Repair of radial free flap donor site by full-thickness skin graft from inner arm.

Sixty-two consecutive patients had 63 radial free flaps taken and the donor site repaired with either a full-thickness or split-skin graft. A full-thickness graft was harvested from the inner upper arm in 53 patients (85%). The donor site was assessed using a visual analogue scale, tactile sensitivity, and the Vancouver scar assessment score.

Protection of the patient's hair with a standard swimming cap during major maxillofacial operations.

During maxillofacial operations there is inevitably a lot of blood shed, which soils the patients hair. The cleaning of blood stained hair is a laborious and time-consuming task, particularly after a long operation. To prevent this we advocate using a standard swimming cap to protect the hair.

Linkage analysis of diabetes status among hypertensive families: the Hypertension Genetic Epidemiology Network study.

Type 2 diabetes susceptibility is determined by multiple genetic and environmental factors. Genome-wide linkage scans have localized common regions, possibly harboring susceptibility genes on chromosomes 1, 2, 12, and 20. Variability in linkage findings underscores the probable genetic heterogeneity of type 2 diabetes.

A standardised preprinted template for recording of maxillofacial oncological operations.

Completion of accurate and legible operating notes are the clinician's responsibility. They require time, precision, concentration and legibility. A preprinted template helps meet these needs and complies with the guidelines of the Royal College of Surgeons.

Reduced sodium channel density, altered voltage dependence of inactivation, and increased susceptibility to seizures in mice lacking sodium channel beta 2-subunits.

Sodium channel beta-subunits modulate channel gating, assembly, and cell surface expression in heterologous cell systems. We generated beta2(-/-) mice to investigate the role of beta2 in control of sodium channel density, localization, and function in neurons in vivo. Measurements of [(3)H]saxitoxin (STX) binding showed a significant reduction in the level of plasma membrane sodium channels in beta2(-/-) neurons.

Rapid healing of MRSA infection at the suprafascial radial donor site.

Methicillin-resistant Staphylococcus aureus (MRSA) infection at the radial suprafascial donor site resulted in significant loss of the skin graft, but no tendon exposure, in two patients. The complication was successfully managed with wound debridement, appropriate antibiotics, a negative-pressure wound dressing and early partial-thickness skin grafting. The suprafascial dissection creates a donor site that resists both skin graft loss and tendon exposure.

What have you been told about your illness? Information about diagnosis among psychiatric inpatients.

Introduction: In current psychiatric practice clinicians tend to share with patients information regarding their illness. However, little is known about what the patients would in fact like to know about their diagnosis and prognosis.

Method: We have conducted a cross-sectional survey among psychiatric inpatients, to explore what they believe is wrong with them, what they have been told and by whom, and what they wish to know about their illness.

Genetic analysis of a new mouse model for non-insulin-dependent diabetes.

The TallyHo (TH) mouse strain is a newly established model for non-insulin-dependent diabetes mellitus (NIDDM). TH mice show obesity, hyperinsulinemia, hyperlipidemia, and male-limited hyperglycemia. A genetic dissection of the diabetes syndrome has been carried out using male backcross 1 progeny obtained from crosses between (C57BL/6J x TH)F1 and TH mice or (CAST/Ei x TH)F1 and TH mice.

Suprafascial dissection of the radial forearm flap and donor site morbidity.

A cutaneous free radial forearm flap was harvested from 25 patients using a suprafascial dissection technique. The donor site was managed with either a full or split thickness skin graft and a negative pressure wound dressing. The incidence of initial complete graft take was 96% at day 5 and 100% by 1 month.

Surgical management of chronic parotid disease.

This is a retrospective review of a single surgeon's experience over a 20-year period, and covers the presentation, investigation, histology, management and complications of the surgical treatment of chronic parotid disease. There were 46 superficial parotidectomies (23 with ductal ligation); 3 required removal of calculi and there was one ductoplasty and one total parotidectomy. There were 28 cases of temporary palsy of the VIIth cranial nerve (55%, mean duration 4 months) and this was predominantly panfacial (79%).

