Experience with simultaneous releas of upper and lower eyelids in post-burn ectropion

We present our 2 years experience of performing simultaneous release of both upper and lower eyelids in post-burn ectropion in 29 patients [followed-up for 2 to 20 months]. Over-correction was achieved in all the cases. Only 4 patients needed secondary release later on. It has been observed that simultaneous upper and lower eyelid release is equally effective when compared to the classical approach of single eyelid release at one operative session. It reduces patient's morbidity and is also more cost-effective

Burn wound microflora and their sensitivity pattern: a prospective study

This prospective study was carried out on 60 consecutive patients admitted with acute burns. No such study has been done in Pakistan so far. Contamination rate of burn wounds at the end of first week was 73.8%, while it was 83.2% at the end of three weeks. Staph. aureus was found in 31.7% cases. Although Pseudomonas aeruginosa has been found to be the commonest cause of contamination in many previous reports, it was found in 22.2% cases in this study. Proteus mirabilis, E.Coli and Klebsiella were found prevalent in lesser number of cases. Streptococcus pyogenes was not isolated in any case. The sensitivity pattern reveals that most of Staph. aureus strains were resistant to ampicillin and cloxacillin. Amikacin and azactam were found effective against most of the organisms which were otherwise resistant to commonly used antibiotics

Scalp defects

Scalp defects can result from trauma, tumors or infection. Whereas small defects can be closed with wide undermining and local flap coverage, large full thickness defects with exposed calvarium cannot be treated as such. Twenty patients with scalp defects were treated in the department of plastic and reconstructive surgery Mayo Hospital Lahore from 8.10.89 to 17.9.95. Fourteen [70%] of the patients were females. Thirteen [65%] belonged to rural areas. Trauma [65%], burns [25%], infection [5%] and tumors [5%] were the main causes of defects. Five [25%] patients [all females] had avulsion injury of the scalp. The size of defects varied from a minimum of 9 cm[2] to a maximum of 615 cm[2]. Nineteen [95%] had skin grafting with eighteen [90%] requiring split and one [5%] full thickness graft. Three [15%] required local flap rotation and seven [35%] bone chiselling. Majority [80%] of patients required two or less operations. The mean hospital stay was 38.5 days. There was only one mortality, which was related to burn injuries. It is concluded that bone chiselling followed by skin grafting is a safe and effective way of treating very large scalp defects and should be offered to patients where microsurgery is not feasible or available

Tissue expansion in reconstructive plastic surgery of face and scalp

Reconstruction with chronic intermittent expansion of face and scalp defects was done in twenty cases in this study conducted over a span of four years [1990-94] in Plastic Surgery Department, Mayo Hospital, Lahore. Tissue expanders, made up of silicon, were used with volume capacity ranging between 70 and 450cc. Weekly saline injections in the remote valve [port] were given and expanded skin advanced to cover the defect after 8-12 weeks. The indications, experiences and complications encountered in this series of twenty patients have been described, advantages and problems are discussed