Necrotizing external otitis.

Necrotizing external otitis is a severe osteomyelitis of the temporal bone principally affecting elderly diabetics. It is caused by the gram negative bacillus, Pseudomonas aeruginosa. Clinical findings and diagnosis are reviewed. Long term therapy with intravenous antibiotics is recommended for cure, although newer antimicrobial agents give promise of being successful when administered orally.

Comparing DuoDERM E with scarlet red in the treatment of split skin graft donor sites.

A prospective, randomised, controlled study compared DuoDERM E (DE) with scarlet red (SR) in the treatment of split skin graft donor areas in 60 patients. Healing and donor site comfort were significantly better in the DE group. There was no clinical infection in either group. The wound leakage rate was higher in the DE group, requiring an average of 0.8 replacement dressings per donor site as compared with an average of 0.04 for the SR group. An estimate of the cost per donor site for the first ten days of dressing is given.

Obstructive sleep apnea.

Obstructive sleep apnea represents a common disorder with potentially high morbidity and mortality. Its clinical significance and treatment options have not been fully defined. Excessive daytime sleepiness and the cardiovascular complications of obstructive sleep apnea constitute a significant public health problem. Clinical features and treatment are discussed.

Recurrent orf in an immunocompromised host.

A 30-year-old farmer with Nezelof's syndrome developed a giant orf on his hand. Recurrence followed surgical excision. Three excisions and split skin grafts were required before its eradication. He re-presented 8 years later with a further orf on the finger of his opposite hand. This lesion had not grown to the exuberant proportion of the previous lesion, but it defied repeated excisions, and various medical therapies including idoxuridine, interferon and transfer factor. Excision with hypochlorite dressings perioperatively and delayed split skin grafting led to eventual eradication.

A comparison of calcium alginate and scarlet red dressings in the healing of split thickness skin graft donor sites.

Forty-six patients had split thickness skin grafts harvested from the upper inner thigh. Calcium alginate (Kaltostat) and scarlet red dressings were applied to each half of the wound. Dressings were changed after 10 days and healing of the donor site was assessed. Seventy-two per cent of wounds dressed with calcium alginate and 84% of wounds dressed with scarlet red were healed at 10 days. Scarlet red was shown to be significantly better than Kaltostat in the healing of split thickness skin graft donor sites when assessed at 10 days (p less than 0.04).

Titanium in reconstructive surgery of the skull and face.

Titanium is widely used as an implant material. This report describes its use for cranioplasty and malar defects and the technique used to fashion these prostheses in a centre which does not have the facility for producing computer-generated full-size craniofacial models. The use of these prostheses has produced very satisfactory results with minimal morbidity and no complications.

The hairless osteotomized radial forearm flap.

A case is reported demonstrating that the radial osteocutaneous free flap can be "ill-treated" by excision of its hairy skin and split-skin grafting prior to transfer and osteotomy of its bony element during transfer without apparent adverse effect.

The groin flap in hand injuries.

The groin flap has been used as Burwood Hospital in 12 cases of hand injury. The types of injury, the variety of application and the complications are presented and the usefulness of the groin flap discussed in the light of this experience.

Pretibial lacerations.

Pretibial lacerations are common and cause considerable morbidity, especially for elderly women. Factors predisposing to this injury are discussed and guidelines for management outlined.

The back tube pedicle in head and neck reconstruction.

The use of a back tube pedicle in 19 patients, presenting for reconstruction of defects in the head and neck region, is shown and aspects of surgical technique discussed. In general, satisfactory results were achieved and it is recommended that the back should be considered more often as a donor site when the more convenient deltopectoral flap is not available, not desirable.