Oral cavity onlay grafting using foam impregnated with honey:--a case report.

The often difficult problem of graft immobilisation in the oral cavity may be surmounted by use of a material which is cheap and readily available. A case in which honey impregnated foam material was used as a stent in oral grafting is described. Foam constitutes an ideal material which is highly recommended.

Metastatic basal cell carcinoma of the spine.

A rather progressive case of basal cell carcinoma of the left zygoma which subsequently metastasized to spine and brain resulting in mortality is presented. Surgical management of spinal metastases should be prompt and radical.

Update on management of chronic osteomyelitis: report of four cases.

Pessimism has existed concerning the cure of patients with chronic osteomyelitis. This has been based on the lack of complete bone and soft tissue debridement in the face of inability to completely cover the resultant wound with adequately perfused tissue. Regional and distant tissue transfers, allow freedom of debridement based on tissue viability rather than on amount of local tissue available to close the wound. Four cases in which regional and distant flaps were used to close defects created after debridement are presented. An overview of reconstruction of such defects is discussed. It is concluded that early management of compound fractures particularly those that require reconstruction will prevent the development of chronic osteomyelitis and thereby undue morbidity.

Lower limb trauma: a review of 40 cases treated at the regional burns and plastic surgery unit, Merseyside, England.

This is a review of 40 patients with lower limb trauma that required reconstruction, treated at Mersey Regional Plastic Surgery and Burns Centre during the year 1989. 73% had bone involvement while there was soft tissue injury only, in 27%. Seven patients (18%) had the affected limb amputated. Of the rest, 6 were treated with skin grafts only, 13 with local flaps and 14 with free flap reconstruction. The soft tissue healing time was least in patients who had free flaps. The time taken by skin and bone to heal and the average duration of hospitalisation was also less in cases that had early management compared to those who had delayed and late treatment. Early reconstruction in severe lower limb trauma is desirable and cost effective.

Reduction mammoplasty for unilateral breast hypertrophy.

Three cases of unilateral hypertrophy of the female breast are presented and the various methods of their management highlighted. We advocate increased awareness of the condition and improved general surgical training to cope with it.

Lip parameters in Nigerian children.

This is a study of lip dimensions in normal Nigerian children. It was carried out at University College Hospital, Ibadan, Nigeria, between January of 1986 and January of 1987. Two hundred and forty children of both sexes and aged from birth to 12 years had parameters relating to the anatomy of the human lip evaluated. The parameters determined included length of the upper vermilion arc, width of the mouth, and heights of the cutaneous upper lip and upper vermilion. All measurements were taken with the lips at rest. The length of upper vermilion arc and mouth width demonstrated a steady increase with age, mean male values being significantly greater than female values at 2 to 3 and 8 to 9 years. The heights of the cutaneous upper lip and upper vermilion showed an initial steady growth up to 6 years, followed by a decline in the rate of growth of the lip. There was a linear relationship between weight and height of the children and upper vermilion arc length, mouth width, and height of the cutaneous upper lip. Objective assessment of the size of the lip and mouth and surgical planning based on established standards are recommended.

Flexor tendon injuries: the result of primary management: a retrospective review of 50 cases treated at Whiston Hospital, England.

A retrospective review of 50 cases treated over a 12-month period with 95 tendon injuries was carried out. Post-operative management utilising a modified Kleinert method was used for cases over eight years of age, while those under eight were immobilised in plaster cast. Our results after a mean follow up period of 14 weeks compared well with other series using the Kleinert method. Zone II injuries gave an unexpected better results than those in other zones.

Keloids: a study of the immune reaction to sebum.

A controlled study of the "immune reaction to sebum" pathogenesis of keloids was carried out at the University College Hospital, Ibadan, Nigeria; on 22 humans using a homogenate solution of liquid paraffin and vernix caseosa from neonates. The 22 human volunteers comprised two groups, 11 of which were keloid formers and 11 non keloid formers. 0.1cc of sterile liquid paraffin was injected intradermally into the anterior aspect of the left forearm. The mean reaction in keloid formers was 11.55mm while in non keloid formers, it was 8.18mm. Although a higher reaction was demonstrated in this study, in keloid formers, this was found not to be significant (p less than 0.05), thus suggesting that sebum may not be an important factor in the pathogenesis of keloid.