickness skin graft donor sites.

Bilateral scrotal flaps: a skin restoration for penile paraffinoma.

Foreign body injection into the penile shaft, in the mistaken belief that it could increase the size, is not uncommon among Thai males. Paraffin, oil, and other materials had been injected into the penile skin and predictably followed by a lot of complications. Foreign body granuloma, disfigurement, chronic and unhealed ulcer, painful erection, and the inability to achieve sexual activities are those following complications. In the severe cases, even though the complete resection of the skin and all of the infiltrated tissue was meticulously performed, some foreign bodies had to be left since they had incorporated into either the corpus cavernosum or corpus spongiosum. Durable resurfacing skin can't be perfectly achieved by skin grafting in these situations. Between 1996 and 2002, 31 patients with penile paraffinoma have been treated using bilateral scrotal flaps. Both functional and cosmetic goals without any major complications were achieved in all of the patients.

The role of SMAS flap in preventing Frey's syndrome following standard superficial parotidectomy.

Between 1992 and 2002, 46 patients who underwent standard superficial parotidectomy with a superficial muscoloaponeurotic system (SMAS) preservation technique were included in a retrospective study. Twenty-six patients were evaluated by questionnaire for subjective symptoms of gustatory sweating and flushing as well as satisfaction with the aesthetic appearance of their cheek. Six of twenty-six patients (23.1%) complained of symptoms of Frey's syndrome. Seven of twenty-six patients (26.9%) demonstrated a positive Minor's starch iodine test. By this technique the incidence of Frey's syndrome is substantially reduced from 48% by subjective review and 72% by objective measurement reported in the previous study by the same group of surgeons without using the SMAS preservation technique. This study supports the role of the SMAS flap in preventing Frey's syndrome following standard superficial parotidectomy.

Comparison among Op-site, polyvinyl chloride film and tulle gauze in the treatment of skin graft donor sitet.

A prospective analytic study was performed at the Division of Plastic and Reconstructive Surgery, Department of Surgery, King Chulalongkorn Memorial University Hospital and the Department of Surgery, Chiang Mai University Hospital to compare among Polyvinyl chloride film (PVC film), Op-site and tulle gauze in the treatment of skin graft donor site. From October 1998 to January 2000, 81 donor sites in the same number of patients were treated by three different methods; tulle gauze (26 patients), Op-site (27 patients) and PVC film (28 patients). Each wound was followed until it was completely healed and visual analogue scale was used for pain evaluation. Donor site dressed with PVC film had a healing time of 10.44 days which was not different from Op-site (10.54 days) but significantly faster (p<0.001) than tulle gauze (17.84 days). Pain as measured with visual analogue scale in the group of PVC film (1.48) was not different from Op-site (1.34) but significantly less than (p<0.001) tulle gauze (5.45). There was no difference in the rate of infection between each group. In conclusion, the authors found no difference between Op-site and PVC film in healing time and pain. Both of them were better than tulle gauze. The results demonstrate the usefulness of PVC film as a donor site dressing as it promises relatively rapid healing, less pain and is inexpensive.