British journal of plastic surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
The use of pH adjusted lignocaine in controlling operative pain in the day surgery unit: a prospective, randomised trial.
We report the results of a randomised, case matched, controlled, double blind study on 40 patients undergoing correction of their prominent ears, comparing efficacy of pH adjusted lignocaine to lignocaine alone in controlling operative pain. Each patient received commercial lignocaine in one ear and the same preparation reconstituted with 1 ml of 8.4% sodium bicarbonate in the other ear according to our randomisation protocol. 30 patients were studied to compare the difference between the buffered and commercial preparation infiltrated at room temperature. ⋯ Buffered lignocaine imparts a significant reduction in pain on infiltration, compared to the commercial preparation at both room and body temperature. Both preparations were equally effective in obliterating pain during the operation itself.
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Case Reports
The distally based superficial sural flap for reconstruction of the lower leg and foot.
We describe our experience with the use of distally based superficial sural flaps for coverage of defects in the lower leg and foot in 21 patients. In 18 patients the flap was successfully transferred, in 2 cases partial necrosis of the flap occurred and 1 flap failed completely. ⋯ The advantages of this flap are: easy and quick dissection, hence saving operating time, minimal morbidity of donor site and preservation of major arteries of the leg. Although the flap was described as reliable for covering defects around the ankle joint, we have been able to cover defects of the dorsum of the foot distally and up to the mid-third of the tibia proximally.