Frequency of oronasal fistulae in complete cleft palate repair

To determine the frequency of oro-nasal fistula in patients undergoing complete cleft palate repair by two flappalatoplasty. Case series. Department of Plastic Surgery, Services Hospital, Lahore, from January to December 2013. Patients admitted to the study place for repair of cleft palate after informed consent obtained were included. Cleft palate was repaired by two-flap palatoplasty, using Bardach technique. Patients were discharged on the second postoperative day and followed-up at third week postoperatively. During follow-up visits, fistulae formation and their sites were recorded on pre-designed proforma. Among the total 90 patients, 40 patients [44.4%] were male and 50 patients [55.6%] were female. The mean age was 6.4 +/- 5.7 years ranging from 9 months to 20 years. At third week follow-up, 5 patients [5.6%] had fistulae formation. Four patients [80%] had anterior fistulae and one patient [20%] had posterior fistula. With two-flap palatoplasty Bardach procedure for repair of cleft palate, the complication of fistula formation was uncommon at 5.6%, provided the repair was tension free and multi-layered

Dorsal tongue flap: a reliable solution in recalcitrant secondary palatal fistulas

To determine the efficacy of Dorsal Tongue Flap in repair of palatal fistula in terms of closure of fistula. It was a descriptive study which was carried out in the department of plastic surgery, Services institute of Medical Sciences, Services Hospital Lahore over 12 months from 16th July 2010 to 15th July 2011. Forty patients who were having recurrent palatal fistula included in this study. All underwent palatal fistula repair by dorsal tongue flap. Each patient was followed after one month of operation for fistula closure. In this study 65.0 percent of the patients were males. 21 [52.5%] of the patients belonged to age group 10-15 years, while 14 [35.0%] of the respondents were 16-20 years of age and remaining 5 [12.5%] of them were 21-30 years of age. 90 percent patients had overall efficacy in terms of complete fistula closure. Tongue flap is an effective and reliable treatment for palatal fistula closure in recurrent and resistant cases

Use of amniotic membrane in the treatment oif toxic epidermal necrolysis in burn units

To determine the outcome of the use of Amniotic membrane in the treatment of Toxic Epidermal Necrolysis. Quasi experimental study from 2002 to 2004. Mulitcentric including Plastic, Reconstructive, Microsurgery and Burns Unit, Civil Hospital Karachi, and some private hospitals of Lahore and Karachi. Ten patients with Toxic Epidermal Necroplysis [TEN]. All these patients were treated on the lines of burns patients i.e. I/V fluids, antibiotics, blood transfusions, high protein diet, etc. The only modality which was different, was the daily application of fresh amniotic membrane on the wounds instead of topical silver sulphadazine. Deep wounds were subsequently covered with skin auto grafts. Out of 10 patients with TEN, three were males and seven females. Three female patients expired after five to seven days of stay in the unit, the remaining seven i.e three males and four females survived. On an average the healing time of these seven patients was 33 days. Skin grafting was needed in only one patient. The use of amniotic membrane in TEN patients in specialized burn units will definitely result in better prognosis for these patients

Penile Torniquet Syndrome

To study the presentation and outcome of cases of Penile Torniquet Syndrome.Retrospective study over a period of five years i.e. Jan.1998 to Dec.2002.Civil Hospital and Usman Memorial Hospital, Karachi, and Allied Hospital, Faisalabad. Patients: Six cases of Penile Torniquet Syndrome.The patients underwent either a two or three stage repair.The ages of the patients ranged from 2-10 years. All patients belonged to the poor socio-economic group. All patients were circumscribed. In all cases the presentation was late with part of the glans just hanging down because of the constriction ring and with a urethro-cutaneous fistula. The results of the surgical repair was good in five cases. One case was lost in follow up. We conclude that although Penile Torniquet Syndorme is a rare condition, but it should be in the mindsof the treating physicians and surgeons so that early diagnosis and prompt treatment can be carried out