Therapeutic Plasma exchange therapy in Burns.

Severe burn injury affects the body in many devastating ways, the most severe being systemic inflammatory response syndrome. This results in a myriad of effects like increasing capillary permeability, thereby fluid loss. It also causes a surge in inflammatory mediators like interleukin (IL)-6, which further increases the capillary leak and fluid loss. This results in refractory hypotension in patients despite adequate fluid resuscitation. Plasma exchange has been used in the management of a number of illnesses with a significant inflammatory component, and, therefore can be considered to have a role in burn injury. In our article, we would like to share our experience of using therapeutic plasma exchange therapy in burn patient.

An Innovative Skin Simulation Model to Augment Competency-based Training in Facial Plastic Surgery.

Introduction Competency-based medical education (CBME) approach in the medical curriculum has been introduced globally with the goal of providing flexibility, accountability, and learner-centeredness among medical learners. Traditional surgical skill training in most places has relied on "see one, do one, teach one model," while simulation model-based training has been shown to improve competencies in surgical trainees. We wanted to assess the usefulness of a hydrophilic barrier adhesive foam wound dressing as a novel skin simulation model for learning biomechanics and practice of cutaneous flaps among plastic surgical resident trainees at our institute. Materials and Methods An absorbent, soft polyurethane foam pad located centrally upon a larger polyurethane membrane, coated with a hydrocolloid adhesive, forming an island dressing, was used as a simulation model for this study. It was obtained from the hospital store either after or nearing their expiry dates of clinical use. Plastic surgery residents in different years of training were invited to participate in a simulation workshop, using this novel model, and give their feedback. Results Seventeen residents in different plastic surgery training levels participated in the workshop and gave their feedback on the skin flap simulation model. The simulation model received extremely high (100%) scores on two parameters, namely, utility for flap and suture practice and high scores (88%-94%) for texture, ability to mark, and improving confidence among trainees. Conclusions Adhesive bilayer polyurethane foam can be used as a novel cutaneous skin flap simulation model for understanding the biomechanics of skin flaps and cutaneous flap practice.