Study to Determine the Effect of Diaper-Based Wound Care Method in Reducing Wound Contamination Period in Patients Suffering from Perianal Burn Wound.

Background Local wound care in perianal burn wounds is difficult owing to the risk of contamination from fecal soiling. The problem is aggravated in small children and bedridden critical patients who are unable to convey passage of stools. We used diaper-based wound care to reduce contamination. Materials and Methods We used ethylene trioxide sterilized diaper-based dressings in such patients. These were changed at 6-hour interval. Total and mean prevented period of contamination was noted as primary objective parameters. Time to heal, maceration of surrounding skin, and wound culture swab results were noted as other parameters. Result The diaper-based wound care led to reduced mean daily and total contamination period. Conclusion This diaper-based wound care method reduces contamination period of perianal wounds in patients suffering from perianal burn.

Outcomes of Tendon Transfer Surgery for Correction of Ulnar Claw Hand: A Case Series.

This case series presents detailed postoperative physiotherapeutic rehabilitation and functional outcomes of 3 patients following tendon transfer surgery for the correction of claw hand due to traumatic nerve injury. Three patients with different etiologies of claw hand and sociodemographic characteristics presented to the hand therapy center after claw correction surgery. Two patients underwent flexor digitorum superficialis 4-tail tendon transfer, and 1 patient underwent the Zancolli lasso procedure. Hand therapy began after 4 weeks of appropriate postoperative immobilization. It began with the activation and strengthening of the new muscle-tendon unit and its integration into functional activities. All patients returned to work 12 weeks after surgery, followed by an assessment of outcomes at 16 weeks. Satisfactory improvements in the functional outcomes based on the Brand criteria, the Patient-Rated Wrist and Hand Evaluation, and the Patient-Specific Functional Scale were observed in all patients at 16 weeks.

A Rare Cause of Chronic Life Threatening Bleeding in a Girl: The Ulcerated Blind Loops.

Ulceration in a blind loop can lead to massive gastrointestinal tract (GIT) bleeding. A 13-year old girl presented with symptomatic melena requiring repeated blood transfusion since childhood. She was an operated case of small bowel atresia in neonatal life. Her upper and lower gastrointestinal endoscopies were normal. Operation showed presence of multiple ulcers in two blind loops (parts of previous side to side anastomosis) and at the anastomotic site. She underwent resection and end-to-end anastomosis of the small bowel leading to complete resolution of melena and anemia.

Methylene blue dye injection for identification of occult gastrointestinal bleeding.

The exact site of small bowel bleeding is difficult to detect intraoperatively. We present a simple method of on-table identification of the site of the bleed. A 55-year-old lady presented with recurrent episodes of melena and drop in hemoglobin. Digital subtraction angiography (DSA) revealed angiodysplasia of a vessel supplying the proximal jejunum. A microcatheter was placed at this site in the DSA suite, just prior to laparotomy. Two cubic centimeters of methylene blue dye was injected into the microcatheter on-table which demarcated the 6 in. of involved jejunum which was then resected. Patient is currently doing well over a 6-month follow up with no further episodes of melena. In conclusion, preoperative DSA and selective catheterization of the affected vessel allow for on-table localization of the exact site of bleed. This simple method avoids more invasive techniques of detection and enables limited segmental resection of the affected bowel.