No abstract

BACKGROUNDChronic ulcers are defined as a slow or non-healing breakdown of epidermal and dermal tissue that lasts more than 6 weeks. Regardless of aetiology, chronic ulcers cause considerable and prolonged distress for patients. The use of newer dressings with collagen dressing may increase the wound-healing potentials.The aim of this study is to compare the efficacy of collagen dressing with that of conventional dressing in the management of chronic ulcers and their healing process.

Cauterisation of 144 ear perforations (Right and Left) with 20 percent TCA (Trichloracetic acid) was tried in patients having 2 to 6mm perforations. Perforations were dry for 3 weeks-3 months or more. 30 patients were having traumatic perforations such as slap on face, blast injuries or associated with head injuries. Most of the patients were having perforations due to inflammation. Few of them had recent attack of otitis media which were effectively treated by suitable antibiotics, antihistamines and subsequently taken for cauterization of perforation. Site of perforation was mostly on the anteroinferior quadrant, next the inferior quadrants. Still less number in the entire four quadrant, least no. in P. S. quadrant. Traumatic perforations were irregular in shape varying from 2-6mm in size and were elliptical in shape. Hearing loss ranged from 15dB-45dB (Depending upon size and site of perforation). Main presenting symptoms in inflammation cases were intermittent discharge as well as deafness. In traumatic case history of pain and deafness was the main symptom. We did wait for 1 month in traumatic cases to achieve spontaneous closure. In inflammatory cases cautery was considered first line of treatment. It has to be done several times at 10 days interval. Most of the times closure of perforation was achieved with 3 attempts, inflammatory cases 5 th or 6 th attempt. In one case as many as 23 attempts. In 6 cases of perforation after partial take of graft in myringoplasty occurred after 3 months cauterization was attempted and we got closure in 5 of them. In one case re myringoplasty had to be done.