Journal of Plastic Surgery and Transplantation

Plastic surgery training in India traces its roots back to 600 B.C when Sushrutha laid the foundations of this speciality. Today almost 65 years after the first plastic surgical unit was established in India, the speciality has expanded and evolved rapidly but facesmany challenges as it grows further. This article aims to highlight the strengths and weaknesses of plastic surgical training in India compared with the rest of the world. It also suggests improvements in the existing training curriculum so that the future residents would be better equipped to deal with the rigours and demands of modern-day plastic surgery. There must be adequate funding to set up centres of excellence of teaching and research and incentives to attract the brightest minds as faculty to lead this process of change.Standardisation of plastic surgery training curricula and frequent interaction between centers of different countries would help ensure that the speciality would grow further and provide a firm foundation for the future.

Hypertrophic scar and keloids belong to the spectrum of abnormal wound healing. It has been a bothersome complication of scars. Various risk factors have been proposed to be in association with incidence of hypertrophic scars, the important one being familial predisposition and location of the scar. In this article we would like to put forth our experience in assessing the association between hypertrophic scar and blood group.

It is well known that LLLT has role in the wound bed preparation of ulcers, but the role of LLLT in healing delayed healing skin graft donor sites has very scanty data. In this article we sharing our experience of treating a skin graft donor site which was showing delay in healing.

Wound management is an integral part of surgical specialties. The process of wound healing has been studied in detail and the management of wound and its myriad treatment options have been evolving since the advent of scientific advancements. Proper wound assessment is an important part of wound management. Here we share our experience with the use of Bates-Jenson Wound Assessment Tool in the assessment of wounds.

Background: It a great challenge which requires great efforts to treat the patient with burn injury. Immediate treatment significantly improves mortality rates. Management of a burn case usually involve, appropriate fluid resuscitation, attainment of resuscitation targets using consensus formulas for initial fluid administration, topical agents to control pain, reduction of fluid loss as well to prevent bacterial growth. Objective: our aim was to look for the evidence of effectiveness of HBOT and the patient’s satisfaction improvement due to reduction in wound pain. Study Design: Study carried out was prospective case control study. Place of Study: Prana HBO Centre, located in the Northern parts of Mumbai, in India. Methods: In group I in comprised of 22 patients with burn injury who got regular HBO therapy. HBO therapy was given with compressed with air at a pressure of 2.5 atmosphere absolute (ata). At this pressure the patient breathed 100% oxygen via facial mask. The HBO therapy protocol included 90 minutes oxygen breathing at 2.5 ata, twice daily over 6 days. 20 sessions were performed for each patient. In group II patients with burn injury were 21 who also received burn treatments in our setup but without HBO therapy. Results and Discussion: The mean improvement in pain relief in group I was 4.9 ± 1.2 in comparison to group II which was 3.2 ± 0.85, comparatively improvement in pain score was significantly higher in group I and at par with group II. Hyperbaric Oxygen therapy can improve pain score and patient satisfaction in our study. However the possibility of cost effectiveness of the HBO therapy would need further discussion. Future, the clinical trials with large sample size and different types of burn injury shall be considered. Conclusion: Findings shows the beneficial effects of HBO therapy, as well suggests that the HBO therapy has a significant improvement in the pain relieve and satisfaction improvement. Hence, HBO therapy, as an adjuvant treatment, could be helpful for pain control and satisfaction associated with burn injuries.

Background: Sacrococcygeal pilonidal sinus is an acquired disease commonly seen in young adults especially males in gluteal cleft and it is known for recurrence and affects the patient’s quality of life. Rhomboid excision of sinus with Limberg rotation flap coverage is a well-known surgical modality for this. This prospective study is carried out to determine the effects of the Limberg flap rotation surgery especially for its feasibility in a General surgical unit for the sacrococcygeal pilonidal sinus patients, their compliance, outcomes of the surgery such as wound infection, postoperative pain relief, recurrence rates, and back to routine duration. Patients and methods: This is a prospective study of 40 Limberg flaps done from 2017 January to 2018 December in general surgical unit by the same surgical team for both primary and recurrent Pilonidal sinuses, and patients who previous incision and drainage had done for the pilonidal abscess. The various demographic, clinical and surgical data are studied and compared to other studies. Results: There were 34 (85%) male patients and 6 (15%) female patients and all patients successfully underwent surgery, with very minimal postoperative pain, stayed in hospital for average 10 days, returned to work after 3 weeks. The operative time, blood loss, hospital stay, surgeon’s performance scale, wound hypothesia, wound cosmoses score, patient satisfaction score, and patient quality of life were studied. The Limberg flap surgery had better clinical results regarding frequency of seroma formation and time to drain removal, pain score and early return to normal works. Out of the 40 patients operated 1 (2.5%) developed superficial skin necrosis, 2 (5%) developed seroma, and 1(2.5%) type-1 diabetic female developed surgical site infection. Conclusion: In this procedure of Limberg flap there are significant benefits in terms of postoperative pain, infection rates, less hospital stay and early return to work with almost nil recurrences.