RESUMO
Aetiology of the scalp defects may be burns, trauma, avulsion, infection, resection for neoplasm or congenital defects, the goals & principles are similar, and their repair is dependent upon their location, size and depth. In the case of the scalp, the repair of even small defects is complicated. We wanted to assess the epidemiology, etiological factors, type and site of distribution, various modalities, overall cosmetic effect and function of both donor as well as recipient sites of scalp defects. We also wanted to evaluate the epidemiological and aetiological factors influencing the various modalities of scalp defect management and the overall cosmetic effect on both donor as well as recipient site. METHODSA descriptive study was conducted at Sham Shah Medical College and associated SGM Hospital, Rewa, which is also known as Vindhya region of Madhya Pradesh. A total of 44 cases of scalp defects, that were treated in the department of surgery over a period of 18 months from May 2018 to November 2019 constitute the material of this study. Patients were included in the study after obtaining an informed consent. One-year follow-up of the patients was done, RESULTS26 cases [59.01%] of scalp defect were repaired with transposition flap; rotation flap was done in 2 cases [4.45%], bipedicled flap was done in 2 cases [4.45%], double opposing rotational flap was done in 01 case [2.27], S.T.G. was done in 7 cases [15.9%], and primary closure was done in 6 cases [13.63%]. In our study 59.09% cases are due to trauma and occur in second to fourth decade out of which 26 patients have exposed bone, and out of 26 patients, 09 patients have fracture of bone. CONCLUSIONSScalp reconstruction depends on the nature and the region of the defect. A range of reconstruction techniques have been described. The quality of the residual scalp is critical for performing a local flap. Local flaps are the reference for the reconstruction of such defects. Knowledge of scalp anatomy is essential for preparing these flaps. The parietal zone is the location offering the greatest flap mobilization possibilities. A review is provided of the different techniques for the reconstruction of large scalp defects.
RESUMO
Introduction: Burn injury causes a considerable amount of disability, prolonged hospital stay, and burden on the public healthsector. Main requirement in burn wound management is an economical, easy to apply, readily available dressing, or method ofcoverage that will provide good pain relief, protect the wound from infection, promote healing, prevent heat and fluid loss, beelastic, non-antigenic, and adhere well to the wound while waiting for spontaneous epithelialization of superficial partial thicknessburns. The sterilized paraffin gauze dressing is non-adherent and non-allergenic and helps in speedy recovery of burn wounds.Materials and Methods: A prospective study of 90 patients with partial thickness burns who were salvageable (≤40% bodysurface area), admitted to Burn unit of Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital,Rewa from June 1, 2017, to May 31, 2018. The autoclaved liquid paraffin gauze was applied over burn wound. Patients wereassessed on the basis of subsidence of pain, time of epithelialization if occurred after liquid paraffin gauze dressing. Patients’blood investigations were noted and the assessment of the effect of hemoglobin (anemia) and platelet counts in burn woundhealing in terms of mean epithelialization time were done.Results: Mean epithelialization time was 16 days. In 25% of cases epithelialization developed in 10–12 days. Post-burn painsubsided in 4–6 days in maximum in 54.44% cases. Mild and moderate anemia had no significant effect on wound healingtime (mean epithelialization time). Patient with less than normal platelet counts (<1.5 lakh/cumm) had more epithelializationtime and with normal platelet count had less epithelialization time. 15 patients developed complications and most commoncomplication was hyper granulation (11.11%).Conclusion: Burn wounds pose a great burden on health-care infrastructure and burn units. We can conclude that liquid paraffingauze dressing has good patient acceptability and less painful, it is easily available and relatively less expensive. In developingand resource-poor countries, most of the patients are from the rural background so these patients will need a dressing that isrelatively less expensive and easily available such as liquid paraffin gauze dressing.