Role of customised negative-pressure wound therapy in the integration of split-thickness skin grafts: A randomised control study.

BACKGROUND: Split-thickness skin grafting (STSG) is a time-tested technique in wound cover, but many factors lead to suboptimal graft take. Role of custom-made negative-pressure wound therapy (NPWT) is compared with conventional dress in the integration of STSG and its cost is compared with widely used commercially available NPWT. MATERIALS AND METHODS: This is a parallel group randomised control study. Block randomisation of 100 patients into one of the two groups (NPWT vs. non-NPWT; 50 patients each) was done. Graft take/loss, length of hospital stay post-grafting, need for regrafting and cost of custom-made negative pressure wound therapy (NPWT) dressings as compared to widely used commercially available NPWT were assessed. RESULTS: Mean graft take in the NPWT group was 99.74% ± 0.73% compared to 88.52% ± 9.47% in the non-NPWT group (P = 0.004). None of the patients in the NPWT group required second coverage procedure as opposed to six cases in the non-NPWT group (P = 0.035). All the patients in the NPWT group were discharged within 4-9 days from the day of grafting. No major complication was encountered with the use of custom-made NPWT. Custom-made NPWT dressings were found to be 22 times cheaper than the widely used commercially available NPWT. CONCLUSIONS: Custom-made NPWT is a safe, simple and effective technique in the integration of STSG as compared to the conventional dressings. We have been able to reduce the financial burden on the patients as well as the hospital significantly while achieving results at par with other studies which have used commercially available NPWT.

Silicone Foley's catheter as an effective alternative to Hunter's rod in staged flexor tendon reconstruction of the hand.

CONTEXT: Staged flexor tendon reconstruction is most suitable treatment method for extensive zone II tendon injuries. The Hunter's rod used in this procedure is costly and not easily available, which adds to the miseries of both patients as well as treating surgeon. AIMS: The aim of this study is to evaluate the results of staged zone II flexor tendon repair using silicone Foley's catheter as a cheaper and readily available alternative to Hunter's rod. SETTINGS AND DESIGN: This was a prospective study. MATERIALS AND METHODS: Seventy digits in 35 patients were treated by the staged flexor tendon reconstruction using silicone Foley's catheter in place of Hunter's rod, and the patients were followed for an average period of 18 months. Early controlled motion exercise protocol was instituted in all cases. RESULTS: As per the Strickland scale, total active motion obtained was excellent in 70%, good in 20%, fair in 7.1% and poor in 2.9% of patients. CONCLUSIONS: Silicone Foley's catheter is cheaper, easily available and an effective alternative to Hunter's rod in staged flexor tendon reconstruction procedure, yielding high rates of excellent and good results with fewer complications.

Giant lipoma: a case report.

A lipoma is a fatty tissue tumor presenting as a painless slowly growing mass that can affect any part of the body rich in adipose tissue. Lipomas can be present in the thigh, shoulder, trunk, etc, although they are usually small. We are reporting a 65-year-old man with a giant lipoma involving his left buttock and lumbar region.

Isolated aglossia in a six year old child presenting with impaired speech: a case report.

INTRODUCTION: The most mobile organ of the body, the tongue is associated with various congenital anomalies; most of which are in association with many other systemic abnormalities. Rarely do they occur in isolation. Isolated aglossia, that we presented, is one of the more rare presentations. CASE PRESENTATION: Our patient is a 6-year-old male child of Asiatic origin from Kashmir (India), who was physically well built and mentally sound and presented with history of impaired speech. The patient had normal velopharangeal competence but absence of tongue which was replaced by a small mucus membrane projection near the floor of oropharangeal isthmus. The patient had no difficulty in feeding or taste sensation but he was unable to pronounce lingual consonants. CONCLUSION: Isolated aglossia is very rare condition explained on the basis of growth failure of lateral lingual swellings and tubercular impar. Such patients do not usually need reconstruction of tongue; as feeding, swallowing and taste sensations are usually intact and speech cannot be improved by reconstruction. However, malocclusion of teeth needs to be taken care of.