Primary closure of the deltopectoral flap-donor site without skin grafting

Deitopectoral flap is a two staged flap requiring skin graft of the donor site. This study was conducted to evaluate the possibility of primary closure of the deltopectoral flap-donor site without skin grafting. The operations were conducted at Rizgari Teaching Hospital in the center of Erbil City, Kurdistan Region of Iraq. From January 2009 to December 2012, 14 deltopectoral flaps for reconstruction of oral/facial cancer ablative defects were done. Data on the age, gender, tumor site, and postoperative complications related to primarily closed deltopectoral flap-donor site [fistula, dehiscence, or hematoma leading to impairment of wound healing] and postoperative hospital stay were recorded. Of the 14 head-and-neck tumours, 10 were squamous cell carcinomas and four were ameloblastomas. Eleven of the patients were males and only three were females. The mean age [ +/- SD] of the patients was 59 +/- 13 years. There was no evidence of partial or complete loss of the flap in any of the patients studied. There was no case of breakdown of the primarily closed donor site. The only registered complication was slight localized dehiscence at the most proximal and distal part of the primarily sutured flap donor site in one patient. Primary closure of deltopectoral flap donor site is possible with minimal complication that overcomes the problem of skin grafting. Minimal wound breakdown in younger patients had been noted and left to heal by secondary intention

Comparison between infiltration and inferior alveolar nerve block anesthesia in extraction of non-vital mandibular posterior teeth [prospective clinical study]

Infiltration anesthesia for the posterior region of the mandible has been routinely avoided because of its questionable effectiveness related to the dense cortical bone of the mandible. The aim of this study was to evaluate the effectiveness of infiltration anesthetic technique on mandibular posterior non-vital teeth. Forty four patients aged between 13and 73 years who attended the Department of Oral and Maxillofacial Surgery in the College of Dentistry, Hawler Medical University for extraction of posterior non vital tooth were included in this study. For the infiltration anesthetic technique, patient's approval was taken. The patients were equally divided into two groups. Group [1] received 0.6 ml out of 1.8 ml of 2% lidocaine with 1:80000 adrenaline injection bucally and the same amount infiltration lingually opposite the intended tooth. Group [2] received 1.5 ml out of 1.8 ml of 2% lidocaine with 1:80000 and the remaining 0.3 ml was injected for long buccal nerve anesthesia. In group [1], 68.2% had no pain during extraction, showed statistically highly significant difference [P = 009]. Gender showed no significant difference. In group [2], 100 % of the patients had no pain during extraction. Infiltration anesthesia for non-vital mandibular molars is effective as a substitute for inferior alveolar block technique