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Intralesional verapamil may be a suitable alternative to triamcinolone in the treatment of hypertrophic scars and keloids.

Background Grafting condition is one of the important determinants of skin-graft take. The technique of VacuumClosure has been claimed to improve the same and thereby graft take. However, there are few comparative studies against the conventional dressing technique evaluating its effectiveness in skin grafting. The present study was undertaken to compare Vacuum-closure with conventional dressing over freshly laid split-skin grafts. Methods Consecutive patients undergoing split-skin grafting were randomized into cases and controls. The grafts in controls were covered by a conventional dressing consisting of vaseline gauze and cotton pads. Those in cases were covered by a vacuum-closure assembly and connected to a wall-suction of 80 mm Hg continuously for four days. The percentage of graft take was assessed at nine days and at two weeks and duration of the dressing were compared between the two groups. The difference in cost of the dressing was noted down. Results Sixty four patients underwent split skin grafting of 71 wounds. Forty three of them were males and twenty nine were females. The grafted wounds included fresh surgically created wounds, traumatic wounds, acute and chronic burn wounds, post-inflammatory wounds and diabetic wounds. Thirty five of the grafts were cases and 36 were controls. Final graft take at two weeks in the study group ranged from 70-100 per cent with an average of 95.29 per cent graft take (SD: 5.9) while the control group showed a graft take ranging between 0-100 percent with an average graft take of 85.89 percent (SD: 25.1) Duration of dressing of the grafts was 11.63 days in cases as against 15.11 days in controls. The differences were statistically significant. The additional cost of the vacuum-closure assembly for an average sized ulcer was 6.27 pounds. Conclusion Negative pressure dressing increases the amount of graft take and should be used particularly when the wound bed and grafting conditions seem less-than-ideal for a complete graft take. Negative-pressure dressing can be economically and effectively assembled using locally available materials. Level of Evidence: Level I, therapeutic study.

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Skin cancers are rather uncommon malignancies comprising less than 1% of all the cancers in India. Saree cancer is a rare type of squamous cell carcinoma (SCC). Saree and dhoti are traditional male and female costumes respectively, which is unique to the Indian subcontinent. Constant wear of this clothing tightly around the waist results in changes in pigmentation and scaling of the skin, acanthosis, scar and ulceration and subsequent, gradual malignant changes. The process of repeated trauma over a long time and consequent interference with the healing process may rationalise the reason for malignant transformation. Few papers have been published on saree cancer, in main stream medical journals. We are presenting a rare case of saree cancer in a 68-year-old woman, with two distant bilateral ulceroproliferative growths in loin (Synchronous), along the waistline, which showed well-differentiated SCC on biopsy. Wide excision with rhomboid transposition flap was done bilaterally.