A plastic surgeon goes to Nepal. What he found surprised him.

Sitting in a rickety jeep rumbling through treacherous mountainous terrain, on winding unpaved roads full of blind curves and teetering on the edge of cliffs recently ravaged by an earthquake, I began to question my decision to go along on this trip.  We were about 3 hours outside Kathmandu, Nepal heading to a small village along the banks of the Melamchi River.  The driver, who could not have been any older than my teenage son, reassured us that we were almost there.  It would be another hour before “there” became “here”! Our destination on this day was a school devastated by the recent earthquakes in that country.  Our goal was to assess the children at this school and provide medical care as needed.  I nervously glanced over to my colleague from the American Society of Indian Plastic Surgeons (ASIPS).  A dear friend and a fellow reconstructive plastic surgeon from San Diego, Dr. Batra.  It was as if I could read his mind.  “What the heck are we doing .. we are plastic surgeons..we belong in the operating room NOT rumbling through earthquake ravaged mountains of Nepal!” The last few days, we were doing exactly that.  Having arrived from the U.S., we were working in a hospital in Kathmandu doing what we do best, reconstructive surgery.  We were in the operating room, our comfort zone where we do our work.  Burn injuries, crush injuries, poorly healing wounds requiring reconstructive su...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Physician Surgery Source Type: blogs

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In this study, we describe for the first time an invertebrate model of burn trauma and concomitant wound infection. We demonstrate that this model recapitulates many of the hallmarks of burn trauma and wound infection seen in mammalian models and in human patients. We outline how this model can be used to discriminate between high and low pathogenicity strains of two of the most common burn wound colonizers Pseudomonas aeruginosa and Staphylococcus aureus, and multi-drug resistant Acinetobacter baumannii. This model is less ethically challenging than traditional vertebrate burn wound models and has the capacity to enable e...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
Background: NovoSorb ® Biodegradable Temporising Matrix (BTM) is a synthetic dermal template recently approved for treatment of full thickness defects of the skin. It requires a two-stage reconstruction where it is initially placed into a defect to generate a neodermis, which is later covered by a split skin graft. It has previously been described for the treatment of acute full thickness burn injury, necrotizing fasciitis and free flap donor site reconstruction.Methods: A consecutive case series review of patients treated with BTM at Middlemore Hospital was performed.
Source: Journal of Plastic, Reconstructive and Aesthetic Surgery - Category: Cosmetic Surgery Authors: Source Type: research
CONCLUSION: In southwest China children under 3 years old, scald burns are most common, and most burns occur at home. It seems that TBSA, skin grafting, age and burn depth are best predictors of the prognosis in hospitalized children with burns. PMID: 32435871 [PubMed - as supplied by publisher]
Source: Wiener Klinische Wochenschrift - Category: General Medicine Authors: Tags: Wien Klin Wochenschr Source Type: research
ConclusionThe ocular environment is critical for successful KPro surgery. A multidisciplinary approach for any lid and ocular surface abnormality in ocular burns or Stevens –Johnson syndrome is important to improve the quality of the ocular surface and accommodate KPro and AGV, which is vital for maintaining vision after KPro surgery. FP8 AGV may be feasible for IOP control in adult KPro cases with restricted subconjunctival space.
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
CONCLUSIONS The findings suggest that in Southwest China, prevention programs for children aged 0-9 years, injuries occurring in winter and non-workplace sites, and fire burns were imperative. PMID: 32417848 [PubMed - as supplied by publisher]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
CONCLUSIONS: From the evidence available, the Ponseti technique may produce significantly better short-term foot alignment compared to the Kite technique. The certainty of evidence is too low for us to draw conclusions about the Ponseti technique compared to a traditional technique. An accelerated Ponseti technique may be as effective as a standard technique, but results are based on a single small comparative trial. When using the Ponseti technique semi-rigid fibreglass casting may be as effective as plaster of Paris. Relapse following the Kite technique more often led to major surgery compared to relapse following the Po...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
ConclusionsMicrografting is a feasible alternative for wound coverage and a useful tool for surgeons  when donor sites are limited.Level of evidence: Level IV, therapeutic  study.
Source: European Journal of Plastic Surgery - Category: Cosmetic Surgery Source Type: research
Publication date: Available online 12 May 2020Source: BurnsAuthor(s): Avi Adam Cohen, Lior Har-Shai, Dean Ad-El, Tamir Shay
Source: Burns - Category: Dermatology Source Type: research
This study was designed to establish a mouse model for studying the inhibitory effect of dermal substitutes on FTSG contraction. Secondarily, the model quantitatively assessed the specific effect of Integra ™ on FTSG contraction and examined if Integra™ can be used in a single-stage procedure with a FTSG.MethodsEighteen male Wistar mice had a quadrangular 3  × 2 cm full-thickness skin defect produced on their back and divided into two groups. In the first group, the graft obtained from the defect was sutured back down as a FTSG. In the second group, Integra™ was placed under 30% o...
Source: European Journal of Plastic Surgery - Category: Cosmetic Surgery Source Type: research
Conclusions: Enzymatic debridement is a useful tool in the treatment of burned hands but the decision-making and correct timing of operative intervention in deep partial thickness burns after debridement requires experience. In our cohort, spontaneous healing of deep partial thickness burns was best in patients with contact burns and less than 15% burn TBSA. PMID: 32315252 [PubMed - as supplied by publisher]
Source: Journal of Plastic Surgery and Hand Surgery - Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research
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