Overview of Burn Injury in Srinagarind Hospital : A preliminary Report

 Srinagarind Hospital is the only university hospital in the upper Northeastern region of Thailand.  The burn unit section has been set up for more than 5 years already, but the allocated space is only 4 beds in a single room with 2 isolated room available providing for both severe burn and other appropriate general surgical cases as well.  Regarded as the tirtiary center for the referring system in this region, a great number of major burn cases from regional provinces have been referred here.  An overiew of burn injury regarding age, sex, incidence, cause, severity of injury, mortality and bacteriology were reviewed.  This study is only the preliminary study to express an overview of burn injury in this hospital during a 3 year period.

Maxillofacial Injuries in Srinagarind Hospital

 A retrospective analysis of 64 patients who had sustained maxillofacial fractures and were treated in Srinagarind Hospital , Khon Kaen University from August 1984 to July 1987 was undertaken. Male to female ratio was 7:1 The ages ranged from 4 to 60 years with the mean of 28.5 years. Most patients (59.38%) were admited to the hospital within 1 day following the injuries. The average hospital stay was 9.51 days. Motorcycle accidents accounted for the largest number of fractures (62.62%). There were 34 patients who lost consciousness immediately after the accidents and 13 patients had the history of alcohol consumption just before the accidents.Major and minor associated injuries occurred in 18.75% and 20.3% respectively. Types of facial fractures were mandible 49% , zygoma 26% , maxilla 15% , nasal bone 6% and orbit 4% , Most of the operative interventions were intermaxillary fixation and interosseous wiring. There were 24 morbidities and 2 mortalites in the series. One patient died from intraabdominal hemorrhage and another developed diabetes insipidus after head injury and finally died from respiratory failure.

Large Lateral Abominal Wall Reconstruction

 Reparing of large  abdominal wall defect is still a challenging and frustrating task for reconstructive surgeon. The articles on reconstruction of large lower and central abdominal wall defect have long been published for sevesal occasios. Ohtsuka et al (1979) demonstrated the versatillity of rectus abominis myocutaneous flap, either superiorly base or inferiorly base, to reconstruct abdominal wall defect.

Tranverse Abdominal Island Flap for Breast Reconstruction

 The psychosocial literature is replete with studies describing morbidity associated with mastectomy, “the stress of which causes considerable upset in virtually all areas of a patent’s life” Specific types of psychological distress resulting from radical surgery include clinically significant mood disturbance, decreased sexual interest and satisfaction increased self-consciousness about clothes and revealing underwear, negative changes in one’s body image, fears about recurrence and of late anxiety about the relative merits of breast reconstruciton.

Free Jejunal Autotransplant for Reconstruction of Pharyngoesophageal Defect.

 Microsurgical revascularization in the neck has improved the survival rate of free small-bowel grafts used to replace the cervical esophagus.  Compared with previous intraoral reconstruction techinques using skin or myocutaeous flaps, the stage free jejunal grafts result in low morbidity, rapid postoperative recovery and no additional head and neck scars.  A case of successful reconstruction of cervical esophagus removed along with larynx in CA thyroid using free jejunal autotransplant was presented.  Intraoperative procedure, advantages and disadvantages were discussed n detail.