Dr. Preethitha Babu

Non healing wounds are a major functional and financial burden to the patient and treating surgeon alike. Many methods of adjuvant wound therapy and wound bed preparation exist like Autologous Platelet Rich Plasma injection (APRP), Autologous Lipoaspirate injections (ALA), Bone marrow aspiration therapy (BMAT) etc. Several methods of temporary wound cover are available nowadays like integra, apligraf, collagen etc. Though such temporary dressing materials are available none can meet the biological properties of an allograft. Cadaveric allografts have long been used as a temporary wound cover in patients with extensive burns to reduce the morbidity and mortality in patients. In this article we describe the use of cadaveric allograft as a method for wound bed preparation in patients with non-healing ulcers in a tertiary burns centre.

Aim: The repair of zone II flexor tendon injuries is an evolving topic in hand surgery. It was hypothesized that variability would exist within the hand surgeon community in treatment of zone II flexor tendon repairs in surgical material used, surgical technique, and postoperative rehabilitation protocol. Methods: A single-answer multiple-choice survey was distributed to the 12 plastic surgery trainees of a tertiary care center. Surgeons were asked questions about surgical technique, suture type, common complications, postoperative management, and the factor that plays the largest role in guiding their surgical preferences. Responses were compared with current medical evidence. Conclusions: This study demonstrates that the majority of respondents are performing zone II flexor tendon repairs in accordance with the best currently available evidence, although there is variability with respect to suture material, surgical technique, and rehabilitation protocols.

Introduction: Hypertrophic scars are abnormal scars that are a source of great functional, psychological and financial burden to the patient. Currently available treatment modalities are either very cumbersome to use or have not provided very satisfactory results. Intense pulsed light (IPL) therapy for the management of hypertrophic scars has been recently introduced. However, most of the studies available are from the Western population. In this trial, we aim to study the effect of IPL on the South Indian population with darker skin and compare it with an existing treatment modality (silicone gel sheet). Materials and Methods: This trial was an interventional clinical trial conducted from September 2015 to March 2017 on 28 patients with 65 hypertrophic scars. Each scar was divided into 2 equal parts (4.6 x 1 cm2). One half of the scar was treated to 4 sessions of 29J/cm2 of IPL at 3 weekly intervals. A silicone gel sheet (SGS) was applied over the other half and changed at 3 weekly intervals. The Vancouver scar scale was used to grade both halves of the scar before treatment, at each visit and 3 weeks after treatment completion. Results: Scars treated with IPL showed a significant reduction in the pliability (p=0.002) and hyperpigmentation (p=0.000) as compared to scars treated with SGS. Though the percentage reduction in the height of the scar was more in the IPL group (15.4% as compared to 4.6%in the SGS group), the result was not statistically significant (p<0.065). As most scars in our study showed normal vascularity at the beginning, the percentage reduction in vascularity between both groups was the same (p<0.597). The reduction in the median VSS score was more in the IPL group compared to SGS group (p=0.00). Conclusion: IPL therapy offers a safe and effective means of hypertrophic scar treatment, especially on large scars where other treatment modalities may not be feasible. Minimal side effects that occur can be prevented with proper pre, intra and post procedure cooling.

Wound management forma a key part of the plastic surgeon’s daily practice. In addition to being a financial burden to the patient, it is a major social and emotional problem. The key to management of any wound is proper wound assessment. Wound assessment not only enables the treating physician to know the current status of the wound but enables us to monitor the progress of the wound to intervention. Though many wound assessment tools are available currently, none assess the periwound skin which also forms an integral part of the wound. In this article, the authors have assessed the efficacy of the triangle of wound assessment (TOWA) and its application in the management of postoperative wounds.

De Barsy syndrome, a rare genetic disorder, is characterized by progeroid features, cutis laxa, ocular abnormalities, growth retardation, and intellectual disability. We present a case of 1½- year-old male child with De Barsy syndrome associated with incomplete cleft palate.