Local tissue reactions to oil-based breast implant bleed.

We present two cases (three implants) of symptomatic local tissue reactions to Trilucent breast implant bleeds. The implant shells had changed their colour and texture. Capsule histology showed foreign body reaction and inflammatory changes. These findings question the safety of these implants.

Dermasorb versus Jelonet in patients with burns skin graft donor sites.

A prospective and randomized trial that compares Jelonet (Smith & Nephew PLC, London, England) with a new hydrocolloid dressing, Dermasorb (Convatec Ltd., Clwyd, United Kingdom), is presented. The dressings were applied on contiguous donor sites in 21 patients that required skin grafting for burn wounds. Pain experienced with the dressing in situ was assessed on days 2, 4, 7, and on two subsequent occasions. During dressing changes, pain experienced was again assessed, bacteriologic swabs were taken, and the percentage of epithelialization was recorded. Questionnaires completed by investigators and patients were used to assess the perceived performances of both dressings. The results showed that Dermasorb is a less painful dressing than Jelonet, in which wounds heal faster. Dermasorb was preferred by both investigators and patients. No clinical or laboratory evidence of any differences of colonization or infection were found. All results were statistically significant. We would strongly recommend the use of Dermasorb as a split-thickness skin graft donor site dressing for a patient with burns.

Burns in octogenarians.

With the aim of identifying patterns of burn injury, remediable risk factors, and policies in the overall surgical and medical management a retrospective review of 111 octogenarian burn victims admitted between 1983 and 1993 is presented. The mean age was 84 years, with the mean percentage body surface area burned (%BSAB) being 9.6 per cent (range 0.5-65 per cent). Contrary to expectations, the annual incidence appears to be declining, the possible reasons for which are discussed. Surgery was required in 69 patients; in 11 this was performed within 1 week of injury. When compared to the more traditional delayed surgical approach, early surgery conveyed no benefits in either mortality (early group, 18 per cent; delayed group, 13 per cent) or length of hospital stay (early group survivors, 38 days; delayed group survivors, 42 days). Medical and social problems were very common and led to an often difficult and frequently prolonged rehabilitation, with the mean length of hospital stay for all patients being 29 days. The mortality of the whole group was 26 per cent, the patients on average faring better than their predicted mortalities as derived using either the Baux index, the Bull table or the Abbreviated Burn Severity Score.

Ecstasy and Whizz at a rave resulting in a major burn plus complications.

A patient who sustained a major burn following abuse with Ecstasy and Whizz is described. His progress was complicated by hyperpyrexia, acute renal failure and convulsions, all of which have been recently recognized as potential side-effects of Ecstasy abuse. This report further highlights the dangers of substance abuse.

Basaloid squamous carcinoma of the buccal cavity.

Basaloid-squamous carcinoma was first recognized as a separate pathologic entity in 1986. It has been described in the hypopharynx, larynx, base of tongue, and nasal cavity. We report the first case of this rare tumor occurring in the buccal cavity and review the atypical squamous cell carcinomas that occurred in these sites.