The internet and various social media platforms as source of information to patients with wounds in Kenya.

Background: The internet has led to the realization that the world is a global village. Due to technological advancements, anyone can access the internet and various video sharing platforms and in turn, get access to or share information across the world. One of the most sought-after critical pieces of information on the internet, as well as social media platforms, is information regarding wounds. Objective: To determine the views of patients with chronic wounds regarding the internet and other social media platforms as a source of information regarding wounds. Methodology: A descriptive prospective study covering the period between November 1, 2022, and January 30, 2023. All patients with chronic wounds presenting in the plastic outpatient clinic, together with patients presenting themselves in the wound clinic at Kenyatta National Hospital (KNH) during this period, were informed about the study and asked to participate. After consenting, they were then required to sign an informed consent form after agreeing to participate. Data collection was done through interviews and filled out in structured questionnaires. Data points included demographics, information on internet use, and interaction with the various social media platforms. Results: 83.4% of the participants were of the opinion that the contents shared were done so by professionals, compared to 12.5% who indicated that the owners or uploaders of the contents were laymen. 2.6% and 1.5%, on the other hand, opined that the owners or uploaders of the contents were unknown and difficult to tell, respectively. Discussion: The participants in the current study felt that some aspects regarding content on wounds that is shared on the internet as well as other social media platforms would need further improvement. Such areas included information regarding wound dressing concepts, the etiology and pathophysiology of wounds, complications of wounds, and wound pain management.

A staged approach for complex scalp defects using titanium mesh and anterolateral thigh flaps: Two case reports.

INTRODUCTION AND IMPORTANCE: Scalp tumors are diverse, with the characteristics of individual tumors depending on the cell lineage. Invasive squamous cell carcinoma and sarcomas of the scalp are a variety of uncommon, aggressive neoplasms of the head and neck. Resecting large invasive tumors causes extensive full-thickness scalp defects, and repairing these defects remains challenging. CASE PRESENTATION: The authors present two successful cases using a staged approach with titanium mesh and free tissue transfer (anterolateral thigh flap) technique. CLINICAL DISCUSSION: Complex scalp defects are challenging to manage when insufficient local tissue is available. This frequently necessitates the use of microvascular free tissue transfer for reconstruction. The availability of microsurgery in developing countries such as ours has enabled functional and aesthetic reconstruction for patients presenting with such complex defects. CONCLUSION: Free flaps are safe and reliable when scalp defects are significant and require both scalp and calvarial reconstructions. The ALT-free tissue transfer shows predictable results in both clinical cases.

Re-implantation of foot and ankle following crush injury of the distal leg with 22 cm bone deficit: A case report.

INTRODUCTION/IMPORTANCE: Crush injury with extensive soft tissue damage to an extremity is generally considered a contraindication to re-implantation and the extremity best managed by prosthesis. However good prosthesis is not easily available especially in resource constrained environment, the overall long term quality of life is also considered better with re-implantation. CASE PRESENTATION: We report a 24 year old tourist patient who presented with post-traumatic amputation of the left leg following a road traffic accident. The patient had no other injuries. Clinical examination revealed extensive soft tissue damage to the involved leg. Radiograph done demonstrated segmental fracture of the distal tibia. The foot was successfully re-implanted after a lengthy surgery of 10 h. The patient was then subjected to an Illizarov bony lengthening procedure to correct the limb discrepancy length of about 20 cm. CLINICAL DISCUSSION: Our patient through multidisciplinary approach and after a combination of many procedures had his foot salvaged with good functional outcome. Though the injury had both bony and soft tissue loss, limb shortening necessitated by the segmental fracture followed by Illizarov technique were able to ensure adequate length. CONCLUSION: Post-traumatic crush amputation of the foot previously considered a contraindication for re-implantation could be salvaged by re-implantation in combination with bone lengthening procedure with good functional outcome.