Considerations for double-hand replantation in a resource-constrained healthcare facility.

Bilateral-hand amputation is extremely rare and double-hand replantation is even rarer. Only one case of successful double replantation at arm level has been reported from India. We present a case of double-hand replantation at proximal palmar level in a young adult executed in a small nursing home.

Combined Use of the Mathieu and Incised Urethral Plate Techniques for Repair of Distal Penile Hypospadias.

Though both the Mathieu and incised urethral plate techniques are individually described for single-stage repair of distal penile hypospadias, each has its own shortcomings. We describe the combination of the two techniques by taking their advantages and reducing their limitations. Thirteen patients belonging to the age group of 3-22 years with distal penile hypospadias and mild chordee were operated by this technique with a mean follow-up of 8 months.

Rare case of nasolacrimal duct opening into face.

Congenital anomaly of nasolacrimal duct is mostly obstructive in nature or is seen in oblique facial clefts. Nasolacrimal duct drain into the inferior meatus in the nose in a normally developed face. We report a rare case of aberrant opening of distal end of nasolacrimal duct into the external skin lateral to the ala of nose in an adult patient.

"Partial duplication of lower lip and hemimandible" A rare case.

Duplication of mandible and lower lip is a very rare congenital entity. We report an extremely uncommon case of Congenital Duplication of Lower lip and Mandible in a 3 year old girl, who was treated surgically in a single stage for correction of both lip and mandible. This was a commissure preserving single staged procedure.

Single stage reconstructions in head and neck surgery using deltopectoral and pectoralis major myocutaneous flaps.

Even though free tissue transfers are a routine in many centres, pedicle flaps still have a huge roll to play in our country. There are many centres in the country where pedicle flaps are in use because of logistic problems. Deltopectoral and pectoralis muscle flaps are usually preferred for composite cheek defects.

Muscle conserving free gracilis transfer (mini-gracilis free flap).

Gracilis is a commonly used muscle for free tissue transfer. It is also split into two based on its pedicles and used as two units. Use of distal part as a free flap in isolation has never been described in literature.