Objective: Evaluation of the effect of Ringer Lactate, as the resuscitative burn fluid according to Parkland Formula, on restoring the levels of body electrolytes and proteins. Design: A retrospective cohort study. Setting: The National Burns Unit, Mafraq Hospital, Abu Dhabi, United Arab Emirates (UAE). Patients: One hundred and fifteen patients admitted with fresh burns between 1st of January 2011 and 31st of December 2013, who met inclusion and exclusion criteria. Methods: Team collected demographic and clinical data for each patient using a standard form. Patients received Ringer Lactate solely as the resuscitative burn fluid according to Parkland Formula. Baseline (pre-) and third-day (post-) variables included levels of sodium, potassium, chloride, proteins, and albumin. Researchers then performed paired comparisons of serum electrolytes and protein levels. Results: Mean values showed maintenance of the potassium and chloride levels within the normal range after administering the Ringer Lactate, significant decline in sodium, and a marked hypoproteinaemia and hypoalbuminaemia post-resuscitation. Conclusions: Ringer Lactate used as the mere resuscitative post burn fluid is suboptimal. Sodium supplementation may be required to correct hyponatremia. Colloids, preferably intravenous albumin should be added, as advised by the original Parkland Formula.

Objectives: Evaluation of the effects of withholding plasma during the initial part of the burn shock period (the shock period in the study is estimated as the first 36 hours following the burns) when it will be lost into the interstitial tissues through the permeable capillaries. During that time crystalloids are administered. Another objective is to evaluate the effect of administering normal saline as the crystalloid resuscitation fluid during the initial part of the shock period. Design: A Retrospective 4 years study compares the use of normal saline as the resuscitative intravenous fluid during the first 12 hours post burns followed by intravenous 5% Purified Plasma Protein Fraction (PPPF) during the rest of the shock period i.e. the remaining 24 hours, with the use of the PPPF throughout the burns shock period according to Muir and Barclay formula.

We report a case of 77 years old male patient who presented to our hospital with bleeding from a fungating mass of the nose. Investigations revealed the lesion to be moderately differentiated basaloid type squamous cell carcinoma, with lung, liver and spleen metastasis. Oncologists started palliative chemotherapy for the patient. Excision of the tumour required removal of most of the nose including the lateral nasal cartilages and the nasal septum. Nasal reconstruction was done by using left nasolabial flap after deepithelialising 3 parts of it and covering that flap with a forehead flap. Residual tumour of the upper lip required further excision later on and coverage with a fan flap. The patient survived about 6 months after the surgery in a good appearance and was accepted and approached well by his family. We think that this type of reconstruction is suitable for late stages cancer nose considering the life expectancy of this category of patients.

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Ingrowing toenails are common particularly in young adults. They usually result in a prolonged period of discomfort or pain that is sufficient to interfere with working and social activities. Apart from the toes, ingrowing nails can affect the fingers as well. Surgery is still the mainstay of treatment. A number of techniques have been described in the literature. But in all there is a high recurrence rate and sometimes the cosmetic result is not acceptable. In this article we describe our technique of surgical management of ingrowing nails of the toes and fingers. The technique involves excision of a part of the lateral nail fold and raising a composite flap consisting of the nail bed and the underlying periosteum which is then advanced. 105 cases were operated using this technique with very good postoperative results.

We report a case of combined hand trauma in the form of circumferential degloving injury of the hand with full thickness friction burns of the hand, forearm and the distal part of the upper arm. On exploration the hand was found avascular with loss of vital structures and full thickness burns. As a salvage procedure the hand was embedded in the subcutaneous tissue of the abdomen for 4 weeks and after that elevated as an inferiorly based flap on the bilateral superficial inferior epigastric arteries. Two weeks later the hand was freed by division of the base of the flap bilaterally. The details and description of the injury, the procedure and the outcome are discussed.