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Split-thickness skin grafting is widely used in the management of leg ulcers but is fraught with suboptimal take especially in less than ideal wound beds. The use of negative pressure dressing to prepare wound beds is an established practice. However, its use to improve graft survival is yet to be a common practice. We aim to compare quantitative and qualitative split thickness skin graft take in leg and foot ulcers using either traditional wound dressing or negative pressure dressing methods.Sixty-two cases were recruited for the study and assigned into two groups of 31 cases each by convenient sampling method. Group A patients had negative pressure dressings in both phases, whereas group B patients had traditional wound dressing in both phases. The percentage skin graft take for both groups, and the pattern of complications were assessed. Results were analyzed using IBM SPSS statistics for windows (version 21.0; IBM Corp, Armonk, NY). Student t-test was used to compare the percentage graft take, whereas Chi-square was used to compare significance of complications in both dressing methods.The negative pressure dressing showed better skin graft take with mean value of 99.2 ± 0.95% compared with traditional dressing with mean take of 89.7 ± 6.44%, which was statistically significant with a P value of0.001. The complication rate was 12.9% in the negative pressure dressing group and 96.8% in the traditional wound dressing group, showing about 7.5 times more complication in the traditional wound dressing. This is statistically significant with a P value0.001.Negative pressure dressing for split-thickness skin graft contributes significantly to improved split-thickness skin graft take with reduced complication rate as compared with conventional wound dressing method.

Background: Parotidectomy has been traditionally done with general endotracheal anaesthesia mostly in tertiary institutions where there is adequate anaesthetic manpower. A lot of patients with parotid masses presents to other cheaper healthcare providers including medical outreaches where there is paucity of both anaesthetic manpower and gadgets. Aim: To share our experience in parotidectomy using local anaesthetics in medical outreaches where there is inadequate support of anaesthetic personnel and gadgets. Method: Patients counseled for parotidectomy had local anesthetic infiltration and nerve block with 1% ligdocaine in 1:100,000 adrenaline. Lazy-S incision was used starting pre-tragally down to the angle of the mandible. Branches of the facial nerve were gently separated from the mass which is delivered to the wound and shelled out. Wounds were closed in layers without drain. Conclusion: Parotidectomy with local anaesthetic agents is a safe option especially in settings of medical outreaches in resource poor countries with limited anaesthetic manpower and gadgets. The safety of surgery on day case basis and avoidance of use of hardly available nerve stimulator all the more make it an appealing alternative.

Aims and Objectives: To identify fistula rates and determine the relationship between cleft palate index (CPI) and oronasal fistula. To delineate palatal index with high risk of fistulation in our study population. Materials and Methods: A 1-year prospective study. All consecutive patients with cleft palate that presented to the study institutions within the period and met inclusion criteria were studied. Palatal cleft width was measured in millimeters using fine pointed calipers at the level of the tuberosities intra-operatively. Maxillary intertuberosity width was measured. CPI was calculated as a ratio of cleft width to maxillary width. Palatoplasty was by von Langenbeck repair or intravelar veloplasty. Data were documented and analyzed. P < 0.05 were considered statistically significant. Results: Forty-six patients were studied. Ages ranged from 10 months to 28 years. Ranges of measured parameters were cleft width 4–25 mm, maxillary width 35–82 mm and CPI 0.07–0.49. Nineteen patients developed oronasal fistula; 41.30% overall fistula rate. Likelihood of fistula occurring increased as palatal index increased. Fistula was common in patients with CPI in excess of 0.22. Risk of fistula formation was statistically significant, becoming higher with palatal index of 0.26 and above. Discussion and Conclusion: Cleft palate exhibits great variability in tissue deficiency and segments separation. This may influence cleft severity. Palatal index estimates cleft severity and allows identification of patients at risk of fistula formation thereby necessitating individualized surgical attention for a better outcome.

Background : Aesthetic surgery is not well developed in Nigeria. It forms a small part of plastic surgery service at the National Orthopaedic Hospital Enugu. Few reports of the scope of aesthetic surgery are available from the sub region. We report our experience of aesthetic surgery in our centre, a Nigerian sub regional apex hospital specializing in plastic, orthopaedic and trauma surgery, and make pertinent recommendations. Patients and methods : Retrospective analysis records of consecutive patients attended to between January 2000 and December 2005. Results : Elective plastic surgical procedures performed were 3,759, of which 68 (1.81%) were for aesthetic indications. Fifteen of the clients (22.06%) were male and 53 (77.94%) female. Fifty procedures (73.53%) were performed on the face, nine on the limbs, six on the trunk, two on the skull and one on the neck. Fifty four of these (79.41%) were scar revisions, six mammoplasties, and three were otoplasties, two cranioplasties, and one lip augmentation, one abdominoplasty and one rhinoplasty. Forty nine were carried out by consultants and nineteen by senior residents; seventeen of those procedures being scar revision. Specialized instruments such as lasers and cannulae for liposuction or liposculpture were not available. Conclusion : Aesthetic surgery is still underdeveloped in our practice.

Hypothesis Postburn mentosternal contractures can be clinically classified into 4 major groups based on the location of the contracting band(s) and extent of flexion or extension away from the anatomical position of the neck and jaws. Each group can be further subclassified depending on the width of the contracting segment(s) and availability of surrounding supple skin. Design Case series. Setting Nigerian subregional apex hospital specializing in plastic surgery, orthopedic surgery, and traumatology. Patients A consecutive sample of 41 patients with postburn mentosternal contractures who underwent surgery between 1997 and 2002 and 4 patients who had not yet had surgery, seen between January and March 2003. Data were obtained from operative records, photographic records, and interview of teams who treated the patients. During data collection, a classification system was devised in which mild, moderate, and severe anteriorly located contractures were designated types 1, 2, and 3, and posteriorly located contractures were considered type 4. Subtypes a through d were included to denote characteristics affecting reconstruction. Results The classification system was successfully used to classify postburn mentosternal contractures as a guide to management. Sufficient data were available to classify 32 of the 45 patients. The observers were not blinded. Conclusion The classification system is useful in describing severity and guiding reconstructive options, but further study is required before it is used in choice of airway management for anesthesia.