R K Chittoria

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.

Innovative usage of accessory auricles as full-thickness skin graft

Accessory auricles are relatively rare malformations arising from the first branchial arch which contains skin, fat and cartilage. The treatment is usually surgical removal for the cosmetic purpose. We are sharing our experience of utilising the accessory auricle skin as full thickness graft for post.burn reconstruction of the fingers contracture of a child. Even though this type of association is rare, it is an innovative idea following Sir Harold Gilles’ principle ‘Never throw anything away’.

Role of jet force technology in wound management

Aim: The aim was to study the role of jet force technology (JFT) in wound management. Methods: This is a retrospective analysis of 18 cases of chronic nonhealing wounds in which JFT was used. Chronic wounds which had already undergone surgical debridement but which were not ready for reconstruction (skin graft/flap) secondary to a persistent bacterial load or infection (tissue culture positive) were included in the study. Patients were divided into two groups. Group 1 included those patients who were poor candidates for anesthesia or who refused for reconstruction and were managed with JFT only. Group 2 included those patients who were cleared for anesthesia and who were and who were managed with JFT and skin graft or flap coverage. The time to negative wound cultures after JFT and the total duration of healing were noted. Results: In both the groups, all tissue culture positive chronic wounds became negative after 2 ± 1 weeks and were ready for reconstruction. In Group 1 (6 patients), the wounds completely healed in 5‐6 weeks with JFT only. In Group 2 (12 patients), the wounds completely healed in 3‐4 weeks with JFT and skin graft/flap. Conclusion: Hydrotherapy with JFT helps in the removal of contaminants, debris, and microbial colonization of the wound leading to spontaneous wound healing and facilitating wound bed preparation for wound coverage by a skin graft or flap.

Diode and Nd:YAG laser in a case of refractory acne keloidalis nuchae

Acne keloidalis nuchae (AKN) is a disease of unclear etiology that mainly affects males. Medical treatment of AKN is difficult, with refractory cases often requiring ablation by laser or surgical resection. We report herein, a 23-year-old male with refractory AKN treated successfully with combined laser ablation, using an 810-nm diode laser and a 1064-nm Nd:YAG laser.

Unburied K-wire induced injuries: taking the edge off

Unburied K-wires left projecting from the fingers after hand surgery can lead to inadvertent injuries if left open, especially in children or disoriented patients, particularly at the time of reversal of anesthesia and in the immediate postoperative period. Different ways have been described to circumvent this. Many surgeons twist the K-wire on itself along with capping of the wire tip, but this requires considerable twisting force on an already inserted K-wire, which can lead to malalignment or even refracture.[1] Furthermore, the bent K-wire acts like a hook, catching onto dressing materials or clothes and subsequently may migrate out.