Fungal necrotizing fasciitis of face- a reconstructive challenge

Fungal necrotizing fasciitis (NF), particularly in the face, is an unusual infection. It is mostly seen in immunocompromised individuals and can be gravely destructive if diagnosis and treatment are delayed. We report this rare case of a 27-year-old, immunocompetent male who presented with gangrenous patch of skin on the cheek following blunt trauma to the right side of the face. Till now no case has been reported in literature with such an extensive soft tissue loss of face and involvement of facial skeleton due to fungal etiology. Clinical suspicion of necrotizing fasciitis led to early surgical intervention. Histopathological examination of the debrided tissue identified the infective organism as Apophysomyces elegans. Intravenous antifungal therapy with liposomal amphotericin B was initiated. Despite the prompt commencement of the treatment, the infection continued to spread, and the patient had to undergo serial debridement which resulted in orbital exenteration, partial maxillectomy and mandibulectomy on the right side. This resulted in a huge soft tissue defect requiring flap cover. A free anterolateral thigh flap was harvested to cover the soft tissue defect, but the blood flow could not be established. For salvage, scalp and pectoralis major muscle flaps were raised and used to cover the large hemifacial defect. The oral lining was created with a folded deltopectoral flap in a second stage. However, there was persistence of the fungal elements in wound bed even after prolonged systemic liposomal amphotericin B therapy and it invaded the flap margins due to which there was partial necrosis of the flap. In this article, we aim to describe the difficulties faced by us in the management of such devastating infection and the reconstructive challenge that it posed.

ARC technique – An innovative method to assess true defect in postburn contracture release

Most commonly, skin grafts are used to resurface the raw areas resulting after the release of postburn contractures but in the extensively burned patient, donor sites may be limited. There is no accurate technique described in literature for the assessment of the true defect preoperatively. We describe a technique to accurately assess the true defect which helps to determine the amount of skin graft required preoperatively

Sustainable approach of La doped CuFe2O4 nanomaterial for electrochemical lead and paracetamol sensing action with multiple applications

Abstract This present research aimed to investigate the novel applications of synthesized La doped CuFe2O4 nanomaterial (LCF NMs) using renewable bio-fuel (Aegle Marmelos extract) by combustion process. The sensor applications were accomplished by modified electrode using LCF NMs with graphite powder and examined its excellent sensing action towards heavy metal (Lead content) and drug chemical (Paracetamol) substances. The thermodynamics of redox potential and super-capacitor behavior of LCF NMs were investigated through Cyclic Voltametric (CV) and Electrochemical Impedance Spectral (EIS) methods under specific conditions at scan rate of 1 to 5 mV/s. The heterogeneous photo-catalytic process of prepared NMs on Fast orange Red (FOR) dye-decolouration was investigated and noted its excellent degradation (91.7%) at 90 min using 20 ppm of dye solution and 40 mg of synthesized samples under Sun-light irradiation. Further, the antibacterial activity of synthesized NMs is investigated against various strains of gram positive (Bacillus subtillis) and gram negative bacteria (Pseudomonas aeruginosa), which confirms that the LCF NMs have higher activity towards gram positive bacteria with an average inhibition zone of 19 mm. This synthesized LCF NMs is a multi-functional material with stable and eco-friendly materials