The Nigerian Association of Plastic, Reconstructive and Aesthetic Surgeons (NAPRAS) instituted a lecture in honor of the doyen of Plastic Surgery in Nigeria, Professor Joseph Olatunde Oluwasanmi. A man who took up the challenge to specialize in plastic surgery thus becoming the first indigenous consultant plastic surgeon in 1967. He rose through the ranks to become a professor in 1973. The 2017 annual conference of the association took place in Sokoto and the lecture focused on the history and practice of plastic surgery in Nigeria. The lecture chronicled those who practice plastic surgery in Nigeria beginning from Mr Michael Norbert Tempest, a British Surgeon who worked in University College Hospital (UCH), Ibadan as a consultant, while Mr J.O. Oluwasanmi (now Prof J.O. Oluwasanmi) worked under him as a Senior Registrar. Oluwasanmi was later appointed as the first indigenous Consultant Plastic Surgeon in1967 after returning from the UK where we went for his specialty training in plastic surgery. Many other centers sprang up providing plastic surgery services. These centers include Lagos University Teaching Hospital, Lagos; National Orthopedic Hospital, Igbobi Lagos; National Orthopedic Hospital, Enugu; Ahmadu Bello University Teaching Hospital, Kaduna; Mangu Rehabilitation Centre, Mangu Plateau State and ECWA Evangel Hospital Jos (now Bingham University Teaching Hospital). Most of these centers have continued to provide plastic surgery services and training while several others have joined the train. Plastic surgery is now well established in Nigeria, however there are still challenges that affect the provision of excellent service. These challenges include; inadequate personnel, lack of awareness of the practice of plastic surgery, limited infrastructure, poverty and lack of universal health coverage, cultural practices and believes, patients’ expectations, complications, complexity of cases and workload.
Context: The female breast is a symbol of femininity. With recent developments in the surgical management of breast pathology, women now demand better aesthetic outcomes. Data on breast morphometry which should guide Nigerian breast surgeons in decision making is scarce. Aims: This study was aimed at measuring morphometric breast values in nulliparous Nigerian females, thus establishing reference data for the region. Settings and Design: This was a prospective and community-based study in which volunteer female students from the study hospital and 3 secondary schools in the community underwent breast measurements in order to establish reference data. Methods and Material: Physical measurements were carried out using measuring tape and meter rule, in the standing position. Statistical Analysis Used: Data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 16 and Student’s t-test analysis carried out.Results : Five hundred female volunteers with age range 15–30 years were studied. The average distance from the suprasternal notch to the right and left nipples were 19.76 cm and 20.09 cm respectively. The average distance from right and left nipples respectively to their inframammary folds were 8.13 cm and 8.28 cm. Breast dimensions were symmetrical in >50% of subjects. In the subjects with asymmetry, more were found to have greater left breast dimensions than right. Conclusions: Physical measurements of the Nigerian female breast are comparable with ranges in other parts of the world except for the Inframammary fold to nipple distance which is longer than values in studies on white subjects. This study establishes preliminary morphometric breast reference data for Nigerian females.
Introduction: Perineal burn contractures remain under reported in our region. We have set out to study the pattern of presentation, describe the formation of these contractures and identify any recurring patterns that will form a basis for a classification that will be useful in planning their management. Methods: A retrospective study of the patients seen over a three year period (2009–2011) at the National Orthopaedic hospital Dala is presented. Information was retrieved from case notes in the medical records department. The bio-data, type of care received post injury associated percentage burns, formation of contractures, were all noted. Results: All the seven patients seen were children of which five were females. Flame burn was the main type of burn. All burns occurred at home. Four major types of contractures were identified as transverse bands, hooding, fusion and obliteration. An equal number of patients presented following home versus hospital care. Conclusion: The relative rarity of post burn perineal contractures leaves little experience for the young surgeon to take advantage of when in training. A classification system will help to make it easier to identify what structures are involved and make planning easier. In the absence of specialized care it is doubtful that there is any statistical difference in the likelihood of perineal contracture development of patients managed at home by traditional healers versus those presenting in peripheral centers lacking formal burn management protocols. Most childhood burns still occur at home. There is a need to continually educate the public on the need to make the home a safe place for children.
Background: Parotidectomy has been traditionally done with general endotracheal anaesthesia mostly in tertiary institutions where there is adequate anaesthetic manpower. A lot of patients with parotid masses presents to other cheaper healthcare providers including medical outreaches where there is paucity of both anaesthetic manpower and gadgets. Aim: To share our experience in parotidectomy using local anaesthetics in medical outreaches where there is inadequate support of anaesthetic personnel and gadgets. Method: Patients counseled for parotidectomy had local anesthetic infiltration and nerve block with 1% ligdocaine in 1:100,000 adrenaline. Lazy-S incision was used starting pre-tragally down to the angle of the mandible. Branches of the facial nerve were gently separated from the mass which is delivered to the wound and shelled out. Wounds were closed in layers without drain. Conclusion: Parotidectomy with local anaesthetic agents is a safe option especially in settings of medical outreaches in resource poor countries with limited anaesthetic manpower and gadgets. The safety of surgery on day case basis and avoidance of use of hardly available nerve stimulator all the more make it an appealing alternative.
To report the case of a four year old girl with Tessier 4 right-sided orofacial cleft deformity, type I left cleft foot and hypoplastic right thumb. The patient presented with right-sided congenital orofacial defect, left foot defect and abnormally small right thumb noticed at birth. The pregnancy, labor and delivery periods were uneventful. She subsequently had repair of the orofacial cleft and the cleft foot defects. The post-operative period was uneventful. The patient is currently being followed up in the clinic. Tessier 4 cleft, though a rare orofacial cleft deformity may occasionally be associated with other congenital anomalies as it is found in the index case.
