Effects of maize silage substitution with sugarbeet or citrus pulp ensiled with corncobs on growth performance, digestibility, and economic benefits in buffalo calves.

Ensiling of high-moisture agro-industrial wastes with dry roughage as animal feeds may be a secure way to reduce the feeding cost. The objective of this study was to investigate the effects of either sugarbeet or citrus pulp ensiled with ground corncobs and used as a replacement of maize silage or maize fodder in total mixed ration (TMR) for fattening of buffalo calves. Twenty male calves of Nili-Ravi buffalo (aged 14 ± 2 months weighing 133 ± 5 kg) were randomly assigned to one of four iso-nutritious (12% CP and 69% TDN) experimental diets with 50:50 forage to concentrate ratio (dry matter basis) as: (1) TMR maize silage, (2) TMR sugarbeet pulp ensiled with corncobs, (3) TMR citrus pulp ensiled with corncobs, and (4) TMR green maize fodder with wheat straw. All calves received TMRs for ad libitum intake twice daily for 80-day period. Daily feed intake, fortnightly body weights, and digestibility and N balance study during last 15 days were recorded of individual animals. The calves fed TMR sugarbeet pulp silage got highest daily gain (856 g/d, P < 0.05) than citrus pulp silage (776 g/d) or green maize fodder (704 g/d). Average intake of nutrients was same among all the calves. Feed conversion ratio and digestibility of DM, NDF, and ADF were higher (P < 0.05) with TMR sugarbeet pulp silage compared to other TMRs. Economic benefit (output/input) with TMR sugarbeet pulp silage had 15.46, 34.27, and 37.36% higher effect for fattening of buffalo calves compared to citrus pulp silage, green maize fodder, and maize silage-based TMRs, respectively. In conclusion, sugarbeet pulp ensiled with ground corncobs is simple and appropriate method for silage making and its inclusion up to 50% of DM in TMR had pronounced economic impact to the production of buffalo calves.

Keystone Flaps: Physiology, Types, and Clinical Applications.

The keystone perforator flap (KPF) was first introduced in 2003 by Behan et al for use in reconstruction after skin cancer excision. Since its initial description, KPF use has been expanded to complex defects of various etiologies and disorders throughout the body. At its most basic, the KPF is a perforator-type flap designed with a 1:1 flap-to-defect width ratio. Keystone perforator flaps are specifically raised on pedicles arising from musculocutaneous or fasciocutaneous perforator vessels. Major advantages of the KPF derive from the maintenance of perforator vascular territories, perforosomes, permitting increased flap viability. In turn, this allows for more aggressive undermining in sites away from perforators when greater skin mobilization is necessary. Furthermore, the KPF is relatively easy to perform leading to shorter operative times and no postoperative monitoring period. There are basically 4 different types of keystone flaps in order of increasing undermining and disturbance of underlying fascia. These different classifications of KPFs may be used in different anatomical locations over the entire body based on skin laxity and defect size/depth. Numerous advancements and modifications have been documented adapting the KPF to specific conditions, including myelomeningoceles, and scrotal and lower eyelid defects. The purpose of this article is to provide an organized review of the KPF with emphasis on different classifications, applications, and limitations as well as an overview of the surgical technique. We have additionally included a discussion on KPF physiology and review of current literature.

Use of reverse lateral arm flap for coverage of elbow in burn patients.

BACKGROUND: Flap coverage is superior to graft for elbow defects secondary to burns to preserve range of motion. Reverse lateral arm flap is one of the few local options available with good colour and contour match and no sacrifice of major blood vessel. There has been few clinical series describing its use. The aim of this study is to describe its usefulness in both acute and post burn deformities for coverage.of elbow defects. METHODS: Patient's record with burns and elbow defects covered with this flap was reviewed for this descriptive case series. RESULTS: Six patients; three males and three females, underwent one stage reverse lateral arm flap for elbow defects from February 2012 to March 2013. Two patients had acute electrical burns, one had acute flame burn and three patients.had post burn antecubital contractures. All flaps survived completely providing stable coverage and good range of motion after three months. CONCLUSION: reverse lateral arm flap must be kept in the armamentarium of a plastic surgeon for coverage of elbow defects