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History of BAPS
LfrifishJournal ofPlastic Surgery (1988), 41, 557-553 0 1988 The Trustees of British Association of Plastic Surgeons
Letters to the Editor following these guidelines, there have been no wounds colonised or infected by the organism following the use of leeches.
Surgery for severe trismus in submucous fibrosis Sir, I was happy to receive the letter from Dr Viegas (British Journal of Plastic Surgery, 1988, 41, 100) regarding the difficulty he has experienced in closing the posterior part of the release incision when attempting to correct the trismus due to submucous fibrosis, with bilateral nasolabial flaps. Normally in all cases of trismus due to submucous fibrosis, one has to release the mucosa up to the fauces to obtain proper release. The distance from the angle of the mouth to the fauces is usually between 5 and 5.5 cm in most adults. The base of our naso-labial flap is situated approximately 2 cm from the angle of the mouth and the flap raised is 4 cm long. The flap could be extended to 5 cm or more in length, if required. It is at the second stage, of division of the flap, that the intraoral mucosa from the base of the flap to the angle of the mouth is incised and the flap is divided in such a manner that the extra 2 to 2.5 cm is available from the base for resurfacing that remaining portion of the oral mucosa. Hence the total length of the flap is between 6 and 7.5 cm. It is possible to go across up to the midline in the soft palate and feed the flap into the defect, if it is necessary to do so. I am sure that if he follows this technique carefully he will get a flap of more than adequate length and breadth for resurfacing the oral mucosa. Yours faithfully, N. M. Kavarana, MS, Chief, Plastic and Reconstructive Tata Memorial Hospital, Bombay, India.
Yours faithfully, N. S. G. Mercer, FRCS, Registrar in Plastic Surgery, Frenchay Hospital, Bristol. BS16 1LE.
Reference
Surgery Service,
Medical leeches and infection Sir, In 1987 we reported a high incidence of infection with Aeromonas hydrophila following the therapeutic use of leeches. We recommended both more strict criteria for their use and the addition of prophylactic antibiotics (/3 lactamase resistant, e.g. Augmentin, or a cephalosporin) (Mercer et al., 1987). We are pleased to report that over the last year, 557
Mercer, N. S. G., Beere, D., Jknemisa, A. J. and Thomas, P. (1987). Medical leeches as sources of wound infection. British Medical Journal, 294,937.
History of BAPS Sir, I would like to point out to you odd errors of fact in John Barron’s section of the History of the British Association ofPlastic Surgeons on page 21. I was not sent by the army toBritain. I had been there since 1937 andonly transferred to the Australian army from the Emergency Medical Service late in 1940. Ken Starr was the other man sent for training in Britain along with Officer Brown. John Barron must have known this for he took over my appointment at the Hill End Unit, to which I was a foundation appointee along with Mowlem and Grocott (from Stoke on Trent). It was my transfer to the Australian army which created the vacancy for Barron. All this is as detailed in my book. Also, he has Henry Pickerill listed as a trainee from New Zealand. He was a colleague of Gillies at Sidcup and had no part in World War II. He was indeed head of the New Zealand section at Sidcup. Barron (as a fellow New Zealander) must surely have known this too. Anyway, that is just for the record for I thought the publication was a good start for a formal history, which in my view must sometime be written objectively by one person. However, it is good to see something on the record for a start. Yours faithfully, (Sir) Benjamin Rank 12 Jerola Avenue, Mt. Eliza, Australia 3930.
Letters to the Editor following these guidelines, there have been no wounds colonised or infected by the organism following the use of leeches.
Surgery for severe trismus in submucous fibrosis Sir, I was happy to receive the letter from Dr Viegas (British Journal of Plastic Surgery, 1988, 41, 100) regarding the difficulty he has experienced in closing the posterior part of the release incision when attempting to correct the trismus due to submucous fibrosis, with bilateral nasolabial flaps. Normally in all cases of trismus due to submucous fibrosis, one has to release the mucosa up to the fauces to obtain proper release. The distance from the angle of the mouth to the fauces is usually between 5 and 5.5 cm in most adults. The base of our naso-labial flap is situated approximately 2 cm from the angle of the mouth and the flap raised is 4 cm long. The flap could be extended to 5 cm or more in length, if required. It is at the second stage, of division of the flap, that the intraoral mucosa from the base of the flap to the angle of the mouth is incised and the flap is divided in such a manner that the extra 2 to 2.5 cm is available from the base for resurfacing that remaining portion of the oral mucosa. Hence the total length of the flap is between 6 and 7.5 cm. It is possible to go across up to the midline in the soft palate and feed the flap into the defect, if it is necessary to do so. I am sure that if he follows this technique carefully he will get a flap of more than adequate length and breadth for resurfacing the oral mucosa. Yours faithfully, N. M. Kavarana, MS, Chief, Plastic and Reconstructive Tata Memorial Hospital, Bombay, India.
Yours faithfully, N. S. G. Mercer, FRCS, Registrar in Plastic Surgery, Frenchay Hospital, Bristol. BS16 1LE.
Reference
Surgery Service,
Medical leeches and infection Sir, In 1987 we reported a high incidence of infection with Aeromonas hydrophila following the therapeutic use of leeches. We recommended both more strict criteria for their use and the addition of prophylactic antibiotics (/3 lactamase resistant, e.g. Augmentin, or a cephalosporin) (Mercer et al., 1987). We are pleased to report that over the last year, 557
Mercer, N. S. G., Beere, D., Jknemisa, A. J. and Thomas, P. (1987). Medical leeches as sources of wound infection. British Medical Journal, 294,937.
History of BAPS Sir, I would like to point out to you odd errors of fact in John Barron’s section of the History of the British Association ofPlastic Surgeons on page 21. I was not sent by the army toBritain. I had been there since 1937 andonly transferred to the Australian army from the Emergency Medical Service late in 1940. Ken Starr was the other man sent for training in Britain along with Officer Brown. John Barron must have known this for he took over my appointment at the Hill End Unit, to which I was a foundation appointee along with Mowlem and Grocott (from Stoke on Trent). It was my transfer to the Australian army which created the vacancy for Barron. All this is as detailed in my book. Also, he has Henry Pickerill listed as a trainee from New Zealand. He was a colleague of Gillies at Sidcup and had no part in World War II. He was indeed head of the New Zealand section at Sidcup. Barron (as a fellow New Zealander) must surely have known this too. Anyway, that is just for the record for I thought the publication was a good start for a formal history, which in my view must sometime be written objectively by one person. However, it is good to see something on the record for a start. Yours faithfully, (Sir) Benjamin Rank 12 Jerola Avenue, Mt. Eliza, Australia 3930.