A. Eldad

A new temporary synthetic skin substitute

Eighteen months of experience with a new synthetic temporary skin substitute (Omiderm, Omikron Scientific Ltd., Rehovot, Israel) is presented. The substitute is a thin, transparent, flexible membrane. It is used when a biological dressing would otherwise have been used. Our experience consists of laboratory studies and 75 clinical cases including donor sites application, chronic wounds, ulcers, partial thickness and full thickness burns. The membrane is very elastic, permitting free movement and physiotherapy during the healing process. The material protects the wound and prevents either the accumulation of fluid under it or wound desiccation. It does not interfere with the normal healing process. It reduces pain, prevents bacterial invasion and is very easy to handle. Complications, such as haematoma formation or infection, were quite few. We recommend its use in routine daily practice.

Very deep burns of the hand due to low voltage electrical laboratory equipment: a potential hazard for scientists

A low voltage (24 V) electrical deep burn of the hand injured a professor of applied physics when performing an experiment in his laboratory. The potential hazard of the equipment is described, the injuries are reported and the literature is reviewed.

Use of buried skin implants after recurrent failure of conventional skin grafting in a massive burn: the renewal of an old technique

The technique of burying small pieces of skin under old granulation tissue after recurrent failure of conventional skin grafting is described in a patient with 95 per cent full skin thickness burns. This method of treatment, which was described in the past and neglected, is of value for massive burns or grafting in difficult areas. The technique is described again and the relevant literature reviewed.

Full thickness, split thickness and culture epithelium as a treatment for ulcerative lichen planus

SummaryUlcerative lichen planus is a rare and chronic form of lichen planus. The disease affects mainly the feet and the oral cavity. This form is not only extremely painful and disabling, but carries the hazards of malignant transformation. Only nine patients described in the literature had excision and skin grafting of their lesions, with good short and long-term results. We present a case report of a patient with 27 years history of ulcerative lichen planus and multiple skin grafting and recurrencies. We present an alternative method of treatment with culture epithelium allograft as a temporary measure.

Complete and partial denudation of the penis following circumcision

SummaryTwo cases of iatrogenic denudation of the penis following a ritual Jewish circumcision are presented. They were treated within 24 h by split thickness skin grafting. The different approaches in repair are described, and the literature is reviewed.

Sebaceous gland adenocarcinoma

SummaryMalignant neoplasms of sebaceous glands are rare; these generally occur in the ocular adnexae where sebaceous carcinoma presents as an infiltrating malignancy with a poor prognosis. Extraocular sebaceous carcinoma are rarer but have a better prognosis. Those tumors occur generally in older patients. A 32-year-old man is presented 10 years post-surgery with local recurrence and nodal metastasis. The potential course of this tumor is emphasized and the relevant literature reviewed.

Influence of a temporary synthetic skin substitute on capillary stasis in burns

SummaryThe prognosis of deep partial thickness burns depends on several factors e.g. infection, wound dehydration, mechanical trauma etc. As shown by Zawacki years ago, the prognosis can be influenced by immediate post-burn application of various dressings. Appropriate dressings can cause early reversal of the capillary “stasis zone”, improving the prognosis. In his study, Zawacki showed that he could achieve the best results by using porcine skin grafts. In our study, we repeated Zawackis experimental model, replacing porcine skin graft with a temporary synthetic skin substitute, Omiderm®. Deep partial thickness burns were inflicted on guinea pigs, who were then divided into three groups and treated as follows: removal of burn blister, burn blister left intact and removal of burn blister which was then replaced by Omiderm. At various times the animals were sacrificed and perfusion with India ink was performed in order to evaluate capillary stasis and its reversal. Upon statistical analysis of results we found that by using Omiderm we achieved early reversal of the stasis zone, as compared to the other groups. It seems to us that appropriate early treatment of deep partial thickness burns can make a significant difference to the prognosis of the burn wound.