Background. Early excision of burn eschar and urgent skin cover is mandatory for survival in all major burns. The tremendous cost and time delay in cultured skin and the shortage of donor allograft can make early skin cover a life threatening problem for paediatric patients in this country. The Meek micrografting technique was introduced in 2003 as a rescue method to achieve epithelialisation in major burns. Objective. To evaluate its role in the management of major burns with reference to its efficacy, technical detail and role in major burn surgery.

There has been a change in the management of infantile haemangioma with the introduction of propranolol. The aim of this study is to retrospectively evaluate a simple treatment for infantile haemangioma at the Red Cross War Memorial Children’s Hospital (RCWMCH) and document the results. While it is known that all haemangiomas undergo involution at some stage, some haemangiomas pose certain problems. These relate mainly to visual axis obstruction and aesthetics. Subjects are children in the first two years of life presenting with haemangiomas. All patients were treated with oral propranolol in conjunction with haemangioma size documentation, using a simple radiological modality, i.e. ultrasound imaging. Patients are followed up and clinical and radiological evaluations are undertaken to observe changes in size and appearance. Propranolol is non-selective β-adrenergic antagonist that is used extensively for the treatment of a multitude of disorders, mainly cardiovascular indications. The main adverse effects include bradycardia, hypotension and bronchospasms. For the purposes of this study, all subjects were routinely examined, especially with regard to the cardiopulmonary systems. Any perceived anomaly was referred to the cardiorespiratory physicians at RCWMCH for further evaluation, which includes all the necessary investigations such as electrocardiograms(ECG) and echocardiograms. Therefore, only fit healthy patients were selected for this study. Patients are educated and fully informed regarding the adverse effect profile of propranolol, and advised of the appropriate route of management.

Includes bibliographical references. / More than three-quarters (77%) of the 40.5 million people living in South Africa are black African, of which more than 40% are urbanised. Black African women living in urban areas have a significantly higher prevalence (62%) of overweight than urban black males (28%) or white females (53%). It was previously thought that obesity in black South African women was not associated with deleterious metabolic sequelae and was termed "healthy" obesity...

The standard surgical treatment of velopharyngeal insufficiency (VPI) includes revision palatoplasty, posterior pharyngeal flap and sphincter pharyngoplasty. These procedures are not without complication and can also be challenging to the occasional cleft surgeon. The greatest complication is iatrogenic obstructive sleep apnoea particularly in high risk patients. With the introduction of posterior pharyngeal wall augmentation, a lesser and simpler surgical procedure, various materials have been used for this purpose with limited success and significant complication rates. Augmentation of the velo-pharynx with autologous fat has been practiced for decades. Autologous fat has multiple advantages compared to other biological and synthetic materials used for augmentation of the velopharynx. Autologous fat is readily available, has low donor site morbidity, does not migrate, injects easily and is non-allergenic. The outcome of fat grafting for VPI is good and stable long term, albeit unpredictable due to the resorption of fat. The procedure may therefore need to be repeated in order to achieve the desired results. The aim of this study is to evaluate and document the outcome of autologous fat grating for the treatment of mild to moderate VPI in children at the Red Cross War Memorial Children's Hospital (RCWMCH). A retrospective folder review was conducted on 9 consecutive patients who underwent velopharygeal fat grating for the treatment of mild to moderate VPI at the RCWMCH from 2010 to 2014. All the patients had had primary palatoplasty performed previously and subsequently developed VPI. Patients were assessed pre- and postoperatively by two cleft surgeons, and an experienced speech and language therapist with the aid of laterl view videofluoroscopy (VF). Pre-operative and post-operative perceptual speech assessments were performed by a dedicated speech and language therapist. Two senior cleft surgeons performed pre-and post-operative videofluoroscopy interpretations. Eleven fat grafting procedures were performed on 9 patients and an average of 5.64 ml (range 1 ml to 7 ml) of autologous fat was transferred to the velopharynx. The average age at the time of operation was 6.5 years (range 3 years to 14 years) with a follow-up period of 18 months (range 7 months to 34 months). Most of the patients (7 out of 9) showed improved speech following fat grafting. There were no complications related to the fat grafting procedure. This small study suggests that fat grafting is an effective, minimally invasive surgical alternative for the treatment of mild to moderate VPI and to our knowledge, is the first reported study from Africa.

The concept suggesting primary excision and immediate grafting as the definitive treatment for a thermal burn is not new (1 ). To avoid the sequelae of local and systemic sepsis, early excision of burn eschar to remove all devitalized tissue has been a widely accepted method of treatment of deep burns since 1929, when Wells performed total excision and grafting of electric burns (2). While the technique has many advantages, it is not without significant complications. Haemorrhage accompanying burn wound excision can be deceptively large, as can the metabolic stress associated with large surgical procedures performed in the post-burn period (3).

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

No description available.

No description available.

The ACL is one of the major ligaments in the knee connecting the femur to the tibia which provides stability by resisting shear in sagittal plane. ACL tears occur in 1 out of 3000, and due to inability to heal, reconstructive surgeries are performed at a rate of 200,000/year. Final graft fixation tension during surgery has been shown to wane due to stress-relaxation which has been correlated with negative clinical outcomes. Therefore, preconditioning, which currently is an isometric load (88N), is performed to remove stress-relaxation after the final tension has been applied in vivo. Three preconditioning protocols, creep, stress relaxation, and none, were tested to show significant differences and variance in graft tension after 30 minutes. The results suggest that the current preconditioning protocol may not be efficient enough to remove stress-relaxation after final fixation, and that a creep protocol causes less variability than the other preconditions performed.

Thesis (MMed (Surgical Sciences. Plastic and Reconstructive Surgery))--University of Stellenbosch, 2010. / The repair of full-thickness defects of the lower eyelids poses a challenge because a graft in combination with a flap is typically used to replace either the posterior or anterior lamella. This often results in aesthetically and functional unsatisfactory outcomes. A rotation-advancement tarso-conjunctival cheek flap, which reconstructs both posterior and anterior lamella with vascularized tissue similar to the native eyelid, is described. Nine patients underwent reconstruction with a rotation-advancement tarso-conjunctival cheek flap. The indications, complications and outcomes were evaluated. The follow-up time ranged from 6 to 60 months with an average of twenty three months. The main indication for use of this flap is full-thickness defects of the lower eyelid between 25 – 75 %, typically after tumour ablation. All the patients had a functional and aesthetically satisfactory outcome. One patient underwent a revision canthoplasty. The rotation-advancement tarso-conjunctival cheek flap adheres to basic plastic surgery principles resulting in a satisfactory outcome; (a) Vascularized tissue is used to reconstruct the defect. (b)The flap composition is similar to the native eyelid i.e. replace like with like. (c) The flap makes use of tissue that is excess and therefore limits donor morbidity.