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Temporary tracheostomies are not always necessary for head and neck free flap reconstruction
Complex head and neck cancer cases with reconstruction can be challenging due to the risk of loss of airway. Temporary tracheostomies are often used to protect the airway following complex oral and maxillofacial ablative surgery and reconstruction. However, while this...
ERAS in microvascular breast reconstruction
Enhanced recovery after surgery (ERAS) is an important concept in today’s accountancy dominated hospitals, effectively decreasing the length of stay (LOS) of postoperative patients. This is something that surgeons will have to consider – or have protocols foisted upon them...
Prophylactic postoperative antibiotics for enucleation or evisceration
The authors report on a retrospective, multicentre, comparative case series looking at prophylactic antibiotics and the incidence of orbital cellulitis following enucleation or evisceration. Of the 644 cases included in the analysis, all received a single perioperative intravenous dose of...
Ultrastructural changes in keloid scars
One of the most intriguing and infuriating problems confronting plastic surgeons is the occurrence of hypertrophic and keloid scars, in some patients – particularly black Africans – but not in others. Many theories have been proposed regarding the cause of...The applications of mesotherapy in aesthetic medicine
Mesotherapy is a modern form of therapy that consists of injecting medicines, vitamins and minerals as close as possible to the area that needs treatment. It is an astonishingly effective technique in aesthetic medicine as it treats layers of the...
Seasonal impact in burn profiles
This study provides a seven-year retrospective review of burns management in one burns unit in Portugal. Particular focus is given to the cause (including whether or not the burn was work related or domestic), anatomical location and depth of burn,...How I Do It - Reduction thyroplasty
Introduction Male to female transgender patients often undergo reduction thyroplasty – a procedure to reduce the external appearance of the thyroid cartilage of the larynx, and feminisation of the voice. Reduction thyroplasty, often erroneously called ‘tracheal shave’, is one of...
Comparison of petrolatum gel with silver sulfadiazine dressings in small superficial burns
This was a randomised controlled trial set up in a single burns centre in Manila in the Philippines. Inclusion criteria were superficial burns not requiring skin grafting, and up to 10% total body surface area in young, fit adults between...Gross Negligence Manslaughter in Healthcare: The medico-legal dilemma (part 12) – Risk
Risks are ubiquitous in medicine. It is very important to realise that a risk can be both a threat and a friend. Risks relate to probabilities. The probability or possibility that the outcome may not be as desired. The Law does have a perverse view on this. The Law likes, demands, seeks cause and consequence. An honest doctor can rarely satisfy the Law. And that is why it was such a bad thing to see this poor Judge being led by the nose by two unscrupulous Medical “Experts”!Genioplasty
With the chin playing a vital part in facial harmony, genioplasty can have a hugely positive impact on patients’ self-esteem and quality of life. The authors share their expertise in the optimal techniques when performing an osseous genioplasty. The perception...
