Use of smartphone has become ubiquitous. With smartphone cameras becoming powerful, they are replacing digital cameras and digital SLRs as primary instruments to take photos and record videos. It is natural even for plastic surgeons that smartphones are handy to take still photographs and even record high-definition or 4K videos. Another invention which has become popular with smartphone photography is a selfie stick. We explain the possibility and methodology of using an iPhone and selfie stick to take operative photographs and high-quality videos.

Background: While using radial forearm free flap in palate reconstruction, the pedicle lies in the nasal floor, constantly exposed to the nasal secretions and turbulent air current. To overcome this problem, we have designed a procedure which utilises the adipofascial extension to wrap the pedicle and nasal side of the flap. Materials and Methods: The study was done during 2017 and 2018, 2 years’ period. Totally 13 consecutive patients with defect in the palate status post-oncological resection and those in whom local flaps were not enough to cover the defect were included into the study. These patients were divided into two groups. First group in whom adipofascial extension was not used to cover the pedicle and second group in whom adipofascial extension was used to cover the pedicle. The incidence of nasal crusting, secondary haemorrage, blow out and flap necrosis were analysed and compared. Results: In Group 1, we had 2 among 6 (33%) patients with secondary haemorrage. One patient had partial flap loss. On exploring, we noticed thrombosis of cephalic vein. We did not had any incidence of blow out of the pedicle. In Group 2, none of the patients had any secondary haemorrage. All flaps healed well. On doing nasal endoscopy at 6 months of follow-up, all flaps showed complete mucosalisation at the nasal side. Conclusion: Use of adipofascial extension while planning a radial forearm free flap to cover the nasal side of the flap and pedicle in the nasal floor helps to reduce the nasal crusting and secondary haemorrhage.

Background:Successful restoration of structure and function using autologous free fat grafts has remained elusive. Review of literature shows that various harvesting and preparation techniques have been suggested. The goal of these techniques is to obtain greater adipocyte cell survival and consequently more reliable clinical results.Materials and Methods:In our technique, a piece of mesh is kept at one end of the lipoaspiration syringe, which is then connected to the Suction pump. As one syringe fills, it is replaced by another one until the required amount of fat is obtained.Results:By using a polypropylene mesh in our technique, we can separate the transfusate from the harvested fat graft during harvesting itself. The fat graft thus obtained is dense and concentrated, with fewer impurities.Conclusion:Hence, we recommend our technique as a reliable method for extracting sterile emulsified fat in an economical way.

Introduction: Necrotising Pancreatitis (NP) is the severe form of acute pancreatitis accounting for significant mortality (15- 40%), morbidity (~25%) and has significant health costs. The traditional management of infected necrosis has centered on open surgical debridement which is accompanied by significant risk of stress, organ failure and complications. Short-term and long-term functional outcomes after operative treatment of NP have not been studied extensively. Aim: To evaluate the short-term and long-term surgical outcomes in patients undergoing surgery for NP. Materials and Methods: This was a cross-sectional study of patients who underwent surgery for NP conducted at Manipal Hospital, Bangalore between June 2009 to March 2016. The electronic records pertaining to such patients were retrieved. Various surgeries done were grouped. Surgical complications and short-term outcomes like new onset organ failure, Surgical Site Infection (SSIs), haemorrhage, bowel fistula, re-explorations, and requirement of additional procedures, hospital stay and the mortality were studied by hospital data. Long-term outcomes like endocrine/exocrine insufficiency, weight loss, recurrent pancreatitis, incision hernia were studied by prospective data collected from telephonic interview; questionnaires in addition to data collected as and when patient gets admitted and in Outpatient Department (OPD) during follow-up. A comparison with different surgical techniques like laparoscopy, open necrosectomy, Video assisted necrosectomy was made. Statistical analyses were performed by STATA 11.2 (College Station TX USA). Mann-Whitney test were used to find the significance difference between the length of stay and Intensive Care Unit (ICU) stay with the groups and it is expressed as mean and standard deviation, Chi-square test has been used to measure the association between different clinical variables. p<0.05 was considered as statistically significance. Results: Forty six patients underwent surgical treatment during the study period. Patients’ age ranged from 25 to 75 years (median age- 44 years). Median postoperative ICU stay was 12 days (range of 01- 32 days). The mean follow-up was 3.5 years. The overall mortality rate was 26% (12 patients). The mortality rates between laparatomy (33%) and minimally invasive necrosectomy (23%) groups were not significantly different (p=0.436). Secondary diabetes mellitus was observed in 18 (40%) and exocrine insufficiency in 8 (18%) of patients. The other long-term complications were recurrent pancreatitis in 7 (15%), biliary stricture 3 (6%) and incisional hernia in 3 (6%). Conclusion: Mortality rate, organ failure rates and median ICU admission rate were similar across all surgical techniques though there was a trend of overall reduced complication rate. A long-term and close follow-up is advised in these patients for the late complications to be identified and treated.