No abstract

No abstract

Introduction: Use of patient specific Polymethyl methacrylate (PMMA) implants for the reconstruction of cranial defects has become a standard practice with excellent long-term results. However, for the reconstruction of midface and mandibular osseous defects other alloplastic materials are preferred but their use is limited due to high cost. This is a report of our experience with the use of low-cost patient specific PMMA implants fabricated using 3D printed moulds in the reconstruction of osseous defects involving different areas of the facial skeleton not limited to cranium. Methods: The 25 consecutive patients with craniofacial osseous defects who underwent reconstruction using customized PMMA implants were analyzed. All PMMA implants were fabricated intraoperatively with the use of 3D printed flexible moulds or templates.Results: A total of 34 implants were used in 25 consecutive patients. Out of 34 implants 25 were used for midface and mandibular osseous defects. Most common etiology was posttraumatic deformity (n ¼ 19) followed by tumor (n ¼ 3), craniofacial anomalies (n ¼ 2) and post-craniotomy (n ¼ 1). One patient out of 25 (n ¼ 1) had postoperative implant exposure. The follow-up was ranged from 3 to 19 months with an average of 12 months. The aesthetic outcome was found to be good to excellent with mean visual analogue score of 4.08. Conclusions: Polymethyl methacrylate implants fabricated intraoperatively using 3D printed moulds provide accurate and precise reconstruction at an exceptionally low cost. PMMA has an excellent moulding property with low infection rates. As shown in our study its application may be easily extended to all areas of the craniofacial skeleton.

were no cases of penetration injury in group I while in group II, penetration injury to the surgeon was noted in 5 (33.3%) cases. Conclusion: Maxillomandibular fixation screws provided good intraoperative MMF. Placement of screws consumes less time and reduces the intraoperative period and also the risk of penetration injury to the surgeon. We also observed better oral hygiene, better patient compliance, and no major complications with the use of MMF screws. Hence, MMF screws proved to be an efficient alternative to the conventional methods of achieving IMF.

Background Cutaneous mucormycosis is a rare and fulminant infection associated with high mortality. Plastic surgeons come across this infection in the settings of road traffic accidents, surgical site infections, and as a secondary infection with underlying bacterial soft tissue infections. Due to this infection's rarity and aggressive course, it is essential to initiate prompt multidisciplinary management at the first presentation. With this study, we aim to present a protocol for managing the condition. Methods This is a retrospective observational study of patients with cutaneous mucormycosis managed at a tertiary care hospital from January 1, 2016 to November 30, 2022 excluding patients with mucormycosis who tested positive for coronavirus disease 2019. Results Of 24 patients, 22 were males, and most were in the age group of 41 to 60 years. Sixteen patients survived and five out of eight deceased had comorbidities, six presented primarily without prior debridement, and six had trunk involvement. Conclusion A high index of clinical suspicion is necessary for early diagnosis and management of patients with invasive cutaneous mucormycosis. A multidisciplinary approach with appropriate medical and surgical management can improve outcomes in cases that otherwise carry a high mortality rate.

Summary: In this unique case report, we present a patient of left zygomatico maxillary complex reconstruction with a combination of autogenous tissue (osteocutaneous free fibula flap) and alloplastic implant [patient-specific templated polymethyl methacrylate (PMMA)]. In such large defects, reconstruction using either autogenous tissue or alloplastic implant alone is inadequate and leads to poor functional and aesthetic outcomes. In this case we used osteocutaneous free fibula flap for left alveolus and patient-specific templated PMMA implant for reconstruction of orbital wall and zygoma. Osseointegrated implants were placed secondarily in the fibula for complete dental rehabilitation. With the use of virtual surgical planning and 3D printing we were able to achieve a good result for a complex defect. Since both autogenous tissue and alloplastic implant were used for complete reconstruction, we have named this as “hybrid reconstruction.”

No abstract

The objective of this study was to obtain a fast, accurate and reliable method of species identification of unknown biological samples for forensic applications, especially in illegal trade of animals as well as meat fraud. Meat fraud and adulteration not only affects the market but also increases the risk of religious and ethnic conflicts around the world [1]. In this study, species-specific and gender differentiating Real time PCR technique was employed to analyse 15 meat samples collected from a suspected site. Out of 15 samples collected from suspected site, 54% and 13% samples were of Cow and buffalo origin respectively. All 54% cow samples were of male while one each of buffalo were of male and female origin. Two samples were inconclusive. These findings indicated that species and gender-specific PCR is very sensitive and can be used for forensic species identification and the detection of meat fraud and adulteration.