Aims and objectives 1. To study effectiveness of lower limb problems like: lower limb injuries, difficult to heal wounds like amputation stumps, necrotizing fasciitis, diabetic foot, burns wounds and deep electrical burns wounds, cellulitis and extensively oozing wounds. 2. Improvement in take of graft or flap. 3. Reduction of infection and surface bacterial count in wounds reducing morbidity and mortality and making treatment cost effective, also. 4. Salvaging lower limbs. Methods: Standard method of VAC application is used in our study with step wise manner. Wound debridement, hemostasis done, VAC applied by standard method. Negative pressure around 125 to 150 kept in our study. Out of 100 cases, 50 cases are lower limb injuries due to trauma, accident, amputation stumps, 40% cases are due to necrotising fasciitis and cellulitis, septicaemia. 10% cases are due to bedsore and its infection management. Lower limb wounds with exposed tendons or bones, orthopaedic implants exposed,-are well managed with VAC. Standard method of VAC application is followed in each case. Result: Out of 100 cases of lower limb problems with difficult to heal wounds, amputation stumps treated, we found infection is effectively reduced, wound discharge is reduced, wounds granulated well and early, and wound bed prepared early for skin graft take or flap take. Conclusion: Vacuum assisted closure (VAC) is very good modality of treatment, which assists plastic surgeons in healing wounds specially in difficult to treat lower limb wounds.

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BACKGROUNDPatient with burn scar of face, extremities, exposed part of abdomen in Indian clothing, seek consultation for aesthetic improvement of scar, even though there is no functional impairment. MATERIALS AND METHODS10 patients were studied from January 2007 to June 2016 for post-burn scar with tangential excision and thin split thickness skin grafting. Median time from injury to surgery was 66.2 months and mean follow up of 18 months. RESULTSTangential excision and thin split thickness skin grafting gave a fair aesthetic result with good overall patient satisfaction. The colour match was fairly good with no need for another operation. CONCLUSIONTangential excision and thin split skin grafting are good options for aesthetic reconstruction of burn scars. KEYWORDSPost-Burn Scar, Tangential Excision, Thin Skin Graft. HOW TO CITE THIS ARTICLE:Mehta J, Shahane PL, Zade M, et al. Aesthetic management of post-burn scar.

Background: Kite thread injuries specially due to chinese Manza is one of the major cause of an emergency in the casulty of NKPSIMS, Nagpur., India. Neck, face, legs, hands are the typically most affected sites as most of the patients are travelling on a speedy two wheeler, eyes cannot see manza thread of kite. Methods: We have studied 30 cases of manza cut injury presenting to a tertiary care centre at Nagpur during last few years. All the patients had varying degrees of injuries which were managed in our hospital were no mortality amongst these cases. Result: A total 30 cases were identified. Males are most commonly affected. The most common age group affected was 16 to 30 years. Hand, neck and face are most commonly involved. There were no cases of mortality. Conclusion: Kite flying is very enjoying game, famous in Gujrat, Maharashtra since years, but introduction of chinese or nylon manza in kite flying causing grievous injury even death, not only to flyer but also to the innocent other people, animals and birds. This study attempts to enlighten the side effects of chinese manza and necessity to ban it legally in kite flying.

Background: Extensive soft tissue defects of leg, ankle and foot are challenge to reconstructive surgeons due to lack of local tissue. Microvascular flap coverage has become a standard line of treatment as large amount of tissue transfer is required. Large transverse fasciocutaneous cross leg flap remains an alternative for reconstruction of such extensive defects. We present our experience with this flap in 14 patients.Methods: A total of 14 patients were operated for large transverse fasciocutaneous cross leg flap cover for defects over leg (9), ankle and foot (3) and sole (2). Age group ranged from 4 years to 50 years with 4 patients below 12 years of age. Male to female ratio was 5:2. Flaps were divided at 3weeks and final inset was done.Results: 11 patients had complete flap survival. Two patients had marginal necrosis and one patient had superficial necrosis of proximal flap margin after flap division. One patient with partial skin graft loss at donor area required secondary skin grafting at the time of flap division. Average hospital stay was 34.5 days (range 10 - 50 days). The donor limb had no joint stiffness related to immobilisation and cosmetic outcome of flap and donor area was satisfactory.Conclusions: large transverse fasciocutaneous cross leg flap is safe, technically easy and is associated with minimal donor site morbidity. It offers the possibility of limb salvage in difficult situations.