Giant Penoscrotal Lymphedema: Planning And Surgical Technique To Treat A Rare Debilitating Disease.

Background: Giant penoscrotal lymphedema is a rare condition and is treated by surgical debulking and reconstruction with remaining skin and skin grafts. The described techniques may result in a staged surgery, multiple blood transfusions, orchidectomy and early debulking of the scrotal skin. We present a case series describing our technique to address all the concerns, discuss management to decrease progression and transmission in secondary cases and present a novel questionnaire to assess of quality of life of these patients.

Priming of adipose-derived stem cells with curcumin prior to cryopreservation preserves their functional potency: Towards an 'Off-the-shelf' therapy for burns.

Stem cells-based treatment for burn wounds require frozen cells as an off-the-shelf therapy; however, cryopreservation-induced oxidative stress resulted in post-thaw cell death or loss of cell functions, thus arrested their clinical practicality. Although antioxidant priming to stem cells increase their resistant to oxidative stress, but this strategy is still unexplored on cryopreserved cells. Herein, we investigated whether curcumin priming before cryopreservation could preserve the therapeutic potency of thawed stem cells.

An Algorithm for Reconstruction of Electrical Injuries of the Scalp.

Background: Electrical injuries of the scalp are a frequent occurrence in developing countries. Burns can be contact or conductive and result in extensive tissue damage. The authors present their experience with treatment of scalp and calvarial electrical injuries and propose a management algorithm.

Lower extremity reconstruction: utility of smartphone thermal imaging camera in planning perforator based pedicled flaps.

Background: Presence of good size perforators are mandatory to design perforator based pedicelledflaps specially in lower limb as flap failure rate isrelativelyhigh. We have explored the use ofsmartphonebaseddynamic thermal imagingand compared it with doppler to devise a protocol forplanning and executionof pedicled perforator flaps anddescribedits use in deciding delay of flap. We have also compared the time required for detecting dominant perforators.

Accuracy of Thermal Imaging Camera in Identification of Perforators.

Objective: To determine the diagnostic accuracy of thermal imaging camera in the identification of perforators using peroperative visual inspection as gold standard.

Study Design: Descriptive study. Place of Study: Jinnah Burn and Reconstructive Surgery Centre / Allama Iqbal Medical College, Lahore, from October 2017 to September 2018.

Glycerol Preserved Amnion: A Viable Source of Biological Dressing for Superficial Partial Thickness Facial Burns.

Objectives: To evaluate the role of amnion as a biological dressing in superficial partial thickness facial burns.

Study Design: Randomized controlled trial.

Place And Duration Of Study: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from January 2017 to December 2018.

Antioxidant pretreatment enhances umbilical cord derived stem cells survival in response to thermal stress .

Pretreatment of stem cells with antioxidants accelerates their ability to counter oxidative stress and is associated with the overall therapeutic outcome of their transplantation. Wharton Jelly derived mesenchymal stem cells (WJMSCs) were cultured and pretreated with various doses of antioxidants; Vitamin C (Vit C), Vitamin E (Vit E), Vitamin D3 (Vit D3) and their Cocktail, followed by exposure to heat injury. Assessment of WJMSCs survival, paracrine release, wound healing and expression of angiogenic and survival markers was conducted.

Vacuum-assisted Closure in Integration of Skin Graft Over Scalp Wounds: A Randomised Control Trial.

Objective: To compare outcome of split thickness graft with and without vacuum-assisted closure over the scalp soft tissue defects in terms of graft take and complications.

Study Design: Randomised controlled trial.

Place And Duration Of Study: Department of Plastic Surgery, Jinnah Burns and Reconstructive Surgery Centre, Lahore, from June 2017 to June 2018.

Deep-seated Hibernoma of Thigh: A Rare Benign Adipocytic Tumor.

Hibernoma is a rare benign soft tissue adipocytic tumor. Mostly found in adults, it is usually located in the limbs, and is deepseated or intramuscular. Usually asymptomatic, it causes symptoms when it becomes large enough to compress adjacent structures, mimicking well differentiated liposarcoma clinically and radiologically.

Vitamin E preconditioning alleviates in vitro thermal stress in cultured human epidermal keratinocytes.

Aims: Thermal burns are the most common type of skin injuries. Clinically, the deteriorating thermal wounds have been successfully treated with skin cell sheets, suspensions or bioengineered skin substitutes. After thermal injury, oxidative microenvironment prevalent in the burnt tissue due to imbalance between production of free radicals and antioxidants defense aiding to destruction of cellular or tissue components.

Bi-allelic Variants in METTL5 Cause Autosomal-Recessive Intellectual Disability and Microcephaly.

Intellectual disability (ID) is a genetically and clinically heterogeneous disorder, characterized by limited cognitive abilities and impaired adaptive behaviors. In recent years, exome sequencing (ES) has been instrumental in deciphering the genetic etiology of ID. Here, through ES of a large cohort of individuals with ID, we identified two bi-allelic frameshift variants in METTL5, c.

Efficacy Of Micro-Needling On Post Acne Scars.

Background: Acne effects 80-90% of teenage population all around the world. Resulting scars can lead to facial disfigurement and psychological issues in affected population. To counter this problem many treatment options have been tried including resurfacing lasers, dermabrasion, peeling, fillers, platelet rich plasma therapy etc.

Early Active Mobilization Vs Immobilization Following Modified Kessler Repair Of Extrinsic Extensor Tendons In Zone V TO VII.

Background: The long-disputed issue of rehabilitation of extensor tendon repairs in zones V-VII has been treated with either complete immobilization or mobilization within the constraints of splint. In recent times, most authors have preferred some mobilization. Many studies have shown good results with early mobilization techniques; however, these studies have limitations.

Complex Reconstruction of Nose and Upper Lip after Assault.

A 21-year male, farmer by profession, was admitted in Plastic Surgery Department via outpatient department, with amputation of nose and upper lip with the knife during resistance against robbery attempt. He was having the blockage of the right side of nostril and difficulty in mouth opening. Upper lip vermilion and mucosal reconstruction with the bilateral facial artery musculo-mucosal (FAMM) flap and moustache reconstruction was done with visor flap.

Granulocyte Colony Stimulating Factor in Burn Patients with Neutropenia.

Objective: To assess the role of granulocyte-colony stimulating factor (G-CSF) for improving neutropenia in burns patients with neutropenia.

Study Design: Experimental study.

Place And Duration Of Study: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from May to October 2017.

Oropharyngeal, Hypopharyngeal and Cervical Esophageal Reconstruction: An Experience of Pedicle Flaps.

Objective: To review the experience of single-stage reconstruction following pharygolaryngectomy and cervical esophageal defect with pedicle flaps in a tertiary care centre.

Study Design: Retrospective study.

Place And Duration Of Study: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from June 2007 to June 2017.

Pakistan Comprehensive Fistula Classification: A Novel Scheme and Algorithm for Management of Palatal Fistula/Dehiscence.

Background: It is not easy to find a management-based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae that do not describe the fistula details comprehensively and guide toward its management. The authors have come across a wide variety of fistulae that could not be classified according to any of the prevailing classification systems.

Single Bilateral Undivided TRAM Flap for a Bilateral Breasts Reconstruction Including Intermammary Presternal Skin Defect Coverage.

We present a case report of 30-year female presenting with a large skin and soft tissue defect of anterior chest wall, after bilateral mastectomy. Unlike other patients, she also had sternum defect after resection of skin of sternum. She had a 34x17 cm defect of anterior chest when she presented to us.