Australasian survey of split skin graft donor site dressings.

BACKGROUND: There is an ever increasing array of products available for wound dressings. The aim of the present study was to establish which dressings should be used as standard controls for future studies; what factors are regarded as most important in assessing a dressing; what the level of satisfaction is with the available products; what the strengths and weaknesses of the commonly used dressings are; and what dressings would be preferred if cost were no issue. METHODS: A postal survey was sent to every plastic and reconstructive surgeon registered in Australasia (n = 217). A total of 53% responded. RESULTS: The most commonly used dressing type overall is the calcium alginates, despite the fact that they were not the highest performing dressings. This is also the most commonly used in Australia. In contrast scarlet red is still used most commonly in New Zealand. The level of satisfaction with the most commonly used dressing varied very little. The factor regarded most important was patient comfort level. A profile of the commonly used dressing was constructed. Calcium alginates and or scarlet red should be used as the control for new product comparisons. CONCLUSIONS: Most of the respondents were satisfied with their preferred dressing and were not interested in trying alternative dressings.

A comparison of Zenoderm with DuoDERM E in the treatment of split skin graft donor sites.

A prospective, randomised, controlled study compared Zenoderm (ZM) with DuoDERM E (DE) in the treatment of split skin graft donor areas in 64 patients. The donor site comfort was similar in the two groups. DE usage resulted in significantly faster healing but also a higher leakage rate than ZM. Two patients in the ZM group developed infection in their donor sites. The cost is significantly less with ZM than DE.

Upper-limb surgery for tetraplegia.

We reviewed the results of reconstruction of 97 upper limbs in a consecutive series of 57 tetraplegic patients, treated from 1982 to 1990. Of these, 49 had functional and eight had cosmetic reconstructions. The principal functional objectives were to provide active elbow extension, hook grip, and key pinch. Elbow extension was provided in 34 limbs, using deltoid-to-triceps transfer. Hook grip was provided in 58 limbs, mostly using extensor carpi radialis longus to flexor pollicis longus transfer, and key pinch in 68, mostly using brachioradialis to flexor pollicis longus transfer. Many other procedures were employed. At an average follow-up of 37 months, 70% had good or excellent subjective results, and objective measurements of function compared favourably with other series. Revisions were required for 11 active transfers and three tenodeses, while complications included rupture of anastomoses and problems with thumb interphalangeal joint stabilisation and wound healing. We report a reliable clinical method for differentiating between the activity of extensor carpi radialis longus and brevis and describe a successful new split flexor pollicis longus tenodesis for stabilising the thumb interphalangeal joint. Bilateral simultaneous surgery gave generally better results than did unilateral surgery.

Lignocaine vs bupivacaine in prominent ear correction: a controlled trial.

Thirty patients were assigned to two equal groups to compare the effects of ear infiltration with bupivacaine versus lignocaine prior to correction of prominent ears. There was a statistically significant decrease in narcotic requirement in the first 4 h postoperatively in the bupivacaine group, associated with a decrease in the antiemetic requirement. The choice of local anaesthetic did not significantly affect the incidence of vomiting.

Absolute minimum instability thresholds in a nonlinear ring cavity containing a Kerr medium.

Stability analysis of an arbitrary-finesse ring cavity containing a Kerr medium of arbitrary response time reveals an absolute minimum threshold for the driving intensity necessary for realization of self-pulsing instabilities. This threshold is minimized not only with respect to cavity mistuning but also with respect to the medium's response time. The instability threshold is typically six times that for optical bistability.

The hairless osteotomized radial forearm flap.

A case is reported demonstrating that the radial osteocutaneous free flap can be "ill-treated" by excision of its hairy skin and split-skin grafting prior to transfer and osteotomy of its bony element during transfer without apparent adverse effect.

Comparative reliability of nasal pharyngoscopy and videofluorography in the assessment of velopharyngeal incompetence.

A panel of three has reviewed a series of 100 videotape records of nasopharyngoscopy, basal fluorography and lateral fluorography made of patients being investigated for velopharyngeal incompetence. The quality of each record was assessed and estimates of movement made as a basis for comparison of the three methods. Nasopharyngoscopy and lateral fluorography provide a high proportion of material with good definition of the velopharyngeal isthmus (80%). Basal fluorography is less reliable (60%). Lateral fluorography was found to be unreliable as a measure of velopharyngeal incompetence, while estimates of movement from the other two were compatible. Basal fluorography is the procedure of choice in young children. Nasendoscopy provides good quality information more often than basal fluorography in patients over the age of eight and is markedly superior in the presence of a pharyngeal flap.

Prediction formulae for normal pulmonary function values in New Zealand European subjects.

The prediction formulae for normal pulmonary function values, VC, FEV1, FRC, RV, TLC and DCO, in New Zealand European subjects have been established for the first time. The 159 male and 169 female volunteers were aged 15--75 years and were non-smokers and healthy.

Barbecue burns.

An increasing incidence of methylated spirit burns in barbecue users is documented in a three year retrospective survey. A plea is made for better public education on the correct use of methylated spirit in this context.

The groin flap in hand injuries.

The groin flap has been used as Burwood Hospital in 12 cases of hand injury. The types of injury, the variety of application and the complications are presented and the usefulness of the groin flap discussed in the light of this experience.