Journal of Plastic, Reconstructive & Aesthetic Surgery, 2008
... Titre du document / Document title. Key points in technique : Split thickness skin grafting t... more ... Titre du document / Document title. Key points in technique : Split thickness skin grafting to bare skull as a single stage procedure. Auteur(s) / Author(s). FOONG Deborah PS ; BABAR Ahmed Z. ; MCGROUTHER Duncan A. ; WONG Jason ; Revue / Journal Title. ...
Northern International Medical College Journal, 2015
Objective : The objective of this study was to evaluate the accuracy of Fine Needle Aspiration Cy... more Objective : The objective of this study was to evaluate the accuracy of Fine Needle Aspiration Cytology (FNAC) in diagnosis of Papulonodular skin disease. Methodology : This prospective s t udy was carried out in Bangabandhu Sheik Mujib Medical University (BSMMU) in t h e department of Dermatology and Veneral disease and department of Pathology. Study period was March 2012 to August 2012 (six months). Thirty (30) patients with papulonodular skin lesion for more than 6 weeks were enrolled. Data were collected and analysis was done by using SPSS. Results : Among 30 patients, 14 cases which were histopathologically diagnosed as epidermal inclusion cyst, pilar cyst, lipoma were also diagnosed positive by FNAC and accuracy were 100%. Rest 16 cases which were histopathologically positive as lupus vulgaris, prurigo nodularies,post-kala-a-zar dermal leishmaniasis, erythema nodosum, mycosis fungoides were diagnosed negative by FNAC. Overall accuracy of FNAC was only 46.7%. Conclusions : FNAC has significant limitation for diagnosis of papulonodular skin disease and not a good alternative to histopathology in diagnosis of papulonodular skin disease.
A 28-year-old woman who was 6 months postpartum following her second pregnancy presented with a h... more A 28-year-old woman who was 6 months postpartum following her second pregnancy presented with a history of painful protrusion and weakness of her abdominal wall musculature. Despite having had physiotherapy there was no improvement in muscle strength. MRI scan of her abdominal wall was performed which showed significant diastasis of the recti but no herniae were seen. The effect of this on the patient's quality of life was marked, and therefore abdominoplasty with mesh reinforcement was planned. In order to limit the consequences of infection, a Strattice mesh (a tissue regeneration mesh) was selected. Standard panniculectomy and plication of the rectus sheath using non-absorbable sutures was performed, and the mesh sutured to the anterior abdominal wall using an on-lay technique. The patient recovered well from the procedure, with a significant return of functionality to her abdominal wall, enabling her to return to work some3 months later.
Introduction: Necrotizing fasciitis is a rare condition with a mortality rate of around 34%. It c... more Introduction: Necrotizing fasciitis is a rare condition with a mortality rate of around 34%. It can be mono-or polymicrobial in origin. Monomicrobial infections are usually due to group A streptococcus and their incidence is on the rise. They normally occur in healthy individuals with a history of trauma, surgery or intravenous drug use. Post-operative necrotizing fasciitis is rare but accounts for 9 to 28% of all necrotizing fasciitis. The incidence of wound infection following saphenofemoral junction ligation and vein stripping is said to be less than 3%, although this complication is probably under-reported. We describe a case of group A streptococcus necrotizing fasciitis following saphenofemoral junction ligation and vein stripping. Case Presentation: A 39-year-old woman presented three days following a left sided saphenofemoral junction ligation with long saphenous vein stripping at another institution. She had a three day history of fever, rigors and swelling of the left leg. She was pyrexial and shocked. She had a very tender, swollen left groin and thigh, with a small blister anteriorly and was in acute renal failure. She was prescribed intravenous penicillin and diagnosed with necrotizing fasciitis. She underwent extensive debridement of her left thigh and was commenced on clindamycin and imipenem. Post-operatively, she required ventilatory and inotropic support with continuous veno-venous haemofiltration. An examination 12 hours after surgery showed no requirement for further debridement. A group A streptococcus, sensitive to penicillin, was isolated from the debrided tissue. A vacuum assisted closure device was fitted to the clean thigh wound on day four and split-skin-grafting was performed on day eight. On day 13, a wound inspection revealed that more than 90% of the graft had taken. Antibiotics were stopped on day 20 and she was discharged on day 22. Conclusion: Necrotizing fasciitis is a very serious complication for a relatively minor, elective procedure. To the best of our knowledge, this is the first report in the English-language literature of this complication arising from a standard saphenofemoral junction ligation and vein stripping. It highlights the need to be circumspect when offering patients surgery for non-life-threatening conditions.
