M T Friji

The reconstructive microsurgery ladder in orthopedics

It was interesting to read the article titled ‘‘The Reconstructive icrosurgery Ladder in Orthopedics’’ [1]. The authors have viewed the history of microsurgery in orthopedics and introprimitive binocular microscope to operate on patients with chronic otitis in 1921 [8]. In 1946, Perritt applied the use of the microscope to ophthalmology [9]. It is true that Jacobson and Suarez were the first to utilise the microscope to perform microvascular anastomosis. They were also the ones who introduced the diploscope, a stereoscopic microscope for microvascular anastomosis [7], thus setting the stage for modern microvascular surgery.

New regenerative approach to atrophic rhinitis using autologous lipoaspirate transfer and platelet‐rich plasma in five patients: Our Experience

Dear Editor, Atrophic rhinitis (AR) is a debilitating chronic nasalmucosal disease of unknown aetiology. The condition is characterised by progressive nasal mucosal atrophy, atrophy of the underlying bone of the turbinate, abnormal widening of the nasal cavities with paradoxical nasal obstruction and formation of viscid secretions and dried crusts leading to a characteristic fetor (ozaena). Atrophic Rhinitis was first described by Fraenkel in 1876, but the aetiology of the disease is still a matter of dispute. Various methods of treatment, both medical and surgical, have been tried without much success. However, clinical features of the disease can be attributed to the destruction of the normal respiratory epithelium and metaplasia to a nonciliated squamous epithelium and loss of mucociliary clearance. Thus the curative treatment of AR should address the reversal of this basic pathologic alteration in its microanatomy. Promotion of regeneration of normal nasal mucosa must be the aim of any treatment for long-lasting success. The aim of this article is to present a new regenerative approach to reverse atrophy of nasal mucosa by grafting autologous of lipoaspirate.

Algorithm based on eighteen patients with acquired traumatic earlobe defects not associated with jewellery

Dear Editor, Acquired earlobe defects are quite common. These may range from the ubiquitous split ear lobule to loss of portion of the earlobe or to more complex defects involving part of the ear helix. Simple earlobe defects can be closed primarily. Reconstruction of the latter types of defect is more difficult. While the surgical options available for these earlobe defects are many and varied, no specific algorithms could be found in the English literature that would help in the selection of a flap design for a particular defect. This study proposes to introduce a new classification scheme for acquired earlobe defects and suggests an algorithm to aid in the treatment planning of such conditions.

Camphor burns of the palm and non-suicidal self-injury: an uncommonly reported, but socially relevant issue

Camphor is a waxy white sublimating chemical derived from natural as well as synthetic sources and widely used in various communities worldwide for a number of medicinal, culinary, and religious reasons. Camphor is burnt as an offering to God in many religious communities. We report three incidences of self inflicted injury from burning camphor on the palm resulting in full thickness burns. Non-suicidal self-injury is socially unacceptable destruction or alteration of body tissue when there is no suicidal intent or pervasive developmental disorder and we have explored an association between this and burn injury. This report also highlights the unique social and cultural pattern of this burn injury and the importance of psycho-therapeautic help for these victims.

Five “Ds” of plastic surgery

Although there are a variety of definitions that describe plastic surgery, confusion persists in the minds of both the lay public and doctors. A common lay misconception is that actual pieces of plastic are used to repair injured tissues or placed over defects to make them appear better. On the other hand, resident doctors from specialities such as ear-nose-throat and general surgery fail to appreciate the vast scope that plastic surgery specialty entails. In recognition of this, trainee plastic surgeons are often asked to briefly define our specialty in their final exams, so that subsequent misconceptions are minimized.

Effectiveness of fibrin glue in adherence of skin graft

Background: Graft fixation is important for graft take. Fibrin glue has been proposed as an ideal material, because of its human origin and it provides firm adhesion in seconds or minutes. Objective: To evaluate the efficiency of fibrin glue, in increasing the take of skin graft. Assessment includes surgical time taken for graft fixation, haematoma/seroma formation, engraftment and wound closure by day 14. Methods: The study is an observational prospective study conducted in the Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, from January 2016 to June 2016. Sixteen patients who underwent split skin grafting were assessed during the study period. Fibrin glue was used on the recipient bed before grafting. Results: Better haemostasis and graft adhesion, with a significant reduction of surgical time, were noted. Conclusion: The safety profile of fibrin glue was excellent as indicated by the lack of any related serious adverse experiences. These findings demonstrate that it is safe and effective for attachment of skin grafts, with outcomes at least as good as conventional methods.

Are lasers superior to lights in the photoepilation of Fitzpatrick V and VI skin types? – A comparison between Nd:YAG laser and intense pulsed light

ABSTRACT Background and objectives: There are no large volume comparative studies available to compare the efficacy of lasers over lights for hair removal in Fitzpatrick V and VI skin types. This study is designed to compare the efficacy of Nd:YAG laser versus IPL in the darker skin types. Study design/materials and methods: Thirty-nine patients included in Group-1 were treated with Nd:YAG and 31 in Group-2 with IPL. Both groups received 5 sessions of treatment. The hair counts were assessed using digital photography and manual counting method before and after treatment and the results were analysed. Patient satisfaction scores and pain scores were recorded in each session and compared. Results: Mean hair reduction in the IPL group was 25.70 and Nd:YAG group was 24.12 (95% CI). In the Nd:YAG group, 59% of subjects had burning sensation while the figure was 32.3% in IPL group. Burning was less in IPL group (p < 0.023). There were no statistically significant differences noticed regarding hyperpigmentation in both the groups (p < 0.115). Conclusion: Both Nd:YAG and IPL are equally effective for epilation of the darker skin types. Nd:YAG is associated with mild burning sensation in a significant number of patients. Patient satisfaction scores were comparable in both the groups.

Mnemonics for gillies principles of plastic surgery and it importance in residency training programme

How to cite this article: Gupta A, Gupta S, Kumar A, Jha MK, Bhattacharaya S, Tiwari VK. Novel use of preputial flap. Indian J Plast Surg 2017;50:112-4. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Utility of laser in lobuloplasty

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Camphor burns over the forehead: Socially relevant non-homicidal injury in a child

1. Agrawal KS, Bachhav M, Shrotriya R. Namaste (counterbalancing) technique: Overcoming warping in costal cartilage. Indian J Plast Surg 2015;48:123-8. 2. Kim DW, Shah AR, Toriumi DM. Concentric and eccentric carved costal cartilage: A comparison of warping. Arch Facial Plast Surg 2006;8:42-6. 3. Agrawal K, Shrotriya R, Bachhav M. Diced cartilage under perichondrial carpet with reinforcement (DCUP) technique for nasal dorsal augmentation. J Cleft Lip Palate Craniofac Anomal 2016;3:3-8. 4. Tastan E, Yücel ÖT, Aydin E, Aydogan F, Beriat K, Ulusoy MG. The oblique split method: A novel technique for carving costal cartilage grafts. JAMA Facial Plast Surg 2013;15:198-203.