No abstract

ABSRTACT: Covering of large wounds after mastectomy in locally advanced Ca breast with skin that can withstand radiotherapy is a challenge to the surgeon. Here this study we used a local advancement flap from the adjacent area called Thoraco-Abdominal Flap (TA flap) for such giant defects. This is based on superficial and lumbar arteries and is thick to with stand consequent RT. MATERIALS AND METHODS: Of the total 107 cases of LABC 32 had post mastectomy defects of larger than 12 cm and could not be closed by simple approximation. Among the 32 cases 17 cases are covered by split thickness skin grafting. 15 cases are covered by TA flap. These cases are assessed for mean operating time, mean blood loss, post-operative stay, flap necrosis and viability of the flap after radiotherapy. RESULTS: There is minimal extra time or blood loss in these cases. All the flaps healed well except for small edge necrosis in 4 cases. In all the patients we could start radiotherapy in the fourth week of surgery and all the flaps withstood RT well. After further evaluation probably this can be recommended as procedure for giant post mastectomy defects particularly for those who require RT early.

BACKGROUND Chronic ulceration of the lower leg is a frequent condition, with a prevalence in the population over 60 years of age. The incidence of ulceration is rising as a result of the ageing population and increased risk factors for atherosclerotic occlusion such as smoking, obesity and diabetes. For a proper treatment of patients with leg ulcers, it is important to be aware of the large differential diagnosis of leg ulceration and to effectively manage the conditions. Aims and Objectives-The main objective of the study was to analyse the incidence of different types of chronic leg ulcers, risk factors and their management.

PeutzJegher syndrome is a rare disorder characterized by mucocutaneous melanin deposits over lips, oral mucosa, fingers and multiple hamartomatous polyps in gastrointestinal tract. These individuals may present with small intestinal intussusception with these polyp as lead point. We report a case of 15 year old boy presenting with intestinal obstruction with oral melanin deposits and found to have multiple hamartomatous polyps in small intestine.

A 28 years old male presented with a case of painless soft fluctuant swelling of right parotid gland is reported to our hospital. The lesion was found to be a cystic lesion through the pre-operative examinations and investigations. The cyst was completely excised, taking care not to injure the lower division of the facial nerve. Post recovery was uneventful with no defect of the facial nerve functions. The histologic picture confirmed that the cyst was lymphoepithelial cyst which is so called "branchial cyst". Through the literature reviews of parotid lymphoepithelial cyst the discussions on prevalence, origin, diagnosis, histological finding, investigation and the modes of treatment are made. The ultra sound was found to be valuable in the pre-operative evaluation of the parotid swelling furthermore it is non-invasive, harmless, painless and relatively quick.