Sudhir Singh

Done a lot of cases successfully in our place with bacteriophages in small nonhealing chronic wounds but its use in extensive infected burn wound healing is also encouraging. Our clinical evidence of topical application of bacteriophages on extensive multi-drug resistant [MDR] bacterial infected burn wounds has been done for the first time and has never been reported in the literature. The medical revolution is on the horizon for treating superbugs and their positive effect on the economy especially in treating skin wounds.   Keywords: Bacteriophages.

Extensive burns of more than 50% have high mortality and those over 90% have almost nil survival rate. All resuscitative measures fail as patient gets infected leading to burn wound sepsis causing septicemia and leading to mortality as the end clinical result. So we need clinically evidenced and rationally based burn dressing strategy to increase extensive burn patient survival. This is random retrospective selection of five patients in each two groups from second degree burn patients of more than 50 percent treated by collagen in one group and other by Nanocrystalline Silver dressings and observed for clinical evidence of patients survival keeping all resuscitative and treatment modalities as standard treatment protocol in all cases. The nano crystalline silver dressing is cost effective, rational and evidence based strategy. It is easy to use, has powerful anti bacterial effect, decreased frequency of dressing changes, shortened time of wound cleaning and painless dressing. It helps make the wound sterile for further treatment within a week. It is a great weapon in the hand of Burn Surgeon for rapid and better recovery of patients. This nano crystalline sustained release silver dressings are best suited to take care of burn wounds of more than 50%. Bacteriophages treatment is reserved for multiple drug resistant bacteria and had good recovery. Keywords: Extensive burns, Nano crystalline silver, Acticoat, SSD, Bacteriophage, Collagen, Skin tempII.

We do get strange cases of self insertion of foreign bodies in the penile urethra. It is very difficult to know the reason for inserting variety of objects. Here this case needs discussion due to extreme rarity and strangeness of getting a metal amulet with the attached hanging thread inserted inside the penile urethra. Keywords: Amulet, Foreign body self inserted in penile urethra, Psychiatric selferotism

Partial superficial congenital constriction band or groove on nape is very rare and needs only cosmetic surgery‘. This case is being reported for its extreme rarity. Keywords: Congenital constriction band, Z Plasty, Amniotic band, Tuberculous scar, Lipodystrophy nape.

There is crisis of availability of PPE and proper facemasks to get protected while operating patients irrespective of Corona virus infection in OT in our place during present time in March-April 2020. So necessity is mother of invention. I devised a method of indigenously creating face mask shield for OT purpose to tide over the crisis period till proper PPE kit and better shield masks are available to us as frontline COVID19 warriors in OT. It seems to be good indigenous method to cross over the present crisis of proper PPE for facial masks. It gives the wearer a welcome sense of security. It feels like I am behind a shield and that in itself can be reassuring to be protected from direct onslaught of Corona virus. Keywords: Corona, Mask shield, N95, Plastic OHP A4 sheet, Surgical mask.

Reporting two cases one of two centimetres breadth and the other of four centimetres breadth exposed tibia bone devoid of periosteum due to post debridement involving periosteum elevator to remove infective tissue which was successfully covered by a simple procedure with MatriDerm® and split skin graft in a single stage. Tibia bone was not drilled to sprout granulation tissue from bone marrow to create a granulated vascularised bed for second-stage skin grafting. It avoided local flap or microsurgical free flap surgery for small exposed bone devoid of periosteum. Both cases had a pleasing aesthetic outlook after a few months of follow-up. Difficult to find instances of more than two centimetres of exposed tibia devoid of periosteum covered successfully in a single stage by this procedure.   Keywords: MatriDerm the skin substitute, Trauma, Diabetic wound, Split skin graft, Tibia bone denuded off periosteum, Single stage