Skin grafting in the treatment of pigmented neavei

Large congenital naevi often present a problem because of their site, size, and encroachment over vital structures, especially when they present in the head and neck area. They have to be removed and resurfaced because of the obvious disfigurement and further most of the types have a predisposition to be converted into malignancy. Among available treatment options are included tissue expansion, flap repair, serial excision, dermabrasion lasers, and as presented in this study skin grafting. Twenty-five cases are presented here, in which 8 full thickness grafts and 17 thick split thickness grafts were used. The results of surgery have been presented; skin grafting is technically easy, cheaper, less time consuming method with acceptable cosmesis

Management of speech defects in delayed cleft palate repairs with superior pedicle pharyngoplasty

Twenty five cases of cleft palate presented in the Outpatient Department of Plastic surgery at JPMC. All of them were delayed and were not in the optimum age group [6-9 months] for palatal repair. Sixteen case were between 15 to 21 years of age and 9 cases [male] were between 5-14 years of age. There were 9 females and the rest were males. A speech defect persists in all cleft palates that are delayed after the optimum age group of the palatal repair. The degree of velopharyngeal incompetence [VPI] varied in all these patients. Perceptual tests were carried out in a clinical setting due to lack of speech pathologists and a cleft palate team. Superior pedicle Pharyngoplasty was carried out in all the cases regardless of pharyngeal wall movement. There was marked speech improvement in 23 cases belonging to the older age group. In 2 patients the speech improvement was minimal and this is attributed to articulation defects, rather than failure. Speech therapy is indicated in all such patients