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Morel-Lavallee lesions (MLL) are rarely diagnosed posttraumatic sequel. They follow closed degloving injuries due to accumulation of blood and debris in the subcutaneous plane. Though they are not uncommon, they are rarely diagnosed which results in delay in their treatment. Diagnosis is through a combination of clinical examination, history, and imaging studies. MRI is the diagnostic modality of choice. Different treatments have been used for their management like compression therapy, sclerosant injection, pulse lavage, and open debridement. These treatments have met with varying success. Treatment protocols vary when managing acute and chronic MLL. The knowledge of such lesions hastens their diagnosis and treatment.

Splenic abscess is an uncommon and lifethreatening condition. Due to its nonspecific clinical picture, it remains a diagnostic challenge. Multiple radiological modalities are used for the diagnosis. In this retrospective study we analyzed 75 patients treated between 1999 and 2009. The patients were divided into three groups depending on the treatment received. Group I (n=14) consisted of patients treated with only antibiotics, Group II (n=19) patients were treated with percutaneous drainage and Group III (n=42) with splenectomy. We tried to establish epidemiologic and clinical features and therapeutic options in splenic abscess. Our study suggests that percutaneous drainage is a safe and effective alternative to surgery especially in unilocular or bilocular abscesses thus allowing preservation of the spleen. It should be considered as the first line of treatment although splenectomy remains the final definitive procedure if percutaneous drainage fails.

Klippel-Trenaunay syndrome is a well-known conglomeration of capillary malformations, bony or soft tissue hypertrophy, and abnormal deep or superficial veins. Although it generally presents with grossly enlarged limbs, it can present with more serious features like haematuria, haematochezia, and seizures. This retrospective study included patients admitted with the diagnosis of Klippel-Trenaunay syndrome in this institute from 2001-2010. The patients' demographic data, clinical features, associated findings, and treatments given were tabulated. A total of 19 patients were included in the study. Two patients presented with haematocezia and had to undergo bowel resection. Five presented with bleeding and ulceration. Debulking surgery was done in three of them. Patients also presented with abdominal distension, jaundice, seizures, and haematuria. Although the common presentation of varicose veins was treated with sclerotherapy, the treatment was tailored to each patient. Klippel-Trenaunay syndrome is a multifaceted disorder which can manifest in a number of different ways. These features may be missed by an unwary plastic surgeon treating them only for the limb hypertrophy.

Context:Wound measurement is an important aspect of wound management. Though there are many techniques to measure wounds, most of them are either cumbersome or too expensive.Aims:To introduce a simple and accurate technique by which wounds can be accurately measured.Settings and Design:This is a comparative study of 10 patients whose wounds were measured by three techniques, i.e. ruler, graph and our technique.Materials and Methods:The graph method was taken as the control measurement. The extent of deviation in wound measurements with our method was compared with the standard technique. The statistical analysis used was ANOVA.Results:The ruler method was highly inaccurate and overestimated the wound size by nearly 50%. Our technique remained consistent and accurate with the percentage of over or underestimation being 2-4% in comparison with the graph method.Conclusions:This technique is simple and accurate and is an inexpensive and non-invasive method to accurately measure wounds.

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Jatropha curcas is common plant found all over India more commonly in the southern parts. Though it is a common cause of accidental poisoning among children in these parts, standard texts rarely cover it. Gastrointestinal manifestations are predominant feature of poisoning with the seeds of Jatropha curcas. Mortality is rare.

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.