Closure of sacral pressure sore with V-Y technique

Gluteus maximus musculocutaneous flap is among the various methods available for closure of sacral pressures sores. A case is presented where bilateral flaps were raised on sides of a sacral bed sores in the shope of "V" and were advanced into the defect. Donor area was closed. In the shape of "Y". A similar technique was successfully used in another case, moving only skin and fascia without the muscle. Advantages of V-Y advancement are that it is simple, safe and executed in single stage

Amniotic membrane in burn wounds: does vascularization from bed really occur?

To establish whether role of amniotic membrane as biological dressing is because of blood vessel growth into it. Design: Prospective study of 22 cases of indoor burn patients. Setting; Plastic, Reconstructive Surgery and Burns Unit, Dow Medical College and Civil Hospital, Karachi. Subjects: Twenty two cases of indoor burn patients were studied. In nine cases freeze dried amniotic membrane and in thirteen cases fresh amniotic membrane was applied. Main outcome measures: Histopathological examination of biopsy specimen to see capillary budding and vascular ingrowth into membrane. Result: In none of the 22 cases studied capillary budding and any blood vessel growth into the membrane was found. The role of amniotic membrane in the management of burn wound stands the test of time and failure of documentation of vascular ingrowth into it does not alter its clinical utility

Ketamine in burn wound management

Modern day treatment of burns often involves early tangential excision of the wound, followed by autografting or coverage with biological dressings. These procedures are painful and frightening for patients. Most general anesthetic agents cause immunosuppression in already metabolically stressed patient and may cause liver damage. They also require full time attention of anesthesiologist. To counter these difficulties a short acting anaesthetic agent Ketamine, was tried in burn patients. Ketamine was given intravenously in a dose of 2mg / kg body weight. Thirty-two cases were studied and total dose of Ketamine administered ranged between 50 mg and 200 mg. Duration of the procedures ranged between 20 minutes and 50 minutes. Untoward reactions included only increased salivation, vomiting and unpleasant dreams in two cases. We conclude that Ketamine is a useful agent for minor intervention of the burn wound