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How I Do It - Innovative delivery devices: Juvapen

The administration of botulinum toxin is traditionally performed using a small syringe plus needle. There are a few ways this can be performed. Either an integrated insulin syringe is used of 1ml, 0.5ml or 0.3ml which comes attached to a...

We need to talk about amputation – a difficult conversation in the developing world

What do you do when a patient refuses amputation? The author shares various cases and outlines her team’s approach to this scenario in Gaza. What to do when a patient refuses amputation for a severely damaged lower limb that will...

Practising surgery in a war zone: an interview with Dr Volodymyr Melnyk

It is now nine months since the full-scale Russian invasion of Ukraine commenced in late February 2022, with Putin announcing a “special military operation” to “denazify and demilitarise” Ukraine. The rest of the world, however, saw it for what it...

Topical phenytoin effect on pressure ulcers healing: A literature review of the evidence

A pressure ulcer (PU) is a localised injury to the skin and / or underlying tissue usually over a bony prominence, because of pressure, or pressure in combination with shear (EPUAP/ NPUAP 2009/PPPPIA 2014). Bennett et al. [1] claimed total...

Transnasal endoscopic choanal atresia surgery

Surgery is currently the only definitive treatment for congenital choanal atresia (CCA). There are various surgical approaches including transnasal, transeptal or transpalatal. The authors propose that the preferred option is transnasal endoscopic choanal atresia surgery (TECAS) and set out to...

CAD/CAM assisted mandibular reconstruction free hand: is there a difference?

The gold standard for the reconstruction of the mandible is a free bony flap, the fibula is commonly used. The fibula is a straight bone and indeed all the other donor sites present various other considerations and difficulties, to allow...

Changing trends in the management of osteoradionecrosis (ORN)

In the wake of new drugs that have been introduced for ORN like pentoxifylline, tocopherol, clodronate etc, traditional ‘conservative’ management of osteoradionecrosis (ORN) including minimal surgical debridement and hyperbaric oxygen therapy (HBOT) is under review. This study is a retrospective...

Dental implant rehabilitation in fibula free flaps

The fibula free flap was first described in 1975 and since then has gone on to become the gold standard technique for reconstruction of longer spans in the mandible or maxilla. It is a reliable flap that affords good quality...

Exposure of the forearm and distal radius

Klausmeyer and Mudgal are a plastic surgeon from Colorado and an orthopaedic surgeon from Boston, respectively, who both specialise in hand surgery. In this article the authors describe the approaches to the forearm and distal radius. They commenced with a...

Oral photoprotection

The author presents an insightful review of the benefits of systemic photoprotection through orally ingested nutrients, advocating a need for a greater level of protection against free-radicals. Vitamin C is discussed in relation to its role in immune function, collagen...

Effects of ultraviolet radiation on the skin

A comprehensive paper concerning the dermal effects of sun exposure, including strategies which aesthetic nurses can adopt to guide patients in making evidence-based choices in selecting suitable sun protection. The key principles of ultraviolet radiation (UVR), including the immediate and...

Quantity for quality

Although facial paralysis is not uncommon, the number of patients who require free muscle transfer is much smaller. Besides that, the diversity of surgical and non-surgical interventions, the multitude of methods for perioperative assessment, and outcome measurements likewise lead to...