Biobrane is a versatile biosynthetic wound dressing. There is good evidence (Grade A) to support the use of Biobrane in the management of burns, particularly in partial-thickness burns in children. Biobrane also has many potential uses as a dressing outside the burns unit of which we feel reconstructive surgeons should be aware. Conditions resulting in disruption of the epidermis such as toxic epidermal necrolysis (TEN) and paraneoplastic pemphigus have been managed successfully using Biobrane (Grade B). Biobrane has also been successfully used following dermabrasion, skin-graft harvesting, and laser resurfacing (Grades B to C). Temporary coverage with Biobrane has been successfully used in individuals with chronic wounds such as open sternotomy sites and venous ulcers (Grades B to C). Biobrane has a wealth of potential uses outside its traditional remit; however, further prospective clinical trials are warranted if these new applications are to become more widely accepted.
The external auditory canal is intimately related to the temporomandibular joint, separated only by its bony anterior wall. Neoplasm, trauma or inflammation in this area can result in displacement of the temporomandibular joint into the ear canal; however, spontaneous herniation is rare. Persistence of the primitive foramen of Huschke can result in dehiscence of the anterior canal wall, allowing articular tissue to prolapse into the ear canal. Surgical closure of these defects is known to be effective in ameliorating symptomatic cases.
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