Limberg flap has been used for the closure of moderate size sacral pressure sores in 5 cases. It provides a good padded skin cover with the suture line away from the midline which is the area of ulceration. No breakdown or ulceration in the flap or donor defect suture line were seen during 1-4 years of follow up. Operative technique is briefly described and important points on flap planning are discussed.

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Abdominal well reconstruction entails usage of ingenious techniques to support and protect abdominal viscera as well as provide an aesthetic contour. This is a case report wherein the lower abdominal wall was reconstructed with an ipsilateral, supercharged, reverse latissimus dorsi muscle flap with skin graft. Such innverted motor muscle transfer by its dynamic role ensures prevention of ventral herniation of the abdominal viscera. Supercharging of vascularity and innervation of an inferiorly based latissimus dorsi muscle is a useful addition to existing methods of abdominal wall reconstruction.

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Provision of durable skin cover for chronic ulcers of the heel is a challenging problem. It is compounded by the absence of sensation in leprosy patients. Abductor hallucis muscle flap with rotation advancement of sole skin has been found to be a satisfactory procedure in the management of heel ulcers in six leprosy patients.

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Hemifacial hyperplasia is a rare congential deformity, affecting soft and bony tissues of one half of the face. The etiology of the condition is unknown and no pattern of heredity is described. A case of hemifacial hyperplasia and its management is described here.

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Subclavian perivascular approach has been attempted for brachial plexus block for upper extremity surgery in 160 consecutive cases. In eight patients the approach could not be used since paraesthesia could not be elicted. Twelve patients needed peripheral nerve block supplementation. Four patients needed general anaesthesia with an overall success rate of 85 percent. There were no complications attributable to the technique. This is our anaesthetic technique of choice for upper extremity surgeries.

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Statements regarding outcome in Plastic Surgery are often subjective and lack reproducibility, mainly because of lack of quantification of aesthetic issues. A method is being presented using maxillo-facial injuries as a prototype, to resolve virtually any plastic surgical problem into 3 basic components - Function, Aesthetics and Psycho-social. Unfavourable results are graded according to a strictly defined protocol. Aesthetic evaluation is performed by the patient and relatives/friends in a manner designed to reduce subjectivity and physiciam-induced bias. The system provides a comprehensive patient-satisfication index which has been found useful for everyday post-surgical assessment and computer-based data-recording. It allows us to quantify results, pin point shortcomings and foster a desirable doctor-patient relationship. With the use of such a system it should be possible to document, compare and even predict treatment-outcomes with a degree of precision not previously achieved.

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An attempt was made to reduce the cost of burn care by adopting certain simple methods without in any way compromising the quality of treatment. The important factors which escalate the cost of treatment are the expensive dressing materials and high cost of antibiotics. By implementing the Value Engineering methods, savings in cost of dressing materials and antibiotics of 50.07 percent and 49.35 percent respectively were achieved.

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The immunological parameters of 30 patients admitted within 6 hours of burns injury were compared with those of controls. Serum levels of immunoglobulins (IgG, IgA, IgM), complements (C3 & C4) and protiens (total & albumin) were estimated on admission and two weeks later in surviving patients. the aim of this prospective study was to find out the clinical importance of immunological monitoring in burns patients. It was observed that the initial fall and rebound increase in C3 and C4 levels were found to be highly significant. We conclude that IgA, IgG, C3 and C4 monitoring can help in predecting prognosis of burns patients. Based on the immunological parameters initially in nonsurvivors and two weeks later in surviving patients we can say hypothetically that prophylactic or therapeutic administration of immunoglobulins for their general or specific role could bring hopes for burns patients in future.

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Dental Impression Compound was found to be a useful material to fabricate immediate postoperative and maintenance splints after contracture release in 50 cases.

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