Modified S-plasty: an alternative to the elliptical excision to reduce the length of suture.

Background: When the tension obtainable with an elliptical excision of a skin lesion would be excessive, instead of resorting to skin grafts or flaps, it is possible to apply an alternative plastic that reduces the length of the suture by approximately one third and assumes a curved lazy-S profile, also improving aesthetic result.

Methods: This is obtained with a modified shortened S-plasty, which distributes the vectors of tension in two different directions at the apices and in the central part. The traction on the suture line is reduced, facilitating wound healing.

[External otitis].

Otitis externa is one of the most common diseases in ORL practice, during summer; the treatment of otitis externa may be simple and easy or protracted and frustrating, also with fatal outcome. Many local factors may interfere with the normal defences against infections in the external auditory canal. Removing or dissolving the cerumen by water or other instruments eliminates an important barrier to infections: its acids inhibit the growth of bacteria (Staphylococcus aureus and Pseudomonas aeruginosa) and fungi (Aspergillus).