Background: Maxillofacial injury was usually found in low to middle countries moreover it commonly associated with brain injury, the major etiological factors are traffic collision, violence, and fall from hight. The incidence and etiology was important to developed treatment moreover to improve patient care in the future. The aim of this study was to analyze the incidence of the pattern of maxillofacial fracture in a patient with a traumatic head injury and to measure the incidence of the cause of injury, age, and gender distribution Methods: This is a retrospective study in Songhklanagarind hospital. We evaluate all patients who presented with a concomitant maxillofacial and traumatic head injury in Songklanagarind hospital between 2007 and 2016. Results: 859 patients consisting of 73.3% male and 22.7% female. The mean age was 39.5 years.The severity of the traumatic head injury was mild traumatic head injury 70.15%. Moreover the alcohol consumption was significantly related to a mild and severe traumatic head injury (P < 0.05). The most frequent was maxilla bone. 33.9% of patients were undergone the operation. Conclusion: In this retrospective study, the maxilla bone fracture was the most frequent site involved. The patients with mild traumatic head injury are related to the coronoid process of mandible, Le Fort fracture type II and type III, moderate traumatic head injury is only related to the coronoid process of mandible and severe traumatic head injury are related to Le Fort fracture type II and III. Keyword: traumatic head injury, maxillofacial fracture

Objective: Controlling infection and promoting healing should be the aims of hard-to-heal diabetic ulcer treatment, along with improving a patient's general condition and their blood sugar control. Many hard-to-heal diabetic ulcers present with cavities, tracks or a combination of these. There is a new biocellulose (with a nanosilver dressing) which has the ability to contour around and conform to the irregular surface of a wound bed. The purpose of this study was to evaluate its efficacy compared with a silver sulfadiazine cream, for hard-to-heal diabetic ulcer treatment. Methods: In this randomised control trial, patients with hard-to-heal diabetic ulcers were divided into two equal-sized groups: treatment with the biocellulose with blue nanosilver (experimental group), and treatment with silver sulfadiazine cream group (control group). Cotton gauze was used as the secondary dressing for both groups. Demographic data, wound size, wound classification, wound photography and bacterial cultures were recorded at the beginning of the study. Wounds were debrided as necessary. Dressings were changed twice daily in the control group, and every three days in the experimental group. Results: A total of 20 patients took part in the study (10 patients in each group). The highest mean wound healing rates were 91.4% in the experimental group and 83.9% in the control group. No wound infections or adverse effects from the dressings were detected in either group. Conclusion: In this study, biocellulose with blue nanosilver adapted well to the wound bed. Wound reduction was greater in the experimental group than the control group. Biocellulose with blue nanosilver could therefore be a good choice for hard-to-heal diabetic ulcer treatment, due to its good healing rates and minimal care requirements.

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Sternal clefts are rare congenital chest-wall deformities, which can be complete or incomplete; therefore, reconstruction with autologous tissue is essential to protect the heart and prevent respiratory infection. In this report, we present the case of a 16-month-old baby girl from a preterm, twin pregnancy with a partial superior sternal cleft. A moist dressing for promoting wound healing was used until cutaneous layer complete epithelialization at which time we performed reconstruction with autologous tissue. After surgery the patient recovered with close-to-natural chest wall contour and adequate heart and lung function.