Combined treatment of adenoid cystic carcinoma of the salivary glands.

A retrospective review of the experience of a single surgeon over a 20-year period is presented. Fifteen patients with primary adenoid cystic carcinoma of the major (6) or minor (9) salivary glands underwent combined treatment with wide local excision and radical postoperative radiotherapy. The actuarial survival is 100% at 5 years and 62% at 10 and 15 years.

Negative pressure wound dressing of the radial forearm donor site.

Donor site complications of the radial forearm are a significant cause of post-operative morbidity. 15 patients had radial forearm free tissue donor sites treated with split skin grafts and a negative pressure dressing. All grafts showed 100% take at 5 days.

Clinical experience with the negative pressure wound dressing.

Between 1997 and 1999, more than 300 patients have been treated using negative pressure wound dressings. The technique has been used successfully to prepare various acute, chronic or infected wounds to accept a skin graft or flap, and to promote graft take at difficult donor sites. The advantages include rapid healing by secondary intention, reduced time to skin grafting, an increase in the rate of graft take and a reduction in donor site complications.

Diabetes education materials: recommendations of tribal leaders, Indian health professionals, and American Indian community members.

Purpose: The Association of American Indian Physicians, the only national organization of its kind, conducted a series of focus groups to gather input from tribal leaders, Indian health professionals, and American Indian community members to guide the development of culturally appropriate diabetes education materials for the National Diabetes Education Program.

Methods: During the focus groups, participants shared their experiences with and recommendations for a variety of diabetes education materials.

Results: Overall, 95% of participants expressed a strong preference for diabetes education materials relevant to their specific tribe or culture.

Precautions against cross-infection during operations for maxillofacial trauma.

One hundred oral and maxillofacial units in the UK were sent a postal questionnaire. Surgical staff of all grades were asked which infection-control measures were taken during the treatment of maxillofacial fractures. Two hundred and ninety-four questionnaires were completed, a response rate of 49%.

Double gloving and a system for identifying glove perforations in maxillofacial trauma surgery.

The treatment of some maxillofacial fractures has an incidence of glove perforation as high as 50%, with over 80% going unnoticed at the time of operation. We investigated double gloving and a glove perforation indication system to ascertain whether the latter offered any additional protection. 1061 gloves used for 113 patients were examined.

Prophylactic plating of the donor site of osteocutaneous radial forearm flaps.

We carried out a retrospective study of fracture morbidity of radial forearm osteocutaneous donor sites. During a period of three-and-a-half years, 12 patients had had composite flaps taken, and 5 of them had subsequently fractured the radius. We then elected to plate the radius prophylactically and found that over a period of just over two years, none of the 8 patients who had had prophylactic plating at the original harvesting operation had subsequently fractured the radius.

Nicorandil-induced severe oral ulceration: a newly recognized drug reaction.

Nicorandil, a potassium-channel activator used for the long-term treatment of ischemic heart disease, has been recently implicated as having a drug side effect of recurrent aphthous stomatitis. Three patients are reported with drug-induced aphthouslike ulceration secondary to nicorandil.

Severe ocular abnormalities in C57BL/6 but not in 129/Sv p53-deficient mice.

Purpose: To demonstrate the importance of genetic background interaction on the development of ocular phenotypes in p53-deficient mice.

Methods: Eyes of adult mice, homozygous and heterozygous for the p53 gene disruption in the 129/SvJ and C57BL/6J (B6) genetic backgrounds, and their F1 progeny were examined by indirect ophthalmoscopy and by light microscopy.

Results: Indirect ophthalmoscopy revealed unilateral or bilateral vitreal opacities, fibrous retrolental tissue, and retinal folds in adult B6 mice but not in 129/Sv mice homozygous for a p53 null mutation.