Measurement of surface temperature as an aid to the diagnosis of burn depth.

In 60 burned patients, the depth of injury was assessed clinically, and then surface temperature measurements were taken of the burn and of nearby unburned skin. The final diagnosis of burn depth was determined by the time taken to heal or by the findings at excision of the burn. The temperature difference between burned and unburned skin correlated with the depth of the injury. Overall diagnosis of burn depth was 60 per cent accurate by clinical assessment and 78 per cent accurate by measurement of surface temperature. Accuracy was greater when burns of the hand, face and feet, and burns seen late, were excluded.

Use of tissue expanders after burns and other injuries.

During the first year of use of tissue expansion at the Birmingham Accident Hospital, 24 patients had expansion procedures at 29 sites. Most of these were to revise burn scars. A number of complications occurred and five procedures were abandoned. The advantages and problems of the technique are discussed.

Some anatomical observations on the human placenta as applied to microvascular surgical practice.

The human placenta has many vessels traversing its foetal surface. A variety of sizes is available down to vessels of diameter 1 mm. Selection of a suitable artery can provide a vessel that can be satisfactorily used for microsurgical practice. Where other preparations are not available, the human placenta appears to offer a reasonable, cheap and readily available alternative.

Prediction of gall-stone pancreatitis by computer.

The clinical features at presentation of 53 patients admitted with primary acute pancreatitis due to gall stones were compared with those of 31 patients in whom the disease was due to other causes. Between these two groups 10 significant differences existed. By listing the frequency of symptoms and signs for each group a computer data base was prepared and incorporated into a program used in the differential diagnosis of acute abdominal pain. A program written to predict the presence of gall stones in patients with acute pancreatitis was accurate in 92% of the patients studied. A predictive index devised from the presence of three of the significantly differing clinical features correctly identified 82% of patients with gall-stone pancreatitis. Predicting the presence of gall stones on admission by analysing the presenting symptoms and signs with a computer had an accuracy comparable to that of ultrasonography or radiology and may be of value in the management of patients with acute pancreatitis.