Autogenous control augmentation system - A refinement in diced cartilage glue graft for augmentation of dorsum of nose.

BACKGROUND: In the context of different grafts being used for dorsal augmentation, diced cartilage with glue has gained worldwide acceptance. AIMS: To develop a system of tools to objectively evaluate the desired dimensions of the required graft for dorsal augmentation and to prepare a corresponding customized-glued-diced cartilage construct. MATERIALS AND METHODS: A modification of the diced cartilage glue technique called Autogenous control augmentation system (ACAS) was used in ten patients. RESULTS: Of the ten patients, in which this technique was used, eight underwent primary rhinoplasties and two underwent secondary rhinoplasties between July 2017 and December 2017 with a follow-up ranging from 3 to 8 months. In all the cases, the dorsum is straight, and height is maintained. CONCLUSION: The technique has all the advantages of the diced cartilage glue. The shape resembles alloplastic implant with height and width varying from radix to tip. There is tapering of the cephalic and caudal ends for more natural results. The brow tip aesthetic lines are better defined. The limitation of this study is short follow up.

Treating mucormycosis using a multimodality approach: a case series.

Most fungal infections found in wounds are secondary or superadded, and are generally benign in their clinical course in healthy individuals, with the exception of mucormycosis. This is a life-threatening infection caused by fungi of the order Mucorales. Primary cutaneous disease may occur following traumatic implantation of spores, or use of contaminated bandages, or as a complication of extensive burns, diabetic acidosis and other specific immunocompromised conditions. The clinical spectrum is highly non-specific and is often triggered by seemingly innocuous trauma. The superficial vesicles or patchy erythema rapidly degrade to haemorrhagic necrosis and rapidly progressive gangrenous lesion. The problem with diagnosing mucormycosis remains, therefore, that the condition has poor clinical indicators and requires reliance on microscopy and fungal culture. Management starts with a clinical suspicion, taking into account the risk factors and lack of response to first-line agents, as well as an aggressive clinical course. Treatment is multimodal, with medical correction of the risk factors and optimisation of limiting factors, such as diabetes, neutropenia and immunosuppressants. Treatment generally involves radical and repetitive surgical debridement, intravenous amphotericin B with monitoring of the nephrotoxicity, along with adjuvant modalities, such as hyperbaric oxygen therapy, colony stimulating factor, interferons gamma and white blood cell transfusion. Successful courses of therapy typically last 4-6 weeks and require cumulative doses that are equivalent to >2g of amphotericin B deoxycholate.

Osseous Metaplasia Mimicking Long Bone in Intramuscular Vascular Malformation.

We describe a case of intramuscular vascular malformation with extensive ossification within the posterior compartment muscles of leg which grossly mimicked long bone leading to equinus deformity of foot. Phleboliths and calcifications are characteristic of vascular malformations, while massive ossification is rare. To our knowledge, no extensive ossified vascular malformation within the leg muscle has been reported. Intramuscular vascular lesions occur with an incidence of 0.8%, most frequent in upper and lower extremities. Most are venous malformations. The diagnosis is rarely made before surgery and requires a definitive histological analysis, as there are no pathognomonic clinical or radiographic findings, especially with extensive ossification. Spontaneous regression does not occur, and excision of lesion is due to aesthetic and functional disturbances.

Efficacy and safety of oxum in treatment of chronic wounds.

Chronic wounds represent a major health burden contributing to substantial mortality, morbidity and costs. Several new treatment options are currently available, which has revolutionised the management of chronic wounds. The present study is a single centre, prospective, clinical trial comparing oxum (super oxidised water) and betadine as a topical treatment of chronic wounds conducted in 30 Indian patients, with 15 patients in each group. At the end of the study, there was a significant reduction in primary parameters such as wound area and microbial colony count in oxum treated group compared to betadine group. However, both the oxum and betadine treated group showed a similar results when the secondary parameters such as oedema, erythema and granulation tissue were considered. Oxum was better tolerated than betadine. It can be concluded that use of oxum (super oxidised water) is a novel technological innovation in the therapy of chronic wounds. Oxum has been shown to be effective, well tolerated and superior to betadine in wound care.