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2007 Fiji Mission
In 2004, 2005 and 2006 surgical tours of Fiji were undertaken under the umbrella of Interplast with a team of friends from Australia, and together we travelled to the Northern capital of Labasa (reports of these tours are posted on this web site). However, in 2007 Interplast did not have funding for this outreach, and [...]
2006 Fiji Mission
This is the third consecutive trip to Labasa, capital of Vanua Levu in Fiji. The team comprised of Mr. John Crock, Mr. Simon Donahoe, Dr. Renald Portelli, Mrs Catherine Boaden and Roarian observer Mr John Berens. John Crock and his wife Wendy were already working in Fiji on an insland in the Western province, and [...]
2005 Fiji Mission
June 2005 was the second consecutive tour of the Interplast team comprising of John Crock, Simon Donahoe, Renald Portelli and Jim Beaumont to Labasa, Fiji. To outsiders the area is known as the ‘friendly north’ but to the locals it is called the ‘forgotten north’. The draining population is in the vicinity of 50,000. 25,000 live in [...]
2004 Fiji Mission
An Interplast expedition was undertaken to Labasa in June 2004. The team members comprised of two plastic surgeons (John Crock and Simon Donahoe), one anaesthetist (Renald Portelli), and one theatre nurse (James Beaumont). In addition, Sue Atwood from Interplast Australia and Val Nicholson from Rotary Australia came as observers/ liaison officers. The team rendezvoused in Labasa; [...]
Squamous Cell Carcinoma
Essentially squamous cell carcinoma is caused by sun damage in genetically susceptible people. There are however, a range of other conditions which may result in the development of multiple squamous cell carcinomata, including genetic conditions such as scleroderma pigmentosa (which is a DNA breakage), arsenic poisoning, radiation, chronic burns scars and other rarer conditions. Squamous cell carcinoma [...]
Melanoma
The understanding of melanoma requires an understanding of the skin anatomy. In this talk, it is noticed that the melanocytes, from which melanoma is derived, are cells which migrate from the neural crest in the developing embryo. Because these cells are migratory in nature, it is probably true to say that when they become malignant, this explains [...]
Basal Cell Carcinoma
To understand this condition, it is imperative that one first of all understands the normal anatomy of the skin. The skin is made up of two layers; the epidermis and the dermis. In the developing foetus, the epidermis is formed from the outermost cell covering of the embryo, called the ectoderm. It acts as a [...]
Trigger Finger
Trigger finger or stenosing teno-vaginitis is a condition which may occur either in the early years (in which case its cause is congenital) or in the mid to later years of life (in which case its cause is degenerative). Normally, tendons run inside a tendon sheath, with has a number of thickenings along its course [...]
Skin
Understanding skin pathology, requires first and foremost an understanding of skin anatomy. Integral to this, is an understanding of the embryology of the skin. Skin forms the covering to the body, and its function is not only protective, but also its thermoregulation and is integrally involved in homeostasis (balance) of fluid levels in the body. The [...]
Scars: General Information
Any wound that breaches the dermis results in a scar. Only superficial epidermal injuries heal without scarring. The scar formation is a very complex process that we understand in part, but cannot presume to have fully fathomed. When a wound is formed, the injured blood vessels vasoconstrict for a period of approximately 45 minutes. Once [...]
Scar Management
Apart from the physiology and cell biology of scars and scar maturation, the whole perception of scars is quite a complex topic. In some cultures, scarring is an integral part of life and is used for tribal markings, and personal identification. Even in the Western culture, different people have different perceptions of scarring. To a [...]
Reconstructive Surgery
The Greek word “plasticos” means to mould, and is the genesis of the term “plastic surgery”. The aim of all of our surgery is to restore normal function, while at the same time taking into consideration aesthetic considerations. This requires a detailed understanding of anatomy, physiology and pathology, and even with the incredible technological and [...]
Blepharoplasty (Eyelid Surgery)
Blepharoplasty is a surgical procedure intended to reshape the upper eyelid or lower eyelid by the removal and/or repositioning of excess tissue as well as by reinforcement of surrounding muscles and tendons. When an advanced amount of upper eyelid skin is present, the skin may hang over the eyelashes and cause of loss of peripheral [...]
Ostoplasty (External Ear Surgery)
Otoplasty is surgery to change the appearance of a person’s external ears. Otoplasty Ear Surgery can take many forms that can range from the surgical change of bringing over-projecting ears closer to the head, reducing the size of very big ears, or reshaping various bends in the cartilage. Other reconstructive procedures deal with the deformed, or [...]
Ganglion Cysts
Ganglions can occur anywhere in the body where synovial fluid is found. Synovial fluid usually lubricates joints and tendons and looks very similar to KY Jelly. The synovial fluid is incredibly slippery, smooth and crystal clear. It would appear that some sort of irritation in either the joint or tendon sheath, which normally contains the [...]
The Wrist
The wrist remains a very difficult area of the body to treat as it is intricate, contains very small joints and numerous ligaments. To complicate the issue, much literature exists which is either contradictory, confusing or highly detailed, and may render the reader baffled at first sitting. The following treatise is an attempt to simplify [...]
Dupuytren’s Contracture
Dupuytren’s disease was a condition that was first recognized in the early 1800s. Paradoxically, it was an English surgeon, Dr. Astlee Cooper who first described the condition and started to treat it. However, Baron von Dupuytren in Paris was much more active in both treating and describing the condition, and as such, had his name [...]
Carpal Tunnel Syndrome
Carpal tunnel syndrome was first appreciated in the 1950s and is a condition where by the median nerve is compressed as it passes out of the forearm, under a thick band of tissue called the flexor retinaculum, and into the hand. It is now endemic in the Western world. It is important to understand the [...]
Hand Reconstruction
Hand surgery is a delicate art form. The complex interactions between bones, ligaments, tendons, nerves and soft tissue, mean that any surgery undertaken requires the utmost precision and function and form are inseparably intertwined. While clinicians of diverse backgrounds practice exclusively in the area of hand (and upper limb) conditions, it is widely accepted that [...]