Background:Non-healing trophic ulcers in Hansen's disease patients is one of the major causes for disability. It has been shown that autologous platelet-rich fibrin matrix (PRFM) is effective in healing chronic non-healing leg ulcers.Aim:The objective of this study is to demonstrate the efficacy of autologous platelet-rich fibrin matrix (PRFM) in non-healing trophic ulcers in patients treated for Hansen's disease.Design:A prospective study.Setting:An institution-based clinic.Participants:Seven treated patients with Hansen's disease, with a mean age of 38.33 years, with nine non-healing trophic ulcer of more than 6 weeks duration.Measurements:Photographs were taken before treatment and at every subsequent sitting. Area and volume were calculated at baseline and every subsequent sitting till the closure was achieved.Materials and Methods:The healthy ulcers were treated with PRFM at weekly intervals, repeated once a week for a maximum of five sittings as per requirement.Results:The mean percentage improvement in the area was 93.52%, and volume was 97.74% at the end of the second sitting. All ulcers closed by a maximum of five sittings. No adverse events were noted.Conclusion:PRFM for the treatment of trophic ulcers in treated patients with Hansen's disease is a feasible, safe, simple and inexpensive method.

Background: Platelet-Rich Plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. After skin graft reconstruction, the healing process is longer and may be difficult, depending on the wound site, skin defect size, and patient comorbidities. The potential value of PRP lies in its ability to incorporate high concentrations of platelet-derived growth factors into the skin graft. Since not all patients afford commercially available recombinant platelet rich plasma for skin graft, platelet extract from patient’s own blood is being used in this study to test and demonstrate the therapeutic role of PRP in skin graft. The aim of this randomized, prospective study is to compare the effectiveness of PRP in skin graft with conventional method like sutures, staplers or glue.Methods: The source of data were the patients admitted as inpatients for the management of wounds to the department of general surgery, JSS Hospital, Mysore from September 2016 to September 2018. Total of 60 patients were studied; 30 cases were randomly chosen for study with autologous platelet rich plasma and 30 cases received conventional methods like staples/sutures used to anchor the skin grafts in a control group.Results: Autologous PRP showed faster and better healing rates. With PRP study group instant graft adherence was seen in all cases. Hematoma, graft edema, discharge from graft site, frequency of dressings and duration of stay in hospital were significantly less in the PRP. There were no adverse effects or reactions seen with the use of autologous PRP among the study group.Conclusions: The combination of PRP with Split Thickness Skin Graft (STSG) significantly improved clinical outcomes and shortened the wound healing time. Therefore, this treatment combination could provide a way to heal skin after skin graft reconstruction with minimal recovery time. It is found to be highly beneficial in many aspects both to the patient and surgeon based on our results.

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Myocardial abscess is a rare and usually a fatal c relatively a rare manifestation of staphylococcal septicemia especially in pediatric population. Here we are presenting a case of intramural myocardial abscess following right thigh a immunocompetent child with no structural heart disease. Incision and drainage of thigh abscess with aggressive appropriate antibiotic therapy saved the child despite the fatal myocardial abscess. Even in the absenc endocarditis in staphylococcal septicemia, it is mandatory to look for myocardial abscess for early diagnosis and betteroutcome. A high index of clinical suspicion is required to make a prompt diagnosis.A 4-year-old male patient presented to emergency depar moving the right lower limbsince 4 days. There was no history of intramuscular injections or recent trauma. Figure-1:Child with right thigh abscess.