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 1997
A relatively atraumatic, simple and very reliable method of retrieving the proximal end of a seve... more A relatively atraumatic, simple and very reliable method of retrieving the proximal end of a severed flexor tendon of a finger or thumb is described. The technique involves passing a Silastic feeding tube into the flexor tendon sheath, placing the retracted tendon within its lumen, and securing it in place with a single stitch. The feeding tube is then withdrawn until the tendon presents within the distal wound. Hypodermic needle fixation and tendon repair is then carried out in the usual manner.
Journal of Medical Case Reports - J Med Case Rep, 2010
INTRODUCTION: Necrotizing fasciitis is a rare condition with a mortality rate of around 34%. It c... more INTRODUCTION: Necrotizing fasciitis is a rare condition with a mortality rate of around 34%. It can be mono- or polymicrobial in origin. Monomicrobial infections are usually due to group A streptococcus and their incidence is on the rise. They normally occur in healthy individuals with a history of trauma, surgery or intravenous drug use. Post-operative necrotizing fasciitis is rare but accounts for 9 to 28% of all necrotizing fasciitis. The incidence of wound infection following saphenofemoral junction ligation and vein stripping is said to be less than 3%, although this complication is probably under-reported. We describe a case of group A streptococcus necrotizing fasciitis following saphenofemoral junction ligation and vein stripping. CASE PRESENTATION: A 39-year-old woman presented three days following a left sided saphenofemoral junction ligation with long saphenous vein stripping at another institution. She had a three day history of fever, rigors and swelling of the left leg...
The results of a prospective, randomised and controlled trial on the use of adrenaline as a vasoc... more The results of a prospective, randomised and controlled trial on the use of adrenaline as a vasoconstrictive agent to reduce blood loss in reduction mammaplasty are presented. Thirty-five patients were entered into the trial and randomised to receive either infiltration with adrenaline (16 patients) or normal saline (19 patients). Highly significant reductions in per-operative blood loss and in total blood loss, as measured by the fall in haemoglobin level at 48 h, were noted. There was no difference in the amount of post-operative drainage between the two groups. No systemic or local adverse effects from the infiltration were observed.
Journal of Plastic, Reconstructive & Aesthetic Surgery, 2008
... Titre du document / Document title. Key points in technique : Split thickness skin grafting t... more ... Titre du document / Document title. Key points in technique : Split thickness skin grafting to bare skull as a single stage procedure. Auteur(s) / Author(s). FOONG Deborah PS ; BABAR Ahmed Z. ; MCGROUTHER Duncan A. ; WONG Jason ; Revue / Journal Title. ...
Northern International Medical College Journal, 2015
Objective : The objective of this study was to evaluate the accuracy of Fine Needle Aspiration Cy... more Objective : The objective of this study was to evaluate the accuracy of Fine Needle Aspiration Cytology (FNAC) in diagnosis of Papulonodular skin disease. Methodology : This prospective s t udy was carried out in Bangabandhu Sheik Mujib Medical University (BSMMU) in t h e department of Dermatology and Veneral disease and department of Pathology. Study period was March 2012 to August 2012 (six months). Thirty (30) patients with papulonodular skin lesion for more than 6 weeks were enrolled. Data were collected and analysis was done by using SPSS. Results : Among 30 patients, 14 cases which were histopathologically diagnosed as epidermal inclusion cyst, pilar cyst, lipoma were also diagnosed positive by FNAC and accuracy were 100%. Rest 16 cases which were histopathologically positive as lupus vulgaris, prurigo nodularies,post-kala-a-zar dermal leishmaniasis, erythema nodosum, mycosis fungoides were diagnosed negative by FNAC. Overall accuracy of FNAC was only 46.7%. Conclusions : FNAC has significant limitation for diagnosis of papulonodular skin disease and not a good alternative to histopathology in diagnosis of papulonodular skin disease.
A 28-year-old woman who was 6 months postpartum following her second pregnancy presented with a h... more A 28-year-old woman who was 6 months postpartum following her second pregnancy presented with a history of painful protrusion and weakness of her abdominal wall musculature. Despite having had physiotherapy there was no improvement in muscle strength. MRI scan of her abdominal wall was performed which showed significant diastasis of the recti but no herniae were seen. The effect of this on the patient's quality of life was marked, and therefore abdominoplasty with mesh reinforcement was planned. In order to limit the consequences of infection, a Strattice mesh (a tissue regeneration mesh) was selected. Standard panniculectomy and plication of the rectus sheath using non-absorbable sutures was performed, and the mesh sutured to the anterior abdominal wall using an on-lay technique. The patient recovered well from the procedure, with a significant return of functionality to her abdominal wall, enabling her to return to work some3 months later.
