PubMed Health⌕ Search

Biomedical subjects

P S Bhandari

Publications and source records attributed to P S Bhandari.

8 recordsLinked to original sources
PubMed2007

A study of regional nerve blocks and local anesthetic creams (Prilox) for donor sites in burn patients.

BACKGROUND: Burn patient requires multiple visits to the operation theatres and undergoing anesthesia with its attendant risks and post anesthesia recovery. It is possible now with the availability of local anesthetic creams like Prilox to conduct these procedures in the minor OT without any discomfort to the patient. MATERIALS AND METHODS: Hundred patients of post burn raw areas were selected. These patients had at least one area of healthy skin on anterior, medial or lateral thigh. No patient had a known drug allergy. The age group varied from 5 to 75 years with no bias towards any sex. These patients were then given anesthesia according to the group, and were assessed for the ease of grafting, amount of graft being harvested, subjective pain score, post operative pain relief and any post operative complication. The nerve block technique being used was either femoral and/or LCT block or 3-in-1 block and popliteal fossa block. RESULTS: Both the group of patients had a virtual painless process of skin grafting. It is safe in selected patients to combine the two techniques in order to harvest larger areas. DISCUSSION: Both techniques of local anesthestic creams and nerve block are safe and convenient to use. Nerve blocks are more useful where larger grafts are required, the creams being more useful in children and where less graft is required.

Adolescent↗
PubMed2006

Microbiological safety and clinical efficacy of radiation sterilized amniotic membranes for treatment of second-degree burns.

Amniotic membranes collected from the placentae of screened donors were processed and sterilized by gamma irradiation at 25 kGy. The sterility assurance level (SAL) of gamma irradiated amniotic membranes and clinical efficacy in second-degree burn wound healing were evaluated. Processed air-dried amniotic tissue from 159 batches of processing was checked for the bioburden level before sterilization. About 39% of the tissues had bioburden in the range of 10(1)-10(2)/100 cm(2) and 54.8% in the range of 10(2)-10(3)/100 cm(2). Based on the bioburden of the processed tissue prior to sterilization and the D(10) value of 2.3 kGy for the radiation resistant reference strain Bacillus pumilus, the sterility assurance level of the amniotic membranes irradiated at 25 kGy is found to be 10(-7) to 10(-11). The burn wound healing rate was compared between the radiation sterilized amniotic membranes and glycerol preserved amniotic membranes. Fifty patients with partial-thickness burns (up to 70% TBSA) were selected for the study. The scalds constituted 82% (41 patients) whereas flame burns accounted for 18% (9 patients). Various aspects like ease of application, patient comfort, development of fluid under the membrane, bacterial culture of drained fluid, rate of epithelialization, development of hypertrophic scars, keloids, unstable scars and restriction of joint movements were recorded with the application of gamma irradiated and glycerol preserved membranes. Radiation sterilized amniotic membranes had advantage over the glycerolized membranes with respect to the ease of application. Five patients with glycerol preserved membranes and four with gamma irradiated membranes developed fluid. The bacteriology of fluid showed Pseudomonas aeruginosa in four cases, Staphylococcus aureus in two cases, Escherichia coli in two cases and Acinetobacter in one case. The application of radiation sterilized amniotic membranes on the burn wound favoured epithelialization. In all the patients, membranes dessicated and separated in 10-14 days time leaving behind an epithelialized surface.

Adult↗
PubMed2004

Simultaneous and symmetrical reconstruction of heminose and restoration of nasal airway in congenital absence of heminose.

Congenital absence of heminose is an extremely rare anomaly. Reconstruction of full thickness defects of the nose requires lining, support and cover. Reconstruction of congenital absence of heminose has an additional requirement of reconstruction of the nasal airway. Simultaneous reconstruction of the heminose and internal nasal passage has not been reported earlier. In a case of congenital absence of heminose, reconstruction of the heminose and internal nasal passage was done simultaneously by using expanded forehead tissue and a nasolabial flap. The nasolabial flap is robust and supports the alar margin without any need of cartilage support. The bulk of subcutaneous tissue it carries lies on the outerside of nostril and, therefore, it does not obstruct the nasal opening. This was covered by expanded forehead tissue, which got thinned out due to tissue expansion, thus achieving symmetry with other half of nose. Skin of the nasolabial flap lines nasal passage thereby avoiding the need of splintage of nasal airway which is required if nostril is lined by split skin graft.

Adolescent↗
PubMed2002

Total ear reconstruction in postburn deformity.

The external ear enjoys a special place in society all over the world. It is meant to be flaunted and adorned. Ear piercing is routine, with a range of jewelry pieces concentrating in enhancing its natural beauty. Persons with deformed ears have to limit their range of hair styles. There is a definite need to reconstruct the deformed ear of both sexes. To achieve desirable results in ear reconstruction is a difficult task. Although cartilage fabrication is an important step in ear reconstruction in postburn deformity of the ear, the final outcome is mainly decided by the quality and quantity of skin available in the auricular region for draping of framework.

Burns↗
PubMed2000

Use of triamcinolone acetonide injection in ear reconstruction.

Reconstruction of the complicated contours of the ear is a difficult task. To maintain and recreate the reconstructed contours of ears masked by the following various reasons is even more difficult. During the first stage of cartilage transplantation, the ear contours are quite often masked as a result of prolonged edema; thick, draping skin; organized hematoma; or inflammatory exudates. Dressings and splints have been reported as management methods of the ear postoperatively after the first stage of cartilage transplantation, but it is difficult to use these for a period of 6 months, the time when edema subsides. The author used triamcinolone acetonide injection locally in the area of the scapha and triangular fossa of the reconstructed ear to recreate the contours that were masked. This is a simple and effective method for achieving the desirable contours.

Ear, External↗
PubMed1999

Reverse flow instep island flap.

The retrogradely perfused medial plantar artery flap was used in a leprosy patient with a plantar ulcer over the heads of the second and third metatarsals. The flap is based on the anastomosis of the medial plantar artery with the branch of the first plantar metatarsal artery, which supplies the medial side of the great toe. This design provides reconstruction with like local tissues while not distorting the weight-bearing pattern of the foot.

Foot↗
PubMed1998

Total ear reconstruction in post burn deformity.

Severe thermal injuries to the external ear, in most cases, lead to a total destruction of the pinna. Total ear reconstruction in such cases of burns is one of the most difficult problems faced by a plastic surgeon. This is because of the paucity and poor quality of the skin available in the auricular region. Depending upon the quality and quantity of skin available in the auricular region, patients with total loss of ear following burns were divided into five groups. The surgical procedure for ear reconstruction differed in each group due to differences in skin available for coverage of the cartilage framework. Different covering methods which were used for the draping of the cartilage framework were, normal post auricular skin, local grafted or scarred but soft and supple skin, post auricular fascia, temporoparietal fascia (pedicled or free) and free radial forearm fascial flap. A temporoparietal fascial flap was the cover of choice if local skin was not healthy. During the past eight years, seventy six cases of total ear reconstruction were done for post burn ear deformities. The technique and results are presented here.

Burns↗