Introduction: Necrotizing fasciitis is a rare condition with a mortality rate of around 34%. It c... more Introduction: Necrotizing fasciitis is a rare condition with a mortality rate of around 34%. It can be mono-or polymicrobial in origin. Monomicrobial infections are usually due to group A streptococcus and their incidence is on the rise. They normally occur in healthy individuals with a history of trauma, surgery or intravenous drug use. Post-operative necrotizing fasciitis is rare but accounts for 9 to 28% of all necrotizing fasciitis. The incidence of wound infection following saphenofemoral junction ligation and vein stripping is said to be less than 3%, although this complication is probably under-reported. We describe a case of group A streptococcus necrotizing fasciitis following saphenofemoral junction ligation and vein stripping. Case Presentation: A 39-year-old woman presented three days following a left sided saphenofemoral junction ligation with long saphenous vein stripping at another institution. She had a three day history of fever, rigors and swelling of the left leg. She was pyrexial and shocked. She had a very tender, swollen left groin and thigh, with a small blister anteriorly and was in acute renal failure. She was prescribed intravenous penicillin and diagnosed with necrotizing fasciitis. She underwent extensive debridement of her left thigh and was commenced on clindamycin and imipenem. Post-operatively, she required ventilatory and inotropic support with continuous veno-venous haemofiltration. An examination 12 hours after surgery showed no requirement for further debridement. A group A streptococcus, sensitive to penicillin, was isolated from the debrided tissue. A vacuum assisted closure device was fitted to the clean thigh wound on day four and split-skin-grafting was performed on day eight. On day 13, a wound inspection revealed that more than 90% of the graft had taken. Antibiotics were stopped on day 20 and she was discharged on day 22. Conclusion: Necrotizing fasciitis is a very serious complication for a relatively minor, elective procedure. To the best of our knowledge, this is the first report in the English-language literature of this complication arising from a standard saphenofemoral junction ligation and vein stripping. It highlights the need to be circumspect when offering patients surgery for non-life-threatening conditions.
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 1997
A relatively atraumatic, simple and very reliable method of retrieving the proximal end of a seve... more A relatively atraumatic, simple and very reliable method of retrieving the proximal end of a severed flexor tendon of a finger or thumb is described. The technique involves passing a Silastic feeding tube into the flexor tendon sheath, placing the retracted tendon within its lumen, and securing it in place with a single stitch. The feeding tube is then withdrawn until the tendon presents within the distal wound. Hypodermic needle fixation and tendon repair is then carried out in the usual manner.
Journal of Medical Case Reports - J Med Case Rep, 2010
INTRODUCTION: Necrotizing fasciitis is a rare condition with a mortality rate of around 34%. It c... more INTRODUCTION: Necrotizing fasciitis is a rare condition with a mortality rate of around 34%. It can be mono- or polymicrobial in origin. Monomicrobial infections are usually due to group A streptococcus and their incidence is on the rise. They normally occur in healthy individuals with a history of trauma, surgery or intravenous drug use. Post-operative necrotizing fasciitis is rare but accounts for 9 to 28% of all necrotizing fasciitis. The incidence of wound infection following saphenofemoral junction ligation and vein stripping is said to be less than 3%, although this complication is probably under-reported. We describe a case of group A streptococcus necrotizing fasciitis following saphenofemoral junction ligation and vein stripping. CASE PRESENTATION: A 39-year-old woman presented three days following a left sided saphenofemoral junction ligation with long saphenous vein stripping at another institution. She had a three day history of fever, rigors and swelling of the left leg...
The results of a prospective, randomised and controlled trial on the use of adrenaline as a vasoc... more The results of a prospective, randomised and controlled trial on the use of adrenaline as a vasoconstrictive agent to reduce blood loss in reduction mammaplasty are presented. Thirty-five patients were entered into the trial and randomised to receive either infiltration with adrenaline (16 patients) or normal saline (19 patients). Highly significant reductions in per-operative blood loss and in total blood loss, as measured by the fall in haemoglobin level at 48 h, were noted. There was no difference in the amount of post-operative drainage between the two groups. No systemic or local adverse effects from the infiltration were observed.
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